HM2010 Abstract Number: 1

Resuscitation Outcomes in Hospitalized Functionally Dependent Nursing Home Patients

Background: The relationship between functional status and outcomes following in‐hospital cardiac arrest is not well described. We hypothesized that decreased functional status would correlate with worse outcomes following in‐hospital cardiopulmonary resuscitation (CPR). We further theorized [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Resuscitation Outcomes in Hospitalized Functionally Dependent Nursing Home Patients

HM2010 Abstract Number: 2

Narcotic‐Induced Constipation in the Hospital Setting: The Role of Interdisciplinary Communication

Background: Narcotic‐induced constipation (NIC) is a common complaint among patients taking narcotics and significantly impedes optimal pain control and recovery. Its most feared and potentially fatal complication is fecal impaction with subsequent bowel perforation, Although [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Narcotic‐Induced Constipation in the Hospital Setting: The Role of Interdisciplinary Communication

HM2010 Abstract Number: 3

Predictors of Intravenous Immunoglobulin Treatment Success in Severe Clostridium difficile–AssociatedDisease

Background: Clostridium difficile–associated disease (CDAD) is the most common cause of health care–associated infectious diarrhea. The past decade has witnessed an unprecedented increase in CDAD incidence, fatality rate, and resistance to metronidazole. catalyzing the search [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Predictors of Intravenous Immunoglobulin Treatment Success in Severe Clostridium difficile–AssociatedDisease

HM2010 Abstract Number: 4

A Meta‐Analysis of Intravenous Ascorbic Acid for the Treatment of Anemia in Hemodialysis Patients

Background: High doses of erythropoietin and iron, usually required for the treatment of anemia in hemodialysis patients, are associated with longterm adverse consequences. Ascorbic acid, an antioxidant, can increase the available functional iron, decrease iron [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on A Meta‐Analysis of Intravenous Ascorbic Acid for the Treatment of Anemia in Hemodialysis Patients

HM2010 Abstract Number: 5

Chronic Kidney Disease Is a Significant Risk Factor of Pocket Hematoma Formation after Pacemaker and Implantable Cardioverter‐Defibrillator Placement Independent of Anticoagulation and Antiplatelet Agents

Background: Pocket hematoma formation is a common complication after pacemaker and implantable cardioverter‐defibriIlater (ICD) placement. In this study, we investigated the influence of patients' comorbidities on the rate of pocket hematoma formation after pacemaker and [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Chronic Kidney Disease Is a Significant Risk Factor of Pocket Hematoma Formation after Pacemaker and Implantable Cardioverter‐Defibrillator Placement Independent of Anticoagulation and Antiplatelet Agents

HM2010 Abstract Number: 6

Metabolic Syndrome Is an Independent Predictor of Significant Coronary Artery Disease and Carotid Artery Stenosis in Patients with Moderate to Severe Aortic Stenosis

Background: Metabolic syndrome (MetS) portends an increased risk of coronary artery disease (CAD), independent of traditional risk factors, and is also associated with increased carotid intimal wall thickness. Metabolic syndrome has also been associated with [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Metabolic Syndrome Is an Independent Predictor of Significant Coronary Artery Disease and Carotid Artery Stenosis in Patients with Moderate to Severe Aortic Stenosis

HM2010 Abstract Number: 7

Metabolic Syndrome Predicts Poor Outcome in Patients with Systolic Heart Failure Who Received Implantable Cardioverter‐Defibrillators for Primary Prevention of Sudden Cardiac Death

Background: The study sought to determine the outcomes of patients with metabolic syndrome (MetS) who received an implantable cardiovertor defibrillator (ICD) for primary prevention of sudden cardiac death. Methods: This was a retrospective study of [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Metabolic Syndrome Predicts Poor Outcome in Patients with Systolic Heart Failure Who Received Implantable Cardioverter‐Defibrillators for Primary Prevention of Sudden Cardiac Death

HM2010 Abstract Number: 8

Predictors and Prognosis of Worsening Renal Function in Patients with Diastolic Heart Failure Hospitalized with Acute Heart Failure and Treated with Intravenous Furosemide

Background: The purpose of this study was to assess the predictors and prognosis of worsening renal function (WRF) in patients hospitalized with acute diastolic heart failure. Methods: We retrospectively evaluated 149 patients who were admitted [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Predictors and Prognosis of Worsening Renal Function in Patients with Diastolic Heart Failure Hospitalized with Acute Heart Failure and Treated with Intravenous Furosemide

HM2010 Abstract Number: 9

Does CT Scan of the Chest Add Any Value to Plain Chest X‐Ray in Patient with Pneumonia?

Background: According to the guidelines from the American Thoracic Society, posteroanterior and if possible lateral chest radiographs should be obtained if pneumonia is suspected in adults, The chest radiograph continues to be the initial imaging [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Does CT Scan of the Chest Add Any Value to Plain Chest X‐Ray in Patient with Pneumonia?

HM2010 Abstract Number: 10

Comparative Effectiveness of Continuous‐Infusion with Intermittent Bolus Loop Diuretic Therapy in Patients with Acute Decompensated Congestive Heart Failure

Background: For treatment of acute decompensated congestive heart failure (CHF), intravenous loop diuretics are usually administered as intermittent bolus injections. However, these bolus injections can cause significant hemodynamic effects because of fluctuations in intravascular volume, [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Comparative Effectiveness of Continuous‐Infusion with Intermittent Bolus Loop Diuretic Therapy in Patients with Acute Decompensated Congestive Heart Failure

HM2010 Abstract Number: 11

Methylnaltrexone for Opioid‐lnduced Constipation During Rehabilitation Following Orthopedic Procedures: A Double‐Blind, Randomized Clinical Study

Background: Methylnaltrexone, a quaternary derivative of naltrexone, is a peripheral mu‐opioid receptor antagonist recently approved for the treatment of opioid‐induced constipation (OIC) in patients with advanced illness who are receiving palliative care when response to [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Methylnaltrexone for Opioid‐lnduced Constipation During Rehabilitation Following Orthopedic Procedures: A Double‐Blind, Randomized Clinical Study

HM2010 Abstract Number: 12

Individual Quality Reporting: Should the Discharging Physician Carry All the Risk?

Background: Measuring health care quality is increasingly important. Reliably assessing quality requires a review of the care provided and linking the care to a provider. Payers, patients, and regulators have access to quality reporting at [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Individual Quality Reporting: Should the Discharging Physician Carry All the Risk?

HM2010 Abstract Number: 13

Systematic Review of Resident Workload and Work Activity: Impact on Resident Education and Patient Care

Background: As further limits in resident duty hours are considered, anecdotes of detrimental effects of work intensification (same amount of work in less time) and the continued reliance on residents for tasks of limited educational [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Systematic Review of Resident Workload and Work Activity: Impact on Resident Education and Patient Care

HM2010 Abstract Number: 14

Thoracentesis; A Critical Analysis of Urban Legends

Background: Thoracentesis is a relatively safe procedure. Despite a lack of supporting evidence, common assumptions regarding safety guidelines include: (1) limit fluid removal to < 1.5 L; (2) avoid bilateral procedures; (3) do not tap patients on [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Thoracentesis; A Critical Analysis of Urban Legends

HM2010 Abstract Number: 15

Repeat Thoracenteses: To Talc or Not to Talc?

Background: Thoracentesis is a commonly performed procedure to remove fluid from the pleural space. When repeat thoracenteses are required, patients are often referred to thoracic surgery to undergo more definitive treatment in the form of [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Repeat Thoracenteses: To Talc or Not to Talc?

HM2010 Abstract Number: 16

The Wells Rule Accurately Excludes Pulmonary Embolus in Hospitalized Patients on Heparin Prophylaxis

Background: The Wells rule is commonly used when investigating suspected pulmonary embolism (PE), but its effectiveness when applied to hospitalized patients receiving prophylactic anticoagulation is not known. To explore the utility of the Wells rule [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on The Wells Rule Accurately Excludes Pulmonary Embolus in Hospitalized Patients on Heparin Prophylaxis

HM2010 Abstract Number: 17

Clinical Characteristics of Infective Endocarditis in Hemodialysis Versus Nonhemodialysis Patients

Background: Infective endocarditis (IE) has been recognized as a complication of hemodialysis (HD) since 1966. The incidence is estimated to be 308 per 100.000 patients year, which is 50‐ to 180‐fold higher than the 1.7‐6.2 [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Clinical Characteristics of Infective Endocarditis in Hemodialysis Versus Nonhemodialysis Patients

HM2010 Abstract Number: 18

Management of Postoperative Pain in Elective Hip and Knee Arthroplasty Surgery

Background: Hip and knee arthroplasty surgeries are among the most painful surgical procedures, with half of patients reporting severe postoperative pain, Unrelieved postoperative pain is associated with diminished rehabilitation, delirium, disrupted sleep, and slower healing, [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Management of Postoperative Pain in Elective Hip and Knee Arthroplasty Surgery

HM2010 Abstract Number: 19

Unplanned Intensive Care Unit Transfers: A Useful Tool to Improve Quality of Care

Background: Whether an unplanned intensive care unit transfer (UICUT) results from an error in care and whether these transfers can be prevented has not been previously investigated. We sought to determine the causes of UlCUTs [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Unplanned Intensive Care Unit Transfers: A Useful Tool to Improve Quality of Care

HM2010 Abstract Number: 20

Long‐Term Retention of Central Venous Catheter Insertion Skills after a Simulation‐Based Mastery Learning Intervention

Background: Serious or fatal iatrogenic complications occur in 2.9% to 3.7% of hospitalized patients, and medical procedures are the second most common cause of these complications. In prior work we showed that a mastery learning [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Long‐Term Retention of Central Venous Catheter Insertion Skills after a Simulation‐Based Mastery Learning Intervention

HM2010 Abstract Number: 21

Coding for Hospitalized Patients with Acute Decompensated Heart Failure May Miss the Diagnosis

Background: The Joint Commission core measures for hospitalized patients with acute decompensated heart failure (ADHF) include: use of ACE inhibitors for left ventricular systolic dysfunction, discharge instructions with specific information, left ventricle ejection fraction assessment, [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Coding for Hospitalized Patients with Acute Decompensated Heart Failure May Miss the Diagnosis

HM2010 Abstract Number: 22

Preparing for the Next Pandemic Flu: The Role of the Medical Student — A View from Within

Background: The rising incidence of patients seeking hospital services with flulike illness and related complications has every health care system preparing for busy flu seasons. Based on lessons from previous pandemic flu events, there are [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Preparing for the Next Pandemic Flu: The Role of the Medical Student — A View from Within

HM2010 Abstract Number: 23

Can Hospitalists Identify Clinical Excellence in Their Peers?

Background: Academic medical centers have tripartite missions focused on education, research, and clinical care. Promotion decisions are largely based on research accomplishments. Excellence in patient care in academia had not been well defined until recently, [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Can Hospitalists Identify Clinical Excellence in Their Peers?

HM2010 Abstract Number: 24

Introduction of a Discharge Template to Improve Discharge Documentation for Patients with Heart Failure

Background: The time of hospital discharge is a pivotal period in the care of hospitalized patients and one during which patients are at particular risk for adverse events. This is especially true for patients with [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Introduction of a Discharge Template to Improve Discharge Documentation for Patients with Heart Failure

HM2010 Abstract Number: 25

True Critical Hyperkalemia among Hospitalized Patients

Background: Crilical hyperkalemia is a serious life‐threalening situation. However, we often encounter fictitious laboratory hyperkalemia due to specimen contamination or hemolysis during phlebotomy. This study determined the frequency of true critical hyperkalemia (potassium > 6.5 mEq/L) among [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on True Critical Hyperkalemia among Hospitalized Patients

HM2010 Abstract Number: 26

Cost‐Effective Treatment of Patients with Acute Cholecystitis and Possible Common Bile Duct Stones

Background: The diagnosis of acute cholecyslitis is usually straightforward, but determining whether common bile duct (CBD) stones are present is usually not. Clinicians rely on clues such as a dilated CBD, intrahepatic ductal dilation, elevated [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Cost‐Effective Treatment of Patients with Acute Cholecystitis and Possible Common Bile Duct Stones

HM2010 Abstract Number: 27

Newly Cleaned Physician Uniforms Have Similar Rates of Bacterial Contamination at the End of the Workday as Infrequently Washed White Coats

Background: In 2007, the British Department of Health developed guidelines for health care workers regarding uniforms and work wear that banned the traditional white coat, long sleeves, jewelry, and neckties in the United Kingdom. To [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Newly Cleaned Physician Uniforms Have Similar Rates of Bacterial Contamination at the End of the Workday as Infrequently Washed White Coats

HM2010 Abstract Number: 28

Impact of a Rapid Response Team on Intensive Care Unit Readmission Rate

Background: Rapid response teams (RRTs) assist in the assessment, treatment, and triage of hospitalized patients with physiologic instability, but their effectiveness in reducing transfers to the intensive care unit (ICU), cardiopulmonary arrests, and in‐hospital mortality [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Impact of a Rapid Response Team on Intensive Care Unit Readmission Rate

HM2010 Abstract Number: 29

Evaluating Readmission Rates: How Can We Improve?

Background: Readmission to the hospital is a burden not only to patients, families, and health care workers but also to the health care system. The U.S. government spends an estimated $12 billion a year on [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Evaluating Readmission Rates: How Can We Improve?

HM2010 Abstract Number: 30

How Certain Do We Make a Diagnosis of Pneumonia, How Well Do We Differentiate Community‐Acquired Pneumonia (CAP) from Health Care–Associated Pneumonia (HCAP), and Does This Lead to Errors in Selecting Antibiotics?

Background: Pneumonia is a common entity associated with significant morbidity and mortality. Guidelines for the management of both CAP and HCAP have been recently published, with evidence that compliance is associated with better outcomes. These [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on How Certain Do We Make a Diagnosis of Pneumonia, How Well Do We Differentiate Community‐Acquired Pneumonia (CAP) from Health Care–Associated Pneumonia (HCAP), and Does This Lead to Errors in Selecting Antibiotics?

HM2010 Abstract Number: 31

Advance Directives: The Best Predictor of Congruence Between Preferred and Actual Site of Death

Background: Death in the United States frequently occurs in institutions, despite the majority of persons indicating a preference to die at home. Little research has examined how well individual preferences compare with actual site of [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Advance Directives: The Best Predictor of Congruence Between Preferred and Actual Site of Death

HM2010 Abstract Number: 32

A Hospitalist‐Led Emergency Department Team Improves Hospital Bed Efficiency

Background: Admitted patients boarded in the emergency department (ED) leads to hospital diversion. Active bed management by hospitalists can improve throughput. Minimizing wasted patient movement and inappropriate bed utilization may improve throughput for hospitals routinely [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on A Hospitalist‐Led Emergency Department Team Improves Hospital Bed Efficiency

HM2010 Abstract Number: 33

Effect of Providing a USB Syllabus on Resident Reading of Landmark Articles

Background: Hospitalists play an increasing role in resident education. The acquisition of new knowledge is a primary goal of residency training. Retrieving and retaining influential primary and secondary medical literature can be challenging for house [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Effect of Providing a USB Syllabus on Resident Reading of Landmark Articles

HM2010 Abstract Number: 34

Morale Matters: Top 10 Keys to Happy Hospitalists

Background: Demand for hospitalists continues to rise. Despite reports of high overall provider satisfaction, hospitalist retention and recruitment remain challenging. Identifying specific issues most important to hospitalists may guide efforts to improve and sustain morale. [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Morale Matters: Top 10 Keys to Happy Hospitalists

HM2010 Abstract Number: 35

Sleep in Older Hospitalized Patients: Effects of Disruptions and Perceived Control

Background: Better sleep is associated with improved cognition, mood, and physical health in older adults. Despite the potential health benefits, obtaining quality sleep when hospitalized has been described as difficult. Additionally, perceived control may be [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Sleep in Older Hospitalized Patients: Effects of Disruptions and Perceived Control

HM2010 Abstract Number: 36

A Clinical Prediction Rule to Identify High‐Risk Patients During Interhospital Transfer

Background: Interhospital transfer (IHT) is a common event whereby patients are transferred from community hospitals to tertiary‐care hospitals for specialized care or further workup in the setting of a diagnostic dilemma. Hospitalists are frequently the [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on A Clinical Prediction Rule to Identify High‐Risk Patients During Interhospital Transfer

HM2010 Abstract Number: 37

Reduction of Catheter‐Associated Urinary Tract Infections through a Bundled Intervention in a Commilunity Hospital

Background: Urinary tract infections (UTIs) are the most common type of nosocamial infection, with 80% associated with indwelling urinary catheters. The relative frequency of catheter‐associated UTIs (CAUTIs) imparts greater clinical and cost implications to patients [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Reduction of Catheter‐Associated Urinary Tract Infections through a Bundled Intervention in a Commilunity Hospital

HM2010 Abstract Number: 38

Scripted Social History Questions Increase Screening Rates for Intimate Partner Violence on Inpatient Medicine Teaching Services

Background: Although numerous professional organizations recommend routine screening for intimate partner violence (IPV), and the Joint Commission for Accreditation for Health Care Organizations requires screening for IPV in in patient admissions, screening rates in outpatient [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Scripted Social History Questions Increase Screening Rates for Intimate Partner Violence on Inpatient Medicine Teaching Services

HM2010 Abstract Number: 39

Catch as Catch Can: How Physicians Manage Tests Pending at Discharge

Background: With increasing pressure to shorten the length of stay of hospitalized patients, physicians are discharging more patients with tests pending at discharge (TPAD). Little is known about how physicians currently manage TPADs. Methods: Using [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Catch as Catch Can: How Physicians Manage Tests Pending at Discharge

HM2010 Abstract Number: 40

What's Out There? Characterizing Tests Pending at Discharge

Background: Approximately 40% of medical patients are discharged with tests pending, and these test results change patient care over one third of the time. Little is known, however, about what types of tests are pending [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on What's Out There? Characterizing Tests Pending at Discharge

HM2010 Abstract Number: 41

Predictors and Outcomes of Heart Failure after Hip Fracture Repair: A Population‐Based Study

Background: Hospitalists frequently participate in the perioperative care of hip fracture patients. Hip fracture repairs in the elderly carry high rales of postoperative morbidity, including heart failure and other adverse cardiac events. Heart failure also [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Predictors and Outcomes of Heart Failure after Hip Fracture Repair: A Population‐Based Study

HM2010 Abstract Number: 42

Quality of Care for In‐Hospital Stroke: Analysis of a Statewide Registry

Background: It is estimated that 7%–15% of all strokes occur in the hospital. It might be expected that strokes occurring in the inpatient setting would receive higher quality of care, more rapid evaluation, and a [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Quality of Care for In‐Hospital Stroke: Analysis of a Statewide Registry

HM2010 Abstract Number: 43

Effect of a Multicomponent Campaign on Pressure Ulcer Prevention and Care

Background: A 2‐year quality improvement campaign at a single teaching hospital was launched to improve the identification, documentation, and treatment of pressure ulcers (PUs) in the wake of the CMS declaration that severe hospital‐acquired PUs [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Effect of a Multicomponent Campaign on Pressure Ulcer Prevention and Care

HM2010 Abstract Number: 44

Problems Versus Systems: How Does the Internal Medicine Clerkship Influence Medical Students' Note Writing?

