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Hospital Medicine

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69 papers 100 to 500 followers Guidelines & Review Articles of Top 30 Topics in Hospital Medicine
https://www.readbyqxmd.com/read/28459910/acute-pain-management-in-hospitalized-adult-patients-with-opioid-dependence-a-narrative-review-and-guide-for-clinicians
#1
REVIEW
Joshua N Raub, Theresa E Vettese
Pain management is a core competency of hospital medicine, and effective acute pain management should be a goal for all hospital medicine providers. The prevalence of opioid use in the United States, both therapeutic and non-medical in origin, has dramatically increased over the past decade. Although nonopioid medications and nondrug treatments are essential components of managing all acute pain, opioids continue to be the mainstay of treatment for severe acute pain in both opioid-naïve and opioid-dependent patients...
May 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28538121/acute-myocardial-infarction
#2
REVIEW
Jeffrey L Anderson, David A Morrow
New England Journal of Medicine, Volume 376, Issue 21, Page 2053-2064, May 2017.
May 25, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28416525/treatment-of-patients-with-atrial-fibrillation-and-heart-failure-with-reduced-ejection-fraction
#3
REVIEW
Atul Verma, Jonathan M Kalman, David J Callans
Atrial fibrillation (AF) and heart failure with reduced ejection fraction (HFrEF) frequently coexist, and each complicates the course and treatment of the other. Recent population-based studies have demonstrated that the 2 conditions together increase the risk of stroke, heart failure hospitalization, and all-cause mortality, especially soon after the clinical onset of AF. Guideline-directed pharmacological therapy for HFrEF is important; however, although there are various treatment modalities for AF, there is no clear consensus on how best to treat AF with concomitant HFrEF...
April 18, 2017: Circulation
https://www.readbyqxmd.com/read/24733692/mechanical-ventilation-in-acute-hypoxemic-respiratory-failure-a-review-of-new-strategies-for-the-practicing-hospitalist
#4
REVIEW
Jennifer G Wilson, Michael A Matthay
BACKGROUND: The goal of mechanical ventilation in acute hypoxemic respiratory failure is to support adequate gas exchange without harming the lungs. How patients are mechanically ventilated can significantly impact their ultimate outcomes. METHODS: This review focuses on emerging evidence regarding strategies for mechanical ventilation in patients with acute hypoxemic respiratory failure including: low tidal volume ventilation in the acute respiratory distress syndrome (ARDS), novel ventilator modes as alternatives to low tidal volume ventilation, adjunctive strategies that may enhance recovery in ARDS, the use of lung-protective strategies in patients without ARDS, rescue therapies in refractory hypoxemia, and an evidence-based approach to weaning from mechanical ventilation...
July 2014: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28101605/surviving-sepsis-campaign-international-guidelines-for-management-of-sepsis-and-septic-shock-2016
#5
Andrew Rhodes, Laura E Evans, Waleed Alhazzani, Mitchell M Levy, Massimo Antonelli, Ricard Ferrer, Anand Kumar, Jonathan E Sevransky, Charles L Sprung, Mark E Nunnally, Bram Rochwerg, Gordon D Rubenfeld, Derek C Angus, Djillali Annane, Richard J Beale, Geoffrey J Bellinghan, Gordon R Bernard, Jean-Daniel Chiche, Craig Coopersmith, Daniel P De Backer, Craig J French, Seitaro Fujishima, Herwig Gerlach, Jorge Luis Hidalgo, Steven M Hollenberg, Alan E Jones, Dilip R Karnad, Ruth M Kleinpell, Younsuk Koh, Thiago Costa Lisboa, Flavia R Machado, John J Marini, John C Marshall, John E Mazuski, Lauralyn A McIntyre, Anthony S McLean, Sangeeta Mehta, Rui P Moreno, John Myburgh, Paolo Navalesi, Osamu Nishida, Tiffany M Osborn, Anders Perner, Colleen M Plunkett, Marco Ranieri, Christa A Schorr, Maureen A Seckel, Christopher W Seymour, Lisa Shieh, Khalid A Shukri, Steven Q Simpson, Mervyn Singer, B Taylor Thompson, Sean R Townsend, Thomas Van der Poll, Jean-Louis Vincent, W Joost Wiersinga, Janice L Zimmerman, R Phillip Dellinger
OBJECTIVE: To provide an update to "Surviving Sepsis Campaign Guidelines for Management of Sepsis and Septic Shock: 2012". DESIGN: A consensus committee of 55 international experts representing 25 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict-of-interest (COI) policy was developed at the onset of the process and enforced throughout. A stand-alone meeting was held for all panel members in December 2015...
