Clinical

Getting in Shape May Help Reduce Irregular Heart Rhythm

(Reuters Health) – For overweight and obese people with atrial fibrillation, improving cardiorespiratory fitness with exercise may help to reduce or eliminate symptoms, a recent Australian study found. Participants with the greatest improvements in their cardiorespiratory fitness were less burdened by symptoms of the arrhythmia and more likely to be symptom free during the study,… [Read More]

PHM15: Physical Burnout for Hospitalists

Presenters: Allison Ballantine and Lisa Zaoutis Physician burnout can be thought of as similar to water level in a reservoir during a drought – there is an imbalance between usage and replenishment. This leads to physician exhaustion, cynicism, and inefficiency. Burnout is a function of both the individual (younger, single, and less resilient are at… [Read More]

NSAIDS May Increase Kidney Risks with High Blood Pressure

(Reuters Health) – Patients with hypertension who regularly take non-steroidal anti-inflammatory drugs (NSAIDs) may increase their risk of developing chronic kidney disease, a study from Taiwan suggests. The researchers examined data on more than 30,000 people with hypertension and found that those who’d been taking NSAIDs for at least three months were 32% more likely… [Read More]

PHM15: Management of Febrile Infants with Urinary Tract Infections

Dr. Pate and Dr. Engel presented a hot topic in pediatric hospital medicine, sparking fruitful conversation about current evidence, identified gaps, and controversies regarding the management of febrile infants with urinary tract infections. After the American Academy of Pediatrics published the updated clinical guideline in 2011, controversies about radioimaging, duration of treatment, and pursuit of… [Read More]

10 Tips for Hospitalists to Achieve an Effective Medical Consult

10 Tips for Hospitalists to Achieve an Effective Medical Consult

A medical consult is an amazing way to learn. Consultation challenges us to practice our best medicine while also exposing us to innovations in other specialties. It can forge new and productive relationships with physicians from all specialties. At its best, it is the purest of medicine or, as some put it, “medicine without the… [Read More]

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Most Important Elements of End-of-Life Care

An Australian team conducted a literature review of expected deaths in the hospital—where the majority of deaths in the developed world occur—and identified elements of end-of-life care that are important to patients and families.1 Published in the British journal Palliative Medicine, the review of nine electronic data bases and 1859 articles released between 1990 and… [Read More]

Clinical Variables Predict Debridement Failure in Septic Arthritis

Clinical question: What risk factors predict septic arthritis surgical debridement failure? Background: Standard treatment of septic arthritis is debridement and antibiotics. Unfortunately, 23%-48% of patients fail single debridement. Data is limited on what factors correlate with treatment failure. Study design: Retrospective, logistic regression analysis. Setting: Billing database query of one academic medical center from 2000-2011…. [Read More]

Prednisolone or Pentoxifylline Show No Mortality Benefit in Alcoholic Hepatitis

Clinical question: Does administration of prednisolone or pentoxifylline reduce mortality in patients hospitalized with severe alcoholic hepatitis? Background: Alcoholic hepatitis is associated with high mortality. Studies have shown unclear mortality benefit with prednisolone and pentoxifylline. Despite multiple studies and meta-analyses, controversy about the use of these medications persists. Study Design: Multicenter, double-blind, randomized trial with… [Read More]

Corticosteroids Show Benefit in Community-Acquired Pneumonia

Joshua LaBrin, MD, SFHM, Kencee Graves, MD, Karli Edholm, MD, Devin Horton, MD, and
Katie Lappe, MD; Division of General Internal Medicine, University of Utah School of Medicine, Salt Lake City