Hospital Medicine 2018

/Hospital Medicine 2018

HM2018 Abstract Number: Top 15 Research & Innovations

SLOWING THE INPATIENT FASTING EPIDEMIC

Background: Traditional inpatient procedural fasting practices lead to excessive periods of patient fasting. Patients are unnecessarily ordered to be nil per os (NPO) at midnight, independent of current recommendations and evidence specific to the type [...]

By | 2018-03-29T15:35:18+00:00 March 29th, 2018|Hospital Medicine 2018, Top 15 Research and Innovation Oral Abstracts|Comments Off on SLOWING THE INPATIENT FASTING EPIDEMIC

HM2018 Abstract Number: Top 15 Research & Innovations

THE MODEL TO AMPLIFY THE MISSING POTENTIAL (AMP) OF HEALTHCARE ORGANIZATIONS STRUGGLING TO IMPROVE QUALITY: RESULTS FROM A SYSTEMATIC REVIEW

Background: Some healthcare organizations struggle to improve quality. Identifying characteristics associated with underperformance may help inform approaches to improvement. Therefore, we sought to: (a) Identify organizational factors associated with low-performing healthcare organizations and (b) propose [...]

By | 2018-03-29T15:35:17+00:00 March 29th, 2018|Hospital Medicine 2018, Top 15 Research and Innovation Oral Abstracts|Comments Off on THE MODEL TO AMPLIFY THE MISSING POTENTIAL (AMP) OF HEALTHCARE ORGANIZATIONS STRUGGLING TO IMPROVE QUALITY: RESULTS FROM A SYSTEMATIC REVIEW

HM2018 Abstract Number: Top 15 Research & Innovations

PATIENT & FAMILY ADVISORY COUNCILS (PFACS): RECRUITING AND SUPPORTING MEMBERS FROM DIVERSE, VULNERABLE AND UNDER-REPRESENTED COMMUNITIES

Background: Ensuring hospital-based Patient and Family Advisory Councils (PFACs) include members from diverse, vulnerable and underrepresented communities is important to ensure that all voices are represented and heard when providing input into hospital quality improvement [...]

By | 2018-03-29T15:35:15+00:00 March 29th, 2018|Hospital Medicine 2018, Top 15 Research and Innovation Oral Abstracts|Comments Off on PATIENT & FAMILY ADVISORY COUNCILS (PFACS): RECRUITING AND SUPPORTING MEMBERS FROM DIVERSE, VULNERABLE AND UNDER-REPRESENTED COMMUNITIES

HM2018 Abstract Number: Top 15 Research & Innovations

THE PATIENT ENGAGEMENT SPECIALISTS (PES) MODEL: A NEW PARADIGM IN THE MANAGEMENT OF HOSPITALIZED OLDER PATIENTS WITH COGNITIVE IMPAIRMENT

Background: Hospitalization in older adults with cognitive impairment is a seminal event that often leads to iatrogenic complications and exacerbation of behavioral disturbances that require a higher level of observation to ensure the patient’s safety. [...]

By | 2018-03-29T15:35:13+00:00 March 29th, 2018|Hospital Medicine 2018, Top 15 Research and Innovation Oral Abstracts|Comments Off on THE PATIENT ENGAGEMENT SPECIALISTS (PES) MODEL: A NEW PARADIGM IN THE MANAGEMENT OF HOSPITALIZED OLDER PATIENTS WITH COGNITIVE IMPAIRMENT

HM2018 Abstract Number: Top 15 Research & Innovations

CURP65, A NEW RISK SCORE FOR INFLUENZA PATIENTS

Background: Community acquired severity scores are well known and used routinely in predicting mortality and risk of inpatient and ICU admission in suspected bacterial pneumonia patients. However such scores have not been studied in patients [...]

By | 2018-03-29T15:35:12+00:00 March 29th, 2018|Hospital Medicine 2018, Top 15 Research and Innovation Oral Abstracts|Comments Off on CURP65, A NEW RISK SCORE FOR INFLUENZA PATIENTS

HM2018 Abstract Number: Top 15 Research & Innovations

FOSTERING COLLABORATION: EXPOSURE TO INTERPROFESSIONAL COLLABORATION IN THE INTERNAL MEDICINE CLERKSHIP

Background: In 2015, medical students in their clinical clerkships (traditionally known as third year medical students) began rotating directly with hospitalist attendings. As we began crafting the rotation, we sought to provide value that was [...]

By | 2018-03-29T15:35:09+00:00 March 29th, 2018|Hospital Medicine 2018, Top 15 Research and Innovation Oral Abstracts|Comments Off on FOSTERING COLLABORATION: EXPOSURE TO INTERPROFESSIONAL COLLABORATION IN THE INTERNAL MEDICINE CLERKSHIP

HM2018 Abstract Number: Top 15 Research & Innovations

TAKING NOTE: HOW MANY NOTES DO HOSPITALISTS LOOK AT WHEN WRITING H&PS?

Background: Recent widespread adoption of electronic health records (EHRs) has dramatically increased the amount of information quickly accessible to clinicians. Given recent pushes for interoperability and consumer generated data in EHRs, the volume of information [...]

By | 2018-03-29T15:35:07+00:00 March 29th, 2018|Hospital Medicine 2018, Top 15 Research and Innovation Oral Abstracts|Comments Off on TAKING NOTE: HOW MANY NOTES DO HOSPITALISTS LOOK AT WHEN WRITING H&PS?

HM2018 Abstract Number: Top 15 Research & Innovations

IMPACT OF INTER-HOSPITAL TRANSFER ON PATIENT OUTCOMES: A NATIONAL EVALUATION

Background: The transfer of patients between hospitals (interhospital transfer, IHT), exposes patients to risks of discontinuity of care. In this study, we aim to better understand which patients may (or may not) benefit from IHT [...]

By | 2018-03-29T15:35:05+00:00 March 29th, 2018|Hospital Medicine 2018, Top 15 Research and Innovation Oral Abstracts|Comments Off on IMPACT OF INTER-HOSPITAL TRANSFER ON PATIENT OUTCOMES: A NATIONAL EVALUATION

HM2018 Abstract Number: Top 15 Research & Innovations

ADDING SCIENTIFIC CONSULTANTS TO OUR ARMAMENTARIUM: A BASIC SCIENCE CONSULT SERVICE

Background: In the dawning era of precision medicine, increasingly sophisticated tools are becoming available to diagnose and investigate rare and unexplained diseases. The application of these tools to clinical practice will require new models of [...]

By | 2018-03-29T15:35:03+00:00 March 29th, 2018|Hospital Medicine 2018, Top 15 Research and Innovation Oral Abstracts|Comments Off on ADDING SCIENTIFIC CONSULTANTS TO OUR ARMAMENTARIUM: A BASIC SCIENCE CONSULT SERVICE

HM2018 Abstract Number: Top 15 Research & Innovations

SAFETY QUEST: A NOVEL WEB-BASED GAME TO TEACH QI AND PATIENT SAFETY

Background: In 2016, ACGME’s first Clinical Learning Environment Review (CLER) report found that trainees had limited knowledge of Quality Improvement (QI) and patient safety (PS) concepts.. Purpose: We have designed a free, interactive, web-based game [...]

By | 2018-03-29T15:35:01+00:00 March 29th, 2018|Hospital Medicine 2018, Top 15 Research and Innovation Oral Abstracts|Comments Off on SAFETY QUEST: A NOVEL WEB-BASED GAME TO TEACH QI AND PATIENT SAFETY

HM2018 Abstract Number: Top 15 Research & Innovations

THE TIP OF THE ICEBERG, ANTIBIOTIC STEWARDSHIP AND FLUOROQUINOLONE USE AT HOSPITAL DISCHARGE: A MULTI-HOSPITAL COHORT STUDY

Background: Inpatient antibiotic stewardship programs often use pre-prescription approval (PPA) or prospective audit and feedback (PAF) to reduce fluoroquinolone prescribing. Whether these stewardship strategies targeting inpatient fluoroquinolone use also influence prescribing at discharge is unknown. [...]

By | 2018-03-29T15:34:57+00:00 March 29th, 2018|Hospital Medicine 2018, Top 15 Research and Innovation Oral Abstracts|Comments Off on THE TIP OF THE ICEBERG, ANTIBIOTIC STEWARDSHIP AND FLUOROQUINOLONE USE AT HOSPITAL DISCHARGE: A MULTI-HOSPITAL COHORT STUDY

HM2018 Abstract Number: Top 15 Research & Innovations

THE ALLERGY THAT WASN’T: INPATIENT PENICILLIN TESTING; AN IMPORTANT STEP FOR ANTIBIOTIC STEWARDSHIP

Background: Approximately 5-10% of the US population reports a Penicillin (PCN) allergy. Only 1 in 10 of these patients are found to have a positive reaction to PCN. This label comes at a grave cost, [...]

By | 2018-03-29T15:34:54+00:00 March 29th, 2018|Hospital Medicine 2018, Top 15 Research and Innovation Oral Abstracts|Comments Off on THE ALLERGY THAT WASN’T: INPATIENT PENICILLIN TESTING; AN IMPORTANT STEP FOR ANTIBIOTIC STEWARDSHIP

HM2018 Abstract Number: Top 15 Research & Innovations

IMPACT OF INDIVIDUALIZED METRICS AND MOBILE DELIVERY ON HOSPITALIST ENGAGEMENT AND OUTCOMES

Background: Inpatient margins and hospital reimbursement have become increasingly dependent upon improving key metrics, such as length of stay and 30-day readmissions. Hospitalists typically lack access to credible, timely, and insightful metrics that inform their [...]

By | 2018-03-29T15:34:53+00:00 March 29th, 2018|Hospital Medicine 2018, Top 15 Research and Innovation Oral Abstracts|Comments Off on IMPACT OF INDIVIDUALIZED METRICS AND MOBILE DELIVERY ON HOSPITALIST ENGAGEMENT AND OUTCOMES

HM2018 Abstract Number: Top 15 Research & Innovations

REAL-TIME HOSPITALIST BURNOUT: IMPLICATIONS FOR SYSTEM-LEVEL SOLUTIONS

Background: In a previous randomized trial we found that shorter ward rotations reduced attending physician burnout at rotation-end. This improvement was offset, however, by negative education outcomes among trainees. Therefore solutions to burnout other than [...]

By | 2018-03-29T15:34:51+00:00 March 29th, 2018|Hospital Medicine 2018, Top 15 Research and Innovation Oral Abstracts|Comments Off on REAL-TIME HOSPITALIST BURNOUT: IMPLICATIONS FOR SYSTEM-LEVEL SOLUTIONS

HM2018 Abstract Number: Plenary presentation

MENTORED IMPLEMENTATION OF THE I-PASS HANDOFF PROGRAM IN DIVERSE CLINICAL ENVIRONMENTS

Background: Handoff miscommunications are a leading source of medical errors. Medical error and adverse event rates decreased following implementation of the I-PASS handoff program (a bundled intervention using a structured mnemonic, I-PASS, and other initiatives [...]

By | 2018-03-29T15:34:50+00:00 March 29th, 2018|Hospital Medicine 2018, Plenary Presentations|Comments Off on MENTORED IMPLEMENTATION OF THE I-PASS HANDOFF PROGRAM IN DIVERSE CLINICAL ENVIRONMENTS

HM2018 Abstract Number: Plenary presentation

THE SLEEP HYGEINE IN THE HOSPITAL PROJECT: SHH!

Background: Sleep deprivation has deleterious effects on immune function, wound healing, insulin resistance, pain, and even mortality. Patients in hospitals often suffer from sleep deprivation due to environmental noise and interruptions from staff. The American [...]

By | 2018-03-29T15:34:49+00:00 March 29th, 2018|Hospital Medicine 2018, Plenary Presentations|Comments Off on THE SLEEP HYGEINE IN THE HOSPITAL PROJECT: SHH!

HM2018 Abstract Number: Plenary presentation

DEEPLY-PERSONALIZED MEDICINE: BRINGING DEEP LEARNING TO SEPSIS CARE

Background: Clinical decision support tools based on predictive analytics can provide actionable information and improve clinical outcomes for patients at risk of developing sepsis. Scoring systems such as Systemic Inflammatory Response Syndrome (SIRS) and National [...]

By | 2018-03-29T15:34:47+00:00 March 29th, 2018|Hospital Medicine 2018, Plenary Presentations|Comments Off on DEEPLY-PERSONALIZED MEDICINE: BRINGING DEEP LEARNING TO SEPSIS CARE

HM2018 Abstract Number: 155

Measuring and Reporting Central Line-Associated Bloodstream Infection: More Than Meets the Eye?

Background: Although central line-associated bloodstream infection (CLABSI) rates are publicly reported, whether these data correlate to clinical documentation or practice is not known. Using data from a large hospital collaborative, we hypothesized that physician [...]

By | 2018-03-21T16:17:45+00:00 March 19th, 2018|Patient Safety, Research, Uncategorized|Comments Off on Measuring and Reporting Central Line-Associated Bloodstream Infection: More Than Meets the Eye?

HM2018 Abstract Number: 110

TWO HURRICANES IN ONE YEAR-LESSONS LEARNED FOR HOSPITALIST STAFFING AND DISASTER PLANNING

Background: Situated in coastal Florida, the four hospitals/1,000 beds in the Health First Integrated delivery network are located right in hurricane alley. Our hospitalist program had to plan for, communicate, and execute our hurricane staffing [...]

By | 2018-03-19T15:43:49+00:00 March 19th, 2018|Innovations, Other, Uncategorized|Comments Off on TWO HURRICANES IN ONE YEAR-LESSONS LEARNED FOR HOSPITALIST STAFFING AND DISASTER PLANNING

HM2018 Abstract Number: 154

Does EKG-Guided Peripherally Inserted Central Catheter Insertion Reduce Risk of Deep Vein Thrombosis?

Background: The position of the tip of a peripherally inserted central catheter (PICC) is associated with deep vein thrombosis (DVT). Optimal position of the tip is the cavoatrial junction; more proximal tip positions are associated [...]

By | 2018-03-19T15:43:52+00:00 March 19th, 2018|Patient Safety, Research, Uncategorized|Comments Off on Does EKG-Guided Peripherally Inserted Central Catheter Insertion Reduce Risk of Deep Vein Thrombosis?

HM2018 Abstract Number: 334

OPTIMIZING COMPLEX PATIENT TRANSITIONS THROUGH COLLABORATIVE CARE

Background: Due to the complexity of patient discharge needs leading to increased length of stay within a large academic medical center, a specialized inpatient unit became a priority. Purpose: The University of Kentucky Healthcare created [...]

By | 2018-03-19T15:43:53+00:00 March 19th, 2018|Innovations, Transitions of Care, Uncategorized|Comments Off on OPTIMIZING COMPLEX PATIENT TRANSITIONS THROUGH COLLABORATIVE CARE

HM2018 Abstract Number: 126

STOPPING HCV IN ITS TRACKS – EXPANDING HCV TESTING CAN HALT THE EPIDEMIC

Background: There is an estimated 160,000 individuals that have been diagnosed with Hepatitis C Virus (HCV) in New Jersey. HCV is a well-known and widespread challenge to personal, societal, and governmental resources and ultimately, human [...]

By | 2018-03-19T15:43:53+00:00 March 19th, 2018|Innovations, Outcomes Research, Uncategorized|Comments Off on STOPPING HCV IN ITS TRACKS – EXPANDING HCV TESTING CAN HALT THE EPIDEMIC

HM2018 Abstract Number: 645

Pituitary Apoplexy with Binasal Visual Defect

Case Presentation: A 67-year-old Japanese man was brought to our hospital because of a headache. He had noticed his headache and retroorbital pain four days before and they had been getting worse gradually. Subsequently, he [...]

By | 2018-03-19T15:43:53+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Pituitary Apoplexy with Binasal Visual Defect

HM2018 Abstract Number: 66

PREPARING FOR INDEPENDENT PRACTICE: AN EDUCATIONAL INTERVENTION PROMOTING STRUCTURED CHART REVIEW, REFLECTION, AND FEEDBACK ON NIGHT ADMITTING ROTATIONS

Background: Feedback on clinical management and diagnostic accuracy may enhance physicians’ learning and reduce diagnostic error. Residents on night admitting rotations rarely receive feedback on their clinical management and seldom have the opportunity to reflect [...]

By | 2018-03-19T15:43:53+00:00 March 19th, 2018|Education, Innovations, Uncategorized|Comments Off on PREPARING FOR INDEPENDENT PRACTICE: AN EDUCATIONAL INTERVENTION PROMOTING STRUCTURED CHART REVIEW, REFLECTION, AND FEEDBACK ON NIGHT ADMITTING ROTATIONS

HM2018 Abstract Number: 911

NON-TRAUMATIC COMPARTMENT SYNDROME DUE TO STREPTOCOCCUS AGALACTIAE IN AN IMMUNOCOMPROMISED HOST

Case Presentation: A 34-year-old male with recently diagnosed Philadelphia chromosome-positive acute lymphoblastic leukemia developed neutropenic fever with right arm pain on day thirteen of induction chemotherapy. He was placed on empiric piperacillin-tazobactam. Blood cultures grew [...]

By | 2018-03-19T15:43:53+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on NON-TRAUMATIC COMPARTMENT SYNDROME DUE TO STREPTOCOCCUS AGALACTIAE IN AN IMMUNOCOMPROMISED HOST

HM2018 Abstract Number: 278

TWICE DAILY INTERDISCIPLINARY ROUNDS AND ITS EFFECT ON TEAM SATISFACTION AND HOSPITAL LENGTH OF STAY

Background: Interdisciplinary rounds (IDR) have become widely implemented in hospital settings in recent years due to proposed positive impact on various outcome measures such as length of stay, frequency of adverse effects, patient and team [...]

By | 2018-03-19T15:43:53+00:00 March 19th, 2018|Innovations, Quality Improvement, Uncategorized|Comments Off on TWICE DAILY INTERDISCIPLINARY ROUNDS AND ITS EFFECT ON TEAM SATISFACTION AND HOSPITAL LENGTH OF STAY

HM2018 Abstract Number: 203

EFFECTIVENESS OF CLINICAL DECISION SUPPORT FOR REDUCING UNNECESSARY HYPERCOAGULABILITY EVALUATIONS IN A LARGE COMMUNITY HOSPITAL

Background: Venous Thromboembolism (VTE) is a potentially life-threatening disorder and in some cases, is related to underlying hypercoagulability which may be congenital or acquired. Guidelines suggest performing extensive work -up for hypercoagulability only in select [...]

By | 2018-03-19T15:43:53+00:00 March 19th, 2018|Quality Improvement, Research, Uncategorized|Comments Off on EFFECTIVENESS OF CLINICAL DECISION SUPPORT FOR REDUCING UNNECESSARY HYPERCOAGULABILITY EVALUATIONS IN A LARGE COMMUNITY HOSPITAL

HM2018 Abstract Number: 80

A NOVEL APPROACH TO IMPROVE FELLOWSHIP INTERVIEW SKILLS

Background: The process by which medical residents apply for subspecialty fellowship is a rigorous one that often involves multiple interviews per day. Data regarding the preparedness of residents who go through the interview process is [...]

By | 2018-03-19T15:43:53+00:00 March 19th, 2018|Education, Innovations, Uncategorized|Comments Off on A NOVEL APPROACH TO IMPROVE FELLOWSHIP INTERVIEW SKILLS

HM2018 Abstract Number: 423

ATRAUMATIC SPLENIC RUPTURE SECONDARY TO BABESIOSIS: A STEALTHY DEADLY DISEASE

Case Presentation: A 66 year-old Caucasian male presented to the emergency department with intermittent fevers, chills, fatigue and dyspnea of 1 week duration. He denied any nausea, vomiting, abdominal pain, changes in bowel habit or [...]

By | 2018-03-19T15:43:53+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on ATRAUMATIC SPLENIC RUPTURE SECONDARY TO BABESIOSIS: A STEALTHY DEADLY DISEASE

HM2018 Abstract Number: 109

Non-Critical Care Telemetry Monitoring for Non-Cardiac Related Diagnoses: Are We Overdoing it?

Background: Telemetry is an essential tool for real-time monitoring of the heart rhythm and QRS morphology of a patient. American College of Cardiology and American Heart Association had published their respective practice standards for in-hospital [...]

By | 2018-03-19T15:43:53+00:00 March 19th, 2018|Other, Research, Uncategorized|Comments Off on Non-Critical Care Telemetry Monitoring for Non-Cardiac Related Diagnoses: Are We Overdoing it?

HM2018 Abstract Number: 595

DIFFUSE ALVEOLAR HEMORRHAGE FROM ATYPICAL HEMOLYTIC UREMIC SYNDROME SECONDARY TO LUPUS NEPHRITIS.

Case Presentation: A 20 year old man with history of Systemic Lupus erythematous (SLE) with Lupus nephritis presented to the hospital with cough and hemoptysis for the past few days. He was found to have [...]

By | 2018-03-19T15:43:53+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on DIFFUSE ALVEOLAR HEMORRHAGE FROM ATYPICAL HEMOLYTIC UREMIC SYNDROME SECONDARY TO LUPUS NEPHRITIS.

HM2018 Abstract Number: 604

My sinuses problems made me swollen all over!!

Case Presentation: A 40-year-old male of Hispanic/Asian origin with a history of diabetes mellitus type II, hypertension, dyslipidemia, recurrent sinusitis and bilateral otitis media presented to the emergency department complaining of acute hand joints pain, [...]

By | 2018-03-19T15:43:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on My sinuses problems made me swollen all over!!

HM2018 Abstract Number: 497

An Unnecessary Procedure in a Sickle Cell Patient with Acute Chest Syndrome

Case Presentation: A 28-year-old woman with sickle cell disease and chronic pain who required inpatient care several times yearly presented with worsening nausea, emesis and uncontrolled pain to the emergency department (ED). Symptoms were typical [...]

By | 2018-03-19T15:43:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on An Unnecessary Procedure in a Sickle Cell Patient with Acute Chest Syndrome

HM2018 Abstract Number: 70

THE IMPACT OF A HIGH VALUE CARE CURRICULUM FOR INTERNAL MEDICINE SUB-INTERNS

Background: Healthcare expenditures in the United States have grown from 5% of the gross domestic product in 1960 to nearly 18% in 2015. Despite spending more for healthcare than any other industrialized country, healthcare outcomes [...]

By | 2018-03-19T15:43:54+00:00 March 19th, 2018|Education, Research, Uncategorized|Comments Off on THE IMPACT OF A HIGH VALUE CARE CURRICULUM FOR INTERNAL MEDICINE SUB-INTERNS

HM2018 Abstract Number: 813

WHILE TISSUE IS THE ISSUE, INFECTIONS ALWAYS COME DOWN TO LOCATION, LOCATION, LOCATION!

Case Presentation: A 25 year-old white man with no significant past medical history presented with gradually progressive dyspnea on exertion and dry cough for approximately two months. He was treated for community-acquired pneumonia with various [...]

By | 2018-03-19T15:43:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on WHILE TISSUE IS THE ISSUE, INFECTIONS ALWAYS COME DOWN TO LOCATION, LOCATION, LOCATION!

HM2018 Abstract Number: 210

A QUALITY IMPROVEMENT PROJECT INVESTIGATING METHODS TO OPTIMIZE CODE STATUS DISCUSSIONS (CSD’s) DURING INPATIENT ADMISSIONS

Background: CSD’s are an integral component of the inpatient admission process. However, despite their importance, CSD’s are not performed during all admissions. Residents physicians, who are at the forefront of the admission process, are rarely [...]

By | 2018-03-19T15:43:54+00:00 March 19th, 2018|Innovations, Quality Improvement, Uncategorized|Comments Off on A QUALITY IMPROVEMENT PROJECT INVESTIGATING METHODS TO OPTIMIZE CODE STATUS DISCUSSIONS (CSD’s) DURING INPATIENT ADMISSIONS

HM2018 Abstract Number: 661

OF ULCERS AND ESCHAR

Case Presentation: A 62-year-old man presented with 5 weeks of progressive right lower extremity ulceration associated with pain, swelling, erythema, fevers, and diaphoresis. Initially, outpatient providers diagnosed patient with cellulitis following minor trauma and complicated [...]

By | 2018-03-19T15:43:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on OF ULCERS AND ESCHAR

HM2018 Abstract Number: 425

MISS UNDERSTOOD: A CASE OF HASHIMOTO’S ENCEPHALOPATHY

Case Presentation: A 75-year-old African-American female with a past medical history of hypothyroidism, hypertension, and Alzheimer’s dementia presented to the emergency room with altered mental status and concern for possible stroke; family also reported new [...]

By | 2018-03-19T15:43:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on MISS UNDERSTOOD: A CASE OF HASHIMOTO’S ENCEPHALOPATHY

HM2018 Abstract Number: 503

ACNE? NOT SO MUCH: A RARE CLINICAL MANIFESTATION OF PROPIONIBACTERIUM ACNES

Case Presentation: A 69-year-old immune-competent male presented with one-month history of fatigue and weakness. Patient endorsed decreased oral intake. He also noted dyspnea on exertion, non-productive cough and peripheral edema. Past medical history was significant [...]

By | 2018-03-19T15:43:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on ACNE? NOT SO MUCH: A RARE CLINICAL MANIFESTATION OF PROPIONIBACTERIUM ACNES

HM2018 Abstract Number: 343

Patterns of opioid prescribing practices in a teaching hospital

Background: Opioids are widely prescribed for cancer and non-cancer related pain in hospitalized patients. The opioid usage increased roughly three times in the past two decades. Pain is a feeling of distress evoked by sensory [...]

By | 2018-03-19T15:43:54+00:00 March 19th, 2018|Research, Translating Research into Practice, Uncategorized|Comments Off on Patterns of opioid prescribing practices in a teaching hospital

HM2018 Abstract Number: 200

ADVANCE CARE PLANNING IN THE PERIOPERATIVE CLINIC: A RETROSPECTIVE CHART REVIEW

Background: High risk patients undergoing elective surgery are at increased risk of life-threatening complications. Also, most are under anesthesia, lacking capacity for at least that time. Despite this they often lack advance directives (ADs) or [...]

By | 2018-03-19T15:43:54+00:00 March 19th, 2018|Perioperative, Research, Uncategorized|Comments Off on ADVANCE CARE PLANNING IN THE PERIOPERATIVE CLINIC: A RETROSPECTIVE CHART REVIEW

HM2018 Abstract Number: 765

LEVOFLOXACIN-INDUCED MYOCLONUS

Case Presentation: A 61-year-old man with stage 5 chronic kidney disease was admitted to the hospital with four days of new, uncontrollable muscle twitching. One week prior, he had undergone incision and drainage of a [...]

