HM2012 Abstract Number: 97544

Identifying Preventable Readmissions: An Interdisciplinary Approach to Building a Conceptual Model

Background: Reducing preventable hospital readmissions is a complex and challenging goal without a clear roadmap for successful attainment. The problem is compounded by the lack of consensus on the defining criteria for preventable readmissions. We [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Identifying Preventable Readmissions: An Interdisciplinary Approach to Building a Conceptual Model

HM2012 Abstract Number: 97545

Targeting Posthospitalization Interventions to Reduce 30 Day Readmissions and Emergency Department Utilization in High Risk Populations

Background: There has been considerable interest in development of strategies to reduce avoidable readmissions after hospital discharges. Studies have shown that home visits after discharge can result in readmission prevention, improved patient satisfaction, understanding and [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Targeting Posthospitalization Interventions to Reduce 30 Day Readmissions and Emergency Department Utilization in High Risk Populations

HM2012 Abstract Number: 97546

Do Housestaff Provide Adequate Work Rounds? Results from 17 Training Programs

Background: Effective hospital work rounds require attention to multiple components: physicians should be able to review patients' course, test results, and treatment plan while attending to their comfort and answering questions. In general, it also [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Do Housestaff Provide Adequate Work Rounds? Results from 17 Training Programs

HM2012 Abstract Number: 97547

Validating a Tool to Rate Handoff Quality Using Standardized Video Scenarios: The Good, Bad, and Ugly

Background: Handoffs are a core competency of hospitalists. While the Society of Hospital Medicine and others recommend improving handoffs, there is a lack of validated tools for teaching and assessing handoff quality. The specific aims [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Validating a Tool to Rate Handoff Quality Using Standardized Video Scenarios: The Good, Bad, and Ugly

HM2012 Abstract Number: 97548

Patient and Familycentered Rounds on a Geriatric Inpatient Service: Resident and Staff Perspectives of Bedside Rounds

Background: While well studied in the pediatric setting, little is known about the application of patient– and family–centered rounds (PFCR) to the adult population, but the potential for care improvement is great. PFCR is a [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Patient and Familycentered Rounds on a Geriatric Inpatient Service: Resident and Staff Perspectives of Bedside Rounds

HM2012 Abstract Number: 97549

Design and Evaluation of a Multidisciplinary Webbased Handoff Tool

Background: Failures in communication among healthcare personnel during intrahospital handoffs in care are known threats to patient safety. In August, 2009, our healthcare system held a multistakeholder summit on handoffs, developed consensus around the need [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Design and Evaluation of a Multidisciplinary Webbased Handoff Tool

HM2012 Abstract Number: 97550

Patient Discharge Education: Perceptions and Practice for Nurses, Interns, and Hospitalists

Background: Nurse–physician communication is essential to ensure consistent and complete discharge instructions to patients. Though comprehensive discharge education can improve patient understanding and may reduce unnecessary rehospitalization, little is known about nurse and physician communication [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Patient Discharge Education: Perceptions and Practice for Nurses, Interns, and Hospitalists

HM2012 Abstract Number: 97551

Emergency Medicine to Internal Medicine Handoffs in Academic Centers: A Survey of National Practices

Background: To improve patient safety, The Joint Commission has called for standardization of physician–to–physician handoffs of patient information. The handoff from Emergency Medicine (EM) to Internal Medicine (IM) providers at the time of patient admission [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Emergency Medicine to Internal Medicine Handoffs in Academic Centers: A Survey of National Practices

HM2012 Abstract Number: 97552

Communication from the Primary Care Physician to the Hospitalist

Background: Communication between primary care physicians (PCPs) and hospitalists occurs only 3–20% of the time. The aim of this study is to assess the PCPs' response to information requests at the time of their patients' [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Communication from the Primary Care Physician to the Hospitalist

HM2012 Abstract Number: 97553

Interventions to Prevent Adverse Events and Readmissions After Hospital Discharge: A Systematic Review

Background: Hospitalists are charged with addressing the gaps in transitional care, which manifest as adverse events (AEs) and readmissions after discharge. The Centers for Medicare & Medicaid Services plan to lower reimbursement to hospitals with [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Interventions to Prevent Adverse Events and Readmissions After Hospital Discharge: A Systematic Review

HM2012 Abstract Number: 97554

Characteristics of a Frequently Readmitted Patient Population on an Inpatient Medical Service

Background: Patients frequently admitted to the hospital use a disproportionate amount of healthcare resources. However, scant information exists about the clinical and social characteristics of this population, as well as the quality of their transitions [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Characteristics of a Frequently Readmitted Patient Population on an Inpatient Medical Service

HM2012 Abstract Number: 97555

Understanding Medication Challenges Among Older Adults After Hospital Discharge

Background: Older adults have a 19% risk of 30–day readmission, and medication safety plays an important role in reducing this risk. We conducted telephone–based interviews as part of a qualitative study to better understand the [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Understanding Medication Challenges Among Older Adults After Hospital Discharge

HM2012 Abstract Number: 97556

Assessment of Teamwork During Structured Interdisciplinary Rounds on Medical Units

Background: Interdisclinlinary rounds (IDR) are commonly used to improve collaboration among hospital team members. To our knowledge, no studies have evaluated teamwork during IDR.Methods: This study was conducted on six general medicine units (three teaching [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Assessment of Teamwork During Structured Interdisciplinary Rounds on Medical Units

HM2012 Abstract Number: 97557

Decreasing Hospital Readmissions in Highrisk Populations: What Do We Know?

Background: The search for alternative care structures that improve quality and lower costs is intensifying. Alternative care organizations (ACOs) offer promise but must demonstrate their cost–effectiveness for widespread adoption to occur. Readmissions to the hospital [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Decreasing Hospital Readmissions in Highrisk Populations: What Do We Know?

HM2012 Abstract Number: 97558

Mental Illness and Substance Abuse Increase Risk for Preventable Hospital Readmission

Background: Readmissions after hospital discharge are a common and costly occurrence in our health care system. Published models describing risk factors for hospital readmission inadequately stratify low–risk and high–risk patients. Patients with psychiatric illness or [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Mental Illness and Substance Abuse Increase Risk for Preventable Hospital Readmission

HM2012 Abstract Number: 97559

Admission Handoffs: A Novel Transition of Care That Leads to Discomfort with Patient Management

Background: Recently adopted resident work hour restrictions from the Accreditation Council for Graduate Medical Education have encouraged separate day and night patient care models. Dividing day and night responsibilities results in "admission handoffs," in which [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Admission Handoffs: A Novel Transition of Care That Leads to Discomfort with Patient Management

HM2012 Abstract Number: 97560

Postdischarge Problems Identified by Nurse Advice Line Calls Following Hospital Discharge

Background: Approximately 20% of patients are either readmitted or have additional visits to emergency rooms or urgent care clinics within 30 days of hospital discharge. Patients discharged from our urban, academic safety net hospital are [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Postdischarge Problems Identified by Nurse Advice Line Calls Following Hospital Discharge

HM2012 Abstract Number: 97561

Comparative Effectiveness of Hospitalbased Educational Interventions for Patients with Asthma or Copd

Background: Because of recent efforts to improve safe transitions from hospital to home, ensuring quality care for patients hospitalized with asthma and COPD has become a priority. A critical factor for safe care transitions may [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Comparative Effectiveness of Hospitalbased Educational Interventions for Patients with Asthma or Copd

HM2012 Abstract Number: 97562

Predictors of Selfreported Handoff Behavior at Hospital Discharge and Its Association with 30Day Readmissions

Background: Poor handoffs may lead to adverse health outcomes. We sought to determine rates of self–reported handoffs from inpatient to outpatient providers, to examine predictors of successful handoffs, and to determine the association between successful [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Predictors of Selfreported Handoff Behavior at Hospital Discharge and Its Association with 30Day Readmissions

HM2012 Abstract Number: 97563

The Effect of a Posthospital Followup Visit on 30Day Readmission Rates in Patients with a Primary Discharge Diagnosis of Chronic Obstructive Pulmonary Disease

Background: Thirty–day readmissions in chronic obstructive pulmonary disease (COPD) patients are frequent and costly. National efforts to reduce 30–day readmissions often suggest a follow–up visit with a physician despite conflicting evidence about the value of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Effect of a Posthospital Followup Visit on 30Day Readmission Rates in Patients with a Primary Discharge Diagnosis of Chronic Obstructive Pulmonary Disease

HM2012 Abstract Number: 97564

Improving Survival from Sepsis in Noncritical Units: Role of Hospitalists and Sepsis Team in Early Detection and Initial Treatment of Septic Patients

Background: Despite recent improvement in knowledge of sepsis physiopathology, severe sepsis, and septic shock still represent a leading cause of death among inpatients all around the world. Although bundled care of sepsis has shown to [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Improving Survival from Sepsis in Noncritical Units: Role of Hospitalists and Sepsis Team in Early Detection and Initial Treatment of Septic Patients

HM2012 Abstract Number: 97565

Ihi Global Trigger Tools and Adverse Events

Background: Most systems for measuring medical errors rely on voluntary reporting of errors and near–miss events. The IHI Global Trigger Tool (IHIGTT) is a manual retrospective review of a random sample of inpatient hospital records [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Ihi Global Trigger Tools and Adverse Events

HM2012 Abstract Number: 97566

Prevalence of Documented Mrsa Infection and Vancomycin Utilization Patterns in Patients Admitted with Skin and Soft Tissue Infections

Background: Treatment of non–purulent cellulitis and cellulitis associated with an abscess is a common reason for hospital admission. Methicillin resistant staph aureus (MRSA) is well documented be a common cause of purulent skin infections, while [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Prevalence of Documented Mrsa Infection and Vancomycin Utilization Patterns in Patients Admitted with Skin and Soft Tissue Infections

HM2012 Abstract Number: 97567

Chest Radiographs and Bronchiolitis: Can Imaging Results Be Predicted?

Background: Despite recommendations by the American Academy of Pediatrics against routine imaging in acute bronchiolitis, chest radiography (CXR) is often performed during admission for bronchiolitis. There have been no studies in the United States that [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Chest Radiographs and Bronchiolitis: Can Imaging Results Be Predicted?

HM2012 Abstract Number: 97568

Rsv Antigen Testing: Clinically Relevant or Mere Academic Exercise?

Background: Acute viral bronchiolitis is responsible for over 150,000 pediatric admissions per year in the United States. Respiratory syncytial virus (RSV) testing is frequently performed in this population. However, there are few studies addressing whether [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Rsv Antigen Testing: Clinically Relevant or Mere Academic Exercise?

HM2012 Abstract Number: 97569

Active Physician Management Position As a Structural Feature to Influence Hospital Outcomes: Effect of an Explicit Physician Director Role in a Longterm Acute Care Unit

Background: Structural measures of hospital quality describe the characteristics of resources, including people, geographic locations, information technology, organizations, and systems of care. Accountable day–to–day management of inpatient unit process and performance represents a potential opportunity [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Active Physician Management Position As a Structural Feature to Influence Hospital Outcomes: Effect of an Explicit Physician Director Role in a Longterm Acute Care Unit

HM2012 Abstract Number: 97570

Hospitalistpharmacist Collaborative at a Regional Cancer Center Decreases Hospital Acquired Vte Events

Background: According to the guidelines of the American Society of Chest Physicians, medical, and surgical oncology patients continue to be at increased risk for venous thromboembolic events (VTE). Undiagnosed and untreated pulmonary embolism is a [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hospitalistpharmacist Collaborative at a Regional Cancer Center Decreases Hospital Acquired Vte Events

HM2012 Abstract Number: 97571

Identifying Predictors Leading to Rapid Response or Medical Code

Background: Rapid Response Teams (RRT) were created with the concept of bringing intensive care management to the bedside during medical emergencies on the wards. Despite widespread use, their overall benefit has been controversial. Although some [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Identifying Predictors Leading to Rapid Response or Medical Code

HM2012 Abstract Number: 97572

Use of a Diuretic Protocol to Improve the Care of Patients Admitted with Heart Failure

Background: The most effective strategy for administration of loop diuretics in patients hospitalized with acute decompensated heart failure (ADHF) still needs to be determined. Delivery of optimal dosing for rapid and safe diuresis must include [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Use of a Diuretic Protocol to Improve the Care of Patients Admitted with Heart Failure

HM2012 Abstract Number: 97573

Inhospital Cardiac Resuscitation: A Nationally Representative Survey

Background: In–hospital cardiac arrest (IHCA) outcomes vary widely between hospitals, even after adjusting for patient characteristics, suggesting variations in resuscitation practice as a potential etiology. However, little is known about the actual standard of resuscitation [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Inhospital Cardiac Resuscitation: A Nationally Representative Survey

HM2012 Abstract Number: 97574

Evolution of Endoflife Care at United States Hospitals in the New Millennium

Background: The use of hospice care has increased in the United States over the past decade. However, data for hospitalizations preceding hospice remains sparse. The objective of this study is to examine the clinical and [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Evolution of Endoflife Care at United States Hospitals in the New Millennium

HM2012 Abstract Number: 97575

The Approach to Clostridium Difficile (C. Difficile) in a Community Hospital, How Do We Compare with Guideline Recommendations

Background: C. difficile is a predominant cause of nosocomial diarrhea. It is most commonly associated with prior antibiotics use, and seen in conjunction with other risk factors such as increasing age, severe underlying illness, impaired [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Approach to Clostridium Difficile (C. Difficile) in a Community Hospital, How Do We Compare with Guideline Recommendations

HM2012 Abstract Number: 97576

Epidemiology of Medication Warnings at an Academic Medical Center

Background: Implementation of computerized provider order entry (CPOE) with drug–drug and drug–allergy checking is an important patient safety measure. The most commonly used CPOE systems, however, generate numerous warnings, which may lead to "alert fatigue." [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Epidemiology of Medication Warnings at an Academic Medical Center

HM2012 Abstract Number: 97577

Specialized Consult Service Reduces Readmission Rate and Length of Stay for Patients Admitted with Skin and Soft Tissue Infections

Background: Cellulitis is a common reason for admission to the hospital. The disease is often over–diagnosed due to difficultly in differentiating it from chronic venous stasis and stasis dermatitis. The natural history and etiology of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Specialized Consult Service Reduces Readmission Rate and Length of Stay for Patients Admitted with Skin and Soft Tissue Infections

HM2012 Abstract Number: 97578

Perceived Control & Sleep in Hospitalized Adults: A Sound Hypothesis?

Background: Although sleep is important for recovery from acute illness, it is often hampered by noise in hospitals. Interestingly, some patients are more vulnerable to noise disruptions, which is now a publicly reported quality measure [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Perceived Control & Sleep in Hospitalized Adults: A Sound Hypothesis?

HM2012 Abstract Number: 97579

Curbing Recurring Testing: A Pilot Intervention to Reduce Laboratory Tests by Residents in the Inpatient Setting

Background: Laboratory testing accounts for a significant percentage of the direct costs of hospitalization. Testing also imposes burdens on the patient due to phlebotomy, which not only causes pain, leads to anemia, and may necessitate [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Curbing Recurring Testing: A Pilot Intervention to Reduce Laboratory Tests by Residents in the Inpatient Setting

HM2012 Abstract Number: 97580

Effectiveness of a Universal Venous Thromboembolism Prophylaxis Strategy in Decreasing Upper Extremity Deep Venous Thrombosis

Background: The increasing use of central venous catheters in hospitalized patients has led to a rising incidence of upper extremity deep venous thrombosis (DVT). The use of venous thromboembolism (VTE) pharmacoprophylaxis in hospitalized patients has [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Effectiveness of a Universal Venous Thromboembolism Prophylaxis Strategy in Decreasing Upper Extremity Deep Venous Thrombosis

HM2012 Abstract Number: 97581

Underutilization of Anticoagulant and Antiplatelet Agents for Stroke Prevention in Atrial Fibrillation at an Academic Medical Center

Background: Atrial fibrillation represents one of the leading diagnoses for hospitalized patients. Patients with atrial fibrillation are five times more likely to have a stroke than those without this condition and approximately 60% of these [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Underutilization of Anticoagulant and Antiplatelet Agents for Stroke Prevention in Atrial Fibrillation at an Academic Medical Center

HM2012 Abstract Number: 97582

The Effect of Universal Venous Thromboembolism Prophylaxis on Complications Related to Anticoagulation

Background: New guidelines by the American College of Physicians (ACP) recommend assessment of the risk of bleeding in medical patients prior to initiation of prophylaxis for venous thromboembolism (VTE). Thus, a routine pharmacoprophylaxis approach for [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Effect of Universal Venous Thromboembolism Prophylaxis on Complications Related to Anticoagulation

HM2012 Abstract Number: 97583

Do Our Patients Care About Post Hospitalization Follow Up? Perspectives from a Resident Run Clinic

Background: Timely access to primary care follow–up is an important factor in preventing hospital readmissions. Patients that lack primary care follow–up within four weeks of discharge are more likely to be readmitted. Moreover, resident clinics [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Do Our Patients Care About Post Hospitalization Follow Up? Perspectives from a Resident Run Clinic

HM2012 Abstract Number: 97584

Hospital or Hotel: Do Early Morning Discharge Orders Get Our Patients Out of the Hospital Sooner?

Background: Many hospitals rely on improved throughput to maintain high volume in the face of limited inpatient capacity. Earlier discharges may free up inpatient beds, decrease the strain on a crowded Emergency Department (ED), and [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hospital or Hotel: Do Early Morning Discharge Orders Get Our Patients Out of the Hospital Sooner?

HM2012 Abstract Number: 97585

Compliance with Recommended Contact Isolation Practices

Background: Data suggest that adherence to contact isolation precautions reduces transmission of multi–drug resistant organisms and C. difficile. Compliance with both hand hygiene and contact isolation precautions is suspected to be poor. This study aims [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Compliance with Recommended Contact Isolation Practices

HM2012 Abstract Number: 97586

Identifying Predictors of a Safe Attending Physician Workload: Results from a Survey of an Online Community of Hospitalists

Background: We examined the relationship between workload and patient safety via a survey of an online community of Hospitalists. This analysis examines the predictors of providers reporting an "unsafe" workload, identifying potential targets for quality [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Identifying Predictors of a Safe Attending Physician Workload: Results from a Survey of an Online Community of Hospitalists

HM2012 Abstract Number: 97587

Electronic Patient Order Entry for Venous Thromboembolism Prophylaxis Has Significantly Reduced the Occurrence of Venous Thromboembolism in Rehabilitation Inpatients

Background: American college of physicians' clinical practice guidelines raises the question of mortality benefit from venous thromboembolism (VTE) prophylaxis and excessive bleeding risk based on newer research outcomes. In this context, a study was designed [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Electronic Patient Order Entry for Venous Thromboembolism Prophylaxis Has Significantly Reduced the Occurrence of Venous Thromboembolism in Rehabilitation Inpatients

HM2012 Abstract Number: 97588

Morning Laboratory Orders in Admission Order Sets: A Lovehate Relationship

Background: Use of computerized provider order entry (CPOE) is on the rise in U.S. hospitals. Order sets are often used in CPOE systems to facilitate efficient order entry; many order sets contain orders for laboratory [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Morning Laboratory Orders in Admission Order Sets: A Lovehate Relationship

HM2012 Abstract Number: 97589

Signs of Catastrophe: Characterizing Acute Inhospital Strokes

Background: In–Hospital strokes (IHS) account for 4–17% of all ischemic strokes and are associated with increased morbidity and mortality compared to strokes with onset in the community. As with all strokes, early identification of IHS [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Signs of Catastrophe: Characterizing Acute Inhospital Strokes

HM2012 Abstract Number: 97590

Comparison of Manual Abstraction to Data Warehouse Facilitated Abstraction for Identifying Hospital Adverse Events

Background: Research suggests the optimal method for identifying hospital adverse events (AEs) is a two stage approach using manual chart abstraction. First, clinicians abstract the entire medical record to identify potential AEs using screening criteria. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Comparison of Manual Abstraction to Data Warehouse Facilitated Abstraction for Identifying Hospital Adverse Events

HM2012 Abstract Number: 97591

Indicators of Clinical Stability in Community Acquired Pneumonia: Does the Resolution Sequence Matter?

Background: There are over 500,000 hospitalizations annually for patients with community–acquired pneumonia (CAP). While a great deal of attention has been paid to the diagnosis, assessment of severity, and selection and timing of antimicrobial therapy [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Indicators of Clinical Stability in Community Acquired Pneumonia: Does the Resolution Sequence Matter?

HM2012 Abstract Number: 97592

Evaluation and Management of Acute Gastroenteritis in a Community Hospital

Background: The incidence of acute diarrhea in the US is 375 million and mortality is 6,000/year. Acute diarrhea is defined as <14 days per WGO and less than 21 days for ACG. One million hospitalizations [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Evaluation and Management of Acute Gastroenteritis in a Community Hospital

HM2012 Abstract Number: 97593

Venous Thromboembolism Prophylaxis Adherence in Hospitalized Medical Patients

Background: Venous thromboembolism (VTE) is a common yet preventable complication affecting hospitalized patients. Appropriate VTE prevention has emerged as an important hospital quality measure with emphasis on enforcing routine risk assessment and compliance with VTE [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Venous Thromboembolism Prophylaxis Adherence in Hospitalized Medical Patients

HM2012 Abstract Number: 97594

Factors Contributing to 7Day Readmissions in an Urban Teaching Hospital

Background: Avoidable hospital readmissions may be reflective of poor quality of inpatient healthcare and may be used as a metric to guide reimbursement rates to hospitals. Most existing risk prediction models rely on administrative databases [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Factors Contributing to 7Day Readmissions in an Urban Teaching Hospital

HM2012 Abstract Number: 97595

Assessing the Potential of a Bleeding Risk Score to Improve Adherence to Pharmacologic Venous Thromboembolism (Vte) Prophylaxis

Background: Despite much evidence and clearly elucidated expert guidelines, VTE prophylaxis remains underutilized, resulting in significant morbidity, mortality, and economic burden. Fear of bleeding has been identified as a barrier to optimal adherence. We hypothesized [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Assessing the Potential of a Bleeding Risk Score to Improve Adherence to Pharmacologic Venous Thromboembolism (Vte) Prophylaxis

HM2012 Abstract Number: 97596

Predictors of Nosocomial Urinary Tractrelated Bloodstream Infection

Background: Urinary tract infection (UTI) is the most frequent healthcare–associated infection in the US. Although bloodstream infection (BSI) secondary to nosocomial UTI occurs less often, it is associated with substantial morbidity, mortality, and additional costs. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Predictors of Nosocomial Urinary Tractrelated Bloodstream Infection

HM2012 Abstract Number: 97597

Convenience Over Evidence? Heparin Nomograms Vs Usual Care at an Academic Medical Center

Background: Though there is little evidence examining the use of intravenous heparin nomograms, concerns about difficulty maintaining therapeutic aPTT levels have led to the adoption of dose–adjustment nomograms at many hospitals. Nomograms can promote standardized [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Convenience Over Evidence? Heparin Nomograms Vs Usual Care at an Academic Medical Center

HM2012 Abstract Number: 97598

Antimicrobial Stewardship on the Hospitalist Service: Skin and Soft Tissue Infections

Background: In a recent study, antimicrobial stewardship opportunitites in the treatment of skin and soft tissue infections (SSTIs) were identified. The authors reported that although Staphylococcus and Streptococcus were the only organisms identified in 97% [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Antimicrobial Stewardship on the Hospitalist Service: Skin and Soft Tissue Infections

HM2012 Abstract Number: 97599

Improving Heart Failure Core Measure Compliance Within the Epic Health Record

Background: Compliance with the Centers for Medicare & Medicaid Services (CMS) core measures is a quality target for many hospitals. The discharge summary is an approved data source for auditing compliance with CMS core measures. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Improving Heart Failure Core Measure Compliance Within the Epic Health Record

HM2012 Abstract Number: 97600

An Association Between Timing of Admission, Medical Team Workload, and 30Day Readmission Rate

Background: The "July effect" refers to a drop in the quality of medical care due to trainees' changeover at the beginning of academic year in July. Greater teaching team workload is associated with worse patient [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Association Between Timing of Admission, Medical Team Workload, and 30Day Readmission Rate

HM2012 Abstract Number: 97601

The Impact of an Electronic Order Set in Reducing Overuse of Proton Pump Inhibitors in the Inpatient Population

Background: Proton pump inhibitors (PPIs) are one of the most commonly prescribed medications. Numerous studies have shown that they are overused during inpatient admissions, despite being linked to an increased rate of pneumonia, Clostridium difficile [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Impact of an Electronic Order Set in Reducing Overuse of Proton Pump Inhibitors in the Inpatient Population

HM2012 Abstract Number: 97602

Treatment of Positive Urine Cultures in Hospitalized Patients: A Driver of Antimicrobial Misuse

Background: Obtaining a urine culture in hospitalized patients is extremely common. Positive cultures frequently trigger antimicrobial therapy, but the appropriateness of this treatment remains unclear. We sought to describe physician management of positive urine cultures [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Treatment of Positive Urine Cultures in Hospitalized Patients: A Driver of Antimicrobial Misuse

HM2012 Abstract Number: 97603

Attending Perceptions of Housestaff Autonomy: Time to Teach New Hospitalists Old Tricks?

