Case Presentation: Ms. Y. is a 61‐year‐old salad bar chef with a medical history of dyslipidemia and osteoporosis who was admitted with fever, chills, hot flushes, and extreme fatigue for 2 days. On the day [...]

Case Presentation: Mr. Z. is a 24‐year‐old landscaper without significant medical history who presented with easy bruising and bleeding for several days. Three months prior to his presentation, he had complained of nausea, vomiting, and [...]

Case Presentation: A 61‐year‐old female nonsmoker was noted to have small nodular opacities in the right lung on a routine chest roentgenogram (CXR). Subsequently, a chest computerized tomography (CT) revealed multiple nodules with primarily upper [...]

Case Presentation: A 20‐year‐old female smoker with history of bulimia presented to the emergency department with a syncopal episode. Computerized tomography (CT) of the cervical spine was performed, which incidentally revealed cavitary pulmonary nodules in [...]

Case Presentation: A 28‐year‐old nursing student with a history of bipolar disorder presented to Tucson Medical Center with symptoms of ataxia and bilateral lower‐extremity weakness of a few weeks’ duration. She had paresthesias that started [...]

Case Presentation: A 62‐year‐old right‐handed white man suddenly started crying at work without clear reason. En route to the emergency room (ER), he had multiple intermittent crying spells each lasted for about 5 minutes. On [...]

Case Presentation: A 62‐year‐old man was admitted to the hospital for shortness of breath, weakness, and chills. The patient had a history of chronic, recurrent sinus infections treated with multiple antibiotics over the last 3 [...]

Case Presentation: A 33‐year‐old white woman with type 2 diabetes presented with left‐sided facial weakness, dysphagia, xerostomia, and decreased hearing on the left. She was presumptively diagnosed with Bell's palsy and empirically treated with a [...]

Case Presentation: A 44‐year‐old woman was admitted in early October with fever, headache, and malaise. She was employed in an elementary school cafeteria where there had been several sick children. She was treated empirically with [...]

Case Presentation: A 50‐year‐old man with a history of hypertension and gout presented with 2 weeks of bilateral lower‐extremity weakness and generalized fatigue. He was diagnosed 10 years ago with gout, initially controlled with antihyperuricemic [...]

Case Presentation: A 70‐year‐old man presented to the emergency department with a recent 15‐pound weight loss over 2 months and hearing loss in this right ear. Medical history was significant for hypertension and coronary artery [...]

Case Presentation: A 40‐year‐old G9P8 Yemeni woman with hypertension and diabetes mellitus at 32 weeks of pregnancy presented to the emergency room with 11 days of left otalgia and facial droop. She also had intermittent [...]

Case Presentation: A 63‐year‐old white woman with a medical history of hypothyroidism, hypertension, hypercholesterolemia, and recent deep vein thrombosis on Coumadin presented to the emergency department with dehydration because of intractable diarrhea and intermittent emesis. [...]

Case Presentation: A 19‐year‐old African American man was “not acting right,” so he was brought to the emergency room (ER) by his mother. Last year, he was treated for syphilis and diagnosed with HIV but [...]

Case Presentation: A 51‐year‐old man with a history of depression and both oral hyperesthesia and stroke suffered during a recent dental procedure was admitted for profound weight loss, malnutrition, and constipation. During admission, he consistently [...]

Case Presentation: A 32‐year‐old woman presented to the emergency department with 2 days of diplopia, worsening headache, pharyngitis, and lethargy. She also reported at that time 1 month of abdominal pain, nausea, vomiting, and diarrhea. [...]

Case Presentation: A 38‐year old Ethiopian man with a history of HIV, tuberculosis, and malaria was admitted to our institution for evaluation of progressively altered mental status. The patient immigrated from Ethiopia 2 weeks prior [...]

Case Presentation: A 45‐year‐old man with diabetes mellitus and hypertension presented with acute renal failure and multiple lesions on his penis and lower extremities. His presenting creatinine was 18, blood urea nitrogen 150, calcium 5.9, [...]

Case Presentation: A 71‐year‐old woman with hypertension presented from an outside hospital for a second opinion. Five months prior to admission she discovered that she had factor V Leiden and developed a deep vein thrombosis [...]

Case Presentation: A 35‐year‐old man was admitted with right upper quadrant pain, nausea, vomiting, and obstipation. He had had 9 presentations with 4 admissions for the same in the preceding 3 months. Recent history included [...]

Case Presentation: A 19‐year‐old man presented with several days of worsening fevers, severe headache, neck stiffness, and photophobia. He reported a sore throat, cough, and malaise 1 week earlier. He denied confusion, vision changes, dizziness, [...]

Case Presentation: A 38‐year‐old man presented with gradual onset of forgetfulness, trembling, falling, and both visual and auditory hallucinations. A few months prior to admission, he became forgetful, had mood swings, and developed an unsteady [...]

Case Presentation: A 76‐year‐old white man on chronic azathioprine therapy for presumed autoimmune kidney disease presents with marked weight loss, chronic cough, night sweats, and functional decline over several months. He was afebrile with an [...]

Case Presentation: A healthy 19‐year‐old white man presented with sudden‐onset severe sharp left upper quadrant (LUQ) abdominal pain radiating to the left shoulder. He was hemodynamically stable, with LUQ tenderness to mild palpation but without [...]

Case Presentation: A 69‐year‐old woman presented with 3 months of fever and dyspnea that remained undiagnosed after an extensive workup in a local hospital. History was pertinent for remote partially treated latent tuberculosis (TB), diabetes, [...]

Case Presentation: A 60‐year‐old man with type 2 diabetes and hypertension was admitted for low‐grade fever and worsening rash. The patient was on intravenous vancomycin (1 g daily) for 4 weeks for right knee joint methicillin‐resistant [...]

Case Presentation: A 47‐year‐old woman was referred to us from the gynecology department at our institution after she complained of chest pain. She was admitted to the hospital for abnormal uterine bleeding and pelvic pain [...]

Case Presentation: A 45‐year‐old woman presented with 5 months of progressive right lumbar back pain radiating to the right abdomen. She denied any history of trauma or neurological symptoms. Associated symptoms included hot flashes, diaphoresis, [...]

Case Presentation: A 41‐year‐old man presented with 3 weeks of nausea, vomiting, and a 10‐pound weight loss. His medical history included hemophilia A and HIV, for which he was taking highly active antiretroviral therapy (HAART). [...]

Case Presentation: A 48‐year‐old man was referred from the clinic with worsening acute renal failure. He reported nausea without emesis but no other symptoms. His creatinine was 8.3 mg/dL (increased from his baseline of 1.4 mg/dL 12 [...]

Case Presentation: A 14‐year‐old African American girl with no medical history presented to the emergency room (ER) with acute diffuse abdominal pain associated with nausea and vomiting. The workup included basic laboratory evaluation and abdominal [...]

Case Presentation: A 23‐year‐old man with untreated acquired immune deficiency syndrome (AIDS) presented with headache and new‐onset generalized seizure. He had recently been hospitalized at a local community hospital for confusion and behavior changes where [...]

Case Presentation: A 63‐year‐old African American woman presented with 2 weeks of progressively worsening right lower quadrant abdominal pain. She noted early satiety, constipation, and an unintentional 10‐pound weight loss. On exam, her abdomen was [...]

Case Presentation: A18‐year‐old healthy female presented to her primary care physician in early April with isolated right calf pain. Her initial workup included an ANA, D‐dimer, Epsteinn‐Barr virus, erythrocyte sedimentation rate (ESR), creatine kinase, and [...]

Case Presentation: A 22‐year‐old woman presented to the emergency department with fever and a rash. Daily fevers had been occurring for 1 month, for which she took cephalexin and high doses of ibuprofen. She had [...]

Case Presentation: A 51‐year‐old woman was admitted to the hospital with severe headaches, nausea, and vomiting. In the weeks preceding her admission, the previously healthy patient on no medications had developed headaches and saw her [...]

Case Presentation: A 57‐year‐old man with diabetes mellitus, hypertension and hyperlipidemia presented to the emergency department (ED) with fevers, rigors, and malaise for 72 hours. In the ED, vitals were normal except for temperature of [...]

Case Presentation: A 56‐year‐old man was admitted to the referring hospital with progressive anemia—hemoglobin of 7.8 g/dL. He received 2 units of red blood cells. Four days later he was tachypneic and tachycardic, with a hemoglobin [...]

Case Presentation: A 28‐year‐old healthy woman presented with 6 hours of severe left leg pain and swelling 1 day after an episode of syncope. She had no family history of venous thromboembolism and denied smoking [...]

Case Presentation: A 13‐year‐old white female presented to the emergency room with complaints of fever, neck stiffness, headache, sore throat, phonophobia, photophobia, nausea, and malaise. She was febrile, in obvious discomfort, and on exam had [...]

Case Presentation: A 26‐year‐old man presented 4 months of a painful, growing left neck mass with purulent drainage and a 1‐week history of a bleeding suprascapular superficial skin lesion with pain. The patient tried topical [...]

Case Presentation: A 79‐year‐old woman with a history of recurrent urinary tract infections (UTIs) presented with a 1‐week history of fever, chills, nausea, vomiting, and abdominal discomfort. She was treated 3 days prior by her [...]

Case Presentation: A 29‐year‐old African American man with no significant medical history presented with generalized fatigue, unintentional 25‐pound weight loss, and arthralgias. Physical examination was unremarkable. Blood work revealed creatinine 2.31 mg/dL, bicarbonate 25.2 mmol/L, glucose [...]

Case Presentation: A 20‐year‐old white man was admitted with a 2‐week history of intermittent right flank pain. Abdominal CT showed a 2‐mm nonobstructing stone in the lower pole of the left kidney and a 3‐mm [...]