By | 2018-03-19T15:43:57+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on LEVOFLOXACIN-INDUCED MYOCLONUS

HM2018 Abstract Number: 38

PATIENT PERCEPTIONS OF PROVIDER BEDSIDE COMMUNICATION AND USE OF THE WHITEBOARD COMMUNICATION TOOL

Background: The use of whiteboards in the inpatient setting has become increasingly prevalent as a potentially effective tool for prevention of communication failures and improved multidisciplinary care. Provider and nursing surveys indicate that this tool [...]

By | 2018-03-19T15:43:59+00:00 March 19th, 2018|Communication, Research, Uncategorized|Comments Off on PATIENT PERCEPTIONS OF PROVIDER BEDSIDE COMMUNICATION AND USE OF THE WHITEBOARD COMMUNICATION TOOL

HM2018 Abstract Number: 342

LOW PROCALCITONIN CAN EFFECTIVELY RULE OUT BACTEREMIA

Background: Blood stream infection is associated with high mortality and morbidity. Blood cultures are considered the gold standard for diagnosing bacteremia in sepsis patients. However, blood culture results may take at least 12 to 24 [...]

By | 2018-03-19T15:44:00+00:00 March 19th, 2018|Research, Translating Research into Practice, Uncategorized|Comments Off on LOW PROCALCITONIN CAN EFFECTIVELY RULE OUT BACTEREMIA

HM2018 Abstract Number: 338

SLEEP FOR HOSPITALIZED PATIENTS – TRANSLATING RESEARCH INTO PRACTICE

Background: Evidence-based medicine and research are the backdrops to our everyday practice of medicine. Although there are defined steps in carrying research project to publication, there is paucity in the translation of research to practice.(1,2) [...]

By | 2018-03-19T15:44:00+00:00 March 19th, 2018|Innovations, Translating Research into Practice, Uncategorized|Comments Off on SLEEP FOR HOSPITALIZED PATIENTS – TRANSLATING RESEARCH INTO PRACTICE

HM2018 Abstract Number: 533

CATATONIA WITH WAXY FLEXIBILTY IN A HOSPITALIZED WOMAN WITH LUPUS

Case Presentation: A 32 year-old female with history of systemic lupus erythematosus, depression and anxiety was admitted to the medical ward with cytomegalovirus pneumonitis and viremia. On hospitalization day 21, patient had an acute change [...]

By | 2018-03-19T15:44:00+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on CATATONIA WITH WAXY FLEXIBILTY IN A HOSPITALIZED WOMAN WITH LUPUS

HM2018 Abstract Number: 524

OPSOCLONUS MYOCLONUS SYNDROME IN A PATIENT WITH VIRAL ENCEPHALITIS

Case Presentation: A 39 year-old woman presented to our hospital in late August with non-neutropenic fever and a diffuse maculopapular rash involving her palms and soles. Past medical history was significant for HER2 positive, locally [...]

By | 2018-03-19T15:44:00+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on OPSOCLONUS MYOCLONUS SYNDROME IN A PATIENT WITH VIRAL ENCEPHALITIS

HM2018 Abstract Number: 606

A RARE CASE OF SELECTIVE IGM DEFICIENCY IN AN OTHERWISE HEALTHY ADULT

Case Presentation: 59 yo Caucasian male presented from an outside hospital (OSH) with primary complaint of “leg abscesses” of 1 wk duration. Patient was afebrile, vital signs stable and in no acute distress complaining of [...]

By | 2018-03-19T15:44:00+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A RARE CASE OF SELECTIVE IGM DEFICIENCY IN AN OTHERWISE HEALTHY ADULT

HM2018 Abstract Number: 228

THE IMPACT OF A HOSPITAL MEDICINE-NEUROSURGERY QUALITY IMPROVEMENT COLLABORATIVE ON NEUROSURGICAL PRE-ADMISSION, OPERATING ROOM AND POST-OPERATIVE OUTCOMES: A PROSPECTIVE INTERRUPTED TIME SERIES STUDY

Background: A lack of standardization in care delivery can lead to variations in outcomes in the high-risk work of neurosurgery. The aim of this program was to develop, implement and evaluate the impact of three [...]

By | 2018-03-19T15:44:00+00:00 March 19th, 2018|Quality Improvement, Research, Uncategorized|Comments Off on THE IMPACT OF A HOSPITAL MEDICINE-NEUROSURGERY QUALITY IMPROVEMENT COLLABORATIVE ON NEUROSURGICAL PRE-ADMISSION, OPERATING ROOM AND POST-OPERATIVE OUTCOMES: A PROSPECTIVE INTERRUPTED TIME SERIES STUDY

HM2018 Abstract Number: 331

PREVENTION OF OVERT HEPATIC ENCEPHALOPATHY RECURRENCE WITH RIFAXIMIN ALONE VERSUS RIFAXIMIN PLUS LACTULOSE THERAPY: IMPACT ON QUALITY OF LIFE AND CAREGIVER BURDEN IN PATIENTS WITH CIRRHOSIS

Background: Rifaximin, a nonsystemic antibiotic, may be used alone or in combination with lactulose for reducing the risk of overt hepatic encephalopathy (OHE) recurrence in adults. This analysis evaluated rifaximin alone and rifaximin + lactulose [...]

By | 2018-03-19T15:44:00+00:00 March 19th, 2018|Research, Transitions of Care, Uncategorized|Comments Off on PREVENTION OF OVERT HEPATIC ENCEPHALOPATHY RECURRENCE WITH RIFAXIMIN ALONE VERSUS RIFAXIMIN PLUS LACTULOSE THERAPY: IMPACT ON QUALITY OF LIFE AND CAREGIVER BURDEN IN PATIENTS WITH CIRRHOSIS

HM2018 Abstract Number: 525

Worsening headache after first-time dialysis

Case Presentation: A 53 year old man presented with a global headache and difficulty concentrating for one week. The patient’s past medical history included systemic amyloidosis status post autologous stem cell transplant, hypertension, and end [...]

By | 2018-03-19T15:44:00+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Worsening headache after first-time dialysis

HM2018 Abstract Number: 187

DATABASE DEVELOPMENT FOR PEDIATRIC HOSPITAL MEDICINE AND ORTHOPEDIC COMANAGEMENT OF PATIENTS UNDERGOING POSTERIOR SPINAL FUSION

Background: The care of surgical patients is becoming more complex as patients with increasing comorbidities require surgical procedures. In adult hospital medicine, co-management of complex medical patients by hospital medicine and surgery has been shown [...]

By | 2018-03-19T15:44:00+00:00 March 19th, 2018|Innovations, Pediatrics, Uncategorized|Comments Off on DATABASE DEVELOPMENT FOR PEDIATRIC HOSPITAL MEDICINE AND ORTHOPEDIC COMANAGEMENT OF PATIENTS UNDERGOING POSTERIOR SPINAL FUSION

HM2018 Abstract Number: 366

CHOOSING WISELY? A COST CONSCIOUS APPROACH WHEN ORDERING IMAGING STUDIES FOR RAPID RESPONSE PATIENTS WITH ALTERED MENTAL STATUS

Background: CT Head imaging for patients with altered mental status is a common procedure that many clinicians utilize to establish a diagnosis. As health care costs rise, practitioners are becoming more conscious about ordering costly [...]

By | 2018-03-19T15:44:00+00:00 March 19th, 2018|Research, Uncategorized, Value in Hospital Medicine|Comments Off on CHOOSING WISELY? A COST CONSCIOUS APPROACH WHEN ORDERING IMAGING STUDIES FOR RAPID RESPONSE PATIENTS WITH ALTERED MENTAL STATUS

HM2018 Abstract Number: 199

A MULTI-CENTER STUDY OF PRE-OPERATIVE NON-INVASIVE CARDIAC TESTING IN OLDER PATIENTS WITH HIP FRACTURE

Background: Current guidelines for the use pre-operative non-invasive cardiac testing, especially in older patients with multi-morbidity and poor functional capacity are unclear. Our study aimed to evaluate the use of nuclear stress test (NST) and [...]

By | 2018-03-19T15:44:01+00:00 March 19th, 2018|Perioperative, Research, Uncategorized|Comments Off on A MULTI-CENTER STUDY OF PRE-OPERATIVE NON-INVASIVE CARDIAC TESTING IN OLDER PATIENTS WITH HIP FRACTURE

HM2018 Abstract Number: 549

RADIATION INDUCED CONDUCTIVE HEART DISEASE: A NEED FOR REGISTRIES

Case Presentation: 72-year-old male with history of hypertension, Stage IIIB squamous cell cancer of the right lung status post chemo-radiation presented to the clinic for a routine annual physical. He was found to be bradycardic [...]

By | 2018-03-19T15:44:01+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on RADIATION INDUCED CONDUCTIVE HEART DISEASE: A NEED FOR REGISTRIES

HM2018 Abstract Number: 439

Rethinking the Diagnosis: A Case of Vertigo

Case Presentation: 80 year-old-male with past medical history of hypertension, coronary artery disease, chronic systolic heart failure, diabetes mellitus type 2, chronic kidney disease stage 2 presented with acute onset of constant vertigo for 1 [...]

By | 2018-03-19T15:44:01+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Rethinking the Diagnosis: A Case of Vertigo

HM2018 Abstract Number: 452

All JAK’d up on Budd

Case Presentation: A 66 year-old woman with a prior history of alcohol abuse presented from an outside hospital for further evaluation of a one week history of increasing abdominal distension, lower extremity edema and a [...]

By | 2018-03-19T15:44:01+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on All JAK’d up on Budd

HM2018 Abstract Number: 283

TECHNOLOGY TRENDS AMONG PARENTS OF HOSPITALIZED CHILDREN

Background: Technology within the inpatient setting is an opportunity to improve communication between patients, families, and their care team. Prior studies identified barriers to patient use of existing healthcare portals and patient preferences for functionality [...]

By | 2018-03-19T15:44:01+00:00 March 19th, 2018|Research, Technology in Hospital Medicine, Uncategorized|Comments Off on TECHNOLOGY TRENDS AMONG PARENTS OF HOSPITALIZED CHILDREN

HM2018 Abstract Number: 884

Provoked DVT- Is It May Thurner Syndrome?

Case Presentation: 28F PMH of cholelithiasis s/p recent lap cholecystectomy presented with chest pain and lower extremity edema for 2 days. Chest pain was not associated with shortness of breath or diaphoresis. It was relieved [...]

By | 2018-03-19T15:44:01+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Provoked DVT- Is It May Thurner Syndrome?

HM2018 Abstract Number: 85

PHYSICIAN PRACTICES SURROUNDING CONSTIPATION MANAGEMENT IN HOSPITALIZED OLDER ADULTS

Background: Despite its prevalence, constipation is frequently under-recognized and treated with ineffective agents in hospitalized older adults.Methods: An anonymous survey was distributed to physicians regarding constipation management in hospitalized older adults. Chi-square or Fisher’s exact, [...]

By | 2018-03-19T15:44:01+00:00 March 19th, 2018|Geriatrics, Research, Uncategorized|Comments Off on PHYSICIAN PRACTICES SURROUNDING CONSTIPATION MANAGEMENT IN HOSPITALIZED OLDER ADULTS

HM2018 Abstract Number: 13

THE EFFECTIVENESS OF MEDICAL ASSISTANT SUPPORT ON RESIDENT INPATIENT TEAMS TO ADDRESS THE HIGH SERVICE VS. EDUCATION IMBALANCE

Background: On the 2016 ACGME survey, our Internal Medicine residents indicated that our service vs. education rating was at 47% compared to the national average of 69%.Purpose: To decrease resident physician workload to improve our [...]

By | 2018-03-22T15:12:50+00:00 March 19th, 2018|Finalist Posters, Innovations, Quality Improvement, Uncategorized|Comments Off on THE EFFECTIVENESS OF MEDICAL ASSISTANT SUPPORT ON RESIDENT INPATIENT TEAMS TO ADDRESS THE HIGH SERVICE VS. EDUCATION IMBALANCE

HM2018 Abstract Number: 535

TISSUE IS THE ISSUE: A RARE PRESENTATION OF DIFFUSE DERMAL ANGIOMATOSIS IN A BODY BUILDER

Case Presentation: A 49-year-old actively competing male powerlifter presented to our institution for a second opinion of swelling, painful purpura, and necrotic skin ulcerations of the arms and legs. One month prior to presentation, he [...]

By | 2018-03-19T15:44:01+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on TISSUE IS THE ISSUE: A RARE PRESENTATION OF DIFFUSE DERMAL ANGIOMATOSIS IN A BODY BUILDER

HM2018 Abstract Number: 880

A CASE OF BILATERAL FACIAL PALSY

Case Presentation: A healthy 33-year-old woman presented with bilateral facial palsy for one week. Three weeks prior to presentation, she developed fevers, headache, diffuse myalgias, and distal limb paresthesias. One week prior to admission, she [...]

By | 2018-03-19T15:44:04+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A CASE OF BILATERAL FACIAL PALSY

HM2018 Abstract Number: 672

A RARE CASE OF MACROPHAGE ACTIVATION SYNDROME IN A PATIENT WITH JUVENILE RHEUMATOID ARTHRITIS

Case Presentation: A 21M with a PMHx of juvenile rheumatoid arthritis on chronic prednisone and Ilaris presented with fevers and diarrhea. He was seen by his rheumatologist on morning of presentation for his monthly Ilaris [...]

By | 2018-03-19T15:44:07+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A RARE CASE OF MACROPHAGE ACTIVATION SYNDROME IN A PATIENT WITH JUVENILE RHEUMATOID ARTHRITIS

HM2018 Abstract Number: 61

HEALTH SYSTEMS, INFORMATICS AND QUALITY IMRPOVEMENT CURRICULUM PROVIDES FRESH IDEAS TO HOSPITAL MEDICINE QI PROJECTS

Background: Identifying system failures and contributing to a culture of safety and improvement has been recognized by the AAMC as a Core Entrustable Professional Activity (EPA) for entering residency. The AAMC has endorsed increased quality [...]

By | 2018-03-19T15:44:07+00:00 March 19th, 2018|Education, Innovations, Uncategorized|Comments Off on HEALTH SYSTEMS, INFORMATICS AND QUALITY IMRPOVEMENT CURRICULUM PROVIDES FRESH IDEAS TO HOSPITAL MEDICINE QI PROJECTS

HM2018 Abstract Number: 5

MOVING THE BAR, EVEN IF YOU CAN’T MOVE THE BED

Background: The Institute for Healthcare Improvement tells us that successful discharge planning starts at admission; however, when that admission occurs to a closed Intensive Care Unit (ICU), traditional discharge planning can be delayed until the [...]

By | 2018-03-22T15:45:08+00:00 March 19th, 2018|Finalist Posters, Other, Research, Uncategorized|Comments Off on MOVING THE BAR, EVEN IF YOU CAN’T MOVE THE BED

HM2018 Abstract Number: 312

Long Stay Committee finds Innovative Discharge Plans for Difficult Discharges

Background: Hospital length of stay has been an important measure of hospital efficiency and resource utilization. Increase length of stay results in higher cost and increased morbidity to patients. Length of stay outliers or “long [...]

By | 2018-03-19T15:44:07+00:00 March 19th, 2018|Innovations, Transitions of Care, Uncategorized|Comments Off on Long Stay Committee finds Innovative Discharge Plans for Difficult Discharges

HM2018 Abstract Number: 570

A CASE OF CONCURRENT BACTERIAL AND VIRAL MENINGITIS IN AN IMMUNOCOMPETENT ADULT PATIENT

Case Presentation: A 35 year-old undomiciled male with a history of epilepsy and recurrent aseptic meningitis was brought in to the emergency department after being found unresponsive. Initial vital signs were notable for temperature of [...]

By | 2018-03-19T15:44:07+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A CASE OF CONCURRENT BACTERIAL AND VIRAL MENINGITIS IN AN IMMUNOCOMPETENT ADULT PATIENT

HM2018 Abstract Number: 135

PHOSPHATIDYLETHANOL LEVEL AS A PREDICTOR OF ACUTE ALCOHOL WITHDRAWAL

Background: Acute alcohol withdrawal syndrome (AWS) is a common complication in hospitalized patients, but its occurrence and severity is difficult to predict based on clinical indicators alone. Phosphatidylethanol (PEth) is an abnormal phospholipid incorporated into [...]

By | 2018-03-19T15:44:07+00:00 March 19th, 2018|Outcomes Research, Research, Uncategorized|Comments Off on PHOSPHATIDYLETHANOL LEVEL AS A PREDICTOR OF ACUTE ALCOHOL WITHDRAWAL

HM2018 Abstract Number: 247

Being A Lean Mean Discharging Machine

Background: Long discharge times (DT), (the time from discharge order to patient leaving room), have detrimental impacts on any hospital. Apart from causing dissatisfaction among patients and their families who are waiting to go home, [...]

By | 2018-03-19T15:44:07+00:00 March 19th, 2018|Innovations, Quality Improvement, Uncategorized|Comments Off on Being A Lean Mean Discharging Machine

HM2018 Abstract Number: 567

A CASE OF RECURRENT HEPATIC ENCEPHALOPATHY: LACTULOSE IS NOT THE ANSWER

Case Presentation: A 51-year-old woman presented with recurrent confusion and altered mental status over the past 6 months. She reported associated hallucinations, altered sleep cycle and hyper-arousal symptoms. She was treated with lactulose and rifaximin [...]

By | 2018-03-19T15:44:08+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A CASE OF RECURRENT HEPATIC ENCEPHALOPATHY: LACTULOSE IS NOT THE ANSWER

HM2018 Abstract Number: 67

ATTITUDES, KNOWLEDGE, AND CLINICAL APPLICATION OF POINT OF CARE ULTRASOUND: A NEEDS ASSESSMENT OF INTERNS IN INTERNAL MEDICINE

Background: Point of care ultrasound (POCUS) significantly augments physical exam and improves medical management, and many medical schools across the United States are implementing undergraduate POCUS curricula. As a result, internal medicine (IM) residency programs [...]

By | 2018-03-19T15:44:08+00:00 March 19th, 2018|Education, Research, Uncategorized|Comments Off on ATTITUDES, KNOWLEDGE, AND CLINICAL APPLICATION OF POINT OF CARE ULTRASOUND: A NEEDS ASSESSMENT OF INTERNS IN INTERNAL MEDICINE

HM2018 Abstract Number: 269

Assessing The Impact Of An Order Panel Utilizing Weight-Based Insulin And Standardized Monitoring Of Blood Glucose For Patients With Hyperkalemia

Background: The use of IV insulin is one of the primary therapeutic options for the treatment of hyperkalemia. Unfortunately the available literature reports that hypoglycemia is a common occurrence as a result of the treatment [...]

By | 2018-03-19T15:44:08+00:00 March 19th, 2018|Quality Improvement, Research, Uncategorized|Comments Off on Assessing The Impact Of An Order Panel Utilizing Weight-Based Insulin And Standardized Monitoring Of Blood Glucose For Patients With Hyperkalemia

HM2018 Abstract Number: 130

Hypertriglyceridemia – Induced Pancreatitis Management, Community-Based Teaching Hospital Experience

Background: Severe hypertriglyceridemia (triglyceride >1000 mg/dl) occurs at a rate of 0.4% and is associated with a range of medical complications including severe pancreatitis and its complications like acute kidney injury . Hypertriglyceridemia (HTG) is [...]

By | 2018-03-19T15:44:08+00:00 March 19th, 2018|Outcomes Research, Research, Uncategorized|Comments Off on Hypertriglyceridemia – Induced Pancreatitis Management, Community-Based Teaching Hospital Experience

HM2018 Abstract Number: 120

ASSOCIATION BETWEEN STEROID MODALITY AND LENGTH OF STAY IN ACUTE COPD EXACERBATIONS

Background: Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity, mortality, and cost with the greatest proportion incurred treating acute exacerbations of COPD (AECOPD). While guidelines recommend oral steroids for the treatment of AECOPD, [...]

By | 2018-03-19T15:44:08+00:00 March 19th, 2018|Outcomes Research, Research, Uncategorized|Comments Off on ASSOCIATION BETWEEN STEROID MODALITY AND LENGTH OF STAY IN ACUTE COPD EXACERBATIONS

HM2018 Abstract Number: 121

AN INVESTIGATIVE BIOFIRE SPUTUM FILM ARRAY PANEL IMPROVES RAPID DIAGNOSTICS IN PATIENTS HOSPITALIZED WITH COMMUNITY ACQUIRED PNEUMONIA

Background: With standard diagnostic methods, the etiologic pathogen of community acquired pneumonia (CAP) is detected in ≤ 50% hospitalized CAP patients. In our previous studies using a diagnostic “bundle”, we were able to detect etiologic [...]

By | 2018-03-19T15:44:08+00:00 March 19th, 2018|Outcomes Research, Research, Uncategorized|Comments Off on AN INVESTIGATIVE BIOFIRE SPUTUM FILM ARRAY PANEL IMPROVES RAPID DIAGNOSTICS IN PATIENTS HOSPITALIZED WITH COMMUNITY ACQUIRED PNEUMONIA

HM2018 Abstract Number: 298

Effect of Default Order Set Settings on Telemetry Ordering: Helping Residents Choose More Wisely

Background: Over the past fifty years, remote cardiac monitoring (“telemetry”) has become routine for many patients admitted to the hospital. Telemetry has many clinical benefits and is recommended by the American Heart Association for a [...]

By | 2018-03-19T15:44:08+00:00 March 19th, 2018|Research, Technology in Hospital Medicine, Uncategorized|Comments Off on Effect of Default Order Set Settings on Telemetry Ordering: Helping Residents Choose More Wisely

HM2018 Abstract Number: 536

ACUTE KIDNEY INJURY: A COLD CASE

Case Presentation: A 56 year-old woman with a history of untreated Hepatitis C, anal cancer status post chemotherapy and radiation, current IV heroin use, and MRSA tricuspid valve endocarditis presented with lethargy, jaundice, abdominal pain, [...]

By | 2018-03-19T15:44:08+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on ACUTE KIDNEY INJURY: A COLD CASE

HM2018 Abstract Number: 582

THE CASE OF THE VANISHING POTASSIUM: REFRACTORY HYPOKALEMIA WITH ACUTE OGILVIE’S SYNDROME

Case Presentation: A 59 year-old male with intellectual disability presented with abdominal pain and distension following a fecal impaction. Imaging revealed diffuse gaseous colonic distension with colonic wall thickening suggestive of inflammatory colitis and colonic [...]

By | 2018-03-19T15:44:08+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on THE CASE OF THE VANISHING POTASSIUM: REFRACTORY HYPOKALEMIA WITH ACUTE OGILVIE’S SYNDROME

HM2018 Abstract Number: 725

BLACK ESOPHAGUS: A CASE OF ACUTE ESOPHAGEAL NECROSIS

Case Presentation: Acute esophageal necrosis (AEN) is a rare condition which presents as acute-onset gastrointestinal bleeding. AEN is associated with vasculitis, coronary artery disease, malignancy, and other conditions which impair maintenance of the esophageal protective [...]

By | 2018-03-19T15:44:11+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on BLACK ESOPHAGUS: A CASE OF ACUTE ESOPHAGEAL NECROSIS

HM2018 Abstract Number: 726

HUMAN HERPES VIRUS 6 MENINGOENCEPHALITIS PRESENTING AS REFRACTORY SEIZURES IN AN IMMUNOCOMPETENT ADULT

Case Presentation: Human Herpes Virus 6 (HHV-6) is a member of the herpesviridae family. HHV-6 is the causative agent in roseola infantum, a usually mild and self-limiting childhood exanthem. HHV-6 is also associated with a [...]

By | 2018-03-19T15:44:13+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on HUMAN HERPES VIRUS 6 MENINGOENCEPHALITIS PRESENTING AS REFRACTORY SEIZURES IN AN IMMUNOCOMPETENT ADULT

HM2018 Abstract Number: 509

A CASE OF URTICARIAL VASCULITIS DUE TO PRIMARY EPSTEIN-BARR VIRUS INFECTION IN A PREGNANT PATIENT

Case Presentation: A 36-year-old Dominican female, G3P2002, at six weeks gestation and no significant medical history presented with complaints of fever, headache, myalgias, nausea, vomiting, diarrhea, and diffuse abdominal pain for two days. She denied [...]

By | 2018-03-19T15:44:14+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A CASE OF URTICARIAL VASCULITIS DUE TO PRIMARY EPSTEIN-BARR VIRUS INFECTION IN A PREGNANT PATIENT

HM2018 Abstract Number: 815

This Friendship Isn’t Working For Me: Septic Shock Secondary to Lactobacillus acidophilus Bacteremia

Case Presentation: A 37 year old woman with past medical history of septic shock secondary to urinary tract infection (UTI), systemic lupus erythematosus treated with oral prednisone 10 mg/day, functional quadriplegia due to transverse myelitis, [...]

By | 2018-03-19T15:44:14+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on This Friendship Isn’t Working For Me: Septic Shock Secondary to Lactobacillus acidophilus Bacteremia

HM2018 Abstract Number: 173

CONCURRENT NSAID AND WARFARIN USE IS ASSOCIATED WITH INCREASED BLOOD TRANSFUSIONS IN HOSPITALIZED PATIENTS

Background: Warfarin is commonly used in long-term anticoagulation and has a narrow therapeutic index. Dosing is dependent on intrinsic patient variables including cytochrome P450 2C9 (CYP2C9) and VKORC1 polymorphisms. High protein binding and CYP-dependent clearance [...]

By | 2018-03-19T15:44:14+00:00 March 19th, 2018|Patient Safety, Research, Uncategorized|Comments Off on CONCURRENT NSAID AND WARFARIN USE IS ASSOCIATED WITH INCREASED BLOOD TRANSFUSIONS IN HOSPITALIZED PATIENTS

HM2018 Abstract Number: 250

APPLICATION OF DATA ANALYTICS AND BOWTIE RISK METHODOLOGY TO REDUCE RATES OF HOSPITAL-ASSOCIATED VENOUS THROMBOEMBOLISM

Background: Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, is a serious public health problem causing over 90,000 deaths each year. VTE rates at our institution have been high and costly, with insurer [...]

By | 2018-03-19T15:44:14+00:00 March 19th, 2018|Innovations, Quality Improvement, Uncategorized|Comments Off on APPLICATION OF DATA ANALYTICS AND BOWTIE RISK METHODOLOGY TO REDUCE RATES OF HOSPITAL-ASSOCIATED VENOUS THROMBOEMBOLISM

HM2018 Abstract Number: 370

MORNING HEADACHES IN CHILDREN: WHAT LURKS BENEATH THE SURFACE?

