Abstract:
:Clozapine was approved by the US Food and Drug Administration in 1989 for the management of treatment-resistant schizophrenia, and has since proven to reduce symptom burden and suicide risk, increase quality of life, and reduce substance use in individuals with psychotic disorders. Nevertheless, clozapine's psychiatric benefits have been matched by its adverse effect profile. Because they are likely to encounter medical complications of clozapine during admissions or consultations for other services, hospitalists are compelled to maintain an appreciation for these iatrogenic conditions. The authors outline common (eg, constipation, sialorrhea, weight gain) and serious (eg, agranulocytosis, seizures, myocarditis) medical complications of clozapine treatment, with internist-targeted recommendations for management, including indications for clozapine discontinuation.
journal_name
J Hosp Medjournal_title
Journal of hospital medicineauthors
Lundblad W,Azzam PN,Gopalan P,Ross CAdoi
10.1002/jhm.2345subject
Has Abstractpub_date
2015-08-01 00:00:00pages
537-43issue
8eissn
1553-5592issn
1553-5606journal_volume
10pub_type
杂志文章,评审abstract:BACKGROUND:The "July phenomenon" refers to a purported worsening of outcomes in teaching-hospital patients with the arrival of new, inexperienced house-staff. Previous quantitative studies of new house-staff and increased mortality have been limited primarily by a focused patient population and the use of limited data ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.917
更新日期:2011-09-01 00:00:00
abstract::Physicians are notorious for poor hand hygiene (HH) compliance. We wondered if lower performance by physicians compared with other health professionals might reflect differences in the Hawthorne effect. We introduced covert HH observers to see if performance differences between physicians and nurses decreased and to g...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2632
更新日期:2016-12-01 00:00:00
abstract:BACKGROUND:Meta-analyses of randomized trials have found that antibiotics are effective in acute exacerbations of chronic obstructive pulmonary disease (AECOPD), but there is insufficient evidence to guide antibiotic selection. Current guidelines offer conflicting recommendations. OBJECTIVE:To compare the effectivenes...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,多中心研究
doi:10.1002/jhm.628
更新日期:2010-05-01 00:00:00
abstract::Interstitial lung disease (ILD) is a diverse group of disorders typically with insidious onset. Diagnosis and management largely occur in the outpatient setting; however, ILD can present acutely necessitating hospitalization. Effective inpatient management requires the clinician to establish an accurate diagnosis and ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.12788/jhm.2774
更新日期:2017-07-01 00:00:00
abstract:BACKGROUND:Interhospital transfer is an understudied area within transitions of care. The process by which hospitals accept and transfer patients is not well described. National trends and best practices are unclear. OBJECTIVE:To describe the demographics of large transfer centers, to identify common handoff practices...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2577
更新日期:2016-06-01 00:00:00
abstract::Increasing numbers of serious hospital/healthcare- or community-acquired infections are caused by resistant (often multi-drug resistant) bacterial pathogens. Because delayed or ineffective initial therapy can have severe negative consequences, patients at risk for these types of infections typically receive initial em...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.983
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:The economic burden of acute kidney injury (AKI) is not well understood. OBJECTIVE:To estimate the effects of AKI on hospitalization costs and length of stay (LOS). DESIGN:Using data from the 2012 National Inpatient Sample, we compared hospitalization costs and LOS with and without AKI. We used a generaliz...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2683
更新日期:2017-02-01 00:00:00
abstract::Many hospitalists are routinely granted hospital privileges to perform invasive bedside procedures, but criteria for privileging are not well described. We conducted a survey of 21 hospitalist procedure experts from the Society of Hospital Medicine Point-of-Care Ultrasound Task Force to better understand current privi...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2837
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:There are 250,000 cases of central line-associated blood stream infections in the United States annually, some of which may be prevented by the removal of lines that are no longer needed. OBJECTIVE:To test the performance of criteria to identify an idle line as a guideline to facilitate its removal. METHOD...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2573
更新日期:2016-07-01 00:00:00
abstract:BACKGROUND:Knowing the number of discharges that will occur is important for administrators when hospital occupancy is close to or exceeds 100%. This information will facilitate decision making such as whether to bring in extra staff, cancel planned surgery, or implement measures to increase the number of discharges. W...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2802
更新日期:2018-03-01 00:00:00
abstract:BACKGROUND:No national policy requires health care providers to discuss with hospitalized patients whether the latter would want cardiopulmonary resuscitation (CPR) or mechanical ventilation (MV) in the event of cardiopulmonary failure. OBJECTIVE:To determine whether hospitalized patients are willing to discuss end-of...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,随机对照试验
doi:10.1002/jhm.78
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:High-flow nasal cannula (HFNC) is increasingly used to treat children hospitalized with bronchiolitis; however, the best practices for feeding during HFNC and the impact of feeding on time to discharge and adverse events are unknown. The study objective was to assess whether feeding exposure during HFNC was ...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3306
更新日期:2019-09-18 00:00:00
abstract:BACKGROUND:Superficial wound cultures are routinely used to guide therapy, despite a lack of clear supporting evidence. PURPOSE:To conduct a systematic review of the correlation between superficial wound cultures and the etiology of skin and soft tissue infections. DATA SOURCES:Medline, EMBASE, CINAHL, Scopus. STUDY...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1002/jhm.688
更新日期:2010-09-01 00:00:00
abstract:BACKGROUND:Computerized clinical knowledge mana-gement systems hold enormous potential for improving quality and efficiency. However, their impact on clinical practice is not well known. OBJECTIVE:To examine the impact of UpToDate on outcomes of care. DESIGN:Retrospective study. SETTING:National sample of US inpatie...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.944
