American journal of hospital medicine, volume 1, issue 2 (2017 April-June)

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https://hdl.handle.net/10355/61454

Viewpoint

Is it Time for Physician Assistant (PA)/Nurse Practitioner (NP) Hospital Medicine Residency Training? / S. Hasan Naqvi

Review Articles

Clostridium difficile Infection: Considerations for Hospitalists / Kristin Hahn-Cover
Imaging Modalities in Acute Ischemic Stroke / Kunal Bhatia, Christopher R. Newey, Naresh Karthikeyan, Premkumar Nattanmai

Original Article

Volunteerism Among Hospitalists and Non-Hospitalists at Academic and Community Medical Centers in North Carolina / Michael J. Gilchrist, Richard Hobbs, E. Allen Liles

Case Reports

Atypical Hemolytic Uremic Syndrome: When the Environment and Mutations Affect Organ Systems. A Case Report with Review of Literature / Mouhanna Abu Ghanimeh, Omar Abughanimeh, Ayman Qasrawi, Abdulraheem Qasem
A Case of Rapid-onset Daptomycin-induced Neutropenia / Jason W. Lancaster, Christine E. Vaudo, Satinder P. Singh

Ask a Specialist

Ask a Pathologist / Kristen Scheitler, Emily Coberly

ID Corner

ID Corner / Christian Rojas Moreno
Answer to ID Corner

ECG Dilemma

ECG Dilemma / Sudarshan Balla
Answer to the ECG Dilemma

Conference Calendar

April-September 2017 / Harleen Chela

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Now showing 1 - 5 of 12

Table of Contents
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2017-04)
Volunteerism among hospitalists and non-hospitalists at academic and community medical centers in North Carolina
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2017-04) Gilchrist, Michael J.; Hobbs, Richard; Liles, E. Allen
Volunteerism is common in the United States, though less is known about volunteerism among medical professionals. We aimed to record and compare volunteer activities among hospitalists and non-hospitalists in academic and community centers.
Is it time for physician assistant (PA)/nurse practitioner (NP) hospital medicine residency training?
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2017-04) Naqvi, S. Hasan
The roles of non-physician providers, such as physician assistants (PA) and nurse practitioners (NP), are constantly evolving in the United States healthcare system. They are a vital part of many inpatient multi-disciplinary teams and their role is even more challenging on the busy hospitalist services. The demand for hospitalists is constantly increasing and the current supply of physicians has been unable to keep up with the increase in demand. Residents' now restricted duty hours and regulations have further widened the gap. With a record number of patients seeking healthcare, a reliance on mid-level providers has increased tremendously in the last few years.
Imaging modalities in acute ischemic stroke
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2017-04) Bhatia, Kunal; Newey, Christopher R.; Karthikeyan, Naresh; Nattanmai, Premkumar
As "time is brain", acute ischemic stroke is considered a medical emergency. With the introduction of thrombolytic therapy and availability of modern neuroimaging modalities, timely diagnosis of an ischemic lesion, exclusion of intracerebral hemorrhage, assessing the degree of brain injury, and evaluation of cerebral vasculature is necessary in acute stroke management. In this review we will highlight the importance of available imaging modalities used to assess patients with acute ischemic stroke.
A case of rapid-onset daptomycin-induced neutropenia
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2017-04) Lancaster, Jason W.; Vaudo, Christine E.; Singh, Satinder P.
A 75-year-old Caucasian woman was transferred to a tertiary academic medical center for management of a foul smelling, non-draining, unstageable sacral pressure ulcer. Upon admission, the patient's laboratory data was notable for a white blood cell count (WBC) of 14.90 x 10-3/[mu]L and absolute neutrophil count of 12.24 x 10-3 /[mu]L. After a complicated hospital course the patient was initiated on daptomycin 6 mg/kg (300 mg) daily in response to wound cultures detecting Enterococcus faecium susceptible only to daptomycin and linezolid. Starting 96 hours after daptomycin initiation, there was a profound reduction in the patient's WBC, reaching a nadir of 1.63 x 10-3 /[mu]L after 12 days of therapy. Prior to documented resolution of her blood dyscrasia the patient was transferred to hospice care and use of antimicrobial therapy was withdrawn. The Naranjo Adverse Drug Reaction Probability Score demonstrated a probable relationship (score equal to 6) between daptomycin and the development of neutropenia. Unlike previous reports of daptomycin-induced neutropenia and/or thrombocytopenia, where patients received prolonged courses of daptomycin with doses ranging from 6-10 mg/kg, this case describes a much more rapid onset of neutropenia that occurred at a dose of 6 mg/kg/day. This case reports highlights the risk for daptomycin to induce neutropenia in patients receiving traditional dosing, not just at higher doses, and within a shorter time-frame than previously documented. Healthcare providers should be cognizant of this adverse reaction, and diligent in monitoring for adverse events, associated with daptomycin use even when used for short courses or at traditional doses.

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