Case Presentation: An 11 year old boy was admitted to the hospital due to 4 days of headache and vomiting. He described the pain as constant, sharp, occipital/frontal in location, and worse in the morning [...]

By | 2018-03-22T12:34:08+00:00 March 19th, 2018|Clinical Vignettes, Finalist Posters, Pediatric, Uncategorized|Comments Off on MORNING HEADACHES IN CHILDREN: WHAT LURKS BENEATH THE SURFACE?

HM2018 Abstract Number: 601

AN UNUSUAL CASE OF MYCOBACTERIUM AVIUM COMPLEX-ASSOCIATED TENOSYNOVITIS

Case Presentation: 64-year-old female with non-insulin-dependent type 2 diabetes mellitus presented to the emergency room with a 2-week history of progressive pain and swelling of her left index finger. Prior outpatient evaluation with X-rays and [...]

By | 2018-03-19T15:44:14+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on AN UNUSUAL CASE OF MYCOBACTERIUM AVIUM COMPLEX-ASSOCIATED TENOSYNOVITIS

HM2018 Abstract Number: 600

A RARE CASE OF RAPID GROWING NON-TUBERCULOUS MYCOBACTERIAL INFECTION AFTER A COSMETIC PROCEDURE

Case Presentation: A 43-year-old female patient with no medical history presented with multiple abdominal wall abscesses. She attended a cosmetic spa four months prior where she received weight loss injections known as “carboxy therapy” to [...]

By | 2018-03-19T15:44:14+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A RARE CASE OF RAPID GROWING NON-TUBERCULOUS MYCOBACTERIAL INFECTION AFTER A COSMETIC PROCEDURE

HM2018 Abstract Number: 795

The “SSA”fest Way To Approach A Case Of Acute Transverse Myelitis

Case Presentation: A 61 year old female presented to the ED with rapidly progressing lower extremity weakness, gait abnormalities, and urinary incontinence. Her neurologic exam was pertinent for bilateral lower extremity motor deficits, diminished reflexes, [...]

By | 2018-03-19T15:44:14+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on The “SSA”fest Way To Approach A Case Of Acute Transverse Myelitis

HM2018 Abstract Number: 76

CLOSING THE LOOP: A MULTI-CENTER INITIATIVE THAT USES PEER-TO-PEER FEEDBACK TO IMPROVE DIAGNOSTIC REASONING IN MEDICAL TRAINEES

Background: Development of diagnostic reasoning is a critical component of medical education, and feedback related to clinical outcomes is an important means of calibrating one’s diagnostic decision-making. The hospital is a key training ground for [...]

By | 2018-03-19T15:44:14+00:00 March 19th, 2018|Education, Research, Uncategorized|Comments Off on CLOSING THE LOOP: A MULTI-CENTER INITIATIVE THAT USES PEER-TO-PEER FEEDBACK TO IMPROVE DIAGNOSTIC REASONING IN MEDICAL TRAINEES

HM2018 Abstract Number: 209

A QUALITY IMPROVEMENT INTERVENTION: A HIGH-VALUE APPROACH TO HEPARIN-INDUCED THROMBOCYTOPENIA

Background: Heparin-Induced Thrombocytopenia (HIT) is an antibody-mediated pro-thrombotic disorder which occurs after exposure to heparin product. Diagnosis of HIT type II is rather challenging as affected individual often has other causes of thrombocytopenia and a [...]

By | 2018-03-19T15:44:14+00:00 March 19th, 2018|Quality Improvement, Research, Uncategorized|Comments Off on A QUALITY IMPROVEMENT INTERVENTION: A HIGH-VALUE APPROACH TO HEPARIN-INDUCED THROMBOCYTOPENIA

HM2018 Abstract Number: 349

PHYSICIAN PERCEPTIONS OF NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS ON HOSPITALIST TEAMS

Background: Physician Assistants (PAs) and Nurse Practitioners (NPs) play a growing role within hospital medicine groups. We studied physician perceptions of NPs and PAs in Hospital Medicine and identified factors that impact these perceptions.Methods: Data [...]

By | 2018-03-19T15:44:15+00:00 March 19th, 2018|Research, Uncategorized, Value in Hospital Medicine|Comments Off on PHYSICIAN PERCEPTIONS OF NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS ON HOSPITALIST TEAMS

HM2018 Abstract Number: 89

INTENSIFICATION OF ANTIHYPERTENSIVE REGIMENS DURING HOSPITALIZATION FOR UNRELATED CONDITIONS: TOO MUCH OF A GOOD THING?

Background: Transient elevations of blood pressure are common in hospitalized older adults and may lead inpatient clinicians to intensify inpatient antihypertensive therapy and discharge patients on these intensified regimens. Intensification of outpatient regimens during hospitalization [...]

By | 2018-03-19T15:44:15+00:00 March 19th, 2018|Geriatrics, Research, Uncategorized|Comments Off on INTENSIFICATION OF ANTIHYPERTENSIVE REGIMENS DURING HOSPITALIZATION FOR UNRELATED CONDITIONS: TOO MUCH OF A GOOD THING?

HM2018 Abstract Number: 695

CLOZAPINE-INDUCED MYOCARDITIS: A RARE ADVERSE DRUG EFFECT THAT MUST BE RECOGNIZED

Case Presentation: We present a case of a 24-year-old male with a history of schizophrenia who presented from a psychiatric facility for fever and tachycardia. The patient had been admitted to the facility for failure [...]

By | 2018-03-19T15:44:15+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on CLOZAPINE-INDUCED MYOCARDITIS: A RARE ADVERSE DRUG EFFECT THAT MUST BE RECOGNIZED

HM2018 Abstract Number: 696

PIPERACILLIN-TAZOBACTAM CAUSING NEPHROGENIC DIABETES INSIPIDUS: AN OLD DRUG, BUT A NEW ADVERSE DRUG EFFECT

Case Presentation: We present a case of a 50-year-old male with a history of developmental disability and hypothyroidism who presented from a nursing home with fatigue and cough for three days. The patient was found [...]

By | 2018-03-19T15:44:15+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on PIPERACILLIN-TAZOBACTAM CAUSING NEPHROGENIC DIABETES INSIPIDUS: AN OLD DRUG, BUT A NEW ADVERSE DRUG EFFECT

HM2018 Abstract Number: 683

ATYPICAL HEMOLYTIC-UREMIC SYNDROME – WHEN DIARRHEA BECOMES LIFE THREATENING

Case Presentation: Atypical (complement-mediated) Hemolytic-Uremic Syndrome is a rare but life threatening thrombotic microangiopathy that affects patients of all ages. About 33-40% of patients sustain end-stage renal disease, stroke, myocardial infarction or have mortality during [...]

By | 2018-03-19T15:44:15+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on ATYPICAL HEMOLYTIC-UREMIC SYNDROME – WHEN DIARRHEA BECOMES LIFE THREATENING

HM2018 Abstract Number: 918

Who done it: Is lupus really to blame?

Case Presentation: A 60-year-old woman presented with non-healing bilateral lower extremity ulcers. She had a history of systemic lupus erythematosus (SLE) treated with prednisone, azathioprine, methotrexate, and hydroxychloroquine. She previously took warfarin for treatment of [...]

By | 2018-03-19T15:44:15+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Who done it: Is lupus really to blame?

HM2018 Abstract Number: 413

Great Toes as the Diagnostic Secret for Fibrodysplasia Ossificans Progressiva

Case Presentation: A 12-year-old female presented to the ER with a 1-week history of painful swelling of her right upper back not alleviated by NSAIDs or warm packs. She denied a history of recent trauma [...]

By | 2018-03-19T15:44:15+00:00 March 19th, 2018|Clinical Vignettes, Pediatric, Uncategorized|Comments Off on Great Toes as the Diagnostic Secret for Fibrodysplasia Ossificans Progressiva

HM2018 Abstract Number: 92

YOU CAN’T HAVE IT ALL: THE EXPERIENCE OF ACADEMIC HOSPITALISTS DURING PREGNANCY, PARENTAL LEAVE, AND THE RETURN TO WORK

Background: Among Society of Hospital Medicine (SHM) members, 40% are women, and most of them are assistant professors, which suggests that a significant proportion of hospitalists are women of childbearing age. The United States lags [...]

By | 2018-03-19T15:44:18+00:00 March 19th, 2018|Other, Research, Uncategorized|Comments Off on YOU CAN’T HAVE IT ALL: THE EXPERIENCE OF ACADEMIC HOSPITALISTS DURING PREGNANCY, PARENTAL LEAVE, AND THE RETURN TO WORK

HM2018 Abstract Number: 314

EMR based sign-out: A tool that improves efficiency and satisfaction

Background: Transitions of care are critical to maintaining patient safety and decreasing adverse events, but they remain a complex process with many pitfalls. Electronic Medical Record (EMR) based handoffs can enhance communication by centralizing content [...]

By | 2018-03-19T15:44:20+00:00 March 19th, 2018|Innovations, Transitions of Care, Uncategorized|Comments Off on EMR based sign-out: A tool that improves efficiency and satisfaction

HM2018 Abstract Number: 215

Development and Implementation of an Electronic Health Record based Medication Reconciliation Risk Stratification Tool to Optimally Deploy Limited Pharmacy Resources

Background: Medication errors occur frequently at transitions of care and lead to significant patient harm. Robust medication reconciliation practices can mitigate these errors, but this process is complex and time-consuming. One of the conclusions of [...]

By | 2018-03-19T15:44:21+00:00 March 19th, 2018|Innovations, Quality Improvement, Uncategorized|Comments Off on Development and Implementation of an Electronic Health Record based Medication Reconciliation Risk Stratification Tool to Optimally Deploy Limited Pharmacy Resources

HM2018 Abstract Number: 675

A RARE CASE OF VASCULITIS-ASSOCIATED CVA IN AN ADULT PATIENT WITH HENOCH-SCHONLEIN PURPURA

Case Presentation: A 64 year-old male with a past medical history significant for COPD presented with fever, abdominal pain and rash. Patient endorsed fever and chills for 2 weeks prior to inpatient hospitalization. Patient subsequently [...]

By | 2018-03-19T15:44:21+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A RARE CASE OF VASCULITIS-ASSOCIATED CVA IN AN ADULT PATIENT WITH HENOCH-SCHONLEIN PURPURA

HM2018 Abstract Number: 676

INSANE IN THE MEMBRANE: A RARE CASE OF VIABLE NEUROCYSTICERCOSIS

Case Presentation: A 23 year-old Central American male with a past medical history significant for an isolated seizure one year prior to present admission presents with seizure and headache. Vital signs, examination and laboratory studies [...]

By | 2018-03-19T15:44:21+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on INSANE IN THE MEMBRANE: A RARE CASE OF VIABLE NEUROCYSTICERCOSIS

HM2018 Abstract Number: 273

Effect of Unit-Level Cessation of Intravenous Push Opiate Use on Patients’ Pain Experience and Hospital Length of Stay

Background: Opiates, frequently used to provide analgesia, are associated with post-analgesia related tolerance effects such as hyperalgesia and hyperkatifeia, which lead to worsening of the pain experience. Patients can subsequently experience dissatisfaction with their care [...]

By | 2018-03-19T15:44:21+00:00 March 19th, 2018|Innovations, Quality Improvement, Uncategorized|Comments Off on Effect of Unit-Level Cessation of Intravenous Push Opiate Use on Patients’ Pain Experience and Hospital Length of Stay

HM2018 Abstract Number: 647

VASCULITIS THROWS A CURVEBALL

Case Presentation: A 19 year-old man presented with two days of non-radiating left testicular pain. He denied associated symptoms or trauma. His past medical and surgical histories were unremarkable. He denied sexual activity and denied [...]

By | 2018-03-19T15:44:21+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on VASCULITIS THROWS A CURVEBALL

HM2018 Abstract Number: 172

HOW OFTEN ARE HEALTHCARE PERSONNEL HANDS COLONIZED WITH MULTI-DRUG RESISTANT ORGANISMS? A SYSTEMATIC REVIEW AND META-ANALYSIS

Background: The hands of hospitalists are often the source for transmitting multidrug resistant organisms (MDROs), and as such are the target of numerous hand hygiene interventions. Despite this focus, the prevalence of various MDROs on [...]

By | 2018-03-19T15:44:21+00:00 March 19th, 2018|Patient Safety, Research, Uncategorized|Comments Off on HOW OFTEN ARE HEALTHCARE PERSONNEL HANDS COLONIZED WITH MULTI-DRUG RESISTANT ORGANISMS? A SYSTEMATIC REVIEW AND META-ANALYSIS

HM2018 Abstract Number: 704

BOOT CAMP INDUCED ATTACK OF ACUTE INTERMITTENT PORPHYRIA

Case Presentation: A 21-year-old otherwise healthy female army recruit undergoing basic training was admitted to an outside hospital with severe abdominal pain, nausea, and vomiting. An abdominal CT was unremarkable. Laboratory results revealed hyponatremia (Na [...]

By | 2018-03-19T15:44:21+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on BOOT CAMP INDUCED ATTACK OF ACUTE INTERMITTENT PORPHYRIA

HM2018 Abstract Number: 193

Proportion of patients seen in perioperative clinic on optimal statin dose prior to surgery

Background: Recent data suggest that there are mortality benefits from preoperative statin therapy in patients at high risk for atherosclerotic cardiovascular disease (ASCVD). Current guidelines recommend moderate or high intensity statin for all patients with [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Perioperative, Research, Uncategorized|Comments Off on Proportion of patients seen in perioperative clinic on optimal statin dose prior to surgery

HM2018 Abstract Number: 752

YOU’RE GETTING ON MY NERVES: A CASE OF EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS

Case Presentation: A 27-year-old white male with adult-onset asthma and recurrent pneumonia presented to a rural hospital with a one month history of ascending lower extremity numbness. He also reported fever, fatigue, night sweats, and [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on YOU’RE GETTING ON MY NERVES: A CASE OF EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS

HM2018 Abstract Number: 565

Malignant Epistaxis: A case of wandering metastasis

Case Presentation: A 79-year-old male with metastatic prostate cancer status post multiple systemic agents presented with recurrent episodes of epistaxis with associated anemia and fatigue. The patient had a pertinent history of multifactorial CKD stage [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Malignant Epistaxis: A case of wandering metastasis

HM2018 Abstract Number: 416

Recollections of the Past: Recurrent Anti-NMDAr Encephalitis

Case Presentation: 17 year-old-male with a history of anti-NMDAr encephalitis three years prior presented with two days of confusion, agitation and insomnia. Associated symptoms included anorexia, blunted affect, slow movements and, though awake, refusal to [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Clinical Vignettes, Pediatric, Uncategorized|Comments Off on Recollections of the Past: Recurrent Anti-NMDAr Encephalitis

HM2018 Abstract Number: 750

Hemobilia due to Mycotic Hepatic Artery Aneurysm

Case Presentation: A 58 year old man with history of Enterococcus faecalis endocarditis and mechanical aortic valve replacement on oral anticoagulation presented to the emergency department with epigastric and right upper quadrant abdominal pain, melena, [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Hemobilia due to Mycotic Hepatic Artery Aneurysm

HM2018 Abstract Number: 237

IMPROVING RESPIRATORY RATE MEASUREMENT ACCURACY IN THE HOSPITAL: A QUALITY IMPROVEMENT INITIATIVE

Background: Respiratory rate (RR) is a predictor of adverse outcomes and an integral component of many risk prediction scores for hospitalized adults. Despite its clinical value, RRs are often inaccurate and may lead to misclassification [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Innovations, Quality Improvement, Uncategorized|Comments Off on IMPROVING RESPIRATORY RATE MEASUREMENT ACCURACY IN THE HOSPITAL: A QUALITY IMPROVEMENT INITIATIVE

HM2018 Abstract Number: 783

EYE’M MELTING

Case Presentation: A 50 year-old gentleman with seronegative rheumatoid arthritis on leflunamide presented with foreign body sensation, irritation, pain and photophobia in bilateral eyes which acutely worsened to bilateral vision loss. Funduscopic and slit-lamp examination [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on EYE’M MELTING

HM2018 Abstract Number: 864

REVENGE OF THE RABBIT

Case Presentation: A 60-year-old female presented to the emergency department with a chief complaint of dyspnea, fevers, and malaise that had worsened over two days. She was found to be in acute hypoxic respiratory failure, [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on REVENGE OF THE RABBIT

HM2018 Abstract Number: 320

A MULTI-DISCIPLINARY, MULTI-PRONGED APPROACH TO IMPROVING HANDOFFS FOR MEDICINE PATIENTS ADMITTED FROM THE EMERGENCY DEPARTMENT

Background: The high volume of handoffs between the Emergency Department (ED) team and the inpatient team on a daily basis makes this a ripe area for care improvement. Effective, safe and organized transitions facilitate high [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Innovations, Transitions of Care, Uncategorized|Comments Off on A MULTI-DISCIPLINARY, MULTI-PRONGED APPROACH TO IMPROVING HANDOFFS FOR MEDICINE PATIENTS ADMITTED FROM THE EMERGENCY DEPARTMENT

HM2018 Abstract Number: 22

IMPROVING CARE TEAM COMMUNICATIONS AND WORKFLOW EFFICIENCY IN HOSPITAL MEDICINE

Background: High volume communications to physicians for non-emergent issues can disrupt workflows and cause delays and inefficiencies. The frustration caused by unnecessary communication can also affect the job satisfaction of the Care Team. Physicians at [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Communication, Research, Uncategorized|Comments Off on IMPROVING CARE TEAM COMMUNICATIONS AND WORKFLOW EFFICIENCY IN HOSPITAL MEDICINE

HM2018 Abstract Number: 784

‘HAIRY’ KIDNEYS AND PERICARDIAL EFFUSION: A DIAGNOSTIC DILEMMA

Case Presentation: A 61 year-old-female presented to an outside institution with worsening exertional dyspnea, chest pressure, and fatigue. Echocardiogram revealed a large pericardial effusion bordering on tamponade which was drained with great improvement of symptoms. [...]

By | 2018-03-19T15:44:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on ‘HAIRY’ KIDNEYS AND PERICARDIAL EFFUSION: A DIAGNOSTIC DILEMMA

HM2018 Abstract Number: 386

CARDIAC AMYLOIDOSIS MISTAKEN FOR ANGIOEDEMA: A DELAY TO DIAGNOSIS

Case Presentation: A 57 year old man with a history of heart failure with preserved ejection fraction (HFpEF), chronic kidney disease (CKD) and hypertension presented with two weeks of exertional dyspnea and lower extremity edema, [...]

By | 2018-03-22T15:50:13+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Posters, Uncategorized|Comments Off on CARDIAC AMYLOIDOSIS MISTAKEN FOR ANGIOEDEMA: A DELAY TO DIAGNOSIS

HM2018 Abstract Number: 329

HOMECOMING: PATIENT CENTRIC NEXT SITE OF CARE RECOMMENDATIONS

Background: Currently, Physical and Occupational Therapy (PT/OT) documentation dictates next site of care. PT/OT recommends how much therapy is needed upon discharge and where the therapist believes these services should be provided, which is often [...]

By | 2018-03-19T15:44:27+00:00 March 19th, 2018|Research, Transitions of Care, Uncategorized|Comments Off on HOMECOMING: PATIENT CENTRIC NEXT SITE OF CARE RECOMMENDATIONS

HM2018 Abstract Number: 65

THE USE OF STANDARDIZED DISCHARGE EDUCATION ACROSS THE CONTINUUM OF CARE REDUCES HOSPITAL READMISSIONS

Background: Hospital readmission rates may be influenced by the level of healthcare literacy. Patients who lack an understanding of their diagnosis and warning signs have the potential to not seek medical care in a timely [...]

By | 2018-03-19T15:44:28+00:00 March 19th, 2018|Education, Research, Uncategorized|Comments Off on THE USE OF STANDARDIZED DISCHARGE EDUCATION ACROSS THE CONTINUUM OF CARE REDUCES HOSPITAL READMISSIONS

HM2018 Abstract Number: 134

THE IMPACT OF GOALS OF TREATMENT ON MORTALITY OUTCOMES

Background: Reversing the life trajectory of hospitalized patients can be challenging. Sixty percent of Americans die in acute care hospitals. Identification of the patient care goals and directives frequently happens after many days of aggressive, [...]

By | 2018-03-19T15:44:28+00:00 March 19th, 2018|Outcomes Research, Research, Uncategorized|Comments Off on THE IMPACT OF GOALS OF TREATMENT ON MORTALITY OUTCOMES

HM2018 Abstract Number: 39

A PALLIATIVE/SURPRISE SCREEN TEST HELPS IMPROVE TRANSITION OF CARE

Background: Early palliative care can be beneficial for patients and the health system alike. The principle of palliative care is to improve quality of life through patient-centric treatment goals and comfort measures. However, many patients [...]

By | 2018-03-19T15:44:28+00:00 March 19th, 2018|Communication, Research, Uncategorized|Comments Off on A PALLIATIVE/SURPRISE SCREEN TEST HELPS IMPROVE TRANSITION OF CARE

HM2018 Abstract Number: 596

The Good Patient: A case of B12 deficiency anemia caused by metformin use

Case Presentation: 44 year old male with insulin dependent type 2 Diabetes mellitus and hypothyroidism presented with fatigue, weakness, dyspnea on exertion and light headedness for several weeks. He denied bloody stools or melena. Medications [...]

By | 2018-03-19T15:44:28+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on The Good Patient: A case of B12 deficiency anemia caused by metformin use

HM2018 Abstract Number: 240

THE CREATION OF A DEDICATED HOSPITAL MEDICINE TEAM TO CARE FOR MEDICAL PATIENTS BOARDING IN THE EMERGENCY DEPARTMENT

Background: Emergency Department (ED) boarding, which occurs when admitted patients do not have an available bed in the hospital, has been associated with adverse patient outcomes. In 2014, 13,109 patients waited greater than 2 hours [...]

By | 2018-03-19T15:44:28+00:00 March 19th, 2018|Innovations, Quality Improvement, Uncategorized|Comments Off on THE CREATION OF A DEDICATED HOSPITAL MEDICINE TEAM TO CARE FOR MEDICAL PATIENTS BOARDING IN THE EMERGENCY DEPARTMENT

HM2018 Abstract Number: 620

LYMPHOCYTIC COLITIS MIMICKING HYPERPLASTIC POLYPOSIS SYNDROME

Case Presentation: 25 year-old female with past medical history of irritable bowel syndrome and asthma was evaluated for one year of watery diarrhea. She reported 3-4 watery bowel movement daily associated with abdominal cramping. No [...]

By | 2018-03-19T15:44:28+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on LYMPHOCYTIC COLITIS MIMICKING HYPERPLASTIC POLYPOSIS SYNDROME

HM2018 Abstract Number: 774

FEVER INDUCED TYPE I BRUGADA PATTERN IN AN ASYMPTOMATIC MAN – A CLINICAL CONUNDRUM

Case Presentation: 59 year old man with past medical history of renal cell carcinoma, with right nephrectomy 20 years ago, presented to the Emergency Department with fever and dysuria. Upon presentation, he was found to [...]

By | 2018-03-19T15:44:28+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on FEVER INDUCED TYPE I BRUGADA PATTERN IN AN ASYMPTOMATIC MAN – A CLINICAL CONUNDRUM

HM2018 Abstract Number: 455

NARROWING THE DIAGNOSIS: A CASE OF AN 18 YEAR OLD WITH SEVERE CARDIOMYOPATHY

Case Presentation: An 18 year old Spanish speaking male from Honduras presented following a motor vehicle accident. Initial assessment in the ED included a CXR and bedside Echocardiogram which noted cardiomegaly and a reduced EF [...]

By | 2018-03-19T15:44:28+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on NARROWING THE DIAGNOSIS: A CASE OF AN 18 YEAR OLD WITH SEVERE CARDIOMYOPATHY

HM2018 Abstract Number: 659

FROM A BURN SCAR TO MALIGNANCY! MARJOLIN’S ULCER, A DISEASE OF WOUND NEGLECT

Case Presentation: A 63-year-old gentleman with a past medical history of hypertension and remote history of left middle finger burn injury. He was admitted to the hospital with a 2-month history of painless left third [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on FROM A BURN SCAR TO MALIGNANCY! MARJOLIN’S ULCER, A DISEASE OF WOUND NEGLECT

HM2018 Abstract Number: 353

ATTENDING PHYSICIAN DELIVERED SEVEN-DAY CARE ON A GENERAL INTERNAL MEDICINE INPATIENT TEACHING SERVICE: RESULTS FROM A NEW MODEL OF CARE IN QATAR

Background: Inadequate access to seven-day inpatient medicine services, particularly at weekends, can lead to poor outcomes. Most evidence in this area is from North America and Europe but there is little or no evidence from [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Innovations, Uncategorized, Value in Hospital Medicine|Comments Off on ATTENDING PHYSICIAN DELIVERED SEVEN-DAY CARE ON A GENERAL INTERNAL MEDICINE INPATIENT TEACHING SERVICE: RESULTS FROM A NEW MODEL OF CARE IN QATAR

HM2018 Abstract Number: 282

Primum non nocere: Is Measuring Daily BNP Harmless?

Background: Serum B-type natriuretic peptide (BNP) levels, measured on admission and discharge, have been a prudent predictor of outcomes among patients with heart failure. However, daily BNP measurements have no benefits for the management of [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Quality Improvement, Research, Uncategorized|Comments Off on Primum non nocere: Is Measuring Daily BNP Harmless?

