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Total 63 results found since Jan 2013.

Clinical guideline highlights for the hospitalist: 2022 American Heart Association/American Stroke Association Guideline for the management of patients with spontaneous intracerebral hemorrhage
GUIDELINE TITLE2022 Guideline for the Management of Patients with Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke AssociationRELEASE DATEMay 2022PRIOR VERSIONGuidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association 2015DEVELOPERAmerican Heart Association and American Stroke AssociationFUNDING SOURCENoneTARGET POPULATIONAdult Patients with Spontaneous Intracerebral Hemorrhage
Source: Journal of Hospital Medicine - February 2, 2023 Category: Hospital Management Authors: Desir ée C. Burroughs‐Ray, Ariana F. VanDillen, Christopher D. Jackson Tags: CLINICAL GUIDELINE HIGHLIGHTS FOR THE HOSPITALIST Source Type: research

Doctors Should Play a Role in Preventing Climate-change-related Health Matters
A 5-year-old with second-degree burns on their hands and thighs after playing on a playground with a metal structure in direct sunlight. A 7-year-old child presenting with altered mental status and a body temperature of 104 degrees, whose family tried to get to an air-conditioned library but couldn’t because the power cables for the bus had melted. A 17-year-old receiving follow-up, gender-affirming care who is struggling to keep their estrogen patch on because it’s been sweating off in a heat wave. Presenters from Seattle Children’s Hospital at Pediatric Hospital Medicine 2022 offered these examples of how climate-c...
Source: The Hospitalist - February 1, 2023 Category: Hospital Management Authors: Ronda Whitaker Tags: PHM22 Quality Improvement Source Type: research

Mr. M
Dr. Migliore I step off the subway, up the elevator, and up several flights of stairs. There’s a homeless man there who always uses the last stair of the lower staircase as a tray for his food. And by tray, I mean he sets his half-eaten rice burrito directly onto the step and picks around at it while I imagine the guacamole is mixing with Hep B and C. diff and MRSA. He looks up at me, I promise myself for the 100th time I’m going to start carrying cash or Kind bars or something; I give him my best sheepish face, and emerge at street level. I walk toward my hospital and pass a gentleman who sits on a ledge next to the ...
Source: The Hospitalist - December 1, 2022 Category: Hospital Management Authors: Lisa Casinger Tags: Essay Source Type: research

Hospital Closures Pose Challenges to Care
Empty beds in a hospital room. When 10-bed Nye Regional Medical Center, in west-central Nevada, closed abruptly in 2015, it meant that the residents of the former gold-mining town of Tonopah would have to drive about two hours across a hundred miles of desert roads to get to the nearest hospital.  The hospital’s CEO, Wayne Allen, didn’t sugar-coat it. “This is a decision that will ultimately jeopardize the health and well-being of our community and surrounding areas,” he said. Hospital closures over the last decade—most notably in rural areas and in pediatrics, but urban closures as well—have left patients wi...
Source: The Hospitalist - November 1, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: Business of Medicine Career Pediatrics PHM22 Source Type: research

Cumulative rehospitalizations and implications for subsequent mortality after first-ever ischemic stroke
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Source: Hospital Practice - September 28, 2022 Category: Hospital Management Authors: Mohammed Yousufuddin Kogulavadanan Arumaithurai Prabin Thapa Mohammad Hassan Murad Source Type: research

There is a Decreased Risk of Hospitalization from Heart Failure in Type II Diabetics Initiated on a SGLT2 Inhibitor When Compared to a GLP-1 Receptor Agonist
Dr. Huang Clinical question: Determine the cardiovascular risk outcome in type II diabetic patients initiated on an sodium-glucose cotransporter-2 (SGLT2)  inhibitor versus a glucagon-like peptide-1 (GLP-1) receptor agonist. Background: Various studies have suggested that several SGLT2 inhibitors and GLP-1 receptor agonists may improve cardiac outcomes—myocardial infarction, stroke, hospitalization for heart failure, and cardiovascular death. Current guidelines recommend using either an SGLT2 inhibitor or GLP-1 receptor agonist for patients with type II diabetes and cardiovascular disease. However, there has been no st...
Source: The Hospitalist - September 1, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: Diabetes Heart Failure In the Literature Source Type: research

