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

Localizing Patients for Hospitalist Services on Dedicated Nursing Units

Background: Admission to the general internal medicine (GIM) service at our 1100‐bed tertiary‐care hospital occurs randomly, with bed assignments determined on a first come, first served basis. Consequently, patients are dispersed to geographically disparate nursing [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Localizing Patients for Hospitalist Services on Dedicated Nursing Units

Conivaptan for the Treatment of Severe Hyponatremia: Open‐Label Study Results

Background: Hyponatremia is a common electrolyte disorder in hospitalized patients often resulting from elevated arginine vasopressin (AVP) levels. Conivaptan (CNV) is a novel AVP‐receptor antagonist that produces aquaresis, the solute‐free, electrolyte‐sparing excretion of water, by [...]

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Impact of Sex, Race, Nursing Home Residence, and Coexisting Diseases on Presentation and Outcome of Myocardial Infarction in the Elderly

Background: The forthcoming wave of geriatric patients is expected to result in rising incidence of myocardial infarction (MI), made uniquely challenging by atypical symptoms, multiple comorbidities, and cognitive impairment. Hence, misdiagnosis, undertreatment, and poor outcome [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Impact of Sex, Race, Nursing Home Residence, and Coexisting Diseases on Presentation and Outcome of Myocardial Infarction in the Elderly

ICU Staffing in Michigan: The Role of Nonintensivist Providers and Hospitalists

Background: The National Quality Forum has advocated the use of board‐certified intensivists to deliver critical care in intensive care units (ICUs). However, the extent of intensivist staffing, the use of nonintensivist providers, and the role [...]

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Impact of Discharge Hyperglycemia on Rehospitalizations of Patients Admitted with Acute Decompensated Heart Failure (ADHF)

Background: Admission hyperglycemia has been associated with adverse clinical outcomes of patients admitted with acute myocardial infarction, stroke, or trauma. The effect of admission or discharge glucose level on clinical outcomes, particularly readmissions in ADHF, [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Impact of Discharge Hyperglycemia on Rehospitalizations of Patients Admitted with Acute Decompensated Heart Failure (ADHF)

Chronic Diarrhea and Abdominal Pain — Pin the Pinworm

Case Presentation: An 84‐year‐old female patient from an assisted‐living facility (ALF) was admitted with complaints of abdominal pain and diarrhea (7‐8 episodes/day, watery, non‐foul‐smelling) for 2 months. She denied nausea, vomiting, fever, chills, anal pruritus, [...]

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Query Fever

Case Presentation: A 37‐year‐old man with no significant PMH was admitted for evaluation of a 3‐week history of high fevers, fatigue, decreased appetite, and flulike symptoms. As an outpatient, he had been seen by his [...]

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Peripherally Inserted Central Catheter Fracture and Embolization: An Unusual Cause of Chest Pain

Case Presentation: A 43‐year‐old man on chronic intravenous antibiotic therapy presented with new‐onset chest pain that had developed while flushing his peripherally inserted central catheter (PICC) line. The pain was pleuritic in quality and was [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Peripherally Inserted Central Catheter Fracture and Embolization: An Unusual Cause of Chest Pain

Multidisciplinary Teamwork Training on a Medical Service

Background: Communication failures pose a significant and ongoing threat to patient safety. The current modes of training in educational silos foster poor teamwork and lack a shared model for high‐quality patient care. A growing emphasis [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Multidisciplinary Teamwork Training on a Medical Service

Creation of a New Admitting Structure to Minimize Patient Handoffs at a University‐Affiliated Teaching Hospital

Background: In July 2003 the ACGME 80/30 work hour regulations went into effect. To maintain compliance with these regulations, new systems of care that might include cross cover and patient handoffs were created. Cross cover [...]

By | 2007-05-24T12:00:35+00:00 May 24th, 2007|Uncategorized|Comments Off on Creation of a New Admitting Structure to Minimize Patient Handoffs at a University‐Affiliated Teaching Hospital