Shamini Selvakumar MD, MSc, Andrew P. J. Olson SFHM
{"title":"That's usually what happens… I think","authors":"Shamini Selvakumar MD, MSc, Andrew P. J. Olson SFHM","doi":"10.1002/jhm.70034","DOIUrl":"10.1002/jhm.70034","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 8","pages":"899-900"},"PeriodicalIF":2.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143672131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tyler B. Larsen MD, FACP, Michael E. Lazarus MD, FACP
{"title":"Tophaceous gout","authors":"Tyler B. Larsen MD, FACP, Michael E. Lazarus MD, FACP","doi":"10.1002/jhm.70032","DOIUrl":"10.1002/jhm.70032","url":null,"abstract":"<p>An 82-year-old male with heart failure with reduced ejection fraction, chronic kidney disease, and gout presented with volume overload. Examination of his right elbow revealed a large, firm, painless, multilobulated nodule that did not transilluminate (Figures 1 and 2). Multiple small, firm subcutaneous nodules scattered across both extremities consistent with gouty tophi (Figure 3) were also present. He first experienced podagra 20 years prior and preferred using lime juice to treat his frequent gout flares. His tophi had slowly grown over that period. A serum uric acid level returned elevated at 11.6 mg/dL. On discharge he resumed allopurinol and colchicine with eventual improvement in his symptoms.</p><p>Tophi are deposits of monosodium urate accompanied by chronic granulomatous inflammatory changes in the surrounding tissue.<span><sup>1</sup></span> While often located around appendicular skeletal joints, tophi may locate in other soft tissue structures including the ears, bursae, tendons, and axial skeleton.<span><sup>1, 2</sup></span> Tophi are associated with longstanding gout and poorly controlled levels of urate.<span><sup>1, 2</sup></span> They are typically firm and painless but can begin to soften with the initiation of urate-lowering therapy and may periodically experience acute inflammation leading to pain.<span><sup>2</sup></span> Tophi are often variable in size and location may lead to misdiagnosis as nodules of rheumatoid arthritis or Heberden's nodes of osteoarthritis.</p><p>The authors declare no conflicts of interest.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 7","pages":"809-810"},"PeriodicalIF":2.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Manpreet S. Malik MD, SFHM, TaRessa K. Wills MD, FACP
{"title":"Chocolate brown ascites","authors":"Manpreet S. Malik MD, SFHM, TaRessa K. Wills MD, FACP","doi":"10.1002/jhm.70017","DOIUrl":"10.1002/jhm.70017","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 6","pages":"663-664"},"PeriodicalIF":2.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anupama Goyal MD, MHP, MBA, Shrestha Sachita MPH, David Bozaan MD, Trevor Denton DPT, Stephanie Taylor MD, MSc
{"title":"Evaluating the evaluation: A qualitative analysis to understand faculty evaluation programs in hospital medicine","authors":"Anupama Goyal MD, MHP, MBA, Shrestha Sachita MPH, David Bozaan MD, Trevor Denton DPT, Stephanie Taylor MD, MSc","doi":"10.1002/jhm.70028","DOIUrl":"10.1002/jhm.70028","url":null,"abstract":"<p>Little is known about the structure and desired outcomes of hospitalist performance evaluations at academic medical centers. We conducted a multicenter open-ended survey study with theory-guided qualitative analysis to summarize essential components and key outcomes for successful hospital medicine (HM) faculty evaluation programs. Twenty-two of 107 (20.6%) HM leaders responded to the survey. Frequently identified inputs were human, organizational, and financial resources. The main areas of evaluation were clinical performance and teaching. Performance evaluation or self-assessment forms were the most often utilized evaluation tools. Half of the respondents highlighted faculty appreciation as a main output of the evaluation. Important faculty-level outcomes were academic promotion, while retention and faculty engagement were salient organizational outcomes. Our multi-site study identified important pathways that shape the implementation and maintenance of successful HM faculty evaluation processes. These findings provide a strategic framework for evaluating and refining faculty evaluation programs over time.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 10","pages":"1087-1091"},"PeriodicalIF":2.3,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://shmpublications.onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70028","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alec B. Rezigh MD, Anand D. Jagannath MD, Austin C. Rezigh MD, Ann Marie Kumfer MD, Stephanie V. Sherman MD