Tranexamic acid minimized perioperative bleeding in patients undergoing noncardiac surgery
Dr. Menon Clinical question: Does tranexamic acid reduce the incidence of life-threatening perioperative bleeding in patients undergoing noncardiac surgery without increasing the risk of major cardiovascular adverse events? Background: Large surgical trials have shown that tranexamic acid reduces the incidence and severity of perioperative bleeding in patients undergoing a cesarean section or cardiac surgery. Other, smaller trials have suggested similar findings with tranexamic acid in patients undergoing orthopedic surgery as well. But, there are limited data on the use of tranexamic acid in patients undergoing non-ortho...
Source: The Hospitalist - August 1, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: Critical Care In the Literature Perioperative Medicine Source Type: research

What Medications Prevent Delirium in Elderly Medical Inpatients?
This study demonstrated lower rates of delirium in the melatonin arm, with an impressive number needed to treat (NNT) below six patients; mortality and length of hospital stay were unaffected.3 A delirium-prevention effect of melatonin has not been reproduced in other studies, notably Jaiswal et al, which randomized patients to a placebo or 3 mg of melatonin and found no difference in rates of delirium prevention.7  The melatonin receptor agonist ramelteon also has small but favorable evidence for preventing non-ICU hospitalized delirium. This comes from a study of 67 patients aged 65 years or older who were randomized to...
Source: The Hospitalist - May 2, 2022 Category: Hospital Management Authors: Ronda Whitaker Tags: Drug Therapy Geriatrics Key Clinical Questions Medication Source Type: research

Anticoagulant choice in antiphospholipid syndrome – associated thrombosis
Background: DOACs have largely replaced VKAs as first-line therapy for venous thromboembolism in patients with adequate renal function. However, there is concern in APS that DOACs may have higher rates of recurrent thrombosis than VKAs when treating thromboembolism. Dr. David Portnoy Study design: Randomized noninferiority trial. Setting: Six teaching hospitals in Spain. Synopsis: Of adults with thrombotic APS, 190 were randomized to receive rivaroxaban or warfarin. Primary outcomes were thrombotic events and major bleeding. Follow-up after 3 years demonstrated new thromboses in 11 patients (11.6%) in the DOAC...
Source: The Hospitalist - December 10, 2021 Category: Hospital Management Authors: Daniel Hickman Tags: Hematology Thrombosis Source Type: research

Optimal patient protocols in regional acute stroke care
We describe acute stroke care as a multi-flow two-level hierarchical facility location problem and the model is formulated as a mixed integer linear program. The objective of the model is the minimization of the total time until treatment in a region and it incorporates volume-dependent in-hospital delays. The resulting model is used to gain insight in the performance of practically oriented patient allocation protocols, used by EMS. We observe that the protocol of directly driving to the nearest stroke centre with s pecial facilities (i.e., the mothership protocol) performs closest to optimal, with an average total time d...
Source: Health Care Management Science - September 1, 2021 Category: Hospital Management Source Type: research

St. Michael’s Outpatient Stroke and Neurology Clinic proves highly specialized care can be delivered quickly
Source: St. Michael's Hospital News and Media - October 30, 2020 Category: Hospital Management Tags: Hospital News Source Type: news

Impact of rhabdomyolysis on outcomes of hospitalizations for heat stroke in the United States
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Source: Hospital Practice - July 26, 2020 Category: Hospital Management Authors: Charat Thongprayoon Tananchai Petnak Swetha R. Kanduri Karthik Kovvuru Wisit Cheungpasitporn Boonphiphop Boonpheng Api Chewcharat Tarun Bathini Juan Medaura Saraschandra Vallabhajosyula Wisit Kaewput Source Type: research

A framework to accelerate simulation studies of hyperacute stroke systems
Publication date: Available online 21 September 2017 Source:Operations Research for Health Care Author(s): Thomas Monks, Durk-Jouke van der Zee, Maarten Lahr, Michael Allen, Kerry Pearn, Martin A. James, Erik Buskens, Gert-Jan Luijckx Stroke care has been identified as an area where operations research has great potential. In recent years there has been a small but sustained stream of discrete-event simulation case studies in modelling hyperacute stroke systems. The nature of such case studies has led to a fragmented knowledge base and high entry cost to stroke modelling research. Two common issues have faced researcher...
Source: Operations Research for Health Care - September 22, 2017 Category: Hospital Management Source Type: research

Study finds risk of hemorrhage with combination of two common statins and stroke prevention drug
Source: St. Michael's Hospital News and Media - November 21, 2016 Category: Hospital Management Tags: Hospital News Source Type: news