Background: Learning to write inpatient notes is an integral part of the internal medicine (IM) clerkship. Anecdotal evidence suggests variation in students' assessment/plan (A/P) sections; students tend to follow either a system‐based or problem‐based A/P [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Problems Versus Systems: How Does the Internal Medicine Clerkship Influence Medical Students' Note Writing?

HM2010 Abstract Number: 45

Preventing Venous Thromboembolism Following Hip Replacement Surgery: Analysis of Special Populations in the United States That May Require Alterations to Anticoagulant Regimens

Background: Patients undergoing hip replacement surgery are at particularly high risk of venous thromboembolism (VTE) and require thromboprophylaxis. Unlike clinical trials, real‐world surgery includes patient populations with comorbidities or on concomitant drugs, who may require [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Preventing Venous Thromboembolism Following Hip Replacement Surgery: Analysis of Special Populations in the United States That May Require Alterations to Anticoagulant Regimens

HM2010 Abstract Number: 46

Are U.S. Hospitals in Compliance with Federal Regulations on Language Access Services?

Background: Federal regulations require health care organizations to provide language services for limited English proficiency (LEP) patients. The National Standards on Culturally and Linguistically Appropriate Services (CLAS standards) in Health Care include 4 that outline [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Are U.S. Hospitals in Compliance with Federal Regulations on Language Access Services?

HM2010 Abstract Number: 47

Discharge Location Disagreements and Rehospitalization Risk among Frail and Elderly Adults

Background: Rehospitalizations are costly and can be disruptive for patient cane. To our knowledge, no study has examined the impact of patient agreement with recommendations for the place of discharge as a cause of rehospitalization. [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Discharge Location Disagreements and Rehospitalization Risk among Frail and Elderly Adults

HM2010 Abstract Number: 48

Renal Function Trends in Patients with Out‐of‐Hospital Cardiac Arrest

Background: For the last 20 years, efforts have focused an improving survival from out‐of‐hospital cardiac arrest and multiorgan failure. Given the many known nephrotoxic insults of postresuscitation care, it is a common belief that renal [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Renal Function Trends in Patients with Out‐of‐Hospital Cardiac Arrest

HM2010 Abstract Number: 49

Obesity and Duration of Hospital Stay with Pneumonia

Background: Obesity has been associated with increased morbidity and mortality. In addition to that it has been noted to increase the duration of hospital stay and also readmissions for overall admissions. We wanted to find [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Obesity and Duration of Hospital Stay with Pneumonia

HM2010 Abstract Number: 50

Strategies for Effective On‐Call Supervision for Internal Medicine Residents: The Superb/Safety Model

Background: Although supervision is central to resident education and patient safety, there is little to guide the use of effective supervision strategies. The aim of this study is to describe effective supervision for on‐call internal [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Strategies for Effective On‐Call Supervision for Internal Medicine Residents: The Superb/Safety Model

HM2010 Abstract Number: 51

A Nurse‐Pharmacist‐Led Medication Reconciliation Process

Background: Medication reconciliation (med rec) is an active process, occurring at transition points in care, whereby medications received by the patient prior to the transition are reviewed and considered when developing the next medication regimen. [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on A Nurse‐Pharmacist‐Led Medication Reconciliation Process

HM2010 Abstract Number: 52

What Was the Impact of the 2003 ACGME Duty‐Hour Rules? Patient Safety, Resident Education, and Resident Well‐Being

Background: In July 2003, the Accreditation Council for Graduate Medical Education implemented duty‐hour rules for all U.S. residents. In December 2008, the Institute of Medicine released a report urging additional restrictions. The issues at stake [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on What Was the Impact of the 2003 ACGME Duty‐Hour Rules? Patient Safety, Resident Education, and Resident Well‐Being

HM2010 Abstract Number: 53

Patients' Ability to Identify Their Hospitalist

Background: Patients' accurate identification of their hospitalist likely leads to increased satisfaction with the quality of care and better communication, especially during the discharge transition. A recent study found that 75% of patients on a [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Patients' Ability to Identify Their Hospitalist

HM2010 Abstract Number: 54

Can a Mail‐Home Hospital Patient Satisfaction Survey Be Used to Assess Individual Hospitalist Communication?

Background: Hospitals are increasingly interested in patient satisfaction as an outcome measure. The Press‐Ganey (PG) patient satisfaction survey contains items related to satisfaction with individual physician's communication. On receipt of the completed survey these results [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Can a Mail‐Home Hospital Patient Satisfaction Survey Be Used to Assess Individual Hospitalist Communication?

HM2010 Abstract Number: 55

Association of Hypoglycemia for Mortality in Subjects Hospitalized with Pneumonia

Background: Prior research has shown that hypoglycemia is associated with worse outcomes for the elderly, in sepsis, and in children with pneumonia. The purpose of this study was to examine whether hypoglycemia (< 70 mg/dL) is [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Association of Hypoglycemia for Mortality in Subjects Hospitalized with Pneumonia

HM2010 Abstract Number: 56

Factors Influencing Hospital Recidivism among Patients Discharged from an Academic Hospitalist Service

Background: Many patients that hospitalists care for have complex social situations and poor access to medical care. These vulnerable populations often do poorly after discharge and may repeatedly return to the hospital for unresolved medical [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Factors Influencing Hospital Recidivism among Patients Discharged from an Academic Hospitalist Service

HM2010 Abstract Number: 57

Are Patients Who Leave against Medical Advice (AMA) At Risk for Higher Mortality and Hospital Readmission at 30 Days?

Background: With 1%–2% of patients leaving the hospital against medical advice (AMA), the potential for these patients to suffer adverse health outcomes is of major concern. Prior studies have shown an increased rate of hospital [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Are Patients Who Leave against Medical Advice (AMA) At Risk for Higher Mortality and Hospital Readmission at 30 Days?

HM2010 Abstract Number: 58

Hospitalist‐Powered Mobile Telemedicine to Admit Patients in the Emergency Department

Background: Hospitalists must help find innovative solutions to challenging problems that face hospitals today. Hospitals face a physician shortage for both hospitalists and other specialty physicians. And hospitals face falling revenues and are under intense [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Hospitalist‐Powered Mobile Telemedicine to Admit Patients in the Emergency Department

HM2010 Abstract Number: 59

Development of a Guideline for Management of Coombs‐Positive Infants in a Community Hospital for Pediatric Hospitalists

Background: Coombs‐positive (DAT+) infants are commonly encountered in the newborn nursery. These infants are at risk for developing severe hyperbilirubinemia and bilirubin encephalopathy. Multiple hospitalists may care for each infant daily, with diverse approaches to [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Development of a Guideline for Management of Coombs‐Positive Infants in a Community Hospital for Pediatric Hospitalists

HM2010 Abstract Number: 60

Hospital Patient Safety Culture and Hospital Readmission

Background: Preventable hospital readmission is a prominent consideration in policy discussions aimed at reducing morbidity and cost in the United States health care system. Research shows patients are more likely to be readmitted after discharge [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Hospital Patient Safety Culture and Hospital Readmission

HM2010 Abstract Number: 61

Barriers and Facilitators to Implementing Project Boost to Improve the Discharge Process

Background: Project BOOST (Better Outcomes for Older adults through Safe Transitions) is being implemented at 30 U.S. hospitals to enhance the hospital discharge process. Pilot sites began implementing Project BOOST'S core elements in January 2009. [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Barriers and Facilitators to Implementing Project Boost to Improve the Discharge Process

HM2010 Abstract Number: 62

Factors Related to Hospital Readmission among Hospitals in the University Health Consortium

Background: Up to three quarters of hospital readmissions may be avoidable, incurring a total cost from unplanned readmissions of $17.4 billion annually. Knowledge regarding the characteristics of patients at highest risk of readmission has been [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Factors Related to Hospital Readmission among Hospitals in the University Health Consortium

HM2010 Abstract Number: 63

Identifying Pediatric Patients at High Risk for Failure to Achieve Continuity of Care at Hospital Discharge

Background: Increasing numbers of hospitalized infants and children are cared for by pediatric hospitalists. Transitions in care and transfer‐of‐care providers at the time of hospital discharge place patients at risk for failure to achieve postdischange [...]

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HM2010 Abstract Number: 64

Perceived Hospitalist Barriers to Addressing Obesity in In patients: A Provider Survey

Background: Obesity is a major contributor of morbidity and all‐cause mortality, and is associated with decreased life expectancy. The long‐term risk of excessive weight gain increases during adulthood and currently more than 70% of the [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Perceived Hospitalist Barriers to Addressing Obesity in In patients: A Provider Survey

HM2010 Abstract Number: 65

A Dedicated Preoperative Medical Consultation Service May Shorten Length of Hospitalization among Medically Complex Surgical Patients

Background: Perioperative medicine platforms (PMPs) are being adopted by many hospitals and HMOs. Despite a growing body of evidence around pre operative medical optimization, the full impact of a dedicated preoperative consultation service on patient [...]

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HM2010 Abstract Number: 66

Application of Long‐Term Care Principles in Acute Care: Comparison of Pressure Ulcer Rates by Case‐Mix Index Analysis

Background: The use of patient safety indicators such as pressure ulcer rate, allows institutions to monitor and compare their level of efficacy with other hospitals. Medicare and Medicaid have instituted quality measures and payment based [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Application of Long‐Term Care Principles in Acute Care: Comparison of Pressure Ulcer Rates by Case‐Mix Index Analysis

HM2010 Abstract Number: 67

Qualitative and Quantitative Assessment of Teamwork on Hospital Medicine Units Indicates Weaknesses in Cohesiveness, Communication, Role Clarity, and Goal Clarity

Background: Highly functional teams require cohesiveness, communication, role clarity, and goal clarity. Although in patient physicians and nurses may ideologically agree on the importance of teamwork, weaknesses in these domains may still exist. To understand [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Qualitative and Quantitative Assessment of Teamwork on Hospital Medicine Units Indicates Weaknesses in Cohesiveness, Communication, Role Clarity, and Goal Clarity

HM2010 Abstract Number: 68

Documentation of Obesity by Hospitalist Providers in the Inpatient Setting

Background: Obesity is an epidemic that has increased dramatically over the past 50 years in the United Stales, A disproportionate number of obese patients are admitted to hospitals, largely because of diseases associated with or [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Documentation of Obesity by Hospitalist Providers in the Inpatient Setting

HM2010 Abstract Number: 69

Recognition of Body Mass Index in the Inpatient Population by Hospitalist Providers

Background: Obesity is a growing epidemic in the United States. A disproportionately high percentage of the obese population is admitted to our nation's hospitals, and once admitted these patients have lengths of stay almost twice [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Recognition of Body Mass Index in the Inpatient Population by Hospitalist Providers

HM2010 Abstract Number: 70

Predictors of Hospital Readmissions within 30 Days after Discharge

Background: Read mission to the hospital soon after discharge is a significant burden to patients and our health care system, We aimed to study the predictors of readmissions within 30 days of discharge from our [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Predictors of Hospital Readmissions within 30 Days after Discharge

HM2010 Abstract Number: 71

Effect of Increased Venous Thromboembolism Prophylaxis on the Incidence of Heparin‐Induced Thrombocytopenia

Background: Unfractionated and low‐molecular‐weight heparins are widely used for venous thromboembolism prophylaxis (VTEP). Heparin‐induced thrombocytopenia (HIT) is a rare but potentially devastating reaction to heparins, with an incidence of 0%‐5% of exposed medical and surgical [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Effect of Increased Venous Thromboembolism Prophylaxis on the Incidence of Heparin‐Induced Thrombocytopenia

HM2010 Abstract Number: 72

Patterns of Computed Tomography (CT) Utilization for Pediatric Patients Seen in the Emergency Department: Results from a National Survey

Background: Increasing the use of computed tomography (CT) imaging over the past 10 years has been accompanied by rising concerns about the effects of radiation exposure, especially in children. One approach to limiting radiation exposure [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Patterns of Computed Tomography (CT) Utilization for Pediatric Patients Seen in the Emergency Department: Results from a National Survey

HM2010 Abstract Number: 73

Disclosing Medical Errors: We Can Afford to Do the Right Thing

Background: Ethical obligations and patient safety principles support prompt and full disclosure of harmful medical errors. In an era of high malpractice premiums, debate on whether disclosure increases or decreases liability claims and costs persists. [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Disclosing Medical Errors: We Can Afford to Do the Right Thing

HM2010 Abstract Number: 74

A Common Blood Group Type (Duffy Null) in African Americans Predicts Increased Mortality in Acute Lung Injury

Background: African Americans suffer nearly double the annual estimated mortality rate of whites in acute lung injury (ALI), and genetic factors may be involved The Duffy blood group antigen is a chemokine receptor on red [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on A Common Blood Group Type (Duffy Null) in African Americans Predicts Increased Mortality in Acute Lung Injury

HM2010 Abstract Number: 75

Impact of a Standard Admission Order Form on Appropriate Use of Venous Thromboembolism Prophylaxis

Background: Venous thromboembolism prophylaxis (VTEP) decreases rates of deep vein thrombosis among inpatients, and increasing VTEP use is a common target for quality improvement initiatives. However, little is known about the balance of appropriate versus [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Impact of a Standard Admission Order Form on Appropriate Use of Venous Thromboembolism Prophylaxis

HM2010 Abstract Number: 76

Accuracy of Google Translate™ for Medical Educational Material

Background: Language barriers present a major challenge to patient education in the rapidly growing population with limited English proficiency. Although professional translations of standard educational material can help to address this challenge, clinicians often encounter [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Accuracy of Google Translate™ for Medical Educational Material

HM2010 Abstract Number: 77

Blood Culture Contamination: A Cluster‐Randomized Crossover Trial Evaluating the Comparative Effectiveness of 3 Skin Antiseptic Interventions

Background: Blood cultures are one of the most commonly performed and valuable diagnostic procedures in hospitalized patients. Contaminated blood cultures, however, result in significant resource utilization and potential complications from exposure to unnecessary therapies. Various [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Blood Culture Contamination: A Cluster‐Randomized Crossover Trial Evaluating the Comparative Effectiveness of 3 Skin Antiseptic Interventions

HM2010 Abstract Number: 78

The Boost 7P Screening TooI for Transitions as a Predictor of Read mission

Background: Project BOOST (Better Outcomes for Older Adults Through Safe Transitions) is a SHM‐mentored quality improvement program targeted at improving the discharge transition process and now has 30 participating sites. Our hospital, one of the [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on The Boost 7P Screening TooI for Transitions as a Predictor of Read mission

HM2010 Abstract Number: 79

Utilizing Audit and Feedback to Improve Hospitalists' Performance in Tobacco‐Dependence Counseling

Background: Cigarette smoking is the leading cause of preventable death in the United Stales, accounting for approximately 440,000 deaths from smoking‐attributable illness each year. Smokers hospitalized for acute illnesses may be more receptive to smoking [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Utilizing Audit and Feedback to Improve Hospitalists' Performance in Tobacco‐Dependence Counseling

HM2010 Abstract Number: 80

Diffusion Lung Capacity Predicts Hospitalization for Pneumonia in Patients with Type 2 Diabetes Mellitus

Background: In previous studies, type 2 diabetes mellitus (DM) has been associated with increased incidence of hospitalization for pneumonia as well as increased pneumonia‐associated morbidity and mortality. It is unknown if decreased lung diffusion capacity [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Diffusion Lung Capacity Predicts Hospitalization for Pneumonia in Patients with Type 2 Diabetes Mellitus

HM2010 Abstract Number: 81

A Mobile Computer‐Assisted Education System to Promote Smoking Cessation for Hospitalized Patients

Background: Tobacco smoking is the leading preventable cause of death in the United States, Most interventions for hospitalized smokers have used some combination of physician advice to quit, behavioral counseling, and self‐help materials including booklets, [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on A Mobile Computer‐Assisted Education System to Promote Smoking Cessation for Hospitalized Patients

HM2010 Abstract Number: 82

Factors Associated with Patients' Understanding of Their Preadmission Medication Regimen

Background: Patients' ability to accurately report their preadmission medication regimen is a vital basis for medication reconciliation in the hospital. Understanding of the medication regimen may also affect postdischarge adherence and medication safety. We examined [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Factors Associated with Patients' Understanding of Their Preadmission Medication Regimen

HM2010 Abstract Number: 83

A Children's Hospital Experience with Warfarin Therapy

Background: Despite the widely recognized risks of anticoagulant therapy, most pediatric patients are started on oral warfarin in the absence of standardized clinical protocols. Given the differing intensity of anticoagulation recommended for clinical and surgical [...]

