Tag Archives: hospital medicine

A Pictorial Essay of Immunotherapy: Complications that Internists Will See, Whether They Like it or Not

Delirium is highly prevalent in hospitalized patients and is a strong and consistent negative predictor of length of stay, mortality, and long-term cognitive outcomes.1 Symptoms commonly associated with delirium include reduced ability to focus, sleep disturbances, psychomotor agitation, and emotional disturbances. The management of the behavioral disturbances of delirium is challenging. Although non-pharmacologic means to reduce […]

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Intra-Abdominal Varix Rupture: A Life-Threatening Cause of Hemoperitoneum

A 54-year-old male with decompensated alcoholic cirrhosis presented after a syncopal event and ground-level fall. Initial examination noted a distended abdomen without overlying bruising. At admission, his hemoglobin was 6.3 g/dL from a baseline of 8-10 g/dL. A computed tomography scan of the abdomen was notable for “complex ascites” adjacent to his liver concerning for […]

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From Evidence Based Medicine to Medicine Based Evidence

Evidence based medicine, using randomized controlled trials and meta-analyses as the major tools and sources of evidence about average results for heterogeneous groups of patients, developed as a reaction against poorly designed observational treatment research and physician reliance on personal experience with other patients as a guide to decision-making about a patient at hand. However, […]

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Mindfulness-Based Laboratory Reduction: Reducing Utilization Through Trainee-Led Daily ‘Time Outs’

Overuse of laboratory investigations is widely prevalent in hospitalized patients, leads to discomfort, and increases direct and indirect costs. Objective We implemented a simple, inexpensive, mindfulness strategy on our inpatient medical clinical teaching unit to reduce unnecessary laboratory orders through education, a forcing function, and daily structured laboratory “time outs.” Methods On a 26-bed unit […]

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Trends of Cannabis Use Disorder Among Inpatients (video)

As states legalize medical and recreational use of marijuana, hospitals are seeing an increase in inpatients who are marijuana users. The most common co-morbidities among marijuana users are psychiatric disease and alcoholism. There has been an increase in older, sicker patients using cannabis, most likely due to the advent of medical marijuana in many states. […]

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The New Trend in Medicine

During the 4 decades of my clinical training and practice of medicine, I always felt a sense of ownership and full responsibility in caring for my patients. What I have noticed over the past decade is a gradual transformation in our health care delivery system and in the attitude of our trainees. Hospitals are being governed […]

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