Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Management of Acute Pancreatitis in the Pediatric Population: A Clinical Report from the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition Pancreas Committee DEVELOPER: Review developed by the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN) Pancreas Committee RELEASE DATE: January 1, 2018 FUNDING SOURCE: NASPGHAN and the National Institutes of Diabetes and Digestive and Kidney Diseases PRIOR VERSIONS: N/A TARGET POPULATION: Children with acute pancreatitis.
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Multicenter Study Observational Study
Opioid Utilization and Perception of Pain Control in Hospitalized Patients: A Cross-Sectional Study of 11 Sites in 8 Countries.
Hospitalized patients are frequently treated with opioids for pain control, and receipt of opioids at hospital discharge may increase the risk of future chronic opioid use. ⋯ In the hospitals we sampled, our data suggest that physicians in the US may prescribe opioids more frequently during patients' hospitalizations and at discharge than their colleagues in other countries, and patients have different beliefs and expectations about pain control. Efforts to curb the opioid epidemic likely need to include addressing inpatient analgesic prescribing practices and patients' expectations regarding pain control.
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Acute severe ulcerative colitis (ASUC) is a potentially life-threatening presentation of ulcerative colitis that in nearly all cases requires inpatient management and coordinated care from hospitalists, gastroenterologists, and surgeons. Even with ideal care, a substantial proportion of patients will ultimately require colectomy, but most patients can avoid surgery with intravenous corticosteroid treatment and if needed, appropriate rescue therapy with infliximab or cyclosporine. ⋯ Care for ASUC must be anticipatory, with patient education and evaluation starting at the time of admission in advance of the possible need for urgent medical or surgical rescue therapy. Here we outline a general approach to the treatment of patients hospitalized with ASUC, highlighting the common pitfalls and critical points in management.
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In patients hospitalized with heart failure (HF) exacerbations, physicians routinely supplement potassium to maintain levels ≥4.0 mEq/L. The evidence basis for this practice is relatively weak. We aimed to evaluate the association between serum potassium levels and outcomes in patients hospitalized with HF. ⋯ Inpatients with heart failure who had mean serum potassium levels of <4.0 showed similar outcomes to those with mean serum potassium values of 4.0-4.5. Compared with mean serum potassium level of <4.0, mean serum levels of >4.5 may be associated with increased risk of poor outcomes.
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Despite rapidly growing interest in Hospital Medicine (HM), no prior research has examined the factors that may be most beneficial or detrimental to candidates during the HM hiring process. We developed a survey instrument to assess how those involved in the HM hiring process assess HM candidate attributes, skills and behaviors. ⋯ In thematic analysis of free-response questions, several themes emerged relating to interview techniques and recruitment strategies, including heterogeneous approaches to long-term versus short-term applicants. These findings represent the first published assessment in the area of HM hiring and should inform HM candidates and their mentors.