Background: While graduated supervision is necessary for residents to progress to independence, it is currently unclear what factors influence housestaff autonomy. This study examined if attending factors and secular trends predicted faculty perceptions of housestaff [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Attending Perceptions of Housestaff Autonomy: Time to Teach New Hospitalists Old Tricks?

HM2012 Abstract Number: 97604

Reducing Barriers in Comunication and Adverse Outcomes in Patient Care: Improving Communication Between Supervising Attendings and Nighttime Residents

Background: Effective communication between attending physicians (AP) and residents is crucial to patient care. As Pediatric Hospitalists we recognize this need further when supervising residents on general inpatient pediatric teams. To date there have been [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Reducing Barriers in Comunication and Adverse Outcomes in Patient Care: Improving Communication Between Supervising Attendings and Nighttime Residents

HM2012 Abstract Number: 97605

Variability in the Assignment of Venous Thromboembolism Risk and Pharmacologic Prophylaxis Recommendations for Hospitalized Medical Patients: Lessons from a Multihospital Quality Collaborative

Background: Hospital–associated venous thromboembolism (VTE) is estimated to affect up to 15% of hospitalized general medical patients and is believed to be the most preventable cause of death in the hospital. Pharmacologic prophylaxis reduces the [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Variability in the Assignment of Venous Thromboembolism Risk and Pharmacologic Prophylaxis Recommendations for Hospitalized Medical Patients: Lessons from a Multihospital Quality Collaborative

HM2012 Abstract Number: 97606

Veterans Administration Acute Care 30Day Mortality Model: Development, Validation, and Performance Variation

Background: Hospital performance measurement efforts often use risk adjusted mortality data. Most existing risk models use administrative data and are disease specific. Importantly, administrative data models increase chances for measurement bias whereas disease specific models [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Veterans Administration Acute Care 30Day Mortality Model: Development, Validation, and Performance Variation

HM2012 Abstract Number: 97607

Overutilization of Noninvasive Cardiac Stress Testing Prior to Elective Tka or Tha

Background: Preoperative non–invasive cardiac stress testing (NIT) is generally not indicated for asymptomatic patients undergoing intermediate–risk noncardiac surgery, such as elective total knee arthroplasty (TKA) or total hip arthroplasty (THA). Current guidelines and evidence suggest [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Overutilization of Noninvasive Cardiac Stress Testing Prior to Elective Tka or Tha

HM2012 Abstract Number: 97608

Urine Sampling in Hospitalised Patients Is Erroneous and Unreliable for Clinical Care

Background: Catheter associated UTI's (CA–UTI) are preventable and high impact secondary to associated costs and poor outcomes. Our UTI prevention group has worked to prevent CA–UTIs, implementing a nursing driven foley removal protocol, prevention guidelines [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Urine Sampling in Hospitalised Patients Is Erroneous and Unreliable for Clinical Care

HM2012 Abstract Number: 97609

More Than Meets the Eye: Measuring the Dual Risks of Low Health Literacy and Poor Vision in Hospitalized Patients

Background: A "universal precaution" approach for all inpatients should be used to ensure adequate education for safe discharge home. However, identification of vulnerable, high–risk (e.g., low health literacy) patients may be necessary in resource–limited hospital [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on More Than Meets the Eye: Measuring the Dual Risks of Low Health Literacy and Poor Vision in Hospitalized Patients

HM2012 Abstract Number: 97610

Computerized Patient Record Order Sets for Venous Thromboembolism (Vte) Prophylaxis and Associated Rates of Vte

Background: Venous thromboembolism (VTE) is a known complication of hospitalization; implementation of proven prophylactic modalities should reduce VTE rates. One potential strategy is the use of computerized order sets. The objective of this study is [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Computerized Patient Record Order Sets for Venous Thromboembolism (Vte) Prophylaxis and Associated Rates of Vte

HM2012 Abstract Number: 97611

Assessing Student Perceptions of Safety Culture During Internal Medicine and Surgery Clerkships

Background: A positive safety culture is essential to patient safety. Validated assessment tools can identify areas for improvement and highlight differences between clinical settings. Few studies have assessed medical student perceptions of safety and none [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Assessing Student Perceptions of Safety Culture During Internal Medicine and Surgery Clerkships

HM2012 Abstract Number: 97612

Fallrelated Injury in the Hospital

Background: 2–9% of adult patients who fall in the hospital suffer serious injury. There is little evidence–based literature to guide physicians when assessing hospitalized patients for fall–related injury. This study was designed to (1) identify [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Fallrelated Injury in the Hospital

HM2012 Abstract Number: 97613

How Much Time Does an Intern Need to Admit a New Patient?

Background: Little information exists about how much work individual patients actually contribute to the workload of a physician. We conducted this study to determine the amount of time internal medicine interns spend on new patient [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on How Much Time Does an Intern Need to Admit a New Patient?

HM2012 Abstract Number: 97614

Reducing Cardiopulmonary Arrests and Intensive Care Transfers Using a Pediatric Rapid Response Team

Background: One of the key components of the Institute for Healthcare Improvement's 100,000 Lives campaign was developing rapid response systems. The adult data regarding their effectiveness is equivocal. There is paucity in the literature with [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Reducing Cardiopulmonary Arrests and Intensive Care Transfers Using a Pediatric Rapid Response Team

HM2012 Abstract Number: 97615

Epidemiology of Inpatient Ambulation to Assess Potential Improvement Strategies for Deep Vein Thrombosis (Dvt) Prevention

Background: Pharmacologic prophylaxis is recommended for general medical inpatients (GMI) at risk of DVT; this includes GMI who are not fully ambulating. However, full ambulation is not well defined in the current literature. In addition, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Epidemiology of Inpatient Ambulation to Assess Potential Improvement Strategies for Deep Vein Thrombosis (Dvt) Prevention

HM2012 Abstract Number: 97616

The Practice and Utility of Daily Complete Blood Counts (Cbcs) on Hospitalized Patients

Background: Hospitalized patients are often subject to numerous, and sometimes daily, blood draws to obtain complete blood counts (CBC). Frequent phlebotomies can cause discomfort and pain, which adversely affects patient satisfaction. In addition, these laboratory [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Practice and Utility of Daily Complete Blood Counts (Cbcs) on Hospitalized Patients

HM2012 Abstract Number: 97617

Comparative Effectiveness of Continuous Subcutaneous Insulin Infusion with Multiple Daily Injections Among Pregnant Women with Diabetes Mellitus: A Systematic Review

Background: For pregnant women with pre–existing diabetes, tight glycemic control is recommended to reduce the risk of fetal anomalies, macrosomia, delivery complications, stillbirth, and neonatal hypoglycemia. We performed a systematic review to determine the comparative [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Comparative Effectiveness of Continuous Subcutaneous Insulin Infusion with Multiple Daily Injections Among Pregnant Women with Diabetes Mellitus: A Systematic Review

HM2012 Abstract Number: 97618

Validation of a Predictive Rule for Severe Acute Lower Intestinal Bleeding

Background: Acute lower gastrointestinal bleeding (LGIB) accounts for about 30 percent of episodes of gastrointestinal bleeding. It encompasses a wide spectrum of symptoms ranging from trivial hematochezia to massive hemorrhage with shock. Identifying those who [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Validation of a Predictive Rule for Severe Acute Lower Intestinal Bleeding

HM2012 Abstract Number: 97619

Pharmacologic Acid Suppression Is Associated with Spontaneous Bacterial Peritonitis in Patients with Cirrhosis: A Metaanalysis

Background: Proton pump inhibitors and H2receptor antagonists (PPI/H2RA) are frequently prescribed in hospitalized patients with cirrhosis. There are conflicting reports regarding the risk of spontaneous bacterial peritonitis (SBP) in hospitalized patients with cirrhosis using acid–suppressive [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Pharmacologic Acid Suppression Is Associated with Spontaneous Bacterial Peritonitis in Patients with Cirrhosis: A Metaanalysis

HM2012 Abstract Number: 97620

Fidaxomicin Inhibits Production of Toxin a and Toxin B in Clostridium Difficile

Background: Fidaxomicin, recently approved for the treatment of C. difficile associated diarrhea, demonstrates bactericidal activity against C. difficile and was superior in clinical trials to vancomycin (VAN) in its sustained clinical response. In this study, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Fidaxomicin Inhibits Production of Toxin a and Toxin B in Clostridium Difficile

HM2012 Abstract Number: 97621

Fidaxomicin Inhibits Spore Production in Clostridium Difficile

Background: Fidaxomicin was recently approved for the treatment of Clostridium difficile associated diarrhea. This is a novel narrow spectrum antibacterial agent that demonstrates potent bactericidal activity against C. difficile. In recent clinical trials with over [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Fidaxomicin Inhibits Spore Production in Clostridium Difficile

HM2012 Abstract Number: 97622

Simulationbased Education Improves Clinical Knowledge and Confidence in Management of Common Urgent Inpatient Conditions

Background: Simulation–based training has been extensively evaluated in non–medical disciplines, and has been shown to have value in procedure–based medical education. However, fewer data are available with respect to the role of simulation in teaching [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Simulationbased Education Improves Clinical Knowledge and Confidence in Management of Common Urgent Inpatient Conditions

HM2012 Abstract Number: 97623

The Prevalence of Obestiy in Asthmatic Preschool Children and the Association Between Asthma and Obesity Among Preschool Children Attending Clinic in a Large Innercity Hospital

Background: Asthma and obesity are chronic conditions with incidences that have increased substantially in the pediatric population in New York City and nationally over the past several decades. According to the New York State Department [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Prevalence of Obestiy in Asthmatic Preschool Children and the Association Between Asthma and Obesity Among Preschool Children Attending Clinic in a Large Innercity Hospital

HM2012 Abstract Number: 97624

Relationship Between 25Hydroxyvitamin D and Peripheral Arterial Disease As Measured by Anklebrachial Index

Background: Low serum 25(OH) D levels are associated with higher prevalence of peripheral arterial disease (PAD). It has been proposed that this inverse relationship is non–linear in that the association diminishes with rising 25(OH) D [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Relationship Between 25Hydroxyvitamin D and Peripheral Arterial Disease As Measured by Anklebrachial Index

HM2012 Abstract Number: 97625

Hospitalization: A Missed Opportunity to Assess for Osteoporosis

Background: More that 1.5 million fractures result from osteoporosis annually in the United States at a cost of fifteen billion dollars. Less than 25% of patients who sustain a fragility fracture receive treatment for osteoporosis. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hospitalization: A Missed Opportunity to Assess for Osteoporosis

HM2012 Abstract Number: 97626

Unsafe Use of Intravenous Haloperidol Pervasive in Hospitalized Elderly

Background: Delirium, an acute decline in attention and cognition, is present in 11–24% of elderly patients on hospital admission, and another 6–56% will develop delirium during their hospital stay. Off–label intravenous (IV) administration of haloperidol [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Unsafe Use of Intravenous Haloperidol Pervasive in Hospitalized Elderly

HM2012 Abstract Number: 97627

Do Physician Relationships Matter? An Analysis of Differences in Relationships Among Inpatient Medical Teams

Background: How inpatient physician teams function is often thought of in terms of the skill sets of individuals on the team, e.g., having a "strong" resident or "good" intern. While individual skills are important, an [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Do Physician Relationships Matter? An Analysis of Differences in Relationships Among Inpatient Medical Teams

HM2012 Abstract Number: 97628

Blood Cultures in Community Acquired Pneumonia: Influence on Antibiotic Therapy and Patient Outcomes

Background: Expert guidelines recommend getting blood cultures for all patients admitted with community–acquired pneumonia (CAP). Blood cultures have been used as a measure of quality of care. However, this diagnostic tool has a low yield [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Blood Cultures in Community Acquired Pneumonia: Influence on Antibiotic Therapy and Patient Outcomes

HM2012 Abstract Number: 97629

Renal Impairment and Responses to Fidaxomicin Versus Vancomycin in Patients with Clostridium Difficile Infection

Background: A few studies have linked chronic renal disease to increased risk and poor outcomes in Clostridium difficile infection (CDI). We studied renal function and clinical outcomes in a large database of CDI patients treated [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Renal Impairment and Responses to Fidaxomicin Versus Vancomycin in Patients with Clostridium Difficile Infection

HM2012 Abstract Number: 97630

Physicians’ Perspectives on an Inpatient Optout Hiv Screening Program

Background: Risk–based HIV testing has been shown to miss a substantial number of patients infected with HIV. The Centers for Disease Control and Prevention (CDC) released recommendations in 2006 that patients between the ages of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Physicians’ Perspectives on an Inpatient Optout Hiv Screening Program

HM2012 Abstract Number: 97631

Venous Thromboembolism After Joint Replacement in Older Veterans with Comorbidity

Background: Venous thromboembolism (VTE) is a common and costly complication of total hip and knee replacement (THR and TKR). Although potent prophylaxis regimens now exist to significantly reduce the risk of VTE, their wide spread [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Venous Thromboembolism After Joint Replacement in Older Veterans with Comorbidity

HM2012 Abstract Number: 97632

Cost Avoidance Through the Use of a Dedicated Clinical Pharmacy Specialist on a Hospitalist Service

Background: In June 2006, our 760–bed academic institution began a Hospitalist Service employing six physician providers. Similar to national trends, the needs quickly outpaced the supply of hospitalists resulting in poor provider satisfaction, delays in [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Cost Avoidance Through the Use of a Dedicated Clinical Pharmacy Specialist on a Hospitalist Service

HM2012 Abstract Number: 97633

Management of Extended Spectrum Betalactamases Positive Urinary Tract Infections in a Community Hospital. Are There Patient Characteristics That Suggest Risk of Esbl?

Background: ESBLs are extremely broad spectrum Beta–Lactamase enzymes found in a variety of Enterobacteriaceae to include Klebsiella pneumoniae, other Klebsiella species and Escherichia coli (E.Coli). These ESBL–producing bacteria are highly effective at inactivating various Beta–Lactam [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Management of Extended Spectrum Betalactamases Positive Urinary Tract Infections in a Community Hospital. Are There Patient Characteristics That Suggest Risk of Esbl?

HM2012 Abstract Number: 97634

Effect of Patient Preference in Medical Decision Making on Inpatient Care

Background: Patients with a higher level of education, more access to medical information, and generous health insurance coverage may be more likely to participate in their medical decision making process. However, few studies directly measure [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Effect of Patient Preference in Medical Decision Making on Inpatient Care

HM2012 Abstract Number: 97635

Moderate to Deep Procedural Sedation with Nitrous Oxide for Painful Procedures in a Pediatric Acute Wound Clinic by Pediatric Hospitalists

Background: Pediatric hospitalists are frequently and increasingly asked to provide sedation for a variety of painful procedures in children. There are a wide variety of agents available for sedation including ketamine, fentanyl, ketofol, and nitrous [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Moderate to Deep Procedural Sedation with Nitrous Oxide for Painful Procedures in a Pediatric Acute Wound Clinic by Pediatric Hospitalists

HM2012 Abstract Number: 97636

Effect Modification of Chronic Narcotic Dependence in Frequently Hospitalized Patients with Comorbid Cardiac Disease

Background: Frequently hospitalized patients are a large burden to the healthcare system, both in terms of hospital days and cost. For many patients, this is due to the severity of their underlying medical comorbidities. However, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Effect Modification of Chronic Narcotic Dependence in Frequently Hospitalized Patients with Comorbid Cardiac Disease

HM2012 Abstract Number: 97637

Hospital Medicine Full Circle: Impact of Incorporating Housestaff Into a Productive Nonteaching Hospitalist Group

Background: Hospital medicine's claim to fame has been shorter length of stay (LOS) and equal, if not better, adherence to quality measures without sacrificing patient satisfaction. Comparative studies highlighting these strong characteristics of hospital medicine [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hospital Medicine Full Circle: Impact of Incorporating Housestaff Into a Productive Nonteaching Hospitalist Group

HM2012 Abstract Number: 97638

Care Pathway Disparities in Patients with Cocaine Induced Myocardial Infarction: A Preliminary Report from the Cpac Study Group

Background: Cocaine is a well known risk factor for the development of early atherosclerosis and myocardial infarction (MI). Several studies in the medical literature have reported the increasing incidence of cocaine use in the American [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Care Pathway Disparities in Patients with Cocaine Induced Myocardial Infarction: A Preliminary Report from the Cpac Study Group

HM2012 Abstract Number: 97639

Brainstem Reflex Score: A Novel Method for Early Prognostication in Patients After Outofhospital Cardiac Arrest

Background: Practice Parameters for prognostication after out–of–hospital cardiac arrest, set forth by the American Academy of Neurology, stress the importance of the neurologic exam findings at 72 hours after successful resuscitation. Absent pupillary or corneal [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Brainstem Reflex Score: A Novel Method for Early Prognostication in Patients After Outofhospital Cardiac Arrest

HM2012 Abstract Number: 97640

The Impact of Copd on Management and Outcomes of Patients Hospitalized with Acute Myocardial Infarction; a Tenyear Retrospective Observational Study

Background: There are limited data regarding contemporary trends in management and outcomes of patients with COPD who develop acute myocardial infarction (AMI). The objective of this population–based study was to describe the management and short–term [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Impact of Copd on Management and Outcomes of Patients Hospitalized with Acute Myocardial Infarction; a Tenyear Retrospective Observational Study

HM2012 Abstract Number: 97641

The Clinical Epidemiology of Human Metapneumovirus Infections in the Adult Inpatient Population

Background: Most studies of human metapneumovirus (hMPV) have been done in pediatric populations. Many of these studies compare hMPV with respiratory syncytial virus or are case reports of hMPV infection in the immunosuppressed. Though there [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Clinical Epidemiology of Human Metapneumovirus Infections in the Adult Inpatient Population

HM2012 Abstract Number: 97642

Does Physicianinduced Demand Explain Geographic Variation in Discretionary Procedures?

Background: There is an extensive literature on geographic variation in utilization intensity. Although system capacity (e.g. hospital bed, physician, and scanner density) has been implicated as a factor, the drivers of this variation have not [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Does Physicianinduced Demand Explain Geographic Variation in Discretionary Procedures?

HM2012 Abstract Number: 97643

Development and Implementation of a Clinical Care Pathway for Acute Vte Reduces Hospital Utilization and Cost at an Urban Tertiary Care Center

Background: An estimated 1 million people in the US develop symptomatic venous thromboembolism (VTE) at a cost of $1.5 billion annually. The American College of Chest Physicians recommends treating deep vein thrombosis (DVT) outpatient whenever [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Development and Implementation of a Clinical Care Pathway for Acute Vte Reduces Hospital Utilization and Cost at an Urban Tertiary Care Center

HM2012 Abstract Number: 97644

Red Blood Cell Parameters Are Independent Risk Predictors of Allcause and Cardiovascular Mortality Among Healthy Us Adults

Background: Red blood cell (RBC) parameters (hemoglobin [Hgb], hematocrit [Hct], mean corpuscular volume [MCV], and red cell distribution width [RDW]) are reported in complete blood count reports and have been hypothesized to be associated with [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Red Blood Cell Parameters Are Independent Risk Predictors of Allcause and Cardiovascular Mortality Among Healthy Us Adults

HM2012 Abstract Number: 97645

Acute Changes in Nterminal Probtype Natriuretic Peptide (Ntprobnp) During Hospitalization and Its Association with Time to Readmission and Death in Patients with Heart Failure

Background: Heart failure is characterized by multiple hospital readmissions and increased risk of death. Our study assesses acute change in NT–proBNP (a cardiac biomarker) and its association with readmission and mortality using a parametric analysis. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Acute Changes in Nterminal Probtype Natriuretic Peptide (Ntprobnp) During Hospitalization and Its Association with Time to Readmission and Death in Patients with Heart Failure

HM2012 Abstract Number: 97646

Whole Blood Viscosity Is an Independent Predictor of Allcause and Cardiovascular Mortality

Background: While whole blood viscosity (WBV) has been shown to be related to the pathogenesis of various diseases, including cardiovascular diseases, laboratory measurement of WBV is time consuming and tedious. WBV can be estimated reliably [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Whole Blood Viscosity Is an Independent Predictor of Allcause and Cardiovascular Mortality

HM2012 Abstract Number: 97647

Hyponatremia and Falls in Elderly Inpatient Hospital Setting Neychelle Fernandes Md,arnold Eiser Md,facp,mary Musuku Md

Background: Falls are the most frequently reported adverse events in inpatient settings. About 30%of people over 65 years will fall every year – making it a major socioeconomic problem in elderly. Hyponatremia is the most [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hyponatremia and Falls in Elderly Inpatient Hospital Setting Neychelle Fernandes Md,arnold Eiser Md,facp,mary Musuku Md

HM2012 Abstract Number: 97648

The Correlation Between Acute Pulmonary Embolism Severity Index (Pesi) and Length of Hospitalization in Patients with Acute Pulmonary Embolism

Background: The evidence about the safety and effectiveness of outpatient care as opposed to inpatient care in selected low–risk patients with acute pulmonary embolism (PE) is accumulating. Most patients enter or remain in the hospital [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Correlation Between Acute Pulmonary Embolism Severity Index (Pesi) and Length of Hospitalization in Patients with Acute Pulmonary Embolism

HM2012 Abstract Number: 97649

Decreased Use of Bronchodilators with Implementation of Bronchiolitis Clinical Score

Background: The 2006 American Academy of Pediatrics (AAP) management guidelines for bronchiolitis recommends reducing the misuse and over–use of short acting beta agonist bronchodilator therapy for pediatric patients with bronchiolitis. Our institution has participated in [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Decreased Use of Bronchodilators with Implementation of Bronchiolitis Clinical Score

HM2012 Abstract Number: 97650

Hospital Variation in Use of Postoperative Medicine Consultations

Background: Medicare payments around episodes of inpatient surgery vary as much as 40–70% across hospitals. Although such variation is attributable to multiple factors, differential use of physician services is one key component. In this context, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hospital Variation in Use of Postoperative Medicine Consultations

HM2012 Abstract Number: 97651

Medical Intensive Care Unit Admitting Patterns in a National Cohort

Background: Critical care makes up nearly 1% of the US gross domestic product, but there is wide hospital variation in critical care resource use. It is possible that some hospitals have higher ICU admission rates [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Medical Intensive Care Unit Admitting Patterns in a National Cohort

HM2012 Abstract Number: 97652

Small Incremental Change in Serum Creatinine Associated with Increased Morbidity and Mortality in Hospitalized Patients with Pneumonia

Background: Relatively little is known about the impact of renal dysfunction on morbidity and mortality in patients with pneumonia, especially in non–severe disease. The contribution of intravenous computed tomography contrast dye to renal dysfunction in [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Small Incremental Change in Serum Creatinine Associated with Increased Morbidity and Mortality in Hospitalized Patients with Pneumonia

HM2012 Abstract Number: 97653

Quantitative Benefitrisk Assessment of Rivaroxaban for the Prevention of Venous Thromboembolism (Vte)

Background: VTE is common after total hip (THR) or knee (TKR) replacement. Anticoagulants reduce the risk of VTE but result in bleeding, requiring assessment of benefit–risk.Methods: To improve estimates of treatment effects on low–frequency events, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Quantitative Benefitrisk Assessment of Rivaroxaban for the Prevention of Venous Thromboembolism (Vte)

HM2012 Abstract Number: 97654

The Modified Wells Score Accurately Excludes Acute Pulmonary Embolism in Patients with an Inr of = 2 on Warfarin

Background: The incidence of new or recurrent acute pulmonary embolism in patients on warfarin with an INR of = 2 is unknown. Also, the utility of using a modified Wells score in diagnosing acute pulmonary [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Modified Wells Score Accurately Excludes Acute Pulmonary Embolism in Patients with an Inr of = 2 on Warfarin