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HM2010 Abstract Number: 84

Higher Hospital Spending Does Not Result in Lower Adjusted Mortality in Sepsis

Background: Sepsis is a common, highly morbid, costly condition, yet little is known about hospital‐level variation in treatment costs or outcomes. We aimed to characterize variations in hospital costs and mortality rates for patients with [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Higher Hospital Spending Does Not Result in Lower Adjusted Mortality in Sepsis

HM2010 Abstract Number: 85

A Taxonomy and Description of Patient‐Driven “Goals for the Day” during Hospitalization

Background: Engaging hospitalized patients in their medical care is a National Patient Safety Goal, but methods to achieve this goal remain challenging. Efforts to create “goals for the day” are traditionally provider driven and fail [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on A Taxonomy and Description of Patient‐Driven “Goals for the Day” during Hospitalization

HM2010 Abstract Number: 86

Patient's Knowledge about Their Hospitalization at Discharge

Background: Hospital discharge represents a potentially dangerous transition in care requiring active engagement with patients and their caregivers. Ensuring that patients undersland any new diagnoses, medications and dosing changes, and follow‐up is essential to preventing [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Patient's Knowledge about Their Hospitalization at Discharge

HM2010 Abstract Number: 87

A Multidisciplinary Intervention Improves Vancomycin Dosing in the Intensive Care Unit

Background: Vancomycin is commonly used in an empiric antimicrobial regimen. The joint 2009 AHSP/IDSA/SIDP guidelines recommend a minimum trough of 10 μg/mL to avoid development of rcsistance and troughs up to 20 μg/mL to improve [...]

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HM2010 Abstract Number: 88

In‐Hospital Cardiopulmonary Arrest: The Role of BMI, Central Venous Catheter, and Other Predictors of Outcome

Background: Survival following in‐hospital cardiac arrest has remained poor, at about 14%. The goal of this study was to determine the factors related to survival, and to evaluate the role of BMI and central venous [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on In‐Hospital Cardiopulmonary Arrest: The Role of BMI, Central Venous Catheter, and Other Predictors of Outcome

HM2010 Abstract Number: 89

Rehydration Therapy in Infants and Children: Recombinant Human Hyaluronidase‐Facilitated Subcutaneous Versus Intravenous Fluid Administration

Background: Establishing intravenous (IV) access can be difficult, especially in children with dehydration, who often have small, volume‐depleted veins. Subcutaneous (SC) rehydration therapy is an alternative to IV rehydration therapy when parenteral treatment is indicated [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Rehydration Therapy in Infants and Children: Recombinant Human Hyaluronidase‐Facilitated Subcutaneous Versus Intravenous Fluid Administration

HM2010 Abstract Number: 90

Underutilization of Antiplatelet Therapy for Primary Prevention by Hospitalists

Background: Many guidelines recommend aspirin for primary prevention of myocardial infarction and cerebrovascular accidents in high‐risk patients. Aspirin use has increased in indicated populations; however, the percentage is still suboptimal. Currently, data from the 1993 [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Underutilization of Antiplatelet Therapy for Primary Prevention by Hospitalists

HM2010 Abstract Number: 91

Improving Timeliness without Compromising Quality: Discharge Summaries Dictated by Internal Medicine Residents

Background: The discharge summary is an important tool for communicating essential information as patients transition from the hospital, yet it frequently does not arrive for outpatient physicians in a timely manner Furthermore, residents are often [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Improving Timeliness without Compromising Quality: Discharge Summaries Dictated by Internal Medicine Residents

HM2010 Abstract Number: 92

Geographic Physician Rounding Improves Staff Satisfaction with Communication and Efficiency on the Academic Internal Medicine Wards

Background: Providing efficient, interdisciplinary care in academic centers today is greatly challenged by work‐hour restrictions, the resulting fragmented team structures, and frequent geographic discontinuity of physician teams. Our objective was to geographically localize physician teams [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Geographic Physician Rounding Improves Staff Satisfaction with Communication and Efficiency on the Academic Internal Medicine Wards

HM2010 Abstract Number: 93

Mental Status Assessment in the Emergency Department: Ready for Prime Time as a Quality Metric?

Background: Delirium and other forms of cognitive impairment are clinically important patient charactenistics that have been shown to be strong predictors of outcomes. Although mental status assessment is the subject of national quality indicators, considerable [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Mental Status Assessment in the Emergency Department: Ready for Prime Time as a Quality Metric?

HM2010 Abstract Number: 94

Effects of Hospitalists on 1‐Year Postdischarge Resource Utilization By Medicare Beneficiaries

Background: Several studies have found that hospitalists reduce cost and length of stay compared to nonhospitalists, with no adverse effect on quality of care or inpatient outcomes. However reduced length of stay could be accomplished [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Effects of Hospitalists on 1‐Year Postdischarge Resource Utilization By Medicare Beneficiaries

HM2010 Abstract Number: 95

Acute Changes in N‐Terminal Probrain Natriuretic Peptide During Hospitalization and the Risk of Readmission and Mortality in Patients with Congestive Heart Failure

Background: Congestive heart failure (CHF) is characterized by multiple hospital readmissions and increased risk of death. Some studies suggest using serial changes in N‐terminal probrain natriuretic peptide (NT‐proBNP) as a predictor of adverse events in [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Acute Changes in N‐Terminal Probrain Natriuretic Peptide During Hospitalization and the Risk of Readmission and Mortality in Patients with Congestive Heart Failure

HM2010 Abstract Number: 96

Implementation of Evidence‐Based Order Sets Improves Clinical and Financial Outcomes in the Treatment of Pneumonia and Heart Failure

Background: Evidence‐based order sets have been shown to improve clinical and financial outcomes. However, most order set studies have been conducted in academic medical centers or stand‐alone hospitals. The Iowa Health System (IHS) is an [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Implementation of Evidence‐Based Order Sets Improves Clinical and Financial Outcomes in the Treatment of Pneumonia and Heart Failure

HM2010 Abstract Number: 97

Incidence of Congestive Heart Failure after Hcapitalization for Pneumonia

Background: Recent studies suggest that there is an increase in cardiovascular disease after pneumonia; however, there is little information on incidence of a new diagnosis of congestive heart failure (CHF) after pneumonia. The aim of [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Incidence of Congestive Heart Failure after Hcapitalization for Pneumonia

HM2010 Abstract Number: 98

Educational Impact of a Teaching Procedure Service Versus Standard Procedural Training on Internal Medicine Interns

Background: Academic medical centers face new challenges in providing access to safe and efficient inpatient procedures while balancing house staff autonomy and education. Internal medicine residents at many medical centers perform invasive bedside procedures without [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Educational Impact of a Teaching Procedure Service Versus Standard Procedural Training on Internal Medicine Interns

HM2010 Abstract Number: 99

Shifting Duties to After Hours in the Era of Work‐Hour Restrictions

Background: A better understanding of how resident physicians allocate their time is critical to making informed changes in resident schedules, given duty‐hour restrictions. Little is known about how much work residents defer to their off [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Shifting Duties to After Hours in the Era of Work‐Hour Restrictions

HM2010 Abstract Number: 100

Effect of a HospitaIist‐Supervised Procedure Service on Patient Satisfaction with Procedures

Background: In recent years, a number of residency training programs have adopted “procedure teams” that supervise residents in performing and troubleshooting invasive bedside procedures. These services have been shown to increase resident comfort and self‐perceived [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Effect of a HospitaIist‐Supervised Procedure Service on Patient Satisfaction with Procedures

HM2010 Abstract Number: 101

Audit of Electronic Health Records and Feedback Improves Medicine Interns' Performance in Inpatient Tobacco‐Dependence Treatment

Background: When residents are exposed to tobacco‐dependence treatment (TDT) training, the teachings are mainly geared toward performing such practice in outpatient settings. However, hospitalized smokers may be more responsive to smoking cessation interventions than nonhospital‐iied [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Audit of Electronic Health Records and Feedback Improves Medicine Interns' Performance in Inpatient Tobacco‐Dependence Treatment

HM2010 Abstract Number: 102

Improving Patient Safety: Impact of Structured Interdisciplinary Rounds on a Medical Teaching Unit

Background: Communication among health care providers is critically important to provide safe care, as poor communication represents a major etiology of preventable adverse events (AE) in hospitals. The aim of this study was to assess [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Improving Patient Safety: Impact of Structured Interdisciplinary Rounds on a Medical Teaching Unit

HM2010 Abstract Number: 103

Improving Teamwork: Impact of Structured Interdisciplinary Rounds on a Hospitalist Unit

Background: Research reveals deficiencies in teamwork on medical units involving hospitalists. The aims of this study were to assess the impact of an intervention, structured interdisciplinary rounds (SlDRs), on nurses' ratings of collaboration and teamwork [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Improving Teamwork: Impact of Structured Interdisciplinary Rounds on a Hospitalist Unit

HM2010 Abstract Number: 104

Improving Teamwork: Impact of Structured Interdisciplinary Rounds on a Medical Teaching Unit

Background: Research reveals deficiencies in teamwork on medical teaching units. The aim of this study was to assess the impact of an intervention, structured interdisciplinary rounds (SlDRs), on hospital care providers' ratings of collaboration and [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Improving Teamwork: Impact of Structured Interdisciplinary Rounds on a Medical Teaching Unit

HM2010 Abstract Number: 105

Who Is My Doctor? The Use of Photos and Signatures on an Internal Medicine Teaching Service to Improve Nursing Satisfaction

Background: Communication between nurses and physicians is instrumental in providing quality patient care. Nurse‐physician relations have been linked to nursing satisfaction and collaboration is associated with positive patient outcomes. Banner Good Samaritan Medical Center (BGSMC) [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Who Is My Doctor? The Use of Photos and Signatures on an Internal Medicine Teaching Service to Improve Nursing Satisfaction

HM2010 Abstract Number: 106

Improving Physician Communication Scores on the HCAHPS Survey: Early Effect of a Multifaceted Physician‐Led Initiative in a Community Teaching Hospital

Background: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey was developed by the Center for Medicare & Medicaid Services (CMS) and the Agency for Healthcare Research and Quality (AHRQ) as a standardized [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Improving Physician Communication Scores on the HCAHPS Survey: Early Effect of a Multifaceted Physician‐Led Initiative in a Community Teaching Hospital

HM2010 Abstract Number: 107

Proton Pump Inhibitors Overuse among Academic and Nonacademic Hospitalists

Background: Over the past decade, several studies reported a sharp increase in the use of proton pump inhibitors (PPIs) in the hospital setting. Between 33% and 65% of these prescriptions were found to be noncompliant [...]

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HM2010 Abstract Number: 108

Value of Repeat Testing for Clostridium difficile Infection (GDI) Using Enzyme Immunoassay Technique in a Large Tertiary Center

Background: Clostridium difficile infection (GDI) is one of the most common hospital‐acquired infections, and its prevalence and severity have been increasing. It is crucial to make a timely and accurate diagnosis so that treatment and [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Value of Repeat Testing for Clostridium difficile Infection (GDI) Using Enzyme Immunoassay Technique in a Large Tertiary Center

HM2010 Abstract Number: 109

Are Clinicians Using the Christopher Algorithm to Diagnose Pulmonary Embolism?

Background: The 200S CHRISTOPHER trial validated a diagnostic algorithm for pulmonary embolism (PE) using the Wells score, D‐dimer, and CT angiography (CTA). Thirty‐two percent of patients had a combination of low Wells score and negative [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Are Clinicians Using the Christopher Algorithm to Diagnose Pulmonary Embolism?

HM2010 Abstract Number: 110

Can Low Clinical Pretest Probability and Negative D‐Dimer Be Used to Exclude Pulmonary Embolism in Hospitalized Patients? A Systematic Review

Background: There is controversy over the use of D‐dimer to exclude pulmonary embolism (PE) in patients hospitalized for other reasons. Some authors have suggested that D‐dimer has limited clinical utility for inpatients because of its [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Can Low Clinical Pretest Probability and Negative D‐Dimer Be Used to Exclude Pulmonary Embolism in Hospitalized Patients? A Systematic Review

HM2010 Abstract Number: 111

Implementation of a Structured Electronic Tool to Improve Patient Handoffs and Resident Satisfaction

Background: The handoff of patient information and care is a vulnerable time during hospitalization. Inadequate communication during handoffs is associated with adverse events and near misses. Although recent guidelines from both the Institute of Medicine [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Implementation of a Structured Electronic Tool to Improve Patient Handoffs and Resident Satisfaction

HM2010 Abstract Number: 112

Predictors of 30‐Day Nonelective Hospital Readmission Rates

Background: Reducing hospital readmission rates will decrease medical costs and improve public health. Moreover, the Centers for Medicare and Medicaid Services (CMS) will no longer reimburse hospitals for certain “preventable readmissions.” The objective of this [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Predictors of 30‐Day Nonelective Hospital Readmission Rates

HM2010 Abstract Number: 113

PrevaIence and Economic Impact of IncidentaI RadioloicaI Findings in Hospitalized Medicine Patients

Background: Patients who are admitted to the hospital often get various diagnostic radiological studies. These tests reveal incidental radiological findings unrelated to their current illness. Purpose: This study was to evaluate the prevalence of these [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on PrevaIence and Economic Impact of IncidentaI RadioloicaI Findings in Hospitalized Medicine Patients

HM2010 Abstract Number: 114

Is There Agreement between Hospitalized Patients' Confidence and Actual Ability to Use Respiratory Inhalers?

Background: Inhalers are often used incorrectly by patients. Therefore, guidelines recommend evaluation of patient comprehension and education of respiratory inhaler use at all points of care, including hospitals. Determining ways to target use of instruction [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Is There Agreement between Hospitalized Patients' Confidence and Actual Ability to Use Respiratory Inhalers?

HM2010 Abstract Number: 115

Patients' Perceptions of Inpatient “Opt‐Out” Testing For Human Immunodeficiency Virus

Background: Risk‐based testing for HIV has been shown to have a limited impact on the rates of screening, and the latest CDC guidelines were expanded to recommend routine, voluntary HIV testing in all health care [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Patients' Perceptions of Inpatient “Opt‐Out” Testing For Human Immunodeficiency Virus

HM2010 Abstract Number: 116

Identifying Patients at High Risk for Medication History Errors at the Time of Hospital Admission

Background: The eighth National Patient Safety Goal, developed by the Joint Commission in 2009, emphasizes the importance of reconciliation of medications during the entire period of hospitalization. The medication reconciliation process starts with obtaining the [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Identifying Patients at High Risk for Medication History Errors at the Time of Hospital Admission

HM2010 Abstract Number: 117

Postoperative Myocardial Infarction in Noncardiac Surgery Patients

Background: The Internal Medicine Preoperative Assessment Consultation and Treatment (IMPACT) Center is a referral‐based clinic providing standardized preoperative evaluation by staff hospitalists. Our aim was to determine whether referral to the IMPACT Center decreased the [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Postoperative Myocardial Infarction in Noncardiac Surgery Patients

HM2010 Abstract Number: 118

Assessment and Optimization of Cardiac Performance for Noncardiac Surgery Patients: The Increase Quality Improvement

Background: Several randomized and observational trials in the past decade and the more recent ACC/AHA guidelines support the use of preoperative beta‐blockers (PBBs) in selected patients undergoing noncardiac surgery (NCS). The Internal Medicine Preoperative Assessment [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Assessment and Optimization of Cardiac Performance for Noncardiac Surgery Patients: The Increase Quality Improvement

HM2010 Abstract Number: 119

Review of Predictors and Negative Outcomes Associated with Patients Who Exceed Their Expected Length of Stay

Background: Length of stay (LOS) is increasingly being recognized as an important quality measure. It reflects the total number of days a patient actually spends in the hospital until discharge and encompasses the cumulative time [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Review of Predictors and Negative Outcomes Associated with Patients Who Exceed Their Expected Length of Stay

HM2010 Abstract Number: 120

Measuring Plasma Oxygen to Estimate True Oxygen Content of Blood in Patients with Extreme Leukocytosis: A Case Report

Background: Spurious hypoxemia is a very rare but known entity in patients with extreme leukocytosis. There are roughly only 15 cases that have been reported and documented spurious hypoxemia in patients with extreme leukocytosis and [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Measuring Plasma Oxygen to Estimate True Oxygen Content of Blood in Patients with Extreme Leukocytosis: A Case Report

HM2010 Abstract Number: 121

Health Care Failure Mode and Effect Analysis: Useful Tool to Develop a Systematic Approach to Avoid Communication Failures in Transition of Care in Patients with Incidental Radiological Finding in Hospitalist Mode of Care

Background: Communication of incidental radiological findings identified during hosprealization is an important part of a successful transition of care. As these are not the source of current illness but do require follow‐up, the likelihood of [...]

By | 2010-04-08T12:00:37+00:00 April 8th, 2010|Uncategorized|Comments Off on Health Care Failure Mode and Effect Analysis: Useful Tool to Develop a Systematic Approach to Avoid Communication Failures in Transition of Care in Patients with Incidental Radiological Finding in Hospitalist Mode of Care

HM2010 Abstract Number: 122

Trends in Pediatric HIV Hospitalizations

Background: The last 15 years have seen tremendous advances in the care of HIV‐infected children. Kourtis et al. documented a 71% decline in pebiatric hospitalizations due to HIV from 1994 through 2003, especially after the [...]

