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Tip-Top Tactics for Bedside Procedure Training
March 6, 2015
David Lichtman, PA, director of the Johns Hopkins Central Procedure Service in Baltimore, Md., says bedside procedure training should be consistent and thorough, regardless of whether the trainee is a medical student, a resident, a fellow, or an established physician.
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What Is the Best Approach to a Cavitary Lung Lesion?
March 3, 2015
Case A 66-year-old homeless man with a history of smoking and cirrhosis due to alcoholism presents to the hospital with a productive cough and fever for one month. He has traveled around Arizona and New Mexico but has never left the country.
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Hospitalists Are Frontline Providers in Treating Venous Thromboembolism
March 3, 2015
Nearly half of all venous thromboembolism (VTE) events occur during or soon after hospitalizations.1 And who are the frontline providers diagnosing and managing VTE in the inpatient setting? “While VTE may not be the No.
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Left Atrial Appendage Closure Noninferior to Warfain for Cardioembolic Event Prophylaxis in Nonvalvular Afibrillation
March 3, 2015
Clinical question: Is mechanical, left atrial appendage (LAA) closure as effective as warfarin therapy in preventing cardioembolic events in patients with nonvalvular atrial fibrillation (Afib)? Background: Anticoagulation with warfarin has long been the standard therapy for prevention of thrombo
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Tramadol Associated with Increased Rate of Hypoglycemia
March 3, 2015
Clinical question: Does tramadol increase rates of hospitalization from hypoglycemia compared to other opioids? Background: As tramadol use has increased in the general population, there have been multiple reports of hypoglycemia after initiation of the painkiller, including in patients with no o
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Longer Surgeries Associated with Increased VTE Risk
March 3, 2015
Clinical question: Does duration of surgical procedure influence venous thromboembolism (VTE) risk? Background: The relationship between surgical procedure length and VTE risk has not been vigorously assessed, although it has been postulated that longer procedures are associated with increased VT
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Mortality, Readmission Rates Unchanged by Duty Hour Reforms
March 3, 2015
Clinical question: Did the 2011 Accreditation Council for Graduate Medical Education (ACGME) duty hour reforms change mortality rates or readmission rates at teaching hospitals? Background: The 2011 ACGME duty hour reforms maintained the 80-hour weekly work limit for medical residents, decreased
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Children with Acute Hematogenous Osteomyelitis Have Similar Outcomes When Discharged with Oral Antibiotics versus Prolonged IV Antibiotics and Escape PICC Complications
March 3, 2015
Clinical question: After hospitalization for acute hematogenous osteomyelitis (AHOM), do children discharged with oral antibiotics have similar clinical outcomes compared to those discharged with home IV antibiotics? Background: AHOM occurs in one in 5,000 children yearly and makes up approximate
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Emergency Department Utilization May Be Lower for Attending-Only Physician Visits versus Supervised Visits
March 3, 2015
Clinical question: Does supervised learning in the ED lead to higher rates of resource utilization? Background: Care at academic medical centers might be more expensive than nonteaching hospitals because of the increased testing and resource utilization that occurs among learners.
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Physician Spending Habits During Residency Training Can Persist for Years
March 3, 2015
Clinical question: For primary care physicians (PCPs), does residency training area affect the pattern of physician spending after training is complete? Background: Regional and system-level variations in the intensity of medical services provided are common in the U.S.
