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Meetings Archive For Hospital Medicine 2010, April 8-11, Washington, D.C...

Abstract Number: 10
Comparative Effectiveness of Continuous‐Infusion with Intermittent Bolus Loop Diuretic Therapy in Patients with Acute Decompensated Congestive Heart Failure
Hospital Medicine 2010, April 8-11, Washington, D.C.
Background: For treatment of acute decompensated congestive heart failure (CHF), intravenous loop diuretics are usually administered as intermittent bolus injections. However, these bolus injections can cause significant hemodynamic effects because of fluctuations in intravascular volume, urine output, and serum electrolytes. Continuous infusion of loop diuretics may have similar or greater diuresis without adverse hemodynamic effects. […]
Abstract Number: 11
Methylnaltrexone for Opioid‐lnduced Constipation During Rehabilitation Following Orthopedic Procedures: A Double‐Blind, Randomized Clinical Study
Hospital Medicine 2010, April 8-11, Washington, D.C.
Background: Methylnaltrexone, a quaternary derivative of naltrexone, is a peripheral mu‐opioid receptor antagonist recently approved for the treatment of opioid‐induced constipation (OIC) in patients with advanced illness who are receiving palliative care when response to laxative therapy has not been sufficient. The aim of this study was to assess the efficacy of subcutaneous (SC) methylnaltrexone […]
Abstract Number: 12
Individual Quality Reporting: Should the Discharging Physician Carry All the Risk?
Hospital Medicine 2010, April 8-11, Washington, D.C.
Background: Measuring health care quality is increasingly important. Reliably assessing quality requires a review of the care provided and linking the care to a provider. Payers, patients, and regulators have access to quality reporting at the institutional level. There is a movement toward providing measures for individual providers. For hospitalized patients, these measures are usually […]
Abstract Number: 13
Systematic Review of Resident Workload and Work Activity: Impact on Resident Education and Patient Care
Hospital Medicine 2010, April 8-11, Washington, D.C.
Background: As further limits in resident duty hours are considered, anecdotes of detrimental effects of work intensification (same amount of work in less time) and the continued reliance on residents for tasks of limited educational value (“scut”) are prominent. The aim of this study was to systematically review the literature to examine how residents spend […]
Abstract Number: 14
Thoracentesis; A Critical Analysis of Urban Legends
Hospital Medicine 2010, April 8-11, Washington, D.C.
Background: Thoracentesis is a relatively safe procedure. Despite a lack of supporting evidence, common assumptions regarding safety guidelines include: (1) limit fluid removal to < 1.5 L; (2) avoid bilateral procedures; (3) do not tap patients on positive‐pressure ventilation (intubated or on Bi‐PAP); and (4) routinely obtain a postprocedure chest x‐ray. To assess the legitimacy of these […]
Abstract Number: 15
Repeat Thoracenteses: To Talc or Not to Talc?
Hospital Medicine 2010, April 8-11, Washington, D.C.
Background: Thoracentesis is a commonly performed procedure to remove fluid from the pleural space. When repeat thoracenteses are required, patients are often referred to thoracic surgery to undergo more definitive treatment in the form of pleurodesis (talc) or Pleur‐X catheter placement. However, these procedures carry significant morbidity, and not all patients are well suited to […]
Abstract Number: 16
The Wells Rule Accurately Excludes Pulmonary Embolus in Hospitalized Patients on Heparin Prophylaxis
Hospital Medicine 2010, April 8-11, Washington, D.C.
Background: The Wells rule is commonly used when investigating suspected pulmonary embolism (PE), but its effectiveness when applied to hospitalized patients receiving prophylactic anticoagulation is not known. To explore the utility of the Wells rule in this cohort, we conducted a retrospective, observational study of inpatients who underwent chest computed tomography (CT) for a concern […]
Abstract Number: 17
Clinical Characteristics of Infective Endocarditis in Hemodialysis Versus Nonhemodialysis Patients
Hospital Medicine 2010, April 8-11, Washington, D.C.
Background: Infective endocarditis (IE) has been recognized as a complication of hemodialysis (HD) since 1966. The incidence is estimated to be 308 per 100.000 patients year, which is 50‐ to 180‐fold higher than the 1.7‐6.2 cases per 100,000 patient‐years reported for the general population. Risk factors for the development of IE are frequent episodes of […]
Abstract Number: 18
Management of Postoperative Pain in Elective Hip and Knee Arthroplasty Surgery
Hospital Medicine 2010, April 8-11, Washington, D.C.
Background: Hip and knee arthroplasty surgeries are among the most painful surgical procedures, with half of patients reporting severe postoperative pain, Unrelieved postoperative pain is associated with diminished rehabilitation, delirium, disrupted sleep, and slower healing, The American Pain Society has published guidelines for optimal postoperative pain control, which many studies define as a pain score […]
Abstract Number: 19
Unplanned Intensive Care Unit Transfers: A Useful Tool to Improve Quality of Care
Hospital Medicine 2010, April 8-11, Washington, D.C.
Background: Whether an unplanned intensive care unit transfer (UICUT) results from an error in care and whether these transfers can be prevented has not been previously investigated. We sought to determine the causes of UlCUTs of patients to a medical ICU, whether they resulted from errors in care, and when clinical deterioration was noted, whether […]