Rapidly Expanding Belly: A Classic Presentation of a Rare Cause of Acute Renal Failure

Case Presentation: A 59‐year‐old man presented to the emergency department with new‐onset right testicular pain in the setting of back pain and abdominal distention. After evaluation by his primary care physician 2 weeks prior, he [...]

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Systemic Capillary Leak Syndrome Mimicking Polycythemia Vera

Case Presentation: A 54‐year‐old man was referred for evaluation of polycythemia vera that was diagnosed after a series of dramatic hospitalizations for near‐syncope. The patient first presented with sudden lightheadedness and presyncope, which led to [...]

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Occam's Razor in Action: Simultaneous Pulmonary Embolism and Acute Myocardial Infarction Secondary to a Previously Undiagnosed Patent Foramen Ovale

Case Presentation: A 79‐year‐old man with no antecedent coronary artery disease underwent resection of recurrent high‐grade lipo‐sarcoma of the right upper extremity with placement of hollow catheters for perioperative brachytherapy. On postoperative day 2, he [...]

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Recorded Patient Care Reports as the Foundation of JCAHO‐Compliant Handoffs That Improve Patient Safety

Background: To improve patient safety through communication among health care professionals, in 2006 the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) began to require a standardized approach to physician‐to‐physician handoff communications. Criteria included an [...]

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Jump‐Starting Hospitalist Clinical Research: The Specialist‐Hospitalist Allied Research Program (SHARP)

Background: Clinical research has developed slowly in most hospitalist programs. Although partly related to the field's youth, it likely also reflects a lack of specific expertise about the clinical issues most worthy of study. Because [...]

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Methylnaltrexone Is Effective in the Treatment of Opioid‐Induced Constipation in Patients with Advanced Illness and Postoperative Ileus without Affecting Analgesia

Background: Methylnaltrexone, a quaternary derivative of naltrexone, is being developed for the treatment of opioid‐induced constipation in patients with advanced illness and postoperative ileus. GI transit, slowed by morphine, is reversed by intravenous, subcutaneous, or [...]

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Effect of a Hospitalist—Clinical Nurse Specialist Team on a Nonteaching Hospitalist Service

Background: The addition of a clinical nurse specialist (CNS) to an inpatient medical team has been shown to reduce length of stay (LOS) and improve patient satisfaction. Many hospitalists practice in nonteaching settings and without [...]

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Incidence of Cardiac Complications Following Hip Surgery: A Population‐Based Study

Background: After coronary artery bypass grafting, hip surgery is the most commonly performed procedure in patients older than 65. In the current American College of Cardiology/American Heart Association (ACC/AHA) preoperative evaluation guideline, orthopedic surgical procedures [...]

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A Pilot Study: Nurse‐Practitioners Improve Inpatient Time to Discharge

Background: Patients discharged from a university hospital operating at full capacity are often delayed. Inpatient cardiology is already highly efficient, and length of stay has been maximally shortened. The addition of a nurse‐practitioner to a [...]

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Fatal Spontaneous Rectus Sheath Hematoma Presenting as a Leukemoid Reaction

Case Presentation: A 62‐year‐old woman with a medical history of chronic obstructive pulmonary disease (COPD), renal insufficiency, and chronic atrial fibrillation was admitted to the hospital for treatment of community‐acquired pneumonia and exacerbation of her [...]

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Mosquito Madness: Improvement of West Nile Virus Encephalitis after Interferon Alpha‐2b

Case Presentation: A 49‐year‐old man presented with a 1‐day history of headache, drenching sweats, photophobia, and vomiting that prompted a CSF evaluation for meningitis. A lumbar puncture revealed protein of 105 mg/dL, a total of [...]

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Pneumococcal Endocarditis Presenting as Endophthalmitis

Case Presentation: A 64‐year‐old man with a medical history of hypertension and smoking presented to the emergency department (ED) with an acutely swollen and painful left eye, along with a 2‐week history of fevers, chills, [...]

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Newborn Circumcision Adds Significant Income to an Academic Pediatric Hospitalist Program

Background: To comply with the 80‐hour workweek restrictions in 2004, the OB‐GYN department at a teaching hospital turned over the routine circumcision program to the pediatric hospitalist group. Taking over the program required a dedicated [...]

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“Minirounds” Improve Physician‐Patient Communication and Satisfaction

Background: Physician‐patient communication is of paramount importance in providing efficient, cost‐effective, and compassionate patient care. Many lawsuits stem from poor communication between health care providers and patients. Face‐to‐face contact is essential for providing good patient [...]

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Reducing Unnecessary Invasive Device Days in a Community ICU with a Physician Daily Note and Daily Multidisciplinary Rounds

Background: Health care‐acquired infections (HAIs) represent a far too common risk and cost of hospitalization. Urinary catheter‐associated urinary tract infection is the most common cause of HAIs, with prolonged catheter use conferring a relative risk [...]

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