Hospital practice最新文献

{"title":"Benign acute myositis in an adult: case-based review.","authors":"N. Kazi, M. Mehmed, X. Chen, O. Asya, D. Sarma, P. Hnynnsi, Ah Abdelhafiz","doi":"10.1080/21548331.2024.2357508","DOIUrl":"https://doi.org/10.1080/21548331.2024.2357508","url":null,"abstract":"Myositis is a clinical condition with a wide spectrum of clinical presentation. We present the case of 33 years old woman with acute history of pain and swelling of both legs. Investigations confirmed acute bilateral myositis of both calf muscles. She responded well to conservative management with full recovery. Benign acute myositis is more common in children and usually follows viral infection. Although our case may represent an adult form of benign acute childhood myositis, she had no history of preceding infections. Benign acute myositis is increasingly reported in adults. It appears to be self-limited with spontaneous full recovery. The diagnosis is largely based on clinical features. Therefore, clinicians should be aware of this type of myositis to avoid unnecessary invasive investigations.","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"43 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140964732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospitalists' COVID-19 management roles in hospitals without infectious disease specialists.","authors":"Toru Morikawa, Taiju Miyagami, Masayuki Nogi, Toshio Naito","doi":"10.1080/21548331.2024.2337614","DOIUrl":"https://doi.org/10.1080/21548331.2024.2337614","url":null,"abstract":"BACKGROUND\u0000Hospitalists may work in a variety of clinical settings to manage COVID-19 cases. However, the extent of their involvement in COVID-19 care is unknown, particularly in hospitals without infectious disease (ID) specialists.\u0000\u0000\u0000METHODS\u0000This study aimed to confirm whether hospitalists provided COVID-19 management in various clinical settings when ID specialists were unavailable. We conducted a multicenter cross-sectional study using a web-based questionnaire. The participants were full-time hospitalists working in Japanese academic community-based hospitals. The study period was from 15 January 2021 to 15 February 2021, during Japan's third wave of the COVID-19 pandemic. The primary outcome was the rate of hospitalists participating in COVID-19 inpatient management in hospitals with or without ID specialists.\u0000\u0000\u0000RESULTS\u0000ID specialists were absent in 31% of small hospitals (those with fewer than 249 registered beds), but only 4% of large hospitals (p < 0.001). Hospitalists were more likely to manage both COVID-19 inpatient care and emergency department care in hospitals without than with hospitals with ID specialists (76 versus 56% (p = 0.01) and 90 versus 73% (p = 0.01), respectively). After adjusting for confounders by multivariate analysis, hospitalists who worked in hospitals without ID specialists had higher odds of participating in COVID-19 inpatient care than those who worked in hospitals with such specialists (adjusted odds ratio: 3.0, 95% CI: 1.2-7.4).\u0000\u0000\u0000CONCLUSION\u0000Hospitalists were more likely to provide COVID-19 inpatient care in various clinical settings in hospitals without ID specialists.","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"112 4","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2024-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140747148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac rehabilitation.","authors":"S. Grace, Rod S. Taylor, D. Gaalema, J. Redfern, K. Kotseva, Gabriela L. M. Ghisi","doi":"10.4135/9781412994149.n63","DOIUrl":"https://doi.org/10.4135/9781412994149.n63","url":null,"abstract":"","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"23 1A 1","pages":"16, 23, 26-8 passim"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70554706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of SARS-CoV-2 variants B.1.617: host tropism, proteolytic activation, cell-cell fusion, and neutralization sensitivity.","authors":"Li Zhang, Qianqian Li, Jiajing Wu, Yuanling Yu, Yue Zhang, Jianhui Nie, Ziteng Liang, Zhimin Cui, Shuo Liu, Haixin Wang, Ruxia Ding, Fei Jiang, Tao Li, Lingling Nie, Qiong Lu, Jiayi Li, Lili Qin, Yinan Jiang, Yi Shi, Wenbo Xu, Weijin Huang, Youchun Wang","doi":"10.1080/22221751.2022.2054369","DOIUrl":"10.1080/22221751.2022.2054369","url":null,"abstract":"<p><p>SARS-CoV-2 has caused the COVID-19 pandemic. B.1.617 variants (including Kappa and Delta) have been transmitted rapidly in India. The transmissibility, pathogenicity, and neutralization characteristics of these variants have received considerable interest. In this study, 22 pseudotyped viruses were constructed for B.1.617 variants and their corresponding single amino acid mutations. B.1.617 variants did not exhibit significant enhanced infectivity in human cells, but mutations T478K and E484Q in the receptor binding domain led to enhanced infectivity in mouse ACE2-overexpressing cells. Furin activities were slightly increased against B.1.617 variants and cell-cell fusion after infection of B.1.617 variants were enhanced. Furthermore, B.1.617 variants escaped neutralization by several mAbs, mainly because of mutations L452R, T478K, and E484Q in the receptor binding domain. The neutralization activities of sera from convalescent patients, inactivated vaccine-immunized volunteers, adenovirus vaccine-immunized volunteers, and SARS-CoV-2 immunized animals against pseudotyped B.1.617 variants were reduced by approximately twofold, compared with the D614G variant.