Outcomes of Compensated Heart Failure Patients Undergoing Elective Major Noncardiac Surgery

Background: Perioperative outcomes of heart failure (HF) patients who have been clinically stabilized prior to noncardiac surgery have not been well studied. We sought to evaluate contemporary surgical outcomes in patients with compensated HF undergoing [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Outcomes of Compensated Heart Failure Patients Undergoing Elective Major Noncardiac Surgery

Abdominal Pain and Jaundice: A Family Affair

Case Presentation: A 30‐year‐old Guatemala‐born man presented with severe, nonradiating epigastric and right upper quadrant abdominal pain, intermittent for the past 2 years, requiring several prior hospitalizations. Pain was accompanied by moderate nausea, vomiting, and [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Abdominal Pain and Jaundice: A Family Affair

Reversal of Opioid‐Induced Gastric Dysfunction in a Critically Ill Burn Patient with Methylnaltrexone

Case Presentation: A 21‐year old man had been admitted to the ICU for a 30% burn injury incurred in a house fire and explosion. He underwent excision and skin grafting and was receiving 60‐100 mg [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Reversal of Opioid‐Induced Gastric Dysfunction in a Critically Ill Burn Patient with Methylnaltrexone

Weight Loss and Gastrointestinal Bleeding from Gastric Amyloidosis Secondary to Occult Plasma Cell Myeloma

Case Presentation: A62‐year‐old white man with a medical history of hypothyroidism and atrial fibrillation was admitted for evaluation of early satiety, nausea, lethargy, and a 20‐pound weight loss over the preceding 3 weeks. On physical [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Weight Loss and Gastrointestinal Bleeding from Gastric Amyloidosis Secondary to Occult Plasma Cell Myeloma

A Pain in the Neck: A Case of Lemierre's Syndrome

Case Presentation: A previously healthy 18‐year old man initially presented to his outpatient physician with fevers and a cough. After 1 week of telithromycin, he developed a sore throat, nausea, and recurrent high fevers. His [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on A Pain in the Neck: A Case of Lemierre's Syndrome

Development of a Critical Care Nursing Coordinator Model to Lead a Rapid‐Response Team in an Academic Medical Center

Background: Rapid‐response teams (RRTs) are a patient safety intervention designed to identify, diagnose, and treat hospitalized patients who are clinically deteriorating outside an intensive care unit (ICU). The ability to implement and sustain a successful [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Development of a Critical Care Nursing Coordinator Model to Lead a Rapid‐Response Team in an Academic Medical Center

Enhancing the Transition from Hospital to Home for the Older Adult

Background: When elderly patients are discharged home following an acute hospitalization, they are at high risk of having an unsuccessful transition with untoward health care outcomes. Our team has developed an interdisciplinary, comprehensive intervention to [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Enhancing the Transition from Hospital to Home for the Older Adult

Impact of Fundoplication Versus Gastrojejunal Feeding Tubes on Mortality and Aspiration Pneumonia Prevention in Young Children with Neurological Impairment Who Have Gastroesophageal Reflux Disease

Background: Aspiration pneumonia (AP) is the most common cause of death in children with neurological impairment who have gastroesophageal reflux disease (GERD). Fundoplications and gastrojejunal feeding tubes (GJT) are frequently employed to prevent AP in [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Impact of Fundoplication Versus Gastrojejunal Feeding Tubes on Mortality and Aspiration Pneumonia Prevention in Young Children with Neurological Impairment Who Have Gastroesophageal Reflux Disease

Effect of a Standardized Subcutaneous Insulin Order Set and an Insulin Management Algorithm on Inpatient Glycemic Control and Hypoglycemia

Background: Poor glycemic control in hospitalized patients is strongly associated with increased length of stay, mortality, infections, and other undesirable outcomes. Poor glycemic control and suboptimal insulin regimens are the rule in inpatient ward settings, [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Effect of a Standardized Subcutaneous Insulin Order Set and an Insulin Management Algorithm on Inpatient Glycemic Control and Hypoglycemia

Incidence and Predictors of Postoperative Fevers in Patients Undergoing Hip and Knee Surgery

Background: Surgeons in the perioperative management of their patients are increasingly involving hospitalist physicians. This relationship includes preoperative assessments and postoperative referrals or comanagement for medical conditions including fevers, diabetes, hypertension, and coronary artery disease. [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Incidence and Predictors of Postoperative Fevers in Patients Undergoing Hip and Knee Surgery

Discontinuation of Antiplatelet Therapy Prior to Noncardiac Surgery in Patients with Drug‐Eluting Stents: A Retrospective Cohort Study

Background: Drug‐eluting coronary stents (DESs) pose a challenge in the perioperative setting. Sirolimus and paclitaxel may inhibit re‐endothelialization of the traumatized vessel, making it vulnerable to platelet‐mediated thrombosis. Given anecdotal evidence and case series suggesting [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Discontinuation of Antiplatelet Therapy Prior to Noncardiac Surgery in Patients with Drug‐Eluting Stents: A Retrospective Cohort Study

Human Monocytic Ehrlichiosis Presenting as Altered Mental Status

Case Presentation: A previously healthy 54‐year‐old man presented with a history of fever, sore throat, myalgias, worsening lethargy, diarrhea, and epistaxis. The patient had traveled to Mount Calazano, Italy, and England the month before admission [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Human Monocytic Ehrlichiosis Presenting as Altered Mental Status

RLQ Pain Long after an Appendectomy

Case Presentation: An 11‐year‐old girl presented to the pediatric emergency department complaining of 3 days of right lower quadrant (RLQ) abdominal pain. Her pain was sharp, intermittent, exacerbated by touch or movement, alleviated by lying [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on RLQ Pain Long after an Appendectomy

Acute Pancreatitis after Propofol Administration

Case Presentation: A 36‐year‐old woman with no medical history presented to the emergency department complaining of 1 day of chills, vomiting, and progressively worsening epigastric pain. The previous day the patient had had dilatation and [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Acute Pancreatitis after Propofol Administration

Thinking Globally: Adrenal Tuberculosis in an Indian Man on Vacation in the United States

Case Presentation: A 41‐year‐old Indian man vacationing in the United States presented with a 2‐day history of vomiting and lightheadedness. He had been vomiting at least 6 times a day and felt extremely thirsty. Review [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Thinking Globally: Adrenal Tuberculosis in an Indian Man on Vacation in the United States