March 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/27929242/community-acquired-pneumonia-in-adults-diagnosis-and-management
#6
Alexander Kaysin, Anthony J Viera
Community-acquired pneumonia is a leading cause of death. Risk factors include older age and medical comorbidities. Diagnosis is suggested by a history of cough, dyspnea, pleuritic pain, or acute functional or cognitive decline, with abnormal vital signs (e.g., fever, tachycardia) and lung examination findings. Diagnosis should be confirmed by chest radiography or ultrasonography. Validated prediction scores for pneumonia severity can guide the decision between outpatient and inpatient therapy. Using procalcitonin as a biomarker for severe infection may further assist with risk stratification...
November 1, 2016: American Family Physician
https://www.readbyqxmd.com/read/26547467/does-this-patient-with-chest-pain-have-acute-coronary-syndrome-the-rational-clinical-examination-systematic-review
#7
REVIEW
Alexander C Fanaroff, Jennifer A Rymer, Sarah A Goldstein, David L Simel, L Kristin Newby
IMPORTANCE: About 10% of patients with acute chest pain are ultimately diagnosed with acute coronary syndrome (ACS). Early, accurate estimation of the probability of ACS in these patients using the clinical examination could prevent many hospital admissions among low-risk patients and ensure that high-risk patients are promptly treated. OBJECTIVE: To review systematically the accuracy of the initial history, physical examination, electrocardiogram, and risk scores incorporating these elements with the first cardiac-specific troponin...
November 10, 2015: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27528647/state-of-the-art-evaluation-of-emergency-department-patients-presenting-with-potential-acute-coronary-syndromes
#8
REVIEW
Judd E Hollander, Martin Than, Christian Mueller
It is well established that clinicians cannot use clinical judgment alone to determine whether an individual patient who presents to the emergency department has an acute coronary syndrome. The history and physical examination do not distinguish sufficiently between the many conditions that can cause acute chest pain syndromes. Cardiac risk factors do not have sufficient discriminatory ability in symptomatic patients presenting to the emergency department. Most patients with non-ST-segment-elevation myocardial infarction do not present with electrocardiographic evidence of active ischemia...
August 16, 2016: Circulation
https://www.readbyqxmd.com/read/17606095/the-electrocardiogram-in-the-patient-with-syncope
#9
REVIEW
Jacqueline Dovgalyuk, Christopher Holstege, Amal Mattu, William J Brady
Syncope is a common and challenging presentation for the emergency physician. Various investigators have developed clinical risk score and clinical decision rules which are designed to identify the population at highest risk for adverse events. In each of these clinical decision tools, the electrocardiogram (ECG) is one of the key clinical variables used to evaluate the patient. Certain electrocardiographic presentations in the patient with syncope will not only provide a reason for the loss of consciousness but also guide early therapy and disposition in this individual...
