Alcohol Withdrawal in a Suicidal Patient

Case Presentation: A 63‐year‐old man with a history of alcoholism and withdrawal seizures presented to the ED after a suicide attempt. The patient had persistent suicidal ideation and was placed on a psychiatric hold. In [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Alcohol Withdrawal in a Suicidal Patient

Bilateral Adrenal Hemorrhage after Bilateral Total Knee Arthroplasty

Case Presentation: A 52‐year‐old man with bilateral total knee arthroplasty (TKA) done 9 days prior to admission presented with complaints of bilateral upper quadrant abdominal pain, nausea, and vomiting of 2 days' duration. He was [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Bilateral Adrenal Hemorrhage after Bilateral Total Knee Arthroplasty

Painless Acute Aortic Dissection Presenting as Left Lower Extremity Weakness and Numbness

Case Presentation: A 76‐year‐old woman presented with left lower extremity numbness and weakness for 1 hour. She denied chest or back pain. Vital signs were unremarkable. Neurological examination revealed 0/5 motor strength and decreased pinprick [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Painless Acute Aortic Dissection Presenting as Left Lower Extremity Weakness and Numbness

Abdominal Pain That Is Not in the Abdomen — An Unusual Presentation of Non‐Hodgkin B‐Cell Lymphoma

Case Presentation: The epidural space is a well‐known, albeit uncommon, location for lymphomatous involvement. We present a Hispanic man with an initial complaint of upper abdominal pain that progressed to a posterior spinal canal compression [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Abdominal Pain That Is Not in the Abdomen — An Unusual Presentation of Non‐Hodgkin B‐Cell Lymphoma

A Novel System Designed to Optimize Communication between Hospitalists and Primary Care Physicians

Background: Communication is central to the coordination of quality patient care. Yet studies have documented poor communication among physicians and have associated poor communication with serious adverse outcomes. A recent meta‐analysis revealed that direct communication [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on A Novel System Designed to Optimize Communication between Hospitalists and Primary Care Physicians

Building a Hospital Medicine Curriculum to Enhance Internal Medicine Residency Education Using the Hospital Medicine Core Competencies

Background: Our program's house staff and medical student curricula were heavily weighted toward ambulatory medicine. Our division and training program wanted to develop a learning tool focused on inpatient skills, using the Society of Hospital [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Building a Hospital Medicine Curriculum to Enhance Internal Medicine Residency Education Using the Hospital Medicine Core Competencies

Mortality Review

Background: It is known that 60% of American patients die in the hospital. As our population ages and technology advances, in‐patient management becomes more complex in the hospital. It is unknown how much of inpatient [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Mortality Review

Use of an Insulin Infusion Conversion Equation (MCE) to Improve Inpatient Glycemic Control

Background: Data from the medical literature suggest a benefit of glycemic control during acute illness. Glycemic control can be accomplished easily by use of IV insulin infusions. However, IV insulin is often discontinued during a [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Use of an Insulin Infusion Conversion Equation (MCE) to Improve Inpatient Glycemic Control

Effect of Hospitalist Attending Physicians on Trainee Education: A Systematic Review

Background: Hospitalist programs are increasingly prevalent in teaching hospitals. Consequently, internal medicine and pediatrics trainees may receive much of their inpatient education from hospitalists. The objective of this study was to characterize the effects of [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Effect of Hospitalist Attending Physicians on Trainee Education: A Systematic Review

Dyspnea in Diabetics Is a Result of Restrictive Lung Pattern Rather Than Diastolic Dysfunction

Background: Although it is widely recognized that type II diabetes (DM) is associated with diastolic dysfunction (DD), and despite increasing evidence that diabetic lung disease is more prevalent than generally recognized, it is unknown which [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Dyspnea in Diabetics Is a Result of Restrictive Lung Pattern Rather Than Diastolic Dysfunction

Impact of Obesity on MICU Outcomes

Background: As the epidemic of obesity spreads throughout the United States, an increasing number of obese patients are seen in the intensive care unit. Management of these patients can be challenging; however, it is unclear [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Impact of Obesity on MICU Outcomes

Perioperative Anticoagulation Management: Practice Patterns and Outcomes at 9 Hospitals

Background: At the time of a major surgery, patients requiring chronic oral anticoagulation therapy must have had this treatment either stopped and restarted or "bridged," substituting heparin or low‐molecular‐weight heparin (LWMH) except during and shortly [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Perioperative Anticoagulation Management: Practice Patterns and Outcomes at 9 Hospitals

Emphysematous Pyelonephritis

Case Presentation: A 62‐year‐old woman with diabetes presented with 4 days of crampy, epigastric pain exacerbated by urination and radiating to the right and left upper quadrants. She endorsed nausea and emesis but denied fever [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Emphysematous Pyelonephritis

Vancomycin‐lnduced Linear IgA Bullous Dermatosis

Case Presentation: A 77‐year‐old man with a history of colon cancer was admitted with early sepsis. He was given vancomycin and ceftriaxone. On hospital day 4, the vancomycin was discontinued because of a high drug [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Vancomycin‐lnduced Linear IgA Bullous Dermatosis

Intra‐arterial tPA Use in an Acute Embolic CVA in an Elderly Hospitalized Patient with Recent Gastrointestinal Bleeding

Case Presentation: An 89‐year‐old woman with a history of paroxysmal atrial fibrillation and gastrointestinal (GI) bleeding less than 2 weeks prior was admitted to the hospital with worsening dyspnea over the past 3 days. She [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Intra‐arterial tPA Use in an Acute Embolic CVA in an Elderly Hospitalized Patient with Recent Gastrointestinal Bleeding