Cleveland Clinic journal of medicine
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Interventions for benign prostatic hyperplasia have evolved from transurethral resection of the prostate and simple prostatectomy to a myriad of office-based and operating-room procedures. The contemporary approach involves matching the right procedure to the right patient, choosing on the basis of prostate characteristics, patient preference, and urologist expertise. This review details currently available and guideline-backed surgical and procedural treatments.
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For patients with decompensated cirrhosis, health maintenance is critical to improve survival rates and prevent adverse outcomes. We review the primary care management of cirrhosis and its complications, such as esophageal varices, hepatocellular carcinoma, and chemical or medication exposures. We also highlight specific immunizations and lifestyle modifications to prevent decompensation, and we summarize current screening guidelines.
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The management of COVID-19 has evolved through the course of the pandemic to now include options for outpatients, inpatients with life-threatening critical illness, and everyone in between. The goals of therapy include preventing disease progression and preventing worsening disease in those admitted to the hospital, with the hopes of preserving resources and improving patient outcomes. The Infectious Diseases Society of America and the National Institutes of Health have issued guidelines on treating COVID-19, which the authors review here.
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Portopulmonary hypertension, ie, pulmonary arterial hypertension in a patient with portal hypertension, affects transplant eligibility and has a poor prognosis. The pathogenesis remains an area of active research, with various mechanisms proposed. Diagnosing it requires a detailed history, physical examination, laboratory tests, and echocardiographic evaluation, followed by a careful hemodynamic assessment.