American journal of hospital medicine, volume 5, issue 1 (2021 January-March)https://hdl.handle.net/10355/850832024-03-29T06:39:13Z2024-03-29T06:39:13ZMissed opportunities : the case for inpatient lung cancer screeningJohnstone, JoeCovey, Andreahttps://hdl.handle.net/10355/850862021-10-18T18:59:55Z2021-01-01T00:00:00ZMissed opportunities : the case for inpatient lung cancer screening
Johnstone, Joe; Covey, Andrea
"Over the past twenty years, the hospitalist field has grown from an uncommon metropolitan profession to a ubiquitous, broad specialty focused on the rapidly evolving field of inpatient medicine 1. Hospitalists are no longer limited to acute medical conditions; the hospitalist in 2021 has an ever-broadening scope of practice and is increasingly seen as an expert in transitions of care, quality improvement, and high value medicine 2. Their role in public health is increasingly recognized by their work in infection control, antibiotic stewardship, addiction medicine, and smoking cessation to name a few. Hospitalists can continue their innovation and improve care by recommending and performing lung cancer screening (LCS). The coronavirus pandemic advanced the field of telehealth significantly and bundling of in-person services is the natural progression of this trend."
null
2021-01-01T00:00:00ZNon-Caucasian race, chronic opioid use and lack of insurance or public insurance were predictors of hospitalizations in cyclic vomiting syndromeKanagala, VikramBhandari, SanjayTaranukha, TatyanaRein, LisaBrazauskas, RutaVenkatesan, Thangamhttps://hdl.handle.net/10355/850872021-10-18T18:59:56Z2021-01-01T00:00:00ZNon-Caucasian race, chronic opioid use and lack of insurance or public insurance were predictors of hospitalizations in cyclic vomiting syndrome
Kanagala, Vikram; Bhandari, Sanjay; Taranukha, Tatyana; Rein, Lisa; Brazauskas, Ruta; Venkatesan, Thangam
"Cyclic vomiting syndrome (CVS) is a chronic disorder of gut brain interaction (DGBI) characterized by recurrent episodes of vomiting and is diagnosed with Rome criteria (1). CVS is treated with prophylactic medications such as amitriptyline, which is considered first-line therapy (2, 3). This reduces the frequency of emergency department (ED) visits and hospitalizations (2). However, patients continue to be hospitalized for acute CVS flares. Reasons for CVS-related hospitalizations in these patients are unknown. Multiple causes such as disparities in access to health care, chronic opioid use and chronic marijuana use have been purported (4-6). Hospitalizations in CVS have serious social and economic consequences. They can result in reduced productivity (workdays lost, job loss), and sometimes social problems like divorce (8, 9). In a study using the Nationwide Inpatient Sample, total hospital charges incurred in CVS-related hospitalizations were ~$400 million in 2 years (10). It is crucial to understand risk factors for hospitalizations given the significant impact of CVS on patients and the health care system. The primary aim of our study was to determine risk factors for CVS-related hospitalizations and length of stay (LOS) in patients with CVS. We hypothesized that history of psychiatric comorbidity, chronic opioid use, lack of insurance and African American (AA) ethnicity would increase the risk of hospitalizations."--Introduction.
null
2021-01-01T00:00:00ZPyogenic liver abscess and gastrointestinal lemierre syndrome due to fusobacterium nucleatumHitchcock, NicoleNelson, Taylor B.https://hdl.handle.net/10355/850842021-10-18T18:59:55Z2021-01-01T00:00:00ZPyogenic liver abscess and gastrointestinal lemierre syndrome due to fusobacterium nucleatum
Hitchcock, Nicole; Nelson, Taylor B.
Pyogenic liver abscess (PLA) affects men disproportionately to women and is occurring with increasing incidence. The mortality associated with PLA nears 15% in the Western world. PLA constitutes a significant number of total liver abscesses and can rarely be caused by the gram-negative bacilli, Fusobacterium. Virulent strains of Fusobacterium have been described as a rare cause of thrombophlebitis and metastatic abscesses. Fusobacterium necrophorum is specifically implicated in the development of Lemierre syndrome (LS) which comprises periodontal abscess and internal jugular vein thrombosis. Similar infection involving intra-abdominal abscess and abdominal vessel thrombosis suggests a gastrointestinal (GI) variant of LS. We describe a case of liver abscesses and hepatic vein septic thrombosis due to Fusobacterium nucleatum in a healthy adult male patient without significant risk factors.
null
2021-01-01T00:00:00ZVoriconazole-induced PeriostitisWilden, AnaBran, Andreshttps://hdl.handle.net/10355/850852021-10-18T18:59:55Z2021-01-01T00:00:00ZVoriconazole-induced Periostitis
Wilden, Ana; Bran, Andres
"CASE: A woman in her 60s presented with complaints of severe multifocal bone pain, including the shoulders, sternum, and hips, which had persisted for several months. Two years earlier, the patient had undergone heart transplant for ischemic cardiomyopathy. She had a history of post-transplant AKI on CKD, hypertension, hyperlipidemia, osteoporosis, hypothyroidism and COPD. She was on maintenance immunosuppression with azathioprine, tacrolimus and prednisone. She was on voriconazole for chronic suppression of Bipolaris sp. mediastinitis diagnosed shortly after transplantation and had remained on the antifungal. The patient reported bone pain and a lump on the left clavicle that was palpable on physical examination. Radiograph of the left clavicle can be seen below (Figure 1). Laboratory values demonstrated an elevated creatinine (2.28mg/dL), BUN (35 mg/dL), TSH (2.77 mcunit/mL), alkaline phosphatase (616 units/L), ALT (62 units/L), and AST (67 units/L).
null
2021-01-01T00:00:00Z