Case Presentation: Guillain–Barré syndrome (GBS) is widely perceived in the medical community as an autoimmune, monophasic ascending polyneuropathy with a fairly limited set of core clinical features and very similar and predictable course in the [...]

Case Presentation: A 70‐year‐old right‐handed white man with a medical history significant for but not limited to coronary artery disease and hypertension presented to the emergency department with acute left‐sided hemiplegia, facial droop, and slurred [...]

Case Presentation: A 27‐year‐old African American man with a history of scoliosis status post spinal surgery as a child presented to our institution for evaluation of bone pain that began approximately 4 months prior to [...]

Case Presentation: A 57‐year‐old healthy woman with no medical history was transferred to our institution for evaluation of fever, abdominal pain, and neutropenia. Patient reported that she developed abdominal pain 5 days prior to presentation [...]

Case Presentation: A 62‐year‐old woman with a medical history of rheumatoid arthritis (RA), diabetes mellitus, and hypertension presented with fever of 102°F and 10/10 diffuse abdominal, lower back, and flank pain for the past week. [...]

Case Presentation: A 54‐year‐old African American woman with a history of asthma presented with a 3‐week history of left lower quadrant (LLQ) pain associated with subjective fever, nausea, and vomiting. Her medical history was unremarkable [...]

Case Presentation: A 35‐year‐old Hispanic woman from New York City presented with a 7‐day history of fever, headache, retro‐orbital pain, and myalgia. Her symptoms began during her visit to Puerto Rico, where she suffered from [...]

Case Presentation: A 34‐year‐old African American woman with history of sickle cell trait (SCT) presented with acute onset of pain in the right hip and buttock radiating down the posterior aspect of the right leg [...]

Case Presentation: A 78‐year‐old woman presented with 1 month of weakness and falls. She had had a 50‐pound weight loss over the previous year. Previously, she was diagnosed with breast cancer and treated with a [...]

Case Presentation: A 48‐year‐old man with a history of hypertension, diabetes, and hepatitis C presented to the ED after being found disorientated. He remembered driving to the grocery store, at which point he became confused, [...]

Case Presentation: A 44‐year‐old male patient was admitted for recurrent progressively worsening colicky abdominal pain and bleeding per rectum of about 2 months’ duration. There was also an episode of lightheadedness and clear vomiting on [...]

Case Presentation: A 65‐year‐old African American man patient had a 2‐month history of generalized weakness, loss of appetite, loss of weight, and dizziness. He required hospitalization 6 weeks earlier because of hypotension, hyponatremia, hyperkalemia, and [...]

Case Presentation: A 32‐year‐old man experienced several days of hallucinations and strange behavior. He was brought in by a coworker from an industrial ship that had sailed from India. He had been in bed for [...]

Case Presentation: A 42‐year‐old African American woman presented to the hospital with a 1 week history of nasal congestion, sore throat, and fever of 38.8°C. Over 12 hours, she developed acute headache, photophobia, and neck [...]

Case Presentation: A 31‐year‐old white man with a history of schizoaffective disorder, nonadherent to therapy, was brought to the emergency department for paranoia. The patient had developed a fear of eating, initially of most protein [...]

Case Presentation: A 29‐year‐old white woman with a stated a history of stage 1 breast cancer was admitted for pancytopenia secondary to cyclophosphamide. The pancytopenia was discovered when a complete blood count (CBC) was drawn [...]

Case Presentation: A 13‐year‐old girl with no medical history was admitted with a 1‐month history of intermittent fever, 20‐pound weight loss, fatigue, dry cough, and 2 months of left neck mass, initially painful but now [...]

Case Presentation: A 61‐year‐old woman presented to the emergency department with a painful, nonpruritic rash over the palms of the hands, elbows, face, and behind the ears for 1 week. Associated symptoms included weakness and [...]

Case Presentation: Case 1 is a 58‐year‐old man presenting with obtundation, fatigue, polydipsia, and polyuria of 3 weeks’ duration. Labs showed calcium (Ca) 15 mg/dL, creatinine (Cr) 1.78 mg/dL, and normal phosphorus, magnesium, SPEP, and UPEP. Intact [...]

Case Presentation: A 64‐year‐old woman presented with diarrhea, 100‐pound weight loss, and occasional abdominal discomfort ongoing for 6 months prior to presentation. She endorsed profuse watery, green, foul‐smelling diarrhea as frequently as 6–8 times per [...]

Case Presentation: A 46‐year‐old man presented with a 1‐week history of bilateral lower facial nerve paralysis and 3 weeks of fever, headache, mild transaminitis, and hepatosplenomegaly. Illness began with acute onset of fever (103°F), headache, [...]

Case Presentation: A 61‐year‐old white man with significant history of hypertension was brought to the emergency department with sudden onset shortness of breath, epigastric pain, diaphoresis, and light‐headedness for 30 minutes. Examination was positive for [...]

Case Presentation: A 55‐year‐old white man without a significant medical history presented to the emergency department (ED) with acute onset of lightheadedness, confusion, and speech difficulty for 2 hours’ duration. Although he was hypotensive, peripheral [...]

Case Presentation: A 62‐year‐old man was found unresponsive with a stab wound to the posterior chest wall 2 weeks prior to admission and presented to our hospital with a full‐thickness wound on the infrascapular region. [...]

Case Presentation: A previously healthy 86‐year‐old white woman presented to the hospital with complaints of left leg swelling and pain of 4 days’ duration. On examination, the left leg was significantly swollen compared with the [...]

Case Presentation: A 31‐year‐old Mexican male migrant worker was admitted with 7 months of gradually worsening cough, hemoptysis, night sweats, fevers, and weight loss. Physical exam revealed bilateral upper‐lobe wheezing and rhonchi. Chest x‐ray showed [...]

Case Presentation: A 19‐year‐old man presented with 1 day of pain and numbness in his left arm accompanied by left‐sided facial numbness. The patient reported chest pain, neck pain, nausea, and a dry cough as [...]

Case Presentation: A 66‐year‐old woman presented with vomiting, bilateral leg pain, and a fall. Over the past 6 months, the patient had complained of an unsteady gait, intermittent shooting pains from the knees to the [...]

Case Presentation: A 75‐year‐old woman presented with a 3‐week history of visual hallucinations and fomication. She reported seeing insects, cars, and snakes in her house and acknowledged the hallucinations were inappropriate. She reported anxiety secondary [...]

Case Presentation: A 50‐year‐old renal transplant patient presented to the emergency room with mild respiratory symptoms. Medications included sirolimus, cyclosporine, and prednisone. Vital signs were temperature 37.9°C, pulse 98/minute, blood pressure 109/64 mm Hg, respiratory rate [...]

Case Presentation: An 81‐year‐old woman comes to the emergency department with acute‐onset shortness of breath and left‐sided, nonradiating chest pain. A month prior, she had a dual‐chamber pacemaker implantation for a diagnosis of sick sinus [...]

Case Presentation: The patient is a 16‐year‐old male who was transferred to a tertiary‐care center after being evaluated in a local emergency department (ED) for acute onset of confusion and agitation. He was restrained by [...]

Case Presentation: Case 1 is a 62‐year‐old woman with a history of end‐stage renal disease and poorly controlled diabetes mellitus who presented with confusion, fever, and an abscess on the posteromedial aspect of the left [...]

Case Presentation: A 70‐year old woman had 2 episodes of intracranial bleed over 6 months and was referred to hematology to rule out bleeding diathesis. Neurological exam showed a mild right‐sided facial palsy. Blood pressure, [...]

Case Presentation: A 60‐year‐old, previously healthy woman presented with intermittent right‐sided numbness. She also had a lump on the left parietal scalp for a year with no symptoms. This was assessed outpatient and was adjudged [...]

Case Presentation: A 67‐year‐old man presented to his doctor with 3 months of poor appetite, weight loss, and persistent nonbloody diarrhea. He complained of fatigue and intermittent chest pain with a chronic nonproductive cough. He [...]

Case Presentation: A 48‐year‐old woman presented with 2 episodes of bright red blood per rectum. Medical history included diverticular disease responsible for a previous episode of gastrointestinal bleed and congenital adrenal hyperplasia from 21‐hydroxylase deficiency. [...]

Case Presentation: This is a 16‐year‐old African American male with a history of hereditary angioedema of unknown type, diagnosed at age 12, who presented with abdominal pain. He reported a 1‐week history of intermittent non‐bloody [...]

Case Presentation: A 59‐year‐old white woman with a history of breast cancer presented with a 3‐day history of sharp, crampy right lower abdominal pain, radiating to the left lower quadrant and associated with nonbloody diarrhea [...]

Case Presentation: A 65‐year‐old woman presented with progressive abdominal distension for 2 months. It started after she underwent nephrectomy for left‐sided renal cell carcinoma, followed by splenectomy for injury sustained during nephrectomy. She noticed abdominal [...]

Case Presentation: A baby girl was born about 6 months ago after a cesarean section at 36 weeks with APGARs of 8 and 8 and body weight of 2030 g and received routine resuscitation. Mother is [...]

Case Presentation: A 48‐year‐old Chinese man reported a 1‐day history of paresthesias, shortness of breath, anxiety, and profound total‐body weakness. The evening prior to presentation he had prepared some dried blowfish that he had brought [...]

Case Presentation: A 20‐year‐old man with a history of congenital long QT syndrome status post–automatic implantable cardiac defibrillator (AICD), intravenous drug abuse, and hepatitis C presented with 1 week of low‐grade fever and myalgia. Last [...]

Case Presentation: A 63‐year‐old man with chronic stag‐horn nephrolithiasis and chronic kidney disease presented with generalized arthralgias of 3 weeks’ duration, worse in the morning. In the days prior to presentation, he noticed pink urine [...]