{"title":"Eye catching","authors":"Alec B. Rezigh MD, Anand D. Jagannath MD, Austin C. Rezigh MD, Ann Marie Kumfer MD, Stephanie V. Sherman MD","doi":"10.1002/jhm.70031","DOIUrl":"10.1002/jhm.70031","url":null,"abstract":"<p>A 55 year-old man with type 2 diabetes mellitus presented to the emergency department with subacute nausea, vomiting, and abdominal pain. He was found to have epididymitis and hyperglycemia that improved with antibiotics and supportive care. However, he was also discovered to have significant acute kidney injury and chronic, relapsing-remitting bouts of eye pain and redness, confirmed to be uveitis on ophthalmologic evaluation. Despite completing an appropriate course of antibiotics, his pyuria and kidney injury persisted. An extensive infectious, autoimmune, and malignancy work-up was negative. As such, renal biopsy was pursued and revealed findings consistent with tubulointerstitial nephritis. With a negative secondary work-up, he was diagnosed with tubulointerstitial nephritis and uveitis (TINU) syndrome.</p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 6","pages":"628-632"},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Clinical guideline highlights for the hospitalist: Management of Helicobacter pylori infection in children and adolescents","authors":"Marisa Román MD, Michelle W. Parker MD","doi":"10.1002/jhm.70030","DOIUrl":"10.1002/jhm.70030","url":null,"abstract":"","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 6","pages":"594-596"},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Monee Amin MD, Meredith Trubitt MD, MPH, Avital Y. O'Glasser MD, Michelle N. Brooks MD
{"title":"Publish or perish: A path forward for digital scholarship","authors":"Monee Amin MD, Meredith Trubitt MD, MPH, Avital Y. O'Glasser MD, Michelle N. Brooks MD","doi":"10.1002/jhm.70027","DOIUrl":"10.1002/jhm.70027","url":null,"abstract":"<p>\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 10","pages":"1118-1121"},"PeriodicalIF":2.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Literature and Medicine","authors":"Aditi Mahajan M.Ed","doi":"10.1002/jhm.70026","DOIUrl":"10.1002/jhm.70026","url":null,"abstract":"<p>In the 1960s sociologists observed that many physicians practiced medicine with “detached concern” and for decades this seemed to be the goal.<span><sup>1</sup></span> Even now, in medical education, we are taught to care but not too much, taught to empathize but not take things home with us, taught to listen but not to absorb, but every day as I go to work and I rotate under a revolving door of residents, fellows, and attendings, the ones who I look up to the most, and the ones who seem to change their patients lives the most are the ones who engage beyond the science of medicine. As a third-year medical student trying to understand what kind of doctor I want to be, I have been paying close attention to how medicine is being practiced.</p><p>A theme that has echoed throughout all of my rotations, especially on the outpatient side, was that patients repeatedly said that they “just wanted to feel like someone understood what they were going through”. These were patients who had healed physically, been sent home to loving family and friends, our hands washed of our role in their journey. But now, the patients were stuck with another mountain to scale, seemingly alone. They had to process the traumatic event of illness and of healing, and they felt so alone in that journey. One instance that stands out to me was when I rotated through Internal Medicine. I spent 1 month on inpatient wards, spending multiple days with patients, tracking every lab value, and checking in with them multiple times a day. Then I rotated through outpatient medicine clinics. In one of my cardiology outpatient visits, I met a patient who had recently been admitted to the hospital for hypertension and heart failure. She came to clinic feeling frustrated and overwhelmed. In talking to her she emphasized that while she was in the hospital people were paying a lot of attention to her; weighing her daily, tracking her labs, and keeping her on a cardiac sodium restricted diet. She got better and then was discharged home, where she lived alone with a dog to take care of. While she was happy to be home, she realized that she now had to manage her health herself. She alone was responsible for tracking her diet, checking her blood pressure, and taking her pills. It was a stark change from being admitted and she was struggling to