HM2012 Abstract Number: 97655

Impact on Length of Stay and Costs in Patients Admitted to an Observation Unit with Chest Pain, Syncope and Abdominal Pain

Background: Hospitals are focusing more on patient admission status as inpatient or observation due to changes in reimbursement and increased scrutiny from regulatory agencies. Observation units allow for more efficient and appropriate care for patients [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Impact on Length of Stay and Costs in Patients Admitted to an Observation Unit with Chest Pain, Syncope and Abdominal Pain

HM2012 Abstract Number: 97656

Observation Status: Impact on Hospital and Patient Outcomes

Background: Hospitals vary in their procedures for assigning patients to "observation" status (OBS). This outpatient designation has a number of implications including reduced hospital payments, lower patient co–payments, and often results in OBS time not [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Observation Status: Impact on Hospital and Patient Outcomes

HM2012 Abstract Number: 97657

Severe Sepsis in Patients Admitted to the General Medical Ward: Organ Dysfunction and Functional Outcomes

Background: Severe sepsis, defined as infection causing new organ dysfunction, is the most common non–cardiac reason for ICU admission. Interventions to remedy the dismal outcomes related to severe sepsis have focused primarily in the ICU. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Severe Sepsis in Patients Admitted to the General Medical Ward: Organ Dysfunction and Functional Outcomes

HM2012 Abstract Number: 97658

Mortality Reduction Associated with Structure, Process, and Management Redesign of a Hospital Medicine Unit

Background: Opportunities exist to re–create hospital units as effective and reliable microsystems. We used specific structure, process, and management design features to re–launch a hospital medicine unit: 1. Unit–based physician teams, 2. Structured Interdisciplinary Bedside [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Mortality Reduction Associated with Structure, Process, and Management Redesign of a Hospital Medicine Unit

HM2012 Abstract Number: 97659

Does Statin Withdrawal Influence Outcomes After Head and Neck Cancer Surgery: A Retrospective Cohort Study of 443 Patients

Background: Failure to resume perioperative statins after high–risk or vascular surgery is known to increase the risk of postoperative cardiac events. The effect of statin withdrawal on outcomes after moderate risk surgery is unknown. We [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Does Statin Withdrawal Influence Outcomes After Head and Neck Cancer Surgery: A Retrospective Cohort Study of 443 Patients

HM2012 Abstract Number: 97660

Changing Demographics of Pediatric Hospitalizations

Background: Health care reform has had a focus on access to care. For pediatrics this usually means access to ambulatory services. Hospitalization is an uncommon pediatric event but access to pediatric beds may be a [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Changing Demographics of Pediatric Hospitalizations

HM2012 Abstract Number: 97661

Not Just for Adults: Predictors of C. Difficile Infections in Hospitalized Children

Background: Recent studies report the incidence of C. difficile infections (CDI) in children is increasing across the nation and that CDI may occur outside the traditional risk factors.Our objective: To describe clinical factors associated with [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Not Just for Adults: Predictors of C. Difficile Infections in Hospitalized Children

HM2012 Abstract Number: 97662

Twitter, Facebook and Medical Blogging: Using the Social Media As a Means for Public Educatio

Background: Background: Social media is a powerful tool for providing specialized information to large target audiences. Parents and teens now frequently turn to social media as a quick method of obtaining health information. Objective:Introduce a [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Twitter, Facebook and Medical Blogging: Using the Social Media As a Means for Public Educatio

HM2012 Abstract Number: 97663

Results of a Survey of Academic Hospitalist Researchers

Background: Hospital Medicine (HM) has become one of the fastest growing U.S. medical specialties, and many academic medical centers have developed HM programs. Concerns have been raised regarding the challenges that face HM researchers, particularly [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Results of a Survey of Academic Hospitalist Researchers

HM2012 Abstract Number: 97664

Effect of Roflumilast Treatment on Healthrelated Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

Background: Roflumilast, a FDA–approved, once–daily, oral, selective phosphodiesterase–4 inhibitor, has been shown to reduce the risk of chronic obstructive pulmonary disease (COPD) exacerbations in patients with severe COPD associated with chronic bronchitis and a history [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Effect of Roflumilast Treatment on Healthrelated Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

HM2012 Abstract Number: 97665

Deconstructing Morale: The Hospitalist Morale Assessmenta Multisite Analysis

Background: Recruiting new hospitalists is expensive and turnover remains a challenge. Monitoring morale may help leaders improve retention. There are no published instruments that quantify hospitalist morale. Our study describes the Hospitalist Morale Assessment (HMA), [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Deconstructing Morale: The Hospitalist Morale Assessmenta Multisite Analysis

HM2012 Abstract Number: 97666

Dronedaroneinduced Henochschonlein Purpura

Background: Dronedarone is an antiarrhythmic drug approved by the FDA in 2009.Small–vessel vasculitis has not been previously reported in association with dronedarone.Methods: 71 year old male was admitted with 1 week history of generalized skin [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Dronedaroneinduced Henochschonlein Purpura

HM2012 Abstract Number: 97667

Hospital Medicine Track Interest and Competencies Among Internal Medicine Residents: An International Multicenter Needs Assesment Survey

Background: Since 1996, Hospital Medicine grew faster than any other specialty in the history of medicine, and now reaches institutions around the world. The Core Competencies of Hospital Medicine, published by the Society of Hospital [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hospital Medicine Track Interest and Competencies Among Internal Medicine Residents: An International Multicenter Needs Assesment Survey

HM2012 Abstract Number: 97668

Myocardial Damage in Carbon Monoxide Poisoning: Reversible or Irreversible?

Background: Carbon monoxide (CO) poisoning is the most common cause of death from poisoning in the United States. Cardiovascular complications and their contribution to acute outcomes are yet to be defined.Methods: We retrospectively reviewed the [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Myocardial Damage in Carbon Monoxide Poisoning: Reversible or Irreversible?

HM2012 Abstract Number: 97669

Utilization and Outcomes of Telemetric Ekg Monitoring on a Medicine Service

Background: American Heart Association (AHA) guidelines for the use of telemetric EKG monitoring focus primarily on patients admitted with cardiac diagnoses. There is limited data to guide the use of telemetry in patients admitted with [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Utilization and Outcomes of Telemetric Ekg Monitoring on a Medicine Service

HM2012 Abstract Number: 97670

Effect of Roflumilast Treatment on Dyspnea in Patients with Chronic Obstructive Pulmonary Disease

Background: Roflumilast, a once–daily oral selective phosphodiesterase–4 inhibitor, has been shown to reduce the risk of chronic obstructive pulmonary disease (COPD) exacerbations in patients with severe COPD associated with chronic bronchitis and a history of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Effect of Roflumilast Treatment on Dyspnea in Patients with Chronic Obstructive Pulmonary Disease

HM2012 Abstract Number: 97671

An Evaluation of the Safety and Efficacy of Roflumilast for the Treatment of Chronic Obstructive Pulmonary Disease

Background: COPD is a leading cause of mortality in the US, and COPD exacerbations increase mortality risk, hospitalizations, and healthcare costs, accelerate disease progression, and decrease quality of life. Exacerbations increase in frequency with more [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Evaluation of the Safety and Efficacy of Roflumilast for the Treatment of Chronic Obstructive Pulmonary Disease

HM2012 Abstract Number: 97672

The Scope of Practice of Nurse Practitioners and Physician Assistants on Inpatient Medicine Services in the Veterans Health Administration

Background: Nurse Practitioners (NPs) and Physician Assistants (PAs) have been shown to be cost–effective substitutes for physicians with similar outcomes in primary care and surgical settings. The Veterans Health Administration (VHA) is one of the [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Scope of Practice of Nurse Practitioners and Physician Assistants on Inpatient Medicine Services in the Veterans Health Administration

HM2012 Abstract Number: 97673

Epidemiology of Copy and Pasting in the Medical Record at a Tertiarycare Academic Medical Center

Background: The electronic health record (EHR) is recognized as a key component of the modern practice of medicine. Despite numerous advantages, EHR have enabled frequent copy–paste events (CPE). While previous studies show that CPE occur [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Epidemiology of Copy and Pasting in the Medical Record at a Tertiarycare Academic Medical Center

HM2012 Abstract Number: 97674

Failure of the Swift Score to Predict Readmission to the ICU

Background: Despite initial recovery from critical illness requiring intensive care unit (ICU) admission, many patients remain at risk of subsequent deterioration and unplanned readmission to the ICU. Readmitted patients have higher mortality rates and significantly [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Failure of the Swift Score to Predict Readmission to the ICU

HM2012 Abstract Number: 97675

Transitional Hospitalists: Where Do They Go?

Background: Pediatric Hospital Medicine has seen tremendous growth in the last ten years. The Washington University program has been representative of that growth. Many of our former hospitalists chose our program as a transition to [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Transitional Hospitalists: Where Do They Go?

HM2012 Abstract Number: 97676

Characteristics of Patient Population with Long Length of Stay

Background: Hospital Medicine has contributed to improvements in patient throughput with associated reductions in hospital length of stay (LOS). Despite overall downward LOS trends, a small group of outliers continue to have long LOS. A [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Characteristics of Patient Population with Long Length of Stay

HM2012 Abstract Number: 97677

Teamwork Without Teams: An Ethnographic Study of Hospitalists’ Everyday Work

Background: Teamwork is key to safe, effective healthcare, but care systems are often not designed to support teamwork. The ABIM has developed an assessment of interprofessional teamwork for hospitalists, which gives physicians concrete, actionable feedback [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Teamwork Without Teams: An Ethnographic Study of Hospitalists’ Everyday Work

HM2012 Abstract Number: 97678

Hospitalist Practice Characteristics: The Vha Experience

Background: As in the private sector, the Veterans Health Affairs (VHA) has seen a steady increase in the number of hospitalist programs. Currently, nearly 90% of VHA hospitals have hospitalists admit at least a portion [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hospitalist Practice Characteristics: The Vha Experience

HM2012 Abstract Number: 97679

Pediatric Hospitalist Satisfaction and the Influencing Factors: The Washington University Experience

Background: Pediatric Hospital Medicine has seen tremendous growth in the last ten years, with diverse staffing models at individual programs. The program at Washington University provides a broad range of clinical services. In 2000, we [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Pediatric Hospitalist Satisfaction and the Influencing Factors: The Washington University Experience

HM2012 Abstract Number: 97680

Hospital Medicine Patient Cross Cover and Work Evaluation During Night Shifts

Background: Care provided at night is the soft underbelly of any care delivery system. Disease onset and progression knows no diurnal boundary. However, resource allocation in terms of care delivery is frugal compared to day [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hospital Medicine Patient Cross Cover and Work Evaluation During Night Shifts

HM2012 Abstract Number: 97681

The Structure of Hospital Medicine Programs at Academic Medical Centers

Background: The growth of academic hospital medicine (AHM) over the past 15 years has been shaped by numerous forces. For leaders of academic hospitalist programs to keep pace, it is useful to understand the factors [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Structure of Hospital Medicine Programs at Academic Medical Centers

HM2012 Abstract Number: 97682

Experience Using an Electronic Medical Record (Emr) to Improve Communication Around the Time of Interhospital Transfer

Background: Inter–hospital transfer (IHT) is a high–risk transition of care that often involves patients with complex and worsening medical problems. Ineffective hand–offs between providers may contribute to errors and adverse events during IHTs. Even within [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Experience Using an Electronic Medical Record (Emr) to Improve Communication Around the Time of Interhospital Transfer

HM2012 Abstract Number: 97683

Patient Preparedness for Discharge

Background: At our tertiary care center hospitalists were charged to improve throughput by discharging patients in a timely fashion. Using Lean methodology, we developed multiple rapid improvement events (RIEs) to tackle various facets of the [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Patient Preparedness for Discharge

HM2012 Abstract Number: 97684

Med Wreck: Use of Safety Checklists and Teachback As a Novel Approach to Improving Discharge Transitions and Medication Reconciliation Fidelity

Background: As hospitalists, our continuum of care extends beyond a patient's hospital stay and includes a safe transition to home or a care facility. Improving discharge planning, including the patient's paperwork, eases this transition. In [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Med Wreck: Use of Safety Checklists and Teachback As a Novel Approach to Improving Discharge Transitions and Medication Reconciliation Fidelity

HM2012 Abstract Number: 97685

A Statewide Multisite Collaborative to Improve the Quality of Care Transitions: An Innovative Partnership Between a Health Plan, Physician Organizations, Hospitals, and the Society of Hospital Medicine

Background: Effectively transitioning patients from the hospital to home is an important priority for many hospitals and health care providers. Increasingly, reports have highlighted gaps in the quality of care that arise during and after [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Statewide Multisite Collaborative to Improve the Quality of Care Transitions: An Innovative Partnership Between a Health Plan, Physician Organizations, Hospitals, and the Society of Hospital Medicine

HM2012 Abstract Number: 97686

Standardization of Discharge Documentation to Post Acute Care (Pac) Facilities R Shaaban, Do, P Owusugriffin, Md Baystate Medical Center

Background: Hospital discharge documentation are the primary documents communicating a patient's care plan to the post–hospital care team. Usually, it is the only form of communication that accompanies a patient to the next setting of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Standardization of Discharge Documentation to Post Acute Care (Pac) Facilities R Shaaban, Do, P Owusugriffin, Md Baystate Medical Center

HM2012 Abstract Number: 97687

Development and Use of a Mass Customized Discharge Instruction Template to Standardize and Improve Discharge Instruction Content

Background: Discharging a patient from the hospital is a complex and high–risk task. Patients require clear and understandable instructions from their discharging providers in order to successfully transition from the hospital back to the home [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Development and Use of a Mass Customized Discharge Instruction Template to Standardize and Improve Discharge Instruction Content

HM2012 Abstract Number: 97688

Improving Care Transitions Through Use of a Coaching Intervention

Background: Preventable rehospitalizations are disconcerting for patients, contribute to high costs, and are partly due to deficiencies in patients' ability to execute post–discharge care plans. Increasing patient engagement and self–empowerment through use of an evidence–based [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Improving Care Transitions Through Use of a Coaching Intervention

HM2012 Abstract Number: 97689

Bridging the Transitions of Care

Background: The immediate post–discharge period is a vulnerable time both for patients and their care providers. Several studies have been published highlighting safety issues identified during the immediate post–discharge period. To address these problems, we [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Bridging the Transitions of Care

HM2012 Abstract Number: 97690

Pilot of a Triage System to Increase Efficiency in Handoffs Between Ward Teams and a Single Nocturnal Covering Provider in a Tertiary Care Teaching Hospital

Background: Since the advent of resident hour restrictions in 2003, hand–offs between providers have become increasingly prevalent. The process of hand–offs can require a substantial amount of time depending on the number of patients being [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Pilot of a Triage System to Increase Efficiency in Handoffs Between Ward Teams and a Single Nocturnal Covering Provider in a Tertiary Care Teaching Hospital

HM2012 Abstract Number: 97691

Improving Written Signouts Through Workshops and Structured Audits: The Updated Approach

Background: The July 2011 ACGME guidelines mandate that residency programs monitor and ensure resident competency in patient handoffs. The guidelines' concomitant restrictions on resident duty hours are likely to increase both the volume and complexity [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Improving Written Signouts Through Workshops and Structured Audits: The Updated Approach

HM2012 Abstract Number: 97692

Use of Rapid Pdsa Cycles to Improve Pediatric Resident Handoffs

Background: Every handoff of patient care between physicians poses a risk for error. New duty hours have increased the number of handoffs occurring between residents. Residents must be trained to deliver accurate, consistent, and efficient [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Use of Rapid Pdsa Cycles to Improve Pediatric Resident Handoffs

HM2012 Abstract Number: 97693

A Novel Approach to Teaching Handoffs to Internal Medicine Residentsa Pilot Project

Background: Handoffs of hospitalized patients represent critical points in patient care. Poor quality handoffs carry the risk of poor outcomes for patients and physicians. The Joint Commission and Society of Hospital Medicine (SHM) have published [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Novel Approach to Teaching Handoffs to Internal Medicine Residentsa Pilot Project

HM2012 Abstract Number: 97694

Pilot Use of a Discharge Clinic to Develop an Educational Experience in Transitions of Care for Internal Medicine Housestaff

Background: Healthcare delivery has become divided into discrete silos of care. With a growing separation between inpatient and outpatient services, transitions of care have become an increasingly vulnerable time for patients. For patients at San [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Pilot Use of a Discharge Clinic to Develop an Educational Experience in Transitions of Care for Internal Medicine Housestaff

HM2012 Abstract Number: 97695

A Brief Structured Peertopeer Feedback Intervention to Improve the Quality of Resident Discharge Summaries

Background: High–quality communication is required for safe hospital discharge and is accomplished primarily through the discharge summary. Clear, concise, and meaningful correspondence between providers is essential and yet, first year medical residents are generally charged [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Brief Structured Peertopeer Feedback Intervention to Improve the Quality of Resident Discharge Summaries

HM2012 Abstract Number: 97696

The Daps Tool: An Actionable Screen for Psychiatric Risk Factors for Rehospitalization

Background: Approximately 20% of hospitalized patients are rehospitalized within 30 days of discharge. The presence of depression, anxiety, and substance abuse in a hospitalized patient increases the patient's risk for rehospitalization. By identifying and treating [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Daps Tool: An Actionable Screen for Psychiatric Risk Factors for Rehospitalization

HM2012 Abstract Number: 97697

A Knowledgebased Approach to Decreasing Chf Readmisssions Tailored to Individual Patients

Background: Congestive heart failure (CHF) affects nearly 5 million people in US. Thirty day re–hospitalization rate for Medicare beneficiaries hospitalized for congestive heart failure is 27% of which 90% are unplanned. The reimbursement by CMS [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Knowledgebased Approach to Decreasing Chf Readmisssions Tailored to Individual Patients

HM2012 Abstract Number: 97698

Impact of Employing College Students to Make Limited Postdischarge Phone Calls for Hospitalists

Background: Hospital discharge represents a "voltage drop" in care that can lead to unexpected problems including costly readmission. Post–discharge phone calling is a strategy advocated by national and local organizations to improve the quality of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Impact of Employing College Students to Make Limited Postdischarge Phone Calls for Hospitalists

HM2012 Abstract Number: 97699

Achieving Rapid Improvement in Hospital Readmissions: A Project Boost Pilot As a Driver of System Wide Change

Background: A mentored Project BOOST pilot was undertaken at North Memorial Medical Center, a level I trauma center serving north Minneapolis and the northwestern metropolitan area on the A6 cardiac telemetry unit. BOOST target tool [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Achieving Rapid Improvement in Hospital Readmissions: A Project Boost Pilot As a Driver of System Wide Change

HM2012 Abstract Number: 97700

Increasing Readmissions Awareness: What Will You Do Differently?

Background: Patients with a prior hospitalization in the last 6 months are at increased risk of readmission. However, given our current system of care, providers may be unaware that a patient was previously admitted to [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Increasing Readmissions Awareness: What Will You Do Differently?

HM2012 Abstract Number: 97701

Brown Bag Medications: Development and Implementation of a Program to Provide Discharge Medications

Background: Patients often struggle with managing their medications after hospital discharge, and it is estimated that up to 40% of discharge prescriptions go unfilled. For institutions without an in–house discharge pharmacy, novel solutions are needed [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Brown Bag Medications: Development and Implementation of a Program to Provide Discharge Medications

HM2012 Abstract Number: 97702

Rn and Md Communication: A Lean Performance Improvement Project at Baystate Medical Center

Background: Communication between hospitalists and nurses can lead to frustration on both sides when it is fragmented, incomplete and complicates patient care. As part of a year long LEAN project at our institution to improve [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Rn and Md Communication: A Lean Performance Improvement Project at Baystate Medical Center

HM2012 Abstract Number: 97703

Hospital Medicine Ipad Trial

Background: With the many workflow changes that the inpatient EHR will require of the clinical staff, the EHR Device Committee determined there was a potential need for a device that is more portable and has [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hospital Medicine Ipad Trial

HM2012 Abstract Number: 97704

Enhancing the Quality of Familycentered Rounds: The Rounding Apgar

Background: Conducting Family–Centered Rounds (FCR) has become a common practice in pediatric hospital medicine. As many learners may be a part of the pediatric inpatient team for a brief time, orientation to the goals and [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Enhancing the Quality of Familycentered Rounds: The Rounding Apgar

HM2012 Abstract Number: 97706

Lean Inpatient Unit Base Care Model

Background: The hospital is an urban facility with 453 licensed beds. The hospitalist group is the only hospitalist service operating in the hospital and will perform over 14,000 admissions in 2011. In 2009, we recognized [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Lean Inpatient Unit Base Care Model

HM2012 Abstract Number: 97707

The Problem with Problem Lists Using the Ehr to Exceed the Meaningful Use Goal

Background: The Centers for Medicare and Medicaid Services (CMS) provide financial incentives to hospitals that demonstrate meaningful electronic health record (EHR) implementation. The American Recovery and Reinvestment Act of 2009 specifies meaningful use; for hospitals, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Problem with Problem Lists Using the Ehr to Exceed the Meaningful Use Goal

HM2012 Abstract Number: 97708

Communication Coaching: A Multifaceted Intervention to Improve Physicianpatient Communication

Background: Patients' poor understanding of medical information discussed during their hospital admission can result in lack of adherence to treatment plans and poorer health outcomes. Improving communication with patients can not only improve patient satisfaction [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Communication Coaching: A Multifaceted Intervention to Improve Physicianpatient Communication

HM2012 Abstract Number: 97709

Feasibility of Routine Health Literacy Assessment for Hospitalized Adults: The Health Literacy Screening (Heals) Study

Background: The Institute of Medicine report on health literacy called for incorporation of health literacy assessment into healthcare information systems, as well as large–scale epidemiologic studies of the effects of health literacy on clinical outcomes. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Feasibility of Routine Health Literacy Assessment for Hospitalized Adults: The Health Literacy Screening (Heals) Study

HM2012 Abstract Number: 97710

Improving Access with a Hospitaliststaffed Post Discharge Clinic

Background: Hospital discharge is a vulnerable moment for patients, and poor primary care access threatens follow–up. New models that include hospitalists in post–discharge care could improve post–discharge access.Purpose: The Post Discharge Clinic (PDC), a hospitalist–staffed [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Improving Access with a Hospitaliststaffed Post Discharge Clinic

HM2012 Abstract Number: 97711

Boosting the Discharge Process Mentored Implementation of Project Boost to Optimize the Discharge Process

Background: Hospital discharge is a stressful and hazardous venture for older adults. Recent research documents that up to 49% of patients experience at least one medical error, and one in five patients discharged from the [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Boosting the Discharge Process Mentored Implementation of Project Boost to Optimize the Discharge Process

HM2012 Abstract Number: 97712

Discharge Coordination and Transitions in Care: Utilization of Patient Calls and Prescheduled Primary Care Appointments to Promote a Seamless Transition in Care

Background: A coordinated, standardized hospital discharge process helps to ensure a safe and adequate transition in care. All patients need to clearly understand discharge instructions, have access to discharge medications and have a plan for [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Discharge Coordination and Transitions in Care: Utilization of Patient Calls and Prescheduled Primary Care Appointments to Promote a Seamless Transition in Care

HM2012 Abstract Number: 97713

Patient Care Transition to Improve Patient Satisfaction on a Medical Unit

Background: Patient satisfaction is an important quality performance measure directly impacts the reputation of the hospital and long–term financial performance of the hospital. In our hospital, Press–Ganey patient satisfaction scores for medical floors/hospitalists' were in [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Patient Care Transition to Improve Patient Satisfaction on a Medical Unit

HM2012 Abstract Number: 97714

Improving the Inpatient Management of Neonatal Jaundice: Followup from Year 1

Background: Neonatal jaundice is a common condition that can result in acute bilirubin encephalopathy if not treated appropriately. Despite evidence–based guidelines for monitoring and treating hyperbilirubinemia, variation in care persists. Previously published quality improvement efforts [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Improving the Inpatient Management of Neonatal Jaundice: Followup from Year 1

HM2012 Abstract Number: 97715

The Impact of a Radiology Utilization Campaign on Test Ordering Practices

Background: Mandates to shift our care delivery systems from a focus on quality or cost to one of value is challenging. Unnecessary and expensive diagnostic tests contribute to wasteful spending that does little to improve [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Impact of a Radiology Utilization Campaign on Test Ordering Practices