Case Presentation: A 48‐year‐old white woman was brought in by her husband for dizziness, unsteady gait, altered mental status, and 1 episode of fall. Symptoms started about 1 week earlier following an upper respiratory infection [...]

Case Presentation: A 69‐year old man with a history of congestive heart failure was admitted for recurrent syncope. He initially presented with 4 months of progressive dyspnea on exertion and facial swelling. Subsequently, he developed [...]

Case Presentation: A 22‐year old previously healthy man developed acute‐onset right upper quadrant pain, vomiting, and jaundice. He consumed 4–6 alcoholic drinks occasionally and denied diarrhea, bloody stools, or fevers. Medical history was notable for [...]

Case Presentation: A 78‐year‐old man with no history of lung disease presents with increasing dyspnea on exertion. Two weeks prior to presentation, the patient underwent endovascular stenting of his left femoral artery that was complicated [...]

Case Presentation: An 82‐year‐old man presented with recurrent episodes of severe hypoglycemia requiring frequent hospitalizations at an outside facility. He was first diagnosed with hypoglycemia 4 months ago when found unconscious by his wife. These [...]

Case Presentation: A 47‐year‐old woman presented with a 2‐day history of lower back pain and acute onset of abdominal pain that was associated with an episode of nausea and emesis. She was afebrile with elevated [...]

Case Presentation: A 67‐year‐old man presented with a 2‐week history of worsening diffuse body rash. The patient had initiated oral terbinafine 250 mg daily 1 month prior for toenail onychomycosis; he denied any other new medications. [...]

Case Presentation: A 51‐year‐old white woman was admitted with a 3‐day history of recurrent generalized abdominal cramping and bloating with 10–15 nonbloody watery diarrhea stools per day. She denied nausea, vomiting, fever, chills, or sweats. [...]

Case Presentation: A 40‐year‐old white woman received an intramuscular injection of medroxyprogesterone in her right deltoid. Within minutes she experienced excruciating pain in her entire right arm, mild finger paresthesias, and a mottled, reticular, livedoid [...]

Case Presentation: A 71‐year‐old man with history of chronic atrial fibrillation was admitted to our hospital with an acute flare of chronic obstructive pulmonary disease. On examination, in addition to signs of respiratory distress and [...]

Case Presentation: A 62‐year‐old man with a history of Wegener's granulomatosis presented to the emergency department with abdominal discomfort, low‐grade fever, and increasing confusion. The patient was on standard immunosuppressive therapy with cyclophosphamide, and a [...]

Case Presentation: A 70‐year‐old man presented with sore throat, cough, and increasing respiratory distress. He was tachycardic and tachypneic, with a fever of 101.5°F. His breathing was labored and stridorous. He had no angio‐edema. His [...]

Case Presentation: A 41‐year‐old white woman with history of peripheral vascular disease presented with a syncopal episode and leg pain. She reported bilateral lower‐extremity pain for the past 5 days. Because of a history of [...]

Case Presentation: Case 1 is a 47‐year‐old man with a 30‐year history of cocaine abuse who was admitted with recurrent cellulitis. Seven months prior he had suffered trauma to his left hand complicated by septic [...]

Case Presentation: A 56‐year‐old man with recently diagnosed HIV‐associated toxoplasma encephalitis presented after a generalized seizure. Two weeks prior, he began treatment for toxoplasmosis with pyrimethamine, sulfadiazine, and leu‐covorin. His course was complicated by a [...]

Case Presentation: A 68‐year‐old white male patient presented with progressive dyspnea on exertion, weakness, and an unintentional 50‐pound weight loss over the prior 6 months. He had a history of coronary artery disease, hypertension, and [...]

Case Presentation: This is an 11‐year‐old male who was well until 3 days prior to admission, when he developed nasal congestion, fever, and a tender swelling of the forehead. The patient's medical history was significant [...]

Case Presentation: Ovarian hyperstimulation syndrome (OHSS) is a complication of exogenous gonadotropin stimulation, used in infertility cases. Most cases are mild and self‐limited, but occasionally they can become severe and require hospitalization. A 31‐year‐old woman [...]

Case Presentation: A 71‐year‐old man was admitted to the hospital for worsening left leg cellulitis. He had noticed a “pimple” on the dorsum of his foot on Sunday. He cleaned the area with hydrogen peroxide, [...]

Case Presentation: A 64‐year‐old Hispanic retired truck driver with type 2 diabetes mellitus presented with a 1‐week history of left foot pain. His initial blood cultures were positive for Klebsiella species. MRI findings were consistent [...]

Case Presentation: A 48‐year‐old man presented with 2 weeks of ascending numbness and tingling of the right leg and toes. The numbness continued to ascend to the level of the umbilicus. He also noted 1 [...]

Case Presentation: A 36‐year‐old man presented with 6 weeks of abdominal pain, bloody stools, and fatigue. Pain was described as dull, 6 of 10 in intensity, nonradiating, in bilateral upper quadrants and epigastrium, lasting minutes [...]

Case Presentation: A 78‐year‐old woman with a history of small bowel obstructions with subsequent resections presented with a 3‐week history of progressive abdominal distention, escalating pain, and nausea. Her symptoms reached maximum intensity in the [...]

Case Presentation: A 20‐year‐old woman presented with 2 weeks of worsening dyspnea, pleuritic chest pain, and dry cough. She was previously healthy. No weight loss, night sweats, fevers, or chills were reported in the past. [...]

Case Presentation: A 76‐year‐old white man presented with a1‐year history of abdominal fullness, bloating, episodic choking spells, and wheezing. These episodes worsened with food, usually to liquids, but had become more frequent over the last [...]

Case Presentation: A 58‐year‐old woman with a history of Sjogren's syndrome, neuromyelitis optica (NMO; Devic's disease) diagnosed 12 years ago, transverse myelitis, and sleep apnea presented with worsening left leg weakness for 4 months. The [...]

Case Presentation: Vancomycin, an antibiotic frequently used in the treatment of Methicillin‐resistant Staphylococcus Aureus, can cause many adverse reactions. Vancomycin has seldom been implicated as a cause of thrombocytopenia, and there is limited evidence that [...]

Case Presentation: A 40‐year‐old woman with recently diagnosed Graves’ disease and atrial fibrillation presented with a 3‐week history of abdominal distension, shortness of breath, and palpitations. She had associated diarrhea and a 20‐pound weight loss. [...]

Case Presentation: A 44‐year‐old man with no medical history presented to the emergency department with a purpuric rash for 1 week. The rash originated in the trunk and upper extremities and progressed to involve the [...]

Case Presentation: A 3‐year‐old healthy Hispanic female presented with a 7‐day history of persistent fevers and 3 days of jaundice, abdominal pain, and emesis. She was noted to be irritable and had just developed a [...]

Case Presentation: A 52‐year‐old woman was sent to the hospital by her vascular surgeon for pain and dry gangrene at the tip of the right second digit. Two weeks prior, her symptoms began with a [...]

Case Presentation: A 76‐year‐old man with scoliosis and hypertension presented with acute onset of dyspnea associated with cough and chest tightness. Physical exam was remarkable for a temperature of 102.3°F, RR of 25, and oxygen [...]

Case Presentation: An 80‐year‐old woman with hypertension and hyperthyroidism was found obtunded in the morning by a family member and brought in to the emergency department. Patient had taken polyethylene glycol electrolyte solution and bisacodyl [...]

Case Presentation: A 39‐year‐old pharmacy technician was referred by her local physician for continued outpatient evaluation of bruising, epistaxis, and diarrhea. These conditions had been present for 3 months. She had been on disability leave [...]

Case Presentation: A 68‐year‐old African American man with a medical history of gastric carcinoma status post resection and history of left‐sided spontaneous pneumothorax was admitted to the hospital with gross hematuria for 1 day. He [...]

Case Presentation: A 63‐year‐old woman with history of bariatric surgery, gastroparesis, daily emesis, on parenteral nutrition, aortic insufficiency, and mitral regurgitation (presumed secondary to past use of anorectic drugs) was admitted with fever, lethargy, orthostatic [...]

Case Presentation: A 64‐year‐old woman presented with 12 hours of fevers and confusion. She had gone to her primary care doctor 1 day earlier with complaints of dysuria. She was diagnosed with a urinary tract [...]

Case Presentation: A 60‐year old woman with type 2 diabetes mellitus presented with a 1‐week history of worsening left eye pain, redness, and gradual vision loss following a recent outside hospitalization. She also complained of [...]

Case Presentation: An 83‐year‐old woman with a history of invasive ductal breast cancer in remission status post lumpectomy and radiation presented with complaints of generalized weakness. Her vital signs were stable, and exam was remarkable [...]

Case Presentation: The patient was a 28‐year‐old man with history of bipolar disorder with psychotic features, polysubstance abuse, and hyperlipidemia. He had been chronically institutionalized in a psychiatric hospital for 7 years prior this presentation. [...]

Case Presentation: A 79‐year‐old man with a medical history of gout presented with fever of 103°F, chills, palpitations, left lower‐extremity pain, swelling, and redness. Patient denied any trauma to his limb. Physical exam was unremarkable [...]

Case Presentation: A 45‐year‐old woman with a history of chronic migraines and diabetes was brought to the emergency room for decreased responsiveness with hypoxic respiratory failure. She had been treated for migraines at an outside [...]

Case Presentation: A 58‐year‐old woman presented to the emergency room for evaluation of a progressive pruritic rash. She initially noticed the eruption 72 hours after receiving intravenous iron sucrose for the first time. Past medical [...]

Case Presentation: A 45‐year‐old woman presented from a rescue mission with 1 month of worsening pruritis and a scaling rash. She had multiple emergency room visits during this time for a pruritic, scaly eruption that [...]

