SMA Syndrome: The SBO Mimic

Case Presentation: An 18‐year‐old man with a history of GERD transferred to our institution from an outside hospital for evaluation of refractory nausea, projectile bilious emesis, and abdominal pain. He had been in his usual [...]

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When to Depend on the Kinins of Strangers: An Unusual Case of Chronic Abdominal Pain

Case Presentation: A 28‐year‐old woman presented with an acute exacerbation of chronic, intermittent abdominal pain. The patient described intense cramping and colicky periumbilical pain lasting 1‐2 days and occurring 2‐3 times per year for 9 [...]

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Cervical Spine Manipulation: Neck Relief and Brain Grief

Case Presentation: A 37‐year‐old woman with an unremarkable medical history was admitted with sudden onset of dizziness, aphasia, and right arm numbness and weakness. The patient's symptoms lasted approximately 45 minutes and then slowly resolved, [...]

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Cerebral Nocardiosis Caused by N. brasiliensis, a Nocardial Species That Commonly Causes Skin Infection

Case Presentation: A 44‐year‐old woman with history of SLE on chronic prednisone presented to the ED with complaints of severe headaches and neck stiffness. A CT scan revealed acute communicating hydrocephalus and bilateral cerebellar lesions. [...]

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A Strategy to Enhance the Discharge Process and Improve Throughput

Background: The discharge process is consistently rated among the lowest components of patient satisfaction markers in surveys. Discharge delays and late discharges can also negatively affect throughput by preventing bed availability for new admissions. Barriers [...]

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MCOMM: Redefining Medical Communication in the 21st Century

Background: Communication between members of the medical team — MDs, RNs, PAs, and house staff — has traditionally relied on a 1‐way paging system. Although effective, this medium has significant limitations including a 1‐way flow [...]

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Systematic Review of Hospital Time‐Motion Literature

Background: Time‐motion studies have been used since the early 20th century to provide minute‐by‐minute accounts of how time is spent in factories and office settings alike. More recently, time‐motion methodology has been used in the [...]

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Provider Intuition Predicts Clinical Deterioration in Ward Patients

Background: In‐hospital cardiac arrest is rarely sudden and may be preventable if interventions are performed when patients are in the early stages of clinical deterioration. However, identifying high‐risk patients remains a significant challenge. Scoring tools [...]

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Effect of Time of Hospital Admission on Patient Outcomes

Background: Staffing and resource availability in hospitals diminish from day to night. Also, patients admitted at night are often passed off to a new care team in the morning. The impact of this discontinuity on [...]

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Risk‐Adjusted Administrative Data Can Be Used as a Tool to Monitor the “Weekend Effect” on Inpatient Mortality

Background: Increased mortality has been observed for patients admitted on weekends to hospitals in several studies. The reasons for this “weekend effect” are unclear but may be related to reduced staffing levels, increased handoffs, or [...]

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Patterns of Peripherally Inserted Central Catheter Use Among Hospitalized Patients in a Community Hospital

Background: Peripherally inserted central catheters (PICCs) have become an increasingly attractive option for short‐term vascular access in hospitalized patients. PICC placement is a minimally invasive procedure and provides a convenient, dependable intravenous access. These advantages, [...]

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Risk Factors for Clostridium difficile‐Associated Disease in the Hospital

Background: Environmental exposure to other patients carrying an agent is an important risk for many serious infections. This so‐called “colonization pressure” has been implicated in the acquisition of Clostridium difficile‐associated disease (CDAD) in the ICU [...]

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Recognition and Treatment of Chronic Kidney Disease by Hospitalists Post‐Electronic GFR Reporting

Background: Recognition of chronic kidney disease (CKD) may be improved by electronic glomerular filtration rate (eGFR) reporting. The National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI) provides recommendations on quantitative evaluation for proteinuria, prescription [...]

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A Case of Extreme Subcutaneous and Peripheral Insulin Resistance

Case Presentation: A 34‐year‐old man was admitted for evaluation of elevated blood glucose despite extreme subcutaneous (SQ) insulin requirements. He had a 12‐year history of type 2 diabetes mellitus without episodes of ketoacidosis, managed initially [...]

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An Orange a Day Keeps the Doctor Away

Case Presentation: A 3‐year‐old boy with PDD, keratosis pilaris, and gingivitis presented to a New York City ED with limping after a fall. Initial evaluation was negative for fracture, and he was discharged with follow‐up [...]

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