News
Younger Type 2 Diabetics Face Greater Mortality Risks
November 11, 2015
NEW YORK - People with type 2 diabetes are 15 percent more likely to die from any cause and 14 percent more likely to die from a cardiovascular cause than non-diabetics at any given time, according to data from several Swedish registries. The rates are significantly lower than previous estimates.
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Differences in Care, Outcomes for In-Hospital Versus Community-Onset Stroke
November 4, 2015
Clinical question: Are there any differences in care and outcomes for in-hospital versus community-onset stroke? Background: In-hospital stroke accounts for 4%-17% of all strokes. Hospitalists and other non-neurological services have to identify and treat subsequent stroke in their patients.
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Oral Steroids Not Inferior to Intravenous Steroids in Multiple Sclerosis Relapses
November 4, 2015
Clinical question: Is there any difference between oral and intravenous methylprednisolone for multiple sclerosis relapses? Background: When relapses of multiple sclerosis occur, studies have shown that intravenous steroids are the treatment of choice.
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ED Lung Ultrasound Useful for Differentiating Cardiogenic from Noncardiogenic Dyspnea
November 4, 2015
Clinical question: Is lung ultrasound a useful tool for helping to diagnose acute decompensated heart failure (ADHF)? Background: Lung ultrasound is an emerging bedside tool that has been promoted to help evaluate lung water content to help clinicians differentiate ADHF from other causes of dyspn
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When Should Hospitalists Order Continuous Cardiac Monitoring?
November 4, 2015
Case Two patients on continuous cardiac monitoring (CCM) are admitted to the hospital. One is a 56-year-old man with hemodynamically stable sepsis secondary to pneumonia. There is no sign of arrhythmia on initial evaluation.
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Clinical Care Pathway for Cellulitis Can Help Reduce Antibiotic Use, Cost
November 4, 2015
Clinical question: How would an evidence-based clinical pathway for cellulitis affect process metrics, patient outcomes, and clinical cost? Background: Cellulitis is a common hospital problem, but its evaluation and treatment vary widely.
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Can Low-Risk Patients with VTE Be Discharged from ED on Rivaroxabon?
November 4, 2015
Clinical question: Can a low-risk patient newly diagnosed with VTE in the ED be immediately discharged home on a direct factor Xa inhibitor? Background: Studies have shown that rivaroxaban incurs a risk of 2.1% in VTE recurrence and of 9.4% in clinically relevant major and non-major bleeding (in
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Coronary CT Angiography, Perfusion Imaging Effective for Evaluating Patients With Chest Pain
November 4, 2015
Clinical question: When evaluating the intermediate-risk patient with chest pain, should coronary computed tomography angiography (CCTA) be used instead of myocardial perfusion imaging (MPI)? Background: CCTA has been shown in prior randomized controlled trials to save time and money compared to
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Antimicrobial Stewardship Resources Often Lacking in Hospitalists’ Routines
November 4, 2015
The best antibiotic stewardship programs weave improvements into the routines of hospitalists. But at the end of the day, developing and overseeing these important programs does require some level of time and money.
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Chemotherapy Does Not Improve Quality of Life with End-Stage Cancer
November 3, 2015
Clinical question: Does palliative chemotherapy improve quality of life (QOL) in patients with end-stage cancer, regardless of performance status? Background: There is continued debate about the benefit of palliative chemotherapy at the end of life.
