Diagnosis and Management of Acid-Base Disorders
Publication date: July 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 3 Author(s): Sang Hoon Woo , Sumbul Desai , Lisa ShiehTeaser Acid-base disorders are frequently encountered in hospitalized patients. A stepwise approach to acid-base disorders reduces confusion and helps clinicians identify simple or mixed disorders. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Diagnosis and Management of Valvular Heart Disease
This article addresses the 4 major left-sided valvular disorders regarding etiology, pathophysiology, clinical assessment, and management. Discussions on management focus on indications for echocardiography, key echocardiography findings, and indications for surgical intervention. Guidelines from the 2014 American College of Cardiology/American Heart Association report and the 2008 European Society of Cardiology guidelines are summarized. Right-sided valvular disease is also briefly discussed in addition to current guidelines for endocarditis prophylaxis. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
The Role of Hospital Medicine in Inpatient Clinical Documentation
Publication date: October 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 4 Author(s): Kenji Asakura , Letizia Alto , Erik Ordal , Winthrop F. WhitcombTeaser Inpatient clinical documentation comprises physician documentation of the diagnoses that arise during an inpatient stay, and is often incomplete because of either missing information or the use of inaccurate terminology. Inadequate documentation results in an inaccurate reflection of the illness severity of patients, leading to underbilling and unrealistic skewing of research data. Clinical documentation improvement specialists can help physicians corre...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Comanagement
Publication date: October 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 4 Author(s): Alan BrionesTeaser In this article, the background, key principles, ideas in practice, unresolved questions and future directions, and resources of comanagement are discussed. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Vesiculobullous Skin Disease
Publication date: October 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 4 Author(s): Brian Markoff , Jacob LevittTeaser Vesiculobullous skin disease is a group of diseases that cause blistering of the skin. The differential is broad and includes multiple causes such as infection, allergic reaction, physical trauma, and autoimmune disease. Autoimmune bullous diseases are those caused by dysregulation of the immune system, leading to autoantibodies against protein components of the skin and mucous membranes. In turn, this causes disruption of the integrity of these crucial areas, leading to bullae formation. T...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Opioid Essentials
Publication date: October 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 4 Author(s): Micah Mann , Emily ChaiTeaser The risk for harm associated with opioids has been demonstrated in hospitalized patients, but it is difficult to imagine treating severe pain without opioids, which offer therapeutic benefit with enough flexibility to be used in almost any clinical scenario. In skilled hands, opioids represent an indispensable therapeutic tool that is efficacious, flexible, and safe. Recent opinion advocating a more liberal approach to treating pain with opioids should be taken as a call for hospitalists to stre...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Diabetic Ketoacidosis
Publication date: October 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 4 Author(s): Erin Gabriel , Sonia SoniTeaser The defining features of diabetic ketoacidosis (DKA) are metabolic acidosis, ketonemia, and hyperglycemia. The most common precipitating factors of DKA are acute medical illness (infection), nonadherence to insulin therapy, new onset diabetes, and medications that interfere with carbohydrate metabolism. The diagnostic criteria for DKA include acidosis, low serum bicarbonate, increased anion gap, ketonemia, and ketonuria. Treatment of DKA includes intravenous fluid resuscitation, correction of ...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Systemic Lupus Erythematosus in Hospital Patients
Publication date: October 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 4 Author(s): Dennis Chang , Leslie KerrTeaser A systemic lupus erythematosus (SLE) flare is a measurable increase in disease activity that results in a change in therapy. The two most common causes of hospitalization for patients with SLE are SLE flare and infection. Infection must be ruled out before attributing symptoms to an SLE flare. Other common causes are thromboembolism, adverse drug reaction, and acute coronary syndrome. The two most common SLE flares are arthritic flares and mucocutaneous flares. All patients with SLE in the ho...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
The Hospitalized Adult with Severe Ulcerative Colitis
Publication date: October 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 4 Author(s): Imuetinyan Asuen , Benjamin L. CohenTeaser Intravenous corticosteroids are the mainstay of initial treatment of patients hospitalized with severe ulcerative colitis (UC). Response to intravenous corticosteroids should be assessed early, usually by day 3, using clinical, radiologic, and biochemical markers. Therapeutic alternatives for steroid-refractory cases should be considered early. Clostridium difficile is prevalent in hospitalized patients with UC flare and may require multiple testing to be detected. Unfractionated he...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Hemodialysis Vascular Access Complications Recognition and Management
Publication date: October 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 4 Author(s): Maria Anaizza Aurora Reyna , Tonia KimTeaser Of the 3 basic types of vascular access for hemodialysis (arteriovenous [AV] fistula, AV graft, venous catheter), AV fistula is the method of choice, and is associated with lower complication rates. Physical examination can accurately detect and localize stenosis and thrombosis in AV fistulas/grafts. There is no consensus supporting the routine use of either anticoagulants or antiplatelet strategies to reduce the risk of thrombosis in long-term use of vascular access. Special atte...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Septic Arthritis
Publication date: October 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 4 Author(s): Hyung J. Cho , Leah A. Burke , Mikyung LeeTeaser The incidence of septic arthritis appears to be increasing, which may be accounted for by the increasing use of immunosuppressive treatments, invasive procedures, and an aging population. Hospitalists should understand the common sources of infection in septic arthritis, and perform the necessary diagnostic testing. Synovial fluid analysis should be interpreted accurately. Treatment consists of antibiotics of appropriate modality and duration. The correct initial antibiotic r...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Pulmonary Embolism
Publication date: October 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 4 Author(s): Tuyet-Trinh N. Truong , Daniel S. Jones , Andrew S. DunnTeaser Pulmonary embolism (PE) is defined as partial or complete occlusion of a pulmonary arterial branch by thrombus originating from the pelvis or legs, leading to impaired blood flow and increased cardiac right ventricular pressure. PE and deep vein thrombosis are presentations of the same underlying process, venous thromboembolism. PE is the third most common cardiovascular condition of the industrialized world and has high mortality if appropriate treatment is not...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Acute Coronary Syndrome
Publication date: October 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 4 Author(s): Tao Xu , Usman BaberTeaser In this article, the epidemiology, patient evaluation and diagnosis, patient management, procedures, antiplatelet and anticoagulant therapy, and clinical guidelines of acute coronary syndrome are discussed. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