Case Presentation: An 84‐year‐old cattle farmer presented to the emergency room with a 5‐day history of dry cough, progressive shortness of breathb and temperature to 39.4°C. Past medical history included coronary artery disease and atrial [...]

Case Presentation: An 8‐day‐old girl born full term, normal spontaneous vaginal delivery, with transient tachypnea of the newborn requiring a 5‐day stay in the neonatal intensive care unit, presented to her private medical doctor for [...]

Case Presentation: A 79‐year‐old man with a history notable for hyperlipidemia and stage I prostate cancer presented to his physician with fatigue and easy bruising for 3 weeks after returning from a recent 2‐month trip [...]

Case Presentation: A 67‐year‐old man with polycythemia vera was admitted for management of elevated hematocrit (Hct). The patient denied chest pain, headache, paresthesias, easy bruisability, epistaxis, or melena. He reported red eyes and generalized pruritis. [...]

Case Presentation: We describe a 79‐year‐old man with a history of hypertension and benign prostatic hypertrophy who presented with 5 days of fevers to 103°F and myalgias. The patient also complained of a dry cough [...]

Case Presentation: A 31‐year‐old woman who was 8 weeks pregnant presented to her obstetrician for an initial prenatal examination. On physical exam, a firm, fixated 4 × 5 cm mass was palpated in the midline of [...]

Case Presentation: A 62‐year‐old African American man with a questionable history of heavy alcohol use was admitted to the urology service for incision and drainage of a scrotal abscess. At the time of incision and [...]

Case Presentation: A 50‐years‐old diabetic man presented with cough, fever, weight loss, malaise, and diffuse abdominal pain of 2 weeks’ duration. He denied dysuria, recent hospitalization, sick contacts, or visits to any long‐term care facility. [...]

Case Presentation: Patient is a 16‐year‐old Hispanic male who was transferred to our tertiary‐care center with hypertension that was refractory to antihypertensive medications. He reported a 1‐month history of profuse sweating, itching, and muscle fasciculations [...]

Case Presentation: A former 27‐week‐gestation Hispanic male aged 2 years and 9 months with a history of grade 2 intraven‐tricular hemorrhage in the neonatal period presented with sub‐acute onset of ataxia, difficulty with hand coordination, [...]

Case Presentation: A 64‐year‐old man with a history of quadri‐plegia at the C5–C6 level more than 25 years ago secondary to a motor vehicle accident presented with blisters on both feet and worsening positional hypertension. [...]

Case Presentation: An 87‐year‐old Russian‐speaking man with a history of peptic ulcer disease presented to the emergency department (ED) with 1 week of abdominal distension, nausea, and vomiting. An abdominal CT scan showed gastric outlet [...]

Case Presentation: Case I—a 45‐year‐old man was admitted to the hospitalist service with fever and leg swelling. Physical examination was significant for tachycardia, hypotension, and gangrene of left leg. From blood cultures, complete blood count, [...]

Case Presentation: A 37‐year‐old HIV‐positive obese man on highly active antiretroviral therapy (HAART) was admitted with progressive dyspnea and right upper quadrant pain without tenderness to palpation. His chest x‐ray revealed a right pleural effusion. [...]

Case Presentation: A 31‐year‐old man with bipolar disorder presented with nausea, vomiting, abdominal pain, and blurry vision several hours after consuming antifreeze and alcohol in a suicide attempt. He was afebrile with a heart rate [...]

Case Presentation: The patient is a 53‐year‐old white woman with a history of systemic lupus erythematosus, WHO class 3A lupus nephritis on mycophenolate and pred‐nisone 10 mg/day. Two months prior to presentation she developed multiple erythematous [...]

Case Presentation: Sinonasal symptoms are very common in the general community, and most cases are successfully treated with empirical antibiotics, unlike our patient. The patient is a 47‐year‐old white man with a medical history of [...]

Case Presentation: A 7‐year‐old Hispanic male presented to the emergency department (ED) with a 4‐day history of fever and worsening ankle pain and swelling. He was otherwise healthy prior to the onset of symptoms. The [...]

Case Presentation: A 34‐year‐old woman presented with 6 weeks of worsening left calf pain, described as sharp, shooting, and increased on weight bearing. She had a 20 pack‐year smoking history and was taking oral contraceptive [...]

Case Presentation: A 54‐year‐old man presented with 4 weeks of progressive pruritis, diarrhea, and jaundice. He denied herbal medications, acetaminophen ingestion, recent travel, alcohol use, intravenous drug use, sexual activity, tattoos, or environmental exposures. Eight [...]

Case Presentation: A 46‐year‐old man presented with 2 months of worsening anasarca. He had a history of AIDS, Kaposi's sarcoma (KS), and hypothyroidism. The patient endorsed worsening orthopnea, dyspnea, and weight gain for several months, [...]

Case Presentation: A 50‐year‐old woman presented with acute‐onset confusion and seizure‐like episodes. She had experienced recent fatigue, generalized weakness, dyspnea on exertion, and ataxia for several days. She did not drink alcohol or use illicit [...]

Case Presentation: A 48‐year‐old man without significant medical history presented to our hospital with 3 weeks of increasing abdominal girth. Imaging revealed moderate ascites as well as extensive omental and peritoneal implants, diffuse lymphadenopathy, and [...]

Case Presentation: A 10‐year‐old African American male presented with progressive chest pain, dyspnea, and fever. One month prior, the child was hospitalized for fevers associated with right knee pain and swelling. Arthrocentesis revealed leukocytosis but [...]

Case Presentation: Our patient is a 65‐year‐old woman from the Philippines with a medical history significant for rheumatoid arthritis and diabetes mellitus who presented to an outside medical facility with complaints of increased abdominal girth, [...]

Case Presentation: A 72‐year‐old Dominican man with history of diabetes, hypertension, dementia, chronic renal insufficiency, epilepsy, cholesteatoma, and smoking presented for generalized weakness, confusion, otorrhea, otalgia, progressive hoarseness, and weight loss of 11 kg over 2 [...]

Case Presentation: A 56‐year‐old white man was admitted with 3 days of worsening mentation refractory to increasing doses of lactulose. History included remote alcohol abuse, alcohol‐induced cirrhosis diagnosed after a sentinel variceal bleed, and chronic [...]

Case Presentation: An 80‐year‐old woman with diabetes, hypertension, and hypothyroidism was admitted with 1 week of generalized weakness. She also reported persistent left‐sided neck pain. In the office, her systolic blood pressure was 240 mm Hg, [...]

Case Presentation: This is a 27‐year‐old woman transferred from the university emergency department to our Maryland General Hospital for management of severe asthma exacerbation. A few days prior to this visit, she was having coldlike [...]

Case Presentation: A 56‐year‐old woman with a history of thymoma completely resected 4 months earlier presented with 2 weeks of intermittent facial flushing, facial twitching, lacrimation, hypertension, and a sense of déjà vu. The episodes [...]

Case Presentation: Genitourinary tract infections in adult men are typically bacterial in origin. However, fungal infections are a rare but serious cause of acute genitourinary pathology with notable morbidity. A 69‐year‐old African American man with [...]

Case Presentation: A 77‐year‐old man presented to the hospital with a chief complaint of fever and weakness. Six weeks prior to this admission he underwent elective left total hip arthroplasty, which was complicated by a [...]

Case Presentation: A 36‐year‐old man living in the United States since 1996 (born in a sub‐Saharan country) presented with 4 days of fever, malaise, watery diarrhea, progressive dyspnea, and dry cough. He subsequently developed slurred [...]

Case Presentation: A 20‐year‐old African American man with a history of MSM (having sex with men) and previously treated for syphilis was admitted with 3 weeks of watery nonbloody diarrhea. Two weeks after symptoms started, [...]

Case Presentation: A 64‐year‐old man presented with sporadic hiccups, transient apnea, severe left‐sided chest pain, and diaphoresis for 6 months. The above constellation was associated with epigastric/left‐sided pulsatile motions under the left thoracic cage, herein [...]

Case Presentation: A 57‐year‐old man was “found down” at home. The patient reported seizures for 2 days. He denied chronic medical conditions including history of seizures. He reported drinking a case of beer daily. Physical [...]

Case Presentation: A 58‐year‐old man with alcoholic cirrhosis presented with anemia and hematochezia. Five weeks prior, he had received 2 units of red cells and 3 units each of platelets and plasma for anemia, thrombocytopenia, [...]

Case Presentation: A 66‐year‐old woman presented with pneumonia, severe sepsis, acute respiratory failure requiring mechanical ventilation, acute kidney injury, and disseminated intravascular coagulation. Her medical history included diabetes and hypertension. Her temperature was 103.9°F, blood [...]

Case Presentation: A 51‐year‐old white man with a medical history of acid reflux and Bell's palsy presented to the clinic with several months’ history of nausea, abdominal fullness, bloating, and left upper quadrant pain with [...]

Case Presentation: A 54‐year‐old heterosexual man presented with a 4‐month history of progressive photophobia of the left eye. He denied any diplopia, pustule discharge, and visual field defects. Four months previously, he was treated with [...]

Case Presentation: A 66‐year‐old white woman with a history of biopsy confirmed class III systemic lupus erythematosus (SLE) nephritis presented with shortness of breath, fatigue, myalgias, and recurring rash on her right lower extremity. Past [...]

Case Presentation: A 59‐year‐old man with a history of cirrhosis, hepatitis C, diabetes mellitus, and hypertension was admitted with melena. Home medications were lisinopril and metformin. Vital signs were normal, and physical exam revealed coffee‐ground [...]

Case Presentation: A 39‐year‐old African American woman presented with nausea, postprandial emesis, early satiety, abdominal distension/pain for 1 week, and 2 days of hematemesis. Physical exam revealed a diffusely distended, tender abdomen and a firm, [...]

