Journal of hospital medicine : an official publication of the Society of Hospital Medicine
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Hypertension is the major risk factor for cardiovascular (CV) disease such as myocardial infarction (MI) and stroke. This risk is well known to extend into the perioperative period. Although most perioperative hypertension can be managed with the patient's outpatient regimen, there are situations in which oral medications cannot be administered and parenteral medications become necessary. They include postoperative nil per os status, severe pancreatitis, and mechanical ventilation. This article reviews the management of perioperative hypertensive urgency with parenteral medications. ⋯ When oral therapy cannot be administered, patients with hypertensive urgency can have their blood pressure (BP) reduced with hydralazine, enalaprilat, metoprolol, or labetalol. Due to the scarcity of comparative trials looking at clinically significant outcomes, the medication should be chosen based on comorbidity, efficacy, toxicity, and cost.
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There is concern in the US about the burden and potential ramifications of dissatisfaction among physicians. The purpose of this article is to systematically review the literature on US physician satisfaction. ⋯ The majority of factors associated with satisfaction are modifiable. Tangible recommendations for measuring and diminishing dissatisfaction are given.
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There is concern in the US about the burden and potential ramifications of dissatisfaction among physicians. The purpose of this article is to systematically review the literature on US physician satisfaction. ⋯ The majority of factors associated with satisfaction are modifiable. Tangible recommendations for measuring and diminishing dissatisfaction are given.
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Handoffs are ubiquitous to Hospital Medicine and are considered a vulnerable time for patient safety. ⋯ The systematic review and resulting recommendations provide hospitalists a starting point from which to improve in-hospital handoffs.
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Handoffs are ubiquitous to Hospital Medicine and are considered a vulnerable time for patient safety. ⋯ The systematic review and resulting recommendations provide hospitalists a starting point from which to improve in-hospital handoffs.