</p>","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"9 1","pages":"1024-1036"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9004538/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82082610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How could perioperative anxiety be addressed via surgical team communication approaches? Findings from a scoping review.","authors":"Mariana-Denisa Petrescu, Florian Popa, Victor-Lorin Purcărea","doi":"10.1080/21548331.2022.2059979","DOIUrl":"10.1080/21548331.2022.2059979","url":null,"abstract":"<p><strong>Objectives: </strong>Surgical patients and their families experience high rates of perioperative anxiety, which determine a negative impact on their surgery-related outcomes. Understanding what communicational aspects positively impact perioperative anxiety may help promote more efficient, patient-centered communication approaches which could address this issue. The aim of this scoping review was to synthesize published research on communication between surgical employees and adult patients and their relatives, and its role in managing perioperative anxiety.</p><p><strong>Methods: </strong>A scoping review approach was used across four international databases to search for publications detailing communicational interventions and approaches employed in surgical contexts and their impact on surgical patients' and their caregivers' perioperative anxiety levels. Results were narratively synthesized.</p><p><strong>Results: </strong>Twenty-two studies were included in this scoping review, which were grouped according to their communication intervention into one of five categories: technology-assisted interventions, interpersonal communication, educational programs, tools for facilitating exchange of information and theory-derived communication strategies. Records reported mixed results in terms of reducing perioperative anxiety. Facilitating and hindering factors in interpersonal communication in this context were further synthesized.</p><p><strong>Conclusion: </strong>A multitude of communicational approaches and their effect on anxiety have been investigated within surgical settings, with varying results. Existing evidence suggests that it is vital to address surgical patients' anxiety through personalized empathetic communication, tailored to an individual's case, preferences, and needs. Key aspects of patient-healthcare professional communication which may impact perioperative anxiety were identified and may be utilized in future trainings for communication skills among surgical teams.</p>","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"50 1","pages":"159-169"},"PeriodicalIF":0.0,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46643371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"COVID-19 and alcohol use disorder: putative differential gene expression patterns that might be associated with neurological complications","authors":"J. Muhammad, R. Siddiqui, N. Khan","doi":"10.1080/21548331.2022.2088183","DOIUrl":"https://doi.org/10.1080/21548331.2022.2088183","url":null,"abstract":"ABSTRACT Background Several lines of evidence suggest that SARS-CoV-2 invasion of the central nervous system leads to meningitis and encephalopathy syndromes. Additionally, chronic alcoholics were found to be at a higher risk of developing mental health problems and serious neurological manifestations, if exposed to SARS-CoV-2 infection. Methods Herein, we studied RNA seq data from alcoholics’ brain tissue and COVID-19 patient’s brain tissue to identify the common differentially expressed genes. Results Overlap analysis depicted the expression of seven genes (GHRL, SLN, VGF, IL1RL1, NPTX2, PDYN, and RPRML) that were significantly upregulated in both groups. Along with these, protein–protein interaction analysis revealed 10 other key molecules with strong interactions with the aforementioned genes. Conclusions Taken together with the functional effect of these genes, we suggest a strong molecular link between COVID-19-induced severities and neurological impairment in patients suffering from alcohol abuse disorder. These findings emphasize the importance of identifying chronic alcoholism as a risk factor for developing cognitive and memory impairment in COVID-19 