Implantable Cardioverter-Defibrillator and Pacemaker Infections
Publication date: Available online 10 January 2015 Source:Hospital Medicine Clinics Author(s): Ryan M. van Hoff , Harley P. FriedmanTeaser As the use of implantable cardiac devices increases, the incidence of device-associated infections in patients with these devices is increasing in parallel. It is important for hospitalists to understand the presentation, diagnosis, and management of patients with cardiac implantable electronic device infections because they are likely to encounter them and they may be the first medical contact with these patients. Principal tenets of management include the initiation of empiric a...
Source: Hospital Medicine Clinics - January 11, 2015 Category: Internal Medicine Source Type: research
New Drugs in 2013
Publication date: January 2015 Source:Hospital Medicine Clinics, Volume 4, Issue 1 Author(s): Jared Grochowsky , Joseph Ming Wah LiTeaser Many new promising drugs emerged in 2013, including breakthroughs in the area of cancer, diabetes, pulmonary hypertension, hepatitis C, and multiple sclerosis treatment. Many of the trends in drug approval, including most of the drugs approved for oncologic diagnoses, are similar to previous years; however, there have also been drugs that are novel in their action to treat their respective diseases. Six new drugs were chosen and are reviewed due to their potential relevance to hosp...
Source: Hospital Medicine Clinics - November 30, 2014 Category: Internal Medicine Source Type: research
Understanding Medical Literature
This article seeks to demystify the topic by showing how EBM can be incorporated into everyday practice. It explains key EBM concepts and efficient literature search strategies, and shows how to critically appraise a scientific article. Throughout, it incorporates current evidence on key medical topics, from early goal-directed therapy in sepsis to the use of statins in patients without coronary artery disease. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - November 30, 2014 Category: Internal Medicine Source Type: research
Approach to the Medical Ethics Consultation
This article outlines the history of medical ethics in the hospital setting, the most common reasons for medical ethics consultation requests, and the philosophic approaches used in medical ethics consultations. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - November 30, 2014 Category: Internal Medicine Source Type: research
Inpatient Nutrition Support
This article summarizes aspects of malnutrition that are commonly encountered in the hospital setting, and reviews the use of nutrition support. Important features of both enteral and parenteral nutrition are discussed, including laboratory tests and diagnosis, management, accompanying risks, and complications. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - November 30, 2014 Category: Internal Medicine Source Type: research
Bridging Anticoagulation
This article reviews the indications and proper approach to the use of bridging anticoagulation in patients on long-term warfarin therapy who require an interruption in warfarin for purposes of a surgery or procedure, and reviews the relevant evidence and current practice guidelines to provide a guide to front-line providers. Certain procedures can often be safely performed on therapeutic warfarin. For surgeries that do require interruption in anticoagulation, bridging is recommended for all high-risk patients and certain moderate-risk patients, depending on procedural risks and patient preferences. Low-risk patients who r...
Source: Hospital Medicine Clinics - November 30, 2014 Category: Internal Medicine Source Type: research
Inpatient Constipation
This article proposes diagnostic criteria for inpatient constipation, reviews existing literature, and recommends protocols for the prevention and treatment of inpatient constipation. More research is needed to develop inpatient-specific data on prevention and treatment strategies, and on how to handle this condition during transitions of care. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - November 30, 2014 Category: Internal Medicine Source Type: research
Hypokalemia and Hyperkalemia
Publication date: January 2015 Source:Hospital Medicine Clinics, Volume 4, Issue 1 Author(s): Jesse Theisen-ToupalTeaser Hypokalemia and hyperkalemia are common in the inpatient population. Serum potassium concentration is used to diagnose hypokalemia and hyperkalemia. Most potassium is intracellular and has a normal concentration of approximately 150 mmol (mEq)/L. Serum potassium has a normal concentration of 3.5 to 5.0 mmol/L. Hypokalemia is defined as a serum potassium concentration less than 3.5 mmol/L, and hyperkalemia is defined as a serum potassium concentration of higher than 5.0 mmol/L. In this article, t...
Source: Hospital Medicine Clinics - November 30, 2014 Category: Internal Medicine Source Type: research
Use of Microbiological Cultures in the Hospitalized Patient
This article discusses the use and interpretation of the most common microbiological cultures encountered by hospitalists, and the management of common infections encountered in the hospitalized patient. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - November 30, 2014 Category: Internal Medicine Source Type: research
Obstructive Sleep Apnea in the Hospitalized Patient
This article describes OSA and its incidence in hospitalized patients. It presents tools that can be used to identify patients at risk for OSA-related complications, and makes suggestions for the proper care and monitoring of these patients in the hospital setting. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - November 30, 2014 Category: Internal Medicine Source Type: research
Supraventricular Tachycardia and the Use of Telemetry in Hospitalized Patients
This article discusses various diagnostic approaches used to identify types of supraventricular tachycardia, the evidenced-based guidelines available to help guide management, and the importance of the judicious use of telemetry when caring for hospitalized patients. (Source: Hospital Medicine Clinics)
Source: Hospital Medicine Clinics - November 30, 2014 Category: Internal Medicine Source Type: research
Literature Update in Hospital Medicine
Publication date: April 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 2 Author(s): William Southern , Bradley A. Sharpe , Romsai Tony BoonyasaiTeaser Perioperative statins reduce perioperative myocardial infarctions, atrial fibrillation, and length of stay. Statins do not increase the risk of intracranial hemorrhage. New oral anticoagulants are superior to warfarin in preventing stroke in patients with atrial fibrillation, and may have a better safety profile. In patients who have an acute gastrointestinal bleed while on warfarin, restarting warfarin after a week may lead to fewer thromboses and lower morta...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Care for the Rehospitalized Patient with Chronic Spinal Cord Injury
Publication date: April 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 2 Author(s): Kelly Armstrong , Joshua Eickstaedt , Ronald ReevesTeaser A myriad of physiologic changes occur following spinal cord injury (SCI), and survivors of SCI are at risk for numerous complications. Considerable progress in SCI care has been achieved in the last 50 years and life expectancy and causes of death after SCI are approaching those of the general population. As additional progress is made in restoring function after SCI, the impact of SCI is expected to continue to decrease over time. However, a partnership between the h...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Utilization Review Essentials
Publication date: April 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 2 Author(s): Pamela Foster , Leslie PrairieTeaser The purpose of this article is to introduce the fundamental concepts of utilization review, a process used by hospitals to ensure that patients are receiving optimal care in the appropriate setting. Criteria for the types of hospital admission status are discussed in addition to an outline of the screening functions performed by members of the hospital utilization review team. Basic health care payment methodology is explored, including the recent impact of medical necessity denials through...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
Nephrotic Syndrome
Publication date: April 2014 Source:Hospital Medicine Clinics, Volume 3, Issue 2 Author(s): Bhavna Chopra , Leslie ThomasTeaser Minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), and membranous nephropathy (MN) are the most common causes of the nephrotic syndrome, diagnosed by demonstrating edema, proteinuria, hypoalbuminemia, and hyperlipidemia. MCD, FSGS, and MN vary by renal prognosis and known secondary causes. Renal biopsy is the gold standard for the proper diagnosis of MCD, FSGS, and MN. Management of the nephrotic syndrome is 2-fold: treatment of symptoms and complications (ie, edema, hy...
Source: Hospital Medicine Clinics - October 12, 2014 Category: Internal Medicine Source Type: research