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HM2010 Abstract Number: 123

A Hospital‐Based Curriculum for Patient‐Centered Care and Safe Transitions: Effect on 30‐Day Heart Failure Readmissions

Background: Hospital readmission is a common and costly problem, with an average 30‐day readmission rate of 20% for Medicare patients. HF is the most common reason for readmission. Inattention to care across transitions is a [...]

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HM2010 Abstract Number: 124

Patients with Hospital‐Acquired Pressure Ulcers: Inaccurate Documentation and Poor Outcomes

Background: Pressure ulcers are a significant source of morbidity in hospitalized patients. In 2006 the Centers for Medicare and Medicaid Services (CMS) identified the development of a stage 3 or 4 pressure ulcer while hospitalized [...]

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HM2010 Abstract Number: 125

Are Proton Pump Inhibitors Overutilized in Hospitalized Patients Thereby Increasing Their Risk of Adverse Effects? A Community Hospital Experience

Background: Proton pump inhibitors (PPIs) are one of the most prescribed medications and are frequently used in hospitalized patients. Although PPIs have well‐defined indications for both therapy and prophylaxis, they are often overutilized. Recently, there [...]

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HM2010 Abstract Number: 126

Hospitalist Orthopedics Team Approach to Improving Care of Osteoporosis for Fragility Hip Fracture Patients

Background: Osteoporosis, the underlying cause of most hip fractures, is underdiagnosed and underrated. The Joint Commission's recent report on osteoporosis diagnosis and management showed that only 20% of patients with fragility or low‐impact fractures are [...]

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HM2010 Abstract Number: 127

Practice Patterns for Antibiotic De‐escalation in Culture‐Negative HCAP

Background: Published guidelines for treatment of health care‐associated pneumonia (HCAP) recommend initial broad‐spectrum antibiotic therapy with appropriate de‐escalation based on culture results. Guideline recommendations are heavily based on data from intubated patients, in whom cultures [...]

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HM2010 Abstract Number: 128

Assessment of Improvements to IT‐Based Medication Reconciliation

Background: Medication discrepancies, defined as unexplained differences in documented medication regimens across different sites of care, are prevalent and an important contributor to adverse drug events (ADEs) among hospitalized and recently discharged patients. In 2006, [...]

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HM2010 Abstract Number: 129

Reducing Hypoglycemia in the Intensive Care Unit

Background: For light glycemic control in the intensive care unit (ICU), recent studies attribute a lack of benefit and potential harm primarily to a higher frequency of hypoglycemia. Two caloric variations, caloric interruptions and caloric [...]

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HM2010 Abstract Number: 130

Hospital Medicine Education Program Reduces Floroquinolone Use

Background: Clostridium difficile infection (CDI) is a growing epidemic in U.S. hospitals. Much of the rapid rise in severe cases of CDI over the past 10 years is thought to be from the fluoroquinolone (FQ)–resistant [...]

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HM2010 Abstract Number: 131

Man datory VTE Prophylaxis Protocol Shows Increase in Overall Compliance But May Result in Underprophylaxis

Background: To increase the use of venous thromboembolism (VTE) prophylaxis, a multidisciplinary team at an academic medical center developed a VTE prophylaxis protocol that was added into medicine admission and surgical postoperative order sets. In [...]

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HM2010 Abstract Number: 132

Effects of a Hospitalist Medical Director Initiative on Patients with Long Lengths of Stay

Background: Patients with very long lengths of stay (LOS) comprising the tail of a normal distribution contributed significantly in raising the overall LOS in our academic teaching hospital. This finding held, even when cases were [...]

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HM2010 Abstract Number: 133

Effects of a Formulary Change for VTE Prophylaxis at an Academic Medical Center

Background: In April 2009, a large academic medical center switched the low‐molecular‐weight heparin (LMWH] on its formulary from enoxaparin to dalteparin. This formulary change was studied to determine how venous thromboembolism (VTE) prophylaxis rates and [...]

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HM2010 Abstract Number: 134

Assessing Impact of Usual Care on Quit Rates 4 Weeks Postdischarge among Hospitalized Smokers

Background: The hospital setting is an ideal environment to counsel patients on smoking cessation. The effectiveness of hospital‐based care for smoking is unclear, specifically among African Americans, who face a disproportionate burden of tobacco‐related disease. [...]

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HM2010 Abstract Number: 135

Who Oversees Internal Medicine House Staff Procedures? Hospitalist Inexperience and Discomfort with Procedure Supervision in an Academic Medical Center

Background: Despite the removal of most internal medicine (IM) residency procedure requirements, residents at all levels continue to perform bedside procedures. Hospitalists may find themselves responsible for oversight of inpatient procedures performed by their residents. [...]

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HM2010 Abstract Number: 136

Increased Mortality and Readmission among Patients Discharged Against Medical Advice

Background: Approximately 500,000 patients are discharged from U.S. hospitals against medical advice (AMA) each year. The clinical implications of discharge AMA are not known. We hypothesized that discharge AMA would be associated with a strong [...]

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HM2010 Abstract Number: 137

Patients Cared for by Physicians with a Tendency toward Shorter Lengths of Stay May Have Increased Mortality

Background: Since the prospective payment system began in 1962, hospitals have been incentivized to shorten inpatient length of stay (LOS). Though average LOS has since become shorter, few studies have examined the impact of shorter [...]

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HM2010 Abstract Number: 138

Medication Changes in the Elderly during Hospitalization

Background: In the United States the elderly make up a disproportionately large percentage of acute hospitalizations. In 2003 persons older than 65 years old made up 12% of the U.S. population but accounted for 33% [...]

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HM2010 Abstract Number: 139

Safe Procedural Sedation for Radiological Studies in Children Using Propofol by a Pediatric Hospitalist Team

Background: There is increasing use of propofol by nonanesthesiologists to sedate children for ambulatory diagnostic imaging studies. There is little published data on the safety profile and frequency of adverse events when propofol is used [...]

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HM2010 Abstract Number: 140

Why Do Physicians Prescribe Stress Ulcer Prophylaxis to Hospitalized General Medicine Patients?

Background: Although multiple studies have shown that inappropriate use of stress ulcer prophylaxis (SUP) is common for non‐intensive care unit (ICU) hospitalized patients, little is known about why physicians prescribe SUP without supporting evidence. This [...]

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HM2010 Abstract Number: 141

Not All Care Is Equal: Differences in Care of Venous Thromboembolism among Insured and Uninsured Patients

Background: Venous thromboembolism (VTE) is a common and potentially lethal problem. The 2009 Joint Commission has set new goals for the standard of care for all patients with VTE. To our knowledge, no research exists [...]

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HM2010 Abstract Number: 142

Cost and Trajectory of Care for Dying Patients

Background: Cost of medical care at the end of life is high, especially for hospitalizations that end in death. Palliative care services have been associated with decreased costs, including lower intensive care unit (ICU) costs. [...]

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HM2010 Abstract Number: 143

Hand Hygiene Practices among Hospitalists in 3 Different Practice Settings

Background: Proper hand hygiene is one of the simplest interventions to reduce spread of infectious diseases in the hospital setting. CDC currently recommends hand washing with soap and water or alcohol‐based gel before and after [...]

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HM2010 Abstract Number: 144

Improving Service Excellence with Etiquette‐Based Medicine

Background: Providing quality care is a top priority in hospital medicine. Quality of patient care comprised not only “technical” components (correct diagnosis and medical management), but also “sefvice” elements. Quality of service pertains to the [...]

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HM2010 Abstract Number: 145

Prevention of Venous Thromboembolism: improving Rates of Appropriate Prophylaxis

Background: Venous thromboembolism (VTE) is a common complication of hospitalization, with an estimated 600,000 cases in 2002, and is associated with substantial morbidity and mortality. The increasing focus on patient safety, with both financial implications [...]

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HM2010 Abstract Number: 146

Impact of a Simple Computerized Decision Support on Venous Thromboembolism Prophylaxis in the Inpatient Setting

Background: Venous thromboembolism (VTE) is an important cause of morbidity and mortality in hospitalized patients, so payers and regulators are encouraging hospitals to invest in systematic approaches to prevent them. Here, we describe an initiative [...]

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HM2010 Abstract Number: 147

Impact of a Computerized Decision Support on Venous Thromboembolism Treatment in the Inpatient Setting

Background: Venous thromboembolism (VTE) is frequently under‐ or overtreated in hospitals. Thus, regulators are encouraging hospitals to invest in systematic approaches to better manage anticoagulation. Here, we describe an initiative to implement VTE treatment best [...]

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HM2010 Abstract Number: 148

Racial/Ethnicity Disparities in ICU Outcomes

Background: Racial and ethnicity differences in health outcomes exist across many areas in medicine. Few studies have investigated race/ethnicity differences among critically ill patients and have not fully accounted for severity of illness, socioeconomic status [...]

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HM2010 Abstract Number: 149

Implications of Obesity for the General Medicine Inpatient

Background: The long‐term health consequences related to obesity are well documented. Recent surgical and intensive care unit literature has reported no significant differences in morbidity or mortality related to obesity. However, the full consequences of [...]

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HM2010 Abstract Number: 150

Discharge Summary Redesign Yielding Timely Completion and Forwarding

Background: At our quaternary academic medical center the process of dictating discharge summaries historically led to delays such that discharge summaries were being completed on average of more than 5 days after discharge. Our geriatricians [...]

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HM2010 Abstract Number: 151

Duplicate Medication Orders after CPOE Implementation

Background: Computer provider order entny (CPOE) systems with clinical decision support can alert providers to medication ordering errors such as duplicate medication orders. Yet many ordering errors persist despite these interventions. Duplicate orders after CPOE [...]

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HM2010 Abstract Number: 152

Relationship between Patient Perceptions of Hospitalist Communication and Length of Stay

Background: Length of stay in U.S. hospitals has been trending downward, and correlations to both outcomes and patient satisfaction are mixed. We compared measures of patient satisfaction with hospitalists' communication skills to average patient length [...]

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HM2010 Abstract Number: 153

Comparing a Procalcitonin‐Based Guideline to the IDSA/ATS 2007 Pneumonia Guideline: A Cost Minimization Analysis

Background: Community‐acquired pneumonia is a clinical diagnosis determined by the presence of respiratory signs and symptoms. Unfortunately, these clinical findings are not specific and may represent manifestations of other conditions. In addition, pneumonia may be [...]

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HM2010 Abstract Number: 1000

Hand Hygiene — Follow the Leader?

Background: Considerable resources have been devoted to improving hand hygiene compliance, yet true compliance remains unacceptably low, especially among physicians. Estimates from U.S. hospitals conclude that 2 million hospital‐acquired infections occur yearly, resulting in 100,000 [...]

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HM2010 Abstract Number: 1001

Preventing Catheter‐Associated Urinary Tract Infection in U.S. Hospitals, 2005–2009

Background: Urinary catheters are frequently used in acute care settings, resulting in substantial morbidity and costs from catheter‐associated urinary tract infection (CAUTI). National data from 2005 revealed that preventing CAUTI was a low priority for [...]

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HM2010 Abstract Number: 1002

Neutropenia and Low Platelets as a Result of Hydralazine

Background: Neutropenia is a serious and potentially fatal complication of drug therapy that can be induced by a number of medications. Failure to correctly identify and remove the offending agent can result in serious morbidity [...]

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HM2010 Abstract Number: 1003

Asymptomatic Hypertension in the Hospital: Should It Be Treated?

Background: High Wood pressure (BP) is frequently treated in patients hospitalized for reasons other than hypertension, but there are no evidence based guidelines for the management of asymptomatic high BP not associated with target organ [...]

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HM2010 Abstract Number: 154

The ABCs of Hospitalized Patients: A Multidisciplmary Checklist for Improving Quality of Inpatient Care

Background: Over the past several decades, there has been a rapid influx ol new information lor diagnostic and therapeutic interventions. It is increasingly challenging for hospitalists to continue to integrate new knowledge while complying with [...]

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HM2010 Abstract Number: 155

Reducing Inappropriate Variability in Coding Through the Use of a Stepped Feedback System

Background: Proper coding is an essential skill necessary to capture the appropriate level of care provided by the physician. Both undercoding and overcoding are problematic, and few residency programs adequately educate trainees in this skill. [...]

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HM2010 Abstract Number: 156

Decreasing the Rate of Contaminated Blood Cultures

Background: Contaminated blood cultures in the hospital setting are a potentially preventable cause of increased length of stay, unnecessary resource utilization, and unnecessary use of antibiotics. Estimates of the impact of contaminated blood cultures range [...]

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HM2010 Abstract Number: 157

Using Lean to Design Morning Rounds for Hospitalists and Residents: The Virginia Mason Rounding System (VMRS)

Background: Interns, residents, and hospitalists conduct morning rounds in hospitals to determine the plan of care for the patients and to determine the learning needs of the house staff. At Virginia Mason Medical Center with [...]

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HM2010 Abstract Number: 158

Improving Quality and Safety on a Medical Service: Outcomes from a Divisional Case Review Process

Background: The delivery of safe and high‐quality patient care requires providers to learn from cases involving suboptimal events or outcomes. Although hospitai incident reporting systems generate triggers for case reviews, literature demonstrates insufficient representation of [...]

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HM2010 Abstract Number: 159

Assessing and Improving Handoff Communications for Interhospital Transfers at an Academic Medical Center

Background: Poor handoff communication poses a threat to patient safely. The medical literature to dale has focused on handoffs within a single facility or at hospital discharge. There are no assessments of the quality of [...]

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HM2010 Abstract Number: 160

Structured Screen Prompts in a Computerized Discharge Instruction Module and Adherence to Discharge Medication Reconciliation Standards

Background: For institutions without a fully integrated EMR, providing a complete and legible discharge medication list is challenging. Medication reconciliation forms must serve the needs of both patient safety goal standards and the patient. In [...]

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HM2010 Abstract Number: 161

Morbidity, Mortality, and Improvement Conferences Engage Residents in Systems‐Based Practice

Background: An institutional requirement is lo conduct quarterly morbidity and mortality (M&M) conferences involving the internal medicine house staff. However, traditional MSM conferences often fail to address systems‐based factors or generate solutions to issues raised [...]

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HM2010 Abstract Number: 162

Dear Doctor: A Tool to Facilitate Patient‐Centered Care and Enhance Communication

Background: The results of publicly reported patient care surveys, such as the Hospital Consumer Assessment of Hospitals and Health Systems (HCAHPS), suggest that physician communication with patients could be improved. Patient‐centered care: which attempts to [...]

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HM2010 Abstract Number: 163

Electronic Medication Reconciliation (eMed Rec) Improves Compliance with the HF‐1 Core Measure Metric

Background: In 2004, the Centers for Medicare and Medicaid Services (CMS) and the Joint Commission (JC) determined a standard set of discharge instructions must be provided to patients with a principle diagnosis of congestive heart [...]

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HM2010 Abstract Number: 164

Tomorrow Night's Coverage Today!

Background: Every hospitalist program needs night coverage. Noctumists are in high demand and short supply and rotating hospitalists from days to nights is a dissatisfier. Night coverage is Typically more expensive than day coverage because [...]

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HM2010 Abstract Number: 165

eMed Rec: One List One Process, Universal Access

Background: Medication errors are common, costly, and have Ihe potential for harm. In 2006, Ihe Joint Commission challenged hospitals to implement medication reconciliation at transition points across the continuum. At our institution, compliance with this [...]

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HM2010 Abstract Number: 166

Staying Up‐to‐Date in Hospital Medicine by Using A Web‐Feeds Portal for Medical Journals

Background: With today's flow of information, on top of academic and clinical duties, hospitalist face the challenge of staying up‐to‐date to provide the besl care for palients. Web feeds are powered by an extensible markup [...]

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HM2010 Abstract Number: 167

A Standardized EHR Discharge Documentation Tool to Mistake‐Proof CHF Bundle Compliance

Background: In 2005, CMS and JCAHO implemented the Heart Failure Core Measures Set along with other core measures, in launching their hospital Performance Measures Initiative. Virginia Mason Medical Center (VMMC) has been able to improve [...]

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HM2010 Abstract Number: 168

A Description of Patient Safely Interventions Derived from Resident‐Run Modified Root Cause Analysis Conferences

Background: Teaching quality improvement (01} to house staff is still in its infancy. Using modified root cause analyses (RCAs) in monthly resident‐run conferences has been suggested as one manner to improve resident Ql exposure and [...]

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HM2010 Abstract Number: 169

Reducing Discharge Times: From Orderto Door

Background: Hospital efficiency and throughput has a great impact on available bed‐days. When hospitals run at high capacity, the need to care for patients in the most efficient manner possible is of paramount importance to [...]

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HM2010 Abstract Number: 170

Improving Patient Safety and CMS Performance through Medication Reconciliation 170

Background: Medication reconciliation is a major patient safety concern nationally and is linked to CMS measures. In 2006 an audit of the discharge medication list given to patients and the hospital summary sent to The [...]

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HM2010 Abstract Number: 171

A Novel Financial Incentive Program for Residents to Improve Communication with Primary Care Physicians

Background: Financial incentive programs have been successfully used lo encourage performance improvement, but until now. few such programs have engaged physicians‐in‐training. UCSF Medical Center and Office of Graduate Medical Education implemented a novel group financial [...]

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HM2010 Abstract Number: 172

Reducing Delays in Reporting of Routine Morning Laboratory Tests

Background: Delays in reporting inpatient routine morning laboratory tests to physicians lead to dissatisfaction and affect clinical decisions and safety and discharge plans. Test reporting limes and customer satisfaction have therefore been suggested as performance [...]

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HM2010 Abstract Number: 173

Project Boost: Identifying Barriers to the Discharge Process

Background: Transition Irom hospital to home is a vulnerable time for the frail elderly, and the complex discharge process benefits from a multidisci‐plinary approach and care coordination. Asuboplimel discharge process may lead to dissatisfaction, early [...]