patients. GRAPHICAL ABSTRACT","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"50 1","pages":"189 - 195"},"PeriodicalIF":0.0,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45433465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A multidisciplinary approach to heart failure care in the hospital: improving the patient journey","authors":"Vijay U. Rao, A. Bhasin, Jesus Vargas, Vijaya Arun Kumar","doi":"10.1080/21548331.2022.2082776","DOIUrl":"https://doi.org/10.1080/21548331.2022.2082776","url":null,"abstract":"ABSTRACT Background Despite advancements in care for patients with heart failure (HF), morbidity and mortality remain high. Hospitalizations and readmissions for HF have been the focus of significant attention among health care providers and payers, with an eye toward reducing health care costs. However, considerable variability exists with regard to inpatient workflows and management for patients with HF, which represents a significant opportunity to improve care. Objective Here we provide a summary of optimal inpatient management strategies for HF, focusing on the multidisciplinary team of emergency medicine providers, admitting hospitalists, cardiovascular consultants, pharmacists, nurses, and social workers. Methods The patient journey serves as the template for this review article, from the initial presentation in the emergency department, to decongestion and stabilization, optimization of guideline-directed medical therapy, and discharge and appropriate disposition. Conclusion This review aims not to be proscriptive but rather to provide best practices that are clinically relevant and actionable, with the goal of improving care for patients during the sentinel hospitalization for HF.","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"50 1","pages":"170 - 182"},"PeriodicalIF":0.0,"publicationDate":"2022-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43314327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends, outcomes, and management of acute myocardial infarction in patients with chronic viral hepatitis","authors":"Akshay Machanahalli Balakrishna, Mahmoud Ismayl, D. Butt, F. Niu, Azka Latif, A. Arouni","doi":"10.1080/21548331.2022.2072314","DOIUrl":"https://doi.org/10.1080/21548331.2022.2072314","url":null,"abstract":"ABSTRACT Objectives There is a paucity of data on the management and outcomes of chronic viral hepatitis (CVH) patients [including chronic hepatitis B (CHB) and chronic hepatitis C (CHC)] presenting with acute myocardial infarction (AMI). Methods We utilized the National Inpatient Sample database (2001–2019) and studied the management and outcomes of CVH patients with AMI and stratified them by subtypes of CVH. The adjusted odds ratio (aOR) of adverse outcomes in CVH groups were compared to no-CVH groups using multivariable logistic regression. Results Of 18,794,686 AMI admissions, 84,147 (0.45%) had a CVH diagnosis. CVH patients had increased odds of adverse outcomes including in-hospital mortality (aOR 1.40, 95%CI 1.31–1.49, p < 0.05), respiratory failure (1.11, 95%CI 1.04–1.17, p < 0.001), vascular complications (1.09, 95%CI 1.04–1.15, p < 0.001), acute kidney injury (1.36, 95%CI 1.30–1.42, p < 0.001), gastrointestinal bleeding (1.57, 95%CI 1.50–1.68, p < 0.001), cardiogenic shock (1.44, 95%CI 1.04–1.30, p < 0.001), sepsis (1.24, 95%CI 1.17–1.31, p < 0.001), and were less likely to undergo invasive management. On subgroup analysis, CHB had higher odds of adverse outcomes than the CHC group (p < 0.05). Conclusion CVH patients presenting with AMI are associated with worse clinical outcomes. CHB subgroup had worse outcomes compared to the CHC subgroup.","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"50 1","pages":"236 - 243"},"PeriodicalIF":0.0,"publicationDate":"2022-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43485525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac auscultation predicts mortality in elderly patients admitted for COVID-19","authors":"N. Roig-Marín, P. Roig-Rico","doi":"10.1080/21548331.2022.2069772","DOIUrl":"https://doi.org/10.1080/21548331.2022.2069772","url":null,"abstract":"ABSTRACT Introduction COVID-19 has had a great impact on the elderly population. All admitted patients underwent cardiac auscultation at the Emergency Department. However, to our knowledge, there is no literature that explains the implications of cardiac auscultation at the Emergency Department. Material and methods Data collection from our hospital records. Our cohort consists of 300 admissions with a mean age of 81.6 years and 50.7% men. Results Pathological cardiac auscultation at the Emergency Department was a risk factor for in-hospital mortality (RR = 1.9; 95% CI 1.3–2.8), heart failure (RR = 3.2; 95% CI = 1.8–5.6), respiratory failure (RR = 1.8; 95% CI = 1.3–2.5), acute kidney injury (RR = 2.6; 95% CI = 2–3.2), and ICU admission (RR = 3.3; 95% CI = 1.3–8.2). The findings in patients