July 2007: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26742458/the-electrocardiogram-in-the-acs-patient-high-risk-electrocardiographic-presentations-lacking-anatomically-oriented-st-segment-elevation
#10
REVIEW
Mathew Macias, Jordan Peachey, Amal Mattu, William J Brady
ST-segment elevation myocardial infarction (STEMI) is defined as pathologic ST-segment elevation occurring in at least 2 anatomically contiguous leads in a patient with a clinical presentation consistent with acute myocardial infarction (AMI); these findings can suggest the need for urgent revascularization. Unfortunately, the electrocardiogram (ECG) may be nondiagnostic in a large portion of patients who initially present with AMI; furthermore, it is now recognized that ECG patterns that do not meet the traditional diagnostic criteria for STEMI may represent significant AMI--these patterns are generally referred to as the STEMI equivalent patterns in that they are caused by occlusion of an epicardial coronary artery, place significant portions of the left ventricle in jeopardy, and can result in a poor outcome if not recognized and treated appropriately...
March 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27557303/treatment-of-patients-with-cirrhosis
#11
REVIEW
Phillip S Ge, Bruce A Runyon
No abstract text is available yet for this article.
August 25, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27502078/acute-myocardial-infarction
#12
REVIEW
Grant W Reed, Jeffrey E Rossi, Christopher P Cannon
Acute myocardial infarction has traditionally been divided into ST elevation or non-ST elevation myocardial infarction; however, therapies are similar between the two, and the overall management of acute myocardial infarction can be reviewed for simplicity. Acute myocardial infarction remains a leading cause of morbidity and mortality worldwide, despite substantial improvements in prognosis over the past decade. The progress is a result of several major trends, including improvements in risk stratification, more widespread use of an invasive strategy, implementation of care delivery systems prioritising immediate revascularisation through percutaneous coronary intervention (or fibrinolysis), advances in antiplatelet agents and anticoagulants, and greater use of secondary prevention strategies such as statins...
January 14, 2017: Lancet
https://www.readbyqxmd.com/read/27434444/cellulitis-a-review
#13
REVIEW
Adam B Raff, Daniela Kroshinsky
IMPORTANCE: Cellulitis is an infection of the deep dermis and subcutaneous tissue, presenting with expanding erythema, warmth, tenderness, and swelling. Cellulitis is a common global health burden, with more than 650,000 admissions per year in the United States alone. OBSERVATIONS: In the United States, an estimated 14.5 million cases annually of cellulitis account for $3.7 billion in ambulatory care costs alone. The majority of cases of cellulitis are nonculturable and therefore the causative bacteria are unknown...
July 19, 2016: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/27418577/management-of-adults-with-hospital-acquired-and-ventilator-associated-pneumonia-2016-clinical-practice-guidelines-by-the-infectious-diseases-society-of-america-and-the-american-thoracic-society
#14
Andre C Kalil, Mark L Metersky, Michael Klompas, John Muscedere, Daniel A Sweeney, Lucy B Palmer, Lena M Napolitano, Naomi P O'Grady, John G Bartlett, Jordi Carratalà, Ali A El Solh, Santiago Ewig, Paul D Fey, Thomas M File, Marcos I Restrepo, Jason A Roberts, Grant W Waterer, Peggy Cruse, Shandra L Knight, Jan L Brozek
It is important to realize that guidelines cannot always account for individual variation among patients. They are not intended to supplant physician judgment with respect to particular patients or special clinical situations. IDSA considers adherence to these guidelines to be voluntary, with the ultimate determination regarding their application to be made by the physician in the light of each patient's individual circumstances.These guidelines are intended for use by healthcare professionals who care for patients at risk for hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), including specialists in infectious diseases, pulmonary diseases, critical care, and surgeons, anesthesiologists, hospitalists, and any clinicians and healthcare providers caring for hospitalized patients with nosocomial pneumonia...
September 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/27240854/acute-pancreatitis-new-developments-and-strategies-for-the-hospitalist
#15
REVIEW
John F Dick, Timothy B Gardner, Edward J Merrens
Acute pancreatitis (AP) remains the most common reason for hospital admission of all the gastrointestinal illnesses in the United States. Since the last narrative review in the Journal of Hospital Medicine in 2010, new developments in regard to diagnosis and classification, fluid resuscitation, antibiotic use, nutritional support, and management of complications have helped refine the approach and improve outcomes in this disease. Whereas there is still no proven pharmacologic therapy to specifically combat the inflammatory consequences of AP, recent interventions have led to increased survival, shorter length of stay, and more appropriate transfer criteria for pancreatitis patients...