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HM2010 Abstract Number: 174

A Potent Partnership: Empowering Residents to Lead a Failure‐Modes‐and‐Effects Analysis for an Academic Medical Center

Background: The Joint Commission requires hospitals to conduct failure‐modes‐and‐effects analyses [FMEAs] to evaluate error‐prone care processes. The Accreditation Council for Graduate Medical Education (ACGME) similarly expects resident competency in quality improvement and patient safety but [...]

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HM2010 Abstract Number: 175

Implementation of a Discharge Follow‐Up Clinic for Internal Medicine Patients at an Academic Medical Center

Background: Two years ago our academic hospitalists observed increasing difficulty in scheduling timely ambulatory follow‐up appointments for patients discharged from teaching and nonteaching hospital services. Several believed that this negatively affected patient care and was [...]

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HM2010 Abstract Number: 176

The Medical Respite Program: Ensuring Safe Discharges for Homeless Patients

Background: Homeless persons have higher rates of emergency department visits and acule care hospitalizations than housed populations. They account for excess costs per hospitalization, largely because of an increased length of slay. A study from [...]

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HM2010 Abstract Number: 177

Teamcards — Improving Patient‐Physic Ian Communication with a Picture

Background: Health care providers are searching for methods to improve patient satisfaction. A hospitaiwide survey at our institution studied 2 years of our patient satisfaction data, which indicated that problems with communication between caregivers, notably [...]

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HM2010 Abstract Number: 178

Developing a Longitudinal Ql Curriculum to Practically Teach Quality Improvement to Trainees

Background: Program directors are responsible for teaching and evaluating resident competence in quality improvement (QI) activities. Recent literature has highlighted various methods to accomplish this goal using varied curricula, facilitation tools, and rotational structures. The [...]

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HM2010 Abstract Number: 179

Innovative Strategies That Improve the Clinical Handoff (l‐Switch) Phase 4: Implementing a Handoff Cognitive Simulation Curriculum Across Multiple Specialties in a Single Academic Institution

Background: Learning effective handoff skills is critical lo patient safety and continues lo grow in importance since the implementation of resident duty‐hour restrictions and will likely become more critical across specialties given recent recommendations by [...]

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HM2010 Abstract Number: 180

Advancing Geriatrics Education: An Efficient Faculty Development Program for Academic Hospitalists Increases Geriatric Teaching

Background: Hospitalists care for an increasing number of older patients. As teachers of medicine, they are uniquely positioned to teach geriatric skills to residents. Faculty development programs focused on geriatrics leaching skills are often expensive [...]

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HM2010 Abstract Number: 181

Reengineering the Management of Patients with Hip Fracture in a Community Hospital Setting

Background: Mission Hospital is a regional community hospital serving Ihe population of western North Carolina, We repair around 500 hip fractures per year in patients older than 65, more lhan any hospital in North Carolina [...]

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HM2010 Abstract Number: 182

Development of a Provider Coding Education Program to Improve Charge Capture and Coding Accuracy in an Academic Hospitalist Practice

Background: An academic medical center added 15 adult hospitalists over the past 2 years. Many of the new faculty did not have prior experience with billing. Over the same time, the Department of Internal Medicine [...]

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HM2010 Abstract Number: 183

Pharmacist‐Driven Discharge Medication Reconciliation as Part of Project BOOST

Background: Discharge transitions in care represent a high‐risk period for medication errors and adverse drug events such as medication discrepancies. Although there is literature on improving admission medication reconciliation (Cornish et al. Arch Mem Med. [...]

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HM2010 Abstract Number: 184

A Discharge Pharmacist to Improve Medication Safety and Cost Avoidance

Background: Hospitalization and discharge‐associated transitions often involve changes in medication regimens that can lead lo adverse drug events and possible avoidable health care utilization. Studies have shown that discharge adverse events are prevalent, and medication [...]

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HM2010 Abstract Number: 185

Creating a Hospitalist Managed Comprehensive Sickle Cell Anemia Program

Background: In 2007 our Department QI Hospital Medicine was responsible lor the care QI more than 90% QI admissions for adults wilh sickle cell anemia (SCA), the majority of which were for sickle cell crisis. [...]

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HM2010 Abstract Number: 186

The Chicago Breathe Project: A Multi‐Institution Educational Innovation to Improve Resident Knowledge and Skills in Caring for Patients with Inhalers

Background: Asthma is responsible for a substantial proportion of ER visits and hospitalizations nationally, especially in minority communities. Since 2009, asthma patients have now been at increased risk because of a mandated replacement of the [...]

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HM2010 Abstract Number: 187

A Patient Hotline: Developing a Postdischarge Telephone Triage System

Background: Adverse events tallowing hospital discharge are common and represent a vulnerable time for patients. Unlike ambulatory practices That provide contact mechanisms for patients who have questions about their care, hospital medicine groups are faced [...]

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HM2010 Abstract Number: 188

Implementing Strategies to Improve Transfusion Practices at an Academic Medical Center

Background: Transfusion of red hlnnri cells (RBCs) in the appropriate clinical setting can be a lifesaving procedure, but This therapeutic power does not come without cost. The latter cannot only be measured in dollars, but [...]

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HM2010 Abstract Number: 189

Documentation Improvement and Residents Core Competency in Practice‐Based Learning and Improvement and System‐Based Practice

Background: National data on clinicians' documentation shows 60%‐80% inappropriate documentation on common hospital DRGs. We developed a documentation improvement project to improve clinicians' performance and to develop residents' core competency in system‐based practice (SBP) and [...]

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HM2010 Abstract Number: 190

The Advocate for Clinical Education (ACE): A Point‐of‐Care Coaching and Feedback Model for Resident Education in Quality Improvement and Patient Safety

Background: As quality improvement (Ql) and patient safety (PS) gain momentum as unquestioned core competencies in hospital medicine, residency Training programs are charged wilh educating the next generation of physicians in practice and promotion of [...]

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HM2010 Abstract Number: 191

An Initiative to Improve Coordination of Bedside Blood Glucose Testing, Insulin Administration, and Food Delivery

Background: One of the barriers to the safe management of inpatients with hyperglycemia is the lack of coordination between bedside blood glucose (BBG) Testing, insulin administration, and food delivery. This results in potential for mismatch [...]

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HM2010 Abstract Number: 192

A Root Cause Analysis‐Driven Initiative to Reduce Hospital Falls

Background: Falls are a high‐risk, high‐volume, and high‐cost challenge for hospitals. As part of the 2009 national patient safety goals, the Joint Commission emphasized the need to reduce the risk of harm resulting from falls [...]

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HM2010 Abstract Number: 193

Quality and Financial Outcomes from Gain Sharing: A 3‐Year Experience at Beth Israel Medical Center in New York

Background: Health care costs now comprise 16% of our gross national product. If we do not modify how we spend our health care dollars, this cost will increase to 50% by 2080. Gain‐sharing programs strive [...]

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HM2010 Abstract Number: 194

Immersion of House Staff in Case Review: Blending Education with Quality Improvement

Background: The ACGME requires that residents achieve competence in systems‐based practice (SBP) and practice‐based learning and improvement (PBL). Residency programs are challenged to develop, teach, and measure the impact of educational curricula in These arenas. [...]

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HM2010 Abstract Number: 195

Improving Patient‐Centered Care among House Staff through Observed Rounds

Background: In most internal medicine residency programs, house staff round on their patients each morning. This practice provides residents with the opportunity To review with patients the hospital course, results from previously completed tests, changes [...]

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HM2010 Abstract Number: 196

Using Standardized Patients for Work Rounds and Discharge Quality Improvement

Background: Work rounds are an established part of internal medicine residency training and an essential component of patient‐centered care. Work rounds provide house staff with the opportunity to review patients' hospital course, test results, treatment [...]

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HM2010 Abstract Number: 197

Using ABIM Performance Improvement Modules to Improve Care Set Utilization and Quality‐Care Indicators and to Enhance Resident Education in Quality Improvement

Background: ACGME requires residents training in internal medicine residency programs to be active participants in quality improvement projects. ABIM offers practice improvement modules (PIM) to teach residents QI techniques. In 2008. Baystate Medical Cenler (BMC) [...]

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HM2010 Abstract Number: 198

Development of a Pediatric Hospitalist Sedation Program

Background: There is growing demand for safe procedural sedation in pediatric hospitals around the country. Purpose: Through training with pediatric anesthesiologists, we have developed a successful model for a pediatric hospitalist‐administered sedation program. Description: In [...]

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HM2010 Abstract Number: 199

The First 3 Years of a Hospital‐Based Comparative Effectiveness Center; Translating Research into Practice to Improve the Quality, Safety, and Cost Effectiveness of Patient Care

Background: Variations in physician practice are well documented, despite the existence of best practices. Difficulty in translating research inlc practice, as well as industry influence, may be factors responsible for such variation. For academic medical [...]

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HM2010 Abstract Number: 200

Implementation of a Hospitalist‐Based Internal Medicine Ward System at a Community‐Based Teaching Hospital

Background: The literature consistently demonstrates that trainees are more satisfied when hospitalist teaching models are implemented. Before implementation of our ward system, house staff Teams cared for patients with different attendingsof record, and each attending [...]

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HM2010 Abstract Number: 201

eTriage — An Innovative Way to Improve the Hospital Admission Process

Background: Emergency department (ED) overcrowding remains a major problem in the United States, leading to ambulance diversions, treatment delays, and patients leaving prior to physician evaluation. In addition, the total number of inpatient hospital beds [...]

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HM2010 Abstract Number: 202

Innovative Strategies That Improve Clinical Handoff (l‐Switch) Phase 3: Multi‐Institutional Randomized Controlled Trial Evaluating the Educational and Performance Effect of Cognitive Simulation on Resident Handoffs

Background: Handoff skills continue to be a critical part of resident training. Few large‐scale studies exist to assess the most effective method 1c teach proper handoff skills. Purpose: A prospective, randomized, controlled trial was conducted [...]

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HM2010 Abstract Number: 203

An Electronic Dashboard to Improve Compliance with Inpatient Quality Measures

Background: Inpatient quality measures, such as compliance with multidisciplinary ventilator bundles to prevent ventilator associated pneumonia and venolhromboembolism (VTE) prophylaxis have been linked to reduced morbidity and mortality. However, at many hospitals not all suitable [...]

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HM2010 Abstract Number: 204

A History Is Worth a Million Dollar Workup

Case Presentation: A 79‐year‐old female with a history of hypolhyroidism presented with recurrence of her symptoms within days of discharge. On her last admission she presented with a 2‐week history of recurrent high‐grade fevers, headache, [...]

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HM2010 Abstract Number: 205

Clinical and Diagnostic Pitfalls in Vitamin B12 Deficiency

Case Presentation: A 36‐year‐old woman with PMH significant for iron‐deficiency anemia, presented with weakness, dyspnea, blurry vision, and dizziness. She denied hemoptysis, hematemesis, or hematochezia. Her menstrual cycles were regular. Physical exam showed pale conjunctiva, [...]

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HM2010 Abstract Number: 206

Mononeuritis Multiplex and Peripheral Neuropathy in Wegener's Granulomatosis

Case Presentation: A 69‐year‐old woman was hospitalized with a 4‐month history of generalized weakness, paresthesias, and bilateral lower‐extremity pain. Her past medical history was significant for hypertension, dyslipidemia, and surgically treated ovarian cancer Review of [...]

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HM2010 Abstract Number: 207

Small B‐Cell Lymphoma Manifesting Solely as Nephrotic Range Proteinuria: A Case Report

Case Presentation: A 45‐year‐old white female with no significant past medical history presented with bilateral lower‐extremitiy edema for 6 months. Physical examination was unremarkable except for pitting edema. Initial workup showed hypoalbuminemia and 24‐hour urinary [...]

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HM2010 Abstract Number: 208

An Unlikely But Potentially Fatal Association — TTP and Legionella Pneumonia

Case Presentation: A 46‐year‐old man with diabetes meHitus, hypertension, and hyperlipidemia was admitted with history of myalgias, cough with sputum, emesis, chills, abdominal pain, and diarrhea. Examination was significant for an ill‐appearing male, normolensive, and [...]

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HM2010 Abstract Number: 209

A Lesser‐Known Cause of Recurrent Hypovolemic Shock

Case Presentation: A 41‐year‐old woman was admitted for evaluation of recurrent diarrhea and lightheadedness. She described recurrent episodes over the preceding year of nausea and diarrhea, followed by worsening dizziness. She also had bilateral hip [...]

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HM2010 Abstract Number: 210

Renal Artery Dissection from Blunt Abdominal Trauma: A Case Report and Literature Review

Case Presentation: This is a 43‐year‐old white man who suffered blunt abdominal wall trauma from a collision with a teammate during a Softball game. The patient initially presented to the emergency department 1 day after [...]

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HM2010 Abstract Number: 211

Stevens‐Johnson Syndrome Secondary to Mycoplasma pneumoniae: A Scary Combination

Case Presentation: A 15‐year‐old male presented after 4 days with painful oral lesions preceded by nonspecific URI symptoms. Lesions were described as blisters on the lips and ulcers in the oral mucosa. The patient received [...]

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HM2010 Abstract Number: 212

Wernicke's Encephalopathy after Bariatric Surgery: A Case Series

Case Presentation: Case 1 is a 57‐year‐old African American female patient with morbid obesity, type 2 DM, HTN. and CKD stage 3 who was admitted for DKA. She had undergone Roux‐en‐Y gastric bypass surgery 2 [...]

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HM2010 Abstract Number: 213

Complete Splenic Infarction at 8000 Feet

Case Presentation: A 32‐year‐old African American male with sickle cell trait and congenital nephrogenic diabetes insipidus without previous sickle cell‐related complications traveled to Bogota, Columbia, located 8661 feet above sea level. On arrival to Bogotá, [...]

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HM2010 Abstract Number: 214

Disseminated Histoplasmosis and CD4 Lymphocytopenia: Chicken or the Egg?

Case Presentation: A 54‐year‐old woman with no past medical history presented with a 2‐month history of increasing fatigue, fever, and loss of appetite. She denied any other symptoms. She was pale and febrile (101.7°F) and [...]

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HM2010 Abstract Number: 215

“Boxing Glove” Hand: The RS3PE Syndrome

Case Presentation: A 73‐year‐old male with HTN presented with 1 month of bilateral UE throbbing pain in his upper arms followed by his hands. This was associated with swelling ascending up from his hands to [...]

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HM2010 Abstract Number: 216

The Trouble with Double: Clinical Implications of Double SVC

Case Presentation: A 20‐year‐old healthy female presented with history of dizziness for 1 year, with recent increase in frequency and duration. She had no vertigo and no aggravating or relieving factors. She denied any hearing [...]

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HM2010 Abstract Number: 217

Peripheral T‐Cell Lymphoma and Sutton's Law: The Need for Repeat Biopsies

Case Presentation: Mr. B is a 68‐year‐old man with a history of melanoma and histoplasmosis infection who presented with an enlarged, painful left inguinal lymph node. This dramatically increased in size over 2 months, prompting [...]

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HM2010 Abstract Number: 218

Diarrhea, Recurring Symptom Different Diagnosis

Case Presentation: A 57‐year‐old while female presented with 9 weeks of diarrhea and abdominal pain. She characterized her stools as large volume and nonbloody. She had noticed an associated 20‐pound weight loss. She denied recent [...]

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HM2010 Abstract Number: 219

HSV in Older Children

Case Presentation: This is a 2‐year‐old female who presented in status epilepticus with a fever. She had no previous history of seizures. She was stabilized and loaded with AEDs, and treated with empiric antibiotic therapy [...]

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HM2010 Abstract Number: 220

A Case of Alcoholic Cirrhosis in a Teetotaler

Case Presentation: An 82‐year‐old female with a history of hypertension and paroxysmal atrial fibrillation presented as a transfer to our institution She presented with fatigue, a 10‐pound weight loss, and right upper quadrant abdominal pain [...]

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HM2010 Abstract Number: 221

Same Disease, Different Service

Case Presentation: An 18‐year‐old woman presented with 4 weeks of constant, painless vaginal bleeding. She had had a normal spontaneous vaginal delivery that required anepisiotomy 4 months prior to presentation. She noted associated nausea, vomiting, [...]

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HM2010 Abstract Number: 222

Disfigurement Is More Than Skin Deep

Case Presentation: A 26‐year‐old man presented with 1‐month history of abscesses on his neck. He reported recurrent abscesses for 6 years, on his scalp and posterior neck. The lesions periodically enlarged and partially regressed, emitting [...]

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HM2010 Abstract Number: 223

Leukemia Cutis: Presentation of Acute Myeloid Leukemia Relapse

Case Presentation: A 49‐year‐old man presented with a diffuse, nontender, nonpruritic papular exanthem. He stated that it started on the chest and spread to his back and extremities. He has acute myeloid leukemia (AML), subtype [...]

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HM2010 Abstract Number: 224

Pure Seminoma with Associated Hypoglycemia

Case Presentation: A 39‐year‐old male with a PMH significant for infantile seizures and a 3‐year history of bilateral lower‐extremity edema presented with a 1‐day history of seizures. Patient noted a 1‐week history of right‐sided scrotal [...]

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HM2010 Abstract Number: 225

Abdominal Compartment Syndrome in an Open Abdomen: Case Report and Literature Review

Case Presentation: This 65‐year‐old man was transferred to the intensive care unit for acute shock on postoperative day 1 s/p laparotomy for ventral hernia mesh repair. Rapid intravenous fluid resuscitation was initiated, and central venous [...]

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HM2010 Abstract Number: 226

Sepsis and Pulse Pressure Variation: Dynamic Consequences

Case Presentation: An 83‐year‐old man was admitted to the hospital with suspected right upper load pneumonia. His physical exam and laboratory values were significant for a temperature of 38.4°C, a heart rate of 108, a [...]

