American journal of hospital medicine, volume 8, issue 3 (2024 July-Sept)

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https://hdl.handle.net/10355/107862

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    Turmeric-induced liver injury in a patient with concurrent semaglutide use
    (University of Missouri, Department of Medicine, Division of Hospital Medicine, 2024-09) Zhang, Emily; Poltiyelova, Elona; Rezvani, Mitra
    Turmeric has surged in popularity as one of the most widely used dietary supplements in the United States. Recognized for its anti- inflammatory and antioxidant properties, it has traditionally been regarded as safe. Recent literature and reports in LiverTox have documented over a dozen cases of acute liver injury associated with the use of turmeric supplements. However, potential drug interactions with turmeric have been described but not well-documented. Thus, we present a case of drug-induced liver injury (DILI) correlated with turmeric supplement use and the concurrent use of semaglutide.
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    Quantifying time from medical clearance to psychiatric placement in hospitalized patients
    (University of Missouri, Department of Medicine, Division of Hospital Medicine, 2024-09) Lipten, Samuel; Jernigan, Michael; Verma, Ritchie; MacLean, Rachel; Tucker, Tyler; Moore, Amber
    Introduction: Patients presenting to the hospital with active psychiatric illness often have concurrent general medical conditions requiring medical clearance before transfer to a psychiatric facility. There may be a time lag from medical clearance to psychiatric placement which could have implications for patient care and hospital capacity constraints. Materials and Methods: We performed a chart review for 106 patients at an academic medical center from June through December of 2020 to determine this time from medical clearance to psychiatric placement (TMCPP). Results: The average TMCPP was 2.1 days with a range of 0 to 13 days, with aggregate time spent awaiting discharge during the 7- month study of 220 days. Conclusion: These delays may contribute to emergency department overcrowding and ultimately result in delays in care across the health care system.
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    OPAT and the hospitalist : a short review on the IDSA recommendations and practice
    (University of Missouri, Department of Medicine, Division of Hospital Medicine, 2024-09) Enyew, Alelegn; Mishra, Prashant; Husain, Mir A
    Infectious Disease Society of America defines OPAT as administration of parenteral antimicrobial therapy in at least 2 doses on different days without intervening hospitalization. The first description of successful administration of OPAT was published in 1974, where the safety and efficacy of its use to treat chronic bronchopulmonary infections in children with cystic fibrosis was reported.1 OPAT has developed and passed through different refinements since then. The Infectious Disease Society of America recommends all patients should have an ID expert review prior to initiation of OPAT. This recommendation is a strong recommendation with very low-quality evidence. With the increasing burden on the ID consultation service, a valid question to answer is whether a hospitalist led OPAT management should be an option especially in short duration OPAT of a week or less. In this short review we will try to review the available data behind the recommendations of IDSA and we will also review OPAT practice in a few other countries.
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    Comparison of hospital-at-home and in-hospital hospitalizations of randomized controlled studies – a systematic review and meta-analysis
    (University of Missouri, Department of Medicine, Division of Hospital Medicine, 2024-09) Niv, Yaron
    Background: Several studies demonstrated clinical and economic benefits of hospital-at- home (HaH), but using different methods, study groups, and indications, the results are unequivocal. Our systematic review and meta-analysis include only randomized- controlled studies comparing outcomes of HaH with those of regular in-patient hospitalizations. Aim: To compare outcomes of HaH with those of regular hospitalization. Methods: English Medical literature searches were conducted for Hospital-at- Home compared to In-Hospital hospitalization in randomized, controlled studies (RCTs). Searches were performed in PubMed, EMBASE, Scopus, and CENTRAL. Meta-analysis was performed and pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated. Heterogeneity was evaluated and I2 statistic was used to measure the proportion of inconsistency in individual studies. We also calculated a potential publication bias. Results: 14 randomized controlled studies representing 43 sub-studies were selected according to the inclusion criteria. The odds ratio of "hospital-at-home" and "in-hospital" comparison was 0.638 95% CI 0.512 to 0.796. In the issues of clinical outcomes, HaH was found to be non-inferior than a regular hospital, but much better in patient preference with OR 0.396 95% CI 0.277 to 0.566 for worse outcomes. Heterogeneity and inconsistency were small, with no significant publication bias. Conclusion: This meta-analysis showed that HaH may be recommended for patient hospitalization when needed, according to the specific indications and patients matching to HaH criteria.