Clinical question Does barium impaction therapy using high-dose barium enemas prevent recurrent diverticular bleeding? Bottom line This small study demonstrates that barium impaction therapy using high-dose barium enemas is safe and effective at reducing the rate of recurrent diverticular bleeding. Note that this study was conducted in Japan, where the rate of rebleeding for patients… [Read More]
Clinical question: Do steroids improve outcomes in patients with severe community-acquired pneumonia and a high inflammatory response? Bottom line In patients with severe community-acquired pneumonia (CAP) who have elevated levels of C-reactive protein (CRP), a short course of methylprednisolone decreases treatment failure, mainly by reducing radiographic progression of pulmonary infiltrates within 3 days to 5… [Read More]
4/8/15 Session: Last-Minute Heroics and Palliative Care – Do They Meet in the Middle? HM15 Presenter: Tammie Quest, MD Summation: Heroics- a set of medical actions that attempt to prolong life with a low likelihood of success. Palliative care- an approach of care provided to patients and families suffering from serious and/or life limiting illness;… [Read More]
HM15 Session RAPID FIRE PANEL: Hot Topics in Practice Management Updates on Key Issues, Including the Key Characteristics of an Effective HMG HM15 Presenters: Roy Sittig MD SFHM, Jeffrey Frank MD MBA, Jodi Braun Summation: Speakers covered timely topics regarding the Accountable Care Act, namely Medicaid Expansion and Bundled Payment arrangements; and reviewed the seminal paper… [Read More]
In a presentation on guidelines for ALTE, Jack Percelay, SHM representative to the AAP Subcommittee, provided further insight to the work that has been done for the clinical entity known as apparent life-threatening events (ALTE) since a consensus statement was put forward by the NIH in 1986. The original statement emphasized 4 possible features to constitute… [Read More]
Listen to Daniel Hunt, MD, chief of the hospital medicine unit at Massachusetts General Hospital, Boston, discuss his recent article titled “Perspectives” in the New England Journal of Medicine on consultation visits by primary care providers.
Jeffrey Greenwald, MD, a hospitalist at Massacusetts General Hospital with 15 years of experience in hospital medicine, discusses his view of the spectrum of endocrine disorders and how hospitalists should approach the question of when to call in an endocrine specialist.
Amy Boutwell, MD, MPP, a hospitalist and founder of Collaborative Healthcare Strategies, talks about what clinicians can do to help improve care transitions based on her experience directing IHI’s STAAR Initiative (State-Action on Avoidable Re-hospitalizations).
Johns Hopkins hospitalist Eric Howell, MD, SFHM, discusses connections between SHM, hospitalist practices, handoffs, and successful care transitions.
Clinical question: Is fondaparinux as safe and effective as argatroban and danaparoid in treating heparin-induced thrombocytopenia (HIT)? Background: Guidelines for the treatment of HIT recommend using danaparoid (factor Xa inhibitor), argatroban, or lepirudin (both direct thrombin inhibitors). Reduced availability, cost, and complexity of administration limit these options, and fondaparinux is often used off label in… [Read More]