1. Top Medical Journal Articles of 2013What is old is new and what is new is old once moreEthan Cumbler MD, FHM, FACPAssociate Professor of MedicineUniversity of Colorado School of MedicineDirector UCH Acute Care for the Elderly UnitAssociate Chief of Hospital Medicine

2. Criteria For SelectionPeer Reviewed Publication from 2013-2014Sound MethodologySubject Area Relevant to Internal MedicinePotential to Change Clinical Practice 3. What is Old?On December 13, 1799, GeorgeWashington developed a sore throat. Whatwas his therapy that day?A. Willow bark teaB. Fresh air and exerciseC. Removal of 5-7 pints of blood2000 years ago 200 years ago 4. Whats New?A 42 year old man presents with 3 days of melenafollowed by bright red hematemesis. What Hblevel should trigger transfusion?A. 11 g/dlB. 9 g/dlC. 7 g/dlD. 5 g/dlE. Let me get my lancet 5. Liberal Transfusion not beneficial for GIB.Clincial QuestionWhat is the best transfusion threshold in a GIB?Villaneuva C, et al. Transfusion Strategies for Acute Upper Gastrointestinal Bleeding. NEJM 2013;368:11-21 6. DesignUnblinded RCT921 pts with severe UGI bleed Excluded if massive exsangination, recent CVA or ACSTransfusion for Hb