Hospital Medicine

Forty percent of hospitalized patients report breakdowns in care

Forty percent of hospitalized patients report breakdowns in care

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Hospital patients reported breakdowns in care, which included information exchange, medications, delays in admission, team communication, providers' manner, and discharge.

Increased mortality for percutaneous coronary intervention at safety-net hospitals

Increased mortality for percutaneous coronary intervention at safety-net hospitals

Risk-adjusted in-hospital mortality is significantly increased at safety-net hospitals for patients undergoing percutaneous coronary intervention.

Less than 10% of women present to the ER after hysterectomy for benign disease

Less than 10% of women present to the ER after hysterectomy for benign disease

Risk factors for emergency department visits include younger age, higher parity, Medicare or self-pay insurance, and postoperative pain.

New data show aspirin safe for heart failure patients

New data show aspirin safe for heart failure patients

Data from a clinical trial show that patients taking daily aspirin were not at heightened risk of being hospitalized for heart failure.

WHO updates Essential Medicines List, recommendations for antibiotics

WHO updates Essential Medicines List, recommendations for antibiotics

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The update includes 30 new medicines for adults and 25 for children and groups antibiotics into 3 distinct categories.

Effects of the obesity paradox: VTE risk in atrial fibrillation

Effects of the obesity paradox: VTE risk in atrial fibrillation

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Researchers found a paradoxical increase in thromboembolism risk in low-weight patients with atrial fibrillation and VTE who were treated with direct oral anticoagulants.

Adverse events common in hospitalized patients taking antibiotics

Adverse events common in hospitalized patients taking antibiotics

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Many adverse events could be avoidable with more judicious use of antibiotics.

Idarucizumab reverses anticoagulant effect of dabigatran in emergency situations

Idarucizumab reverses anticoagulant effect of dabigatran in emergency situations

Researchers found that idarucizumab is effective for dabigatran reversal among patients with uncontrolled bleeding and who are undergoing urgent surgery.

Heart failure hospitalization rate declining in the United States

Heart failure hospitalization rate declining in the United States

There were 526.86 hospital admissions for every 100,000 people in 2002, compared with 364.66 per 100,000 in 2013.

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.

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