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HM2010 Abstract Number: 227

Chemotherapy, Confusion, and a Concerning Creatinine

Case Presentation: A 68‐year‐old woman with non‐small cell lung cancer (NSCLC), diffuse large B‐cell lymphoma (DLBCL), and chronic renal insufficiency was admitted from the infusion center with confusion. Recently diagnosed with both NSCLC and DLBCL, [...]

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HM2010 Abstract Number: 228

Spontaneous Coronary Artery Dissection (SCAD): Often a Postmortem Diagnosis

Case Presentation: Spontaneous coronary artery dissection (SCAD) is a very rare cause of acute coronary syndrome in young otherwise healthy patients with a striking predilection for the female sex. We describe a patient who underwent [...]

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HM2010 Abstract Number: 229

Spare the Knife

Case Presentation: A 35‐year‐old man presented with 4 days of right leg pain secondary to a chronic ulcer. Though the ulcer on his shin had been present for 2 months, he recently noted the pain [...]

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HM2010 Abstract Number: 230

An Unusual Cause of a Common Complaint: Extensive Dural Venous Thrombosis Presenting as a Headache

Case Presentation: Dural venous thrombosis or cerebral vein thrombosis (CVT) is a rare but potentially fatal condition that can present as a severe headache and can be challenging to diagnose. A 46‐year‐old nonsmoking white female [...]

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HM2010 Abstract Number: 231

Spontaneous Intra‐Abdominal Hemorrhage: A Case Report

Case Presentation: A 34‐year‐old African American male with sickle cell trait and Gilbert's syndrome presented To Ihe emergency room with left‐sided, throbbing flank pain that radiated To the ipsilateral testicle. Four months ago, he underwent [...]

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HM2010 Abstract Number: 232

The Curse of Medusa — An Unusual Presentation

Case Presentation: We present a patient with massive cutaneous bleeding from a collateral site — Ihe caput medusa. A43‐year‐old man with history of alcoholic liver disease, Child‐Pugh class B, presented to the hospital with cutaneous [...]

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HM2010 Abstract Number: 233

An Abnormal Electrocardiogram That Is Shocking

Case Presentation: Our general medicine consultation service was asked to evaluate a 63‐year‐old woman who was admitted to the psychiatric ward with severe bipolar disorder. She initially presented with catatonia and severe depression. After undergoing [...]

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HM2010 Abstract Number: 234

Saved by the Hip

Case Presentation: A 73‐year‐old white male with well‐controlled hypertension, type 2 diabetes, osteoarthritis, and gout presented to our preoperative clinic in anticipation of undergoing left hip arthroplasty. The patient had experienced left hip and back [...]

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HM2010 Abstract Number: 235

What Lies Beneath…

Case Presentation: An 18‐year‐old African American male brought in by his guardian with chief complaints of bizarre behavior for 10 days. The patient had (not unusually) “disappeared” for several days with friends. However, he had [...]

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HM2010 Abstract Number: 236

When Good Drugs Go Bad

Case Presentation: A 60‐year‐old female presented with 5 days of abdominal pain and vomiting. She has diabetes treated with insulin and metformin. She noted malaise, poor oral intake, and decreased urination. Examination revealed an ill‐appearing [...]

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HM2010 Abstract Number: 237

A Painful Rash of Acute Onset

Case Presentation: A 47‐year‐old woman presented with 2 days of painful rash over her bilateral thighs and buttocks. Six days prior, ultrasonography had revealed bilateral lower‐extremity deep vein thrombosis, and she had received intravenous unfractionated [...]

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HM2010 Abstract Number: 238

A Rare Cause of Ascites: Malignant Peritoneal Mesothelioma

Case Presentation: A 70‐year‐old male with hypothyroidism, BPH, and alcohol dependence in the past presented to the hospital with a 3‐month history of weight loss (35 pounds), anorexia, and abdominal distention for 2 weeks. He [...]

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HM2010 Abstract Number: 239

Another Cause of RLQ Pain: Strangulated Internal Hernia

Case Presentation: A 77‐year‐old white male with no past medical or surgical history presented with 36 hours of progressive, nonradiating, abdominal pain. His pain started in Ihe epigastric region and moved to the right lower [...]

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HM2010 Abstract Number: 240

Can newborns Be Treated with Tamiflu?

Case Presentation: The baby girl was born at 34 and 3/7 weeks gestational age to a 21‐year‐old P0101 via C‐section secondary to chorioamnionitis and fetal tachycardia. Prior to delivery, the mother had flulike symptoms, highly [...]

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HM2010 Abstract Number: 241

Unusual Presentation with a Skin Rash

Case Presentation: A 27‐year‐old woman with an unremarkable past medical history consulted her doctor because of a sore throat and difficulty swallowing consistent with a viral illness. Symptoms improved over the next 2 days until [...]

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HM2010 Abstract Number: 242

Statin‐Induced Pancreatitis

Case Presentation: A 76‐year‐old woman presented with complaints of severe epigastric pain radiating to the back of 8 hours' duration. Her pain was associated with anorexia and was aggravated by food. There were no associated [...]

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HM2010 Abstract Number: 243

Membranous Nephropathy and IgA Deficiency

Case Presentation: A 54‐year‐old white woman presented with complaints of lower‐extremity (LE) swelling and significant joint discomfort. Her PMH was remarkable for IgA deficiency, recurrent sinus infections, and UTI. Her PSH included multiple sinus surgeries, [...]

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HM2010 Abstract Number: 244

A Case of Cognitive Decline, Psychosis, Hypoglycemia, and Hypoalbuminemia — Finding a Unifying Diagnosis

Case Presentation: A 30‐year‐old woman with history of obesity s/p gastric bypass 6 years ago presented for evaluation of hypoglycemia. Her initial day of hospitalization was for an elective calcium gluconate stimulalion study by interventional [...]

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HM2010 Abstract Number: 245

Parainfluenza Virus: Not Your Typical Atypical

Case Presentation: A 49‐year‐old man presented with a 1‐week history of fevers, shortness of breath, dry cough, and myalgia. At presentation, his temperature was 103, pulse was 107, and oxygen saturation was 83% on room [...]

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HM2010 Abstract Number: 246

Paralysis Following Bronchial Artery Embolization

Case Presentation: A 53‐year‐old male with fibrosing mediastinilis presents with a 1‐day history of cough and hemoptysis. His past medical history was significant for hypertension and fibrosing mediastinitis diagnosed in 2005. On exam, the patient [...]

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HM2010 Abstract Number: 247

Exercise‐Induced Rhabdomyolysis in an Athlete with Sickle Cell Trait

Case Presentation: A 30‐year‐old man African American with sickle cell trait presented to the ED with a complaint of lower back muscle spasms that began near the end of a basketball game earlier that day. [...]

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HM2010 Abstract Number: 248

“Cluck, Cluck … It's Stuck”: Esophageal Perforation by a Chicken Bone, Leading to Septic Thrombophlebitis of the Internal Jugular Vein

Case Presentation: A 90‐year‐old female with a history of Alzheimer's presented with a 1‐day history of fever and confusion. Initial blood pressure was 91/56, and temperature was 102.8°F. The patient was oriented but had difficulty [...]

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HM2010 Abstract Number: 249

The Right Heart, the Wrong Disease

Case Presentation: A 29‐year‐old presented with sudden onset of chest pressure associated with palpitations, dizziness, and shortness of breath. EMS found her obtunded and hypotensive. A wide‐complex QRS tachycardia was observed, leading to defibrillation. Her [...]

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HM2010 Abstract Number: 250

Sepsis of the Sea

Case Presentation: A 57‐year‐old presented with 1 week of worsening right lower‐extremity swelling and tendemess. He reported initially injuring his leg or a metal pot during a seafood boil. He did not seek medical care [...]

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HM2010 Abstract Number: 251

Rheumatoid Nodules of the Vocal Cords: A Case Report and Literature Review

Case Presentation: This is a 28‐year‐old female whose past medical history includes juvenile rbeumatoid arthritis, obstructive sleep apnea, hypertension, and congenital blindness. She has been hospitalized twice for evaluation of dyspnea on exertion despite using [...]

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HM2010 Abstract Number: 252

Bilateral Nonarteritic Ischemic Optic Neuropathy in the ICU

Case Presentation: A 66‐year‐old smoker, hypertensive, diabetic male was admitted to the ICU with MSSA pneumonia resulting in severe septic shock with ventilator‐dependent respiratory failure and multiple organ failure. Subsequently, he developed acute, painless, bilateral [...]

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HM2010 Abstract Number: 253

Cocaine Intoxication Mimicking Meningitis

Case Presentation: A 26‐year‐old woman was found unresponsive and surrounded by peritoneal dialysate. She was last known to be conscious 12 hours prior. Past medical history includes uncontrolled type I diabetes mellitus, hypertension, depression, schizoaffective [...]

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HM2010 Abstract Number: 254

Inflammatory Pseudotumor of the Liver Presenting in a Young Man with Fever and Abdominal Pain

Case Presentation: A 24‐year‐old man with no medical history presented with 2 weeks of intermittent night sweats and 2 days of crampy right upper quadrant abdominal pain without other associated symptoms. He denied any history [...]

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HM2010 Abstract Number: 255

Swallow‐Induced Symptomatic Atrioventricular Block

Case Presentation: A 52‐year‐old female was admitted for the evaluation of recurrent atypical chest pain. Outpatient nuclear stress testing had suggested modest but reversible ischemia. Past medical history includes PTSD, depression, anxiety, GERD, hypertension, and [...]

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HM2010 Abstract Number: 256

Massive Hemolysis as Initial Indication of Clostridium perfingens Septicemia

Case Presentation: An 85‐year‐old female with complaint of pain located below her right costal margin described as severe, intermittent, and radiating down both legs. This was associated with nausea, vomiting, and diaphoresis. She reported 6 [...]

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HM2010 Abstract Number: 257

Sigmoid Sinus and Jugular Venous Thrombosis Complicating Pharyngitis

Case Presentation: A 27‐year‐old female day‐care worker with a history of childhood tonsillectomy noted fever, sore throat, and right ear pain for 1 week. Two days before admission she developed pain involving the right side [...]

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HM2010 Abstract Number: 258

Right Atrial Compression and Hemodynamic Instability from Diaphragmatic Eventration

Case Presentation: A 53‐year‐old man was transferred to our hospital for renal failure, uremic encephalopathy, and septic shock. The patient had recently become reclusive and family reported 3‐4 weeks of nausea, vomiting, and diarrhea without [...]

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HM2010 Abstract Number: 259

Left Subclavian Artery Stenosis as a Cause of Non‐ST‐Elevation Myocardial Infarction in a Patient with Previous Coronary Artery Bypass Graft: Coronary Subclavian Steal Syndrome

Case Presentation: A 57‐year‐old female presented in the emergency department with dyspnea and sharp chest pain radiating to the left shoulder. The pain was associaled with use of her left arm. She had a history [...]

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HM2010 Abstract Number: 260

Severe Malaria

Case Presentation: A 56‐year‐old Nigerian female presented to the ED with 2 weeks of malaise, anorexia, and nausea. At the symptoms onset, she had returned from a month‐long trip to Nigeria to visit friends and [...]

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HM2010 Abstract Number: 261

Without Due Vigilance, Occam's Razor Can Cut You

Case Presentation: A 28‐year‐old with a supratentorial primitive neuroectodermal tumor treated with resection and chemutlkerepy was admitted for a thigh wound. She had recently been hospitelized for declining mental slatus and was found to have [...]

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HM2010 Abstract Number: 262

The Common Presentation Is Not Classic

Case Presentation: A 20‐year‐old previously healthy man presented with 1 month of lower back pain. He noted a 30‐pound weight loss, night sweats, fatigue, and bleeding from the gums over the same time period. He [...]

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HM2010 Abstract Number: 263

The Gift That Keeps on Taking

Case Presentation: A 23‐year‐old woman with history of hemoglobin SS disease presented with 4 days of sharp, right‐sided chest and back pain She was afebrile with clear lungs on exam and with CXR devoid of [...]

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HM2010 Abstract Number: 264

When Plasmapheresis Fails

Case Presentation: A 57‐year‐old Hispanic male presented with altered mental status associated with progressive weakness over the preceding 2 months. On admission, he was found to have hypercalcemia, thrombocytopenia, hemolytic anemia and acute renal failure [...]

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HM2010 Abstract Number: 265

Oseltamivir Toxicity in a Hemodialysis Patient

Case Presentation: Our patient is a 45‐year‐old female with a history of systemic lupus erythematosus and end‐stage renal disease requiring hemodialysis (HD) who was admitted to the hospital from her dialysis center after being found [...]

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HM2010 Abstract Number: 266

Purple Glove Syndrome; A Case Report and Review of the Literature

Case Presentation: A 69‐year‐old white female was seen by the rheumatology service at the request of the vascular service, regarding bilateral hand edema and severe pain. Two days previously, the patient had been made NPO [...]

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HM2010 Abstract Number: 267

Recurrent Bacterial Infection, Renal Failure, and Anemia on a 10‐Year History of Monoclonal Gammopathy: Symptomatic Myeloma but for Red Cell Casts

Case Presentation: A 79‐year‐old woman with longstanding MGUS presented to her primary MD with fatigue and was found to have anemia and renal failure. She was sent to the emergency department, where she was found [...]

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HM2010 Abstract Number: 268

A Keen Eye on “Sweet Urine“: Fanconi‐Like Syndrome Related to Ifosfamide

Case Presentation: A 58‐year‐old male with history of extraskeletal osteosarcoma treated with left nephrectomy, splenectomy, and partial resection of stomach, pancreas, and colon was admitted for febrile neutropenia. History was remarkable for recent chemotherapy treatment [...]

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HM2010 Abstract Number: 269

Paget‐Schroetter Syndrome: A Common but Forgotten Entity

Case Presentation: A 36‐year‐old healthy male presented with a 6‐hour onset of pain, swelling, and purplish discoloration of the left upper extremity after lifting weights at the gym. He denied any trauma to the shoulder [...]

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HM2010 Abstract Number: 270

Isolated Pulmonic Valve Endocarditis: Missed Opportunities

Case Presentation: A 58‐year‐old man was admitted with a 5‐day history of shortness of breath, cough, and weakness. His medical history was remarkable for an 8‐month course of recurrent pneumonia and intermittent fevers He had [...]

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HM2010 Abstract Number: 271

Mollaret's Meningitis, 65 Years of History: A Case Report and Review of the Literature

Case Presentation: A 57 year‐old woman presented for a headache and nausea for 2 weeks. PMH was significant for depression, SLE controlled on no treatment, and previous episodes of aseptic meningitis. Vitals were stable, and [...]

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HM2010 Abstract Number: 272

Weissetia confusa Bacteremia in a Liver Transplant Patient with Hepatic Artery Thrombosis

Case Presentation: A 54‐year‐old man with a history of nonalcoholic steatohepatitis and hepatocellular carcinoma presented 2 months after an orthotopic liver transplant with fever and abdominal pain. Two weeks prior he had a hepatic artery [...]

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HM2010 Abstract Number: 273

Lemon Juice and Vision Loss in an Intravenous Drug User

Case Presentation: A 28‐year‐old previously healthy female with a history of intravenous drug abuse (IVDA) was referred to our hospital after 2 days of progressively worsening right monocular vision loss. Three days prior to symptom [...]

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HM2010 Abstract Number: 274

Cutaneous Causes of Weakness

Case Presentation: A48‐year‐old woman was admitted to the hospital with shortness of breath and generalized weakness. She noted 3 months of a progressive weakness, and the recent onset of progressive eyelid swelling. She also noted [...]

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HM2010 Abstract Number: 275

A Granulomatous Effusion

Case Presentation: A 30‐year‐old woman presented with 1 month of progressively worsening dyspnea on exertion. Her exercise tolerance had decreased; she could barely take a few steps or even pick up her 6‐month old child. [...]

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HM2010 Abstract Number: 276

Radiculopathy of Disseminated Lyme Disease Masked by Cervical Spondylosis 276

Case Presentation: An 82‐year‐old man with cervical spondylosis presented to his PCP in mid‐August for acute neck pain with radiation to the hghl arm. The patient was treated for similar pain with steroid injections in [...]

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HM2010 Abstract Number: 277

A Teen with Varices: An Uncommon Presentation of a Familiar Disease

Case Presentation: A 16‐year‐old female lifeguard presented with a 2‐day history of black stools, diarrhea, abdominal pain, and lightheadedness. She noted easy bruising and frequent nosebleeds but denied fever, nausea, vomiting, or respiratory symptoms. In [...]

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HM2010 Abstract Number: 278

A Case of Chronic Fevers in a Peripatetic Patient

Case Presentation: A 73‐year‐old white male with a PMH of hypertension presented with a 5‐ to 6‐month history of intermittent fevers. During the initial onset he noted low‐grade fevers which progressed to range from 101°F [...]

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HM2010 Abstract Number: 279

Looking at the Wrong Head: Different Strokes for Fasting Folks

Case Presentation: A 38‐year‐old right‐handed male presented with a chief complaint of slurred speech and difficulty ambulating. He had similar symptoms the previous day which resolved spontaneously over a few hours. On admission, all other [...]

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HM2010 Abstract Number: 280

Fever, Rash, and Acute Renal Failure: Making of a Perfect Storm

Case Presentation: A 66‐year‐old male with a PMH of Charcot‐Marie‐Tooth disease and asbestosis presented with a 7‐day history of bilateral leg swelling with a painful rash. The patient also gave a history of having an [...]

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HM2010 Abstract Number: 281

Unusual Presentation of Cryptococcal Meningitis

Case Presentation: A 67‐year‐old male with metastatic colon cancer on treatment with irinotecan and bevacizumab presented with failure to thrive and ongoing weight loss not amenable to nutritional interventions. He denied headache, fever, chills, night [...]

