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Articles by Michael Herscher
Treatment of opioid use disorder in hospitalized patients
Clinical An opportunity for impact Publish date: December 14, 2021 Case A 35-year-old woman with opioid use disorder (OUD) presents with fever, left arm redness, and swelling. She is admitted to the hospital for cellulitis treatment. On the day after admission she becomes agitated and develops nausea, diarrhea, and generalized pain. Opioid withdrawal is suspected. How should her opioid use be addressed while in the hospital?
Compression therapy prevents recurrence of cellulitis
Clinical Publish date: December 7, 2021 Background: Recurrent cellulitis is a common condition in patients with lower-extremity edema. Although some clinicians recommend compression garments as a preventative treatment, there are no data evaluating their efficacy for this purpose. Study design: Participants were randomized to receive either education alone or education plus compression therapy. Neither the participants nor the assessors were blinded to the treatment arm.
Characteristics and outcomes of older adults with long-standing versus late-onset asthma
Objective: To examine the effect of age of onset on clinical characteristics and outcomes in a cohort of older patients with long-standing (LSA) and late-onset asthma (LOA). Methods: In all, 452 patients 60 years of age and older with persistent asthma were recruited. We defined LOA as asthma developing at age 40 or later and LSA as developing before age 40.
Postoperative Clostridium Difficile Infection Associated with Number of Antibiotics, Surgical Procedure Complexity
Clinical question: What are the factors that increase risk of Clostridium difficile infection (CDI) in postoperative patients? Background: CDI has become an important infectious etiology for morbidity, lengthy and costly hospital admissions, and mortality. This study focused on the risks for postoperative patients to be infected with C. diff. Awareness of the risk factors for CDI allows for processes to be implemented that can decrease the rate of infection.
Most Postoperative Readmissions Due to Patient Factors
Clinical question: What is the etiology of 30-day readmissions in postoperative patients? Background: As the focus of healthcare changes to a quality-focused model, readmissions impact physicians, reimbursements, and patients. Understanding the cause of readmissions becomes essential to preventing them. The etiology of 30-day readmissions in postoperative patients has not specifically been studied.
Ischemic Hepatitis Associated with High Inpatient Mortality
Clinical question: What is the incidence and outcome of patients with ischemic hepatitis? Background: Ischemic hepatitis, or shock liver, is often diagnosed in patients with massive increase in aminotransferase levels most often exceeding 1000 IU/L in the setting of hepatic hypoperfusion. The data on overall incidence and mortality of these patients are limited.
AIMS65 Score Helps Predict Inpatient Mortality in Acute Upper Gastrointestinal Bleed
Clinical question: Does AIMS65 risk stratification score predict inpatient mortality in patients with acute upper gastrointestinal bleed (UGIB)? Background: Acute UGIB is associated with significant morbidity and mortality, which makes it crucial to identify high-risk patients early. Several prognostic algorithms such as Glasgow-Blatchford (GBS) and pre-endoscopy (pre-RS) and post-endoscopy (post-RS) Rockall scores are available to triage such patients.
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