October 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/26519602/management-of-the-critically-ill-patient-with-cirrhosis-a-multidisciplinary-perspective
#16
REVIEW
Mitra K Nadim, Francois Durand, John A Kellum, Josh Levitsky, Jacqueline G O'Leary, Constantine J Karvellas, Jasmohan S Bajaj, Andrew Davenport, Rajiv Jalan, Paolo Angeli, Stephen H Caldwell, Javier Fernández, Claire Francoz, Guadalupe Garcia-Tsao, Pere Ginès, Michael G Ison, David J Kramer, Ravindra L Mehta, Richard Moreau, David Mulligan, Jody C Olson, Elizabeth A Pomfret, Marco Senzolo, Randolph H Steadman, Ram M Subramanian, Jean-Louis Vincent, Yuri S Genyk
No abstract text is available yet for this article.
March 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27208050/2016-acc-aha-hfsa-focused-update-on-new-pharmacological-therapy-for-heart-failure-an-update-of-the-2013-accf-aha-guideline-for-the-management-of-heart-failure-a-report-of-the-american-college-of-cardiology-american-heart-association-task-force-on-clinical-practice
#17
Clyde W Yancy, Mariell Jessup, Biykem Bozkurt, Javed Butler, Donald E Casey, Monica M Colvin, Mark H Drazner, Gerasimos Filippatos, Gregg C Fonarow, Michael M Givertz, Steven M Hollenberg, JoAnn Lindenfeld, Frederick A Masoudi, Patrick E McBride, Pamela N Peterson, Lynne Warner Stevenson, Cheryl Westlake
No abstract text is available yet for this article.
September 27, 2016: Circulation
https://www.readbyqxmd.com/read/26925883/acg-clinical-guideline-management-of-patients-with-acute-lower-gastrointestinal-bleeding
#18
Lisa L Strate, Ian M Gralnek
This guideline provides recommendations for the management of patients with acute overt lower gastrointestinal bleeding. Hemodynamic status should be initially assessed with intravascular volume resuscitation started as needed. Risk stratification based on clinical parameters should be performed to help distinguish patients at high- and low-risk of adverse outcomes. Hematochezia associated with hemodynamic instability may be indicative of an upper gastrointestinal (GI) bleeding source and thus warrants an upper endoscopy...
April 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/26916489/management-of-pulmonary-embolism-an-update
#19
REVIEW
Stavros V Konstantinides, Stefano Barco, Mareike Lankeit, Guy Meyer
Pulmonary embolism (PE) remains a major contributor to global disease burden. Risk-adapted treatment and follow-up contributes to a favorable outcome. Age-adjusted cutoff levels increase D-dimer specificity and may decrease overuse of imaging procedures and overdiagnosis of PE. Primary systemic fibrinolysis has an unfavorable risk-benefit ratio in intermediate-risk PE; catheter-directed techniques are an option for patients with hemodynamic decompensation and high bleeding risk. New oral anticoagulant agents are effective and safe alternatives to standard anticoagulation regimens...
March 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/21661104/frequently-asked-questions-by-hospitalists-managing-pain-in-adults-with-sickle-cell-disease
#20
REVIEW
Wally R Smith, Lanetta B Jordan, Kathryn L Hassell
Pain is the predominant medical presentation to hospitalists for patients with sickle cell disease (SCD). Dramatic treatment gains of SCD in childhood have resulted in more adults now requiring hospitalization than children. This has created new challenges to improve the quality of hospital care for SCD. The evidence base for pain management in SCD is lacking. We therefore offer some evidence and our informed opinion to answer frequently asked questions (FAQs) about pain management by hospitalists caring for adults with SCD...
May 2011: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
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