Case Presentation: A 55‐year‐old man with developmental delay underwent cervical fusion. He was discharged with a urinary catheter to a rehabilitation center. He developed urosepsis and was readmitted to the hospital 1 month later. On [...]

Case Presentation: A 55‐year‐old woman presented with 2 months of progressively worsening dyspnea on exertion, cough productive of yellow sputum, and occasional hemoptysis. She had noted edema of the lower extremities. Her lungs were clear [...]

Case Presentation: This is a 39‐year‐old farmer admitted with dyspnea and productive cough with dark sputum. The patient stepped into a closed silo 3 days prior to admission. Approximately 8 hours later, he developed significant [...]

Case Presentation: This is an 18‐year‐old woman diagnosed with pulmonary Langerhans cell histiocytosis (LCH) 3 months prior to becoming pregnant. She was treated at the time with etoposide and dexamethasone. She remained asymptomatic until 27 [...]

Case Presentation: A previously healthy 43‐year‐old man from northwestern Wisconsin presented to his local medical center with 3 days of generalized malaise, arthralgias, low‐grade fever, and constant left‐sided chest pain, worse with deep inspiration and [...]

Case Presentation: A 36‐year‐old man with a history of congenital obstructive uropathy status post cadaveric renal transplant in 2006 presented with fever, shortness of breath, and cough for 3 days. He had had a recent [...]

Case Presentation: A 47‐year‐old white man with no past history presented with 4 days of periumbilical abdominal pain, nausea, and fevers to 102°F. A few days prior to presentation, he and his wife ate at [...]

Case Presentation: Ms. L. is a 19‐year‐old with history of asthma who presented with persistent right scapula pain and intermittent left chest pain for 2 weeks without an inciting event. She had had chest pain [...]

Case Presentation: Mr. J. is a 79‐year‐old man with a history of pulmonary embolism (PE)/deep vein thrombosis (DVT), coronary artery disease status post coronary artery bypass graft with ICM ejection fraction (EF) of 36% in [...]

Case Presentation: Ms. V. is a 64‐year‐old woman with a history of psoriasis, hypothyroidism, and grade IIb cutaneous T‐cell lymphoma (CTCL) treated with chemotherapy, radiation, and light therapies recently hospitalized with community‐acquired pneumonia and sepsis [...]

Case Presentation: The patient is a 61‐year‐old woman with a medical history of hypertension, non–small cell lung cancer which was resected 6 weeks prior to admission, coronary disease, and previous cecal ulcer and polyps. She [...]

Case Presentation: A 39‐year‐old woman with a benign medical history presented with a 5‐day history of abdominal pain and fever. She had been on Bactrim for a urinary trace infection for a week prior to [...]

Case Presentation: This is a 65‐year‐old woman with history of Crohn's disease and prolonged surgical hospitalization 14 weeks prior to admission for perforated colon secondary to diverticulitis requiring lower anterior resection with end‐ileostomy. Her course [...]

Case Presentation: A 53‐year‐old man presented with fever, altered mental status, headache, and diarrhea. He had a creatinine of 3.86 mg/dL (with no known prior renal disease) and a platelet count of 8000/μL. His hemoglobin was [...]

Case Presentation: A 50‐year‐old male painter with a history of depression presented to the emergency room with altered mental status. His wife stated he had been acting strangely the night prior to admission and was [...]

Case Presentation: This is a 51‐year‐old woman with a medical history significant for a seizure disorder diagnosed after she had a tonic‐clonic type seizure at age 16. She was treated with phenytoin, but this was [...]

Case Presentation: A 60‐year‐old white woman with a history of coronary artery disease presented with a 2‐day history of dyspnea and pleuritic chest pain. The chest pain varied in its intensity, and it increased with [...]

Case Presentation: A 34‐year‐old woman with no medical history presented with complaints of severe, intermittent headaches and dizziness of 3 months’ duration. Her primary care physician had diagnosed her with “malignant hypertension” and initiated treatment [...]

Case Presentation: A 57‐year‐old woman with hepatitis C presented with sudden‐onset, large‐volume hematemesis. After initial resuscitation, an urgent upper endoscopy was performed. This revealed isolated gastric varices with evidence of a recent bleed. Despite no [...]

Case Presentation: A 28‐year‐old woman, previously in good health, was admitted to the hospital after presenting with 4 weeks of myalgias, chills, night sweats, and persistent fevers. She had no upper respiratory symptoms, photophobia, or [...]

Case Presentation: A 41‐year‐old African American woman presented with a 3‐week history of low‐grade fever, malaise, generalized arthralgia, unintentional 20‐pound weight loss, and tender left posterior cervical lymphadenopathy. She reported no animal exposure, international travel, [...]

Case Presentation: This is a 71‐year‐old Mexican American woman who was admitted with a 2‐month history of progressively worsening lower back pain, weight loss, and night sweats. She was treated with ketorolac injections in Mexico [...]

Case Presentation: A 47‐year‐old man with a history of hepatitis C infection, hypertension, diabetes, and bicuspid aortic valve presented with 2 weeks of fevers, chills, and rigors. He was afebrile and hemodynamically stable at the [...]

Case Presentation: A 59‐year‐old Hispanic man presented with 3 days of intermittent substernal chest pain radiating to the left axilla, occurring at rest, and associated with shortness of breath, diaphoresis, and nausea. His medical history [...]

Case Presentation: A 43‐year‐old woman without any medical history presented to the emergency room with a severe headache, neck pain, chills, vomiting, and photophobia for 7 days. She also had complaints of recent loss of [...]

Case Presentation: A 45‐year‐old woman was admitted with vomiting. Her medical history was notable for Down syndrome, type 2 diabetes, and moderate aortic stenosis. Four weeks before admission she presented to her physician with a [...]

Case Presentation: A healthy 44‐year‐old man presented with a 4 day history of myalgia, cough, fever, and dyspnea after a hiking expedition. Two weeks prior to admission he had traveled to the Catskill Mountains, sleeping [...]

Case Presentation: A 47‐year‐old man with a history of ul‐cerative colitis (UC) was admitted for malaise, fever, and neck pain. On arrival he was ill‐appearing, febrile (39.2°C), hypotensive (80/63 mm Hg), and tachycardic (163 bpm) with [...]

Case Presentation: A 17‐year‐old white boy was admitted for 12 days of high fevers, nonbloody diarrhea, mild hearing loss, and a 5‐kg weight loss. He denied sick contacts or recent travel and had no significant [...]

Case Presentation: A 65‐year‐old undomiciled man without known medical history presented to the hospital with fever amd right shoulder and knee pain. Following arthrocentesis, he was diagnosed with methicillin‐sensitive Staphylococcus aureus (MSSA) polyarthritis, thought to [...]

Case Presentation: C.M. is a 38‐year‐old man who presented to the hospital with severe abdominal distention that developed over 1 month. Four days prior to admission, he had some diarrhea. Past medical history included constipation [...]

Case Presentation: A 47‐year‐old white man with a history of alcohol abuse was transferred to our hospital with loss of consciousness and subsequently intubated en route for airway protection. His medical history was unremarkable. On [...]

Case Presentation: This is a 35‐year‐old Hispanic woman with a history of familial Mediterranean fever (FMF) on disability for 6 years given the severity and frequency of the FMF attacks. The patient had been unable [...]

Case Presentation: A 38‐year‐old African American man with a medical history of hiradenitis suppurativa (HS) presented with 1‐year history of left leg ulcer with a 2‐week increase in size and malodorous discharge. He denied any [...]

Case Presentation: A 58‐year‐old man with a medical history of chronic obstructive pulmonary disease (COPD) came to the emergency department (ED) with complaints of worsening cough and shortness of breath and was admitted for COPD [...]

Case Presentation: A 69‐year‐old Hispanic man presented with several months of progressive bilateral paraorbital swelling and ptosis. The patient had presented 1 year ago to an outside physician complaining of sudden‐onset bilateral eyelid swelling. At [...]

Case Presentation: A 22‐year‐old woman with a 4‐year history of active systemic lupus erythematosus (SLE) presented with a 4‐day history of fever, nonproductive cough, and shortness of breath. Two months earlier she had been admitted [...]

Case Presentation: A 36‐year‐old white man presented with a 4‐week history of palpitations, presyncope, and progressive dyspnea on exertion. He reported a significant decrease in his exercise tolerance over the last few months. Family history [...]

Case Presentation: A 58‐year‐old African American woman presented with the acute onset of exquisite left thigh pain and erythema. Her medical history was significant for idiopathic thrombocytopenia purpura, autoimmune hemolytic anemia, and pernicious anemia because [...]

Case Presentation: A 28‐year‐old white woman with allergic rhinitis was seen in our clinic with a 1‐week history of a hard, reddishviolet nodule on her right forearm. The nodule was pruritic but not painful. She [...]

Case Presentation: A 48‐year‐old man with Raynaud's and recently diagnosed CREST syndrome presented with 1 month of exercise intolerance and progressive shortness of breath, with no chest pain, peripheral edema, weight gain, cough, fever, or [...]

Case Presentation: A previously healthy 59‐year‐old man developed low back pain, symptoms of lumbar radiculopa‐thy following a cross‐country drive. MRI showed mild lumbar spinal stenosis. Over 3 months, he developed paraplegia and urinary/fecal incontinence. Laboratory [...]

Case Presentation: A 40‐year‐old white man presented with a chief complaint of fevers and lip and scrotal swelling. Two weeks prior, he had chills and sore throat, followed by right submandibular and cheek swelling and [...]

Case Presentation: An 85‐year‐old woman with chronic obstructive lung disease, hypertension, and a history of cere‐brovascular accident presented to the hospital with chest pain for 1 day that was worse with deep inspiration. She also [...]