HM2012 Abstract Number: 97716

Assessment of Timely Test Results and Impact on Patient Satisfaction Utilizing Routine Midnight Blood Draws As Opposed to Daily Am Blood Draws in an Urban Teaching Hospital

Background: Routine blood tests are performed in the early morning hours at most hospitals. Timely review of those laboratory tests during morning rounds is critical for safe and efficient patient care. However, availability of those [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Assessment of Timely Test Results and Impact on Patient Satisfaction Utilizing Routine Midnight Blood Draws As Opposed to Daily Am Blood Draws in an Urban Teaching Hospital

HM2012 Abstract Number: 97717

Who Needs Detox? A Protocol for Evaluation of Patients with Alcohol Withdrawal

Background: Our hospital medicine practice noted a high number of admissions and readmissions to the internal medicine service for the specific purpose of acute detoxification from alcohol dependence. We noted a lack of a clear [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Who Needs Detox? A Protocol for Evaluation of Patients with Alcohol Withdrawal

HM2012 Abstract Number: 97718

Hospitalist Management of Vasoocclusive Pain Crisis

Background: Sickle cell vaso–occlusive pain crises (VOC) are associated with considerable morbidity and mortality, prolonged hospital stays and significant resource utilization. Suboptimal treatment of pain during VOC is associated with increased morbidity and mortality. Standardized [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hospitalist Management of Vasoocclusive Pain Crisis

HM2012 Abstract Number: 97719

Application of Clinical Microsystems to Improve Pain Relief in Sickle Cell Disease (Scd) Patients Admitted with Acute Vasoocclusive Crisis

Background: The management of acute vaso–occlusive crisis remains a challenge. Long Island Jewish Medical Center is a 500–adult bed tertiary care facility with more than 500 reported admissions for acute vaso–occlusive crisis in 2009. Suboptimal [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Application of Clinical Microsystems to Improve Pain Relief in Sickle Cell Disease (Scd) Patients Admitted with Acute Vasoocclusive Crisis

HM2012 Abstract Number: 97720

Palliative Care Referral of Hospitalized Congestive Heart Failure Patients

Background: Congestive heart failure (CHF) is a leading cause of hospitalization nationwide in people over more than 65. Moreover, CHF exacerbation is one of the leading causes of readmission –— creating a substantial financial burden [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Palliative Care Referral of Hospitalized Congestive Heart Failure Patients

HM2012 Abstract Number: 97721

Impact of a Standardized Recommendation and Electronic Prompts on Followup of Indeterminate Pulmonary Nodules Found on Computed Tomography

Background: Lung cancer is the leading cause of cancer death in both men and women worldwide. Given that pulmonary nodules are a common finding on chest CT, a judicious plan for follow–up is necessary. A [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Impact of a Standardized Recommendation and Electronic Prompts on Followup of Indeterminate Pulmonary Nodules Found on Computed Tomography

HM2012 Abstract Number: 97722

Improving Inpatient Glycemic Control Using a Multifaceted Approach

Background: Nationally, manifestations of poor glycemic control are one of Medicare's Hospital Acquired Conditions that are publically reported and no longer reimbursed. Insulin is also one of the JC's top five high –risk medications. Furthermore, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Improving Inpatient Glycemic Control Using a Multifaceted Approach

HM2012 Abstract Number: 97723

Implementation of a Hospitalwide Hiv Alert to Increase Testing and Prevention

Background: 1.2 million people in the United States are living with an HIV infection and one in five is unaware of their infection. In Chicago, there are currently over 20,000 people living with HIV/AIDS and [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Implementation of a Hospitalwide Hiv Alert to Increase Testing and Prevention

HM2012 Abstract Number: 97724

Using an It Tool to Efficiently Identify Preventable and Nonpreventable Venous Thromboembolism

Background: In–hospital venous thromboembolism (VTE) remains a major cause of morbidity and mortality in US hospitals and is known to be preventable. Despite an extremely high level of compliance with VTE prophylaxis guidelines at our [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Using an It Tool to Efficiently Identify Preventable and Nonpreventable Venous Thromboembolism

HM2012 Abstract Number: 97725

Educating Fellows in Practicebased Learning & Improvement and Systemsbased Practice: The Value of Quality Improvement in Clinical Practice

Background: In 1999, the Accreditation Council for Graduate Medical Education identified six general competencies in which residents must be trained. Among these are two relatively abstract and complex competencies: Practice–Based Learning & Improvement (PBLI) and [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Educating Fellows in Practicebased Learning & Improvement and Systemsbased Practice: The Value of Quality Improvement in Clinical Practice

HM2012 Abstract Number: 97726

Introduction to the Electronic Medical Record: Impact of a Preclerkship Curriculum

Background: Electronic Medical Record (EMR) systems are becoming more prevalent in clinical settings. However, students generally receive little formal instruction regarding effective use of the EMR during their undergraduate medical training. Since the implementation of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Introduction to the Electronic Medical Record: Impact of a Preclerkship Curriculum

HM2012 Abstract Number: 97727

A Medical Invasive Procedure Service and Resident Procedure Training Elective

Background: Experience in invasive bedside procedures is increasingly difficult to acquire for both resident and attending physicians. Inconsistent training, work hours restrictions, decreasing emphasis on procedural training, and lack of confidence can lead to a [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Medical Invasive Procedure Service and Resident Procedure Training Elective

HM2012 Abstract Number: 97728

Show Me the Money: Implementation of a Unique Cost Awareness Curriculum for Medical Residents

Background: Approximately $700B of annual healthcare spending is wasted, with physicians directly influencing 87% of this expenditure. Medical training has emphasized quality improvement but few programs are addressing the ACGME requirement that physicians–in–training now "incorporate [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Show Me the Money: Implementation of a Unique Cost Awareness Curriculum for Medical Residents

HM2012 Abstract Number: 97729

The Design, Implementation and Impact of an Internal Medicine Resident Ultrasoundbased Procedure Service

Background: The American Board of Internal Medicine (ABIM) states that Internists who perform procedures must obtain the appropriate training to safely and competently perform that procedure. ABIM also recommends initial training in these procedures be [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Design, Implementation and Impact of an Internal Medicine Resident Ultrasoundbased Procedure Service

HM2012 Abstract Number: 97730

Embedding the Concepts of Waste and Systems Failure Reduction in an Innovative Quality Curriculum for Resident Education

Background: Integrating healthcare quality into the Internal Medicine resident training curriculum has been a focus of our institution's Educational Innovations Program of the ACGME. Five years ago, at Baystate Medical Center we began a PGY2 [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Embedding the Concepts of Waste and Systems Failure Reduction in an Innovative Quality Curriculum for Resident Education

HM2012 Abstract Number: 97731

Improving Advance Care Planning Documentation Through a Residentled Incentive Program

Background: Documentation of Advance Care Planning (ACP) is often driven by outpatient providers. However, in–patient hospitalization presents a unique opportunity to elicit and document end–of–life wishes, and additionally strengthen communication between inpatient and outpatient providers. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Improving Advance Care Planning Documentation Through a Residentled Incentive Program

HM2012 Abstract Number: 97732

An Experiential, Longitudinal Multidisciplinary Qi Curriculum for Hospitalist Residents

Background: Formal training in quality improvement (QI) has become increasingly important. Both theAccreditation Council for Graduate Medical Education (ACGME) and the American Board of Internal Medicine(ABIM) have created competencies in the areas of practice–based learning [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Experiential, Longitudinal Multidisciplinary Qi Curriculum for Hospitalist Residents

HM2012 Abstract Number: 97733

Implementation of a Formalized Physician Assistant Training Model

Background: As Hospitalist demand continues to grow, a growing number of programs are utilizing Physician's Assistants (PAs) and Nurse Practitioners (NPs) to assist with delivery of care on the inpatient medical wards. Since the field [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Implementation of a Formalized Physician Assistant Training Model

HM2012 Abstract Number: 97734

Accountable Care Unit on a Medical Ward in a Teaching Hospital: A New Care Model Designed to Improve Patient and Hospital Outcomes

Background: Properly designed, hospital units have potential to optimize outcomes for patients, staff, and trainees. Such units would be of great value if they converge high high–performing teams with active management while promoting principles of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Accountable Care Unit on a Medical Ward in a Teaching Hospital: A New Care Model Designed to Improve Patient and Hospital Outcomes

HM2012 Abstract Number: 97735

ICU Hospitalist a Novel Method of Care for the Critically Ill Patients in Economically Lean Times

Background: ICU patients account for over 18 million patient days annually in the United States and cost 1 % of GDP. The Leapfrog group recommended that ICU patients be managed exclusively by board–certified intensivists for [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on ICU Hospitalist a Novel Method of Care for the Critically Ill Patients in Economically Lean Times

HM2012 Abstract Number: 97736

Effectiveness of Patient Centered Team Rounds at the Bedside in an Adult Hospitalist Practice

Background: Institutions that focus on patient–family centered care have seen improvements in their patient and staff satisfaction. Bedside rounding with the patient/family involved is a tool that hospitalists can use to deliver care that centers [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Effectiveness of Patient Centered Team Rounds at the Bedside in an Adult Hospitalist Practice

HM2012 Abstract Number: 97737

Quick Rounds for Geographical Rounding

Background: Hospital –based medicine could be more effective when there is collaboration and open communication from sub specialties, nursing and discharge planning. To facilitate this effort the hospitalist group partnered with nursing leadership to establish [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Quick Rounds for Geographical Rounding

HM2012 Abstract Number: 97738

Patient Plan of Care Rounds: Success of Teambased Inpatient Rounding

Background: Developing collaborative practice models is emerging as a core strategy in creating an ideal patient safety climate, improving patient care outcomes, and increasing patient satisfaction. However structuring a workflow for team members that allows [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Patient Plan of Care Rounds: Success of Teambased Inpatient Rounding

HM2012 Abstract Number: 97739

Quality Officer of the Block (The Qb): An Innovative Role to Promote Hospitalist Engagement and Enhance Group Performance

Background: Hospitalist groups strive to perform at a high level on multiple measures, including readmissions and patient satisfaction. Individual hospitalists, however, may find it difficult to become actively involved in quality improvement (QI) due to [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Quality Officer of the Block (The Qb): An Innovative Role to Promote Hospitalist Engagement and Enhance Group Performance

HM2012 Abstract Number: 97740

A Viable Metric and Extraction Tool for Tracking Medication Reconciliation in the Electronic Health Record

Background: Medication reconciliation (MR) was identified as a National Patient Safety Goal in 2006 and during the summer of 2011 the Joint Commission is tracking it as a part of the accreditation process. Beyond its [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Viable Metric and Extraction Tool for Tracking Medication Reconciliation in the Electronic Health Record

HM2012 Abstract Number: 97741

Improving Medication Safety for Pregnant and Breastfeeding Women Using Computerized Provider Order Entry

Background: The Joint Commission requires that pregnancy and lactation information for a patient must be accessible to practitioners who participate in the management of the patient's medications. To facilitate this process, we developed computer–based decision [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Improving Medication Safety for Pregnant and Breastfeeding Women Using Computerized Provider Order Entry

HM2012 Abstract Number: 97742

Hardwiring a Core Measures Review Process: Ownership of Improvement in a Large Tertiary Medical Center

Background: Core measures are publicly reported measures that gauge the quality of the process of patient care reflecting compliance to standards of care. This organization has employed many real–time electronic record enabled tools and clinical [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hardwiring a Core Measures Review Process: Ownership of Improvement in a Large Tertiary Medical Center

HM2012 Abstract Number: 97743

Ehr (Electronic Health Record) to Your Advantage: Improving Bed Throughput by Targeting Early Discharges. Utilising Ehr Enabled Worklows and Ehr Based Infoview/ Clarity Reporting Tools

Background: The average time of discharge at a hospital is more than the average time of admission and this creates a bottleneck in patient flow. Patients have to wait longer for an available bed. Pushing [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Ehr (Electronic Health Record) to Your Advantage: Improving Bed Throughput by Targeting Early Discharges. Utilising Ehr Enabled Worklows and Ehr Based Infoview/ Clarity Reporting Tools

HM2012 Abstract Number: 97744

Actionable Quality Improvement: Synergizing the Emr and Bi

Background: Today's healthcare industry is in transition, moving from paper based processes to highly customizable electronic medical records (EMR). This technology opens new opportunities to provide clinical staff information to develop treatment plans, ensure consistent [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Actionable Quality Improvement: Synergizing the Emr and Bi

HM2012 Abstract Number: 97745

Daily Review of Telemetry Orders by Providers Leads to Improved Appropriateness of Use of Telemetry

Background: Christiana Care Health System (CCHS) is a 1100–bed hospital system with all telemetry enabled beds. Continuous cardiac monitoring (CCM) is ordered for a default period of 72 hours at the time of admission on [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Daily Review of Telemetry Orders by Providers Leads to Improved Appropriateness of Use of Telemetry

HM2012 Abstract Number: 97746

Developement of Medical Simulation Training for Practicing Hospitalists: Fundamentals of Implementation

Background: Medical simulation training has rapidly emerged as an effective model of clinical skill development. A validated educational approach, this technique allows practitioners the ability to gain proficiency and confidence in ongoing professional practices such [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Developement of Medical Simulation Training for Practicing Hospitalists: Fundamentals of Implementation

HM2012 Abstract Number: 97747

A Systematic Approach to Enhance Communication and Optimize Patient Flow Through the Use of Technology

Background: Communication failures are frequently cited as contributing to patient care errors and delays, specifically with regards to discharge planning. The common medical model, usually structured as a physician service team, houses patients across multiple [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Systematic Approach to Enhance Communication and Optimize Patient Flow Through the Use of Technology

HM2012 Abstract Number: 97748

Quality Improvement Through Rapid Process Improvement Workshops

Background: Process improvement projects often lack the structure and buy–in to achieve their goals. The Rapid Process Improvement Workshop (RPIW) is one quality improvement tool to make QI projects more effective.Purpose: To utilize RPIWs to [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Quality Improvement Through Rapid Process Improvement Workshops

HM2012 Abstract Number: 97749

Striving to Save 21 Million Neurons Through Quality Improvement

Background: Approximately two million neurons are lost every minute during an ischemic stroke. University of Colorado has a median time of 71 minutes for door to tissue plasminogen activator (t–PA) administration. The American Stroke Association [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Striving to Save 21 Million Neurons Through Quality Improvement

HM2012 Abstract Number: 97750

Hospitalist As Medical Director of a Telemedicine Supported Stroke Center: Identifying Key Roles for Success

Background: Approximately 795,000 strokes occur each year in the United States; Stroke is a leading cause of death nationally and remains the leading cause of long–term disability. Only ten percent of the hospitals in the [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hospitalist As Medical Director of a Telemedicine Supported Stroke Center: Identifying Key Roles for Success

HM2012 Abstract Number: 97751

Multidisciplinary Longitudinal Approach to Patients with High Admission Rates

Background: High–volume, high–cost patients pose a challenge to healthcare institutions due to fragmented care, socioeconomic issues,and lack of outpatient resources. Recently, New York's Medicaid program adopted a measure to reduce payment to hospitals with a [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Multidisciplinary Longitudinal Approach to Patients with High Admission Rates

HM2012 Abstract Number: 97752

Surveillance and Pharmacist Intervention for Vulnerable Hospitalized Geriatric Patients on Highrisk Medication Regimens

Background: Clinical decision support systems are useful tools to discourage the use of potentially inappropriate medications (PIMs) in the geriatric inpatient population. These interventions have had variable success, in large part because geriatric medication decisions [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Surveillance and Pharmacist Intervention for Vulnerable Hospitalized Geriatric Patients on Highrisk Medication Regimens

HM2012 Abstract Number: 97753

What Role Should Hospitalists Play in Provider Billing?

Background: Many providers find E/M coding rules confusing and frustrating. Tasking hospitalists with completing charge tickets often leads to delinquent or inaccurate charges. Hospitalist groups have incorporated various education methods and incentives to improve documentation, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on What Role Should Hospitalists Play in Provider Billing?

HM2012 Abstract Number: 97754

Deliberate Practice Makes Perfect: Expertise Training on the Wards

Background: Academic productivity is a key component of advancement in academic medicine and development of expertise, however many new attendings lack the knowledge and experience to publish a paper. For example, a multi–institutional survey of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Deliberate Practice Makes Perfect: Expertise Training on the Wards

HM2012 Abstract Number: 97755

Promoting Professionalism Via a Videobased Educational Workshop for Academic Hospitalists

Background: Unprofessional behaviors undermine the hospital learning environment and patient care quality.A prior needs assessment of residents and hospitalists regarding lapses in professionalism was utilized to identify clinical scenarios which increased during internship at our [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Promoting Professionalism Via a Videobased Educational Workshop for Academic Hospitalists

HM2012 Abstract Number: 97756

A Hospitalist Clinical Coach Program for New Faculty

Background: Starting a new job with a hospitalist group can be stressful and exhausting as new hires adapt to changes in processes, workloads, and institutional culture. Surveys have indicated high hospitalist attrition rates between 13–22% [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Hospitalist Clinical Coach Program for New Faculty

HM2012 Abstract Number: 97757

Healthcare Leadership Track: A Novel Track to Train Leaders in Inpatient Medicine

Background: Recognition of poor value in US healthcare is leading to reform of the hospital payment system. Effective physician leadership will be crucial for the potential gains from aligning incentives to be translated into improved [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Healthcare Leadership Track: A Novel Track to Train Leaders in Inpatient Medicine

HM2012 Abstract Number: 97758

Medical Hospitalist Physician Assistant with Advanced Surgical Training

Background: Medical hospitalists typically manage hospitalized patients. However hospital medicine is evolving to meet the changing demands of hospitals and communities. A recent innovation, surgical co–management is now part of the standard repertoire of most [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Medical Hospitalist Physician Assistant with Advanced Surgical Training

HM2012 Abstract Number: 97759

Creation of a Financially Viable Hospitalist Run Observation Unit in a Safety Net Hospital

Background: Observation services are provided for clinical conditions that do not meet inpatient admission criteria but require a period of observation for evaluation and treatment. Dedicated observation units can serve this purpose and are found [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Creation of a Financially Viable Hospitalist Run Observation Unit in a Safety Net Hospital

HM2012 Abstract Number: 97760

Reengineering the Evening Huddleour First Step to Leverage Afterhours Care to Improve Patient Flow

Background: The advent of hospitalists has greatly improved the afterhours care in the hospital. A majority of the care planning happens when the hospitalists round in the daytime and the afterhours care is limited to [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Reengineering the Evening Huddleour First Step to Leverage Afterhours Care to Improve Patient Flow

HM2012 Abstract Number: 97761

Trismus: The Phantom Menace

Case Presentation: A 73–year–old man presented with symptom of locked jaw for one day. On further enquiry, he reported that he suffered an injury to the right leg after stepping on a rusty steel object [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Trismus: The Phantom Menace

HM2012 Abstract Number: 97762

Smoker with Chest Pain, Could It Be Pulmonary Langerhanse Cell Histiocytosiscase Report

Case Presentation: We report a case of a 43–year–old African American female with a 30 years history of tobacco use who presented with complaints of severe retrosternal chest pain for 4 hours associated with mild [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Smoker with Chest Pain, Could It Be Pulmonary Langerhanse Cell Histiocytosiscase Report

HM2012 Abstract Number: 97763

New Onset Celiac Disease in an 89 Year Old Man

Case Presentation: An 89–year–old man with past medical history of hypothyroidism, coronary artery disease, and atrial fibrillation on warfarin, is sent from his primary care physician for two week history of new onset diarrhea. The [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on New Onset Celiac Disease in an 89 Year Old Man

HM2012 Abstract Number: 97764

Absence of Proof Is Not Proof of Absence

Case Presentation: A 59–year–old man presented with sudden onset left–sided facial droop, aphasia, and left upper and lower extremity weakness. His medical history included hepatitis C, cirrhosis, and hepatocellular carcinoma. CT of the brain showed [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Absence of Proof Is Not Proof of Absence

HM2012 Abstract Number: 97765

A Case of Maythurner Syndrome Associated with Phlegmasia Cerulea Dolens

Case Presentation: A 37–year–old woman with a past medical history of depression, anxiety and migraine, who presented to emergency complaining of severe left leg pain and swelling which is sudden in onset. Pain is 10/10, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Case of Maythurner Syndrome Associated with Phlegmasia Cerulea Dolens

HM2012 Abstract Number: 97766

Put a Leash on It Severe Sepsis and Shock Following Canine Attack

Case Presentation: A 28–year–old man presented with a 4–day history of progressively worsening left calf pain and swelling that began after he was bitten by a dog. He also complained of fevers and rigors. Initial [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Put a Leash on It Severe Sepsis and Shock Following Canine Attack

HM2012 Abstract Number: 97767

Chronic Hypoxemia with Ataxic Gait

Case Presentation: A 52–year year–old Caucasian female presented with history of wide based ataxic gait for four days. Head CT showed possible pontine stroke, however the MRI was interpreted as normal. Patient denied any dyspnea [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Chronic Hypoxemia with Ataxic Gait

HM2012 Abstract Number: 97768

Confused Patient, Puzzled Doctor

Case Presentation: A 70–year–old man presented with confusion, mumbling, malaise, and headache after having recently taken oral antibiotics for a skin lesion on his forehead. His prior history was complicated by previously treated chronic lymphocytic [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Confused Patient, Puzzled Doctor

HM2012 Abstract Number: 97769

Adding Insult to Injury a Case of Acute Exacerbation of Ipf

Case Presentation: A 65–year–old male with a history of Parkinson's, hypertension, and smoking presented 2 weeks after an uncomplicated left shoulder arthoplasty with one week of worsening shortness of breath, fever, cough, and profound hyoxemia. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Adding Insult to Injury a Case of Acute Exacerbation of Ipf

HM2012 Abstract Number: 97770

One Patient at a Time: Identifying a Community Outbreak of Shigella Infection

Case Presentation: This is a 17–year–old–man who is part of a strict religious community in Brooklyn, NY, with no significant past medical history who presents to the emergency room with the complaint of diarrhea for [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on One Patient at a Time: Identifying a Community Outbreak of Shigella Infection

HM2012 Abstract Number: 97771

Saddling Up for a Journey to an Unexpected Diagnosis

Case Presentation: Ms. P was frustrated after her neurosurgeon cancelled a scheduled lumbar laminectomy to correct her spinal stenosis. The surgeon had concluded this 73–year–old woman was a prohibitive surgical risk due to hypertension, COPD [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Saddling Up for a Journey to an Unexpected Diagnosis

HM2012 Abstract Number: 97772

Adult Kawasaki Disease

Case Presentation: A 44–year–old non–smoking, physically active male presented to our hospital with acute onset substernal chest pressure of one hour duration with associated right arm numbness and diaphoresis. His past medical history is relevant [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Adult Kawasaki Disease

HM2012 Abstract Number: 97773

Beck’s Triad in Fifty Year Old Woman

Case Presentation: A 50–year–old African American woman with history of tobacco use (35 pack–years) and hypersensitivity pneumonitis presented with shortness of breath and chest pain for the past 2 weeks. Chest pain is pressure in [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Beck’s Triad in Fifty Year Old Woman

HM2012 Abstract Number: 97774

Sore Throat and Fever It Is Not Just an Infection

Case Presentation: A 42–year–old man who works for the Justice Department stationed in Ghana presented with 3 days history of headache, fatigue fever (105°F) and sore throat. He was treated with anti–malarial and antibiotics. Few [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Sore Throat and Fever It Is Not Just an Infection

HM2012 Abstract Number: 97775

Kikuchifuijimoto Disesase in a 4Yearold Boy

Case Presentation: A 4–year–old Hispanic male presented to the emergency department (ED) with 4 weeks of fever and increasing cervical lymphadenopathy. His mother reported daily fevers of approximately 38.3°C with neck pain and swelling. He [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Kikuchifuijimoto Disesase in a 4Yearold Boy

HM2012 Abstract Number: 97776

A Curious Case of Caffeineinduced Hypokalemic Paralysis

Case Presentation: A 45–year–old white female with a remote history of bulimia, chronic mild hypokalemia, and a recent upper respiratory infection presented with two 2 days of ascending muscle weakness and paralysis. Physical exam showed [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Curious Case of Caffeineinduced Hypokalemic Paralysis

HM2012 Abstract Number: 97777

A Spitting Headache

Case Presentation: A 55–year–old man with a history of eosinophilic esophagitis requiring repeated stricture dilations presented to the Emergency Department with headache, fevers, nuchal rigidity, nausea, vomiting, photosensitivity, and myalgias. These symptoms followed a recent [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Spitting Headache