HM2018 Abstract Number: 167

A DATA MINING APPROACH TO DETECTING MEDICATION ORDER NEAR MISSES ASSOCIATED WITH ELECTRONIC ORDER SETS

Background: Adverse drug events (ADEs) are responsible for up to 770,000 inpatient injuries and deaths annually in the United States, most of which are from prescribing errors. Electronic order sets are designed to improve quality [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Patient Safety, Research, Uncategorized|Comments Off on A DATA MINING APPROACH TO DETECTING MEDICATION ORDER NEAR MISSES ASSOCIATED WITH ELECTRONIC ORDER SETS

HM2018 Abstract Number: 102

CARING FOR REFUGEES AND OTHER MIGRANTS IN NEW MEXICO: A SIMPLE HANDOUT FOR HOSPITALISTS

Background: In 2016, the United States resettled 96,900 refugees. In addition to its share of US resettled refugees, New Mexico was among the 10 states with the largest share of undocumented migrants (85,000) in 2014. [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Innovations, Other, Uncategorized|Comments Off on CARING FOR REFUGEES AND OTHER MIGRANTS IN NEW MEXICO: A SIMPLE HANDOUT FOR HOSPITALISTS

HM2018 Abstract Number: 906

AN ANATOMICAL EXPLANATION FOR A CHRONIC GASTROINTESTINAL COMPLAINT

Case Presentation: 75 yo female with a 20 year history of chronic dyspepsia, H. pylori, and C. difficile presented to the Emergency Department complaining of worsening nausea and two days of hematochezia. The patient stated [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on AN ANATOMICAL EXPLANATION FOR A CHRONIC GASTROINTESTINAL COMPLAINT

HM2018 Abstract Number: 870

CLONUS AND CONFUSION: A CASE OF SEROTONIN SYNDROME AND SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE

Case Presentation: A 23-year-old woman with generalized anxiety disorder presents with 1 day of altered mental status. She had been taking duloxetine and fluoxetine chronically; however, fluoxetine was abruptly stopped for several weeks and then [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on CLONUS AND CONFUSION: A CASE OF SEROTONIN SYNDROME AND SYNDROME OF INAPPROPRIATE ANTIDIURETIC HORMONE

HM2018 Abstract Number: 729

REINFORCING THE ATTACK AGAINST THE BODY: THE ASSOCIATION OF TWO AUTOIMMUNE DISORDERS

Case Presentation: We present a case of acquired hemophilia A (AHA) in an elderly patient with longstanding rheumatoid arthritis (RA). An 85-year-old woman was transferred from an outside hospital for further evaluation of spontaneous soft [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on REINFORCING THE ATTACK AGAINST THE BODY: THE ASSOCIATION OF TWO AUTOIMMUNE DISORDERS

HM2018 Abstract Number: 869

A CASE OF PEMBROLIZUMAB-INDUCED COMPLETE HEART BLOCK AND MYASTHENIA GRAVIS

Case Presentation: A 60-year-old man with coronary artery disease and metastatic renal cell carcinoma presents with worsening dyspnea on exertion 3 weeks after his first infusion of pembrolizumab. On presentation, he was tachycardic and in [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A CASE OF PEMBROLIZUMAB-INDUCED COMPLETE HEART BLOCK AND MYASTHENIA GRAVIS

HM2018 Abstract Number: 255

Improving Oncology Handoffs with Standardized Elements

Background: Standardizing inter-shift handoff procedures enhances continuity of care and quality with an associated reduction in preventable medical errors. This is particularly relevant in the inpatient oncology population where patients have a relatively high morbidity/mortality [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Quality Improvement, Research, Uncategorized|Comments Off on Improving Oncology Handoffs with Standardized Elements

HM2018 Abstract Number: 230

REDUCING DISCHARGE DELAYS AND ROOM TURNOVER TIME: DECREASING INEFFICIENCIES IN THE DISCHARGE PROCESS

Background: As a group of medical students in a five-week leadership program, we were charged with making a medicine inpatient unit at an urban quaternary care academic medical center the best unit in the hospital. [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Innovations, Quality Improvement, Uncategorized|Comments Off on REDUCING DISCHARGE DELAYS AND ROOM TURNOVER TIME: DECREASING INEFFICIENCIES IN THE DISCHARGE PROCESS

HM2018 Abstract Number: 928

Unrecognized Staphylococcal Vertebral Osteomyelitis and Epidural Abscess Leading to Meningitis, Infective Endocarditis, Cerebrovascular Accident, Sepsis and Death in a Previously Healthy Patient

Case Presentation: A 71-year-old Caucasian female with no known past medical history complained of insidious onset low back pain that became constant and severe, associated with generalized weakness and diffuse pain over the course of [...]

By | 2018-03-19T15:44:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Unrecognized Staphylococcal Vertebral Osteomyelitis and Epidural Abscess Leading to Meningitis, Infective Endocarditis, Cerebrovascular Accident, Sepsis and Death in a Previously Healthy Patient

HM2018 Abstract Number: 853

COMMON DRUG REACTION LEADS TO ALMOST FATAL CONCLUSION

Case Presentation: A 46-year-old Hispanic male with acquired immunodeficiency syndrome (AIDS), history of lymphoma in remission and hypertension presented with fever, generalized weakness and 20 pounds of weight loss over a month. On arrival, he [...]

By | 2018-03-19T15:44:32+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on COMMON DRUG REACTION LEADS TO ALMOST FATAL CONCLUSION

HM2018 Abstract Number: 440

BREAKTHROUGH INVASIVE PULMONARY SCOPULARIOPSIS IN AN IMMUNOCOMPROMISED HOST

Case Presentation: A 59-year old man presented with high grade fever (102 F), non-productive cough, and malaise for two months duration. His medical history was significant for of relapsing Chronic lymphocytic leukemia; on chemotherapy, Chronic [...]

By | 2018-03-19T15:44:34+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on BREAKTHROUGH INVASIVE PULMONARY SCOPULARIOPSIS IN AN IMMUNOCOMPROMISED HOST

HM2018 Abstract Number: 826

A CASE OF LOPERAMIDE-INDUCED VENTRICULAR TACHYCARDIA

Case Presentation: Loperamide is an over-the counter anti-motility opioid agonist considered to be specific to the intestinal µ receptor, safe for non-prescription use, and to have low abuse potential. However, several cases of fatal cardiac [...]

By | 2018-03-19T15:44:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A CASE OF LOPERAMIDE-INDUCED VENTRICULAR TACHYCARDIA

HM2018 Abstract Number: 456

IS DABIGITRAN EFFECTIVE IN THE MORBIDLY OBESE?

Case Presentation: A 50 year-old African American female with medical history of morbid obesity (BMI 40.8), hypertension, hyperlipidemia, diabetes mellitus, obstructive sleep apnea, atrial fibrillation, right MCA infarct one year prior to admission, and right [...]

By | 2018-03-19T15:44:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on IS DABIGITRAN EFFECTIVE IN THE MORBIDLY OBESE?

HM2018 Abstract Number: 875

WHIPPIT ABUSE: NOT A LAUGHING MATTER

Case Presentation: 46 year old woman presented with 1 week of bilateral lower extremity tingling, numbness, abnormal gait, leg spasms and impaired concentration. Exam revealed a disheveled, confused appearing Caucasian woman with a spastic, unsteady [...]

By | 2018-03-19T15:44:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on WHIPPIT ABUSE: NOT A LAUGHING MATTER

HM2018 Abstract Number: 36

Unexpected Roadblocks with the Implementation of a Code Status Educational Video Tool for Hospitalized Patients

Background: Many patients and their surrogates have a poor understanding of the process of cardiopulmonary resuscitation (CPR), its limitations, and its complications. Lack of knowledge about CPR may lead patients to choose a code status [...]

By | 2018-03-19T15:44:35+00:00 March 19th, 2018|Communication, Innovations, Uncategorized|Comments Off on Unexpected Roadblocks with the Implementation of a Code Status Educational Video Tool for Hospitalized Patients

HM2018 Abstract Number: 812

NOT YOUR AVERAGE GASTROINTESTINAL BLEED: WHEN AORTIC DISSECTION REPAIR GOES AWRY

Case Presentation: A 59-year old male with a history of hypertension, chronic kidney disease, and Stanford Type A aortic dissection (treated six years prior by open followed by endovascular repair) presented with a four-day history [...]

By | 2018-03-19T15:44:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on NOT YOUR AVERAGE GASTROINTESTINAL BLEED: WHEN AORTIC DISSECTION REPAIR GOES AWRY

HM2018 Abstract Number: 924

NOT ALL LACTATES ARE CREATED EQUAL: THE CASE OF A TYPE B LACTIC ACIDOSIS CAUSED BY INHALED ALBUTEROL

Case Presentation: A 90-year-old female presented with 3 weeks of cough and dyspnea despite a course of antibiotics prescribed by her primary care provider. She was admitted for management of pneumonia. On hospital day 2 [...]

By | 2018-03-19T15:44:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on NOT ALL LACTATES ARE CREATED EQUAL: THE CASE OF A TYPE B LACTIC ACIDOSIS CAUSED BY INHALED ALBUTEROL

HM2018 Abstract Number: 292

Point of Care Ultrasound Improves Shared Diagnostic Understanding Between Patients and Providers

Background: Point of care ultrasound (POCUS) has become an integral part of the physical examination and a valuable diagnostic tool. POCUS is unique among medical technologies in that it requires physical co-location of the provider [...]

By | 2018-03-19T15:44:35+00:00 March 19th, 2018|Research, Technology in Hospital Medicine, Uncategorized|Comments Off on Point of Care Ultrasound Improves Shared Diagnostic Understanding Between Patients and Providers

HM2018 Abstract Number: 737

A KIDNEY’S CRISIS

Case Presentation: A 46-year-old female presented for evaluation of two days of nausea and vomiting. She also described swelling in her legs and decreased urination over that time. Exam revealed blood pressure of 150/100 (baseline [...]

By | 2018-03-19T15:44:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A KIDNEY’S CRISIS

HM2018 Abstract Number: 47

LESSONS LEARNED FROM A RESIDENT-CREATED EXPERIENTIAL QUALITY IMPROVEMENT AND PATIENT SAFETY CURRICULUM FOR MEDICAL AND NURSING STUDENTS AT THE UNIVERSITY OF NEW MEXICO

Background: Quality improvement and patient safety (QI/PS) methods are being used to drive positive change in healthcare. To date, these efforts have led to slow and inconsistent change. Insufficient expertise remains a significant rate-limiting step [...]

By | 2018-03-19T15:44:35+00:00 March 19th, 2018|Education, Research, Uncategorized|Comments Off on LESSONS LEARNED FROM A RESIDENT-CREATED EXPERIENTIAL QUALITY IMPROVEMENT AND PATIENT SAFETY CURRICULUM FOR MEDICAL AND NURSING STUDENTS AT THE UNIVERSITY OF NEW MEXICO

HM2018 Abstract Number: 599

Blocking a Rash Diagnosis: An Unusual Case of Infective Endocarditis

Case Presentation: An 82-year-old man with a history of hypertension and known aortic insufficiency presented with bilateral lower extremity rash, ankle edema, and bradycardia. The ankle edema began two weeks prior to presentation followed by [...]

By | 2018-03-19T15:44:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Blocking a Rash Diagnosis: An Unusual Case of Infective Endocarditis

HM2018 Abstract Number: 41

Aren’t Adults Just Big Kids?: Standardizing Care of Adults in Pediatric Hospitals

Background: Nationally, the number of adult patients (18+ years of age) with chronic congenital and childhood conditions being admitted to children’s hospitals has been increasing, and in some cases outpacing the rate of increase in [...]

By | 2018-03-19T15:44:36+00:00 March 19th, 2018|Consultative Medicine, Innovations, Uncategorized|Comments Off on Aren’t Adults Just Big Kids?: Standardizing Care of Adults in Pediatric Hospitals

HM2018 Abstract Number: 401

Eye See You Noticed: Being a Pupil of the Physical Exam

Case Presentation: A healthy 11-year old female presented with 5 days of fever, headache, and progressive symptoms that included blurry vision, photophobia, lightheadedness, nausea, and intermittent vomiting. Family history was positive for migraine headaches. On [...]

By | 2018-03-19T15:44:36+00:00 March 19th, 2018|Clinical Vignettes, Pediatric, Uncategorized|Comments Off on Eye See You Noticed: Being a Pupil of the Physical Exam

HM2018 Abstract Number: 896

BILATERAL GIANT CELL ARTERITIS WITH RENAL ANCA-ASSOCIATED VASCULITIS

Case Presentation: 72-year-old Caucasian woman with PMH of cervical spinal stenosis presented with one-month history of worsening generalized weakness and soreness in all her extremities. Three months prior she had complained of persistent headaches for [...]

By | 2018-03-19T15:44:36+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on BILATERAL GIANT CELL ARTERITIS WITH RENAL ANCA-ASSOCIATED VASCULITIS

HM2018 Abstract Number: 131

HOW DOES GEOGRAPHIC COHORTING IMPACT THE WORK DAY?

Background: Background: Geographic cohorting (GCh) of clinicians to a single unit may improve teamwork and improve outcomes. The physical proximity between the care team is purported to mediate these positive effects. We conducted an exploratory [...]

By | 2018-03-19T15:44:36+00:00 March 19th, 2018|Outcomes Research, Research, Uncategorized|Comments Off on HOW DOES GEOGRAPHIC COHORTING IMPACT THE WORK DAY?

HM2018 Abstract Number: 390

SYPHILITIC HEPATITIS: AN UNCOMMON AND OVERLOOKED MENIFESTATION OF SECONDARY SYPHILIS

Case Presentation: An otherwise healthy 31 years old Brazilian male presented to the hospital with two months history of constitutional symptoms, diffuse pruritic rash on torso and extremities, and diffuse lymphadenopathy. He lived with his [...]

By | 2018-03-22T15:50:13+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Posters, Uncategorized|Comments Off on SYPHILITIC HEPATITIS: AN UNCOMMON AND OVERLOOKED MENIFESTATION OF SECONDARY SYPHILIS

HM2018 Abstract Number: 654

HICC-UP THE ANTE: A CATASTROPHIC CASE OF BABESIOSIS

Case Presentation: An 82 year-old male with atrial fibrillation, hypertension, and Type 2 Diabetes Mellitus presented with hiccups for five days. He also endorsed non-productive cough for weeks, chills, dysuria, and dark urine, for which [...]

By | 2018-03-19T15:44:36+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on HICC-UP THE ANTE: A CATASTROPHIC CASE OF BABESIOSIS

HM2018 Abstract Number: 309

Exploring patient and clinic staff members’ experiences with transitional care services: A case study approach

Background: Patients, particularly the elderly and those who have chronic illnesses, often experience adverse events when transitioning from the hospital to home. An estimated 20% of all discharged patients suffer a preventable adverse event (e.g., [...]

By | 2018-03-19T15:44:36+00:00 March 19th, 2018|Research, Transitions of Care, Uncategorized|Comments Off on Exploring patient and clinic staff members’ experiences with transitional care services: A case study approach

HM2018 Abstract Number: 97

THE HOSPITALIST FACULTY SCHOLARS PROGRAM: “TOPSOIL” TO NURTURE HOSPITALIST SCHOLARSHIP AND CAREER DEVELOPMENT

Background: Academic hospital medicine faculty often seek career paths in medical education, quality improvement, and/or research. However, few have formal training to develop scholarship in those domains. In recognition of the desire from faculty within [...]

By | 2018-03-19T15:44:36+00:00 March 19th, 2018|Innovations, Other, Uncategorized|Comments Off on THE HOSPITALIST FACULTY SCHOLARS PROGRAM: “TOPSOIL” TO NURTURE HOSPITALIST SCHOLARSHIP AND CAREER DEVELOPMENT

HM2018 Abstract Number: 316

HOME HEALTH NURSE PERSPECTIVES ON COMMUNICATION AFTER DISCHARGE: RESULTS FROM A STATEWIDE SURVEY

Background: Communication is critical to high-quality care transitions, yet little is known about the quality of information transfer from the hospital to home health care (HHC) setting. We performed a cross-sectional survey of HHC nurses [...]

By | 2018-03-19T15:44:36+00:00 March 19th, 2018|Research, Transitions of Care, Uncategorized|Comments Off on HOME HEALTH NURSE PERSPECTIVES ON COMMUNICATION AFTER DISCHARGE: RESULTS FROM A STATEWIDE SURVEY

HM2018 Abstract Number: 176

CORE 4 ELEMENTS ARE ASSOCIATED WITH SUSTAINED READMISSIONS REDUCTION IN PEDIATRIC HOSPITAL MEDICINE

Background: Inconsistent transitions of care from the inpatient to outpatient setting may lead to preventable readmissions. Critical processes completed at discharge shown to reduce readmissions at our institution include admission and discharge medication reconciliation, clinically [...]

By | 2018-03-19T15:44:36+00:00 March 19th, 2018|Pediatrics, Research, Uncategorized|Comments Off on CORE 4 ELEMENTS ARE ASSOCIATED WITH SUSTAINED READMISSIONS REDUCTION IN PEDIATRIC HOSPITAL MEDICINE

HM2018 Abstract Number: 558

VASODILATOR TESTING FOR IDIOPATHIC PULMONARY HYPERTENSION: IS IT REALLY NECESSARY?

Case Presentation: A 72 year old male presented with worsening shortness of breath and increasing oxygen requirement for six weeks. The patient had been on supplemental oxygen for the past 2 years for hypoxia. As [...]

By | 2018-03-19T15:44:36+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on VASODILATOR TESTING FOR IDIOPATHIC PULMONARY HYPERTENSION: IS IT REALLY NECESSARY?

HM2018 Abstract Number: 587

LISTEN TO YOUR GUT

Case Presentation: 60-year-old woman with a twelve-year history of presumed gastroparesis of unclear etiology, was admitted for worsening chronic abdominal pain, nausea and vomiting with unintentional weight loss of over 80 pounds over a year. [...]

By | 2018-03-19T15:44:39+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on LISTEN TO YOUR GUT

HM2018 Abstract Number: 578

A 50-YEAR-OLD MAN WITH MULTIPLE AND VARIED SYMPTOMS: HICKHAM VERSUS OCCAM – THE END-GAME

Case Presentation: A 50-year-old man visited our hospital with complaints of malaise, appetite loss, diarrhea, and arthralgia, all of which he had experienced for 5 days before the visit. Although he had been previously healthy [...]

By | 2018-03-19T15:44:41+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A 50-YEAR-OLD MAN WITH MULTIPLE AND VARIED SYMPTOMS: HICKHAM VERSUS OCCAM – THE END-GAME

HM2018 Abstract Number: 4

Duke Hospital Medicine Academic Engagement Improvement Project

Background: Many academic hospital medicine programs have reached a critical transition point as they attempt to sustain and develop growth in their non-clinical, academic missions. To meet increasing clinical needs, the Duke Hospital Medicine Program [...]

By | 2018-03-22T15:45:07+00:00 March 19th, 2018|Finalist Posters, Other, Research, Uncategorized|Comments Off on Duke Hospital Medicine Academic Engagement Improvement Project

HM2018 Abstract Number: 591

EBV Double Whammy

Case Presentation: A 19 year old African American male with no significant history presented to the emergency room with complaints of scleral icterus and epigastric abdominal pain after a week of headaches, fatigue and fevers. [...]

By | 2018-03-19T15:44:42+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on EBV Double Whammy

HM2018 Abstract Number: 429

MOYAMOYA WITH DVT AND TRANSIENT ANTIPHOSPHOLIPID ANTIBODIES

Case Presentation: A 60 -year old Caucasian female presented to the emergency department with right-sided hemiparesis and dysarthria. The patient had been admitted to an outside facility one week prior to presentation for left foot [...]

By | 2018-03-19T15:44:42+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on MOYAMOYA WITH DVT AND TRANSIENT ANTIPHOSPHOLIPID ANTIBODIES

HM2018 Abstract Number: 377

ATYPICAL PRESENTATION OF ANTI-SYNTHETASE SYNDROME IN A YOUNG WOMAN WITH REFRACTORY HYPOXIC RESPIRATORY FAILURE

Case Presentation: A 36-year-old female with a history of morbid obesity and hypertension presented with three weeks of progressive dyspnea and productive cough. She was previously diagnosed with community-acquired pneumonia and completed two five-day courses [...]

By | 2018-03-22T15:52:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Posters, Hospital Medicine 2018, Uncategorized|Comments Off on ATYPICAL PRESENTATION OF ANTI-SYNTHETASE SYNDROME IN A YOUNG WOMAN WITH REFRACTORY HYPOXIC RESPIRATORY FAILURE

HM2018 Abstract Number: 174

IMPROVING PATIENT SAFETY OUTCOMES AMONG PATIENTS TRANSFERRED FROM AN OUTSIDE FACILITY: A QUALITY IMPROVEMENT PROJECT

Background: Advances in technology and life-sustaining interventions afford patients access to a wider network of subspecialized care through inter-facility transfers. Implicit in these transfers are multiple complex steps that leave patients vulnerable to adverse events. [...]

By | 2018-03-19T15:44:42+00:00 March 19th, 2018|Innovations, Patient Safety, Uncategorized|Comments Off on IMPROVING PATIENT SAFETY OUTCOMES AMONG PATIENTS TRANSFERRED FROM AN OUTSIDE FACILITY: A QUALITY IMPROVEMENT PROJECT

HM2018 Abstract Number: 658

CMV-INDUCED ACUTE PANCREATITIS IN IMMUNOCOMPETENT PATIENT

Case Presentation: A 29-year-old otherwise healthy male presented to the emergency department with a 1-day history of abdominal pain radiating to his back and associated with nausea and nonbilious vomiting. He denied any fever, chills, [...]

By | 2018-03-19T15:44:42+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on CMV-INDUCED ACUTE PANCREATITIS IN IMMUNOCOMPETENT PATIENT

HM2018 Abstract Number: 897

HIGH IGG4 ANTIBODY LEVELS IN TISSUES WITH NORMAL CIRCULATING LEVELS IN SERUM: A PARADOX OF IGG4-RELATED DISEASE

Case Presentation: 41-year-old Hispanic man presented for reevaluation of the swellings on his forearms newly associated with Raynaud’s phenomenon on his fingers. He initially presented 5 years prior with swellings on his forearms and groin, [...]

By | 2018-03-19T15:44:42+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on HIGH IGG4 ANTIBODY LEVELS IN TISSUES WITH NORMAL CIRCULATING LEVELS IN SERUM: A PARADOX OF IGG4-RELATED DISEASE

HM2018 Abstract Number: 12

HOSPITALIST DIRECTED TRANSFERS IMPROVE EMERGENCY ROOM LENGTH OF STAY

Background: Emergency room (ER) crowding remains a widespread problem. Hospitalist led transfers for stable patients may be one intervention to improve patient flow and ER overcrowding. There are no prior studies assessing the impact of [...]

By | 2018-03-22T15:45:08+00:00 March 19th, 2018|Finalist Posters, Quality Improvement, Research, Uncategorized|Comments Off on HOSPITALIST DIRECTED TRANSFERS IMPROVE EMERGENCY ROOM LENGTH OF STAY

HM2018 Abstract Number: 907

A RECURRENT PAIN IN THE REAR

Case Presentation: 23 year-old woman presenting with left thigh pain and erythema. Reported rapid onset of pain in left upper thigh and buttock one day prior to admission with no associated fever or chills and [...]

By | 2018-03-19T15:44:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on A RECURRENT PAIN IN THE REAR

HM2018 Abstract Number: 420

MILK INDUCED HEART FAILURE

Case Presentation: A 23 month old female with minimal primary care visits presented to the ED after a syncopal episode. She was found to be tachycardic, tachypneic, and hypoxic. Physical exam revealed an irritable, pale [...]

By | 2018-03-19T15:44:43+00:00 March 19th, 2018|Clinical Vignettes, Pediatric, Uncategorized|Comments Off on MILK INDUCED HEART FAILURE

HM2018 Abstract Number: 362

Low-value use of procalcitonin testing after introduction at an academic medical center

Background: Procalcitonin (PCT) is a biomarker that correlates with the presence of bacterial infection in certain clinical scenarios; it has increasingly accepted indications for antibiotic stewardship. Most sources suggest that antibiotics should be considered for [...]

By | 2018-03-19T15:44:43+00:00 March 19th, 2018|Research, Uncategorized, Value in Hospital Medicine|Comments Off on Low-value use of procalcitonin testing after introduction at an academic medical center

HM2018 Abstract Number: 921

RECURRENT CARDIAC ARREST – AN UNEXPECTED CAUSE

Case Presentation: A 52-year-old African-American male was admitted to the hospital with sepsis secondary to urinary tract infection and pneumonia. His past medical history is significant for gunshot wound to C6-C7 region of the spine [...]

By | 2018-03-19T15:44:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on RECURRENT CARDIAC ARREST – AN UNEXPECTED CAUSE

HM2018 Abstract Number: 514

COMMON VARIABLE IMMUNODEFICIENCY WITH GRANULOMATOUS-LYMPHOCYTIC INTERSTITIAL LUNG DISEASE

Case Presentation: A 34 year old male with a history of CVID subclass 2 and 4, with low IgG level, absent IgA, liver nodular regenerative hyperplasia with portal hypertension, and immune thrombocytopenic purpura status post [...]

By | 2018-03-19T15:44:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on COMMON VARIABLE IMMUNODEFICIENCY WITH GRANULOMATOUS-LYMPHOCYTIC INTERSTITIAL LUNG DISEASE

HM2018 Abstract Number: 922

SALICYLATE TOXICITY- WHEN INTUBATION BECOMES NECESSARY

Case Presentation: A 54-year-old female with past medical history significant for major depression with prior suicide attempt was brought to the hospital after a repeat attempted suicide. She reportedly consumed several aspirin pills, but the [...]

By | 2018-03-19T15:44:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on SALICYLATE TOXICITY- WHEN INTUBATION BECOMES NECESSARY

HM2018 Abstract Number: 754

Don’t Leave Me Hanging Out to Dry

Case Presentation: A 49-year old man with no significant medical history presented with dyspnea and presyncope. He presented similarly six weeks prior and was diagnosed with constrictive pericarditis thought to be of a viral etiology. [...]

By | 2018-03-19T15:44:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on Don’t Leave Me Hanging Out to Dry

HM2018 Abstract Number: 891

DYSPHAGIA AORTICA WITH LEFT ATRIAL COMPRESSION: A RARE CAUSE OF DYSPHAGIA IN AN ELDERLY MAN

Case Presentation: An 80 years old male with pertinent history of coronary artery disease, descending fusiform thoracic aortic aneurysm and systolic heart failure presented with shortness of breath and chest pain. Exam revealed bibasilar lung [...]

By | 2018-03-19T15:44:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Uncategorized|Comments Off on DYSPHAGIA AORTICA WITH LEFT ATRIAL COMPRESSION: A RARE CAUSE OF DYSPHAGIA IN AN ELDERLY MAN

HM2018 Abstract Number: 299

DIAGNOSING DISCHARGE BARRIERS WITH A VIRTUAL MULTIDISCIPLINARY ROUNDING TOOL

Background: Reducing length of stay to improve access, minimize hospital-associated morbidity, and reduce cost is a top priority at many hospitals. Information about barriers and delays impacting discharge (i.e., arranging subacute nursing facility placement, setting [...]

By | 2018-03-19T15:44:43+00:00 March 19th, 2018|Innovations, Technology in Hospital Medicine, Uncategorized|Comments Off on DIAGNOSING DISCHARGE BARRIERS WITH A VIRTUAL MULTIDISCIPLINARY ROUNDING TOOL

HM2018 Abstract Number: 260

EMPOWERING MEDICINE RESIDENTS TO THINK BEFORE ORDERING DAILY LABS. A QUALITY IMPROVEMENT STUDY.

