Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Thyroid-stimulating hormone (TSH) is ordered commonly among inpatients, but the possibility of nonthyroidal illness syndrome challenges interpretation. ⋯ Canadian experts agreed upon nine specific indications for ordering an inpatient TSH, with others requiring consideration of previous TSH measurement and clinical context.
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Accurately identifying the number of practicing hospitalists across the United States continues to be a challenge. Characterizing the workforce is important in the context of healthcare reforms and public reporting. ⋯ The number of adult hospitalists continued to grow at a consistent rate, such that hospitalists are in the top five largest physician specialties in the United States. In the absence of more formal identification and consistent use by hospitalists, a threshold continues to be a meaningful tool to characterize the workforce.
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No consensus exists about which medical testing is indicated for youth with new-onset psychotic symptoms. We conducted a chart review of youths aged 7-21 years who were medically hospitalized for workup of new-onset psychotic symptoms from January 2017 through September 2020 in a free-standing children's hospital. ⋯ Notably, 33 (25.2%; 95% CI: 18.0-33.5) had incidental findings unrelated to psychosis, 14 (10.7%; 95% CI: 6.0-17.3) had findings that required medical intervention but did not explain the psychosis, 12 (9.2%; 95% CI: 4.8-15.5) had a positive urine drug screen, and 4 (3.1%; 95% CI: 0.8-7.6) had a neurological exam consistent with conversion disorder. In conclusion, extensive medical testing in the acute setting for psychosis had a low yield for identifying medical etiologies of new-onset psychotic symptoms.