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HM2010 Abstract Number: 282

Is There Lung Disease in the Rheum?

Case Presentation: A 37‐year‐old nonsmoking female with a history of Raynaud symptoms presented to our hospital with 3 months of fatigue, progressive shortness of breath, and a painful, pruritic rash over her trunk and proximal [...]

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HM2010 Abstract Number: 283

Medical Futility and Unilateral DNR

Case Presentation: A 84‐year‐old male with a history of seizure disorder and in persistent vegetative state presented with recurrent UTI. Ultrasound of testis, performed in view of scrotal swelling, revealed marked bilateral scrotal edema with [...]

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HM2010 Abstract Number: 284

A Case of Fungus Ball in the Brain

Case Presentation: A 37‐year‐old nondiabetic Hispanic male with past medical history of seizure disorder and intravenous drug abuse (IVDA) was brought to the hospital with altered mental status. For the past 2 days, he had [...]

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HM2010 Abstract Number: 285

Recurrent Life‐Threatening Hyperkalemia without Electrocardiographic Changes

Case Presentation: We report a case of profound recurrent hyperkalemia with no associated EKG changes in an 84‐year‐old female patient with normal baseline renal functions. Her past medical history was significant for hypertension, CHF, pulmonary [...]

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HM2010 Abstract Number: 286

Acute Purulent Pericarditis Presenting as Cardiac Tamponade: An Unusual Complication of Pneumococcal Pneumonia in the Postantibiotic Era

Case Presentation: A 56‐year‐old female with a history of arthritis initially presented to the emergency room (ER) with progressive weakness, dyspnea, and chest pain. She also reported recent fever and cough, which had resolved spontaneously. [...]

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HM2010 Abstract Number: 287

Challenging Diagnosis, Amazing Recovery

Case Presentation: A 57‐year‐old female with history of stage IVB diffuse large B‐cell lymphoma presented to the emergency department 11 weeks postchemotherapy with altered mental status. Symptoms included confusion, “staring“ episodes, imbalance, and loss of [...]

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HM2010 Abstract Number: 288

An Unexpected Cause of Seizure Recrudescence

Case Presentation: A 43‐year‐old female with a history of epilepsy presented after a witnessed seizure. The patient had been seizure free for more than 15 years and had been taking her medications as prescribed. In [...]

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HM2010 Abstract Number: 289

Intraabdominal Complication of Gastric Sclerotherapy

Case Presentation: A 51‐year‐old man presented with massive, persistent bright red hemalemesis requiring endotracheal intubation. History was only significant for surgically treated intestinal malrotation in the remote past. He denied alcohol consumption, peptic ulcer disease, [...]

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HM2010 Abstract Number: 290

Cerebral Venous Thrombosis in Ulcerative Colitis — A Rare Cause of Headache

Case Presentation: A 24‐year‐old white man presented with a 1‐month history of progressively worsening headache and blurred vision. He also reported a 27‐kg weight loss and persistent diarrhea with hematochezia in the previous 6 months [...]

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HM2010 Abstract Number: 291

Lymphadenopathy in IBD: Think Outside the Box

Case Presentation: A 55‐year‐old male with a history of ulcerative colitis (UC) presented with left‐sided abdominal pain associated with nausea and vomiting. He denied associated diarrhea, hematochezia, melena, fevers or chills. His UC was well [...]

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HM2010 Abstract Number: 292

Cardiac Arrest from Common Drugs: Combination of Fluconazole and Ondansetron Leading to Torsades de Pointes

Case Presentation: A 64‐year‐old female with Hirschsprung disease was admitted to our hospital with fever and chills. She has history of multiple bowel surgeries and ileostomy with short bowel syndrome requiring TPN through a Hickman [...]

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HM2010 Abstract Number: 293

The Presence of One Should Suspect Another

Case Presentation: A 44‐year‐old woman presented with 1 week of headaches and blurry vision. She complained of unsteady gait, weakness, fatigue, diarrhea, subjective fevers, rash, and lip and neck swelling. She noted a history of [...]

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HM2010 Abstract Number: 294

Nonsecretory Multiple Myeloma: An Elusive Malignancy!

Case Presentation: A previously healthy 57‐year‐old African American man was admitted to the hospital with pain in the left hip and the epigastrium. He admitted to a 30‐pound weight loss over the preceding 6 months. [...]

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HM2010 Abstract Number: 295

Community‐Acquired Acinetobacter Sepsis Heralding Acute Myeloid Leukemia

Case Presentation: A previously healthy 37‐year‐old white woman was initially admitted to the hospital with fever, nausea, and vomiting of 2 days' duration. At admission, her blood pressure was 94/60, and temperature was 102°F. Laboratory [...]

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HM2010 Abstract Number: 296

Splenic Abscess — A Rare But Lethal Disease

Case Presentation: An active 83‐year‐old white female presented to Ihe emergency department (ED) with fever rigors and dyspnea for 1 day. The patient was discharged home about 5 days prior to presentation for right leg [...]

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HM2010 Abstract Number: 297

Not Every Unilateral Weakness Is Stroke

Case Presentation: A 47‐year‐old male white male with no significant past medical history presented with sudden onset of severe shortness of breath, diaphoresis, global amnesia, and weakness and paresthesia of the left upper extremity, which [...]

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HM2010 Abstract Number: 298

Intermittent Change in Voice — An Unusual Presentation

Case Presentation: A 69‐year‐old female was admitted with generalized weakness, hoarseness, and shortness of breath. She was initially treated as an acute asthma exacerbation. Her past medical history included asthma, type II diabetes mellitus, hypertension, [...]

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HM2010 Abstract Number: 299

Diffuse Idiopathic Skeletal Hyperostosis (DISH) — A Rare Etiology of Dysphagia

Case Presentation: A 72‐year‐old man with coronary artery disease, atrial fibrillation, hypertension, gout, and obstructive sleep apnea presented to the hospital with progressively worsening dysphagia to soft foods and liquids for a few days. He [...]

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HM2010 Abstract Number: 300

Can't See, Can't Pee, Can't Stand Like Me

Case Presentation: A 47‐year‐old Taiwanese male without significant past medical history presented with complaints of dizziness, decreased urination, and diarrhea. On exam he was noted to be markedly orthostatic. The abdomen was slightly distended. After [...]

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HM2010 Abstract Number: 301

A Rare Cause of Rectal Pain

Case Presentation: A 64‐year‐old male without a significant past medical history presented with a complaint of rectal pain. The pain was worse with bowel movements, and as a result the patient reported a fear of [...]

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HM2010 Abstract Number: 302

Flying under the Radar: Community‐Acquired Methicillin‐Resistant Staphylococcus Aureus Necrotizing Pneumonia in HIV Patients

Case Presentation: A 54‐year‐old man with HIV presented with 2 weeks of flulike illness and 1 day of fever, dyspnea, and pleuritic chest pain. He had a recent CD4 count of 385/mm3, an undetectable viral [...]

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HM2010 Abstract Number: 303

Tuberculosis‐Associated Immune Reconstruction Inflammatory Syndrome in a Non‐HIV Patient

Case Presentation: A 57‐year‐old man presented to the ED with a 5‐month history of persistent fever and weight loss. His past medical history was notable for pulmonary TB, which was partially treated with para‐aminosalicylic acid. [...]

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HM2010 Abstract Number: 304

It Came Out in the End: An Unusual Cause of Infectious Peritonitis

Case Presentation: A 34‐year‐old man with end‐stage renal disease on hemodialysis and cirrhosis presented with 2 months of progressive abdominal distension and diffuse pain. He denied fever and had an otherwise negative review of symptoms. [...]

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HM2010 Abstract Number: 305

There Will Be Blood

Case Presentation: A 76‐year‐old man presented with 10 days of persistent hematuria and lower abdominal pain. He also complained of fatigue and dyspnea on exertion. He denied dysuria, flank pain, or recent trauma. His vital [...]

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HM2010 Abstract Number: 306

A Case of Aortic Dissection That Was Nearly Missed

Case Presentation: The patient is a 66‐year‐old man who was at work discussing a project with his colleagues when he had a sudden feeling of warmth and weakness come up from his legs toward his [...]

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HM2010 Abstract Number: 307

Intussusception… Or Was It?

Case Presentation: A 7‐monlh‐old African American male presented to the ED with a 3 day history of vomiting. Emesis was initially nonbilious but had become bilious in the past 24 hours. ROS was noted for [...]

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HM2010 Abstract Number: 308

A Different Colored Pneumonia

Case Presentation: A 56‐year‐old woman presented with 2 days of shortness of breath, cough, and fatigue. She denied sick contacts, chest pain, orthopnea, or extremity swelling. Her only change in daily routine was spending the [...]

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HM2010 Abstract Number: 309

Pulmonary Renal Syndrome from Hyrjralazine‐lnduced ANCA‐Positive Vasculitis

Case Presentation: A previously active 91‐year‐old woman with a history of hypertension presented with fatigue and a 12‐pound weight loss over 3 months. Initial evaluation was notable for acute renal failure, anemia, and an E. [...]

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HM2010 Abstract Number: 310

An Unusual Cause of Chest Pain: Mycobacterium avium Complex and Immune Reconstitution Inflammatory Syndrome

Case Presentation: A 53‐year‐old man with an 11‐year history of HIV and medication noncompliance was evaluated for intermittent chest pain of 5 days. Three months before admission, he developed MRSA skin abscesses and was found [...]

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HM2010 Abstract Number: 311

Rothia Mucilaginosa Bacteremia: A Case Report

Case Presentation: This is a 64‐year‐old man who presented with a tender, swollen, red left elbow. He reported no subjective levers. He had exfoliated the skin on his elbow using a stainless steel file. He [...]

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HM2010 Abstract Number: 312

High‐Output Heart Failure in a Patient with Exfoliative Erythrodermic Psoriasis

Case Presentation: The patient is a 53‐year‐old female with a past medical history of psoriasis on methotrexate and pulmonary hypertension who presented with worsening psoriasis for several weeks with the appearance of erythroderma involving her [...]

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HM2010 Abstract Number: 3

Optic Atrophy: An Obscure Case of Neurosyphilis

Case Presentation: A 65‐year‐old man with past medical history significant for diverticulosis and irritable bowel syndrome presents with complaints of decreased visual acuity. He reported that his vision had been deteriorating for several months, and [...]

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HM2010 Abstract Number: 314

Pulmonary Artery Sarcoma Mimicking Pulmonary Embolism

Case Presentation: Pulmonary artery sarcoma (PAS) is a rare tumor of the cardiovascular system Proper diagnosis can be a great challenge because clinical and radiological features are commonly indistinguishable from acute or chronic pulmonary embolism [...]

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HM2010 Abstract Number: 315

Niacin and Vitamin C Deficiency in Sjogren's Syndrome: The Forgotten Diagnosis

Case Presentation: A 51‐year‐old female who had previous multiple hospitalization for altered mental status and persistent diarrhea was admitted with complaint of twitching sensation on right side of her face and arm. Her past medical [...]

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HM2010 Abstract Number: 316

“Make It Stop!“: A Rare Cause of Profuse Diarrhea

Case Presentation: A 45‐year‐old male was transferred from an outside hospital for evaluation of chronic diarrhea of unclear etiology. He had 6 weeks of profuse, painless, watery diarrbea up to 6L/day at its peak, associated [...]

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HM2010 Abstract Number: 317

The Forgotten “P“ in MUDPILES

Case Presentation: A 27‐year‐old woman, marginally housed, with a history of recreational carisoprodol (Soma) and acetaminophen (APAP)/hydrocodone use presented with abdominal pain and malaise. On physical exam, she was tachycardic and somnolent. Abdomen was soft [...]

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HM2010 Abstract Number: 318

Cannot Swallow and Losing Weight — What Next …

Case Presentation: A 19‐year‐old African American male presented with 50‐pound of weight loss and poor appetite for 2 months. He reported difficulty in swallowing both solids and liquids. He experienced anterior and lower chest pain [...]

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HM2010 Abstract Number: 319

An Uncommon Etiology of Emphysematous Pyelonephritis

Case Presentation: A 40‐year‐old man with autoimmune hemolytic anemia status postsplenectomy was admitted 1 month ago for salmonella bacteremia and acalculous cholecystitis. His course has been complicated by transfusion‐dependent hemolytic anemia requiring plasmapheresis and acute [...]

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HM2010 Abstract Number: 320

Baby Takes a Bite: Toxic Shock Syndrome from Mastitis

Case Presentation: A 33‐year‐old G1P1 breastfeeding woman was admitted for hypotension and rash 3 days after suslaining a possible infant bite to the right nipple. She developed pain followed by expanding skin breakdown and erythema [...]

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HM2010 Abstract Number: 321

To Fall Perchance to Sleep

Case Presentation: A 70‐year‐old woman with a history of emphysema and recurrent deep venous thrombosis was admitted to the hospital with dysuria and acute renal failure. Physical exam was notable for mild fluid overload, and [...]

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HM2010 Abstract Number: 322

Unusual Presentation of Gouty Arthrittis

Case Presentation: Gout is a crystalline arthropathy characterized by the deposition of urate crystals in joints. Typically, it involves the first metatarsophalangeal joint (podagra), ankle, or knee joint, although other joints may be affected. Gout [...]

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HM2010 Abstract Number: 323

A Delirious Heart: QT Prolongation from Acute Alcohol Withdrawal

Case Presentation: A 35‐year‐old male was admitted for change in mental status. Past medical history was unremarkable, and he was not on any medications. Exam was significant for an awake but combative patient with incoherent [...]

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HM2010 Abstract Number: 324

Complex Regional Pain Syndrome

Case Presentation: A 26‐year‐old white female with a past medical history of right patellar fracture that was surgically corrected with fixation in 2006 fell on her right knee 1 month prior To presenting to the [...]

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HM2010 Abstract Number: 326

Troponin Alarm in a Patient with Hereditary Amyloid Cardiomyopathy

Case Presentation: A 73‐year‐old African American male with history of TIA, atrial fibrillation on Coumadin, CHF, and HTN presented with acute onset of left facial paralysis, dysarthria, and confusion. Symptoms resolved by ED evaluation. Physical [...]

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HM2010 Abstract Number: 327

An Uncommon Manifestation of Wegener's Granulomatosis with Genitourinary Disease

Case Presentation: A 34‐year‐old man, originally from India, presented with 6 months of polyarthralgias, sinusitis, episcleritis, intermittent hearing loss, and microscopic hematuria. He had signs of acute on chronic sinusitis and bilateral ground‐glass iung opacities [...]

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HM2010 Abstract Number: 328

Narrow‐Complex Tachycardia: An Unusual Cause of Acquired Hemiplegia in Childhood

Case Presentation: A previously healthy 2‐year‐old Asian girl presented on day of admission with left upper‐ and lower‐extremity weakness and facial droop. On arrival to ER her exam was benign except for: HR 260. dysarthria, [...]

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HM2010 Abstract Number: 329

Ferritin Can 'Still' Be Used for Diagnosis!

Case Presentation: A 44‐year‐old previously healthy male presented with 3 weeks of severe sore throat, spiking fevers up to 103F, chills, and night sweats. A course of amoxicillin for presumed strep throat had failed. He [...]

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HM2010 Abstract Number: 330

Back to Basics: Remembering Gray's Anatomy

Case Presentation: A 78‐year‐old male presented for a second opinion of 4 months of recurrent nausea, vomiting, and abdominal cramping with an inability to tolerate solid foods. He had early satiety and abdominal distension with [...]

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HM2010 Abstract Number: 331

Sudden Cardiac Death from Takotsubo Cardiomyopathy Triggered by Acute Pancreatitis

Case Presentation: A 70‐year‐old woman developed sudden‐onset right upper quadrant pain that woke her up from sleep. She lost consciousness and was found to be pulseless by EMS. Cardiopulmonary resuscitation was performed, and she was [...]

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HM2010 Abstract Number: 332

Interdisciplinary Problem Solving: Including Lawyers on the Health Care Team

Case Presentation: A 10‐year‐old African American girl known to have asthma and followed by her pediatrician for The disease presenTed To our emergency department (ED) in January with an acute exacerbation of asthma. After appropriate [...]

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HM2010 Abstract Number: 333

Lessons Learned from Delayed Diagnosis

Case Presentation: The patient was a 71‐year‐old Indian businessman with a history of coronary artery disease, diabetes, and hypertension who presents with weakness. Three days PTA, the patient flew from Bombay to San Francisco, where [...]

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HM2010 Abstract Number: 334

To Bleed or Not to Bleed: What Is the Factor?

Case Presentation: An SQ‐year‐old man sustained a large retroperitoneal bleed after a fall. He required transfusion of 13 units of packed red blood cells for continued bleeding. He was found to have an isolated elevation [...]

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HM2010 Abstract Number: 335

An Unususal Presentation of Sarcoidosis as Ascites

Case Presentation: We report an unusual case of a Pakistani housewife admitted for refractory ascites, fever, weight loss, and fatigue and found to have granulomatous hepatitis secondary to sarcoidosis. A 36‐year‐old woman was admitted to [...]

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HM2010 Abstract Number: 336

Unsuspected Pulmonary Embolism: A Bayesian Approach

Case Presentation: We will discuss a case of unsuspected pulmonary embolism (UPE) to provide a framework for clinicians when approaching This newly encountered diagnosis. A 56‐year‐old female presented to our level 1 trauma center after [...]

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HM2010 Abstract Number: 337

Surreptitious Takayasu's Arteritis in a Young African American Male with Ulcerative Colitis

Case Presentation: A 20‐year‐old African American male presented to the hospital for recurrent episodes of severe, diffuse crampy abdominal pain, fatigue, anorexia, vomiting, watery diarrhea, and a 20‐pound weight loss over 2 months. Although he [...]