Background: Healthcare costs are a challenge; for the greatest impact, high-value care education should begin early in residency training. Routine lab ordering for hospitalized patients is a well-known cause of high costs. This study utilized [...]

By | 2018-03-19T13:24:52+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Quality Improvement|Comments Off on EMPOWERING MEDICINE RESIDENTS TO THINK BEFORE ORDERING DAILY LABS. A QUALITY IMPROVEMENT STUDY.

HM2018 Abstract Number: 734

A STROKE MISDIAGNOSED: A CASE OF FAMILIAL CREUTZFELDT-JAKOB DISESASE REVEALED

Case Presentation: A 68 year-old male with hypertension and bipolar disorder presented with a 3-week history of memory deficits, weight loss, and increasing irritability. Exam revealed disorientation, dysarthria, and left sided weakness. MRI was suggestive [...]

By | 2018-03-19T13:24:48+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A STROKE MISDIAGNOSED: A CASE OF FAMILIAL CREUTZFELDT-JAKOB DISESASE REVEALED

HM2018 Abstract Number: 158

An Interdisciplinary Team to Support Implementation of a “System-of-Systems” to Identify, Assess, and Mitigate Threats to Patient Safety in Real-Time

Background: Implementing technology with the goal of eliminating preventable hospital-acquired conditions (e.g., CAUTI, CLABSI, etc.) in the acute care setting is an ongoing challenge, but it is crucial to creating a safer healthcare system. Increasingly, [...]

By | 2018-03-19T13:24:46+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Patient Safety|Comments Off on An Interdisciplinary Team to Support Implementation of a “System-of-Systems” to Identify, Assess, and Mitigate Threats to Patient Safety in Real-Time

HM2018 Abstract Number: 223

SCRIBES IN HOSPITAL MEDICINE- A POWERFUL VALUE-ADDED RESOURCE!

Background: Since the advent of Electronic Health Record(EHR) and subsequent workload of clinical documentation, Hospital Medicine physicians are finding themselves spending more time in front of the computer and less with their patients. The implementation [...]

By | 2018-03-19T13:24:45+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Quality Improvement|Comments Off on SCRIBES IN HOSPITAL MEDICINE- A POWERFUL VALUE-ADDED RESOURCE!

HM2018 Abstract Number: 23

EXPECTATIONS FOR PHYSICIAN COMMUNIATION WITH FAMILY/CAREGIVERS ABOUT GERIATRIC PATIENTS’ CARE DURING HOSPITALIZATION

Background: Elderly inpatients often require the support of family and informal caregivers at transitions and yet adequacy of communication between hospital physicians and members of the patient’s social support is poorly studied.Methods: Mixed methodology survey [...]

By | 2018-03-19T13:24:43+00:00 March 19th, 2018|Communication, Hospital Medicine 2018, Research|Comments Off on EXPECTATIONS FOR PHYSICIAN COMMUNIATION WITH FAMILY/CAREGIVERS ABOUT GERIATRIC PATIENTS’ CARE DURING HOSPITALIZATION

HM2018 Abstract Number: 434

A GIANT BLOB OF FAT – A RARE CASE OF GASTRIC OUTLET OBSTRUCTION.

Case Presentation: A 70 year old man presented with four days of epigastric pain, nausea, vomiting and abdominal distension. He reported 50lbs of weight loss due to decrease in appetite over two months. He denied [...]

By | 2018-03-19T13:24:41+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A GIANT BLOB OF FAT – A RARE CASE OF GASTRIC OUTLET OBSTRUCTION.

HM2018 Abstract Number: 433

‘DIARRHEA, THE TIP OF THE ICEBERG’ A FATAL CASE OF ENTEROPATHY ASSOCIATED T-CELL LYMPHOMA

Case Presentation: A 67 year old woman presented with right upper quadrant abdominal pain and was diagnosed with acute cholecystitis. She underwent elective cholecystectomy, complicated by Clostridium difficile colitis. Despite treatment with oral Vancomycin, she [...]

By | 2019-03-11T16:27:38+00:00 March 19th, 2018|Adult, Clinical Vignettes|Comments Off on ‘DIARRHEA, THE TIP OF THE ICEBERG’ A FATAL CASE OF ENTEROPATHY ASSOCIATED T-CELL LYMPHOMA

HM2018 Abstract Number: 275

Abdominal Aortic Aneurysm Screening in A Resident-Run Clinic – A Commonly Underutilized Screening Test

Background: Abdominal aortic aneurysm (AAA), defined as aortic diameter ≥ 3.0 cm, affects an estimated 1.5% to 1.7% of men aged 65 or older. It was estimated that a ruptured AAA has a mortality rate [...]

By | 2018-03-19T13:24:38+00:00 March 19th, 2018|Hospital Medicine 2018, Quality Improvement, Research|Comments Off on Abdominal Aortic Aneurysm Screening in A Resident-Run Clinic – A Commonly Underutilized Screening Test

HM2018 Abstract Number: 101

REAL-WORLD TREATMENT OF LOWER RESPIRATORY TRACT INFECTIONS IN THE TELAVANCIN OBSERVATIONAL USE REGISTRY (TOUR™)

Background: TOUR™ is a multicenter study designed to characterize the real-world population characteristics and clinical outcomes associated with telavancin (TLV) use through retrospective medical chart review. Telavancin is a lipoglycopeptide antibacterial active against gram-positive pathogens, [...]

By | 2018-03-19T13:24:36+00:00 March 19th, 2018|Hospital Medicine 2018, Other, Research|Comments Off on REAL-WORLD TREATMENT OF LOWER RESPIRATORY TRACT INFECTIONS IN THE TELAVANCIN OBSERVATIONAL USE REGISTRY (TOUR™)

HM2018 Abstract Number: 883

RARE CASE OF HYPOKALEMIC PERIODIC PARALYSIS ASSOCIATED WITH MARIJUANA BINGE EPISODE

Case Presentation: A 30-year-old male presented to the ED with sudden onset flaccid paralysis involving the entire body except the head and neck. He reported heavy marijuana use 2 days prior during which he consumed [...]

By | 2018-03-19T13:24:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on RARE CASE OF HYPOKALEMIC PERIODIC PARALYSIS ASSOCIATED WITH MARIJUANA BINGE EPISODE

HM2018 Abstract Number: 266

MEDICATION RECONCILIATION: REC IT RIGHT, SO IT’S NOT A WRECK

Background: The Joint Commission (TJC) included medication reconciliation (MedRec) as a 2005 National Patient Safety Goal to reduce errors related to medication omissions, duplications and interactions. Medication errors and harms continue to be one of [...]

By | 2018-03-19T13:24:33+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Quality Improvement|Comments Off on MEDICATION RECONCILIATION: REC IT RIGHT, SO IT’S NOT A WRECK

HM2018 Abstract Number: 539

SARCOID WITH SUBACUTE CONFUSION

Case Presentation: A 64 year old male suffered from gradual onset fatigue and change in mentation over the course of a month. His symptoms then progressively worsened as he became confused and developed intermittent headaches. [...]

By | 2018-03-19T13:24:32+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on SARCOID WITH SUBACUTE CONFUSION

HM2018 Abstract Number: 678

AN ATYPICAL PRESENTATION OF MYXEDEMA COMA

Case Presentation: A 49-year-old male presented with altered mental status and diffuse body pain. He denied any alcohol or drug intoxication, chest pain, shortness of breath, or infectious symptoms. His past history included chronic hypothyroidism [...]

By | 2018-03-19T13:24:30+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on AN ATYPICAL PRESENTATION OF MYXEDEMA COMA

HM2018 Abstract Number: 311

EFFECTIVENESS OF COMMUNICATION DURING ICU TO WARD TRANSFER: PREVALENCE OF A SHARED MENTAL MODEL

Background: Previous studies demonstrate patient readmissions to the Medical Intensive Care unit (MICU) from the ward are potentially associated with worse outcomes due to breakdowns in communication during ICU-ward transfer. Though previous work highlights the [...]

By | 2018-03-19T13:24:28+00:00 March 19th, 2018|Hospital Medicine 2018, Research, Transitions of Care|Comments Off on EFFECTIVENESS OF COMMUNICATION DURING ICU TO WARD TRANSFER: PREVALENCE OF A SHARED MENTAL MODEL

HM2018 Abstract Number: 893

SPONTANEOUS ONSET OF COMPLEX REGIONAL PAIN SYNDROME (TYPE 1)

Case Presentation: A 44-year-old Hispanic male presented with a two-month history of sudden onset, severe left lower extremity burning pain associated with edema, erythema, and intermittent paresthesia, limiting his daily activities. His symptoms were initially [...]

By | 2018-03-19T13:24:25+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on SPONTANEOUS ONSET OF COMPLEX REGIONAL PAIN SYNDROME (TYPE 1)

HM2018 Abstract Number: 931

Fulminant gram-negative septic shock due to Capnocytophaga infection.

Case Presentation: 68-year-old female presented to the Emergency Department with dark liquid stool, nausea, and dry heaves for 4 days. She denied eating anything unusual, sick contacts, or recent tick exposure. Medical history was only [...]

By | 2018-03-19T13:24:24+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Fulminant gram-negative septic shock due to Capnocytophaga infection.

HM2018 Abstract Number: 618

EVERY RED IS NOT CELLULITIS: DEPENDENT RUBOR RARE BUT CLASSICAL FINDING OF SEVERE ARTERIAL INSUFFICIENCY

Case Presentation: A sixty-eight-year-old man was admitted for severe depression with suicidal ideation. He had a history of insulin dependent Diabetes Mellitus, non-obstructive coronary artery disease with a ninety-pack year history of smoking. Physical examination [...]

By | 2018-03-19T13:24:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on EVERY RED IS NOT CELLULITIS: DEPENDENT RUBOR RARE BUT CLASSICAL FINDING OF SEVERE ARTERIAL INSUFFICIENCY

HM2018 Abstract Number: 630

LARGE LEFT LIVER LOBE LESION: A LURKING LANGUISHMENT

Case Presentation: A healthy 50-year-old woman with no past medical history was transferred from an outside hospital for intermittent, progressively worsening abdominal pain of six weeks duration. Her pain was sharp, stabbing, and located in [...]

By | 2018-03-19T13:24:21+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on LARGE LEFT LIVER LOBE LESION: A LURKING LANGUISHMENT

HM2018 Abstract Number: 631

PERIPHERAL SMEAR: A HIGH VALUE CARE ADDITION TO THE WORKUP OF A FEVER OF UNKNOWN ORIGIN

Case Presentation: A 68 year old man with past medical history of rheumatoid arthritis with recent travel to Mexico was admitted after clinically worsening at home roughly a week after a previous 10 day admission [...]

By | 2018-03-19T13:24:19+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PERIPHERAL SMEAR: A HIGH VALUE CARE ADDITION TO THE WORKUP OF A FEVER OF UNKNOWN ORIGIN

HM2018 Abstract Number: 731

A RARE CASE OF BCG-OSIS

Case Presentation: A 78-year-man with a high-grade-T1-urothelial carcinoma status post transurethral resection of the prostate (TURBT), on weekly intravesical-BCG for past 2-months, presented a day following his last instillation with fever, chills and altered mental [...]

By | 2018-03-19T13:24:17+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A RARE CASE OF BCG-OSIS

HM2018 Abstract Number: 51

RESIDENT AND HOSPITALIST PERCEPTIONS OF OVERNIGHT TEACHING: TIME FOR IMPROVEMENT

Background: Duty hour restrictions for resident physicians have led to the ubiquity of night float systems. While this change has positively influenced well-being and supervision, limited studies indicate a negative impact of night float rotations [...]

By | 2018-03-19T13:24:16+00:00 March 19th, 2018|Education, Hospital Medicine 2018, Research|Comments Off on RESIDENT AND HOSPITALIST PERCEPTIONS OF OVERNIGHT TEACHING: TIME FOR IMPROVEMENT

HM2018 Abstract Number: 773

A CASE OF CANAGLIFLOZIN INDUCED EUGLYCEMIC DIABETIC KETOACIDOSIS: RARE BUT SIGNIFICANT

Case Presentation: A 54 year-old woman with a past medical history of hypertension and Type 2 diabetes mellitus treated with metformin and canagliflozin presented to the hospital with lethargy and malaise. She reported that her [...]

By | 2018-03-19T13:24:13+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A CASE OF CANAGLIFLOZIN INDUCED EUGLYCEMIC DIABETIC KETOACIDOSIS: RARE BUT SIGNIFICANT

HM2018 Abstract Number: 859

Atypical Acute Encephalitis Due to Immune Checkpoint Inhibitor

Case Presentation: An 84-year-old man with stage II non-small cell lung adenocarcinoma had tumor recurrence in the lungs after lobectomy. For first line systemic therapy he was started on pembrolizumab, a monoclonal antibody immune checkpoint [...]

By | 2018-03-19T13:24:11+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Atypical Acute Encephalitis Due to Immune Checkpoint Inhibitor

HM2018 Abstract Number: 418

Thinking Lupus? Check the Lipase.

Case Presentation: A 10-year-old Hispanic female with 7 years of episodic cervical lymphadenopathy and fever, presented with typical episode, new abdominal pain and emesis. Review of systems was positive for weight loss, night sweats, and [...]

By | 2018-03-19T13:24:09+00:00 March 19th, 2018|Clinical Vignettes, Hospital Medicine 2018, Pediatric|Comments Off on Thinking Lupus? Check the Lipase.

HM2018 Abstract Number: 892

STERNOCLAVICULAR SEPTIC ARTHRITIS: A RARE PRESENTATION OF SHOULDER PAIN

Case Presentation: A 69 years old farmer presented to the hospital with right shoulder pain, fever and chills. Past medical history was significant for coronary artery disease, a remote history of neck tumor status post [...]

By | 2018-03-19T13:24:06+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on STERNOCLAVICULAR SEPTIC ARTHRITIS: A RARE PRESENTATION OF SHOULDER PAIN

HM2018 Abstract Number: 538

NONUREMIC CALCIPHYLAXIS – AN INFREQUENT DIAGNOSIS WITHOUT STANDARD OF CARE

Case Presentation: 59 year old African American male with a history of sarcoidosis on prednisone, pulmonary HTN, CKD 3, NIDDM, and NICM presented to the ED with a 2 week history of leg swelling/pain. He [...]

By | 2018-03-19T13:24:05+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NONUREMIC CALCIPHYLAXIS – AN INFREQUENT DIAGNOSIS WITHOUT STANDARD OF CARE

HM2018 Abstract Number: 890

CONGENITAL INFERIOR VENA CAVA ATRESIA: A RARE CULPRIT ASSOCIATED WITH RECURRENT DEEP VEIN THROMBOSIS

Case Presentation: A 45 years old Vietnamese male was diagnosed with left leg deep vein thrombosis about 2 years ago in Vietnam for which he was taking herbal supplements without improvement. Soon after immigrating to [...]

By | 2018-03-19T13:24:03+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on CONGENITAL INFERIOR VENA CAVA ATRESIA: A RARE CULPRIT ASSOCIATED WITH RECURRENT DEEP VEIN THROMBOSIS

HM2018 Abstract Number: 63

A CHARACTERIZATION OF RESIDENT WORK ROUNDS IN THE UNITED STATES

Background: Resident work rounds (RWR) serve as the venue for team-based patient interaction, subsequent patient care planning, and education through didactics and observation. However, the expectations of RWR are unclear; do residents continue to see [...]

By | 2018-03-19T13:24:02+00:00 March 19th, 2018|Education, Hospital Medicine 2018, Research|Comments Off on A CHARACTERIZATION OF RESIDENT WORK ROUNDS IN THE UNITED STATES

HM2018 Abstract Number: 914

BRONCHIECTASIS IN A YOUNG ADULT: A CASE OF SYMPTOMATIC CYSTIC FIBROSIS IN A HETEROZYGOTE

Case Presentation: A 38-year-old Guyanese man with a history of pulmonary tuberculosis 16 years ago, treated with a standard four-drug regimen, presented with an acute exacerbation of chronic cough which he had suffered for 12 [...]

By | 2018-03-19T13:23:59+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on BRONCHIECTASIS IN A YOUNG ADULT: A CASE OF SYMPTOMATIC CYSTIC FIBROSIS IN A HETEROZYGOTE

HM2018 Abstract Number: 622

HOW PILLS CAN BREAK YOUR HEART

Case Presentation: A sixty-eight year-old woman presented with two days of confusion and lethargy following two weeks of worsening abdominal pain, nausea and emesis. Medical history was significant for chronic pain, depression, hypertension, and a [...]

By | 2018-03-19T13:23:57+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on HOW PILLS CAN BREAK YOUR HEART

HM2018 Abstract Number: 808

A CASE OF ACUTE HEMOLYTIC ANEMIA FOLLOWING HIGH DOSE INTRAVENOUS IMMUNOGLOBULIN (IVIG)

Case Presentation: A 32-year-old African American male past medical history significant for recently diagnosed Guillain-Barre syndrome (GBS) was admitted for recurrent mechanical falls at home. One week prior to his admission, he was treated for [...]

By | 2018-03-19T13:23:56+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A CASE OF ACUTE HEMOLYTIC ANEMIA FOLLOWING HIGH DOSE INTRAVENOUS IMMUNOGLOBULIN (IVIG)

HM2018 Abstract Number: 356

DIFFERENCES IN HEALTHCARE OUTCOMES FOR PATIENTS WITH DELIRIUM BETWEEN TEACHING AND NONTEACHING HOSPITALS

Background: The American healthcare system is focused on promoting value; providing high quality care while paying close attention to associated costs. Studies have shown that admission to a teaching hospital is associated with better outcomes, [...]

By | 2018-03-19T13:23:54+00:00 March 19th, 2018|Hospital Medicine 2018, Research, Value in Hospital Medicine|Comments Off on DIFFERENCES IN HEALTHCARE OUTCOMES FOR PATIENTS WITH DELIRIUM BETWEEN TEACHING AND NONTEACHING HOSPITALS

HM2018 Abstract Number: 840

INTRACTABLE HICCUPS: AN UNSUAL PRESENTATION OF NEUROSARCOIDOSIS

Case Presentation: 65-year-old female with no significant past medical history presented with intractable hiccups for past few months. Hiccups were progressively getting worse with development of intermittent nausea. Her vital signs and physical exam were [...]

By | 2018-03-19T13:23:53+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on INTRACTABLE HICCUPS: AN UNSUAL PRESENTATION OF NEUROSARCOIDOSIS

HM2018 Abstract Number: 881

Hypertrophic Cardiomyopathy with Atrial Fibrillation Masquerading as Left Main Acute Coronary Syndrome

Case Presentation: ST-elevation in lead aVR, with ST-depression in precordial leads, has been reported to arise from left main coronary disease, often required emergent cardiac catheterization. We present a case of unstable SVT in a [...]

By | 2018-03-19T13:23:51+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Hypertrophic Cardiomyopathy with Atrial Fibrillation Masquerading as Left Main Acute Coronary Syndrome

HM2018 Abstract Number: 632

ARTIFICIAL HYPOGLYCEMIA: WHEN NOT TO PANIC ABOUT HYPOGLYCEMIA.

Case Presentation: 87 year old woman with a medical history of coronary artery disease, congestive heart failure, raynaud’s syndrome, sicca syndrome and hyperlipidemia was brought in after choking on food. Her hospital course was complicated [...]

By | 2018-03-19T13:23:48+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on ARTIFICIAL HYPOGLYCEMIA: WHEN NOT TO PANIC ABOUT HYPOGLYCEMIA.

HM2018 Abstract Number: 545

ENDOCARDITIS AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT

Case Presentation: 85 year old female was admitted on account of lethargy and decreased oral intake for the previous week, and evidence of anemia. She had undergone a transcatheter aortic valve replacement(TAVR) 5 months prior [...]

By | 2018-03-19T13:23:45+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on ENDOCARDITIS AFTER TRANSCATHETER AORTIC VALVE REPLACEMENT

HM2018 Abstract Number: 572

Know What You’re Missing: Benzodiazepine Withdrawal-induced Catatonia.

Case Presentation: A 65 yo male with insulin-dependent diabetes, chronic kidney disease, and bipolar disorder was referred to hospital due to a rising creatinine level and decreased urine output. Home medications included furosemide, insulin, amlodipine, [...]

By | 2018-03-19T13:23:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Know What You’re Missing: Benzodiazepine Withdrawal-induced Catatonia.

HM2018 Abstract Number: 54

Integration of a Novel Quality Improvement Curriculum into an Internal Medicine Residency Program

Background: Quality improvement (QI) has been recognized as a core component of medical resident training and progressive engagement with QI is required by the American Council of Graduate Medical Education’s Clinical Learning Environment Review. Prior [...]

By | 2018-03-19T13:23:41+00:00 March 19th, 2018|Education, Hospital Medicine 2018, Innovations|Comments Off on Integration of a Novel Quality Improvement Curriculum into an Internal Medicine Residency Program

HM2018 Abstract Number: 340

Solving Medical Mysteries At The Undiagnosed Diseases Network

Background: Patients with rare disorders or previously undocumented conditions with a genetic basis often go undiagnosed for many years despite extensive evaluations under skilled physicians in their communities and tertiary care centers. These patients are [...]

By | 2018-03-19T13:23:40+00:00 March 19th, 2018|Hospital Medicine 2018, Research, Translating Research into Practice|Comments Off on Solving Medical Mysteries At The Undiagnosed Diseases Network

HM2018 Abstract Number: 516

MIC FOR FLUOROQUINOLONES IN NON-TYPHOIDAL SALMONELLA- WHEN IS IT SUSCEPTIBLE?

Case Presentation: 34 year old lady with AML presented with diarrhea of 2 days duration and was found to be positive for Salmonella on GI PCR, which was subsequently confirmed on stool culture.She was started [...]

By | 2018-03-19T13:23:38+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on MIC FOR FLUOROQUINOLONES IN NON-TYPHOIDAL SALMONELLA- WHEN IS IT SUSCEPTIBLE?

HM2018 Abstract Number: 693

SPINAL EPIDURAL LIPOMATOSIS COINCIDING WITH MULTIPLE SCLEROSIS

Case Presentation: A 26-year-old male without prior medical history was referred by a spine surgeon to the emergency department (ED) with weakness, numbness, and discoordination of the right leg, worsening over a four month period [...]

By | 2018-03-19T13:23:37+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on SPINAL EPIDURAL LIPOMATOSIS COINCIDING WITH MULTIPLE SCLEROSIS

HM2018 Abstract Number: 204

EDUCATIONAL INTERVENTION TO SIGNIFICANTLY REDUCE HEALTH CARE COST IN MEDICAL INTENSIVE CARE UNIT

Background: The diagnostic yield and therapeutic consequences of daily routine chest x-rays are very low. Several studies show discontinuation of daily routine chest x-rays does not affect ICU length of stay, readmission rate, or hospital [...]

By | 2018-03-19T13:23:35+00:00 March 19th, 2018|Hospital Medicine 2018, Quality Improvement, Research|Comments Off on EDUCATIONAL INTERVENTION TO SIGNIFICANTLY REDUCE HEALTH CARE COST IN MEDICAL INTENSIVE CARE UNIT

HM2018 Abstract Number: 194

ACUTE KIDNEY INJURY IN ORTHOPEDIC SURGERY RELATED TO OBESITY AND ANGIOTENSIN AXIS BLOCKADE

Background: Controversy still exists regarding the use of angiotensin axis blockade (AAB) with angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) drugs preoperatively. Multiple studies suggest the AAB results in acute kidney injury [...]

By | 2018-03-19T13:23:34+00:00 March 19th, 2018|Hospital Medicine 2018, Perioperative, Research|Comments Off on ACUTE KIDNEY INJURY IN ORTHOPEDIC SURGERY RELATED TO OBESITY AND ANGIOTENSIN AXIS BLOCKADE

HM2018 Abstract Number: 378

LOW CARBS, HIGH ACUITY: SEVERE KETOACIDOSIS IN A PALEOLITHIC DIET

Case Presentation: A 40-year-old previously healthy female presented nine weeks postpartum with numerous episodes of nonbilious, nonbloody emesis that began 24 hours prior to admission. She took no medications and denied fevers, chills, dysuria, cough, [...]

By | 2018-03-22T15:49:31+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Posters, Hospital Medicine 2018|Comments Off on LOW CARBS, HIGH ACUITY: SEVERE KETOACIDOSIS IN A PALEOLITHIC DIET

HM2018 Abstract Number: 118

SIMPLE PREDICTION SCORE FOR COMPLEX MEDICAL INPATIENTS

Background: Complex patients represent a challenge in the health care system, as they are frequently associated with high health care utilization, longer hospital stays, and higher costs. Nonetheless, the characteristics of the complex patients in [...]

By | 2018-03-19T13:23:30+00:00 March 19th, 2018|Hospital Medicine 2018, Outcomes Research, Research|Comments Off on SIMPLE PREDICTION SCORE FOR COMPLEX MEDICAL INPATIENTS

HM2018 Abstract Number: 836

NOVEL ORAL ANTICOAGULANTS – A CURSE IN DISGUISE ?

Case Presentation: A 90-year-old Caucasian female with non-valvular atrial fibrillation, on therapeutic anticoagulation with warfarin was admitted with community acquired pneumonia. She was treated with Levofloxacin. She underwent cardioversion for symptomatic atrial fibrillation with rapid [...]

By | 2018-03-19T13:23:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NOVEL ORAL ANTICOAGULANTS – A CURSE IN DISGUISE ?

HM2018 Abstract Number: 835

COMPLICATIONS OF TREATING ATRIAL FIBRILLATION BY CATHETER ABLATION

Case Presentation: Introduction: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. In the past decade, catheter ablation of AF has evolved from an investigational procedure to a frequent therapeutic one. Phrenic nerve injury [...]

By | 2018-03-19T13:23:27+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on COMPLICATIONS OF TREATING ATRIAL FIBRILLATION BY CATHETER ABLATION

HM2018 Abstract Number: 191

Major Factors of the Asthma Predictive Index are Not Enough to Identify Term RSV Bronchiolitics that Benefit from Albuterol

Background: Bronchiolitis is one of the leading causes of hospitalization in patients less than 2 years old. It can be a source of frustration for providers as numerous interventions that have been trialed throughout the [...]