HM2012 Abstract Number: 97778

Ayurvedic Remedy for Diabetes As a Cause of Lead Poisoningcase Report

Case Presentation: We present a 56–year–old male, who came to the emergency room with diffuse abdominal pain, decreased oral intake and constipation. Laboratory values showed that hemoglobin had dropped to 9.7 grams per deciliter (from [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Ayurvedic Remedy for Diabetes As a Cause of Lead Poisoningcase Report

HM2012 Abstract Number: 97779

Leucocytoclastic Vasculitis As the Initial Manifestation of Acute Myeloid Leukemia

Case Presentation: A 56–year–old asymptomatic male presented with a rash since 5 days. He noticed the rash on his legs which then spread to his arms. Rash was non tender and non–pruritic. Patient had chills [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Leucocytoclastic Vasculitis As the Initial Manifestation of Acute Myeloid Leukemia

HM2012 Abstract Number: 97780

Case Report: Phenytoin Hypersensitivity Presenting As Worsening Hemiparesis and Fever

Case Presentation: This is a 73–year–old white male with a history of recent strokes and residual left hemiparesis who presented status post mechanical fall and worsening left sided weakness over 1 week. The patient was [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Case Report: Phenytoin Hypersensitivity Presenting As Worsening Hemiparesis and Fever

HM2012 Abstract Number: 97781

A Heartbreaking Sore Throat

Case Presentation: A previously healthy 20–year–old woman presented to the emergency room (ER) with several days of fevers, sore throat, myalgias, and a diffuse rash. The rash emerged as papules on the back of one [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Heartbreaking Sore Throat

HM2012 Abstract Number: 97782

Congestive Heart Failure: When a Compact Differential Falls Short

Case Presentation: A 63–year–old man presented with four 4 days of palpitations, progressive dyspnea on exertion, and orthopnea. He denied chest pain, cough, or fever. He had no personal history of arrhythmia or ischemic heart [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Congestive Heart Failure: When a Compact Differential Falls Short

HM2012 Abstract Number: 97783

Reexpansion Pulmonary Edema in a Patient with Hepatic Hydrothorax and Minimal Ascites

Case Presentation: A 52–year year–old female presented with a chief complaint of 5 days dyspnea, four pillow orthopnea, chest pain when lying supine, and a non productive cough. She denied fevers, chills and night sweats [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Reexpansion Pulmonary Edema in a Patient with Hepatic Hydrothorax and Minimal Ascites

HM2012 Abstract Number: 97784

Questionable Lung Mass with Extensive Adenopathy

Case Presentation: A 58–year–old Caucasian male presented to the emergency department with a three–month history of worsening dyspnea, productive cough, low–grade fevers and chills. Past medical history was significant for 60 pack year smoking history, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Questionable Lung Mass with Extensive Adenopathy

HM2012 Abstract Number: 97785

Beware of the Rub: Infliximabinduced Systemic Lupus Erythematosus

Case Presentation: A 52–year–old woman with seropositive (RF,CCP) ANA negative rheumatoid arthritis (RA) diagnosed in 1999, controlled with methotrexate, hydroxychloroquine, and then infliximab (since 2007; last dose 8 weeks prior to admission (PTA)) now admitted [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Beware of the Rub: Infliximabinduced Systemic Lupus Erythematosus

HM2012 Abstract Number: 97786

A Not so Innocent Bystander: Large Bronchogenic Cyst and Pulmonary Venous Infarct

Case Presentation: A 25–year–old previously healthy man, presented with a 3–month history of intermittent pleuritic chest pain, dyspnea and intermittent hemoptysis after returning from a trip to Europe. He was treated with oral antibiotics for [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Not so Innocent Bystander: Large Bronchogenic Cyst and Pulmonary Venous Infarct

HM2012 Abstract Number: 97787

Refractory Eosinophilic Esophagitis and Severe Gerd: An Unfortunate Combination

Case Presentation: A 39–year–old woman was admitted for severe gastroesophageal reflux (GERD) with nausea and emesis. The patient had 20 years with heartburn which evolved to intermittent episodes of food impaction requiring multiple esophageal dilatations [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Refractory Eosinophilic Esophagitis and Severe Gerd: An Unfortunate Combination

HM2012 Abstract Number: 97788

An Abdominal Etiology for St Elevation on Ekg: Good Heart but Bad Pancreas

Case Presentation: A 65–year–old Black woman with PMH of hypertension presented with 1 hour history of an acute onset of nausea, vomiting, epigastric discomfort, diaphoresis and dizziness. She denied any significant chest pain or shortness [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Abdominal Etiology for St Elevation on Ekg: Good Heart but Bad Pancreas

HM2012 Abstract Number: 97789

Secondary Hemophagocytic Lymphohistiocytosis(Hlh)In a Patient with Sickle Cell Disease(Scd)And Mycobacterium Avium Complex (Mac)

Case Presentation: This is a 22–year–old female with history of SCD and MAC, diagnosed one month prior, who presented with complaints of shortness of breath, pain in lower back and legs, nausea and vomiting. Chest [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Secondary Hemophagocytic Lymphohistiocytosis(Hlh)In a Patient with Sickle Cell Disease(Scd)And Mycobacterium Avium Complex (Mac)

HM2012 Abstract Number: 97790

Chronic Eosinophilic Pneumonia [Cep] Masquerading As a Community Acquired Pneumonia

Case Presentation: This is a 28–year–old male with history of Type 1 diabetes, polysubstance abuse and childhood asthma who was admitted for complaints of fatigue, night sweats and bilateral pleuritic chest pain that had been [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Chronic Eosinophilic Pneumonia [Cep] Masquerading As a Community Acquired Pneumonia

HM2012 Abstract Number: 97791

Taking Her Breath Away

Case Presentation: An 87–year–old female presented with weakness. She reported fatigue over several weeks, now unable to walk. She denied fever, chest pain, or shortness of breath. Past medical history includes CAD, DVT, hypertension, ophthalmic [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Taking Her Breath Away

HM2012 Abstract Number: 97792

A Life Threating Complication of Pharyngitis on the Rise

Case Presentation: We report a previously healthy 18–year–old female who presented to an urgent care clinic with low–grade fever and sore throat, she was given a 5–day course of Azithromycin for pharyngitis. Three days into [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Life Threating Complication of Pharyngitis on the Rise

HM2012 Abstract Number: 97793

A Unique, Life Threatining Cause of Oropharyngeal Dysphagia

Case Presentation: An 84–year–old male with type 2 diabetes, hypertension, and a remote history of pulmonary TB presented with fevers, dysphagia, and scant hemoptysis. Physical exam remarkable for fevers to 38.8 C and bibasilar rhonchi. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Unique, Life Threatining Cause of Oropharyngeal Dysphagia

HM2012 Abstract Number: 97794

Protonix Abuse: It Hurts!

Case Presentation: A 51–year–old Mexican female, with past medical history of hypothyroidism, rheumatoid arthritis, nephrolithiasis, and GERD, presented to our ED with abrupt, sharp, epigastric pain, increasing in intensity and radiating to the back. Pain [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Protonix Abuse: It Hurts!

HM2012 Abstract Number: 97795

Varicella Meningitis in a Healthy Young Female

Case Presentation: A 17–year–old Caucasian female presented to our hospital with complaints of severe, throbbing, fronto–temporal headache for 5 days; associated with photophobia, nausea and non projectile vomiting. There was an isolated episode of 102°F [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Varicella Meningitis in a Healthy Young Female

HM2012 Abstract Number: 97796

A 51Yearold Woman with Anemia: The Dangers of Diagnostic Momentum and Transitions of Care

Case Presentation: A 51–year–old uninsured African American female with no past medical history presented to clinic with bilateral leg swelling, generalized weakness and unintentional weight loss. Her exam was notable for temporal wasting, conjunctival pallor, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A 51Yearold Woman with Anemia: The Dangers of Diagnostic Momentum and Transitions of Care

HM2012 Abstract Number: 97797

Massive Hematemesis Due to a Hepatic Artery Psuedoaneurysm Complicating Pancreatitis

Case Presentation: A 71–year–old woman with diabetes, hypertension and GERD presented with massive hematemesis and syncope. She was a former smoker who drank alcoholic occasionally. Seven months earlier she has mild pancreatitis without gallstones (edema [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Massive Hematemesis Due to a Hepatic Artery Psuedoaneurysm Complicating Pancreatitis

HM2012 Abstract Number: 97798

Guillainbarre Syndrome: A Rare Adverse Reaction Associated with Ciprofloxacin

Case Presentation: A 62–year–old male with a history of hypertension and dyslipidemia presented to the emergency room with distal extremity paresthesia and proximal muscle weakness. Ten days prior, he noticed dysuria and tried over–the–counter phenazopyridine [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Guillainbarre Syndrome: A Rare Adverse Reaction Associated with Ciprofloxacin

HM2012 Abstract Number: 97799

Rare Cause of Lack of Expected Weight Gain in an Infant

Case Presentation: RB was a 6 week old full term infant who presented with lack of expected weight gain. Birth weight was 2.6 kg (3%) and her admit weight was 2.47 kg (3 Standard deviations [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Rare Cause of Lack of Expected Weight Gain in an Infant

HM2012 Abstract Number: 97800

Electrocardiogram Abnormalities Brain and Heart Connection

Case Presentation: An 80–year–old female presented with a 2 day history of intermittent left lateral rib and chest pain. She denied any acute or chronic headache or visual changes. Overall, she appeared well. Vital sign [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Electrocardiogram Abnormalities Brain and Heart Connection

HM2012 Abstract Number: 97801

Colon Cancer Presenting As Malignant Pericardial Effusion

Case Presentation: A 57–year–old man presented acutely after being awoken from sleep with shortness of breath. He had no associated or prodromal symptoms, and no gastrointestinal complaints. Review of systems revealed significant weight loss, with [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Colon Cancer Presenting As Malignant Pericardial Effusion

HM2012 Abstract Number: 97802

Atrial Septal Defects in the Adult Patient: A Case Report and Literature Review

Case Presentation: A 26–year–old Hispanic female without significant past medical history presented with new–onset diabetic ketoacidosis. She was admitted, and blood sugars and metabolic derangements quickly normalized with insulin and intravenous fluids. Physical examination on [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Atrial Septal Defects in the Adult Patient: A Case Report and Literature Review

HM2012 Abstract Number: 97803

Bed Bug Associated Bacteremia

Case Presentation: A 53–year–old female presented with complaints of watery bowel movements every 30 minutes for several days. Although previously plagued with chronic diarrhea, it had resolved 1 month prior with cessation of alcohol abuse. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Bed Bug Associated Bacteremia

HM2012 Abstract Number: 97804

An Unusual Cause of Headache in a Toddler

Case Presentation: A 5–year–old white female presented to the ED with 3 day history of vomiting. She has had two week history of upper respiratory symptoms prior to the onset of vomiting. The emesis was [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Unusual Cause of Headache in a Toddler

HM2012 Abstract Number: 97805

Spontaneous Bacterial Peritonitis Caused by Salmonella in a Case of Cryptogenic Cirrhosis with Sarcoidosis

Case Presentation: A 60–year–old male with sarcoidosis and cryptogenic cirrhosis presented with increasing dyspnea and abdominal distention. He underwent a therapeutic and diagnostic paracentesis. The cell count was consistent with spontaneous bacterial peritonitis (cloudy fluid [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Spontaneous Bacterial Peritonitis Caused by Salmonella in a Case of Cryptogenic Cirrhosis with Sarcoidosis

HM2012 Abstract Number: 97806

Disseminated M. Bovis with Sepsis and Hypersensitivity Reaction Following Intravesical Bcg

Case Presentation: An 85–year–old man received the last of twelve treatments of intravesical Bacillus Calmette–Guérin (BCG) for transitional cell carcinoma of the bladder. Urinary catheter placement was difficult and complicated by hematuria. Over the next [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Disseminated M. Bovis with Sepsis and Hypersensitivity Reaction Following Intravesical Bcg

HM2012 Abstract Number: 97807

Paralysis by Lithium: A Rare Complication of Lithium Toxicity

Case Presentation: A 59–year–old Caucasian male with bipolar disorder presented to an outside hospital with altered mental status, generalized weakness, and lower extremity paralysis after a day of significant physical exertion. Physical exam revealed an [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Paralysis by Lithium: A Rare Complication of Lithium Toxicity

HM2012 Abstract Number: 97808

Intrauterine Midgut Volvulus Without Malrotation

Case Presentation: BG was a 35 week preemie via C/S to a 23–year–oldo G2P1 mom due to preterm labor. Pregnancy was complicated by a progressively dilated loop of bowel without haustrations and only very occasional [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Intrauterine Midgut Volvulus Without Malrotation

HM2012 Abstract Number: 97809

Spontaneous Renal Artery Dissection: A Case Report

Case Presentation: A 42–year–old man with no past medical history presented with right sided abdominal pain of 8 hours duration. He denied dysuria, frequency, or urinary urgency. He was afebrile and his blood pressure was [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Spontaneous Renal Artery Dissection: A Case Report

HM2012 Abstract Number: 97810

Ventricular Tachycardia from Factors Precipitating Hypocalcemia

Case Presentation: A 78–year–old man with metastatic follicular thyroid cancer status post thyroidectomy and radioactive iodine ablation in 2008 was admitted to the hospital for atypical chest pain and back pain for 2 weeks. He [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Ventricular Tachycardia from Factors Precipitating Hypocalcemia

HM2012 Abstract Number: 97811

An Offcolor Diagnosis

Case Presentation: 74–year–old man presents with blue–gray discoloration of the face, neck and upper thorax. The patient had a history of esophageal adenocarcinoma, completing definitive chemo radiation in 2006. His presenting complaint was of weight [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Offcolor Diagnosis

HM2012 Abstract Number: 97812

A Case of Pseudocirrhosis After Chemotherapy

Case Presentation: A 69–year–old lady with metastatic breast cancer presents with 2 months of leg edema and abdominal swelling. Initially diagnosed and treated 13 years earlier, she had recurrence of invasive ductal carcinoma 3 years [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Case of Pseudocirrhosis After Chemotherapy

HM2012 Abstract Number: 97813

Pantoprazoleinduced Neutropenia

Case Presentation: An 82–year–old female with a medical history notable for dementia, type 2 diabetes mellitus, hypertension, hyperlipidemia, cerebrovascular accident, gastroesophageal reflux, and gastric ulcers secondary to Stevens Johnson syndrome was brought into the emergency [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Pantoprazoleinduced Neutropenia

HM2012 Abstract Number: 97814

Kikuchi’s Disease: A Rare Cause of Fever and Lymphadenopathy

Case Presentation: A 29–year–old woman presented to the hospital with fever, chills, and bilateral neck swelling for 1 week. There was no history of recent travel, sick contacts or exposure to tuberculosis. On presentation vital [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Kikuchi’s Disease: A Rare Cause of Fever and Lymphadenopathy

HM2012 Abstract Number: 97815

Hiv & Invasive Meningococcal Disease: Causal or Coincidental?

Case Presentation: A 52–year–old gentleman with human immunodeficiency disease (HIV) and CD4 count greater than 500 cells per cubic millimeter of blood presented with 2 days of diarrhea, lethargy, myalgias, arthralgias, and a rash. He [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hiv & Invasive Meningococcal Disease: Causal or Coincidental?

HM2012 Abstract Number: 97816

Acute Abdomen Due to Large Bowel Angioedema Caused by Angiotensin Converting Enzyme Inhibitor

Case Presentation: A 34–year–old Caucasian female recently diagnosed with hypertension presented to our hospital with an episode of syncope. She was started on hydrochlorothiazide by her primary care physician 1 week prior to admission. Two [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Acute Abdomen Due to Large Bowel Angioedema Caused by Angiotensin Converting Enzyme Inhibitor

HM2012 Abstract Number: 97817

Panhypopitutarisman Overlooked Cause of Persistant Hyponatremia

Case Presentation: An 80–year–old woman presented to the hospital with syncope and several weeks of headache, nausea, dizziness, generalized weakness and anorexia. Vital signs were stable and physical exam was unremarkable except bilateral maxillary sinus [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Panhypopitutarisman Overlooked Cause of Persistant Hyponatremia

HM2012 Abstract Number: 97818

Seized with Something a Diagnostic Challenge

Case Presentation: A 20–year–old man with no past medical history was brought to the hospital with complaints of two witnessed episodes of generalized tonic–clonic seizures. He also complained of headaches which were diffuse, but denied [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Seized with Something a Diagnostic Challenge

HM2012 Abstract Number: 97819

Eosinophilic Gastroenteritisan Often Overlooked Diagnosis

Case Presentation: A 66–year–old woman presented to the hospital for vomiting, diarrhea and abdominal pain since 10 days but persistent for many years. She had been diagnosed as Irritable Bowel Syndrome. Physical exam was unremarkable [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Eosinophilic Gastroenteritisan Often Overlooked Diagnosis

HM2012 Abstract Number: 97820

Time to Back Up? Two Cases Highlighting the Potential Dangers of Kyphoplasty and Vertebroplasty

Case Presentation: A 73–year–old man with atrial fibrillation, and multiple myeloma was admitted with severe back pain secondary to multiple lumbar osteoporotic vertebral compression fractures (VCF). Four kyphoplasties (KP) were performed, providing significant pain relief. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Time to Back Up? Two Cases Highlighting the Potential Dangers of Kyphoplasty and Vertebroplasty

HM2012 Abstract Number: 97821

An Unusual Twist of Stroke

Case Presentation: 45–year–old previously healthy male presented to the ED with progressively worsening headache of 5 days associated with dizziness and a questionable seizure activity per family members. There were no fever, motor, sensory or [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Unusual Twist of Stroke

HM2012 Abstract Number: 97822

An Exotic Cause of Pyogenic Liver Abscess

Case Presentation: An 80–years–old Korean man with a history of liver fluke infection treated 26 years ago presented with 2 weeks history of fever and abdominal pain Pt had a non diagnostic CT scan of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Exotic Cause of Pyogenic Liver Abscess

HM2012 Abstract Number: 97823

Was It the Cia or Was It Enterococcus: Endocarditis Causing a Fixed Delusion

Case Presentation: A 73–year–old man, with a past history of coronary artery disease, s/p CABG, end stage renal disease on hemodialysis and aortic stenosis status post bioprosthetic aortic valve replacement 3 years prior. Presented to [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Was It the Cia or Was It Enterococcus: Endocarditis Causing a Fixed Delusion

HM2012 Abstract Number: 97824

It Is Not Always Sepsis

Case Presentation: A 47–year–old Caucasian male with a history of diabetes, hypertension and depression sustained a fall in the woods and had a fracture of the right ankle a week prior to admission. He had [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on It Is Not Always Sepsis

HM2012 Abstract Number: 97825

Thinking Outside the Box: A Rare Presentation of a Common Disease

Case Presentation: A 29–year–old African American male with no prior medical history was admitted to the hospital with substernal chest pain and cough with minimal expectoration for the past 3 months. He reported a 25 [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Thinking Outside the Box: A Rare Presentation of a Common Disease

HM2012 Abstract Number: 97826

Recurrent Hypoglycemia in an Elderly Woman with Men 1

Case Presentation: A 94–year–old African American female patient admitted to the hospital with altered mental status and slurring of speech. Patient daughter had home blood sugar measured as 22 mg/dl. She had been suffering from [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Recurrent Hypoglycemia in an Elderly Woman with Men 1

HM2012 Abstract Number: 97827

A Case of Biopsy Negative Giant Cell Arteritis

Case Presentation: 61–year–old female with a medical history of asthma, fibromyalgia, hypertension, osteoarthritis, insomnia and anxiety was admitted to the hospital for persistent low–grade fever, cough and myalgias for 12 weeks. Extensive outpatient workup including [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Case of Biopsy Negative Giant Cell Arteritis

HM2012 Abstract Number: 97828

Rare Etiology of Chest Pain and Dyspnea in a 50Yearold Woman with Breast Cancer and Recent Bilateral Mastectomy

Case Presentation: A 50–year–old woman with left breast cancer and a 10–pack–year smoking history presented to the emergency department with pleuritic right–sided chest pain and dyspnea. Six days earlier, she had undergone bilateral total mastectomy. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Rare Etiology of Chest Pain and Dyspnea in a 50Yearold Woman with Breast Cancer and Recent Bilateral Mastectomy

HM2012 Abstract Number: 97829

It’s Not a Tumor: Rare Etiology of Knee Swelling and Tibial Lesion in an Immunocompromised Patient

Case Presentation: A 71–year–old man with chronic lymphocytic leukemia (CLL) and chronic obstructive pulmonary disease presented with fatigue, fever, and right knee pain and swelling. He denied right knee trauma. He also reported dyspnea and [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on It’s Not a Tumor: Rare Etiology of Knee Swelling and Tibial Lesion in an Immunocompromised Patient

HM2012 Abstract Number: 97830

The Worst Cold of His Life

Case Presentation: An 8–year–old boy presented with 1 day of agitation, hypertension, and encephalopathy. Prior to presentation, he was babbling incoherently with some extremity shaking, incontinent of urine and became somnolent. He had a history [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Worst Cold of His Life

HM2012 Abstract Number: 97831

A Case of Injecting Too Deeply

Case Presentation: A 65–year–old female with metastatic breast cancer, glioblastoma multiforme, bilateral pulmonary emboli diagnosed 4 days prior to admission started on enoxaparin, presented with syncope. On the day of admission the patient collapsed on [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Case of Injecting Too Deeply

HM2012 Abstract Number: 97832

Fooled by a Common Pathogen That Is Rarely Isolated

Case Presentation: A 37–year–old Caucasian female with a history of hypothyroidism presented with acute, diffuse, cramping abdominal pain, bloody diarrhea and green mucous discharge. The patient was admitted to our institution for acute gastroenteritis. Physical [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Fooled by a Common Pathogen That Is Rarely Isolated

HM2012 Abstract Number: 97833

Idiopathic Constrictive Pericarditis As the Cause of Hepatic Cirrhosis

Case Presentation: A 51–year–old man with a past medical history significant for obesity, cirrhosis and COPD presented to an outside emergency department for evaluation of progressive edema. The patient was diagnosed with alcoholic cirrhosis 15 [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Idiopathic Constrictive Pericarditis As the Cause of Hepatic Cirrhosis

HM2012 Abstract Number: 97834

The Fungus Among Us Packs a Mean Punch

Case Presentation: A 63–year–old man with type 2 Diabetes and recent diagnosis of high grade Myelodysplastic Syndrome, presented with one week of progressive left eyelid swelling and erythema. He had an associated clear discharge and [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Fungus Among Us Packs a Mean Punch

HM2012 Abstract Number: 97835

Appearances Are Deceptive: Staphylococcal Superinfection of Clavicular Tuberculous Osteomyelitis

Case Presentation: A 25–year–old Asian Indian male studying in Poland presented with pain, swelling and drainage from the right clavicular area of 15 days duration limiting his activity. Four months ago, he was diagnosed with [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Appearances Are Deceptive: Staphylococcal Superinfection of Clavicular Tuberculous Osteomyelitis

HM2012 Abstract Number: 97836

Hanging by a Thread: Systemic Embolization from a Floating Aortic Thrombus

Case Presentation: A 55–year–old male with hypertension and polysubstance abuse presented after 3 days of bilateral flank and epigastric abdominal pain and chills. He was afebrile and exam revealed clear lungs, regular rhythm, no heart [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hanging by a Thread: Systemic Embolization from a Floating Aortic Thrombus

HM2012 Abstract Number: 97837

Group G Hemolytic Streptococcus Causing Infective Endocarditis

Case Presentation: A 42–year–old Hispanic male, butcher by occupation with a history of alcohol abuse, presented with a 6–day history of epigastric abdominal pain, diarrhea and fevers. Vital signs showed fever and mild tachycardia. Laboratory [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Group G Hemolytic Streptococcus Causing Infective Endocarditis

HM2012 Abstract Number: 97838

Keratoderma Blennorrhagica As First Presenting Symptom of Aids

Case Presentation: A 35–year–old bisexual African–American male presented with complaints of a rapidly progressing rash over 2 weeks associated with fatigue. The rash began on his palms, but later appeared on his soles. He denied [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Keratoderma Blennorrhagica As First Presenting Symptom of Aids

