Background/Objectives: Hyperglycemia in hospitalized patients is associated with an increased risk of complications, morbidity, mortality, and healthcare costs, regardless of a prior diagnosis of diabetes. The hospitalist system can improve various outcomes, including length of stay, medical costs, patient satisfaction, and mortality rates. However, the effects of hospitalist care on blood glucose control in hospitalized patients remain unclear. This study aimed to assess the specific effects of hospitalist services on blood glucose control in hospitalized patients, with a focus on hyperglycemia management and patient outcomes. Methods: This retrospective study reviewed the electronic medical records of patients diagnosed with diabetes at Yonsei Severance Hospital in Yongin, between March 2020 and February 2022. It included adults aged ≥20 years who were hospitalized and had undergone blood glucose measurements during hospitalization. Glycemic control was assessed using hemoglobin A1c, and the blood glucose levels were measured four times daily during hospitalization. Variability was quantified using the coefficient of variation and compared between hospitalist-led and traditional specialty care groups, over a 14-day hospitalization period. Results: Despite a higher baseline risk profile, patients receiving hospitalist-led care experienced significantly more stable glycemic variability over time (p = 0.002), suggesting better inpatient glucose management than those receiving traditional specialty care. Conclusions: Hospitalist-led care was associated with more stable glycemic variability over time in hospitalized patients with diabetes, despite a higher baseline burden of comorbidities and poorer glycemic control at admission.

This study aimed to determine the effects of lamotrigine (LTG) on language unction, including problem-solving abilities, in newly diagnosed pediatric epileptic patients. This study included 112 newly diagnosed epileptic patients treated with LTG [69 males and 43 females aged 9.6±2.7 years (mean±SD)]. Repeated neurologic examinations, electroencephalography, neuroimaging studies, and standard language tests including the Test of Problem Solving (TOPS), mean length of utterance in words (MLU-w), Receptive and Expressive Vocabulary Test (REVT), and Urimal Test of Articulation and Phonology were performed before and after initiating LTG treatment. The starting LTG dosage was 1 mg/kg/day (maximum: 25 mg/day) for the first 14 days, which was increased to 2 mg/kg/day for the subsequent 14 days and then up to 7 mg/kg/day (or 200 mg/day) for maintenance. Problem-solving skills as assessed by TOPS scores significantly improved after initiating LTG treatment (33.5±14.5 vs. 35.7±14.25, p<0.01). Scores in the "determining causes" category (11.9±4.7 vs. 12.9±4.8, p<0.01), "making inferences" category (12.9±6.2 vs. 13.6±6.0, p<0.05), and "predicting" category (8.9±5.4 vs. 9.7±5.6, p<0.01) significantly improved after LTG treatment. The MLU-w score did not decrease after LTG treatment (4.7±1.9 vs. 5.0±2.1). There was a significant improvement in receptive language function as assessed using the REVT score (9.4±3.4 years vs. 9.9±3.3 years, p<0.01). Precise articulation also improved after initiating LTG treatment (97.8% vs. 98.5%). Language function including problem-solving skills improved after LTG treatment, suggesting that LTG can be administered without causing significant negative effects on language function in pediatric patients.

Iatrogenic esophageal perforation is a rare condition in children, but occasionally occurs in premature infants due to repeated intubation or nasogastric tube insertion. Esophageal perforation is common in pneumothorax and interstitial emphysema, but rarely occurs in the absence of pneumothorax. Although complications, such as mediastinitis, after esophageal perforation are rare, they can be fatal. Therefore, rapid and accurate diagnosis and appropriate treatment are important. The authors report a case of huge retrocardiac pneumomediastinum and subcutaneous emphysema suspected to be caused by esophageal perforation after repeated intubation.