Andrew J Quinn, Hannah Saven, Rozina Haile, Seung Jae Moon, April Lee, Savanna Thor
OBJECTIVES: Use of proton pump inhibitors (PPIs) is a mainstay in treating upper gastrointestinal bleeding (UGIB). However, the beneficial effects of PPIs are not anticipated to extend beyond the duodenum and may actually contribute to risk of lower gastrointestinal bleeding (LGIB). However, in practice, PPIs are often used for inpatients with LGIB where no benefit exists. METHODS: A retrospective chart review was performed on inpatients during a 2 year prior at an urban academic teaching hospital...
February 26, 2024: Hospital Practice (Minneapolis)
Steven G Chrysant
Physical activity (PA) has pluripotential beneficial effects on body functions. These benefits include reduction in the incidence of cardiovascular disease (CVD), coronary heart disease (CHD), hypertension, type 2 diabetes mellitus (T2DM), and death. In addition to these effects, PA exerts significant beneficial effects on sleep onset, duration and quality, which add to its beneficial effects. In contrast, lack of sleep has been associated with increased incidence of CVD complications and death. In this regard, PA serves as a non-pharmacologic means for sleep improvement especially in older people, who frequently have difficulties in falling asleep...
February 26, 2024: Hospital Practice (Minneapolis)
Baukje S de Vries, Kim J C Verschueren, Sophie Jansen, Vincent Bekker, Marieke B Veenhof, Thomas van den Akker
OBJECTIVES: Sepsis is a common cause of maternal mortality and morbidity. Early detection and rapid management are essential. In this study, we evaluate the compliance with the implemented maternity-specific Early Warning Score (EWS), Rapid Response Team (RRT) protocol and the Surviving Sepsis Campaign (SSC) Hour-1 Bundle in a tertiary hospital in the Netherlands. METHODS: We performed a retrospective patient chart review from July 2019 to June 2020 at the Leiden University Medical Centre...
February 26, 2024: Hospital Practice (Minneapolis)
Alexander Hodson, Noah Clancy, Irwin Foo
OBJECTIVES: Presbycusis is highly prevalent, affecting between a third and two thirds of elderly populations. Effective communication between patient and physician has been shown to directly correlate with the quality of patient care.The Reverse Stethoscope Technique (RST) involves placing the earpieces into the patient's ears and speaking into the diaphragm. Here we aim to show the RST is a simple and effective method to communicate with patients suffering from presbycusis in inpatient settings...
February 22, 2024: Hospital Practice (Minneapolis)
Karoline Kjærgaard, Jesper Mølgaard, Søren M Rasmussen, Christian Sylvest Meyhoff, Eske Kvanner Aasvang
OBJECTIVES: Continuous vital sign monitoring at the general hospital ward has major potential advantages over intermittent monitoring but generates many alerts with risk of alert fatigue. We hypothesized that the number of alerts would be decreased using different filters. METHODS: This study was an exploratory analysis of the alert reducing effect from adding two different filters to continuously collected vital sign data (peripheral oxygen saturation, blood pressure, heart rate and respiratory rate) in patients admitted after major surgery or severe medical disease...
December 21, 2023: Hospital Practice (Minneapolis)
Fadi Farhat, Marwa Hussein, Eman Sbaity, Abdullah Alsharm, Kakil Rasul, Saad Khairallah, Tarek Assi, Niloofar Allahverdi, Ahmad Othman, Joseph Kattan
OBJECTIVES: This study described the epidemiological, clinical, and survival profiles of patients with gastrointestinal stromal tumor (GIST) in North Africa and the Middle East (AfME). METHODS: This regional, multicenter, observational, retrospective study collected 11-year data on demographics, medical history, disease characteristics, current treatment approaches of GIST, the safety of the most common tyrosine kinase inhibitors (TKIs), second cancers, and survival status...
December 19, 2023: Hospital Practice (Minneapolis)
Fnu Jaydev, Warren Gavin, Jason Russ, Emily Holmes, Vinod Kumar, Joshua Sadowski, Areeba Kara
BACKGROUND: Discharges against medical advice (DAMA) increase the risk of death. METHODS: We retrieved DAMA from five hospitals within a large health system and reviewed 10% of DAMA from the academic site between 2016-2021. RESULTS: DAMA increased at the onset of the pandemic. Patients who discharged AMA multiple times accounted for a third of all DAMA. Detailed review was completed for 278 patients who discharged AMA from the academic site...