HM2012 Abstract Number: 97839

Paraspinal Compartment Syndrome in the Setting of Rhabdomyolysis

Case Presentation: A 34–year–old man with history of myocardial infarction, polysubstance use, hepatitis C, and lumbar disc disease presented with severe back pain and extremity weakness. The patient is a martial arts fighter who was [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Paraspinal Compartment Syndrome in the Setting of Rhabdomyolysis

HM2012 Abstract Number: 97840

Riding the Storm: A Rare Cause of Acute Liver Failure

Case Presentation: A 31–year–old man with no past medical history presented to the emergency department with 3 weeks of shortness of breath and yellowing of the skin. The symptoms acutely worsened 4 days prior to [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Riding the Storm: A Rare Cause of Acute Liver Failure

HM2012 Abstract Number: 97841

A Rare Presentation of Lung Cancer

Case Presentation: A 72–year–old male admitted for progressive shortness of breath with pleuritic chest pain for 2 days. He noted weight loss of 25 lbs in the past 6 months. Past medical history includes hypertension [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Rare Presentation of Lung Cancer

HM2012 Abstract Number: 97842

Atypical Solitary Intradural Lung Cancer Metastasis with Imaging Characteristics of Benign Disease

Case Presentation: A 55–year–old male with a 20 pack year smoking history was diagnosed with stage IIIA (T2N2M0) non small (non squamous) cell carcinoma of the upper lobe of the left lung after presenting with [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Atypical Solitary Intradural Lung Cancer Metastasis with Imaging Characteristics of Benign Disease

HM2012 Abstract Number: 97843

Hemophagocytic Lymphohistiocytosis in a Patient with Disseminated Histoplasmosis: A Case Report

Case Presentation: A 28–year–old African American male, recently diagnosed with HIV (CD4 count 12 cells/mm3) was admitted with a history of fever of 2 weeks duration. On exam, he had high grade fever of 38.50 [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hemophagocytic Lymphohistiocytosis in a Patient with Disseminated Histoplasmosis: A Case Report

HM2012 Abstract Number: 97844

Plastic Bronchitis: An Unusual Presentation of Cryptococcal Pneumonia

Case Presentation: A 41–year–old Caucasian male with past medical history significant for morbid obesity, OSA and two recent admissions for pneumonia presented with dyspnea and expectoration of brownish yellow "sea creatures" for 2 weeks. Patient [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Plastic Bronchitis: An Unusual Presentation of Cryptococcal Pneumonia

HM2012 Abstract Number: 97845

An Unusual Pox

Case Presentation: A 54–year–old Haitian Woman with chronic back pain and an implanted neurostimulator placed years ago, presented in the spring with a frontal headache and subjective fevers for 8 days. She noted a nonpuritic [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Unusual Pox

HM2012 Abstract Number: 97846

Toxicity of Tizanidine (Zanaflex) Exacerbated by Coadministration of Ciprofloxacin: A Case Report and Literature Review

Case Presentation: A 32–year–old Asian woman with a variant of multiple sclerosis (MS) was admitted with pyelonephritis and sepsis. She was started on ciprofloxacin (Cipro) 400 mg IV Q12 hours and continued on her home [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Toxicity of Tizanidine (Zanaflex) Exacerbated by Coadministration of Ciprofloxacin: A Case Report and Literature Review

HM2012 Abstract Number: 97847

Two for the Price of One: Simultaneous Hepatic and Cardiac Toxicity from Hydroxychloroquine

Case Presentation: This is a 72–year–old African American woman who presented to the hospital with abdominal pain and failure to thrive which began 1 month prior to presentation. Notably, she was diagnosed with hydralazine–induced lupus [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Two for the Price of One: Simultaneous Hepatic and Cardiac Toxicity from Hydroxychloroquine

HM2012 Abstract Number: 97848

Into the Unknown: A Case of Granulomas of Unknown Significance Presenting As Fever of Unknown Origin

Case Presentation: A previously healthy 43–year–old white man was hospitalized because of recurrent episodes of fever, hepatosplenomegaly, abdominal pain and pancytopenia over the past 6 months. Previous extensive workup was unrevealing in causation. The patient [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Into the Unknown: A Case of Granulomas of Unknown Significance Presenting As Fever of Unknown Origin

HM2012 Abstract Number: 97849

Dysarthria and Ataxia in a Middle Aged Woman

Case Presentation: A 34–year–old female presented with a 1–week history of dysarthria, ataxia and postural instability. The week prior to her presentation she was admitted to a local hospital with significant vomiting and dehydration. She [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Dysarthria and Ataxia in a Middle Aged Woman

HM2012 Abstract Number: 97850

Vitamin B12 Deficiency As a Cause of Hemolytic Anemia

Case Presentation: A 45–year–old black female presented with 2 weeks history of worsening fatigue, malaise, shortness of breath upon exertion and dizziness. She also reported irregular menstrual periods. Laboratory analysis showed: Leukocyte count 2.36 × [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Vitamin B12 Deficiency As a Cause of Hemolytic Anemia

HM2012 Abstract Number: 97851

An Unusual Case of Hypertension

Case Presentation: A change in previously controlled hypertension (HTN) should prompt consideration of a secondary workup. An 81–year–old obese female, with history of HTN, hyperlipidemia, and anxiety, presented with refractory HTN. Her blood pressure (BP) [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Unusual Case of Hypertension

HM2012 Abstract Number: 97852

Disaster Averted? Cytomegalovirusassociated Hemophagocytic Lymphohistiocytosis

Case Presentation: A 24–year–old man presented with 2 weeks of fever, malaise, diarrhea, and cough followed by right upper quadrant pain, leg edema, and dyspnea on exertion. He denied previous illnesses or high–risk behavior, took [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Disaster Averted? Cytomegalovirusassociated Hemophagocytic Lymphohistiocytosis

HM2012 Abstract Number: 97853

Acute Eosinophilic Pneumonia Following Recent Dust Exposure and New Onset Smoking

Case Presentation: A 52–year–old previously healthy woman was admitted to our institution with a chief complaint of dyspnea, dry cough, and fever worsening over 4 days. Her past medical history was positive for lung adenocarcinoma [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Acute Eosinophilic Pneumonia Following Recent Dust Exposure and New Onset Smoking

HM2012 Abstract Number: 97854

A Case of Stridor and Failure to Thrive

Case Presentation: This patient is a 5–week–old male with no significant past medical history who presented with lack of expected weight gain. Patient was born at 39 5/7 weeks gestation to a 23–year–old G2 P2 [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Case of Stridor and Failure to Thrive

HM2012 Abstract Number: 97855

More Than Just Pus, It’s a Tumor

Case Presentation: This is an 80–year–old Caucasian man who was admitted to the hospital with complaints of bilateral upper neck swelling, mainly in the pre–auricular and infra–auricular region, worsened over the last 5 days. The [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on More Than Just Pus, It’s a Tumor

HM2012 Abstract Number: 97856

Disseminated Fungal Infection in an Immunocompetent Individual Commonly Considered?

Case Presentation: A 23–year–old African American Midwestern gentleman with history of subaortic stenosis repair had presented to the Emergency Department (ED) with complaints of pain and swelling in the left ankle, left chest wall and [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Disseminated Fungal Infection in an Immunocompetent Individual Commonly Considered?

HM2012 Abstract Number: 97857

A Case Report and Literature Review: E. Coli Aortitis

Case Presentation: A 78–year–old man presented with a 3–week history of suprapubic post–prandial abdominal pain, fevers, and anorexia. Two weeks prior he was admitted for acute mental status changes, fatigue, and anorexia, with diagnosis of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Case Report and Literature Review: E. Coli Aortitis

HM2012 Abstract Number: 97858

Spontaneous Renal Artery Dissection

Case Presentation: A previously healthy 27–year–old Caucasian male presented with acute onset of right sided flank pain, nausea, vomiting and mild fever for approximately 5 days. He denied any abnormal urinary symptoms and has no [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Spontaneous Renal Artery Dissection

HM2012 Abstract Number: 97859

The Return of a “Forgotten Disease”: Uremic Pneumonitis

Case Presentation: A 23–year–old gentleman presented with a 2–week history of cough, epistaxis, hemoptysis and shortness of breath on exertion, loss of appetite, fatigue, nausea and dysgeusia. He denied rash or arthralgias and reported normal [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Return of a “Forgotten Disease”: Uremic Pneumonitis

HM2012 Abstract Number: 97860

Hemophagocytic Syndrome in a Patient with Recently Diagnosed Hivaids on Harrt Therapy

Case Presentation: A 43–year–old man with recently diagnosed HIV/AIDS on HAART presented for further evaluation of worsening jaundice, abdominal pain and weight loss. He developed immune reconstitution syndrome following the initiation of HAART, and had [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hemophagocytic Syndrome in a Patient with Recently Diagnosed Hivaids on Harrt Therapy

HM2012 Abstract Number: 97861

Time to Quit Smoking a Case of Pulmonary Langerhans Cell Histiocytosis

Case Presentation: A 50–year–old Caucasian female with no prior respiratory ailments presented with worsening non productive cough and exertional dyspnea for 4 months. She denied fevers, weight loss or lower extremity swelling. She reported an [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Time to Quit Smoking a Case of Pulmonary Langerhans Cell Histiocytosis

HM2012 Abstract Number: 97862

Weight Loss at What Cost?

Case Presentation: A 27–year–old female with a h/o headaches presented to the ED with complaint of thunderclap headache that was the worst of her life. It was nine of 10 in severity and was located [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Weight Loss at What Cost?

HM2012 Abstract Number: 97863

Hydatid Cyst: A Challenging Case That Needed a Multidisciplinary Approach and a Translator

Case Presentation: A previously asymptomatic 46–year–old male presented with acute onset of sharp right upper quadrant (RUQ) pain. Patient denied nausea, vomiting, fever or similar symptoms before. The patient is Lebanese and had moved to [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hydatid Cyst: A Challenging Case That Needed a Multidisciplinary Approach and a Translator

HM2012 Abstract Number: 97864

A Case of Waterhousefriderichsen Syndrome That Led to the Diagnosis of Terminal Complement Deficiency

Case Presentation: A previously healthy 19–year–old female, presented with 1 day of fever, severe occipital headaches, nausea, vomiting, diarrhea, severe myalgias and polyarthralgias. She is attending her spring semester in college while living in a [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Case of Waterhousefriderichsen Syndrome That Led to the Diagnosis of Terminal Complement Deficiency

HM2012 Abstract Number: 97865

Multiple Pulmonary Cavities: Why Only in the Right Lung?

Case Presentation: A 51–year–old female with history of anxiety, depression, and tobacco abuse was admitted to the ICU due to severe respiratory distress, hypoxia, productive cough, fever and chills. Her symptoms began 8 days prior [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Multiple Pulmonary Cavities: Why Only in the Right Lung?

HM2012 Abstract Number: 97866

Severe Falciparum Malaria with Extremely High Parasitemia with Excellent Response to Artesunate

Case Presentation: A previously healthy 37–year–old male patient presented with 4 days of fever, nausea, myalgias and headaches. Patient had returned from a 3–week vacation trip to Malawi 2 weeks before this episode. He did [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Severe Falciparum Malaria with Extremely High Parasitemia with Excellent Response to Artesunate

HM2012 Abstract Number: 97867

Sweet Urine: A Case of Tenofovir Induced Fanconi’s Syndrome

Case Presentation: 71 female with multidrug resistant HIV, stable on antiretroviral therapy for 4 years on a regimen containing tenofovir, with CD4 count of 140 cells/ml and non detectable HIV viral load, presented to the [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Sweet Urine: A Case of Tenofovir Induced Fanconi’s Syndrome

HM2012 Abstract Number: 97868

I Looked Like a Water Balloon: A Case of Acute Hiv Nephropathy and Parvovirus B19 Infection

Case Presentation: A previously healthy 35–year–old male patient presented with 2 weeks history of fatigue and a maculopapular rash over his back, torso, extremities and face. He had flu–like symptoms and rinorrhea just before the [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on I Looked Like a Water Balloon: A Case of Acute Hiv Nephropathy and Parvovirus B19 Infection

HM2012 Abstract Number: 97869

Primary Hyperoxaluria a Rare Disorder Presenting with Endstage Renal Disease

Case Presentation: A 20–year–old African American Female was admitted with diffuse skin thickening and intractable pain in these skin lesions. Her past medical history was significant for recurrent kidney stones for which she had undergone [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Primary Hyperoxaluria a Rare Disorder Presenting with Endstage Renal Disease

HM2012 Abstract Number: 97870

Out of Africa: With a Fever

Case Presentation: A 41–year–old African–American woman traveling in Ghana experienced progressive edema, diffuse joint pain and night sweats over a 9–day period. Three days before her presentation she noted dyspnea, dry cough and inability to [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Out of Africa: With a Fever

HM2012 Abstract Number: 97871

An Unusual Case of Meningitis

Case Presentation: A 58–year–old woman presented with a severe headache with onset 3 hours after taking prophylactic amoxicillin for a routine dental cleaning. She described a constant bifrontal headache with mild photophobia, multiple episodes of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Unusual Case of Meningitis

HM2012 Abstract Number: 97872

Sniffing Out a Novel Diagnosis: Glomerulonephritis Induced by Levamisoletainted Cocaine

Case Presentation: A 49–year–old male with diabetes mellitus presented with jaw pain and an absolute neutrophil count (ANC) of 200 cells/mm3. He denied drug use. A periodontal abscess seen on computerized tomogram was treated by [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Sniffing Out a Novel Diagnosis: Glomerulonephritis Induced by Levamisoletainted Cocaine

HM2012 Abstract Number: 97873

In Defense of Occam’s Razor: A 50Yearold Man with Aphasia, Rightsided Weakness and Miliary Lung Nodules

Case Presentation: A 50–year–old male presented to the emergency department with aphasia and weakness. He had been in his usual state of health until 7 hours prior, when he acutely developed right hand weakness and [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on In Defense of Occam’s Razor: A 50Yearold Man with Aphasia, Rightsided Weakness and Miliary Lung Nodules

HM2012 Abstract Number: 97874

Bouveret’s Syndrome: An Uncommon Cause of Gallstone Ileus

Case Presentation: A 77–year–old Caucasian female with a history of morbid obesity, breast cancer status post bilateral mastectomy with reconstruction, deep venous thrombosis, and hypertension presented with a 5–day history of abdominal pain, nausea and [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Bouveret’s Syndrome: An Uncommon Cause of Gallstone Ileus

HM2012 Abstract Number: 97875

Maggots an Unusual Complication of Head Trauma in the Rockies

Case Presentation: A 52–year–old female with end–stage liver disease and no recent travel history sustained head trauma 3 weeks prior to presentation that required laceration repair. She was transferred to our medicine service from an [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Maggots an Unusual Complication of Head Trauma in the Rockies

HM2012 Abstract Number: 97876

Not All It’s Cracked Up to Be: A New Public Health Campaign

Case Presentation: A 41–year–old female with a history of substance abuse presented to the Emergency Department with 1 month of bilateral lower extremity rash and severe pain. On arrival patient had altered mental status, met [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Not All It’s Cracked Up to Be: A New Public Health Campaign

HM2012 Abstract Number: 97877

Clinical Decisionmaking for Patients with Complex and Sociocultural Care Issues

Case Presentation: A 32–year–old African American woman with history of Sickle Cell Disease (SCD) with various complications, depression, and frequent visits to the Emergency Department (ED) presents with a chief complaint of pain crisis. Multiple [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Clinical Decisionmaking for Patients with Complex and Sociocultural Care Issues

HM2012 Abstract Number: 97878

A Clearcut Pneumonia Becomes Hazy

Case Presentation: A 17–year–old male presented with a three–day history of shortness of breath, non–productive dry cough, pleuritic chest pain, and fatigue. He had recently recovered from infectious mononucleosis. He was hypoxic with an oxygen [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Clearcut Pneumonia Becomes Hazy

HM2012 Abstract Number: 97879

Rapid Development of Obstructive Hypertrophic Cardiomyopathy in an Elderly Woman

Case Presentation: An 85–year–old woman with hypertension, coronary artery disease (angioplasty and stent in 1998), peripheral vascular disease presented to the emergency room after a mechanical fall at home. The patient had a sudden fall [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Rapid Development of Obstructive Hypertrophic Cardiomyopathy in an Elderly Woman

HM2012 Abstract Number: 97880

Flagellate Dermatitis from Shiitake Mushrooms

Case Presentation: A 60–year–old man presents to the hospital with 4 days of rash accompanied by severe pain and pruritus. The rash began on the patient's hands bilaterally, then, began to spread centrally. He denied [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Flagellate Dermatitis from Shiitake Mushrooms

HM2012 Abstract Number: 97881

First Report of Hemialgia As a Presenting Symptom in Multiple Myeloma

Case Presentation: A 71–year–old man with hypothyroidism presented with atypical left–sided pain to the emergency room. The patient developed acute left–sided pain about 2 months prior to presentation to ER. The pain started in the [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on First Report of Hemialgia As a Presenting Symptom in Multiple Myeloma

HM2012 Abstract Number: 97882

Acute Oxalate Nephropathy Probably Due to “Fracking” an Environmental and Health Concern

Case Presentation: A 42–year–old male with no medical history was brought to the emergency room unconscious after he had a generalized tonic clonic seizure. As per his wife, he had fatigue and headache for several [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Acute Oxalate Nephropathy Probably Due to “Fracking” an Environmental and Health Concern

HM2012 Abstract Number: 97883

Recurrent Pneumococcal Endocarditis in a Splenectomized Patient

Case Presentation: A 72–year–old male with a remote history of splenectomy secondary to Hodgkin's lymphoma presented with high–grade fever and confusion for 3 days. Nine months prior to this admission, he was diagnosed with pneumococcal [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Recurrent Pneumococcal Endocarditis in a Splenectomized Patient

HM2012 Abstract Number: 97884

Respiratory Failure Leading to an Unexpected Diagnosis of Men Syndrome

Case Presentation: A 58–year–old female presented with severe respiratory distress, diaphoresis, hypertension and tachycardia. Vital signs: BP 215/106, HR 139, RR 38, SaO2 48% on room air. She was intubated due to hypoxia. Her medical [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Respiratory Failure Leading to an Unexpected Diagnosis of Men Syndrome

HM2012 Abstract Number: 97885

A Rare Case of Vasopressinase Induced Diabetes Insipidus (Di) in Pregnancy

Case Presentation: A 15–year–old primigravida with no prenatal care at 32 weeks of gestation presented with preterm contractions, abdominal pain, elevated BP and headache. An elevated sodium of 153 mEq/L was initially believed to be [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Rare Case of Vasopressinase Induced Diabetes Insipidus (Di) in Pregnancy

HM2012 Abstract Number: 97886

A Tear in the Artery Will Not Spare the Nerve

Case Presentation: A 41–year–old Caucasian male presented to the physician's office with 1–week history of dysphasia along with transient left posterior jaw pain and chewing difficulty. He also felt that the food clogged on his [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Tear in the Artery Will Not Spare the Nerve

HM2012 Abstract Number: 97887

An Unusual Case of Carotid Artery Dissection

Case Presentation: A 52–year–old man with a history of obesity suffered a syncopal event immediately after arising from a seated position. Shortly thereafter, he developed epigastric pain, nausea and vomiting. Initial evaluation revealed orthostatic hypotension, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Unusual Case of Carotid Artery Dissection

HM2012 Abstract Number: 97888

Don’t Step on Me: An Unusual Case of Dysphagia

Case Presentation: A 67 year–old previously healthy woman with HIV (CD4 count 1233/mm3) was admitted for 1 month of progressive odynophagia and dysphagia that began with solids and progressed to liquids. She reported food "getting [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Don’t Step on Me: An Unusual Case of Dysphagia

HM2012 Abstract Number: 97889

Strongyloidiasis: Latent but Potentially Lethal

Case Presentation: #1:69–year–old female Chinese immigrant with rheumatoid arthritis on prednisone and methotrexate presented with weakness, abdominal discomfort, cough, fever and chills. She developed sepsis with bilateral lung opacities. Endoscopic biopsy revealed Strongyloides stercoralis. #2:72–year–old [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Strongyloidiasis: Latent but Potentially Lethal

HM2012 Abstract Number: 97890

Hepatic Encephalopathy in Absence of Hepatic Disease?

Case Presentation: Mrs. AS is a 76–year–old female with PMH of CHF, PVOD, T2DM, atrial fibrillation, osteomyelitis, and CKD who was admitted with recurrence of intermittent mental status changes. She was functioning at her normal [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hepatic Encephalopathy in Absence of Hepatic Disease?

HM2012 Abstract Number: 97891

Breast Cancer Without a Breast Mass, but with Cerebellar Effects

Case Presentation: Ms. MM is a 78–year–old female former smoker with history of MAI, OSA, HTN, and anxiety admitted with hypercalcemia and FTT. Primary complaints were progressive weakness, malaise, weight loss, and decreased appetite. Exam [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Breast Cancer Without a Breast Mass, but with Cerebellar Effects

HM2012 Abstract Number: 97892

Burkitt’s Lymphoma Mimicking Ovarian Cancer

Case Presentation: A 50–year–old Asian woman presented with 4 days of abdominal discomfort and progressive distention. She had no significant past medical history and did not consume alcohol. Her physical examination was remarkable for normal [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Burkitt’s Lymphoma Mimicking Ovarian Cancer

HM2012 Abstract Number: 97893

Abdominal Pain with a Detour Above the Abdomen

Case Presentation: A 19–year–old woman with a history of migraines, depression and a bony cyst in her jaw presented with abdominal pain. Three days prior, she acutely developed sharp, non–radiating epigastric pain which was worse [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Abdominal Pain with a Detour Above the Abdomen

HM2012 Abstract Number: 97894

A Rare Cause of Fulminant Liver Failure

Case Presentation: A 44–year–old woman with a past medical history of reflux presented with jaundice. Ten days prior to presentation, she noticed dark urine but did not seek medical attention. Five days prior, she developed [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Rare Cause of Fulminant Liver Failure

HM2012 Abstract Number: 97895

Recurrent Hematemesis: Fact and Fiction?

Case Presentation: A 20–year–old woman with a history of Crohn's disease and a Mallory Weiss tear presented with hematemesis. One month prior to presentation she was admitted to another institution with black, tarry stools. She [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Recurrent Hematemesis: Fact and Fiction?

