Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Clinical hospital medicine fellowships could accelerate the acquisition of increasingly demanding skills while enhancing esteem among subspecialty peers. We sought to determine whether medicine residents perceived such fellowships as relevant and would be willing to forgo substantial income during the training period, in the context of the perspectives of employers and practicing hospitalists. ⋯ This study reveals a potentially unmet demand for clinical hospital medicine fellowship training. Further determination of need and related curricular development could be addressed under the leadership of national hospital medicine educational organizations.
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Review Meta Analysis Comparative Study
Effects of rapid response systems on clinical outcomes: systematic review and meta-analysis.
A rapid response system (RRS) consists of providers who immediately assess and treat unstable hospitalized patients. Examples include medical emergency teams and rapid response teams. Early reports of major improvements in patient outcomes led to widespread utilization of RRSs, despite the negative results of a subsequent cluster-randomized trial. ⋯ Published studies of RRSs have not found consistent improvement in clinical outcomes and have been of poor methodological quality. The positive results of before-after trials likely reflects secular trends and biased outcome ascertainment, as the improved outcomes they reported were of similar magnitude to those of the control group in the RCT. The effectiveness of the RRS concept remains unproven.
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Randomized Controlled Trial Comparative Study
A randomized clinical trial to compare the use of safety net enclosures with standard restraints in agitated hospitalized patients.
Although hospitals attempt to minimize the use of restraints, certain cases require their application. For such patients, there is a need for novel, safe and more humane restraint systems. ⋯ For hospitalized patients requiring restraint, the SOMA Safe Enclosure is effective and more acceptable to relatives, physicians, and secondary nurses than currently used restraints.
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Klebsiella pneumoniae liver abscess is known to be associated with metastatic endophthalmitis, with most cases clustered in Taiwan. We report a case of Klebsiella liver abscess with metastatic endophthalmitis in a nondiabetic Haitian man without underlying medical problems.
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Older adults make up an increasing proportion of patients hospitalized with cardiovascular disease. Such patients often have multiple coexisting geriatric syndromes that may affect management and outcomes and are frequently underdiagnosed and untreated. ⋯ These findings suggest that geriatric syndromes are prevalent among older patients hospitalized for cardiovascular disease. Further study is needed to determine if interventions designed to increase recognition and treatment of these syndromes can improve outcomes in this patient population.