Intimal Sarcoma of Aorta Mimicking Thrombus

Case Presentation: An 83‐year‐old‐active white man with a medical history of hypertension and osteoarthritis and 1‐month history of low back pain presented to the emergency department with a right intertrochantericfemurfracture. He underwent emergent open reduction [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Intimal Sarcoma of Aorta Mimicking Thrombus

Posterior Leukoencephalopathy Syndrome: Blindness in 2 Peripartum Patients

Presentation of Case 1: A healthy 20‐year‐old primagravid woman was admitted to the hospital for delivery. Her prenatal course was unremarkable with no evidence of hypertension. On admission her blood pressure was elevated up to [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Posterior Leukoencephalopathy Syndrome: Blindness in 2 Peripartum Patients

Withdrawal of Enteral Nutrition and Intravenous Hydration in Pediatric Palliative Care

Case Presentation: A 5‐month‐old girl presented to the emergency room with lethargy and respiratory depression. She had multiple injuries consistent with inflicted trauma, including massive intracranial injury, lacerated liver, ruptured bladder, fractured femur, and facial [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Withdrawal of Enteral Nutrition and Intravenous Hydration in Pediatric Palliative Care

Quality Improvement to Optimize Neonatal Nutrition in Low‐Birth‐Weight Infants

Background: There is increasing evidence that providing early and aggressive nutrition to premature infants improves clinical outcomes related to length of stay, weight gain and growth, and improved neurodevelopment. In addition, the early introduction of [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Quality Improvement to Optimize Neonatal Nutrition in Low‐Birth‐Weight Infants

Implementation of an Acute Care Preceptorship for Second‐Year Medical Students

Background: Medical students traditionally learn the clinical skills of taking a patient history and performing a physical examination in Introduction to Clinical Medicine (ICM) courses. Increasingly, these courses use real or simulated patients to give [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Implementation of an Acute Care Preceptorship for Second‐Year Medical Students

Predictors of Fatigue for Interns in Cognitive Specialties

Background: ACGME duty‐hour limitations were intended, in part, to reduce resident fatigue and decrease its many negative consequences. Prior data suggest fatigue‐related reductions in patient safety and resident well‐being. We aimed to assess the factors [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Predictors of Fatigue for Interns in Cognitive Specialties

The Hospitalist: Improving Patient Care and Closing the Quality Gap in Patients with Hip Fracture

Background: Patients with hip fracture are generally elderly, have coronary artery disease (CAD) or risk factors for CAD, and require urgent surgery. Perioperative use of beta‐ers is associated with decrease cardiac mortality and morbidity. However, [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on The Hospitalist: Improving Patient Care and Closing the Quality Gap in Patients with Hip Fracture

Patient Perspectives on Medication Use after Hospital Discharge

Background: Patients often have trouble managing their medications after hospital discharge, and adults with limited literacy skills may face added difficulties. These problems and their potential solutions are not well characterized. Methods: Patients admitted to [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Patient Perspectives on Medication Use after Hospital Discharge

Inaccuracies in the Tabulated Input and Output in Intensive Care: A Potential Risk to Optimal Patient Care

Background: Fluid management of patients can be challenging in the best circumstances. The relationship of total fluid input to total output is commonly used to guide therapeutic decisions involving the use of diuretics and/or fluids. [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Inaccuracies in the Tabulated Input and Output in Intensive Care: A Potential Risk to Optimal Patient Care

Medication Discrepancies during Patient Handoffs: Frequency, Characteristics, and Potential to Harm

Background: Despite increased focus on handoffs, the accuracy of information transferred using resident sign‐outs has not been well characterized. This study aimed to describe the frequency, types, and harm potential of medication discrepancies between patient [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Medication Discrepancies during Patient Handoffs: Frequency, Characteristics, and Potential to Harm

Pulmonary Artery Sarcoma Masquerading as Pulmonary Embolism

Case Presentation: A 39‐year‐old woman with a medical history of polycystic ovarian syndrome presented with pleuritic chest pain, fever, progressive dyspnea on exertion for 1 month, and right upper quadrant abdominal pain. Her physical exam [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Pulmonary Artery Sarcoma Masquerading as Pulmonary Embolism

Pheochromocytoma Presenting as Cardiogenic Shock: An Atypical Presentation

Case Presentation: A 51 ‐year‐old white woman with a history of recent‐onset hypertension and diabetes mellitus presented to a community hospital complaining of chest pain, shortness of breath, and several episodes of emesis over the [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Pheochromocytoma Presenting as Cardiogenic Shock: An Atypical Presentation

Chicken of the “C”: One Man's Tale of Syncope

Case Presentation: A 51 ‐year‐old man was brought to the hospital after being found unconscious in the hallway of his transitional housing establishment. At the time of presentation, he was alert and interactive but made [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Chicken of the “C”: One Man's Tale of Syncope

A Successful Strategy to Improve Inpatient Pneumococcal Vaccination

Background: Administration of the pneumococcal vaccine to inpatients more than 65 years old with community‐acquired pneumonia (CAP) is a measure of hospital quality according to the Joint Commission on Accreditation of Healthcare Organizations and CMS. [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on A Successful Strategy to Improve Inpatient Pneumococcal Vaccination

Strategies for Effective Noise Reduction in a Neonatal Intensive Care Unit

Background: Low sound levels are important for the normal neurological development of preterm infants. The American Academy of Pediatrics recommends an average noise level of 45 dB for premature infants. However, as a consequence of [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Strategies for Effective Noise Reduction in a Neonatal Intensive Care Unit