HM2012 Abstract Number: 97896

Cidp Masquerading As Metabolic Polyneuropathy

Case Presentation: A 61–year–old African American man with long history of diabetes and hypertension as well as end stage renal disease presented with progressive weakness of both legs for 3 months. It started as difficulty [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Cidp Masquerading As Metabolic Polyneuropathy

HM2012 Abstract Number: 97897

Klebsiella Pneumonia Meningitis As a Result of a Latent Strongyloides Infestation

Case Presentation: A 23–year–old Mexican male with no known medical history presented to the emergency department with headache, fever, nausea, vomiting and photophobia. He stated that he was well 1 week prior to admission. On [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Klebsiella Pneumonia Meningitis As a Result of a Latent Strongyloides Infestation

HM2012 Abstract Number: 97898

Anaphylaxis in a Patient with Mastocytosis

Case Presentation: This is a 76–year–old white female with a history of mastocytosis, who was admitted with acute diastolic heart failure and new–onset atrial fibrillation. Intravenous furosemide was initiated for diuresis, Verapamil was utilized to [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Anaphylaxis in a Patient with Mastocytosis

HM2012 Abstract Number: 97899

Pancytopenia in a Prisoner: An Unusual Case of Pernicious Anemia

Case Presentation: A 31–year–old African American male with no medical history presented to the hospital from prison with worsening fatigue, nausea and abdominal discomfort for several weeks. He also reported lightheadedness and unintentional weight loss [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Pancytopenia in a Prisoner: An Unusual Case of Pernicious Anemia

HM2012 Abstract Number: 97900

Diabetic Myonecrosis: An Atypical and Rare Presentation in a Newly Diagnosed Diabetic

Case Presentation: A 23–year–old man with no previous medical history presented to the Emergency department complaining of a 2–week history of intermittent right thigh swelling and pain. He denied any preceding trauma, insect bites, or [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Diabetic Myonecrosis: An Atypical and Rare Presentation in a Newly Diagnosed Diabetic

HM2012 Abstract Number: 97901

Acute Disseminated Encephalomyelitis

Case Presentation: A 54–year–old Caucasian male with medical history of alcohol dependence presented to our hospital with 3 weeks of worsening gait, behavioral changes and slurred speech, as observed by his friends. Exam revealed normal [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Acute Disseminated Encephalomyelitis

HM2012 Abstract Number: 97902

Cogan’s Syndrome: Much More Than Red Eyes and Dizziness

Case Presentation: A 37–year–old male with benign past medical history presented with worsening bilateral conjunctival injection, progressive hearing impairment and disequilibrium for approximately 1 month. He had earlier been on erythromycin eye drops for suspected [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Cogan’s Syndrome: Much More Than Red Eyes and Dizziness

HM2012 Abstract Number: 97903

Urinothorax: A Rare Cause of Pleural Effusion

Case Presentation: A 44–year–old male with history of obstuctive uropathy presented with dyspnea, left sided chest pain, flank pain and hypoxia a day after an urologic procedure. His percutaneous nephrostomy tube was removed 1 day [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Urinothorax: A Rare Cause of Pleural Effusion

HM2012 Abstract Number: 97904

Itching for a Diagnosis

Case Presentation: A 75–year–old female with a history of schizophrenia and diabetes mellitus was transferred to our hospital for sepsis and worsening rash. The rash first appeared on the flexor surfaces of her upper extremities, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Itching for a Diagnosis

HM2012 Abstract Number: 97905

Syncope: A Hospitalist’s Pain in the Neck

Case Presentation: This is an 81–year–old woman with rate controlled atrial fibrillation, hypothyroidism and invasive ductal carcinoma, which was diagnosed in 2008, and treated with breast sparing surgery and radiation. At her first ER visit, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Syncope: A Hospitalist’s Pain in the Neck

HM2012 Abstract Number: 97906

Dual Valve Endocarditis Secondary to Corynebacterium Jeikeium, Case Report and Review of Literature

Case Presentation: A 61–year–old man was admitted with a three–week history of productive cough, fever, chills, night sweats and fatigability. He experienced progressive pleuritic chest pain and dyspnea. His past medical history was significant for [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Dual Valve Endocarditis Secondary to Corynebacterium Jeikeium, Case Report and Review of Literature

HM2012 Abstract Number: 97907

Spontaneous Bacterial Empyema: A Case Report and Literature Review

Case Presentation: A 51–year–old man with liver cirrhosis secondary to alcoholism and hepatitis C complicated with refractory, paracentesis–dependent ascites was found unresponsive in his apartment. His medications were furosemide, spironolactone, thiamine and folic acid. On [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Spontaneous Bacterial Empyema: A Case Report and Literature Review

HM2012 Abstract Number: 97908

Cocaineinduced Ekg Changesthink Beyond Cardiac Cath

Case Presentation: A 67–year–old male presented to our emergency department complaining of typical chest pain few minutes after smoking cocaine. Pain was retrosternal and radiating to left shoulder associated with diaphoresis and nausea but no [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Cocaineinduced Ekg Changesthink Beyond Cardiac Cath

HM2012 Abstract Number: 97909

Persistent Fever and Skin Rash in a Culturenegative 62Yearold Patient

Case Presentation: A 62–year–old man presented with a 3–day history of fever, chills, night sweats, fatigue, and arthralgias, associated with generalized non–pruritic painless skin rash. He has past medical history significant for hypertension, ulcerative colitis [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Persistent Fever and Skin Rash in a Culturenegative 62Yearold Patient

HM2012 Abstract Number: 97910

A Case of Aspergilloma Complicating Welder’s Lung Mimicking Lung Neoplasm

Case Presentation: A 58–year–old male patient, who had worked as a welder for 30 years, complained of 3 months history of progressively worsening hemoptysis. He underwent thoracotomy and right upper lobectomy 5 years ago for [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Case of Aspergilloma Complicating Welder’s Lung Mimicking Lung Neoplasm

HM2012 Abstract Number: 97911

Persistent Fever and a Single Positive Blood Culturehow Far Your Suspecion Can Guide You?

Case Presentation: A 56–year–old male presented with generalized body aches, chills and fever for 8 days. Symptoms were associated with palpitation, sweating, headache, and dry cough. He denied any IV drug abuse. Physical exam showed [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Persistent Fever and a Single Positive Blood Culturehow Far Your Suspecion Can Guide You?

HM2012 Abstract Number: 97912

Family Matters

Case Presentation: A 60–year–old woman with no past medical history presented with sudden onset of confusion, mutism, agitation, and behavioral changes that were precipitated by a stressful family event. On initial presentation, she had no [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Family Matters

HM2012 Abstract Number: 97913

Catecholaminergic Polymorphic Ventricular Tachycardia: A Stress Induced Phenomenon

Case Presentation: A 44–year–old man with no significant past medical history was admitted to the hospital for further evaluation of intermittent chest pain. He had no similar episodes in the past. He denied symptoms of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Catecholaminergic Polymorphic Ventricular Tachycardia: A Stress Induced Phenomenon

HM2012 Abstract Number: 97914

An Unusual Case of a Malignant Thymoma Presenting As Intestinal Pseudoobstruction

Case Presentation: A 50–year–old male with a history of dyslipidemia was evaluated at an outside hospital for abdominal pain, constipation, and intractable nausea and vomiting for five days prior to admission. The pain was crampy [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Unusual Case of a Malignant Thymoma Presenting As Intestinal Pseudoobstruction

HM2012 Abstract Number: 97915

A Great Imitator

Case Presentation: A 54–year–old AAM with HIV/AIDS and G6PD deficiency presented with severe weakness and a diffuse rash with alopecia that began 3 months ago. His weakness progressed gradually and he now required assistance to [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Great Imitator

HM2012 Abstract Number: 97916

Cardiac Tamponade in Purulent Pericarditis Due to Streptococcus Agalactiae

Case Presentation: A 59–year–old Caucasian male presented with progressive shortness of breath and productive cough for 2 weeks along with low–grade fever. He denied any chest pain. Past history was significant for type 2 diabetes [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Cardiac Tamponade in Purulent Pericarditis Due to Streptococcus Agalactiae

HM2012 Abstract Number: 97917

Clonidine Withdrawal in a Child with Adhd

Case Presentation: An 8–year–old female with past medical history significant for bipolar disorder and ADHD presented to an emergency department for evaluation of four days of vomiting and diffuse abdominal pain. The patient had been [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Clonidine Withdrawal in a Child with Adhd

HM2012 Abstract Number: 97918

Recurring Blur

Case Presentation: 62–year–old man with AIDS presented with a history of photophobia and blurry vision in his left eye. He denied any pain, discharge, redness or floaters. There was no associated change in mental status, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Recurring Blur

HM2012 Abstract Number: 97919

If the Big Easy Is Your Oyster, Neurocysticercosis Is the Pearl

Case Presentation: A 36–year–old Hispanic female immigrant presented with two days of headache and neck pain. She had presented on a prior occasion with similar complaints, and was diagnosed with migraine headaches. She was admitted [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on If the Big Easy Is Your Oyster, Neurocysticercosis Is the Pearl

HM2012 Abstract Number: 97920

Can I Have a Mulligan?

Case Presentation: A 21–year–old woman presented with two days of a petechial rash on her upper extremities and chest. She noted no additional symptoms; she had no history of easy bruising or bleeding, or risk [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Can I Have a Mulligan?

HM2012 Abstract Number: 97921

The Perfect Hepatic Storm

Case Presentation: A 31–year–old man with no past medical history presented with three days of progressively worsening abdominal pain radiating to the epigastrum. The pain was dull in character, and associated with nausea and vomiting. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Perfect Hepatic Storm

HM2012 Abstract Number: 97922

Mat: Metastatic Atrial Tachycardia

Case Presentation: A 63–year–old man presented with ten days of dyspnea on exertion, occurring with minimal exertion and resolving after rest. He reported associated palpitations, fevers, chills, and increasing abdominal girth, but denied chest pain, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Mat: Metastatic Atrial Tachycardia

HM2012 Abstract Number: 97923

Not Quite the Rolling Stones

Case Presentation: A 42–year–old woman presented with three days of worsening left flank pain radiating to her groin. She experienced similar pain over the past year, but it had never been this severe. She now [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Not Quite the Rolling Stones

HM2012 Abstract Number: 97924

Under Pressure

Case Presentation: A 35–year–old man presented with new onset seizures. He reported progressively worsening bilateral occipital headache that suddenly resulted in a "white–out" of his vision. He lost consciousness, and was taken to an outside [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Under Pressure

HM2012 Abstract Number: 97925

Your Mind on Your Vitamins, Your Vitamins on Your Mind

Case Presentation: A 73–year–old woman presented with one week of bilateral hand weakness and increasing confusion. She had a baseline Alzheimer's dementia, but her family reported that her confusion markedly increased in the prior week, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Your Mind on Your Vitamins, Your Vitamins on Your Mind

HM2012 Abstract Number: 97926

A Stressful Day in the Cath Lab

Case Presentation: A 67–year–old woman presented with 3 h of sharp, intermittent chest pain and palpations. The episodes lasted for several minutes at a time and were associated with shortness of breath, nausea, diaphoresis, and [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Stressful Day in the Cath Lab

HM2012 Abstract Number: 97927

Blood on Your Hands

Case Presentation: A 35–year–old man presented with 6 h of epistaxis. He had a lifelong history of von Willebrand disease (vWD) type IIB, but denied previous hospitalizations or transfusions. He reported prior epistaxis episodes that [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Blood on Your Hands

HM2012 Abstract Number: 97928

Feeling “Lousy”

Case Presentation: A 48–year–old man with AIDS and a CD4 count of 68 presented with two weeks of fevers, night sweats, nausea and decreased appetite. He had been well until two months earlier when he [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Feeling “Lousy”

HM2012 Abstract Number: 97929

The Pressure of Hiv and End Stage Renal Disease

Case Presentation: A 29–year–old woman with a history of HIV nephropathy and end–stage renal disease presented one day of headaches, nausea, and vomiting. She noted no trauma, and no new neurologic abnormalities. She did note [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Pressure of Hiv and End Stage Renal Disease

HM2012 Abstract Number: 97930

The Devil You Pay

Case Presentation: An 81–year–old man presented with sharp pain in his left foot of 4 h. His left foot was cold with cyanosis of the great toe and distal tips of the second and third [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Devil You Pay

HM2012 Abstract Number: 97931

Backtoback Mrsa Infections

Case Presentation: A 49–year–old T4 paraplegic man presented after being found down in his yard for one day. He was oriented only to self and had several large stage–three decubitus ulcers. His left foot was [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Backtoback Mrsa Infections

HM2012 Abstract Number: 97932

Heroes in a Halfshell? Vibro’s Power

Case Presentation: A 64–year–old man presented with fatigue, fever, and bilateral lower extremity pain. He had a history of Laennec's cirrhosis and was awaiting liver transplant. He noted no recent travel, ill contacts or occupational [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Heroes in a Halfshell? Vibro’s Power

HM2012 Abstract Number: 97933

Size Doesn’t Matter

Case Presentation: A 76–year–old women presented with two days of hemoptysis, dyspnea on exertion, and fatigue stating she coughed up two cups of blood per day. She had no previous history or exposure to tuberculosis, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Size Doesn’t Matter

HM2012 Abstract Number: 97934

Some Patients Don’t Read the Books

Case Presentation: A 46–year–old man presented with three days of fever and nonspecific flu–like symptoms. He denied any prior medical history, or additional associated complaints. He noted an upper respiratory infection two weeks earlier, but [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Some Patients Don’t Read the Books

HM2012 Abstract Number: 97935

Prealbumin Does Nothing for Me

Case Presentation: A 62–year–old man presented with three weeks of abdominal distension and bilateral pitting edema of the lower extremities. He noted no shortness of breath or chest pain. His urine output was normal, and [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Prealbumin Does Nothing for Me

HM2012 Abstract Number: 97936

Don’t Be Afraid to Question a Diagnosis

Case Presentation: A 48–year–old woman presented with six weeks of worsening right upper quadrant pain and lower extremity edema. Associated symptoms included nonbloody diarrhea. She also noted one week of dyspnea while lying flat. Her [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Don’t Be Afraid to Question a Diagnosis

HM2012 Abstract Number: 97937

Pyomyositis in an Immunocompetent Patient: A Case Report and Literature Review

Case Presentation: A 25–year–old Caucasian man with no past medical history complained of 3 days of severe bilateral "gnawing" pain in his calves and forearms. It began in his right calf, preceded by 2 h [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Pyomyositis in an Immunocompetent Patient: A Case Report and Literature Review

HM2012 Abstract Number: 97938

Bad Things Come in Pairs: The Terrible Twos

Case Presentation: A 52–year–old woman with history of systemic lupus erythematosus and end–stage renal disease status post cadaveric renal transplant (2008) presented with three days of a progressive vesicular rash. The rash began in her [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Bad Things Come in Pairs: The Terrible Twos

HM2012 Abstract Number: 97939

Smoking Is Bad for Your Health

Case Presentation: A 22–year–old man, on military deployment, presents to a remote clinic in Central Africa with 2 days of worsening dyspnea on exertion, fever, and fatigue; he denied a cough. His symptoms worsened despite [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Smoking Is Bad for Your Health

HM2012 Abstract Number: 97940

Not Just a Simple UTI in This Women

Case Presentation: A 30–year–old woman presented with 7 days of intermittent fevers, sweats, and flank pain. She noted nausea, vomiting, and dysuria, and severe headaches for the prior five days, a history of uncomplicated urinary [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Not Just a Simple UTI in This Women

HM2012 Abstract Number: 97941

Inadvertent Intravenous Administration of an Oral Preparation of Acetaminophen

Case Presentation: Patient is a 4–year–old male with inadvertent intravenous administration of an oral liquid acetaminophen pharmaceutical preparation. He initially presented to an outside emergency center for evaluation of a closed head injury after a [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Inadvertent Intravenous Administration of an Oral Preparation of Acetaminophen

HM2012 Abstract Number: 97942

Index of Suspicion: Tb Meningitis with Otomastoiditis in a Threeyear Old

Case Presentation: A three–year–old male was transferred to our tertiary care facility with a one week history of vomiting and decreased activity and ongoing worsening mental status after admission to a community hospital for dehydration. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Index of Suspicion: Tb Meningitis with Otomastoiditis in a Threeyear Old

HM2012 Abstract Number: 97943

The Turn of the Worm

Case Presentation: A 48 y/o Cambodian woman with history of immigrating to the US thirty years pta and "cryptogenic cirrhosis" was transferred to our facility with abdominal pain, nausea, and anorexia. PE revealed jaundice, tachypnea, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Turn of the Worm

HM2012 Abstract Number: 97944

Acute Epiglottitis Caused by Methicillin Resistant Staphylococcus Aureus: The Danger of Missing the Boat

Case Presentation: A 46–year–old woman presented with a 4 day history of progressive throat pain and low grade fever. She went to an urgent care clinic 3 days prior to admission and was discharged on [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Acute Epiglottitis Caused by Methicillin Resistant Staphylococcus Aureus: The Danger of Missing the Boat

HM2012 Abstract Number: 97945

Recurrent Seizure Activity Due to Reversible Posterior Leukoencephalopathy Syndrome (Rpls)

Case Presentation: A 45–year–old man presented with encephalopathy after experiencing multiple seizures. The patient's fiancée observed the patient's body stiffen, then he had full–body jerking for 10 min. He lost bladder function, and afterwards was [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Recurrent Seizure Activity Due to Reversible Posterior Leukoencephalopathy Syndrome (Rpls)

HM2012 Abstract Number: 97946

Pseudohypoglycemia: A Case Report

Case Presentation: This is a 37–year–old African American man with history of type 2 diabetes mellitus, scleroderma complicated by esophageal dysmotility requiring total parental nutrition and Raynaud's phenomenon, who was admitted to the hospital for [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Pseudohypoglycemia: A Case Report

HM2012 Abstract Number: 97947

Elevated Brain Natriuretic Peptide in a Case of Hyperthyroidism

Case Presentation: A 56–year–old Caucasian female with a history of asthma since age 14 presented with dyspnea on exertion and productive cough for the past three days. One month prior she was hospitalized for similar [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Elevated Brain Natriuretic Peptide in a Case of Hyperthyroidism

HM2012 Abstract Number: 97948

An Astonishing Discovery in a Patient with Abdominal Fullness and Anemia

Case Presentation: A previously healthy 70yo female presented to the emergency department after a syncopal episode. The patient had been feeling progressively fatigued for 2 months prior to presentation, yet had not seen a physician [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Astonishing Discovery in a Patient with Abdominal Fullness and Anemia

HM2012 Abstract Number: 97949

Thirty Four Years Later and I Can’t Walk

Case Presentation: This is a 52–year–old man with a history of Stage 1A Hodgkin lymphoma diagnosed at age 18 successfully treated with mantle radiation. He recurred at age 48 and underwent chemotherapy and autologous stem [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Thirty Four Years Later and I Can’t Walk

HM2012 Abstract Number: 97950

A Rare Case of Localized Gastrointestinal Amyloidosis

Case Presentation: An 85–year–old Hispanic female with history of hypertension presented with abdominal pain, diarrhea and increased abdominal distension for 4 days. She also had increased fatigue, dysphagia and edematous legs for 4 months. She [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Rare Case of Localized Gastrointestinal Amyloidosis

HM2012 Abstract Number: 97951

Multiorgan Failurean Uncommon Complication of a Common Drug

Case Presentation: This is a 59–year–old man with diabetes and heart failure who was admitted for surgical treatment of recurrent foot infection. He received two weeks of vancomycin and piperacillin–tazobactum before a muscle flap repair. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Multiorgan Failurean Uncommon Complication of a Common Drug

HM2012 Abstract Number: 97952

Sin, Sex and Heartache: An Unusual Presentation, Even for the Great Imitator

Case Presentation: A 21–year–old male with no significant past medical history presents with two episodes of acute pericarditis in a one month period. The first episode was complicated by cardiac tamponade requiring pericardial drain. Work [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Sin, Sex and Heartache: An Unusual Presentation, Even for the Great Imitator

HM2012 Abstract Number: 97953

Curbside Consult: A Surprising Case of Hypernatremia

Case Presentation: A 54–year–old female with metastatic ovarian cancer was admitted to the gynecologic oncology service with increasing abdominal girth, nausea, and vomiting. Her past medical history was significant for papillary serous adenocarcinoma with malignant [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Curbside Consult: A Surprising Case of Hypernatremia

HM2012 Abstract Number: 97954

Incomplete Annular Pancreas: An Unusual Presentation of Peptic Ulcer Disease

Case Presentation: A 25–year–old lady presented with abdominal pain, bloating, nausea, vomiting and diarrhea since one year and 15 pound weight loss since two months. Patient had consulted several physicians before with no avail. Physical [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Incomplete Annular Pancreas: An Unusual Presentation of Peptic Ulcer Disease

HM2012 Abstract Number: 97955

Back Pain from the Tropics

Case Presentation: A 47–year–old lady was sent to our institution by her PMD for evaluation of ataxia, gradually worsening bilateral leg weakness and numbness for 3 years. She also reported low back pain, paraesthesia of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Back Pain from the Tropics

HM2012 Abstract Number: 97956

Lymphangioleiomyomatosis (Lam) Verses Pulmonary Langherhans Cell Histiocytosis (Plch): A Clinical Dilemma

Case Presentation: A 24–year–old Caucasian woman presented with diffuse left sided chest pain and shortness of breath. The pain was sharp, nonradiating, pleuritic, and began acutely while sitting at her computer. Patient reported a chronic [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Lymphangioleiomyomatosis (Lam) Verses Pulmonary Langherhans Cell Histiocytosis (Plch): A Clinical Dilemma

HM2012 Abstract Number: 97957

Inferior Vena Cava Filter Migration to the Right Ventricle Causing Nonsustained Ventricular Tachycardia: A Case Report and Literature Review

Case Presentation: A 69–year–old man with a basal ganglia hemorrhage was found on his 9th hospital day to have multiple right upper and middle lobe pulmonary artery emboli (PE). Because of his recent hemorrhagic stroke, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Inferior Vena Cava Filter Migration to the Right Ventricle Causing Nonsustained Ventricular Tachycardia: A Case Report and Literature Review

HM2012 Abstract Number: 97958

Maythurner Syndrome: A Case Report and Literature Review

Case Presentation: A 27–year–old African American woman without prior medical history reported 12 h of left lower extremity swelling associated with dull, throbbing pain. Her only daily medication was an oral contraceptive. She had no [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Maythurner Syndrome: A Case Report and Literature Review

HM2012 Abstract Number: 97959

Methotrexate Toxicity in a Patient with Acute Cholecystitis

Case Presentation: A 76–year–old bed–bound woman with rheumatoid arthritis presented with one week of abdominal pain. Three days earlier she had developed mouth sores, painful swallowing and decreased oral intake. She was hypotensive and had [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Methotrexate Toxicity in a Patient with Acute Cholecystitis

HM2012 Abstract Number: 97960

A Forgotten Disease: Lemierre’s Syndrome

Case Presentation: A 24–year–old Caucasian male with no past medical history presented with 3–4 days of nausea/vomiting, weakness, sore throat, right lower quadrant pain, and subjective fever. The physical exam showed a fever of 101.8 [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Forgotten Disease: Lemierre’s Syndrome

HM2012 Abstract Number: 97961

“Georgia Home Boy” Toxicity

Case Presentation: A 34–year–old Caucasian male was brought into the emergency room as he was found unresponsive. Patient received three doses of naloxone without any improvement. Patient had a temperature of 93.3 F, blood pressure [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on “Georgia Home Boy” Toxicity

HM2012 Abstract Number: 97962

Streptococcus Pyogenes Sternoclavicular Arthritis in a Healthy Adult

Case Presentation: A 62–year–old male, previously healthy, not immunocompromised, presented with low grade fever, chills, and worsening redness, pain and swelling of the right shoulder, strenoclavicular area and neck. He was recently hospitalized and treated [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Streptococcus Pyogenes Sternoclavicular Arthritis in a Healthy Adult

HM2012 Abstract Number: 97963

Acute Generalized Exanthomatous Pustulosis (Agep): A Case Report and Literature Review

Case Presentation: This is a 76–year–old female with a past medical history of hypertension, hypothyroidism, and hyperlipidemia who was referred by her primary care physician for evaluation of rash and syncope. One week prior to [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Acute Generalized Exanthomatous Pustulosis (Agep): A Case Report and Literature Review

HM2012 Abstract Number: 97964

A Duo of Unusual Diagnoses in a 45Yearold Female with Right Leg Pain

Case Presentation: A 45–year–old female with type 2 diabetes was admitted to the orthopedic surgery service with a painful right thigh mass and hyperglycemia. Her pain had progressed over the past month and was now [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Duo of Unusual Diagnoses in a 45Yearold Female with Right Leg Pain

HM2012 Abstract Number: 97965

Occam’s Razor Versus Hickam’s Dictum; a Weighty Issue

Case Presentation: A 52–year–old male with a past medical history of right sided nephrectomy for clear cell renal carcinoma was admitted for evaluation of a 6 month history of occasional parasthesias and acute onset of [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Occam’s Razor Versus Hickam’s Dictum; a Weighty Issue

HM2012 Abstract Number: 97966

Transient Erythroblastopenia of Childhood Presenting with Focal Neurological Symptoms

Case Presentation: The patient is a previously healthy two–year–old female. While eating in a restaurant with her family, she had a temper tantrum. She then became limp with her eyes rolling back. She recovered in [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Transient Erythroblastopenia of Childhood Presenting with Focal Neurological Symptoms

HM2012 Abstract Number: 97967

Varicella Zosternot All Cases Blister

Case Presentation: A 61–year–old man with HIV, not currently on highly active antiretroviral therapy, hypertension, and monoclonal gammopathy of unknown significance, presented to the hospital with a worsening erythematous macular rash for six days. The [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Varicella Zosternot All Cases Blister

HM2012 Abstract Number: 97968

Intravascular Diffuse Large B Cell Lymphoma. a Difficult Diagnostic Challenge

Case Presentation: A 69–year–old Hispanic male, with a past history of diabetes and coronary artery disease, was admitted for fever, diarrhea and confusion of 4 weeks' duration. Physical examination showed a disoriented patient with multiple [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Intravascular Diffuse Large B Cell Lymphoma. a Difficult Diagnostic Challenge

HM2012 Abstract Number: 97969

Recognition of Infantile Botulism: A Case Illustrating the Importance of Rapid Reassessment After Hospital Transfers

