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ECG dilemma
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2017-04)
ID corner
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2017-04)
Ask a pathologist
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2017-04)
Question and answer regarding a patient who became acutely thrombocytopenic.
Clostridium difficile infection : considerations for hospitalists
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2017-04)
As hospitalists, we often care for patients who either present with diarrhea or develop diarrhea during their hospital visit. We have learned to think of Clostridium difficile infection (CDI) early. In the United States, administrative data...
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)
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 ...
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)
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 ...
Importance of HIV screening
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2019-04)
"Although it can be challenging to think about screenings while trying to fix potentially life-threatening conditions, hospitalists need to actively screen for HIV infection. According to the Centers for Disease Control and Prevention (CDC), 1.1...
Ask a pathologist
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2014-04)
This is a response to the question: I heard there is going to be a shortage of FFP [universal donor type AB plasma] from the American Red Cross during the next few months. What should I do when I need to urgently reverse anticoagulation in patients...
Atypical hemolytic uremic syndrome : when the environment and mutations affect organ systems. A case report with review of literature
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2017-04)
Atypical hemolytic uremic syndrome (aHUS) is a rare thrombotic microangiopathy (TMA) with a genetic predisposition. Like other TMAs, it presents clinically with thrombocytopenia and microangiopathic hemolytic anemia, which ...
New Clostridium difficile infection guidelines : Pearls for the hospitalist
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2018-04)
Clinical vignette: A 40 year-old female with no significant past medical history had a 3-day history of runny nose, headache, cough and post-nasal drip. Her physical exam showed erythematous pharyngeal wall but it was ...
Feasibility of performing apnea test in a brain dead patient on veno-venous extracorporeal membrane oxygenation (ECMO)
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2017-07)
Extracorporeal membrane oxygenation (ECMO) is being increasingly used to provide support in patients with refractory cardiopulmonary distress syndromes. Neurological sequelae, either from the ECMO or the hypoxic/hypotensive ...
Review Article : Neuromuscular causes of weakness in critically ill patients
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2017-07)
Multiple predisposing factors are responsible for the development of neuromuscular weakness in a critically ill patient. Thorough history and physical examination is paramount and should not be omitted despite that the ...
Gabapentin and buprenorphine nasal insufflation in a patient on buprenorphine for opiod use disorder
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2019-04)
Upon introduction into the market, gabapentin was not thought to be a drug with abuse potential. Newer research is showing this to be possible, especially in the population of patients with a history of opioid addiction. ...
Hydromorphone precipitating serotonin syndrome
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2018-04)
Opioid medications are an underappreciated cause of serotonin syndrome. Fentanyl, meperidine, and methadone are more commonly associated with this potentially life-threatening side effect. Here, we present the case of a ...
A case of rapid-onset daptomycin-induced neutropenia
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2017-04)
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...
Imaging modalities in acute ischemic stroke
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2017-04)
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 ...
In pursuit of happiness : Creation of an academic hospitalist wellness committee and well-being survey
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2018-04)
Physician burnout poses a critical threat to the delivery of healthcare. A solution to this problem is a leadership imperative. Managing demands on physicians can prevent burnout and foster engagement. This study assesses ...
Alcoholic hepatitis
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2018-04)
use. Alcohol is the leading cause of liver disease in the world and the third most common cause of preventable death in the United States (1, 2). This goes to show that alcohol use is a major problem and the clinical diseases that arise from its use...
Impact of an Inpatient Diabetes Consulting Service on Post Discharge Glycemic Control
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2019-07)
"Diabetes mellitus has been estimated to affect 30 million Americans in 2015 with an increasing prevalence every year 1. In addition, patients with diabetes have up to a 3-fold increased risk of hospitalization 2. The health care cost for a person...
Are there predictive pupillometry markers in determining external ventricular device (EVD) weaning failure or success in subarachnoid hemorrhage patients?
(University of Missouri, Department of Medicine, Division of Hospital Medicine, 2018-04)
in cerebrospinal fluid (CSF) volume, such as during external ventricular device (EVD) weaning in aneurysmal subarachnoid hemorrhage (aSAH) patients. This pilot study evaluated if changes in pupillary responses could be predictive of EVD weaning failure in a...