By | 2018-03-19T13:23:24+00:00 March 19th, 2018|Hospital Medicine 2018, Pediatrics, Research|Comments Off on Major Factors of the Asthma Predictive Index are Not Enough to Identify Term RSV Bronchiolitics that Benefit from Albuterol

HM2018 Abstract Number: 148

Surviving In-Hospital Cardiac Arrest and the Role of Age

Background: There is limited data on the predictors of outcomes in patients who have in-hospital cardiac arrest. This study aims to understand the factors that might affect the survival from the cardiac arrest and survival-to-discharge [...]

By | 2018-03-19T13:23:23+00:00 March 19th, 2018|Hospital Medicine 2018, Outcomes Research, Research|Comments Off on Surviving In-Hospital Cardiac Arrest and the Role of Age

HM2018 Abstract Number: 712

A RARE CASE OF BILATERAL VOCAL CORD PALSY DUE TO DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS

Case Presentation: An 89-year-old woman presented to the emergency department with dyspnea and dysphagia. She gave a one-year history of progressive hoarseness of voice, intermittent dyspnea, and dysphagia. Physical exam was positive for stridor, but [...]

By | 2018-03-19T13:23:20+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A RARE CASE OF BILATERAL VOCAL CORD PALSY DUE TO DIFFUSE IDIOPATHIC SKELETAL HYPEROSTOSIS

HM2018 Abstract Number: 220

IMPROVING DISCHARGE COMMUNICATION: THE EXCELLENT COMMUNICATION LEADS TO IMPROVED PATIENT SATISFACTION AND EXPERIENCE (ECLIPSE) PROJECT

Background: The hospital discharge is one of the most important aspects of a patient’s hospitalization, yet in residency training, this process often goes overlooked. Most residents are never properly taught how to effectively discharge a [...]

By | 2018-03-19T13:23:18+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Quality Improvement|Comments Off on IMPROVING DISCHARGE COMMUNICATION: THE EXCELLENT COMMUNICATION LEADS TO IMPROVED PATIENT SATISFACTION AND EXPERIENCE (ECLIPSE) PROJECT

HM2018 Abstract Number: 543

Cardiac Tamponade As A Late And Unusual Presentation Of Adenocarcinoma Of The Lung

Case Presentation: We describe a 57 year-old man with no significant medical history, who was in his usual state of health until one week prior to presentation when he developed flu-like symptoms, cough, exertional dyspnea [...]

By | 2018-03-19T13:23:17+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Cardiac Tamponade As A Late And Unusual Presentation Of Adenocarcinoma Of The Lung

HM2018 Abstract Number: 755

WHEN YOU CAN’T C THE DIAGNOSIS

Case Presentation: A 71-year-old woman presented with one month of progressive dyspnea, fatigue, weight loss, bilateral lower extremity edema, and new “purple and red spots” on her extremities. Her medical history included breast cancer more [...]

By | 2018-03-19T13:23:15+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on WHEN YOU CAN’T C THE DIAGNOSIS

HM2018 Abstract Number: 419

NEONATAL CUSHING SYNDROME: AN ATYPICAL PRESENTATION OF MCCUNE ALBRIGHT SYNDROME

Case Presentation: H.C. was admitted to the hospital at 7 weeks of age for failure to thrive. Patient is an ex 37 6/7 weeker, BW was 1.84 kg (0.02%, Z=-3.57), and was induced due to [...]

By | 2018-03-19T13:23:13+00:00 March 19th, 2018|Clinical Vignettes, Hospital Medicine 2018, Pediatric|Comments Off on NEONATAL CUSHING SYNDROME: AN ATYPICAL PRESENTATION OF MCCUNE ALBRIGHT SYNDROME

HM2018 Abstract Number: 718

A Fatal Golfing Tragedy

Case Presentation: IntroductionMost cases of mushroom ingestion are benign with fatalities being rare. Symptoms range from acute gastro-enteritis to psychotropic manifestations that are usually self-limiting. Our case highlights a unique case of mushroom poisoning fatality [...]

By | 2018-03-19T13:23:10+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A Fatal Golfing Tragedy

HM2018 Abstract Number: 495

PAPILLARY MUSCLE RUPTURE AFTER MYOCARDIAL INFARCTION WITH NON-OBSTRUCTIVE CORONARY ARTERY DISEASE

Case Presentation: A 68-year-old woman with a history of hypertension and possible interstitial lung disease presented with one week of worsening midsternal chest pain, diaphoresis and nausea. Initial vitals were unremarkable. Exam revealed bibasilar crackles [...]

By | 2018-03-19T13:23:09+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PAPILLARY MUSCLE RUPTURE AFTER MYOCARDIAL INFARCTION WITH NON-OBSTRUCTIVE CORONARY ARTERY DISEASE

HM2018 Abstract Number: 382

PERITONEAL COCCIDIOIDOMYCOSIS: A TRIAD OF PERITONITIS, OMENTAL NODULES, AND EOSINOPHILIA

Case Presentation: A 50-year-old Filipino man with poorly controlled type 2 diabetes mellitus presented with 4 days of fever, abdominal pain and distention. He endorsed unintentional weight loss of 30lbs over the last year as [...]

By | 2018-03-22T15:50:12+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Posters, Hospital Medicine 2018|Comments Off on PERITONEAL COCCIDIOIDOMYCOSIS: A TRIAD OF PERITONITIS, OMENTAL NODULES, AND EOSINOPHILIA

HM2018 Abstract Number: 770

A LIFESAVING FEVER – UNMASKING BRUGADA

Case Presentation: A 60-year-old man presented with several days of diarrhea, fevers, and syncope. Past medical history was significant for recurrent syncopal episodes, all of which occurred during febrile illnesses. Review of systems was negative [...]

By | 2018-03-19T13:23:05+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A LIFESAVING FEVER – UNMASKING BRUGADA

HM2018 Abstract Number: 733

ACUTE HANTAVIRUS INFECTION: THE IMPORTANCE OF EARLY CLINICAL DIAGNOSIS

Case Presentation: A healthy 35-year-old female from eastern Arizona presented in February with two weeks of fever, headache, epigastric pain, decreased appetite, two episodes of non-bloody emesis, dyspnea, and with orthopnea. She was cleaning out [...]

By | 2018-03-19T13:23:04+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on ACUTE HANTAVIRUS INFECTION: THE IMPORTANCE OF EARLY CLINICAL DIAGNOSIS

HM2018 Abstract Number: 71

An Interdisciplinary Approach to Quality Improvement on the Inpatient Teaching Unit

Background: Interdisciplinary communication, quality improvment, and patient safety, are integral components to providing quality healthcare. Furthermore, the ACGME recognizes the importance of the learning and working environment, a culture of safety, and providing opportunities for [...]

By | 2018-03-19T13:23:02+00:00 March 19th, 2018|Education, Hospital Medicine 2018, Innovations|Comments Off on An Interdisciplinary Approach to Quality Improvement on the Inpatient Teaching Unit

HM2018 Abstract Number: 490

WHEN A MEDICATION CAN BE CAUSE AND CURE. ALEMTUZUMAB AS THE CAUSE OF AUTOIMMUNE HEMOLYTIC ANEMIA

Case Presentation: A 32 year old Caucasian female with a fourteen year history of relapsing-remitting MS was admitted to the hospital for evaluation of severe headache, fatigue and dizziness. On physical exam she was tachycardic [...]

By | 2018-03-19T13:23:00+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on WHEN A MEDICATION CAN BE CAUSE AND CURE. ALEMTUZUMAB AS THE CAUSE OF AUTOIMMUNE HEMOLYTIC ANEMIA

HM2018 Abstract Number: 776

To Pick or Not to Pick: A Case of Mushroom Poisoning

Case Presentation: A 61 year-old female presented with nausea, vomiting, and upper abdominal pain 18 hours after ingesting local wild mushrooms. Initially, her physical exam was benign, including a normal abdominal exam. Her laboratory results [...]

By | 2018-03-19T13:22:59+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on To Pick or Not to Pick: A Case of Mushroom Poisoning

HM2018 Abstract Number: 637

Lidocaine-Induced Takotsubo Cardiomyopathy

Case Presentation: A 47-year-old African American female with a past medical history of complex regional pain syndrome (CRPS), chronic migraines, and history of transient ischemic attack was admitted for elective lidocaine infusion for generalized pain [...]

By | 2018-03-19T13:22:57+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Lidocaine-Induced Takotsubo Cardiomyopathy

HM2018 Abstract Number: 100

THE HOSPITALIST AND THE NEUROSURGEON: THE ODD COUPLE OR A MATCH MADE IN HEAVEN?

Background: The aging population along with increasing multi-morbidity and stricter regulations on house staff duty hours have played an integral role in fueling the drive for medical co-management of surgical patients. Parallel to these trends [...]

By | 2018-03-19T13:22:55+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Other|Comments Off on THE HOSPITALIST AND THE NEUROSURGEON: THE ODD COUPLE OR A MATCH MADE IN HEAVEN?

HM2018 Abstract Number: 205

NPO STATUS WITH CARDIAC STRESS TESTING: AN OUTCOME-BASED APPROACH

Background: It has been routine practice to keep patients undergoing cardiac stress testing nil per os (NPO) until the results of the test were reported. The rationale is to enable left heart catheterization the same [...]

By | 2018-03-19T13:20:50+00:00 March 19th, 2018|Hospital Medicine 2018, Quality Improvement, Research|Comments Off on NPO STATUS WITH CARDIAC STRESS TESTING: AN OUTCOME-BASED APPROACH

HM2018 Abstract Number: 648

CHOREA IN CANCER: AN UNLIKELY CULPRIT

Case Presentation: 52-year-old female with history of Stage IIIA triple negative right sided breast cancer, seizure disorder, and s/p lumpectomy presents with ataxia, confusion, and dyskinesia over the past 2 weeks. The patient is chronically [...]

By | 2018-03-19T13:20:49+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on CHOREA IN CANCER: AN UNLIKELY CULPRIT

HM2018 Abstract Number: 379

A GREAT IMITATOR: A CASE OF CNS INTRAVASCULAR LARGE CELL LYMPHOMA

Case Presentation: A 65 year-old woman with a history of renal cell cancer status post nephrectomy and breast cancer treated with lumpectomy and radiation presented with three weeks of progressive lower extremity weakness and confusion. [...]

By | 2018-03-22T15:49:31+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Posters, Hospital Medicine 2018|Comments Off on A GREAT IMITATOR: A CASE OF CNS INTRAVASCULAR LARGE CELL LYMPHOMA

HM2018 Abstract Number: 521

NOT YOUR TYPICAL HUS: COMPLEMENT MEDIATED HEMOLYTIC UREMIC SYNDROME

Case Presentation: 23 years old female with history of lupus and Sjogren’s syndrome was sent to the hospital by her rheumatologist for worsening anemia, thrombocytopenia and kidney injury. Patient was recently admitted to the hospital [...]

By | 2018-03-19T13:20:46+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NOT YOUR TYPICAL HUS: COMPLEMENT MEDIATED HEMOLYTIC UREMIC SYNDROME

HM2018 Abstract Number: 926

INJECTION SITE REACTION AND LEUKOCYTOCLASTIC VASCULITIS ASSOCIATED WITH ADALIMUMAB THERAPY FOR RHEUMATOID ARTHRITIS

Case Presentation: The patient is a 75-year-old woman with seropositive RA with polyarthropathy, who had recently started adalimumab presented with a diffuse skin eruption. She had been previously treated with tocilizumab (4mg/kg monthly), methotrexate (10 [...]

By | 2018-03-19T13:20:44+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on INJECTION SITE REACTION AND LEUKOCYTOCLASTIC VASCULITIS ASSOCIATED WITH ADALIMUMAB THERAPY FOR RHEUMATOID ARTHRITIS

HM2018 Abstract Number: 912

HEART FAILURE WITH A LARGE RETROPERITONEAL MASS: CONNECTED OR COINCIDENCE?

Case Presentation: A 40 year-old male with no significant past medical history presented with two months of increasing fatigue, anorexia, and progressive exertional dyspnea. Additionally, he reported a mild increase in abdominal girth during the [...]

By | 2018-03-19T13:18:34+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on HEART FAILURE WITH A LARGE RETROPERITONEAL MASS: CONNECTED OR COINCIDENCE?

HM2018 Abstract Number: 336

THE IMPACT OF A STANDARDIZED TOOL ON THE QUALITY OF END-OF-ROTATION HANDOFFS AMONG MEDICINE HOUSESTAFF.

Background: Medical housestaff must participate in a handoff process when transitioning between rotations on hospital services. During this time, a new team of residents assumes care for multiple patients. A prior study demonstrated that this [...]

By | 2018-03-19T13:18:33+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Transitions of Care|Comments Off on THE IMPACT OF A STANDARDIZED TOOL ON THE QUALITY OF END-OF-ROTATION HANDOFFS AMONG MEDICINE HOUSESTAFF.

HM2018 Abstract Number: 428

AN UNUSUAL BUG IN THE SPUTUM

Case Presentation: A 81 year Albanian male presented to the emergency with pain in right upper abdomen. Abnormal vitals during presentation were temperature of 101.8F, respiratory rate of 24/min and blood pressure of 85/66mmg Hg. [...]

By | 2018-03-19T13:18:31+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on AN UNUSUAL BUG IN THE SPUTUM

HM2018 Abstract Number: 277

BARRIERS TO DISCHARGE FOR LENGTH OF STAY OUTLIERS: A REVIEW OF GENERAL MEDICINE PATIENTS IN A UNIVERSITY HOSPITAL

Background: As healthcare costs continue to burgeon and grow at an unprecedented rate, cost utilization is an increasingly important field of research. In-hospital costs are one of the most expensive contributors to healthcare costs in [...]

By | 2018-03-19T13:18:30+00:00 March 19th, 2018|Hospital Medicine 2018, Quality Improvement, Research|Comments Off on BARRIERS TO DISCHARGE FOR LENGTH OF STAY OUTLIERS: A REVIEW OF GENERAL MEDICINE PATIENTS IN A UNIVERSITY HOSPITAL

HM2018 Abstract Number: 141

Incremental Economic Burden of Major Depressive Disorder Patients with Treatment Resistant Depression Admitted in US Hospitals

Background: The subset of admitted Major Depressive Disorder (MDD) patients with treatment-resistant depression (TRD) may be associated with incremental economic burden compared with other MDD patients. This study aimed to characterize and evaluate healthcare resource [...]

By | 2018-03-19T13:18:25+00:00 March 19th, 2018|Hospital Medicine 2018, Outcomes Research, Research|Comments Off on Incremental Economic Burden of Major Depressive Disorder Patients with Treatment Resistant Depression Admitted in US Hospitals

HM2018 Abstract Number: 330

HOSPITAL-ACQUIRED VENOUS THROMBOEMBOLISM AMONG ADULTS ADMITTED TO A CHILDREN’S HOSPITAL

Background: Risk factors for hospital-acquired venous thromboembolism (HA-VTE) have been well-studied in adults, with validated risk assessment tools available. Adults admitted to children’s hospitals are younger but with comorbidities stemming from childhood conditions. There is [...]

By | 2018-03-19T13:18:23+00:00 March 19th, 2018|Hospital Medicine 2018, Research, Transitions of Care|Comments Off on HOSPITAL-ACQUIRED VENOUS THROMBOEMBOLISM AMONG ADULTS ADMITTED TO A CHILDREN’S HOSPITAL

HM2018 Abstract Number: 763

Broadening The Differential For Acute Kidney Injury: A Case Of IgG4-Related Tubulointersitial Nephritis

Case Presentation: A 66-year-old man with history of hypertension, gastroesophageal reflux disease, and hyperlipidemia presented with jaundice and one week of diarrhea with occasional hematochezia. In addition, he noted dark urine, decreased PO intake and [...]

By | 2018-03-19T13:18:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Broadening The Differential For Acute Kidney Injury: A Case Of IgG4-Related Tubulointersitial Nephritis

HM2018 Abstract Number: 916

BACK (AND FLANK) TO THE BASICS

Case Presentation: A 68-year-old man presented with one week of weakness and fatigue. The patient had presented to the emergency department (ED) one week earlier with persistent bleeding from the left ear after a fall [...]

By | 2018-03-19T13:18:20+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on BACK (AND FLANK) TO THE BASICS

HM2018 Abstract Number: 649

STATIN-INDUCED NECROTIZING AUTOIMMUNE MYOPATHY: A CASE OF DELAYED ONSET FOLLOWING STATIN DISCONTINUATION

Case Presentation: Statin-induced necrotizing autoimmune myopathy (SINAM) is an immune mediated myopathy characterized by proximal muscle weakness and necrosis in the presence of autoantibodies to hydroxyl-methyl-glutaryl-coenzyme-A (HMG-CoA) reductase. It is a rare side effect of [...]

By | 2018-03-19T13:18:18+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on STATIN-INDUCED NECROTIZING AUTOIMMUNE MYOPATHY: A CASE OF DELAYED ONSET FOLLOWING STATIN DISCONTINUATION

HM2018 Abstract Number: 753

A Distinct Clinical Entity? Two Cases of TAFRO Syndrome with Different Features

Case Presentation: Case 1: A 25-year-old female was transferred to our hospital with fever and systemic inflammation refractory to prednisolone treatment. Two weeks prior to the transfer, she was admitted to another hospital on account [...]

By | 2018-03-19T13:18:17+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A Distinct Clinical Entity? Two Cases of TAFRO Syndrome with Different Features

HM2018 Abstract Number: 104

PULMONARY DRAIN PLACEMENT BY PROCEDURE-FOCUSED HOSPITALISTS

Background: Small-bore pulmonary drains (PD) have been proven effective at replacing the previous large-bore chest tubes for resolution of pneumothorax (PTX), and management of complicated (CPEs) and recurrent pleural effusions (RPEs). The placement of these [...]

By | 2018-03-19T13:18:15+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Other|Comments Off on PULMONARY DRAIN PLACEMENT BY PROCEDURE-FOCUSED HOSPITALISTS

HM2018 Abstract Number: 817

Tricuspid Valve Infective Endocarditis due to Klebsiella Pneumoniae in Intravenous Drug User

Case Presentation: A 55-year-old woman with intravenous polysubstance abuse presented with a 1-week history of back pain, fever, and cough with blood-tinged sputum. Vital sign on admission showed tachycardia and hypotension but she responded well [...]

By | 2018-03-19T13:18:13+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Tricuspid Valve Infective Endocarditis due to Klebsiella Pneumoniae in Intravenous Drug User

HM2018 Abstract Number: 295

DO THESE MINIATURIZE MONITORING ELEMENTS WORK? AN OBSERVATIONAL ANALYSIS OF THE EFFECTIVENESS OF REVEAL LINQ IMPLANTS IN DETECTING CARDIAC CAUSES OF SYNCOPE IN A COMMUNITY HOSPITAL.

Background: Implantable cardiac monitors (ICM) have continued to gain acceptance since its introduction into clinical practice to help physician accurately detect cardiac causes of syncope that may need further intervention. Their cost-effectiveness in the evaluation [...]

By | 2018-03-19T13:18:12+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Technology in Hospital Medicine|Comments Off on DO THESE MINIATURIZE MONITORING ELEMENTS WORK? AN OBSERVATIONAL ANALYSIS OF THE EFFECTIVENESS OF REVEAL LINQ IMPLANTS IN DETECTING CARDIAC CAUSES OF SYNCOPE IN A COMMUNITY HOSPITAL.

HM2018 Abstract Number: 201

OUTCOMES FOR HIP FRACTURE PATIENTS ON HOSPITALIST VERSUS NON-HOSPITALIST SERVICES

Background: Hip fractures are a major health problem in the geriatric population in the United States, with estimated costs of $18B annually. Hip fractures are highly morbid in the elderly, as deconditioning and acute complications [...]

By | 2018-03-19T13:18:10+00:00 March 19th, 2018|Hospital Medicine 2018, Perioperative, Research|Comments Off on OUTCOMES FOR HIP FRACTURE PATIENTS ON HOSPITALIST VERSUS NON-HOSPITALIST SERVICES

HM2018 Abstract Number: 626

Consider malignancy, but keep an open mind: An uncommon cause of pleural effusion, ascites and pelvic masses

Case Presentation: A 39-year-old African American nulliparous female with a history of endometriosis and recent outside hospitalization presents with 10 days of acute on chronic lower abdominal pain and dyspnea. On exam, she has a [...]

By | 2018-03-19T13:18:09+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Consider malignancy, but keep an open mind: An uncommon cause of pleural effusion, ascites and pelvic masses

HM2018 Abstract Number: 354

LEAN in: Our Secrets to Decreasing Provider Stress, Maximizing Efficiency on a Pediatric Hospitalist Service

Background: Burnout is the syndrome of emotional exhaustion, depersonalization and reduced personal efficacy that occurs in individuals working in the human services field. Recent data suggests that 50% of physicians are experiencing at least one [...]

By | 2018-03-19T13:18:06+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Value in Hospital Medicine|Comments Off on LEAN in: Our Secrets to Decreasing Provider Stress, Maximizing Efficiency on a Pediatric Hospitalist Service

HM2018 Abstract Number: 492

Cutaneous Leukocytoclastic Vasculitis associated with Methimazole

Case Presentation: Anti-thyroid Drugs (ATD) such as propilthiourcil (PTU) and methimazole (MTM) can cause a number of systemic changes such as fever, rash, and respiratory symptoms (from epistaxis to diffuse alveolar hemorrhage). Guidelines almost always [...]

By | 2018-03-19T13:18:04+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Cutaneous Leukocytoclastic Vasculitis associated with Methimazole

HM2018 Abstract Number: 830

My Heartburn is Better but I am confused: A Rare Case of Calcium Carbonate-Induced Severe Hypercalcemia

Case Presentation: A 54 year-old male with history of stroke, hypertension, chronic kidney disease stage III, gastroesophageal reflux, diabetes mellitus, peripheral vascular disease, and alcohol abuse (sober for 3 months), presented with acute change in [...]

By | 2018-03-19T13:18:02+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on My Heartburn is Better but I am confused: A Rare Case of Calcium Carbonate-Induced Severe Hypercalcemia

HM2018 Abstract Number: 874

MULTIFOCAL IN-SITU SIGNET RING CELL CARCINOMA OF THE COLON IN MIDDLE-AGED WOMAN

Case Presentation: A 47 year old woman with Lynch syndrome presented with only intermittent abdominal discomfort and mucus in her stools for several months. Colonoscopy showed patchy erythema in the cecum and the transverse colon. [...]

By | 2018-03-19T13:18:00+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on MULTIFOCAL IN-SITU SIGNET RING CELL CARCINOMA OF THE COLON IN MIDDLE-AGED WOMAN

HM2018 Abstract Number: 87

CONSTANT OBSERVATION PRACTICES FOR HOSPITALIZED OLDER ADULTS WITH COGNITIVE IMPAIRMENT: A SURVEY OF HEALTH CARE PROFESSIONALS

Background: The number of individuals with dementia in the U.S., currently estimated at 5.3 million, is projected to triple by 2050. For patients with cognitive impairment, the unfamiliar and stressful hospital environment often requires constant [...]

By | 2018-03-19T13:17:59+00:00 March 19th, 2018|Geriatrics, Hospital Medicine 2018, Research|Comments Off on CONSTANT OBSERVATION PRACTICES FOR HOSPITALIZED OLDER ADULTS WITH COGNITIVE IMPAIRMENT: A SURVEY OF HEALTH CARE PROFESSIONALS

HM2018 Abstract Number: 705

A CASE OF NON-OCCLUSIVE ACUTE GASTRIC ISCHEMIA FROM HYPOTENSION DURING DIALYSIS

Case Presentation: A 69-year-old man presented with acute onset abdominal pain during hemodialysis. He had a history of end stage renal disease and extensive vascular disease, including coronary artery disease, peripheral arterial disease, and an [...]

By | 2018-03-19T13:17:57+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A CASE OF NON-OCCLUSIVE ACUTE GASTRIC ISCHEMIA FROM HYPOTENSION DURING DIALYSIS

HM2018 Abstract Number: 395

‘GANG’ING UP ON THE SKIN: AN 11-MONTH-OLD WITH ULCERATIVE SKIN LESIONS

Case Presentation: A previously healthy 11-month-old female was admitted to the hospital with new onset of skin lesions. One month prior to admission, her parents noticed “bumps on her bottom.” They initially thought the bumps [...]

By | 2018-03-19T13:17:55+00:00 March 19th, 2018|Clinical Vignettes, Hospital Medicine 2018, Pediatric|Comments Off on ‘GANG’ING UP ON THE SKIN: AN 11-MONTH-OLD WITH ULCERATIVE SKIN LESIONS

HM2018 Abstract Number: 816

Disseminated Herpes Zoster in a Young Immunocompetent Female

Case Presentation: A 37-year-old woman with no significant medical history initially presented to the Emergency Department (ED) with an itchy rash on her left thigh that developed over a week. The only preceding event was [...]

By | 2018-03-19T13:17:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Disseminated Herpes Zoster in a Young Immunocompetent Female

HM2018 Abstract Number: 473

OH, THE PLACES ENDOMETRIUM CAN GO

Case Presentation: A 33-year-old nulliparous female with no past medical history presented with 10 months of postmenstrual umbilical pain. She denied vomiting or bowel habit changes, but noted recent orthopnea and nocturnal wheezing. She had [...]

By | 2018-03-19T13:17:50+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on OH, THE PLACES ENDOMETRIUM CAN GO

HM2018 Abstract Number: 396

PUFF LADDY: A FIVE-YEAR-OLD-BOY WITH FOREHEAD SWELLING

Case Presentation: A previously healthy five-year-old boy presented with forehead swelling in the setting of a recent sinus infection. His initial symptoms were fever and nasal congestion for which he was prescribed a 10-day course [...]

By | 2018-03-19T13:17:48+00:00 March 19th, 2018|Clinical Vignettes, Hospital Medicine 2018, Pediatric|Comments Off on PUFF LADDY: A FIVE-YEAR-OLD-BOY WITH FOREHEAD SWELLING

HM2018 Abstract Number: 430

FACIAL DIPLEGIA: A CASE REPORT OF A STROKE MIMICKER

Case Presentation: A 46-year-old female with a past medical history of hypertension, diabetes mellitus, and asthma who initially presented 2 weeks prior to the emergency department for right-sided facial paralysis and was diagnosed with idiopathic [...]

By | 2018-03-19T13:17:46+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on FACIAL DIPLEGIA: A CASE REPORT OF A STROKE MIMICKER

HM2018 Abstract Number: 347

CO-CREATION OF SHM ADULT CHOOSING WISELY LIST: ENGAGING OUR PATIENTS AND PUBLIC FROM START TO FINISH

Background: The Choosing Wisely campaign aims to engage clinicians and public in addressing overuse in healthcare. Through adoption in 20 countries and 75 organizations, clinician engagement is largely successful. However, patient and public engagement remains [...]