November 23, 2023: Hospital Practice (Minneapolis)
Sofia Al Farizi, Dewi Setyowati, Dyah Ayu Fatmaningrum, Azra Fauziyah Azyanti
BACKGROUND: The COVID-19 epidemic has restricted the use of maternal health services, including prenatal care. Telehealth and telemedicine are remote services that can help in the event of a COVID-19 pandemic. In this study, we examined the use of telehealth and telemedicine in prenatal care in various countries during the COVID-19 pandemic. METHODS: Relevant titles were searched in five e-book databases from 31 December 2019, to 31 July 2021: PUBMED, Science Direct, Scopus, Web of Sciences, and Google Scholar...
November 15, 2023: Hospital Practice (Minneapolis)
Umberto Di Vita, Pier Paolo Bocchino, Tullio Usmiani, Gaetano Maria De Ferrari
Takayasu arteritis (TA) is a chronic granulomatous large vessel arteritis. The renal arteries are affected in up to 60% of patients with TA, with renal artery stenosis (RAS) potentially leading to ischemic nephropathy, severe arterial hypertension, and heart failure. Bilateral RAS may rarely present with recurrent flash pulmonary edema, a life-threatening association which has been termed Pickering syndrome. In this report, we describe a 55-year-old woman with severe refractory arterial hypertension admitted for acute pulmonary edema, initially treated unsuccessfully with medical therapy with vasodilators and diuretics...
November 15, 2023: Hospital Practice (Minneapolis)
Christina J Smith, Ryan Valencia, Caroline M Sierra, Merrick Lopez
OBJECTIVES: Coagulopathy is associated with increased mortality in children in the intensive care unit (ICU). Recommended management of vitamin K-deficient coagulopathy is vitamin K administration. The goal of this study was to evaluate vitamin K administration for coagulopathy in critically ill children and determine a relationship between vitamin K dose and change in prothrombin time (PT) and international normalized ratio (INR). METHODS: This retrospective cohort study reviewed electronic medical records of patients ≤17 years who received vitamin K for acute coagulopathy in the pediatric ICU from January 2013 to January 2021...
November 7, 2023: Hospital Practice (Minneapolis)
Hannah Ra, Hye Young Lee, Dong Kyun Park, Oh Sang Kwon, Yoon Jae Kim
OBJECTIVES: This study sought to uncover whether having a gastrointestinal (GI) hospitalist available during weekday daytime hours results in higher-quality medical care compared to care provided by a team of residents. METHODS: Our hospitalist GI team consisted of two gastroenterologists working weekday daytime hours and two physician assistants. The team of conventional care headed by thirteen professors, comprised twelve residents and eight physician assistants...
November 6, 2023: Hospital Practice (Minneapolis)
Hikmat Abdel-Razeq, Salah Abbasi, Ghadeer Abdeen, Hazem Abdulelah, Jamil Debs, Sarah Al Masri, Majdi H Aljadayeh, Abdalla Awidi
BACKGROUND: This paper explores and discusses local challenges oncologists face for diagnosing and managing breast cancer patients with BRCA gene mutations in Jordan. METHODS: A task force involving key opinion leaders, experts in the management of breast cancer, and stakeholders in healthcare systems where genetic testing is available in Jordan discussed current evidence and local real-life practice. The task force then formulated recommendations to achieve better patient outcomes and satisfaction based on evidence-based medicine and their clinical experience in BRCA-mutated breast cancer management...
November 6, 2023: Hospital Practice (Minneapolis)
Lily L Ackermann, Eric S Schwenk, Chris J Li, John R Vaile, Howard Weitz
OBJECTIVES: To determine if a multidisciplinary pathway focused on non-opioid pain management, delirium assessment, and resource utilization improved outcomes in geriatric hip fracture patients. The goal was to reduce opioid usage, consultation not congruent with guidelines, and increase use of regional anesthesia to reduce delirium and improve outcomes. METHODS: An observational study was performed on hip fracture patients before and after the intervention. Hospitalists were educated on indications for preoperative cardiac consultation and specialized preoperative cardiac testing according to evidence-based guidelines with the inpatient cardiology service...
