Rhode Island medical journal (2013)
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We present a case of drug-induced acute eosinophilic pneumonia with characteristic imaging and bronchioloaveolar lavage (BAL) findings. Although not a common diagnosis, it is important to consider in the right clinical scenario, including a patient with presumed pneumonia that does not respond to typical treatment. ⋯ For drug-induced types, treatment includes removal of the offending agent. Corticosteroids are used if symptoms are severe and can result in rapid clinical improvement.
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The use of hospice care in nursing homes (NHs) has grown exponentially, but an increasing concern is the lack of access to resident and family-centered palliative care when residents do not elect hospice, and in time periods prior to election. This concern is amplified by the high magnitude of palliative care needs present for NH residents (and their families) when the NH will be their final residence; and, it is amplified because of short hospice stays, half of which are 22 days or less. ⋯ It also describes the challenges NHs face in expanding residents' access to palliative care. Opportunities and approaches for increasing palliative care expertise and practice in NHs are presented.
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Because of the multitude of financial, health, and social problems associated with prescription opioid misuse, effective methods of identifying older adults who are misusing these medications are needed. We conducted a pilot investigation to determine the prevalence of previous and current prescription opioid use among older adults visiting the Rhode Island Hospital Emergency Department and their need for opioid misuse interventions. ⋯ We identified problems of improper acquisition, diversion, provider refusal to prescribe opioids, hoarding, and inappropriate use of opioids among this population. Emergency medicine clinicians should query their older adult patients about prescription opioid misuse and associated problematic behaviors.