Case Presentation: A 32‐year‐old African American woman presented to the emergency room (ER) with a 1‐week chief complaint of right lower‐quadrant abdominal pain that was sharp in nature and exacerbated by movement. There was no [...]

Case Presentation: A 56‐year‐old Mexican woman with no prior medical history presented to an outside hospital with otitis media refractory to antibiotics, culture‐negative mas‐toiditis, and a facial nerve palsy that resolved with steroids. After transfer [...]

Case Presentation: A 26‐year‐old woman with a medical history of asthma presented to the emergency department with a 3‐day history of nonproductive cough, dyspnea on exertion, diaphoresis, and right‐sided chest pain. She also noted an [...]

Case Presentation: Our patient is a 42‐year‐old African American woman with a significant history of a locally advanced ductal cancer of left breast (T2N1M0) after a modified radical mastectomy 1 year earlier. She also received [...]

Case Presentation: A 46‐year‐old right‐handed man with no significant medical history presented to our hospital with a 5‐day history of progressive, painful swelling of his left upper extremity. He was a frequent binge drinker, and [...]

Case Presentation: A 20‐year‐old woman with no medical history presented with splenomegaly by outside imaging. She described 7 months of left upper quadrant pain that intensified prior to admission, was 8/10, nonradiating, and worse with [...]

Background: One of the growing challenges in today's health care system is the increase in the number of childhood illnesses that are survived and the number of adults who continue to live with the disease. [...]

Background: Prolonged emergency department boarding times have been associated with poor patient satisfaction, adverse clinical outcomes, longer hospital stays, increased ambulance diversion, reduction in the possibility of increased revenue from additional patient services, and increased [...]

Background: Most responses to Accreditation Council for Graduate Medical Education (ACGME) regulations such as floats, nonteaching services, and midlevel providers have sought to preserve the traditional call system. As a result, hand‐offs have increased, compromising [...]

Background: Communication failure is the most common cause of preventable disability or death in the hospital. Accurate and efficient communication is the cornerstone of multidisciplinary health care. Multiple clinicians and other personnel need to identify [...]

Background: The Internet's penetration onto hospital floors, into patient rooms, and on our mobile devices has profoundly altered the way hospitalists access knowledge resources. Information management and sharing increasingly takes place online and in real [...]

Background: CVC placement is frequently performed by residents. Training of clinical procedures using simulation‐based instruction and modeling with guided practice has been shown to decrease complications. Programs aimed at improving residents’ knowledge and skills often [...]

Background: Patient satisfaction is measured across hospitals through a uniformly administered patient survey called the Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS). This was developed by the Centers for Medicare & Medicaid [...]

Background: Follow‐up appointments are a crucial part of the discharge home. This step can be time consuming as physicians try to navigate each outpatient office's unique system. In 2008 one of our interns identified the [...]

Background: Neonatal jaundice is a common condition that can result in devastating consequences if not treated aggressively. Despite evidence‐based guidelines for monitoring and treating hyperbilirubinemia, variation in care persists that can result in suboptimal outcomes. [...]

Background: Internal medicine residents lack formal training of concepts that pertain to the business of medicine. Previous studies of graduates of various specialties found young practitioners to have little knowledge about basic financial accounting principles [...]

Background: The evolving political and regulatory climes in recent times pose several challenges to hospital medicine. There is a need for a “consumer‐driven” approach to health care that emphasizes both quality of care and consumer [...]

Background: Although educators espouse the benefits of bedside teaching and faculty and trainees report they would prefer more bedside teaching, the proportion of time on rounds spent at the patient bedside has decreased markedly, from [...]

Background: The literature suggests that stat laboratory tests are frequently ordered inappropriately by physicians. In fact, up to 65% of laboratory tests are ordered as stat in teaching hospitals. Previous studies also suggest that reporting [...]

Background: The Anticoagulation Safety Taskforce established a comprehensive Anticoagulation Safety Program over the last 2 years with the overall goal of reducing harm surrounding the use of the 3 most commonly used anticoagulants—heparin, warfarin, and [...]

Background: Hospital readmissions, a consequence of fragmentation of care, has recently been described as a crisis of health care safety, cost, and patient experience. Reducing unplanned readmissions is especially challenging. Despite the emergence of a [...]

Background: Postdischarge care is a challenge, and the readmission rate remains high especially in elderly patients. Because discontinuity is a concern after discharge, post‐discharge transition care (PDTC) needs to be incorporated into hospitalist‐care systems. Purpose: [...]

Background: July has been implicated as a time of increased medical errors because of its association with the onset of residency training. The abrupt transfer of patient care responsibilities at the beginning of each academic [...]

Background: Lack of functional mobility in hospitalized patients results in a substantial loss of lower‐extremity strength and has been associated with increased falls, skin breakdown, and overall worse medical outcomes. Aside from physical therapy consultation [...]

Background: Sepsis is a common condition associated with high mortality. Abundant literature, including the Dillinger guidelines, suggests that prompt placement of a central venous catheter (CVC) is essential in treating sepsis effectively. Numerous barriers prevent [...]

Background: Joint Commission on Accreditation of Healthcare Organizations sentinel event reporting demonstrates that 70% of preventable medical errors are due to communication errors. The national patient safety goals for 2006 include improving “the effectiveness of [...]

Background: Given the current health care reform movement, it is clear that hospital utilization will be paramount for hospitals to provide adequate health care while limiting costs. Purpose: To examine the utilization data for cirrhotic [...]

Background: Project BOOST (Better Outcomes for Older Adults through Safe Transitions) is a Society of Hospitalist Medicine project aimed at improving the care of patients as they transition from hospital to home. Queen's Medical Center [...]

Background: Over 12 months, our academic hospitalist section expanded by nearly 50% and was intimately involved with major changes in the residency ward structure. Section members repeatedly cited the need for improved communication about administrative [...]

Background: Glycemic control in hospitalized patients can improve outcomes and shorten length of stay, whereas hypoglycemia can raise in‐hospital mortality. To improve glycemic control in our tertiary‐care academic hospital, we initiated a multidisciplinary quality improvement [...]

Background: HIV/AIDS is now better understood with regard to disease treatment and prevention but is still not a disease that we can eradicate through preventive measures such as vaccines or elimination of high‐risk behaviors. It [...]

Background: Physician feedback is typically sporadic after residency training is completed. The literature suggests that feedback given in letter form or only for poor performance is ineffective in changing physician behavior and can lead to [...]

Background: Regardless of specialty or discipline, the majority of health care profession students care for hospitalized older adults during their training and in their future careers. It is therefore crucial that students have educational experience [...]

Background: Studies have demonstrated that patients forget 40%–80% of the information they receive almost immediately after hearing it. In addition, nearly half of the information they retain is incorrect. Given the importance of understanding one's [...]

Background: Medical educators have opined that the clinical, communication, and professionalism skills of medical students are best taught and assessed by faculty directly observing clinical encounters between students and patients. Nonetheless, the medical literature suggests [...]

Background: Falls suffered by hospitalized patients are an important reportable event. Approximately 4%–6% of inpatient falls result in serious injury. Recurrent falls or delayed recognition of injury can harm patients and represent a medicolegal risk. [...]

Background: Patient handovers represent vulnerable points in time during a hospitalization. Although changes in the practice of medicine and changes in residency work‐hour restrictions have led to increased patient handovers, training programs have not uniformly [...]

Background: The risks associated with blood transfusions in tandem with spiraling health care costs have placed the spotlight on blood management programs. In addition, Joint Commission on Accreditation of Healthcare Organizations performance measures related to [...]

Background: Syncope, a frequent diagnosis encountered in the emergency department (ED) and inpatient setting, creates risk assessment and disposition challenges. The San Francisco Syncope Rule (SFSR) was developed to help identify lower‐risk syncope patients less [...]

Background: Insulin is a “high‐alert medication” carrying increased risk of significant harm when used in error. The complex nature of inpatient glycemic control requires a team approach. Team structure may be multidisciplinary, utilizing the skills [...]

Background: About 18%–20% of Medicare beneficiaries who are discharged from a hospital are readmitted within 30 days. The health care spending related to this has been estimated at $17 billion. Furthermore, Congress and President Obama [...]

Background: Hospitals are required to review sentinel events (SEs) and develop root cause analyses (RCA), implement action plans, and monitor the effectiveness of implemented plans. Vague definitions of safety terms and nonstandardized review processes impede [...]

Background: Effective transitions of care are essential to improving health care delivery and include high‐quality medication reconciliation and discharge instructions. These are an important focus of the Joint Commission and of the meaningful use of [...]

Background: Improving transitions of care is a quality and patient safety imperative for hospital‐based providers. Inaccurate medication reconciliation during the discharge transition is a known cause of preventable medication errors, patient confusion regarding medication regimens, [...]

Background: An estimated 30,000 hospital medicine physicians practice in the United States today. Many of these physicians are challenged to engage in nonclinical activities, including administrative leadership, quality improvement projects, and educational initiatives. Yet residency [...]

Background: A positive safety culture is an essential component of enhancing patient safety. As hospitalists assume leadership roles within health systems, the capacity to measure a system's safety culture can serve as a key first [...]

Background: Readmissions are a low‐value outcome for patients and costly to society. In the current environment there is ample motivation for hospitals and providers to improve this important patient outcome. Studies have demonstrated important reduction [...]

Background: Although checklists have been used to improve quality of care in surgery and intensive care unit settings, it is unclear if they are helpful for hospitalized medical patients. We developed a checklist to address [...]

Background: An untapped mutualism between house staff and hospitalists exists in academic teaching hospitals. On the one hand, many hospitalists struggle to conduct meaningful research without needed funding for research assistants. On the other hand, [...]