adjust. The doctor I worked with was phenomenal and immediately reassured her and worked with her to set up plans for tracking her intake, taking her medications, and keeping in contact with the office. He also made it a point to connect her with a heart failure support group, providing her community and support during this difficult transition period. This doctor was wonderful and attentive and had the resources on hand to help her. After she left, he also took the time to show me how to navigate local support group resources and emphasized the importance of long-term patient care. He shared that he had experienced some health difficulties a few years ago a","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 10","pages":"1145-1146"},"PeriodicalIF":2.3,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://shmpublications.onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143627086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Addressing the ethical and legal complexities of hospital visitation restrictions for patients who are incarcerated","authors":"Amber R. Comer PhD, JD","doi":"10.1002/jhm.70022","DOIUrl":"10.1002/jhm.70022","url":null,"abstract":"<p>Hospitalization often has a negative effect on patients’ emotional and psychological wellbeing with many patients experiencing loneliness, anxiety, and depression during their stay.<span><sup>1-3</sup></span> While most hospitalized patients are uncomfortable, patients who are incarcerated often face security protocols, such as being handcuffed to the hospital bed, which contributes to making their hospitalization even more daunting.<span><sup>4</sup></span> One security protocol which elicits complex legal and ethical dilemmas is restriction of hospital visitation with patients who are incarcerated. Given that over 7.6 million people are admitted to jail each year in the United States and that the population is aging and experiencing chronic health conditions increasing their likelihood of hospitalization, addressing ethical concerns within visitation policies for hospitalized patients who are incarcerated is imperative.<span><sup>5</sup></span></p><p>Visitation restrictions, despite their rationale, are complex because having visitors during hospitalization is a vital part of recovery and emotional well-being. For example, hospital visitor restrictions have been associated with the increased likelihood of delirium, loneliness, and discordant medical decisions for patients, as well as increased moral distress and ethical dilemmas for clinical care providers.<span><sup>6, 7</sup></span> In addition to potential negative emotional effects, restrictions on hospital visitation can hinder patient autonomy and stifle shared medical decision making when a patient lacks capacity due to a breakdown of communication between the patient's surrogate medical decision maker and the clinical care team.<span><sup>7-9</sup></span></p><p>Despite the potential negative effects of hospital visitor restrictions, restrictions are sometimes necessary to curb the spread of infectious diseases, for example, during a viral epidemic within the community.<span><sup>10, 11</sup></span> While restrictions to hospital visitors are ethically and legally acceptable when implemented as a precaution for protecting patient and staff safety, visitation policies for patients who are incarcerated circumscribe the visitor policies in place for the general patient population, leaving incarcerated patients vulnerable to persistent visitor restrictions during their hospitalization.<span><sup>12</sup></span> This article explores the ethical and legal complexities of hospital visitation restrictions for patients who are incarcerated and provides recommendations for visitation policies for this vulnerable patient population.</p><p>Visitation policies for patients who are incarcerated are usually distinct from visitor policies in place for the general patient population because the law and ethics guiding visitation policies with prisoners is a balance between the objectives of the penal system and the rights of prisoners.<span><sup>7-9, 11-13</sup></span> Penal system visitation policies","PeriodicalId":15883,"journal":{"name":"Journal of hospital medicine","volume":"20 9","pages":"1018-1021"},"PeriodicalIF":2.3,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://shmpublications.onlinelibrary.wiley.com/doi/epdf/10.1002/jhm.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143598340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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