Background: Methylnaltrexone (MNTX) is a peripherally acting µ-opioid receptor antagonist indicated for opioid-induced constipation (OIC), which can be a serious consequence of opioid analgesia. We evaluated whether baseline osmotic agent (eg, milk of magnesia, polyethylene glycol, lactulose, sorbitol) or stimulant (eg, senna, bisacodyl) use affects the efficacy and safety of MNTX among a subgroup of [...]

Background: Despite its prevalence, constipation is frequently under-recognized and treated with ineffective agents in hospitalized older adults. Methods: An anonymous survey was distributed to physicians regarding constipation management in hospitalized older adults. Chi-square or Fisher’s exact, as appropriate, were used to explore associations between demographics and survey answers. T-test was used to compare groups on [...]

Background: Methylnaltrexone (MNTX) is a peripherally acting µ-opioid receptor antagonist indicated for opioid-induced constipation (OIC). We evaluated whether baseline use of laxatives, including stimulants, osmotic agents, stool softeners, or combinations thereof affects the efficacy and safety of MNTX. Methods: This post hoc analysis included pooled data from 2 multicenter, randomized, double-blind, placebo (PBO)-controlled, institutional review [...]

Background: Almost three-quarters of hospitals with 50 or more beds have a palliative care program, and the percentage of annual hospital admissions receiving an initial palliative care consultation is more than 5%. Methylnaltrexone (MNTX) is a peripherally acting µ-opioid receptor antagonist indicated for opioid-induced constipation (OIC) in patients with advanced illness who are receiving palliative [...]

Background: Constipation is a common pediatric complaint and cause of abdominal pain in the pediatric age group. Management for constipation is generally completed in the outpatient setting, but many patients may require inpatient management after failure of outpatient therapy. Methods: We utilized data from the 2012 Kids’ Inpatient Database (KID), a nationally representative sample of [...]

Background: Constipation is commonly encountered in patients admitted to the hospital, with a variety of possible treatments to choose from. Docusate is often prescribed to treat constipation, though evidence suggests it is ineffective. Utilizing an ineffective medication adds to patients’ pill burden, health care costs, and may delay the use of effective medications with downstream [...]

Background: Prolonged intensive care unit (ICU) length of stay (LOS) has been shown to delay patients’ recovery, increase their exposure to the risk of infections, upsurge healthcare costs, and reduce care availability to other critically ill patients. ICU LOS is directly influenced by both medical and institutional factors. The aim of the project is to [...]

Case Presentation:  A 41 year-old male with HIV/AIDS (diagnosed three years ago), cutaneous Kaposi Sarcoma (KS), started on combination antiretroviral treatment (cART) three months ago (CD4 270, Viral load (VL) >2000 at the time of initiation of cART), recent VL of 39, who presented with worsening shortness of breath, cough, abdominal pain, abdominal distention and [...]

Case Presentation: 21 month old male presents to the hospital for constipation that failed outpatient therapy. Parents describe one hard difficult to pass bowel movement (BM) every other day, without pencil thin stools, blood or mucus. Constipation began at 3 months of age when they introduced formula. He passed meconium within the 24 hours of [...]

Case Presentation: A 36 year-old African-American female with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) was admitted to a community hospital with hypercalcemia and acute kidney injury (AKI). She recently was diagnosed with HIV/AIDs with diffuse lymphadenopathy. An abdominal lymph node biopsy showed Mycobacterium avium complex (MAC). She was started on highly active anti-retroviral therapy (HAART) [...]