Background: In many health care settings providers are given regular performance feedback via data dashboards, and financial incentives are often tied to these data. Although this structure is now commonplace for physicians and an important [...]

Background: The failure of recent generations of physicians to be proficient in physical diagnosis is well known in the medical community, and recently even the mainstream media have taken to reporting on the problem. However, [...]

Background: The Institute for Healthcare Improvement recommends that any unplanned readmission within 30 days of discharge prompt a formal case review to identify systematic flaws in discharge processes. Residency programs are also being charged to [...]

Background: Hospitalist groups face increasing pressure to substantiate quality and efficiency of care through performance data. Academic groups are expected to advance the field through scholarly work and provide quality education to students and house [...]

Background: Telemetry use has escalated in hospitals in general, causing some unexpected problems including a tethering effect for patients, with reduction of ambulation, potential for increased falls, and even a potential for increased length of [...]

Background: The transition from hospital to home is critical for patients, especially for those with a complicated medication regimen. Patients often report problems understanding and using the traditional medication discharge list. The authors created a [...]

Background: Preventable rehospitalizations are disconcerting for patients, contribute to high health care costs, and are partly due to deficiencies in patients’ ability to execute the posthospital care plan. Effective patient and family care‐giver engagement and [...]

Background: Despite published inpatient hyperglycemia treatment guidelines, most hospitals have not yet adopted them. In our hospital 50% of inpatients have diabetes, and neither uniform hypoglycemia treatment nor insulin protocol was available on the computerized [...]

Background: The challenges of medication reconciliation at hospital admission and discharge are well recognized, and best practices remain to be fully defined. The accuracy of the preadmission medication list (PAML) may be compromised by patient [...]

Background: The Hospital Outcomes Program of Excellence (HOPE) Initiative is an effort to improve the inpatient medical care provided at the Ann Arbor VA Medical Center. Our goal is to expand and enhance the systems [...]

Background: Hospital patient flow and its measurement are a complex organizational issue. Composite measures may provide a holistic picture of patient flow for monitoring and improving. Purpose: To describe a patient flow composite score tool [...]

Background: Health care workload (WL) and workforce (WF) are complex and dynamic. A significant challenge is measuring and defining the match of WL and WF to optimize processes of care. Purpose: To develop and obtain [...]

Background: The Accreditation Council for Graduate Medical Education (ACGME) sanctioned new accreditation standards that define core competencies in research and other scholarly activities for subspecialty fellows in 2007. There are few descriptions of organizational models [...]

Background: Fragmentation of inpatient care has precluded collaboration among neighboring institutions. Hospitals in large urban areas characteristically function as separate silos. Yet the increased complexity of inpatient care necessitates a different approach. The advent of [...]

Background: Clostridia are anaerobic spore‐forming rods (bacilli). C. difficile is the most serious cause of antibiotic‐associated diarrhea (AAD) and can lead to pseudomembra‐nous colitis. This form of colitis often results from eradication of the normal [...]

Background: Physicians are aware of approximately 40% of the final results of tests pending at discharge (TPADs). Few institutions have standardized systems to manage TPADs. Automated systems using “push” notification may improve awareness of TPADs; [...]

Background: Hospitalization can be an isolating and disorienting experience for elderly patients who find themselves cut off from normal routines and social support. Providing structure to social and cognitive stimulation provided by specially trained hospital [...]

Background: Patients who see a physician shortly after hospital discharge have improved outcomes and reduced read‐missions. To promote follow‐up, Henry Ford Hospital will schedule patients for postdischarge follow‐up appointments (PDFUAs) prior to discharge. Yet patients [...]

Background: The hospitalist model of care may adversely affect the transition to or from the hospital by interrupting the flow of information between providers. The resulting information chasm has been related to readmissions, adverse events, [...]

Background: Beginning in January 2011, hospitals will report central line‐associated bloodstream infections (CLABSIs) to the National Healthcare Safety Network (NHSN) per Center for Medicare and Medicaid Services (CMS) payment rules. The NHSN definition of CLABSI [...]

Background: Hospitalized patients are frequently readmitted within 30 days of their discharge. It is believed that many patients are readmitted because of a recurrence or worsening of the same condition for which they were originally [...]

Background: In 2001 our residency program developed a quality improvement elective. Our goals were to provide residents with hands‐on experience in peer review root cause analysis (RCA) and performance improvement, which would also satisfy the [...]

Background: Our program admits approximately 15,000 patients a year. Bed assignment depends on availability and level of care required. Incorrect placement occurs frequently, leading to delays in patient care and causing a drain on nursing, [...]

Background: Clinician‐educators are responsible for more information and sicker patients than in the past. Yet they face greater time pressures. Faculty development programs ought to teach clinician‐educators to handle these conflicting responsibilities while retaining excellence [...]

Background: Handling deaths is a stressful but unfortunately common event for hospital‐based trainees. This experience is a key component of the practice of palliative care. Training in palliative care is a responsibility and a requirement [...]

Background: Noncardiac surgery in patients with pulmonary arterial hypertension (PAH) is associated with a morbidity of 42% and a mortality of 7%. The most important pathophysiologic consideration is the effect of increased pulmonary vascular resistance [...]

Background: Central line–associated bloodstream infections (CLABSIs) increase length of stay, add an additional $10,000 in costs per event, and increase mortality. Education, procedure carts, and checklists to improve compliance with evidence‐based, sterile procedures have been [...]

Background: The number of attending‐only services in traditional teaching hospitals has increased. This trend is largely a result of decreased patient coverage by residents in response to ACGME duty‐hour restrictions, as well as planned growth [...]

Background: Many hospitalist groups recognize the importance of ensuring that the individual preferences, strengths, and practice styles of their providers are taken into account while determining the work schedule for the practice. Rigid schedules with [...]

Background: Many hospitals lack adequate resources to provide pharmacist‐delivered discharge counseling for all inpatients. We hypothesized that health literacy testing could identify a manageable subset of high‐risk diabetic and anticoagulation patients in need of additional [...]

Background: Hospital‐acquired methicillin‐resistant Staphylococcus aureus (HA‐MRSA) infections annually affect almost 21,000 patients nationwide. Randomized controlled trials have demonstrated the efficacy of chlorhexidine gluconate (CHG) in preventing HA‐MRSA infections associated with invasive procedures. Several small studies [...]

Background: Ultrasonography (US) has improved the yield of bedside invasive procedures over the last decade; however, unsuccessful procedures still occur. As benchmarks for the yield of procedures using US are limited, we aimed to quantify [...]

Background: The Center for Medicaid and Medicare Services requires that a discharge summary be completed only within 30 days of discharge. This rule is inadequate to ensure safe care transitions, as outpatient physicians must receive [...]

Background: Acute lung injury (ALI) is a frequently fatal cause of respiratory failure among hospitalized patients, and a practical and easily obtainable prognostic index at the time of ALI diagnosis is needed for risk prediction. [...]

Background: Acute lung injury (ALI) is a common cause of respiratory failure among hospitalized patients. Large studies have been limited to patients requiring mechanical ventilation, and little is known about non–mechanically ventilated adults with ALI. [...]

Background: Hospital care consumes a large percentage of U.S. health care costs, yet providers practicing in the hospital are often unaware of the actual costs of the diagnostic tests they order. We hypothesized that displaying [...]

Background: The majority of patients with serious illness die in an acute care hospital. The dying process is often filled with clinically and ethically challenging decisions. Frequently, patient care at the end of life is [...]

Background: Upper gastrointestinal bleeding is a common indication for admission to the hospital. Several risk score systems are designed for triage patients with acute nonvariceal upper gastrointestinal bleeding (UGIB). Glasgow Blatchford score (GBS) and clinical [...]

Background: The incidence of in‐hospital cardiac arrest (IHCA) in the United States is unknown but has been estimated using administrative data from large nationally representative samples such the Medicare and Nationwide Inpatient Sample databases. However, [...]

Background: Several previous studies have documented lower initial survival in men than women following cardiac arrest, primarily in the out‐of‐hospital setting. However, the etiology of this discrepancy and its translation into the in‐hospital environment is [...]

Background: Physicians’ levels of burnout shape the trajectory of their professional development, ultimately affecting their career resilience. Burnout poses a challenge to long‐term career resilience by preventing physicians from responding to their intrinsic motivations. However, [...]

Background: Sleep disturbances are prevalent among hospitalized seniors and often neglected by clinicians, despite their potential for negative health outcomes. One of the primary reported causes of sleep loss in hospitals is environmental noise, a [...]

Background: Each year approximately 795,000 persons in the United States experience a stroke. Data from the Paul Coverdell National Acute Stroke Registry suggest many acute stroke patients do not receive treatment according to established guidelines. [...]

Background: The hospital discharge transition can be dangerous for patients with a high risk of failed follow‐up and adverse events. Moreover, about 20% of hospitalized Medicare patients are readmitted within 30 days of discharge. Although [...]

Background: Racial disparities in the quality of health care are well recognized in the United States. Multiple factors drive this disparity gap in quality, but few strategies have proven successful in decreasing the gap. Quality [...]

Background: The number of hospitalists in the United States continues to grow rapidly, yet little is known about the work life of hospitalists to inform whether hospital medicine is a viable long‐term career for physicians. [...]

Background: Nearly two thirds of U.S. hospitals are served by hospitalists who work under a variety of practice models. Differences in hospitalist practice patterns and satisfaction of individual hospitalists across these models are unknown. Methods: [...]

Background: There are limited tools to aid in stratifying peri‐operative risk in orthopedic surgical patients. Frailty has been associated with poor clinical outcomes yet is difficult to measure. We sought to better understand the implications [...]

Background: Assessing perioperative risk is a common challenge in daily internal medicine practice. Risk models are sparse and focus primarily on cardiac and pulmonary risk. Little has been established regarding the implications of more common [...]