By | 2018-03-19T13:17:44+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Value in Hospital Medicine|Comments Off on CO-CREATION OF SHM ADULT CHOOSING WISELY LIST: ENGAGING OUR PATIENTS AND PUBLIC FROM START TO FINISH

HM2018 Abstract Number: 69

Resident Perceptions of Feedback and Teaching

Background: Feedback and teaching are critical to the development of clinical skills. Although they occur with regularity on medical wards, learners infrequently recognize them (Kogan et al. 2000). Feedback has been defined as providing information [...]

By | 2018-03-19T13:17:42+00:00 March 19th, 2018|Education, Hospital Medicine 2018, Research|Comments Off on Resident Perceptions of Feedback and Teaching

HM2018 Abstract Number: 469

NEW ONSET HYPERTENSIVE URGENCY FOLLOWING RENAL ARTERY EMBOLIZATION

Case Presentation: A 64-year-old year old woman with no personal or family history of HTN was diagnosed with right renal angiomyolipoma incidentally on work up for latent TB and referred to interventional radiology for partial [...]

By | 2018-03-19T13:17:40+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NEW ONSET HYPERTENSIVE URGENCY FOLLOWING RENAL ARTERY EMBOLIZATION

HM2018 Abstract Number: 544

BADAS: ‘BAD’ SKIN WITH DIARRHEA

Case Presentation: A 55-year-old woman, with benign past medical history presented with a two-week of low-grade fevers and erythematous papules that evolved into small discrete honey-colored crusted plaques and pustules on her face. She was [...]

By | 2018-03-19T13:17:38+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on BADAS: ‘BAD’ SKIN WITH DIARRHEA

HM2018 Abstract Number: 641

THE STORY OF A CATWOMAN: IS THERE A LINK BETWEEN CIRRHOSIS AND PASTEURELLA

Case Presentation: The patient is a 67 years old female with Hepatitis C and alcoholic liver cirrhosis, HCC, atrial fibrillation who presented to the ED with fever, chills and altered mental status. Per husband, the [...]

By | 2018-03-19T13:17:36+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on THE STORY OF A CATWOMAN: IS THERE A LINK BETWEEN CIRRHOSIS AND PASTEURELLA

HM2018 Abstract Number: 640

DO NOT FORGET IT YET

Case Presentation: The patient is a 23 years old Hispanic male with no significant past medical history presented to the ED with the chief complaints of sore throat, headache, nausea, vomiting for 5 days. He [...]

By | 2018-03-19T13:17:34+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on DO NOT FORGET IT YET

HM2018 Abstract Number: 184

THE ASSOCIATION OF DISCHARGE BEFORE NOON AND LENGTH OF STAY IN PEDIATRIC PATIENTS

Background: Many hospitals set targets for discharging patients before noon in efforts to optimize patient throughput. However, discharge before noon (DCBN) has been associated with increased length of stay (LOS) in an adult population. The [...]

By | 2018-03-19T13:17:28+00:00 March 19th, 2018|Hospital Medicine 2018, Pediatrics, Research|Comments Off on THE ASSOCIATION OF DISCHARGE BEFORE NOON AND LENGTH OF STAY IN PEDIATRIC PATIENTS

HM2018 Abstract Number: 180

ETIOLOGY AND RATES OF INFECTION IN A COHORT OF FEBRILE NEONATES

Background: The clinical evaluation of febrile neonates ≤ 60 days has been extensively debated in the age of doing less invasive testing to yield the same clinical outcomes with fewer complications. Rates of serious bacterial [...]

By | 2018-03-19T13:17:26+00:00 March 19th, 2018|Hospital Medicine 2018, Pediatrics, Research|Comments Off on ETIOLOGY AND RATES OF INFECTION IN A COHORT OF FEBRILE NEONATES

HM2018 Abstract Number: 609

Double Vision — More Than Meets the Eye: A Case of Sphenoid Sinusitis Causing Cavernous Sinus Thrombosis

Case Presentation: A 65-year-old female with a history of sphenoid sinusitis status post recent fiberoptic endoscopic sinus surgery presented with one week of neck stiffness and two days of fever, headache, photosensitivity, and diplopia. Vital [...]

By | 2018-03-19T13:17:24+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Double Vision — More Than Meets the Eye: A Case of Sphenoid Sinusitis Causing Cavernous Sinus Thrombosis

HM2018 Abstract Number: 575

A RARE CASE OF METASTATIC INSULINOMA IN A 28 YEAR OLD FEMALE

Case Presentation: Insulinoma is a rare tumor that originates in the beta cells of the pancreas with an incidence of 1-4 cases/million persons/year. Less than 10% of insulinomas are malignant and represent a treatment challenge [...]

By | 2018-03-19T13:17:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A RARE CASE OF METASTATIC INSULINOMA IN A 28 YEAR OLD FEMALE

HM2018 Abstract Number: 296

Utilizing Electronic Clinical Quality Measures (eCQMs) to perform a Venous Thromboembolism Prophylaxis Rapid Cycle Quality Improvement Initiative

Background: Despite strong performance on Venous Thromboembolism (VTE) Core Measures, our institutional approach to VTE prophylaxis placed significant burden on providers through frequent automated alerts. Within our Electronic Medical Record (EMR), provider alerts triggered when [...]

By | 2018-03-19T13:17:20+00:00 March 19th, 2018|Hospital Medicine 2018, Research, Technology in Hospital Medicine|Comments Off on Utilizing Electronic Clinical Quality Measures (eCQMs) to perform a Venous Thromboembolism Prophylaxis Rapid Cycle Quality Improvement Initiative

HM2018 Abstract Number: 472

Not “Just the Flu”: A case of post-influenza S. aureus pneumonia

Case Presentation: A healthy 22-year-old woman presented to the ED with five days of fevers, dry cough, dyspnea and right-sided pleuritic chest pain. Lab work and a CXR were unremarkable. A nasal swab diagnosed Influenza [...]

By | 2018-03-19T13:17:18+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Not “Just the Flu”: A case of post-influenza S. aureus pneumonia

HM2018 Abstract Number: 219

CREATION AND IMPLEMENTATION OF A CLINICAL DECISION SUPPORT TOOL TO DECREASE VOLUME OF INPATIENT STRESS TESTS AT A PUBLIC ACADEMIC HOSPITAL

Background: Patients admitted to our hospital with chest pain concerning for Acute Coronary Syndrome (ACS) have a length of stay exceeding the community average. We postulated that unnecessary stress test orders in some cases may [...]

By | 2018-03-19T13:17:14+00:00 March 19th, 2018|Hospital Medicine 2018, Quality Improvement, Research|Comments Off on CREATION AND IMPLEMENTATION OF A CLINICAL DECISION SUPPORT TOOL TO DECREASE VOLUME OF INPATIENT STRESS TESTS AT A PUBLIC ACADEMIC HOSPITAL

HM2018 Abstract Number: 542

IT’S ALL IN THE HEAD: A CASE REPORT ON METRONIDAZOLE-INDUCED ENCEPHALOPATHY (MEI) AND NEUROPATHY

Case Presentation: We report a case of a 44 year old female with a history of hepatitis C and alcoholic cirrhosis, abstinent from alcohol for about two years, who presented from a nursing facility with [...]

By | 2018-03-19T13:17:12+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on IT’S ALL IN THE HEAD: A CASE REPORT ON METRONIDAZOLE-INDUCED ENCEPHALOPATHY (MEI) AND NEUROPATHY

HM2018 Abstract Number: 186

Pediatric Clinical Documentation Queries with Definitions: An Innovative Way to Promote Provider Engagement

Background: Clinical Documentation Improvement programs have been present in adult hospitals for many years. These programs strive to promote clinicians working together with nurse specialists to appropriately depict the care delivered and increase coding accuracy. [...]

By | 2018-03-19T13:17:10+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Pediatrics|Comments Off on Pediatric Clinical Documentation Queries with Definitions: An Innovative Way to Promote Provider Engagement

HM2018 Abstract Number: 380

Where’s the Fat? A Challenging Case of Recurrent Ascites of Unclear Etiology

Case Presentation: A 75 year-old man with recently diagnosed bladder cancer presented with fever and dyspnea, one month after a laparoscopic cystectomy, radical prostatectomy, lymph node dissection, and urinary diversion via ileal conduit. On arrival, [...]

By | 2018-03-22T15:49:31+00:00 March 19th, 2018|Adult, Clinical Vignettes, Finalist Posters, Hospital Medicine 2018|Comments Off on Where’s the Fat? A Challenging Case of Recurrent Ascites of Unclear Etiology

HM2018 Abstract Number: 568

SPOTS AND ANEMIA, LYME AND BABESIA!

Case Presentation: A 69-year-old female with no significant past medical history presented with three weeks of intermittent fevers followed by 24-hours of persistent fever associated with nausea, fatigue, and malaise. She lived in the metro-Boston [...]

By | 2018-03-19T13:17:06+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on SPOTS AND ANEMIA, LYME AND BABESIA!

HM2018 Abstract Number: 860

Sour without the Sweet: A Subtle Presentation of Euglycemic Diabetic Ketoacidosis

Case Presentation: A 48-year-old male nurse presented with one week of fever, nausea, abdominal pain, dysuria, urinary frequency, and suprapubic pain. His past medical history was significant for type 2 diabetes mellitus (recent hemoglobin a1c [...]

By | 2018-03-19T13:17:04+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Sour without the Sweet: A Subtle Presentation of Euglycemic Diabetic Ketoacidosis

HM2018 Abstract Number: 697

PARANEOPLASTIC CUSHING’S SYNDROME IN A HYPOTENSIVE, HYPOKALEMIC PATIENT

Case Presentation: A 61 year old woman presented to the hospital with dyspnea and chest pain. She had been gaining weight, and experiencing night sweats and lower extremity swelling for several months. She had a [...]

By | 2018-03-19T13:17:02+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on PARANEOPLASTIC CUSHING’S SYNDROME IN A HYPOTENSIVE, HYPOKALEMIC PATIENT

HM2018 Abstract Number: 594

Acute Severe Mitral Regurgitation With Cardiogenic Shock Due To Papillary Muscle Rupture In Acute Myocardial Infarction

Case Presentation: We describe an interesting case of a 59-year-old female patient who arrived unresponsive to ED, with symptoms concerning for acute coronary syndrome(ACS). There was no informant present along with the patient, so very [...]

By | 2018-03-19T13:17:00+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Acute Severe Mitral Regurgitation With Cardiogenic Shock Due To Papillary Muscle Rupture In Acute Myocardial Infarction

HM2018 Abstract Number: 17

360° EVALUATION OF FELLOW HOSPITALISTS VIA A REDCAP SURVEY

Background: The Hospitalist Division at Washington University in St. Louis provides coverage for multiple different services at Barnes-Jewish Hospital. At the present time, there are a total of 68 MDs and 6 NPs caring for [...]

By | 2018-03-22T15:14:46+00:00 March 19th, 2018|Finalist Posters, Hospital Medicine 2018, Innovations, Quality Improvement|Comments Off on 360° EVALUATION OF FELLOW HOSPITALISTS VIA A REDCAP SURVEY

HM2018 Abstract Number: 272

IMPROVING MOBILIZATION OF HOSPITALIZED ELDERLY MEDICAL PATIENTS

Background: The benefits of early ambulation for patients admitted to a hospital are well recognized. Our hospital has a “Nurse Driven Progressive Mobility Protocol” which is intended to guide bedside practitioners in implementing individualized progressive [...]

By | 2018-03-19T13:16:57+00:00 March 19th, 2018|Hospital Medicine 2018, Quality Improvement, Research|Comments Off on IMPROVING MOBILIZATION OF HOSPITALIZED ELDERLY MEDICAL PATIENTS

HM2018 Abstract Number: 55

A HYPOTENSION GROUP OBSERVED STANDARDIZED CLINICAL ENCOUNTER: ESTABLISHING A CULTURE OF PATIENT SAFETY FOR NEW INTERNS

Background: Incoming interns must understand the specific culture of safety at their new institution as well as processes that they are expected to know on day 1 of residency. As part of an immersive half-day [...]

By | 2018-03-19T13:16:56+00:00 March 19th, 2018|Education, Hospital Medicine 2018, Research|Comments Off on A HYPOTENSION GROUP OBSERVED STANDARDIZED CLINICAL ENCOUNTER: ESTABLISHING A CULTURE OF PATIENT SAFETY FOR NEW INTERNS

HM2018 Abstract Number: 867

EUGLYCEMIC DIABETIC KETOACIDOSIS: A CHALLENGING CONSEQUENCE OF SGLT2 INHIBITION

Case Presentation: A 53-year-old woman with Type 2 Diabetes Mellitus (DM) on insulin complicated by prior DKA presented with headache, nausea, vomiting, and palpitations for several hours. Her DM regimen included insulin glargine, linagliptin, and [...]

By | 2018-03-19T13:16:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on EUGLYCEMIC DIABETIC KETOACIDOSIS: A CHALLENGING CONSEQUENCE OF SGLT2 INHIBITION

HM2018 Abstract Number: 476

SEVERE THROMBOCYTOPENIA INDUCED BY VANCOMYCIN-DEPENDENT ANTI-PLATELET ANTIBODIES

Case Presentation: A 69-year-old woman with metastatic breast cancer, atrial fibrillation (on coumadin) and CKD stage III was admitted after a fall. She was treated for pneumonia with ceftriaxone and azithromycin. On hospital day 2, [...]

By | 2018-03-19T13:16:53+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on SEVERE THROMBOCYTOPENIA INDUCED BY VANCOMYCIN-DEPENDENT ANTI-PLATELET ANTIBODIES

HM2018 Abstract Number: 56

A SIMULATED FIRST NIGHT ON CALL: ESTABLISHING COMMUNITY AND A CULTURE OF PATIENT SAFETY FOR INCOMING INTERNS

Background: The transition from medical student to intern presents a major patient safety concern. Incoming interns must understand the specific culture of safety at their new institution and processes that they are expected to perform [...]

By | 2018-03-19T13:16:51+00:00 March 19th, 2018|Education, Hospital Medicine 2018, Research|Comments Off on A SIMULATED FIRST NIGHT ON CALL: ESTABLISHING COMMUNITY AND A CULTURE OF PATIENT SAFETY FOR INCOMING INTERNS

HM2018 Abstract Number: 114

RISK-STRATIFICATION WITH PROCALCITONIN PREDICTS LENGTH OF STAY IN HOSPITALIZED PATIENTS

Background: Procalcitonin (PCT) is a precursor peptide to calcitonin produced by the thyroid parafollicular cells, and the intestinal and lung neuroendocrine cells. PCT is a proinflammatoy marker specific to bacterial infections, and was initially used [...]

By | 2018-03-19T13:16:48+00:00 March 19th, 2018|Hospital Medicine 2018, Outcomes Research, Research|Comments Off on RISK-STRATIFICATION WITH PROCALCITONIN PREDICTS LENGTH OF STAY IN HOSPITALIZED PATIENTS

HM2018 Abstract Number: 566

NUTRITIONAL DEFICIENCY AS A CAUSE OF ACUTE ASCENDING NEUROPATHY MIMICKING GUILLAIN-BARRÉ SYNDROME

Case Presentation: A 39-year old female with a history of alcohol abuse presented with an eight-day history of numbness involving her bilateral lower extremities and hands which had progressed proximally to involve her chest wall. [...]

By | 2018-03-19T13:16:47+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NUTRITIONAL DEFICIENCY AS A CAUSE OF ACUTE ASCENDING NEUROPATHY MIMICKING GUILLAIN-BARRÉ SYNDROME

HM2018 Abstract Number: 445

BLASTOMYCOSIS PRESENTING WITH ISOLATED EPIDIDYMO-ORCHITIS

Case Presentation: A 68-year-old male with a past medical history of well controlled diabetes mellitus and chronic lymphocytic leukemia-in remission, presented with a painful right scrotal swelling and redness of four days. The patient denied [...]

By | 2018-03-19T13:16:45+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on BLASTOMYCOSIS PRESENTING WITH ISOLATED EPIDIDYMO-ORCHITIS

HM2018 Abstract Number: 449

A CASE OF VOGT-KAYANAGI-HARADA DISEASE AS SEQUELA OF DRESS

Case Presentation: A 32 yo male presented after 1 week of high spiking fevers and a pruritic rash. Sulfamethoxazole-trimethoprim had been started 5 weeks prior. Treatment was started with antihistamines, topical steroids, and prednisone 60mg [...]

By | 2018-03-19T13:16:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A CASE OF VOGT-KAYANAGI-HARADA DISEASE AS SEQUELA OF DRESS

HM2018 Abstract Number: 179

DO MEDICAL STUDENTS SLEUTH? VALIDITY OF PATIENT- AND FAMILY-CENTERED ROUNDS TOOL IN RATING PRESENTER EMPOWERMENT ACTIONS OF MEDICAL STUDENTS AND INTERNS

Background: Medical students and interns are the primary communicators during pediatric patient- and family-centered rounds (PFCR). Presenter empowerment actions (PEAs) represent behaviors that empower presenters during PFCR to deliver effective, patient- and family-centered care. Third [...]

By | 2018-03-19T13:16:42+00:00 March 19th, 2018|Hospital Medicine 2018, Pediatrics, Research|Comments Off on DO MEDICAL STUDENTS SLEUTH? VALIDITY OF PATIENT- AND FAMILY-CENTERED ROUNDS TOOL IN RATING PRESENTER EMPOWERMENT ACTIONS OF MEDICAL STUDENTS AND INTERNS

HM2018 Abstract Number: 398

WHICH ZEBRA IS IT? CHALLENGES IN CHOOSING THE DIAGNOSIS FROM THE HERD

Case Presentation: A 19-year-old female presented to a children’s hospital with a two week history of daily fever, diffuse abdominal tenderness, vomiting, diarrhea, and body aches, starting three weeks after her immigration from Kenya. Laboratory [...]

By | 2018-03-19T13:16:40+00:00 March 19th, 2018|Clinical Vignettes, Hospital Medicine 2018, Pediatric|Comments Off on WHICH ZEBRA IS IT? CHALLENGES IN CHOOSING THE DIAGNOSIS FROM THE HERD

HM2018 Abstract Number: 265

ACCURACY OF A PATIENT’S PCP IN THE EMR

Background: Insufficient communication, particularly at transitions in patient care, is a common and accepted cause of negative outcomes. Handoffs between hospitalists and primary care physicians (PCPs) are infrequent, occurring in 3-20% of cases (2). Many [...]

By | 2018-03-19T13:16:38+00:00 March 19th, 2018|Hospital Medicine 2018, Quality Improvement, Research|Comments Off on ACCURACY OF A PATIENT’S PCP IN THE EMR

HM2018 Abstract Number: 303

#JHMCHAT: A TWITTER-BASED JOURNAL CLUB TO IMPROVE RESEARCH DISSEMINATION AND ENGAGEMENT AMONG HOSPITALISTS

Background: Physicians are increasingly using the social media outlet, Twitter, as a medium to connect and engage. Specifically, Twitter-based journal clubs have created a space for clinicians, educators and researchers to disseminate and discuss recent [...]

By | 2018-03-19T13:16:35+00:00 March 19th, 2018|Hospital Medicine 2018, Research, Technology in Hospital Medicine|Comments Off on #JHMCHAT: A TWITTER-BASED JOURNAL CLUB TO IMPROVE RESEARCH DISSEMINATION AND ENGAGEMENT AMONG HOSPITALISTS

HM2018 Abstract Number: 8

THE EFFECT OF BEDSIDE ROUNDS ON PATIENT-CENTERED OUTCOMES: A SYSTEMATIC REVIEW AND META-ANALYSIS

Background: Bedside rounds (BR) have been proposed as an ideal method to promote patient-centered hospital care. However, their effect on patient-centered outcomes is unclear. Our objective was to determine whether BR, when compared to other [...]

By | 2018-03-22T15:45:08+00:00 March 19th, 2018|Finalist Posters, Hospital Medicine 2018, Outcomes Research, Research|Comments Off on THE EFFECT OF BEDSIDE ROUNDS ON PATIENT-CENTERED OUTCOMES: A SYSTEMATIC REVIEW AND META-ANALYSIS

HM2018 Abstract Number: 680

MARCHIAFAVA-BIGNAMI DISEASE, A RARE COMPLICATION OF ALCOHOLISM

Case Presentation: A 55 year old male with a history of hypertension, hyperlipidemia and significant history of alcohol abuse presented after presyncope with subsequent fall and head trauma. On presentation he was confused and dysarthric. [...]

By | 2018-03-19T13:16:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on MARCHIAFAVA-BIGNAMI DISEASE, A RARE COMPLICATION OF ALCOHOLISM

HM2018 Abstract Number: 692

AN UNUSUAL CASE OF FEVERS; HOW URBAN LEGEND FINDS ITS WAY INTO MODERN-DAY MEDICINE

Case Presentation: A 43-year-old previously healthy Nigerian male presented to the ED with fevers for three weeks. He denied any chronic medical conditions, prior surgeries, or travel in the past year. He had initially presented [...]

By | 2018-03-19T13:16:25+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on AN UNUSUAL CASE OF FEVERS; HOW URBAN LEGEND FINDS ITS WAY INTO MODERN-DAY MEDICINE

HM2018 Abstract Number: 741

IR-RASH-IONAL FEAR

Case Presentation: A 58 year old man, who has sex with men, presented with three weeks of blurred vision. During this period he also noted fevers, malaise, and headache. Physical exam revealed a patchy erythematous [...]

By | 2018-03-19T13:16:24+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on IR-RASH-IONAL FEAR

HM2018 Abstract Number: 156

OPTIMAL DOSING OF 4-FACTOR PROTHROMBIN COMPLEX CONCENTRATE FOR REVERSAL OF WARFARIN ASSOCIATED COAGULOPATHY

Background: While anticoagulants are the core treatment plan for preventing strokes in patients with atrial fibrillation and managing patients with thromboembolic disease, there is a dichotomy of efficacy and harm with their use. Rapid inpatient [...]

By | 2018-03-19T13:16:22+00:00 March 19th, 2018|Hospital Medicine 2018, Patient Safety, Research|Comments Off on OPTIMAL DOSING OF 4-FACTOR PROTHROMBIN COMPLEX CONCENTRATE FOR REVERSAL OF WARFARIN ASSOCIATED COAGULOPATHY

HM2018 Abstract Number: 270

PAIN MANAGEMENT IN THE ERA OF OPIOID ADDICTION

Background: Hospitals are compelled by a variety of factors to optimize patient satisfaction. Pain management has been identified as an important determinant of overall inpatient satisfaction. However, effective pain management may be more challenging in [...]

By | 2018-03-19T13:16:21+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Quality Improvement|Comments Off on PAIN MANAGEMENT IN THE ERA OF OPIOID ADDICTION

HM2018 Abstract Number: 454

Plants in the Lung: a Case of Excipient-Related Granulomatous Disease

Case Presentation: A 27 year-old Caucasian man presented with hypoxia, recurrent fevers, and joint pains. He had Crohn’s disease with partial bowel resection and was actively being treated with Infliximab. He had previously worked as [...]

By | 2018-03-19T13:16:19+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Plants in the Lung: a Case of Excipient-Related Granulomatous Disease

HM2018 Abstract Number: 33

Collaboration is Key

Background: Hospital readmissions continue to remain prevalent despite their negative impact on patient outcomes and economic cost. One in five Medicare beneficiaries is expected to be readmitted within 30 days. As a result, strategies to [...]

By | 2018-03-19T13:16:17+00:00 March 19th, 2018|Communication, Hospital Medicine 2018, Research|Comments Off on Collaboration is Key

HM2018 Abstract Number: 234

A Retrospective Study on the Effect of Inpatient Diabetes Self-Management Support on 30-day Re-admission Rates

Background: The high prevalence of diabetes makes it a common co-morbid condition in hospitalized patients. Healthcare systems have increasingly focused on 30-day readmission rates to improve quality and reduce costs. Readmission rates for patients with [...]

By | 2018-03-19T13:15:30+00:00 March 19th, 2018|Hospital Medicine 2018, Quality Improvement, Research|Comments Off on A Retrospective Study on the Effect of Inpatient Diabetes Self-Management Support on 30-day Re-admission Rates

HM2018 Abstract Number: 690

A RARE CASE OF PULMONARY BLASTOMYCOSIS COMPLICATED BY ARDS IN AN IMMUNOCOMPETENT INDIVIDUAL

Case Presentation: A 71-year-old female presented to an emergency department with progressive weakness and dyspnea with dry cough for 2 weeks; she was afebrile but hypoxic, requiring 2 liters oxygen by nasal cannula. Physical examination was remarkable [...]

By | 2018-03-19T13:15:29+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A RARE CASE OF PULMONARY BLASTOMYCOSIS COMPLICATED BY ARDS IN AN IMMUNOCOMPETENT INDIVIDUAL

HM2018 Abstract Number: 809

ADIPOSE TISSUE INFUSION AS A CAUSE OF RECURRENT FEVER

Case Presentation: An 87-year-old female with a history of bilateral knee osteoarthritis presented to the emergency room with complaints of intermittent fever ongoing at home for two weeks. She recently had a Lipogems injection procedure [...]

By | 2018-03-19T13:15:26+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on ADIPOSE TISSUE INFUSION AS A CAUSE OF RECURRENT FEVER

HM2018 Abstract Number: 756

A Dizzying Experience: A Case of Vertebral Artery Dissection

Case Presentation: A previously healthy 37-year-old male presented to the Emergency Department (ED) with sudden onset nausea and dizziness that after he had turned and looked over his right shoulder. He experienced 3 episodes of [...]

By | 2018-03-19T13:15:24+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A Dizzying Experience: A Case of Vertebral Artery Dissection

HM2018 Abstract Number: 182

THE USE OF NEBULIZED NORMAL SALINE FOR BRONCHIOLITIS AND ASTHMA: NOT STANDARD OF CARE

Background: Asthma and bronchiolitis are the most common respiratory ailments affecting pediatric patients worldwide. Management guidelines have been developed in an effort to standardize the treatment of these patients. Nowhere in these guidelines (both the [...]

By | 2018-03-19T13:15:22+00:00 March 19th, 2018|Hospital Medicine 2018, Pediatrics, Research|Comments Off on THE USE OF NEBULIZED NORMAL SALINE FOR BRONCHIOLITIS AND ASTHMA: NOT STANDARD OF CARE

HM2018 Abstract Number: 218

What to Expect That You’re Not Expecting – Video Education to Improve Patient Self-Efficacy Surrounding Discharge Medication Barriers

Background: Preventable hospital readmissions are a common problem for medical centers in the United States. Recent studies have focused on what patients perceive as causes for their return to the hospital. One factor driving readmissions [...]

