Computer-Based Early Warning System for Potentially Life-Threatening QT Prolongation
Publication date: April 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 2 Author(s): J. Martijn Bos , Pedro J. Caraballo , Michael J. AckermanTeaser QT prolongation is an independent predictor for all-cause cardiovascular mortality and stroke. The Mayo Clinic has developed an institution-wide, computer-based clinical decision support system integrated in the electronic medical record, which automatically alerts physicians of an electrocardiogram with a QTc higher than 470 milliseconds in pediatric patients or 500 milliseconds in adults and directs them to a resource (AskMayoExpert) with instructions on how ...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Neutropenic Fever
Publication date: April 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 2 Author(s): Syed Ahsan Rizvi , M. Rizwan SohailTeaser In this article, the definition, epidemiology, pathogenesis, diagnosis, management, prevention, and performance improvement of neutropenic fever are discussed, and clinical guidelines are presented. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Diagnosing Cellulitis for the Nondermatologist
Publication date: April 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 2 Author(s): Julio C. Sartori-Valinotti , Catherine C. NewmanTeaser Cellulitis, a form of soft-tissue infection involving the deep dermis and hypodermis, is frequently overdiagnosed, leading to inappropriate use of antibiotics. Misdiagnosis occurs in 10% to 30% of patients, mostly in the inpatient setting. For the nondermatologist, a systematic approach with a thorough history and physical examination along with in-depth knowledge of the most common conditions that simulate cellulitis will help narrow the differential diagnosis so as to av...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Fall Prevention in Hospitalized Patients
Publication date: April 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 2 Author(s): Ericka E. Tung , James S. NewmanTeaser Falls are a frequent, dreaded occurrence among inpatients and often lead to serious health consequences and substantial economic burden. Inpatient falls are a core measure of patient safety and quality care. This review guides hospital practitioners in the assessment and intervention of the individual patient and outlines the key steps required for the development of a hospital-wide fall prevention program. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Late Complications of Bariatric Surgery
Publication date: April 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 2 Author(s): Robert E. Kraichely , Catherine C. Romano DeLangeTeaser Obesity is a pandemic condition, and surgery remains the most effective and durable option for weight loss and reduction of obesity-related morbidity and death. These procedures are now better understood than they were even a decade ago and techniques have been refined. The risks of late complications may vary with these refinements, but they are likely to persist if the same types of operations are performed. With prompt recognition, most complications can be successfull...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Fever of Unknown Origin in the Hospitalized Patient
Publication date: April 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 2 Author(s): Riddhi M. Shah , Caroline G. Castillo , Mary J. BurgessTeaser Fever of unknown origin (FUO) is defined as pyrexia of greater than 38.3°C for at least 3 weeks with no identified cause after 3 days of hospital evaluation or at least 3 outpatient visits. Infection, autoimmune disorders, and malignancy remain the most important causes of FUO in a hospitalized patient. Taking a complete history and performing a comprehensive physical examination are profoundly important in establishing the underlying cause of FUO, and imaging s...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Noninvasive Positive Pressure Ventilation
Publication date: April 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 2 Author(s): LaKisha D. Jones , John G. ParkTeaser Noninvasive positive pressure ventilation (NIPPV) is a form of ventilatory assistance delivered via a noninvasive interface (ie, full-face mask, nasal mask/pillows), as opposed to invasive ventilation that is delivered through an endotracheal tube or tracheostomy. Potential benefits of NIPPV include improved gas exchange, decreased work of breathing, avoidance of intubation, facilitation of weaning/extubation, improved mortality, and decreased rate of nosocomial infections (in comparison w...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
2013 Literature Update in Hospital Medicine
Publication date: July 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 3 Author(s): Leonard S. Feldman , William Southern , Bradley A. Sharpe , Romsai Tony Boonyasai , Alexander R. CarboTeaser The Update in Hospital Medicine is designed to keep readers informed about the current state of the literature. For this update, the authors searched journals from mid-January 2013 to February 2014 and sought high-impact articles that had the capability of practice change or practice confirmation for hospitalists. The authors’ initial review yielded 577 articles; from this group, a secondary review targeting those w...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Hospital-based Quality Improvement Initiatives
This article discusses key initiatives occurring within these segments, including new programs implemented by the Centers for Medicare and Medicaid Services, new quality improvement mandates for board certification, and successful examples of quality improvement occurring within and across hospitals and health systems. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Transfusion Medicine Use of Red Blood Cells in Hospital Medicine
Publication date: July 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 3 Author(s): Jeffrey M. Rohde , Derek E. DimcheffTeaser Practitioners of hospital medicine should be familiar with the indications and complications of red blood cell (RBC) transfusions. Recent evidence based guidelines support the widespread use of a restrictive RBC transfusion strategy. Not only does a restrictive transfusion strategy reduce the amount of RBCs used, but it also has been associated with improved patient outcomes. Clinicians should understand how to recognize and effectively manage complications of RBC transfusions. With im...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Diagnosis and Management of Ophthalmic Emergencies in the Hospital
Publication date: July 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 3 Author(s): Rebecca A. Wu , Paul Grant , Jonathan TrobeTeaser In this article, the diagnosis and management of ophthalmic emergencies in the hospital are discussed. The definitions, epidemiology, patient history and examination, diagnosis, management, and prognosis are described for several important ophthalmic conditions including papilledema, sudden vision loss, third cranial nerve palsy, and endogenous endophthalmitis. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Diagnosis and Management of Acute Pain in the Hospitalized Patient
Publication date: July 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 3 Author(s): Adam D. Marks , Phillip E. RodgersTeaser Acute pain is one of the most common complaints of those who seek medical care and is a common reason for readmission after inpatient surgery. The hospitalist needs to be able to understand the underlying mechanism of pain to aid in diagnosis and targeted therapy to achieve adequate analgesia and minimize or avoid side effects. In this article, the pathophysiology, evaluation, and management of acute pain in the inpatient setting are reviewed. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Diagnosis and Management of Infections in Hospitalized Immunocompromised Patients
Publication date: July 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 3 Author(s): Megan Mack , Kevin GreggTeaser In this article, the diagnosis and management of infections in hospitalized immunocompromised patients is discussed. Definitions, epidemiology, approach to infection in the hospitalized transplant patient by organ system, performance improvement, and clinical guidelines are outlined. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
An Approach to the Evaluation and Management of Vasculitis
Publication date: July 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 3 Author(s): Nathan Houchens , Vikas ParekhTeaser The term “vasculitis” represents heterogeneous and often overlapping groups of clinicopathologic syndromes that cause vascular damage and organ dysfunction. Diagnoses are categorized into primary and secondary types, by size of affected vessel, and by patient characteristics. Vasculitis should be included in the differential diagnosis of patients presenting with unexplained constitutional symptoms and red-flag findings such as mononeuritis multiplex. Inpatient evaluation may include subs...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Spontaneous Bacterial Peritonitis
Publication date: July 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 3 Author(s): Jennifer N. Stojan , Michael LukelaTeaser Spontaneous bacterial peritonitis (SBP), a common infection in patients with cirrhosis, is an infection of the ascitic fluid in the absence of an intra-abdominal source, diagnosed when the polymorphonuclear cell count is 250 cells/mm3 or greater, without a known alternative source of infection. Paracentesis should be performed on patients when there is a clinical suspicion for spontaneous peritonitis, with careful consideration of potential contraindications while also recognizing poss...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