November 6, 2023: Hospital Practice (Minneapolis)
Vanessa Esquissato Pinheiro, Alex Silva Ribeiro, Carlos Augusto Marçal Camillo, Juliano Casonatto
OBJECTIVE: This study was designed to analyze the association between the risk of undernutrition and indicators of hospital rehabilitation in patients with COVID-19 while controlling for confounding variables. METHODS: This was an analytical study conducted by analyzing the medical records of patients with COVID-19. A total of 562 adult patients were eligible for the study. In addition to the risk of undernutrition (independent variable), indicators of hospital rehabilitation (dependent variables) were evaluated...
October 28, 2023: Hospital Practice (Minneapolis)
Haris Patail, Tanya Sharma, Wilbert Aronow, Syed Abbas Haidry
Though an infrequent cause of acute coronary syndrome, spontaneous coronary artery dissection is an increasingly recognized cardiovascular condition predominantly seen in middle-aged females. Its pathophysiology is defined by separation of coronary arterial wall layers which cause acute coronary syndrome-like presentations with relatively high recurrence rates. Overall, there is a lack of reported literature and understanding of the short- and long-term management for spontaneous coronary artery dissection...
October 6, 2023: Hospital Practice (Minneapolis)
Rodrigo Lami Pereira, Leyla Bojanini Molina, Kaeli Wilger, Mary S Hedges, Leila Tolaymat, Clare Haga, Ashley Walker, Melinda Gillis, Mingyuan Yin, Nancy L Dawson
OBJECTIVE: Delirium is a clinical diagnosis that can occur frequently in hospitalized patients. A retrospective study was completed to identify the incidence of patients aged greater than 65 developing delirium during hospitalization. METHODS: This study was conducted at a single tertiary care teaching hospital. Charts of discharged patients from November to December 2018 were evaluated and patients less than age 65 or with delirium present on admission were excluded...
October 2023: Hospital Practice (Minneapolis)
Erica Daniels, Geoffrey C Lamb, Anna Beckius
INTRODUCTION: Evidence suggests inappropriate oxygenation may be harmful to patients. To improve oxygen use in our hospital, we initiated a quality improvement project with a goal to reduce the percentage of inappropriate utilization of oxygen by 50% within a year. METHODS: Nasal cannula (NC) oxygen use data for medicine inpatients was abstracted weekly for chart review. A multidisciplinary team developed a guideline for use. Initiation of NC O2 with a baseline SPO2 > 92% was deemed inappropriate and 3+ consecutive SPO2 > 96% was defined as over-supplementation...
August 2, 2023: Hospital Practice (Minneapolis)
Ahmed H Abdelhafiz
Diabetes prevalence increases with increasing age due to increased life expectancy. In older people with diabetes, frailty is an emerging diabetes-related complication. Although the literature is focused on the physical decline as the main manifestation of frailty, other domains such as cognitive and emotional dysfunction are commonly associated with physical frailty constituting a triad of impairment (TOI). The TOI is a better predictor of adverse outcomes than physical frailty alone. Previous diabetes studies focused on cardiovascular events as the main outcome with little data exploring the effect of glycemic control on frailty as a multidimensional perspective...
August 2023: Hospital Practice (Minneapolis)
Elaina Wang, Steven Kim, Aaron Wang, Winston Jiang, Ankur Shah
INTRODUCTION: Dialysis is complicated in the setting of acute brain injury (ABI) due to several factors including acute solute shifts, acid base changes, need for anticoagulation, and changes in intracranial pressure. For these reasons, continuous renal replacement therapy (CRRT) is often the chosen modality for renal replacement needs in these patients. Peritoneal dialysis (PD) is less discussed but shares many of the benefits often attributed to CRRT. We describe, from both nephrology and neurosurgical perspectives, a case successfully managed with PD...
July 27, 2023: Hospital Practice (Minneapolis)
Sagar B Dugani, Karen M Fischer, Darrell R Schroeder, Holly L Geyer, Michael J Maniaci, Margaret Paulson, Ivana T Croghan, M Caroline Burton
OBJECTIVE: The Coronavirus Disease-19 (COVID-19) pandemic caused a decline in hospitalist wellness. The COVID-19 pandemic has evolved, and new outbreaks (i.e. Mpox) have challenged healthcare systems. The objective of the study was to assess changes in hospitalist wellness and guide interventions. METHODS: We surveyed hospitalists (physicians and advanced practice providers [APPs]), in May 2021 and September 2022, at a healthcare system's 16 hospitals in four US states using PROMIS® measures for global well-being, anxiety, social isolation, and emotional support...
July 25, 2023: Hospital Practice (Minneapolis)
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