Background: Sepsis is a major cause of death in hospitalized patients. The preferred setting to care for patients with sepsis is the medical intensive care unit (MICU). However if the MICU is full, patients are [...]

Background: Inappropriate fresh frozen plasma (FFP) prescriptions may account for at least some of the dramatic increase seen in FFP transfusions. In particular, FFP prescribed for bleeding prophylaxis prior to invasive procedures may be largely [...]

Background: Delirium affects 50% of intensive care unit (ICU) patients and is associated with increased mortality and long‐term cognitive impairment. Instruments can accurately measure delirium; however, the sustainability and reliability of delirium measurement tools are [...]

Background: Blood transfusion raises many questions of safety and economics. We examined blood usage and its characteristics in patients taken care of by hospitalists, a group of physicians for whom there is a scarcity of [...]

Background: Inadequate vaccination of eligible inpatients against influenza and pneumococcal infections is a gap in quality care that contributes to the spread of disease in the community. Rates of vaccination at Emory University hospitals were [...]

Background: States in the United States have wide latitude in administering Medicaid, thus creating an opportunity to study interstate differences in quality and outcomes among Medicaid recipients. Studying statewise variations in preventable hospitalization (PH) rates [...]

Background: Hospital medicine is the fastest‐growing medical field in the United States. Given a pressing shortage of hospi‐talist physicians and restrictions on resident duty hours, the number of physician assistants (PAs) in hospital medicine is [...]

Background: The prevalence of community‐acquired methi‐cillin‐resistant Staphylococcus aureus (CA‐MRSA) infections among the pediatric population has been gradually increasing over the years. Similarly, the resistance to other families of antibiotics has also developed rapidly in community [...]

Background: Sonographic measurement of the inferior vena cava (IVC) diameter is straightforward and reliably performed by noncardiologists using hand‐carried ultrasound (HCU) at patients’ bedsides. It provides a noninvasive estimate of the right atrium pressure and [...]

Background: The National Epidemiologic Survey on Alcohol and Related Conditions indicates that American adults have a 30% lifetime prevalence of any alcohol disorder and a 10% lifetime prevalence of any drug disorder. The purpose of [...]

Background: Today's medical students frequently lack positive opportunities for interaction with elderly people because of restructuring and distribution of families according to age. However, the elderly patient will be disproportionately represented in many clinicians’ practices, [...]

Background: Patients frequently encounter questions or problems shortly after discharge. Telephone follow‐up has become an essential part of transitions of care interventions to address postdischarge problems, increase patient satisfaction, and decrease readmission rate. There is [...]

Background: Communication between nurses and physicians has been studied in settings of intensive care units, internal medicine wards, operating rooms, and labor and delivery. These studies have shown that this communication can affect nursing retention [...]

Background: As physicians are forced to spend more time in “indirect” patient care activities, particularly on documentation, it has become difficult to establish meaningful physician–patient relationships. Dr. Michael Kahn proposed a checklist of 6 etiquette‐based [...]

Background: Self‐mutilation has been defined as the deliberate commission of recurrent socially unacceptable direct physical harm to one's own body without conscious suicidal motivation. There is evidence that self‐mutilation has become more prevalent in the [...]

Background: In‐hospital stroke (IHS) represents 5%–15% of all hospitalized acute stroke cases and is associated with poor outcomes. These patients may be excellent candidates for rapid assessment and potential thrombolytic therapies. This project aimed to [...]

Background: American Diabetes Association (ADA) goals for hospitalized patients include: premeal blood glucose (BG) < 140 mg/dL, random BG < 180 mg/dL, and avoid hypoglycemia (BG < 70 mg/mL). To achieve these goals, the ADA recommends use of basal‐mealtime‐supplemental (BMS) insulin regimens, avoidance of [...]

Background: Hospital‐acquired venous thromboembolism (HA‐VTE) is a predictable complication that increases morbidity and mortality. Despite overwhelming evidence supporting the effectiveness of VTE prophylaxis, safe, effective, and cost‐efficient methods to prevent VTE remain underutilized. In the [...]

Background: Ongoing evaluation of sedation programs and individual physician performance are important elements in a successful sedation program. In our institution, quality improvement (QI) forms are used to track adverse events occurring during procedural sedation. [...]

Background: Propofol is widely used to sedate children for radiological procedures. Because propofol is an anesthetic, its use in the past was restricted to anesthesiologists. The hospitalist group at St. Louis Children's Hospital (SLCH) successfully [...]

Background: Localization of medical teams to a hospital unit is an attractive way to organize hospitalist services but its operational impact on work flow has not been examined. Methods: Between April 1, 2010, and July [...]

Background: Localization of medical teams to a hospital unit has been shown to improve nurse–provider communication, but its affect on patient outcomes is unknown. Methods: Between April 1, 2010, and July 10, 2010, we conducted [...]

Background: Studies show that hospitalized patients do not understand their postdischarge care plan. Increased patient involvement in care has been found to improve outcomes; understanding the care plan is the first step in engaging patients. [...]

Background: A unit‐localized hospitalist physician is often utilized to improve the overall efficiency of patient care. The effect of this type of system specifically on discharge time of day and length of stay (LOS) in [...]

Background: Venous thromboembolism (VTE) is a common preventable cause of inpatient mortality. Pharmacologic methods are the preferred mode of prophylaxis according to guidelines. Various risk‐assessment tools are available to assist physicians in identifying patients who [...]

Background: Similar to national trends, the emergency department (ED) at our 960‐bed institution faced increasing volume and overcrowding, resulting in delays in treatment, lower patient satisfaction, and concerns about quality. Between January 2009 and June [...]

Background: Hospital‐based tobacco cessation counseling is critical, especially among African Americans, who suffer a disproportionate burden of tobacco‐related disease. Recently updated cessation guidelines are available, and quality measures for counseling are tied to physician reimbursement. [...]

Background: Venous thromboembolism (VTE) represents significant morbidity and mortality challenges for hospitals. Despite the implementation of risk stratification methodologies and admission order sets to ensure VTE prophylaxis at most hospitals, studies indicate that a significant [...]

Background: Deep vein thrombosis (DVT)–related pulmonary embolism (PE) is the most common cause of preventable death in hospitalized patients. A large tertiary‐care academic medical center focused on increasing venous thromboembolism (VTE) prophylaxis for all medicine [...]

Background: Venous thromboembolism (VTE) is an AHRQ safety measure. VTE rates at our academic medical center were higher than other University HealthSystem Consortium peers. Relative to best practices at leading hospitals, we identified numerous improvement [...]

Background: Five million patients receive packed red blood cell (PRBC) transfusions annually in the United States and Canada, and 43,000 units of PRBCs are transfused daily. Although PRBCs augment oxygen delivery, they also increase the [...]

Background: Dementia is a progressive neurodegenerative syndrome. The percutaneous endoscopic gastrostomy/jejunostomy (PEGJ) tube was first introduced in clinical practice in 1980 as a means to provide nutrition to children. PEGJs are often placed in elderly [...]

Background: Very few studies have focused on patient characteristics that influence length of stay (LOS) after total knee arthroplasty (TKR). The primary goal of this retrospective study was to identify patient characteristics associated with LOS [...]

Background: Current recommendations for diagnosing pulmonary embolism (PE) include using a clinical pretest probability (PTP) assessment as the initial screening tool. However, research has shown that physicians do not consistently use clinical assessment tools, such [...]

Background: Postdischarge assessments of pain and pain control among recently hospitalized patients are an established element of hospital quality measurement. However, retrospective assessments may not accurately measure pain because patient experience varies over time and [...]

Background: Every year, 1%‐2% of hospitalized patients leave the hospital against medical advice (AMA), placing them at risk for increased readmission and 30‐day mortality. Although 1 prior emergency department study suggested clinicians often counsel patients [...]

Background: The literature argues that regions with greater availability of health care services have high‐intensity patterns of care that raise costs but do not improve outcomes. It has been proposed that limiting the supply of [...]

Background: New ACGME duty‐hour requirements limiting intern shifts to fewer than 16 continuous hours go into effect July 1, 2011. Little is known about how this work‐hour reduction might affect patient outcomes. Our objective was [...]

Background: Although concerns have been raised about the effect of the hospitalist model on the doctor–patient relationship, hospitalists now care for many hospitalized patients. How hospitalists explain their role may influence patients’ perception of the [...]

Background: Sickle cell disease (SCD) patients are overre‐presented in emergency department and inpatient settings, requiring more than $2 billion annually for hospitalization. Average length of stay (LOS) is 5.3 days, whereas 14‐day readmission rates can [...]

Background: Prevalence of anemia is increasing in the general population along with other comorbidities. Anemia is associated with higher morbidity and mortality in a variety of settings. Most studies have analyzed elderly patients or specific [...]

Background: The eighth National Patient Safety Goal, developed by the Joint Commission in 2009, emphasizes the significance of reconciliation of medications during the entire period of hospitalization. Inaccuracies in the home medication list may lead [...]

Background: Elevated platelet count is frequently reported to be associated with iron deficiency. However, the causes underlying iron deficiency vary with age and may have differential effect on platelet count. Therefore, we hypothesized that the [...]

Background: Platelet distribution width (PDW) is a quantitative measure of variability in platelet size. It has been hypothesized that increased PDW may be a predictor of mortality. However, this hypothesis has not been examined in [...]

Background: Little is known about the type of research done by hospitalists. The Society of Hospital Medicine (SHM) has selected abstracts for presentation at its annual meeting since 2006. Methods: Three academic hospitalists independently reviewed [...]

Background: Falls are the leading cause of accidental death in the elderly older than 65 years of age in the United States. Many factors lead to falls in the elderly, with a common etiology being [...]