Nita Shrikant Kulkarni, MD
News
No Change in Duration of Mechanical Ventilation with Acetazolamide for COPD Patients with Metabolic Alkalosis
March 1, 2016
Clinical question: Does acetazolamide decrease the duration of mechanical ventilation for patients with chronic obstructive pulmonary disease and metabolic alkalosis? Bottom line: Although acetazolamide effectively decreased the levels of serum bicarbonate and the number of days with metabolic al
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Tamsulosin Effective as Expulsion Therapy for Distal Ureteric Stones
March 1, 2016
Clinical question: Is tamsulosin effective in the management of distal ureteric stones? Bottom line: Tamsulosin promotes stone passage of ureteric stones that are 5 mm to 10 mm. You would need to treat 5 patients with tamsulosin to cause the expulsion of one such stone.
News
PICCs Increase Risk for Upper- and Lower-Extremity DVT
February 2, 2016
Clinical question: Do peripherally inserted central catheters increase the risk for upper- and lower-extremity deep venous thromboses? Bottom line: Although the association between peripherally inserted central catheters (PICCs) and upper-extremity deep venous thromboses (DVTs) was already known,
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NSAIDs Safe, Effective Option for Pleurodesis Pain
February 2, 2016
Clinical question: For pleurodesis, do nonsteroidal anti-inflammatory drugs and smaller chest tubes, as compared with opioids and larger tubes, provide better pain relief while maintaining efficacy of the procedure? Bottom line: Although nonsteroidal anti-inflammatory drugs (NSAIDs) are not neces
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Early Invasive Strategy for Acute Coronary Syndrome May, or May Not, Improve Outcomes
January 8, 2016
Clinical question: Does an early invasive strategy for acute coronary syndrome improve short-term outcomes? Bottom line: According to this real-world observational study, an early invasive strategy—coronary angiogram within 72 hours of presentation—is associated with lower risks of short-term car
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Steroids Beneficial as Adjunctive Treatment for Community-Acquired Pneumonia
November 30, 2015
Clinical question: Should steroids be used as adjunctive therapy for patients with community-acquired pneumonia? Bottom line: Moderate-quality to high-quality evidence suggests that steroids, when added to antibiotics and usual care, can improve outcomes in the treatment of community-acquired pne
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Functional Outcomes Better With Endovascular Thrombectomy for Acute Ischemic Stroke
November 30, 2015
Clinical question: Does endovascular thrombectomy improve clinical outcomes in patients presenting with acute ischemic stroke? Bottom line: High-quality evidence shows that endovascular therapy using mechanical thrombectomy for the treatment of acute ischemic stroke leads to improved functional o
News
Sliding-Scale Insulin Does Not Improve Blood Glucose Control in Hospitalized Patients
November 2, 2015
Clinical question: Does the use of sliding-scale insulin improve blood glucose control in hospitalized patients? Bottom line: Sliding-scale insulin is commonly used to manage hyperglycemia in hospitalized patients.
News
Subclavian Central Lines Have Fewer Infections, Clots; Increased Risk of Pneumothorax
November 2, 2015
Clinical question: Which insertion site for central venous catheterization results in fewer complications? Bottom line: Central venous catheterization via a subclavian insertion site, as compared with femoral and jugular sites, decreases the risk of bloodstream infections and symptomatic deep vei
News
Coronary Computed Tomography Angiography, Radionuclide Stress Testing Similar for Evaluation of Chest Pain
October 5, 2015
Clinical question: Is coronary computed tomography angiography better than stress testing for detecting coronary artery disease? Bottom line: For the evaluation of chest pain in intermediate-risk patients, coronary computed tomography angiography (CCTA) is comparable with myocardial perfusion ima