By | 2018-03-19T13:15:21+00:00 March 19th, 2018|Hospital Medicine 2018, Quality Improvement, Research|Comments Off on What to Expect That You’re Not Expecting – Video Education to Improve Patient Self-Efficacy Surrounding Discharge Medication Barriers

HM2018 Abstract Number: 751

A Case of Red Herrings, Wide Nets and Atypical Features

Case Presentation: A 33 year-old Caucasian female with history of 1 spontaneous abortion presented with periorbital edema, dark urine, arthralgias and fevers (Tmax 102) for 2 weeks. The patient reported many environmental exposures as a [...]

By | 2018-03-19T13:15:19+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A Case of Red Herrings, Wide Nets and Atypical Features

HM2018 Abstract Number: 252

DELIVERING HIGH VALUE CARE FOR DIABETIC KETOACIDOSIS (DKA) THROUGH IMPLEMENTATION OF AN EVIDENCE-BASED MULTI-DISCIPLINARY CLINICAL PATHWAY

Background: At our urban, academic hospital, use of outdated protocols and unnecessary variations in the care of DKA patients treated with ICU requiring IV insulin protocols have led to multiple safety events, delays in care [...]

By | 2018-03-19T13:15:17+00:00 March 19th, 2018|Hospital Medicine 2018, Quality Improvement, Research|Comments Off on DELIVERING HIGH VALUE CARE FOR DIABETIC KETOACIDOSIS (DKA) THROUGH IMPLEMENTATION OF AN EVIDENCE-BASED MULTI-DISCIPLINARY CLINICAL PATHWAY

HM2018 Abstract Number: 674

A RARE PRESENTATION OF GASTRIC SIGNET RING CELL ADENOCARCINOMA (SRCA)

Case Presentation: A 25 year old Hispanic woman, G4P3 pregnant at 18 weeks with underlying hypertension and gallstones, initially presented with low back pain for 10 days. The pain started suddenly, constant, sharp with no [...]

By | 2018-03-19T13:15:15+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A RARE PRESENTATION OF GASTRIC SIGNET RING CELL ADENOCARCINOMA (SRCA)

HM2018 Abstract Number: 189

WHO’S COUNTING? ASSESSING THE EFFECTS OF A SIMULATION-BASED TRAINING INTERVENTION ON NEONATAL HEART RATE AUSCULTATION ACCURACY.

Background: Heart rate (HR) assessment is a vital component in the neonatal resuscitation (NR) algorithm. Research has consistently found auscultation to be an inaccurate means of assessing neonatal HR and may lead to incorrect resuscitation [...]

By | 2018-03-19T13:15:14+00:00 March 19th, 2018|Hospital Medicine 2018, Pediatrics, Research|Comments Off on WHO’S COUNTING? ASSESSING THE EFFECTS OF A SIMULATION-BASED TRAINING INTERVENTION ON NEONATAL HEART RATE AUSCULTATION ACCURACY.

HM2018 Abstract Number: 40

DOES EARLY ENDOSCOPY IMPROVE MORTALITY IN PATIENTS WITH ACUTE NON-VARICEAL GASTROINTESTINAL BLEEDING

Background: Initial management of acute upper gastrointestinal bleeding (UGIB) aims towards aggressive fluid resuscitation to maintain hemodynamic stability. Existing evidence regarding benefit of early endoscopy is unclear with some studies suggesting mortality benefits and some [...]

By | 2018-03-19T13:15:12+00:00 March 19th, 2018|Consultative Medicine, Hospital Medicine 2018, Research|Comments Off on DOES EARLY ENDOSCOPY IMPROVE MORTALITY IN PATIENTS WITH ACUTE NON-VARICEAL GASTROINTESTINAL BLEEDING

HM2018 Abstract Number: 367

Sjogren’s Without the ‘K’

Case Presentation: A 14-year-old Hispanic female with history of recurrent pancreatitis, hypokalemia and disordered eating presents with diffuse weakness. She was admitted twice in recent months for pancreatitis requiring fluid and electrolyte repletion. She developed [...]

By | 2018-03-22T12:35:07+00:00 March 19th, 2018|Clinical Vignettes, Finalist Posters, Hospital Medicine 2018, Pediatric|Comments Off on Sjogren’s Without the ‘K’

HM2018 Abstract Number: 103

ULTRASOUND-GUIDED BEDSIDE CORE NEEDLE BIOPSY – AN INPATIENT MEDICAL PROCEDURE TEAM’S EXPERIENCE

Background: Tissue pathology plays an integral role in the diagnosis of various conditions, especially malignancy. Traditionally biopsy procedures, including core needle biopsy (CNB), have been performed by specialists under imaging guidance. They are traditionally done [...]

By | 2018-03-19T13:15:09+00:00 March 19th, 2018|Hospital Medicine 2018, Other, Research|Comments Off on ULTRASOUND-GUIDED BEDSIDE CORE NEEDLE BIOPSY – AN INPATIENT MEDICAL PROCEDURE TEAM’S EXPERIENCE

HM2018 Abstract Number: 350

TIME OUT FOR TYPE AND SCREEN?

Background: Hemorrhagic complications after cardiac catheterization (CC) and percutaneous coronary intervention (PCI) are associated with an increased risk of mortality. In review of a large catheterization registry, blood transfusions were required following 1.4% of radial [...]

By | 2018-03-19T13:15:07+00:00 March 19th, 2018|Hospital Medicine 2018, Research, Value in Hospital Medicine|Comments Off on TIME OUT FOR TYPE AND SCREEN?

HM2018 Abstract Number: 147

PATTERNS AND OUTCOMES OF VENOUS THROMBOEMBOLISM PROPHYLAXIS PRESCRIBING IN HOSPITALIZED OLDER ADULTS: RETROSPECTIVE COHORT STUDY

Background: Venous thromboembolism (VTE) is a major cause of morbidity and mortality in the United States. The increased risk of VTE among medically ill older adults is firmly established. Guidelines strongly promote the use of [...]

By | 2018-03-19T13:15:03+00:00 March 19th, 2018|Hospital Medicine 2018, Outcomes Research, Research|Comments Off on PATTERNS AND OUTCOMES OF VENOUS THROMBOEMBOLISM PROPHYLAXIS PRESCRIBING IN HOSPITALIZED OLDER ADULTS: RETROSPECTIVE COHORT STUDY

HM2018 Abstract Number: 157

WARFARIN QUALITY METRICS FOR HOSPITALIZED OLDER ADULTS: A RETROSPECTIVE STUDY

Background: Warfarin-associated adverse drug events are dangerous, common, and costly. Anticoagulation safety is a national priority. While multiple tools exist for warfarin management in the outpatient setting, there is a dearth of guidance with regard [...]

By | 2018-03-19T13:14:59+00:00 March 19th, 2018|Hospital Medicine 2018, Patient Safety, Research|Comments Off on WARFARIN QUALITY METRICS FOR HOSPITALIZED OLDER ADULTS: A RETROSPECTIVE STUDY

HM2018 Abstract Number: 639

BONE, DRUGS, AND DISHARMONY: ELEVATED ALKALINE PHOSPHATASE DUE TO VORICONAZOLE-INDUCED PERIOSTITIS

Case Presentation: A 19-year-old male presented with three days of fevers, cough, and pleuritic chest pain. He had a history of cystic fibrosis (CF) with lung and pancreatic involvement and allergic bronchiopulmonary aspergillosis (ABPA). Home [...]

By | 2018-03-19T13:14:57+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on BONE, DRUGS, AND DISHARMONY: ELEVATED ALKALINE PHOSPHATASE DUE TO VORICONAZOLE-INDUCED PERIOSTITIS

HM2018 Abstract Number: 662

SEIZURE-INDUCED TAKOTSUBO CARDIOMYOPATHY

Case Presentation: A 68-year old female with a history of uncomplicated alcohol dependence was brought in by ambulance after a witnessed seizure at home characterized by myoclonus for several minutes and prolonged post-ictal confusion. Upon [...]

By | 2018-03-19T13:14:54+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on SEIZURE-INDUCED TAKOTSUBO CARDIOMYOPATHY

HM2018 Abstract Number: 563

THYROTOXIC PERIODIC PARALYSIS PRESENTING AS PAROXYSMAL DIFFUSE HYPOKALEMIC WEAKNESS

Case Presentation: A 29-year-old Asian male with a one-year history of recurrent generalized muscle weakness presented to the emergency department with whole body paralysis. The patient’s symptoms began abruptly that morning, when he was unable [...]

By | 2018-03-19T13:14:51+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on THYROTOXIC PERIODIC PARALYSIS PRESENTING AS PAROXYSMAL DIFFUSE HYPOKALEMIC WEAKNESS

HM2018 Abstract Number: 740

Penicilliosis: A Contaminant Confirmed

Case Presentation: A 44 year old African American man presented to the hospital for evaluation and treatment following generalized tonic-clonic seizures. He denied recent and remote travel, fever, chills, sick contacts, constitutional symptoms, and felt [...]

By | 2018-03-19T13:14:48+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Penicilliosis: A Contaminant Confirmed

HM2018 Abstract Number: 59

Ultra-Brief Pre-Rounds Teaching

Background: Time with learners is a finite resource on the teaching wards. As patient care becomes progressively more complex and clinical demands increase, it can be easy for teaching to get deferred to the next [...]

By | 2018-03-19T13:14:46+00:00 March 19th, 2018|Education, Hospital Medicine 2018, Innovations|Comments Off on Ultra-Brief Pre-Rounds Teaching

HM2018 Abstract Number: 803

A Rare Case of Acute Interstitial Pneumonia (Hamman-Rich Syndrome)

Case Presentation: A 45-year-old female with PMH of hypertension presented with 3-days of worsening shortness of breath, general malaise and increasing home oxygen (O2) requirements. She was recently discharged from an outside hospital with home [...]

By | 2018-03-19T13:14:45+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A Rare Case of Acute Interstitial Pneumonia (Hamman-Rich Syndrome)

HM2018 Abstract Number: 20

NPPA Hospitalist Clinical Fellowship as a Pipeline to Staffing

Background: There are approximately 7,000 Physician Assistants (PAs) and 10,000 Nurse Practitioners (NPs) working as hospitalists nationally. About 63% of hospitalist groups utilize NPs/PAs. The demand for hospitalists continues to exceed the supply and has [...]

By | 2018-03-22T15:13:05+00:00 March 19th, 2018|Finalist Posters, Hospital Medicine 2018, Innovations, Value in Hospital Medicine|Comments Off on NPPA Hospitalist Clinical Fellowship as a Pipeline to Staffing

HM2018 Abstract Number: 192

What factors predict HSV PCR CSF testing and empiric acyclovir therapy in febrile neonates?

Background: Neonatal herpes simplex virus (HSV) infections are one of the most clinically challenging infections of the newborn period because of the often subtle presentation and devastating consequences of a missed diagnosis. The availability of [...]

By | 2018-03-19T13:14:38+00:00 March 19th, 2018|Hospital Medicine 2018, Pediatrics, Research|Comments Off on What factors predict HSV PCR CSF testing and empiric acyclovir therapy in febrile neonates?

HM2018 Abstract Number: 351

MORTALITY OF HOSPITALIZED PATIENTS WITH CELLULITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

Background: Cellulitis is a common cause of hospitalization. In the United States there are approximately 650,000 hospitalizations for cellulitis yearly, accounting for 1% of all admissions and approximately $10 billion. Most patients when hospitalized are [...]

By | 2018-03-19T13:14:36+00:00 March 19th, 2018|Hospital Medicine 2018, Research, Value in Hospital Medicine|Comments Off on MORTALITY OF HOSPITALIZED PATIENTS WITH CELLULITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS

HM2018 Abstract Number: 447

A DIAGNOSIS HIDING IN PLAIN SITE

Case Presentation: A morbidly obese, but otherwise healthy, 57 year old male, presented to his initial visit with his primary care provider with complaints of dysphagia, vomiting, and unintentional weight loss of 15 pounds over [...]

By | 2018-03-19T13:14:35+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on A DIAGNOSIS HIDING IN PLAIN SITE

HM2018 Abstract Number: 899

HARDER TO BREATHE: AN UNSUAL CASE OF SEVERE HYPERPHOSPHATURIC HYPOPHOSPHATEMIA AND NORMAL FGF-23 LEVELS IN A YOUNG FEMALE PATIENT

Case Presentation: A 33-year-old Caucasian woman presented with increasing fatigue, palpitations and shortness of breath for the previous three weeks. She had a history of iron deficiency anemia, gluten sensitivity, and compensated anorexia. One month [...]

By | 2018-03-19T13:14:33+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on HARDER TO BREATHE: AN UNSUAL CASE OF SEVERE HYPERPHOSPHATURIC HYPOPHOSPHATEMIA AND NORMAL FGF-23 LEVELS IN A YOUNG FEMALE PATIENT

HM2018 Abstract Number: 767

When Thunder Strikes

Case Presentation: Ms. T.J. is a 47-year-old female with a past medical history consisting of migraines and tobacco use who presented with headache. 6 weeks prior to admission, the patient had a sudden onset of [...]

By | 2018-03-19T13:14:30+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on When Thunder Strikes

HM2018 Abstract Number: 845

POST-SURGICAL LEMIERRE’S SYNDROME

Case Presentation: 50-year-old male with past medical history of hypertension, was diagnosed with a Warthin’s tumor. Patient underwent superficial parotidectomy with right neck lymph node dissection level. On POD #10, he presented to the ED [...]

By | 2018-03-19T13:14:27+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on POST-SURGICAL LEMIERRE’S SYNDROME

HM2018 Abstract Number: 339

Revefenacin, an Investigational Long-acting Muscarinic Antagonist for Nebulization: Pooled Results of Replicate Phase 3 Trials in Patients With Moderate to Very Severe Chronic Obstructive Pulmonary Disease

Background: Currently, once-daily nebulized bronchodilator therapy is unavailable for patients with chronic obstructive pulmonary disease (COPD). Prior studies demonstrated that once-daily revefenacin (REV) doses of 88 and 175 µg produced significant bronchodilation in COPD patients. [...]

By | 2018-03-19T13:14:25+00:00 March 19th, 2018|Hospital Medicine 2018, Research, Translating Research into Practice|Comments Off on Revefenacin, an Investigational Long-acting Muscarinic Antagonist for Nebulization: Pooled Results of Replicate Phase 3 Trials in Patients With Moderate to Very Severe Chronic Obstructive Pulmonary Disease

HM2018 Abstract Number: 211

Improving Adherence to Discharge Medications for Hospitalized Heart Failure Patients

Background: Heart failure is a deadly epidemic with over 37 million people affected worldwide with a multitude of physical, psychological and financial implications on patients and the healthcare system. The progression of heart failure can [...]

By | 2018-03-19T13:14:24+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Quality Improvement|Comments Off on Improving Adherence to Discharge Medications for Hospitalized Heart Failure Patients

HM2018 Abstract Number: 879

NOT ALL PNEUMONIA IS INFECTIOUS!

Case Presentation: An 89 year-old male developed coagulase negative Staphylococcus bacteremia and infective endocarditis of mitral valve after urinary procedure for which he was started on Daptomycin for 6 weeks. At week 4, he developed [...]

By | 2018-03-19T13:14:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on NOT ALL PNEUMONIA IS INFECTIOUS!

HM2018 Abstract Number: 833

Blind to the diagnosis: a case of undetected neurosyphilis presenting as unilateral central scotoma.

Case Presentation: A 37-year-old man who has sex with men (MSM) with extensive cerebrovascular history, including non-traumatic internal carotid artery dissection, cerebrovascular accident (CVA) with left-sided hemiparesis, Circle of Willis aneurysm, presented with acute painless [...]

By | 2018-03-19T13:14:21+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Blind to the diagnosis: a case of undetected neurosyphilis presenting as unilateral central scotoma.

HM2018 Abstract Number: 849

HAVE YOU SEEN MY THIAMINE?

Case Presentation: A 26-year-old woman with a past medical history of obesity presented with four weeks of intractable nausea and vomiting associated with poor oral intake and a 60-pound unintentional weight loss. She also complained [...]

By | 2018-03-19T13:14:19+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on HAVE YOU SEEN MY THIAMINE?

HM2018 Abstract Number: 657

POLYARTERITIS NODOSA WITH NEGATIVE INFLAMMATORY MARKERS AND LOCALIZED VASCULITIS OF THE GASTROINTESTINAL TRACT– A CASE REPORT

Case Presentation: Case presentation:A 56 year-old caucasian man with no significant past medical history presented to our center with acute left upper quadrant abdominal pain. CT angiography of the thorax was performed to rule-out pulmonary [...]

By | 2018-03-19T13:12:45+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on POLYARTERITIS NODOSA WITH NEGATIVE INFLAMMATORY MARKERS AND LOCALIZED VASCULITIS OF THE GASTROINTESTINAL TRACT– A CASE REPORT

HM2018 Abstract Number: 534

INVASIVE CYTOMEGALOVIRUS IN A HOST WITH IMMUNE DYSREGULATION

Case Presentation: A 32-year-old woman with history of lupus not on steroid or immunosuppressive therapy for more than 10 years presented with headache, generalized weakness, abdominal pain, nausea, vomiting, and malaise. On exam, the patient [...]

By | 2018-03-19T13:12:43+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on INVASIVE CYTOMEGALOVIRUS IN A HOST WITH IMMUNE DYSREGULATION

HM2018 Abstract Number: 94

ENGAGING PATIENT & FAMILY ADVISORY COUNCILS (PFACS) IN INPATIENT QUALITY IMPROVEMENT & RESEARCH EFFORTS: BARRIERS AND OPPORTUNITIES

Background: Patient & Family Advisory Councils (PFACs) are groups of patients, family members and caregivers who meet regularly to share their experiences of healthcare or perspectives on a specific topic. Over 50% of acute care [...]

By | 2018-03-19T13:12:42+00:00 March 19th, 2018|Hospital Medicine 2018, Other, Research|Comments Off on ENGAGING PATIENT & FAMILY ADVISORY COUNCILS (PFACS) IN INPATIENT QUALITY IMPROVEMENT & RESEARCH EFFORTS: BARRIERS AND OPPORTUNITIES

HM2018 Abstract Number: 392

What to Expect When You’re Expecting….a Baby with Tetrasomy 18

Case Presentation: This is the case of a 39-year old, G3P1001 woman with fetal aneuploidy identified on prenatal screening. Her pregnancy was conceived via anonymous sperm donor, whom had been used for two previous healthy [...]

By | 2018-10-25T10:35:20+00:00 March 19th, 2018|Clinical Vignettes, Hospital Medicine 2018, Pediatric|Comments Off on What to Expect When You’re Expecting….a Baby with Tetrasomy 18

HM2018 Abstract Number: 306

Post-discharge phone call program initiated by hospitalists

Background: Centers for Medicare & Medicaid Services (CMS) reimbursement increasingly depends on patient satisfaction scores and readmission rates to incentivize high-quality inpatient hospital care. Providers are continuously implementing complementary interventions to improve patient satisfaction and [...]

By | 2018-03-19T13:12:38+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Transitions of Care|Comments Off on Post-discharge phone call program initiated by hospitalists

HM2018 Abstract Number: 579

POTENTIALLY FATAL CONJUNCTIVAL HYPEREMIA: THE DANGER TRIANGLE OF THE FACE

Case Presentation: A 54-year-old male was referred to our hospital with a headache and left ophthalmalgia since a few weeks. The patient had a 6-month-old history of odontalgia and gingivalgia, but lived an otherwise healthy [...]

By | 2018-03-19T13:12:37+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on POTENTIALLY FATAL CONJUNCTIVAL HYPEREMIA: THE DANGER TRIANGLE OF THE FACE

HM2018 Abstract Number: 421

Muscle Mystery: Why Won’t my Enzymes Drop

Case Presentation: An 8-year-old female with a 10-day history of intermittent myalgia and fatigue presented to the emergency department after waking with severe, diffuse myalgias. Initial laboratory work-up included CBC, CMP and CPK. Most significant [...]

By | 2018-03-19T13:12:36+00:00 March 19th, 2018|Clinical Vignettes, Hospital Medicine 2018, Pediatric|Comments Off on Muscle Mystery: Why Won’t my Enzymes Drop

HM2018 Abstract Number: 748

CASE OF A MESSY RASH

Case Presentation: A 57 year old Caucasian man with history of  porphyria cutanea tarda- recently started on therapeutic phlebotomy, COPD, alcohol abuse, hypertension was admitted to the hospital with recurrent syncopal spells of one day [...]

By | 2018-03-19T13:12:34+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on CASE OF A MESSY RASH

HM2018 Abstract Number: 888

Neurological damage induced by heroin inhalation: Chasing the dragon syndrome

Case Presentation: A 37-year-old man with no previous psychiatric or significant medical history was brought in by his family to the emergency department for an abnormal behavior included inability to speak and ambulate, motor restlessness, [...]

By | 2018-03-19T13:12:30+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Neurological damage induced by heroin inhalation: Chasing the dragon syndrome

HM2018 Abstract Number: 608

CARDIAC TAMPONADE AS A CAUSE FOR HYPONATREMIA IN PATIENTS WITH ACTIVE MALIGNANCY

Case Presentation: This is the case of a 57-year-old lady with rapidly progressive stage IV pulmonary adenocarcinoma who presented two months after diagnosis with findings of significant hyponatremia. Upon admission, she was afebrile, hypotensive and [...]

By | 2018-03-19T13:12:28+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on CARDIAC TAMPONADE AS A CAUSE FOR HYPONATREMIA IN PATIENTS WITH ACTIVE MALIGNANCY

HM2018 Abstract Number: 915

WERNICKE ENCEPHALOPATHY AFTER SLEEVE GASTRECTOMY FOR MORBID OBESITY

Case Presentation: Wernicke’s encephalopathy (WE) has been considered a disease of alcoholics, but it is also found in other scenarios in which severe nutritional deficiencies can result, such as in cancer patients with cachexia, and [...]

By | 2018-03-19T13:12:25+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on WERNICKE ENCEPHALOPATHY AFTER SLEEVE GASTRECTOMY FOR MORBID OBESITY

HM2018 Abstract Number: 691

Knee Deep in Trouble: A Fungus Complicates Wound Healing

Case Presentation: A 57-year old man with a history of chronic lymphocytic leukemia, complicated by treatment-related myelodysplastic syndrome (MDS), presented with a large, painful, dry ulcer with black eschar on his right knee. He was [...]

By | 2018-03-19T13:12:22+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on Knee Deep in Trouble: A Fungus Complicates Wound Healing

HM2018 Abstract Number: 410

A CASE OF “BILATERAL CELLULITIS” OF THE LOWER EXTREMITIES

Case Presentation: A 17 year-old male teenager presented with two weeks of bilateral lower extremity edema, erythema, and warmth associated with fevers and joint pain at the foot and ankle. After a presumed bug bite [...]

By | 2018-03-19T13:12:21+00:00 March 19th, 2018|Clinical Vignettes, Hospital Medicine 2018, Pediatric|Comments Off on A CASE OF “BILATERAL CELLULITIS” OF THE LOWER EXTREMITIES

HM2018 Abstract Number: 475

METHEMOGLOBINEMIA AND HEMOLYTIC ANEMIA SECONDARY TO PROPHYLACTIC DAPSONE

Case Presentation: An 84 year old female with a past medical history significant for systemic lupus erythematous (SLE) presented to the emergency department with fatigue and dizziness. She had recently been admitted to the same [...]

By | 2018-03-19T13:12:19+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on METHEMOGLOBINEMIA AND HEMOLYTIC ANEMIA SECONDARY TO PROPHYLACTIC DAPSONE

HM2018 Abstract Number: 498

AN ESSENTIAL CLUE IS THE METHYLENE BLUE

Case Presentation: A 47 year old female with a history of depression and remote Roux-en-Y gastric bypass surgery, presented for an elective laparoscopic gastrectomy due to hypertrophic pyloric stenosis causing complete gastric remnant outlet obstruction. [...]

By | 2018-03-19T13:12:12+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on AN ESSENTIAL CLUE IS THE METHYLENE BLUE

HM2018 Abstract Number: 451

YOU MAKE MY HEART STOP: A CASE OF VARICELLA MYOCARDITIS PRESENTING AS STOKES-ADAMS ATTACKS

Case Presentation: A 30 year old well male presented with one day history of multiple episodes of loss of consciousness. Each episode lasted several minutes with no preceding warning. There was no limb jerking, tongue [...]

By | 2018-03-19T13:12:10+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on YOU MAKE MY HEART STOP: A CASE OF VARICELLA MYOCARDITIS PRESENTING AS STOKES-ADAMS ATTACKS

HM2018 Abstract Number: 259

THE BARRIER TO MINDFUL LAB ORDERING: THE ATTENDING

Background: Repetitive morning laboratory orders are a well-known contributor to healthcare cost. Initial data collected in a related project on high-value care showed that 35% of our Internal Medicine residents identified “fear of attendings” as [...]

By | 2018-03-19T13:12:07+00:00 March 19th, 2018|Hospital Medicine 2018, Innovations, Quality Improvement|Comments Off on THE BARRIER TO MINDFUL LAB ORDERING: THE ATTENDING

HM2018 Abstract Number: 738

EARLY RECOGNITION AND TREATMENT OF A PATIENT WITH AN ATYPICAL PRESENTATION OF HASHIMOTO ENCEPHALOPATHY

Case Presentation: Hashimoto encephalopathy is a poorly understood and rare complication of Hashimoto thyroiditis. Patients can present with seizures, movement disorders, or cognitive decline that improves with steroid therapy. The disease is a diagnosis of [...]

By | 2018-03-19T13:12:06+00:00 March 19th, 2018|Adult, Clinical Vignettes, Hospital Medicine 2018|Comments Off on EARLY RECOGNITION AND TREATMENT OF A PATIENT WITH AN ATYPICAL PRESENTATION OF HASHIMOTO ENCEPHALOPATHY

HM2018 Abstract Number: 216

REDUCING HOSPITAL READMISSIONS FOR CHRONIC OBSTRUCTIVE PULMONARY DISEASE: A QUALITY IMPROVEMENT PROJECT

Background: COPD exacerbations are among the leading causes of hospital readmissions. According to the COPD Foundation, in 2013, 22% patients admitted for COPD exacerbation required readmission within 30 days of discharge. This represents a significant [...]

By | 2018-03-19T13:12:03+00:00 March 19th, 2018|Hospital Medicine 2018, Quality Improvement, Research|Comments Off