更新日期:2012-02-01 00:00:00
abstract::Improving early discharges may improve patient flow and increase hospital capacity. We conducted a national survey of academic medical centers addressing the prevalence, importance, and effectiveness of early-discharge initiatives. We assembled a list of hospitalist and general internal medicine leaders at 115 US-base...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2885
更新日期:2018-06-01 00:00:00
abstract:BACKGROUND:Dexmedetomidine is a potentially useful sedative for hospitalized children, but there is little published data regarding its safety, dosage, or efficacy. OBJECTIVE:To report our experience with dexmedetomidine for the sedation of hospitalized children. DESIGN:Retrospective case series. SETTING:Pediatric I...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.282
更新日期:2008-03-01 00:00:00
abstract::Posttraumatic stress disorder (PTSD) is common in the United States, with a prevalence of nearly 8% in the general population and between 10% and 30% in veterans. Despite how common PTSD is, inpatient providers may not be familiar with its manifestations or feel comfortable taking care of patients who may exhibit symp...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.12788/jhm.3409
更新日期:2021-01-01 00:00:00
abstract:IMPORTANCE:There is an increasing trend toward designing hospitals with patient-centered features like reduced noise, improved natural light, visitor friendly facilities, well-decorated rooms, and hotel-like amenities. It has also been suggested that because patients cannot reliably distinguish positive experiences wit...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2297
更新日期:2015-03-01 00:00:00
abstract:BACKGROUND:Best practice alerts (BPAs) provide clinical decision support (CDS) at the point of care to reduce unnecessary blood product transfusions, yet substantial transfusions continue outside of recommended guidelines. OBJECTIVE:To understand why providers order blood transfusions outside of recommended guidelines...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2236
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Experts and national regulatory bodies have deemed femoral vein catheterization (FVC) unsafe, and recommend avoiding it whenever possible. OBJECTIVE:To assess rates of catheter-related bloodstream infections (CRBI) and deep venous thrombosis (DVT) complicating FVC. DESIGN:Prospective observational cohort s...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.696
更新日期:2011-01-01 00:00:00
abstract::Registry data indicate a gap between evidence-based guidelines and current management of patients with acute decompensated heart failure (ADHF). Bridging this gap is crucial given the frequency and cost of hospitalization for this disorder. Patients with ADHF require rapid assessment to determine appropriate treatment...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,评审
doi:10.1002/jhm.395
更新日期:2008-11-01 00:00:00
abstract:BACKGROUND:Hip fractures typically occur in frail elderly patients. Preoperative specialty consults, in addition to hospitalist comanagement, are often requested for preoperative risk assessment. OBJECTIVE:Determine if preoperative specialty consults meaningfully influence management and outcomes in hip fracture patie...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.3264
更新日期:2020-01-01 00:00:00
abstract::Physical examination (PE) is a core clinical competency, and the internal medicine clerkship is a premiere venue for students to develop PE skills. However, clinical rotations often lack opportunities for real-time instruction. We sought to measure the frequency, content, and factors affecting PE instruction during th...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2972
更新日期:2018-06-01 00:00:00
abstract::Efforts to improve the patient experience are increasingly focusing on engaging patients and their "care partners" by using patient portals. The Acute Care Patient Portal Task Force was supported by the Gordon and Betty Moore Foundation to convene a national meeting of an interdisciplinary group of stakeholders, inclu...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2860
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Academic medical centers (AMCs) have a constrained resident work force. Many AMCs have increased the use of nonresident service hospitalists to manage continued growth in clinical volume. To optimize their time in the hospital, it is important to understand hospitalists' work flow. DESIGN:We performed a tim...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.613
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Increasing use of testing among hospitalized patients has resulted in an increase in radiologic incidental findings (IFs), which challenge the provision of high-value care in the hospital setting. OBJECTIVE:To understand impact of radiologic incidental findings on resource utilization in patients hospitaliz...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2722
更新日期:2017-05-01 00:00:00
abstract::Depressive symptoms during a medical hospitalization may be an overlooked prognostic factor for adverse events postdischarge. Our aim was to evaluate whether depressive symptoms predict 30-day readmission or death after medical hospitalization. We conducted a systematic review of studies that compared postdischarge ou...
journal_title:Journal of hospital medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1002/jhm.2547
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:Although severity of illness indices such as pneumonia severity index (PSI) are good predictors of short-term mortality for community-acquired pneumonia (CAP) and healthcare-associated pneumonia (HCAP), other patient factors may have added prognostic value. OBJECTIVE:To identify patient factors beyond the P...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.985
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Angiotensin-converting enzyme inhibitors (ACE-Is) are a widely used class of cardiovascular medication. However, limited data exist on the risks of postoperative nonresumption of an ACE-I. OBJECTIVE:To evaluate the factors and 30-day mortality risks associated with the postoperative nonresumption of an ACE-...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.1002/jhm.2182
更新日期:2014-05-01 00:00:00
abstract:BACKGROUND:In the Medicare population, measures of relative severity of illness (SOI) for hospitalized patents have been used in prospective payment models. Similar measures for pediatric populations have not been fully developed. OBJECTIVE:To develop hospitalization resource intensity scores for kids (H-RISK) using p...
journal_title:Journal of hospital medicine
pub_type: 杂志文章
doi:10.12788/jhm.2948
更新日期:2018-09-01 00:00:00