Teenager with Seizure‐like Events

Case Presentation: The patient was a 14‐year‐old girl with new‐onset seizurelike episodes over 3 months. Her parents identified various triggers for the events: raising her arm, standing from a sitting position, and turning her head [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Teenager with Seizure‐like Events

Raynaud's Phenomenon with Profound Variations in Capillary Blood Glucose Levels: A Case of Pseudohypoglycemia

Case Presentation: A 49‐year‐old man with a history of schizophrenia, diabetes mellitus, and scleroderma presented with recurrent episodes of atypical chest pain and vomiting. Repeated physical examinations revealed intermittent peripheral cyanosis with decreased digital capillary [...]

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Pleurocutaneous Fistula Complicating Chest Tube Placement for Prevotella Empyema: A Case Report

Case Presentation: An 88‐year‐old man presented to the emergency room with respiratory distress, severe leukocytosis, and a large loculated effusion with an air‐fluid level in the left hemithorax. He was intubated and started on broad‐spectrum [...]

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Hospitalist Training Program for Postgraduate Physician Assistants

Background: A recent Society of Hospital Medicine survey reported that approximately 15% of hospitalist groups utilize physician assistants (PAs), and many more are looking to hire PAs to augment their physician services. However, finding physician [...]

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Implementation of Physician Quality Reporting Initiative Program in a Large Community Hospitalist Group

Background: The Centers for Medicare and Medicaid services (CMS) established an incentive program referred to as Physician Quality Reporting Initiative (PQRI) in 2007 for voluntary reporting of at least 3 of the 74 designated measures [...]

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Contributing Factors to Short‐Term Readmissions to an Academic Center Hospital Medicine Program

Background: The literature on hospital medicine emphasizes length of stay, resource utilization, and readmission rates. However, investigation into reasons for readmissions to hospital medicine services remains minimal. Purpose: To describe the ongoing experience of a [...]

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Hospitalists Intent to Participate in the Physician Quality Reporting Initiative, a National Physician‐Level Pay for Reporting Program

Background: Involving physicians in value‐based purchasing or pay for performance programs is gaining momentum as a solution to aligning quality and costs for health care reform. In July 2007, the Centers for Medicare and Medicaid [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Hospitalists Intent to Participate in the Physician Quality Reporting Initiative, a National Physician‐Level Pay for Reporting Program

Incidence and Predictors of Stroke after Hip Surgery

Background: Hip surgery (either total hip arthroplasty or repair of the fracture) is the most common noncardiac surgical procedure performed in patients 65 years or older. Most postoperative complication reports have focused on cardiac events [...]

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Impact of Hospitalists on the Quality of Care of Acute Medical Conditions

Background: Despite existing literature examining the effects of hospitalist care on inpatient hospital‐associated costs and experiences with care, little is known about the impact of hospitalists on performance as measured by the Hospital Quality Alliance [...]

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Measuring Organizational Improvement in Safety: Application of the Global Trigger Tool

Background: At the end of 2006, the Institute of Healthcare Improvement (IHI) leadership announced the 5 Million Lives campaign to foster prevention of adverse events. The IHI global trigger tool (GTT) is the primary measurement [...]

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Use of a Medical Emergency Team Decreased Length of Stay in Severely Ill Medical Patients with Unscheduled ICU Admissions, But Not Costs and Mortality

Background: Medical emergency teams (METs) have been developed to meet the growing needs of unstable hospitalized patients. The benefits of medical emergency teams have been reported as inconsistent in the literature, but METs may decrease [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Use of a Medical Emergency Team Decreased Length of Stay in Severely Ill Medical Patients with Unscheduled ICU Admissions, But Not Costs and Mortality

Esophageal Perforation from the Heimlich Maneuver: Still the Preferred Technique?

Case Presentation: An 87‐year‐old man with a medical history of dementia, stroke, hypertension, seizure disorder, and ITP began to choke on an orange, when his daughter successfully performed the Heimlich maneuver. Following this, the patient [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Esophageal Perforation from the Heimlich Maneuver: Still the Preferred Technique?

A Unique Case of Thrombophilia: Elevated Factor VIII Level

Case Presentation: A 48‐year‐old obese African American woman presented to the ED with left lower extremity pain. She had recently begun oral contraceptives and had had a prolonged automobile drive a few days before presentation. [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on A Unique Case of Thrombophilia: Elevated Factor VIII Level

Tularemia Presenting as a Painless Ulcer with Fever

Case Presentation: A 14‐year‐old man presented with a 3‐week history of nightly fevers and a painless upper back ulcer. The lesion had grown in size despite oral antibiotics after initial culture revealed MSSA. Review of [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Tularemia Presenting as a Painless Ulcer with Fever