Background: Hospitalized patients with advanced illness often encounter constipation when receiving treatment for pain. Methylnaltrexone (MNTX, Relistor®) is a peripherally acting μ-opioid receptor antagonist used to treat opioid-induced constipation (OIC), which does not affect opioid central analgesia. This post hoc analysis evaluated cumulative laxation response rates in adults with advanced illness and laxative refractory OIC [...]

Background: Myelofibrosis is a chronic myeloproliferative neoplasm characterized by progressive bone marrow fibrosis and extramedullary hematopoiesis leading to splenomegaly. Progressive splenomegaly is common in advanced myelofibrosis, and spleen volume is a predictor of survival. The oral selective small-molecule JAK 1/2 inhibitor ruxolitinib is used for symptomatic management of intermediate-2 and high-risk myelofibrosis, and leads to [...]

Background: Telemetry beyond 48 hours is indicated for a select patient population and when used inappropriately has risk. This includes increased cost of care, skin irritation, delirium contribution, and more likely to have false positives resulting in errors or extending length of stay.To encourage care that is truly necessary, free of harm, not duplicative, and [...]

Background: The tumor microenvironment and its interaction with the tumor are indicative of disease progression but has not been clinically applied due to the lack of objective assessment criteria. Proximity associated effects of the tumor to its microenvironment which can explain the long-term behavior of tumor remains to be developed. In this work, we utilized [...]

Background: Self-reported penicillin (PCN) allergy affects 7-10% of the community population and affects almost 20% of hospitalized patients nationally [1,2]. Mislabeling of side effects (gastrointestinal symptoms) or coincidental events (headache) as a true allergic reaction (IgE-mediated type I hypersensitivity) contributes largely to statistics. In recent studies, the rate of positive skin test results to PCN [...]

Background: Current guidelines recommend oral (PO) medications as first line therapy for management of hypertensive urgency. However, patients without end-organ damage who are symptomatic or have extremely high blood pressure (BP) may be classified as either “hypertensive urgency” or “emergency” by treating physicians.Objective: In a cohort of hospitalized patients with severe hypertension but no organ [...]

Background: Hospitalist have not previously had a primary role in the setting of eating disorders beyond stabilization in an acute care setting. Following stabilization, patients in need of further treatment are transferred to an eating disorder facility. While in inpatient or residential care for their eating disorder, patient are monitored by physicians or mid-level providers. [...]

Background: There is a paucity of literature examining length of stay for medical patients requiring discharge to subacute rehabilitation facilities (SAR). At our institution, this subset of patients had an average length of stay (ALOS) of 8.2 days while medical patients being discharged to home had ALOS of 4.2 days during the first half of [...]

Background: Intravenous (IV) anti-hypertensive medications such as labetalol and hydralazine are commonly administered as needed or “prn” to asymptomatic patients in the hospital with elevated blood pressure. This practice may lead to patient harm (such as hypotension or stroke) and increased costs without any known benefit. Much attention has been focused on this issue in [...]

Background: Hospitals and LTC facilities devote substantial staff time to treating COPD patients requiring intense care. Standard of care (SoC) treatment includes nebulized short-acting beta agonists and muscarinic antagonists (SABA, SAMA, or SABA+SAMA). There is a lack of quantitative data on HCP time dedicated to nebulizations. Workflow mapping confirmed the suitability of T&M methodology to [...]