Internal Medicine

Caput Medusae

Caput medusae is a clinical sign characterized by the appearance of dilated, tortuous veins radiating from the umbilicus across the abdominal wall. This condition is named after Medusa, a figure from Greek mythology known for her hair of snakes, due to its resemblance to the radiating pattern of veins.

Caput medusae is a manifestation of severe portal hypertension, which is defined as an increase in the pressure gradient between the portal vein and inferior vena cava. This increased pressure leads to the development of portosystemic collaterals, including those around the umbilicus.

Donohue JF et al. Ensifentrine as a novel, inhaled treatment for patients with COPD. Int J Chron Obstruct Pulmon Dis 2023 Jul 28; 18:1611. (https://doi.org/10.2147/COPD.S413436)

Population:

• Patients with moderate-to-severe Chronic Obstructive Pulmonary Disease (COPD).

• Approximately 1500 participants involved in the trials (ENHANCE-1 and ENHANCE-2).
  

Intervention:

• Administration of Ensifentrine (Ohtuvayre), a novel phosphodiesterase 3 and 4 inhibitor, via nebulizer.

Early home discharge in low-risk PE patients, as identified by validated triage tools (sPESI and Hestia), is safe with very low incidences of adverse events and mortality. However, patients with cancer, elevated troponin, or elevated NT-proBNP have a higher risk of adverse events and may require closer monitoring.

Safety of treating acute pulmonary embolism at home: an individual patient data meta-analysis | European Heart Journal | Oxford Academic (oup.com)

Perioperative Management of Patients Taking Direct Oral Anticoagulants: A Review | Surgery | JAMA | JAMA Network