The Pseu, Pseu, Pseudo‐Heart Attack

Case Presentation: A 62‐year‐old man presented with 1 day of chest pain and shortness of breath. Four months earlier, he had been diagnosed with MRSA endocarditis and had aortic valve replacement surgery. The preoperative evaluation [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on The Pseu, Pseu, Pseudo‐Heart Attack

To Gad or Not to Gad

Case Presentation: A 54‐year‐old white man with a medical history of stage III chronic kidney disease (CKD), diabetes, hypertension, and stroke was admitted with a generalized rash for 2 weeks. About a month prior to [...]

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Not All Brain Lesions Are Created Equal

Case Presentation: An otherwise healthy 37‐year‐old woman presented to a local hospital with left arm paresthesias and word‐finding difficulties. A head CT found a 3‐cm corona radiata lesion with mass effect and steroids were prescribed [...]

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Recurrent Bacterial Meningitis (RBM): An Interesting Presentation Due to a Motor Vehicle Accident (MVA) 10 Years Ago

Case Presentation: A 51‐year‐old diabetic and hypertensive woman was life‐flighted with complaints of fever, headache, mental status changes, and acute respiratory failure. She was found to be in diabetic ketoacidosis. Vancomycin, ceftriaxone, and an insulin [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Recurrent Bacterial Meningitis (RBM): An Interesting Presentation Due to a Motor Vehicle Accident (MVA) 10 Years Ago

Resident Reflections on a New Community Hospital Rotation

Background: Every day, internal medicine (IM) house staff members work on the wards with hospitalist teachers and attendings. Increasing numbers are choosing careers in hospitalist medicine postresidency despite limited exposure to the full range of [...]

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Using Hospital Administrative Data to Determine if DVT/PE Was Present on Hospital Admission or Was Hospital Acquired: Why Your Institution Needs to Know

Background: Hospital‐acquired deep venous thrombosis (DVT) and pulmonary embolism (PE) are common yet preventable diagnoses. Beginning in October 2008, the Centers for Medicare and Medicaid Services (CMS) will not reimburse hospitals for several hospital‐acquired conditions, [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Using Hospital Administrative Data to Determine if DVT/PE Was Present on Hospital Admission or Was Hospital Acquired: Why Your Institution Needs to Know

Cardiorenal Rescue with Slow Continuous Venovenous Ultrafiltration in Patients with Heart Failure

Background: Cardiorenal syndrome (CRS) occurs in 25% of patients hospitalized for heart failure and is associated with increased length of stay, readmission, and death; currently, there are no treatments with proven efficacy. We report our [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Cardiorenal Rescue with Slow Continuous Venovenous Ultrafiltration in Patients with Heart Failure

Safety First: Use of the Gertie‐Marx Needle for Lumbar Punctures

Background: Despite the strength of the 2005 AHRQ recommendations for the use of the Gertie‐Marx® spinal needle (GM) for lumbar punctures (LPs), the use of this device has not reached critical mass at our institution. [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Safety First: Use of the Gertie‐Marx Needle for Lumbar Punctures

Category P: Intended and Unintended Consequences of a Quality Improvement Algorithm Involving Electronic and Paper Reminders

Background: Hospitals are initiating new processes of care to improve compliance with CMS quality measures, often integrating electronic reminders into existing systems of care. Category P is an electronic and paper‐based algorithm to improve timing [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Category P: Intended and Unintended Consequences of a Quality Improvement Algorithm Involving Electronic and Paper Reminders

Comparison of Outcomes between Hospitalists and General Internists in a Tertiary Academic Medical Center

Background: A recent study published in the New England Journal of Medicine showed that hospitalists only modestly reduced length of stay and observed costs. This is a finding different from that observed in prior studies. [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Comparison of Outcomes between Hospitalists and General Internists in a Tertiary Academic Medical Center

Integrated Results of 2 Phase III Studies Comparing Tigecycline with Levofloxacin in Patients with Community‐Acquired Pneumonia (CAP)

Background: TGC, a first‐in‐class glycylcycline approved for treating complicated skin, skin structure, and intra‐abdominal infections, has an expanded spectrum of activity against gram‐positive, gram‐negative, anaerobic, and atypical bacteria, including some resistant strains. The primary objective [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Integrated Results of 2 Phase III Studies Comparing Tigecycline with Levofloxacin in Patients with Community‐Acquired Pneumonia (CAP)

Can't PEE and PE: An Uncommon Combination of 2 Common Diseases in an Air Marshal

Case Presentation: A 38‐year‐old man with no significant medical history presented to the emergency room with inability to void, yellow urethral discharge, and fever up to 101.4°F. He reported being sexually active with 1 female [...]

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Acute Lower Extremity Weakness and Pain: Finding Leriche in the Heart

Case Presentation: A 58‐year‐old woman presented with acute onset of bilateral lower extremity weakness and inability to walk. She described aching pain, “pins and needles,” and numbness over both thighs and buttocks that was worse [...]

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Sudden Cardiac Compromise in a Young Patient with Bipolar Disease

Case Presentation: A 24‐year‐old male patient with bipolar disorder presented with his family to the emergency room with complaints of dyspnea and palpitations. He was diaphoretic and a poor historian. An electrocardiogram revealed diffuse ST‐T [...]

By | 2008-04-03T12:00:45+00:00 April 3rd, 2008|Uncategorized|Comments Off on Sudden Cardiac Compromise in a Young Patient with Bipolar Disease