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HM2010 Abstract Number: 338

A Case of Symptomatic Bradycardia from Amlodipine

Case Presentation: A 42‐year‐old white woman with a past medical history of hypertension was referred to cardiology for symptomatic bradyar rhythmia. She complained of a 1‐month history of dizziness, confusion, and generalized fatigue. She denied [...]

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HM2010 Abstract Number: 339

Abhtrophia defectiva Endocarditis Presenting as Leukocytoclastic Vasculitis

Case Presentation: This is case of a 64‐year‐old male who presented to the rheumatologists office with a lower‐extremity purpuric skin rash. His past medical history included porcine mitral valve replacement 3 years ago for subacute [...]

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HM2010 Abstract Number: 340

Thinking Outside the Box

Case Presentation: A functionally independent 74‐year‐old female, resident of New England, presented with altered mental stalus for 2‐3 weeks. She had a history of diabetes and poorly controlled hypertension (HTN). One month ago she had [...]

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HM2010 Abstract Number: 341

A Wolf in Sheep's Clothing: Acute Epiglottitis in an Adult Patient

Case Presentation: Acule epiglottitis is potentially fatal as it can cause sudden airway obstruction. With an infrequent occurrence in adults, it is underrecognized and misdiagnosed often. We report an adult patient with acute epiglottitis who [...]

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HM2010 Abstract Number: 342

Quicksilver; Is Your Diagnostic “Mettle' Spot On with This CXR Diagnosis?

Case Presentation: A 43‐year‐old man with a history of remote IV drug use, alcoholism, and heavy tobacco use presented to the ER after a car accident complaining of dyspnea and a cough productive of mucopurulent [...]

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HM2010 Abstract Number: 343

Fatal Pulmonary Nocardiosis in a Steroid‐Dependent Patient: The Role of Hypercortisolemia and Reduced Infection Clearance

Case Presentation: A 62‐year‐old man was admitted for fever, dyspnea, cough, and hemoptysis for the past 4 months. His past medical history was notable for chronic lymphocytic leukemia and COPD (controlled with oral steroids). He [...]

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HM2010 Abstract Number: 344

No Big DIL

Case Presentation: A 77‐year‐old woman presented with 2 episodes of severe back and leg pain. The patient had recently had hand swelling and a rash but no other complaints. Physical examination was noteworthy for a [...]

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HM2010 Abstract Number: 345

An Unusual Case of Thromboembolism

Case Presentation: A 48‐year‐old white female with no previous chronic disease presented with a 2‐week history of constitutional symptoms including fever, rhinorrhea, and malaise. After failure of the initial therapeutic trials, she underwent a complete [...]

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HM2010 Abstract Number: 346

Perfection Can Be the Enemy of the Good

Case Presentation: A 53‐year‐old woman presented with right arm numbness extending from the shoulder to the fingertips. She was taking a shower when she had difficulty raising her arm. The numbness and weakness spontaneously resolved [...]

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HM2010 Abstract Number: 347

Isolated Bowel Ulcer in a Young Patient: What Could Be the Cause?

Case Presentation: A 44‐year‐old man was admitted to the hospital for workup of recurrent localized sharp left‐sided abdominal pain associated with frequent loose stools for a year's duration. There was remote few rectal bleeding and [...]

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HM2010 Abstract Number: 348

The Lesions Are Skin Deep

Case Presentation: A 51‐year‐old male with history of diastolic heart failure, hypertension, MRSA bacteremia, and schizophrenia presented with desquamation of the skin that was initially a diffuse, pustular dermatitis of the body sparing the genitalia [...]

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HM2010 Abstract Number: 349

Submassive Acute Pulmonary Embolism with Acute Pulmonary Hypertension and Right Ventricular Dysfunction: A Case Report

Case Presentation: An 88‐year‐old female with hypertension and no prior pulmonary disease presented with acute onset of dyspnea on exertion and chest discomfort. CT angiogram showed multiple acute pulmonary emboli as well as several chronic [...]

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HM2010 Abstract Number: 350

Discharge‐a‐Doozi; An Ethical Quagmire

Case Presentation: John Doe (J.D.) is a 61‐year‐old undocumented man of African descent with no previous medical care admitted to our institution with renal failure and acute onset of bilateral lower‐extremity weakness. He was diagnosed [...]

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HM2010 Abstract Number: 351

An Unusual Presentation of Systemic Sclerosis

Case Presentation: Scleroderma encompasses a spectrum of related disorders, most of which share a characteristic clinical feature of skin thickening due to an excess of collagen fiber deposition. Serologic testing is helpful in confirming, but [...]

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HM2010 Abstract Number: 352

Emphysematous Gastritis — An Unusual Cause of Septic Shock

Case Presentation: Emphysematous gastritis is a rare condition characterized by the presence of air in the wall of stomach because of invasion of gas forming organisms with mortality rates as high as 80%. We present [...]

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HM2010 Abstract Number: 353

Celiac Disease —Tip of the Iceberg!

Case Presentation: A 35‐year‐old white man with a past history significant for gastroesophageal reflux disease presented with a 1‐year history of unexplained arthralgias and a 2‐day history of hematochezia. His hematochezia was thought to be [...]

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HM2010 Abstract Number: 354

No Inflamation Means Reoccurrence

Case Presentation: A 47‐year‐old man with hypertension and depression presented with 2 weeks of right‐sided photophobia and retro‐orbital pain described as constant with increasing intensity over the last 4 days. Several days prior, the patient [...]

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HM2010 Abstract Number: 355

A Malignant Imitator in a Patient with HIV Infection

Case Presentation: A 53‐year‐old male with HIV (CD4 170 and VL 39,000) sought evaluation for excruciatingly painful perirectal sores and a new nodular rash covering his body. A few months prior he had been diagnosed [...]

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HM2010 Abstract Number: 356

Staying the Course

Case Presentation: A 51‐year‐old man presented with a 1‐week history of back pain and fevers. He attributed the back pain to heavy lifting at his new job, but did not have an explanation for the [...]

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HM2010 Abstract Number: 357

FUO by an Unusual Suspect

Case Presentation: T.P. is an 18‐year‐old male with a past medical history significant for the recent onset of seizures who presented to his Pediatrician with a 2 week history of fever, right cervical lymphadenopathy, headaches, [...]

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HM2010 Abstract Number: 358

Homophagocytic Syndrome: A Case Report and Literature Review

Case Presentation: This is a 24‐year‐old man of Filipino descent with no significant past medical history who presented with a 10‐day history of fever, chills, anorexia, and fatigue. He decided to seek medical attention after [...]

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HM2010 Abstract Number: 359

Catastrophic Antiphospholipid Antibody Syndrome in a Woman with Recent Renal Transplant

Case Presentation: A 50‐year‐old woman with a history of systemic lupus erythematosus, HIT, antiphospholipid antibody syndrome (APAS), s/p renal transplant, was admitted for urosepsis and severe left leg and back pain. Treatment included IV antibiotics [...]

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HM2010 Abstract Number: 360

Syncope after Treatment for Abdominal Pain

Case Presentation: A 78‐year‐old man presented with 3 days of fever and intermittent, diffuse abdominal pain. He also reported loose stools and decreased appetite. He had a history of coronary artery disease, atrial fibrillation, syncope, [...]

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HM2010 Abstract Number: 361

Bilateral Adrenal Hemorrhage from Prophylactic Subcutaneous Low‐Molecular‐Weight Heparin Injections

Case Presentation: A 59‐year‐old male with a history of quiescent ITP with normal platelet counts, anxiety, and autoimmune pernicious anemia presented to the ER on postoperative day 19 from a total knee arthroplasty with weakness [...]

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HM2010 Abstract Number: 362

Septic … But What Is the Source?

Case Presentation: A 35‐year‐old woman presented to the emergency room with nausea, vomiting and abdominal pain of 3 days duration. Her initial blood systolic blood pressure was 50. Her physical exam was normal other than [...]

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HM2010 Abstract Number: 363

An Unusual Presentation of Patent Foramen Ovale

Case Presentation: A 51‐year‐old female with no significant past medical history presented with a 1‐week history of left‐sided abdominal pain. The patient was aferile and physical exam revealed mild diffuse abdominal tenderness. Laboratory data were [...]

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HM2010 Abstract Number: 364

Bilateral Renal Infarction: A Case Report and Literature Review

Case Presentation: A 34‐year‐old female with a history of MVP, 2 weeks postpartum, presented with left flank pain associated with nausea and vomiting. She did not take any medications and denied smoking or drug use. [...]

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HM2010 Abstract Number: 365

Hypokalemia and Chronic Diarrhea Presenting as Gastrinoma: The Role of Endoscopic Ultrasound (EUS)–Guided Fine‐Needle Aspiration (FNA) in the Preoperative Diagnosis

Case Presentation: A 47‐year‐old male with a history of chronic diarrhea for 10 years presented with diarrhea and hypokalemia. Potassium was 2.4 mEq/L. Further workup was negative for malabsorption or infectious causes of diarrhea. Stool [...]

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HM2010 Abstract Number: 366

A 42‐Year‐Old Woman with Recurrent Pneumothoraces and Dyspnea

Case Presentation: A 42‐year‐old woman with a history of asthma presented to her primary care physician with acute onsel of shortness of breath, chest discomfort and productive cough. She was diagnosed with bronchitis, but with [...]

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HM2010 Abstract Number: 367

Malignant Disease without a Statue of Limitations

Case Presentation: A 42‐year‐old man presented with 4 months of intractable nausea, vomiting, and a twenty‐pound weight loss. He noted no recent travel, and he had no tuberculosis risk factors. Outpatient attempts at antiemetic therapy [...]

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HM2010 Abstract Number: 368

Cholangiocarcinoma with Bilateral Retinal Detachments: A Case Report and Literature Review

Case Presentation: A 69‐year‐old white female presented with a 5‐week history of fatigue, myalgias, low‐grade fevers, increasing abdominal girth, concurrent hearing loss with bilateral serous otitis media diagnosed 3 days prior by otolaryngology, and 10 [...]

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HM2010 Abstract Number: 369

All ST Elevations Are Not Infarctions

Case Presentation: A 67‐year‐old African American male presented to another hospital with COPD exacerbation. His medical history included chronic obstructive pulmonary disease (COPD), hypertension, and hypercholesterolemia. He was treated with albuterol, ipratropium nebulizer, and intravenous [...]

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HM2010 Abstract Number: 370

Venous Air Embolism: A Potential Life‐or‐Death Situation

Case Presentation: This case is of a 92‐year‐old man who was admitted to the hospital following a syncopal episode. He was apparently found lying down for 1‐5 minutes and was nol able to recall anything [...]

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HM2010 Abstract Number: 371

The Enemy Within

Case Presentation: A 35‐year‐old woman presented with 1 month of fever and diarrhea. She had been diagnosed with HIV 1 year earlier with a current CD4 count of 22/mm3. She was on no anti‐retroviral therapy. [...]

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HM2010 Abstract Number: 372

Putting It All Together, a 'Ben' Interesting Case

Case Presentation: A 42‐year‐old female with an extensive psychiatric history of depression, fibromyalgia, and pseudo‐seizures, as well as obesity and chronic constipation, presented as an outpatient with fatigue, muscle pain, weight loss from poor oral [...]

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HM2010 Abstract Number: 373

Neurological Dilemma …

Case Presentation: A 47‐year‐old woman presented with a 1‐week history of word‐finding difficulty, unclear speech and pareslhesias in her right leg. She denied neck pain, stiffness fever, chills, or problems with vision, memory, menlation, grasp, [...]

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HM2010 Abstract Number: 374

Do Not Forget the ANA

Case Presentation: A normally healthy 67‐year‐old African American male presented with 2 weeks of worsening shortness of breath, orthopnea, and lower‐extremity edema as well as some chest pains and joint aches. One week prior to [...]

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HM2010 Abstract Number: 375

Dazed and Confused

Case Presentation: A 25‐year‐old Filipino female presented after being brought To the emergency department by a friend who noticed her “very abnormal behavior.” The patient was found wandering outdoors and was unaware of her surroundings [...]

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HM2010 Abstract Number: 376

Total Eclipse

Case Presentation: A 59‐year‐old man presented with a 3‐month history of a dry cough. He denied smoking. On further questioning, he noted a 9‐month history of dyspnea that began after an appendectomy. During that hospital [...]

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HM2010 Abstract Number: 377

The Diagnosis Is in the History

Case Presentation: A 75‐year‐old woman with a history of stage II colon cancer in remission and PE 2 years ago presents with 3 days of progressive dyspnea and weakness She was admitted to an outside [...]

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HM2010 Abstract Number: 378

Acute Pain in a Sickle Cell Patient, Beyond Just a Vaso‐Ocelusive Pain Crisis

Case Presentation: A 24‐year‐old woman with sickle cell disease (SCD) presented with 1 day of progressive bilateral lower‐extremity pain. She was afebrile and had no chest, back, or joint pain. She had edema and tenderness [...]

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HM2010 Abstract Number: 379

A Case of Skin Ulcers and Neutropenia: Definitely Not a Helminth Problem

Case Presentation: A 43‐year‐old healthy woman presented with painful lower‐extremity ulcers. Six weeks earlier, she had noticed a single red lesion on her left ankle. Over the next few weeks, the lesion enlarged, turned purple, [...]

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HM2010 Abstract Number: 380

Resistant Hypertensive Urgency Secondary to Surreptitious Noncompliance: A Case Report

Case Presentation: A 32‐year‐old African American male was referred from a corrections facility with severe uncontrolled hypertension for 2 weeks despite being on a regimen of 7 antihypertensive medications. He complained of persistent bitemporal headaches [...]

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HM2010 Abstract Number: 381

Post‐Angioedema Attack Skin Blisters: A Unique Presentation of Hereditary Angioedema

Case Presentation: A 36‐year‐old male with a known history of hereditary angioedema presented to an outside hospital ER with acute respiratory failure requiring endotracheal intubation. The patient received 2 units of fresh frozen plasma after [...]

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HM2010 Abstract Number: 382

Multiorgan Disease — A Frequently Missed Cause of Hematochezia

Case Presentation: A 76‐year‐old woman presented with a 1‐day history of bloody bowel movements and syncope. She also noted weakness and lower abdominal pain but denied nausea or vomiting. She had been constipated for the [...]

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HM2010 Abstract Number: 383

Rapid and Massive Thrombosis Following Initiation of Warfarin in a Hypercoagulable Patient

Case Presentation: A 60‐year‐old man presented with 6 weeks of dizziness, nausea, and progressive headache Initial MRI was notable for a 2.6 × 1.6 × 2.3 cm cerebellar mass that was successfully resected. Its pathology was adenocarcinoma. Given his [...]

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HM2010 Abstract Number: 384

Uncontrolled Diabetes after Discontinuation of Methotrexate

Case Presentation: A 59‐year‐old man with psoriatic arthritis, type 2 diabetes, and HIV presented with uncontrolled diabetes. His blood glucose level was 567 mg/dL. His diabetes had been previously well controlled with glimepiride 2 mg [...]

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HM2010 Abstract Number: 385

Multiorgan Failure Related to Human Monocytic Ehrlichiosis

Case Presentation: A 72‐year‐old man was admitted with a 2‐day history ot lever, chills, headache, myalgias, diarrhea, and confusion. On admission, he developed respiratoryfailure and rapid atrial fibrillalion requiring intubation, and he was admitted to [...]

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HM2010 Abstract Number: 386

Moans and Groans: A Case of Milk Alkali Syndrome

Case Presentation: A 55‐year‐old female with history of hypertension, hypothyroidism, and osteopenia presented with altered mental status for 4 days. She was found to have confusion, anorexia, abdominal pain, and generalized weakness. Family members reported [...]

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HM2010 Abstract Number: 387

Stress Cardiomyopathy (Takotsubo) in a Patient with Presumptive Autoimmune Polyendocrine Syndrome ll

Case Presentation: A 26‐year‐old previously healthy woman presented to the emergency department with a 1‐month history of fatigue, nausea, vomiting, and a 25‐pound weight loss. At the emergency department, she was hypotensive and tachycardic. The [...]

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HM2010 Abstract Number: 388

Spontaneous Coronary Artery Dissection: Distal Rather Than Proximal

Case Presentation: Three previously healthy premenopausal women with negative past medical history presented with chest pain. The patients had positive biochemical cardiac markers and ECG changes showing acute cardiac injury. An emergent cardiac catheterization was [...]

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HM2010 Abstract Number: 389

Recurrent Stroke: An Error in Medication Reconciliation

Case Presentation: A 64‐year‐old woman presented with 1 day of worsening dizziness, nausea, and vomiting. She denied abdominal pain, chest pain, or shortness of breath. Past medical history was notable for cerebrovascular disease with TIA, [...]

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HM2010 Abstract Number: 390

Do We Need to Measure Troponin in Hospitalized Patients with Atrial Fibrillation with Rapid Ventricular Rate (AF/RVR)?

Background: It is a common practice to measure troponin in hospitalized patients with AF/RVR. Tachyarrhythmia has been associated with leakage of troponins. Minor troponin leak with AF/RVR with chronic kidney disease (CKD) and congestive heart [...]

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HM2010 Abstract Number: 1000

Migraine Management and Ischemic Colitis

Case Presentation: A 36‐year‐old white woman presented to the emergency department with 1 day of hematochezia, crampy abdominal pain, and diarrhea. She denied recent travel, antibiotics, or sick contacts. She was a nonsmoker, without cardiovascular [...]

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HM2010 Abstract Number: 1004

An Unusual Case of Dyspnea in a Young Male

Case Presentation: This is a 26‐year‐old white male who presented to the emergency department with chest pain for 4 days. He described the pain as dull, achy, and located over the left chest. The pain [...]

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