Hospital Medicine

Hospital revisits after discharge from observation increase among elderly

Hospital revisits after discharge from observation increase among elderly

Increases were observed in repeat observation stays and any hospital revisit for seniors between 2006 and 2011.

NPs improve care coordination for high-risk complex care patients post-discharge

NPs improve care coordination for high-risk complex care patients post-discharge

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Post-discharge care from hospital to community coordinated by an NP in high-risk complex care patients reduced hospital readmission rates.

NPs have favorable view of retail health clinics

NPs have favorable view of retail health clinics

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A survey found that 77.4% of NPs reported that the care provided in retail health clinics was in accordance with evidence-based guidelines.

Rivaroxaban decreased VTE rate in high-risk orthopedic joint surgery patients

Rivaroxaban decreased VTE rate in high-risk orthopedic joint surgery patients

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Researchers developed a protocol to demonstrate the efficacy of rivaroxaban in lowering the risk of venous thromboembolism among orthopedic joint surgery patients.

Patients routinely overcharged in US emergency departments

Patients routinely overcharged in US emergency departments

Researchers say that minorities and uninsured patients are the most affected.

Restarting anticoagulation may be cost-effective in some VTE cases

Restarting anticoagulation may be cost-effective in some VTE cases

The therapy may be cost-effective for patients with a predicted 1-year VTE risk of 17.5% or more.

The House's healthcare bill: Trumpcare or "Chumpcare"?

The House's healthcare bill: Trumpcare or "Chumpcare"?

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Public opinion polls support the views of professional organizations, with 60% of Americans opposing the new American Health Care Act, 31% supporting it, and 9% undecided.

Tips for adjusting to the night shift

Tips for adjusting to the night shift

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Working through the night and sleeping during the day can be a difficult adjustment.

Patients treated by older physicians have higher mortality than those cared for by younger physicians

Patients treated by older physicians have higher mortality than those cared for by younger physicians

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Researchers found that patients treated by older physicians had higher 30-day mortality than those cared for by younger physicians, despite similar patient characteristics.

Warfarin dosing in HIV patients with deep venous thrombosis

Warfarin dosing in HIV patients with deep venous thrombosis

Results showed that mean induction times, analyzed in 170 patients, were 12.87 days in the HIV-infected patients and 11.19 days in the HIV-uninfected patients.

Surgical pulmonary embolectomy for thrombus distribution is feasible, effective

Surgical pulmonary embolectomy for thrombus distribution is feasible, effective

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Surgical pulmonary embolectomy for peripheral distribution of thrombus demonstrated positive outcomes in patients with either CPE or PPE.

Case study: Recurrent deep vein thrombosis in thoracic outlet syndrome

Case study: Recurrent deep vein thrombosis in thoracic outlet syndrome

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A 53-year-old woman presents to the emergency room for right upper extremity deep vein thrombosis after rib resection and subclavian vein stent placement.

Short-term oral corticosteroid use associated with increased risk for sepsis, venous thromboembolism

Short-term oral corticosteroid use associated with increased risk for sepsis, venous thromboembolism

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Approximately 1 in 5 American adults use corticosteroids in the short term, which is associated with an increased risk for sepsis, venous thromboembolism, and fracture.

Wrong-patient orders are more likely in NICU vs non-NICU pediatric units

Wrong-patient orders are more likely in NICU vs non-NICU pediatric units

Implementation of a combined ID re-entry intervention and distinct naming convention greatly reduced the risk.

Working with multiple attending physicians in the emergency department

Working with multiple attending physicians in the emergency department

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Working with a large number of attending physicians can be one of the biggest difficulties of being an advanced practice provider.

First-year residents will be able to work 24-hour shifts

First-year residents will be able to work 24-hour shifts

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The ACGME announces that residency programs can increase shift hours for first-year residents from 16 to 24 hours.

Case Study in Urgent Care: Leg edema and shortness of breath

Case Study in Urgent Care: Leg edema and shortness of breath

A 44-year-old man presents to an urgent care clinic with leg edema and shortness of breath.

When the PA becomes the patient

When the PA becomes the patient

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A physician assistant's stay in the hospital provides a new perspective of a patient's experience in the emergency department.

Peroxide ingestion as a "natural cure" can be fatal

Peroxide ingestion as a "natural cure" can be fatal

Symptomatic high-concentration peroxide exposures had a high incidence of associated embolic events.

Death rate high in elderly within 7 days of discharge from emergency department

Death rate high in elderly within 7 days of discharge from emergency department

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More than 10,000 Medicare beneficiaries die each year within 7 days of being discharged from emergency departments.

Mortality rate lower in US patients treated by foreign-educated internists

Mortality rate lower in US patients treated by foreign-educated internists

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Researchers observed a somewhat lower mortality among patients treated by international graduates.

Testosterone treatment may increase risk of venous thromboembolism

Testosterone treatment may increase risk of venous thromboembolism

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Researchers sought to determine the risk of venous thromboembolism associated with use of testosterone treatment.

Warfarin may be linked to reduced thromboembolism in nonvalvular atrial fibrillation

Warfarin may be linked to reduced thromboembolism in nonvalvular atrial fibrillation

The reduction in thromboembolism was attenuated after accounting for competing death events.

Use of stronger antibiotics increases in US hospitals

Use of stronger antibiotics increases in US hospitals

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Although the overall use of antibiotics in US hospitals is unchanged, use of broad spectrum agents has increased significantly.

Vital sign instability at hospital discharge linked to increased mortality risk

Vital sign instability at hospital discharge linked to increased mortality risk

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Nearly 17% of patients exhibiting one unstable vital sign at hospital discharge were readmitted or died within 30 days.

ICU care is frequently overused and may not improve hospital mortality

ICU care is frequently overused and may not improve hospital mortality

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Hospital mortality rates do not improve in institutions that frequently use ICU care for patients.

Inpatient mortality, length of stay decreasing for COPD patients, but financial burden increasing

Inpatient mortality, length of stay decreasing for COPD patients, but financial burden increasing

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For patients hospitalized with COPD, mortality and length of stay have decreased while financial burden has increased.

Managing aspergillosis: updated guidelines from IDSA

Managing aspergillosis: updated guidelines from IDSA

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New guidelines for the treatment and management of aspergillosis have been published by the Infectious Diseases Society of America.

New opioid use common post-hospital discharge among Medicare beneficiaries

New opioid use common post-hospital discharge among Medicare beneficiaries

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After an acute hospitalization, many Medicare beneficiaries submit pharmacy claims for opioid prescriptions.

Overcrowding in the emergency department

Overcrowding in the emergency department

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Emergency department clinicians are faced with a number of challenges as ED's become more crowded.

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