with pathological cardiac auscultation were that oxygen saturation in the Emergency Department, arterial pH, and HCO3− were significantly lower, and the ALT/GPT, LDH, and lactate determinations were significantly higher, which is compatible and correlates with the fact that the main variable is indeed a risk factor for a more severe clinical course. Among the findings from pathological auscultation, arrhythmic tone/arrhythmia was the most frequent (50%) and a risk factor for in-hospital mortality (RR = 2.3; 95% CI = 1.6–3.4). Logistic regression was performed from a multivariate analysis that showed that the initial ex novo arrhythmia correlated with pathological cardiac auscultation is an independent risk factor for in-hospital mortality. Conclusion Continuous rhythm monitoring makes it possible to detect ex novo arrhythmias and act proactively, and to offer greater care and attention to these patients who have a higher risk of in-hospital mortality and a worse prognosis. Cardiac auscultation can alert us in order to perform more electrocardiograms in these patients and thus have better monitoring.","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"50 1","pages":"228 - 235"},"PeriodicalIF":0.0,"publicationDate":"2022-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45690221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rational use of antibiotics and covariates of clinical outcomes in patients admitted to intensive care units of a tertiary hospital in Kenya","authors":"Babra Ligogo Murila, D. Nyamu, Rosaline Kinuthia, P. Njogu","doi":"10.1080/21548331.2022.2054632","DOIUrl":"https://doi.org/10.1080/21548331.2022.2054632","url":null,"abstract":"ABSTRACT Objectives Rational use of antibiotics implies appropriate choice of an antibiotic administered at correct dose, frequency, and duration using the most suitable route of administration. Irrational antibiotics use is associated with antimicrobial resistance, drug failure, and high mortality in the critical care units (CCUs). This study sought to establish rational use of antibiotics and determinants of clinical outcomes of patients admitted to the CCUs at the Kenyatta National Hospital (KNH). The findings would guide policy formulation of antibiotics use in hospital CCUs in Kenya and the region. Methods Retrospective review of 220 admissions to the KNH CCUs over the period February 2018–February 2020 was conducted. Participants’ sociodemographics, clinical characteristics, antibiotics therapy, and outcome of admission were extracted from patient files and analyzed using STATA version 23. Determinants of irrational antibiotic use and covariates of clinical outcomes were computed at 95% confidence. Results The prevalence of rational use of antibiotics was only 18.5%. Inappropriate choice of antibiotics (51.0%) and incorrect duration (32.3%) were the most common irrational practices. Flucloxacillin (100%), cefuroxime (93.3%), cefazolin (85.7%), and ceftriaxone (83.0%) were the most irrationally used antibiotics. Irrational use of ceftriaxone was significantly associated with clinical diagnosis (p = 0.012), while that of amoxiclav was associated with patient risk category (p = 0.039). Mortality in the CCUs was 10%, and the odds of dying were almost six times among intubated patients compared to those who were not (AOR 5.5, 95% CI = 1.1–28.1, p = 0.042). Conclusion Irrational antibiotics prescribing is high in the KNH CCUs, attributable largely to incorrect choice and wrong duration of antibiotic use. Mortality was significantly associated with intubation. Intensification of management in critical care settings should be directed toward intubated patients while ensuring appropriate choice of antibiotics administered for the correct duration. Future studies should explore factors that could promote rational antibiotics use in critical care settings. Plain language summary Background Antibiotics are important in the management of infections. Therefore, they should be used properly as guided by the 5Rs of antimicrobials use, namely, right choice of antibiotic for a particular disease, administered at the right dose, for the right duration, at the right frequency via the right route of administration. Aim We sought to establish the extent to which the use of antibiotics adheres to the established guidelines in the treatment and prevention of infections among patients admitted to intensive care units (ICUs) of Kenyatta National Hospital (KNH), Kenya. Methods We reviewed and analyzed medical records of 220 patients admitted in the KNH ICUs in the period between February 2018 and February 2020. Findings Antibiotics were used properly in only 18.5% of","PeriodicalId":75913,"journal":{"name":"Hospital practice","volume":"50 1","pages":"151 - 158"},"PeriodicalIF":0.0,"publicationDate":"2022-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43265313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}