Case Presentation: A 7–month–old Caucasian male was admitted to a hospital in central California due to complaints of poor feeding. There was remote history of choking on a plastic bead which was removed by mother. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Recognition of Infantile Botulism: A Case Illustrating the Importance of Rapid Reassessment After Hospital Transfers

HM2012 Abstract Number: 97970

Case of Unexplained Lactic Acidosis

Case Presentation: A 55–year–old woman presented to Emergency Department (ED) complaining of two weeks history of progressive shortness of breath, lethargy and decreased appetite. She was diagnosed with small cell lung cancer 5 months ago [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Case of Unexplained Lactic Acidosis

HM2012 Abstract Number: 97971

Not Just Another Back Pain

Case Presentation: 47–year–old male with past medical history of chronic back pain presented to emergency room complaining of exacerbation of symptoms. Patient reported three months history of sharp excruciating pain that was located on the [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Not Just Another Back Pain

HM2012 Abstract Number: 97972

Internal Carotid Artery Redundancy and Dissection in a Young Cocaine Abuser

Case Presentation: A 40–year–old male went to his primary medical doctor complaining of headache. He reported a 9/10 dull and achy pain on the right side of his head affecting frontal and temporal regions. He [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Internal Carotid Artery Redundancy and Dissection in a Young Cocaine Abuser

HM2012 Abstract Number: 97973

All Abscess Are Not Caused by Bacteriabipolaris Spicifera Causing Invasive Sinusitis with Brain Extension

Case Presentation: A 27–year–old male with unremarkable past medical history presented to the hospital with severe headache for two days. He had associated sinus pressure, nasal congestion with purulent discharge, proptosis, and tearful eyes for [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on All Abscess Are Not Caused by Bacteriabipolaris Spicifera Causing Invasive Sinusitis with Brain Extension

HM2012 Abstract Number: 97974

Not Just Another Case of Diarrhea in the Hospital: Adult Autoimmune Enteropathy

Case Presentation: A 48–year–old woman in generally good health presented with two months of profuse, large volume watery diarrhea. She was initially diagnosed with Clostridium difficile colitis and symptoms resolved with oral metronidazole. Five days [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Not Just Another Case of Diarrhea in the Hospital: Adult Autoimmune Enteropathy

HM2012 Abstract Number: 97975

Tracing the Etiology of Polyneuropathy After Gastric Bypass Surgery

Case Presentation: This was a 42–year–old Caucasian female with history of alcohol–induced cirrhosis, Roux–en–Y gastric bypass surgery who presented to the hospital for generalized weakness and severe rash. She developed symmetrical weakness in her lower [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Tracing the Etiology of Polyneuropathy After Gastric Bypass Surgery

HM2012 Abstract Number: 97976

Hematological Abnormalities After Bariatric Surgery: More Than Just Iron and Vitamin B12 Deficiency

Case Presentation: A 50–year–old female presented to the hematology clinic for evaluation of pancytopenia. Past medical history significant for bariatric surgery performed one year ago. Complete blood counts were normal prior to surgery. Examination was [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hematological Abnormalities After Bariatric Surgery: More Than Just Iron and Vitamin B12 Deficiency

HM2012 Abstract Number: 97977

An Overlooked Cause of Chest Pain

Case Presentation: A 23–year–old male presented to the Emergency Room with symptoms of substernal chest pain radiating to his neck. The pain began spontaneously one day prior to arrival and progressed through the day. Subsequently [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Overlooked Cause of Chest Pain

HM2012 Abstract Number: 97978

Hiding in the Shadows

Case Presentation: A 72–year–old man with a history of resected multicentric ileal carcinoid tumor underwent evaluation for small bowel obstruction (SBO). A newly elevated urinary 5–hydroxyindoleacetic acid level prompted a single–photon emission computed tomography/computed tomography [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hiding in the Shadows

HM2012 Abstract Number: 97979

An Unusual Case of a Man with Hyperydrosis, Hyponatremia, Orthostasis, and Progressive Cognitive Decline

Case Presentation: 63–year–old male with history of hypertension and dyslipidemia presented to the hospital with a 5 month history of fatigue, 40 lbs. weight loss, diaphoresis, insomnia, short–term memory loss, and hyponatremia secondary to presumed [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Unusual Case of a Man with Hyperydrosis, Hyponatremia, Orthostasis, and Progressive Cognitive Decline

HM2012 Abstract Number: 97980

Not All It’s Cracked Up to Be: A New Public Health Campaign?

Case Presentation: A 41–year–old female with a history of substance abuse presented to the Emergency Department with one month of bilateral lower extremity rash and severe pain. On arrival patient was noted to have altered [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Not All It’s Cracked Up to Be: A New Public Health Campaign?

HM2012 Abstract Number: 97981

Black Diamond Antibodies: A Skiing Accident Leading to Fulminant Hepatic Failure

Case Presentation: A 52–year–old man presented for open reduction and internal fixation (ORIF) of an uncomplicated distal radius fracture after a helmeted skiing accident. One year prior to presentation he underwent shoulder rotator cuff repair [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Black Diamond Antibodies: A Skiing Accident Leading to Fulminant Hepatic Failure

HM2012 Abstract Number: 97982

Stroke As the Initial Manifestation of an Occult Lung Cancer

Case Presentation: Introduction: Albeit a frequent complication in cancer patients, stroke has rarely been reported as an initial manifestation of an occult malignancy. We report a patient presenting with multifocal cerebral infarction who was later [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Stroke As the Initial Manifestation of an Occult Lung Cancer

HM2012 Abstract Number: 97983

Case Reportatovaquone As a Cause of Severe Methemoglobinemia

Case Presentation: A 31–year–old man with a history of human immunodeficiency virus (HIV) presents with shortness of breath, headache, vomiting, diarrhea and tingling in lower extremities. He had been hospitalized eight months prior due to [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Case Reportatovaquone As a Cause of Severe Methemoglobinemia

HM2012 Abstract Number: 97984

Though It Sounded Infectious

Case Presentation: A 22–year–old Caucasian gentleman was referred for the evaluation of a 5–day history of non traumatic lower backache and fever. Backache was acute in onset, non radiating, dull in character and of 4/10 [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Though It Sounded Infectious

HM2012 Abstract Number: 97985

Ibuprofen Induced Granulomatous Interstitial Nephritis

Case Presentation: A 66–year–old Caucasian woman presented to outpatient clinic with the complaints of generalized weakness, nausea, headaches and hiccups of three weeks duration. One day before the onset of her symptoms she was outside [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Ibuprofen Induced Granulomatous Interstitial Nephritis

HM2012 Abstract Number: 97986

Al Amyloidosis: Not to Be Taken Lightly

Case Presentation: 57–year–old male came with 4 weeks of constant 6/10 diffuse abdominal pain which was aggravated by meals. He had worsening constipation with loss of appetite, early satiety and a 15 lb. weight loss. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Al Amyloidosis: Not to Be Taken Lightly

HM2012 Abstract Number: 97987

An Unexpected Etiology of Cyclical Vomiting

Case Presentation: A 35–year–old male presented to the emergency department (ED) complaining of intractable nausea and vomiting. This was a reoccurrence of a long standing affliction dating back 7 years in which he had chronic [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Unexpected Etiology of Cyclical Vomiting

HM2012 Abstract Number: 97988

Staphalococus Aureus Bacteremia Associated Henoch Scholein Purpura

Case Presentation: Henoch–Schönlein purpura (HSP), an IgA mediated systemic vasculitis, presents with a tetrad of lower extremity purpuric rash, bowel angina, acute nephritis and arthritis. HSP is mostly seen in the pediatric population, but rarely [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Staphalococus Aureus Bacteremia Associated Henoch Scholein Purpura

HM2012 Abstract Number: 97989

Moo Is the Clue

Case Presentation: A 39–year–old female presented to the hospital with 2 weeks of fevers, diffuse pain, headaches, neck stiffness, photophobia, nausea and vomiting. Her past medical history includes hypothyroidism, diverticulitis, GERD and gluten intolerance. She [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Moo Is the Clue

HM2012 Abstract Number: 97990

A Piece of Pie

Case Presentation: Pulmonary infiltrates with eosinophilia (PIE syndrome) is characterized by eosinophilic pulmonary infiltrates and peripheral blood eosinophilia. We describe clinical,radiological and histological presentation of a patient with chronic eosinophilic pneumonia.55–year–old lady with a h/O [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Piece of Pie

HM2012 Abstract Number: 97991

A Rare Cause of Mastitis

Case Presentation: A 50–year–old Caucasian woman presented to the emergency department with worsening left breast redness and nipple discharge for 3 days. Examination was significant for erythema encompassing most of the left breast with yellow [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Rare Cause of Mastitis

HM2012 Abstract Number: 97992

Mycobacterium Bovis Bcg Osteomyelitis Masquerading As Spinal Metastasis from Bladder Cancer

Case Presentation: An 80–year–old man was admitted for low back pain and bilateral lower extremity weakness and gait instability for 6 months. He also had weight loss of 40 pounds and fatigue over the last [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Mycobacterium Bovis Bcg Osteomyelitis Masquerading As Spinal Metastasis from Bladder Cancer

HM2012 Abstract Number: 97993

Catastrophic Antiphospholipid Syndrome in a 27Year Old Female

Case Presentation: A 27–year–old female with a past medical history of polycystic ovarian syndrome presented to the hospital with nausea and intractable vomiting starting 2 weeks after intrauterine insemination. Her physical examination was normal. At [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Catastrophic Antiphospholipid Syndrome in a 27Year Old Female

HM2012 Abstract Number: 97994

Acute Esophageal Necrosis Presenting As Otalgia and Sore Throat in a Young Woman

Case Presentation: A 32–year–old woman presented with non bloody vomitus and generalized weakness for 3 days. Medical history was significant for diabetes mellitus type 1 and diabetic ketoacidosis (DKA) in 2006. She was not compliant [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Acute Esophageal Necrosis Presenting As Otalgia and Sore Throat in a Young Woman

HM2012 Abstract Number: 97995

Arteriovenous Shunting Secondary to Renal Cell Carcinoma: An Uncommon Cause of High Output Heart Failure

Case Presentation: A 58–year–old male with uncontrolled hypertension presented to the emergency department complaining of worsening dyspnea on exertion, orthopnea and bilateral lower extremity edema of several months duration. On physical exam he appeared flushed, [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Arteriovenous Shunting Secondary to Renal Cell Carcinoma: An Uncommon Cause of High Output Heart Failure

HM2012 Abstract Number: 97996

Arthritis Due to an Unusual Human Pathogen

Case Presentation: This is a 65–year–old male with diabetes and hypertension who presented to the emergency room with a complaint of right shoulder pain. He was also found to be febrile to 101.5 F with [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Arthritis Due to an Unusual Human Pathogen

HM2012 Abstract Number: 97997

Eosinophilic Fasciitis Complicated by Aplastic Anemia

Case Presentation: The patient is a 62–year–old man with significant PMH of Type II diabetes mellitus, hypertension, and gout, who presented with lightheadedness, and shortness of breath. Laboratory analysis was significant for anemia with a [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Eosinophilic Fasciitis Complicated by Aplastic Anemia

HM2012 Abstract Number: 97998

Out of Sight Should Not Be Out of Mind: What Lurks Just Beneath the Surface of the Cirrhotic Abdominal Wall

Case Presentation: A 51–year–old female with end stage renal disease, cirrhosis, tricuspid regurgitation, and portal hypertension undergoes hemodialysis three times per week and receives periodic therapeutic paracenteses. She routinely has 10L or more removed per [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Out of Sight Should Not Be Out of Mind: What Lurks Just Beneath the Surface of the Cirrhotic Abdominal Wall

HM2012 Abstract Number: 97999

A Rare Presentation of a Common Disease; Pancreatic Panniculitis

Case Presentation: A 50–year–old man presented to his dermatologist with a 2–week history of a rash over his extremities. The nodules were painful, raised and violaceous (Fig. 1). He was empirically treated with oral Prednisone [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Rare Presentation of a Common Disease; Pancreatic Panniculitis

HM2012 Abstract Number: 98000

Pres Syndrome in a Patient with Late Postpartum Eclampsia a Rare Case

Case Presentation: A 28–year–old woman, gravida2 para2, presented to the ER for abdominal pain and distention 2 weeks after cesarean section with total abdominal hysterectomy for placenta accreta. She was diagnosed with retrovesicular abscess which [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Pres Syndrome in a Patient with Late Postpartum Eclampsia a Rare Case

HM2012 Abstract Number: 98001

The Natural Course of M. Kansasii

Case Presentation: A 58–year–old female presented with progressively worsening shortness of breath over years with rapid worsening over the previous weeks. Her medical history is notable for progressive pulmonary disease secondary to M. kansasii diagnosed [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Natural Course of M. Kansasii

HM2012 Abstract Number: 98002

Cementing the Diagnosis

Case Presentation: A 53–year–old female presented to the orthopedic clinic with complaints of left hip pain, back pain, and motor and sensory deficits. Imaging demonstrated multiple lytic bone metastasis and thoracic spinal cord compression. She [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Cementing the Diagnosis

HM2012 Abstract Number: 98003

A Small Bowel Obstruction Caused by Mycobacterial Spindle Cell Pseudotumor

Case Presentation: A 63–year–old man with a history of end stage renal disease status post deceased donor renal transplant and small bowel carcinoid status post excision presented with fevers. Infectious work–up was negative, and a [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Small Bowel Obstruction Caused by Mycobacterial Spindle Cell Pseudotumor

HM2012 Abstract Number: 98004

Cns Complications of Herpes Zoster

Case Presentation: A 75–year–old male presented for inpatient treatment of major depression. A medicine consult was requested for evaluation of a pruritic facial rash that had been present for 2 weeks. Review of the systems [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Cns Complications of Herpes Zoster

HM2012 Abstract Number: 98005

An Unusual Presentation of a Rare Disease

Case Presentation: A 27–year–old African American male inmate with a history of occupational exposure to silica and fiberglass dust presented with an acute onset of dyspnea associated with left–sided pleuritic chest pain. He reported a [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on An Unusual Presentation of a Rare Disease

HM2012 Abstract Number: 98006

Feline, Friend or Foe?

Case Presentation: A 42–year–old man presented with persistent dyspnea for 10 months that had worsened over the last month. He has had multiple hospital admissions for congestive heart failure and anemia of chronic disease. An [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Feline, Friend or Foe?

HM2012 Abstract Number: 98007

Stroke in 28Yearold Female: Migraine Induced or Triptan Use?

Case Presentation: A 28–year–old nonsmoker female with a history of migraines and OCP use presented to the hospital with acute onset confusion, disorientation and right–sided focal neurologic deficits. The patient had migraines since age 12 [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Stroke in 28Yearold Female: Migraine Induced or Triptan Use?

HM2012 Abstract Number: 98008

Acute Cerebrovascular Accident Presenting with Psychosis

Case Presentation: DG is a 50–year–old female with no significant past medical history who presented to the emergency department (ED) two weeks after a near–syncopal episode. She complained of "flu–like" symptoms and ED physicians noted [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Acute Cerebrovascular Accident Presenting with Psychosis

HM2012 Abstract Number: 98009

Risky Business: Surviving the Common and Uncommon Adverse Effects of Cocaine

Case Presentation: A 38–year–old Mexican man presented with one day of sudden onset left shin pain, with generalized weakness and dyspnea. His temperature was 99.0, pulse 90, blood pressure 108/72, respiratory rate 24. On exam [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Risky Business: Surviving the Common and Uncommon Adverse Effects of Cocaine

HM2012 Abstract Number: 98010

A Patient’s Presentation of Persistent Sweet Taste in Her Mouth Leads to a Diagnosis of Small Cell Lung Cancer

Case Presentation: A 60–year–old female bookkeeper with a past medical history significant for a 40 pack year smoking history presented to her primary care physician with a complaint of a persistent sweet taste in her [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Patient’s Presentation of Persistent Sweet Taste in Her Mouth Leads to a Diagnosis of Small Cell Lung Cancer

HM2012 Abstract Number: 98011

Elizabethkingia Meningosepticum Meningitis in an Immunocompetent Adult: Rapid Bacteriologic Diagnosis by Malditof Mass Spectrometry

Case Presentation: We report a case of a 68–year–old female with hypertension and osteoarthritis who presented with altered mental status and bilateral lower extremity cellulitis. Shortly after initial evaluation, the patient became non–responsive and exhibited [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Elizabethkingia Meningosepticum Meningitis in an Immunocompetent Adult: Rapid Bacteriologic Diagnosis by Malditof Mass Spectrometry

HM2012 Abstract Number: 98012

Ruptured Aortic Aneurysm Due to Escherichia Coli

Case Presentation: A 59–year–old male presented with abdominal pain for 5 days. His past medical history was significant for hypertension, dyslipidemia and a stable 5 cm abdominal aortic aneurysm (AAA) detected 4 years ago. The [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Ruptured Aortic Aneurysm Due to Escherichia Coli

HM2012 Abstract Number: 98013

Respiratory Syncytial Virus Bronchiolitis Mimicking Asthma

Case Presentation: A 59–year–old male with a history of asthma presented to our emergency department with severe wheezing associated with shortness of breath. His asthma had been stable, requiring albuterol inhalation one to two times [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Respiratory Syncytial Virus Bronchiolitis Mimicking Asthma

HM2012 Abstract Number: 98014

All That Wheezes Is Not Asthma

Case Presentation: A 71–year–old man with a past history of long standing asthma presented with productive cough for 1 week and nausea, vomiting, diarrhea, fevers, headache, and generalized weakness for 1 day. In the last [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on All That Wheezes Is Not Asthma

HM2012 Abstract Number: 98015

Calming Nerves in This High Pressure Situation

Case Presentation: A 61–year–old male with worsening back pain and right leg weakness secondary to lumbar spinal stenosis underwent an elective L2–S1 laminectomy with L4–L5 fusion. His past medical history included essential hypertension with medication [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Calming Nerves in This High Pressure Situation

HM2012 Abstract Number: 98016

Silent but Deadly: How Occult Relapse of Wegener’s Granulomatosis Can Be Lethal

Case Presentation: A 60 year old male presented with acute dyspnea and pleuritic retrosternal chest pain. His past medical history was significant for Wegener's granulomatosis (WG) in remission for four years. His history was negative [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Silent but Deadly: How Occult Relapse of Wegener’s Granulomatosis Can Be Lethal

HM2012 Abstract Number: 98017

The Other Ibd: Gastrointestinal Involvement in Chronic Granulomatous Disease

Case Presentation: This is a 21–year–old male presenting with a 3–month history of worsening colicky periumbilical abdominal pain. The patient has had fevers, night sweats, diarrhea and hematochezia associated with this pain. He has a [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Other Ibd: Gastrointestinal Involvement in Chronic Granulomatous Disease

HM2012 Abstract Number: 98018

Reactivation of Occult Hepatitis B Infection After Rituximab Treatment: A Case Report

Case Presentation: A 75–year–old African American woman was admitted following two weeks history of fatigue, jaundice, anorexia, intermittent nausea and vomiting. Her physical exam was unremarkable except for profound icterus. She was previously maintained on [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Reactivation of Occult Hepatitis B Infection After Rituximab Treatment: A Case Report

HM2012 Abstract Number: 98019

The Red Breast Herring

Case Presentation: A 71–year–old woman with a history of inverse psoriasis (occurs on skin folds versus extensor surfances), breast cancer status post right lumpectomy and radiation, last treated 3 months ago, presents to the hospital [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Red Breast Herring

HM2012 Abstract Number: 98020

Ms4 Year Not Always Monotonous

Case Presentation: A previously healthy 28–year–old female medical student presented with four days of high fevers (up to 39.9 C) and epigastric pain. In the past month, she completed an infectious disease rotation, then went [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Ms4 Year Not Always Monotonous

HM2012 Abstract Number: 98021

Hepatic Hydrothorax Without Clinical Ascites

Case Presentation: A 44–year–old woman with 30–pack year smoking history, diabetes and non–alcoholic fatty liver disease presented with shortness of breath since two months and recurrent right sided pleural effusion on chest radiographs. Prior to [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Hepatic Hydrothorax Without Clinical Ascites

HM2012 Abstract Number: 98022

When a Skin Bug Goes for Blood: Corynebacterium Minutissimum Bacteremia

Case Presentation: An 81–year–old man with a history of chronic obstructive pulmonary disease, congestive heart failure and chronic kidney disease presented to our hospital with 6–day history of increasing shortness of breath, fever (self recorded [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on When a Skin Bug Goes for Blood: Corynebacterium Minutissimum Bacteremia

HM2012 Abstract Number: 98023

Amyotrophic Lateral Sclerosis(Als) in a Patient with Systemic Lupus Erythematosus (Sle)

Case Presentation: A 68–year–old man with stable lupus nephritis diagnosed in 1999, presented with progressive difficulty with swallowing and speaking since May 2009 requiring percutaneous endoscopic gastrostomy tube placement in August 2010. Muscle atrophy, twitching [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Amyotrophic Lateral Sclerosis(Als) in a Patient with Systemic Lupus Erythematosus (Sle)

HM2012 Abstract Number: 98024

A Curious Case of Collagenous Sprue

Case Presentation: A 57–year–old man with a known history of ischemic cardiomyopathy, high cholesterol, hypertension and diabetes presented with 2–month history of seven daily episodes of watery stools. He lost eleven kg over this period. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Curious Case of Collagenous Sprue

HM2012 Abstract Number: 98025

Not Just the Joints: Abdominal Pain in Lupus

Case Presentation: A 22–year–old woman with a history of systemic lupus erythematosus (SLE) and antiphospholipid antibody syndrome on chronic immunosuppression and anticoagulation presented with one week of post–prandial upper abdominal pain and fevers. Her vital [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Not Just the Joints: Abdominal Pain in Lupus

HM2012 Abstract Number: 98026

The Metamorphosis of a Rash

Case Presentation: A 50–year–old HIV–positive, African American male presented with fever and rash of 3 months duration. He first noticed an "elevated, itchy, red spot that enlarged and oozed when scratched" on his left hand. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on The Metamorphosis of a Rash

HM2012 Abstract Number: 98027

A Common Presentation with an Unlikley Culprit

Case Presentation: A 44–year–old female with a past medical history of HIV presented to the emergency room with bilateral leg pain, edema and erythema that was progressively worsening over several weeks. The patient first began [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Common Presentation with an Unlikley Culprit

HM2012 Abstract Number: 98028

A Complicated UTI

Case Presentation: A 63–year–old male with a history of prostate cancer status post open prostatectomy in 2000 presented in July 2010 to the emergency department with fevers. He reported 6 months of terminal dysuria and [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on A Complicated UTI

HM2012 Abstract Number: 98029

Ruq Pain, Elevated Liver Function Tests, Gall Bladder Wall Thickening: Not Always Acute Cholecystitis

Case Presentation: This is a 64–year–old Caucasian male with past medical history significant for non–ischemic cardiomyopathy with recent EF of 19% who presented to the hospital with chief complaint of right upper quadrant pain and [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Ruq Pain, Elevated Liver Function Tests, Gall Bladder Wall Thickening: Not Always Acute Cholecystitis

HM2012 Abstract Number: 98030

Have You Heard of This Form of Tick Borne Illness?

Case Presentation: A 77–year–old man from Putnam County, New York, was hospitalized on December 5, 2010 for one week history of fever, dysuria and confusion. He was treated for a urinary tract infection without improvement. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Have You Heard of This Form of Tick Borne Illness?

HM2012 Abstract Number: 98031

Metastatic Melanoma: Misdiagnosis As Hemorrhoids

Case Presentation: A 57–year–old Caucasian female started having painless bleeding per rectum. She denied any constipation or pain during bowel movements. She noticed small lump at anal margin. Her other co–morbidities were hypertension, hyperlipidemia, stress [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Metastatic Melanoma: Misdiagnosis As Hemorrhoids

HM2012 Abstract Number: 98032

Idiopathic Perforated Appendicitis: After Diagnostic Colonoscopy

Case Presentation: A 38–year–old Caucasian male with a history of gout presented with odynophagia and epigastric pain following a hiking trip. He was diagnosed with gastro esophageal reflux disease likely secondary to NSAID use. Esophogastroduodenoscopy [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Idiopathic Perforated Appendicitis: After Diagnostic Colonoscopy

HM2012 Abstract Number: 98033

Maythurner Syndrome: Under Recognized Variant

Case Presentation: A 31–year–old Caucasian female, 2 months post–partum, on OCP for 4 weeks experienced left hip and buttock pain while working out at gym. She was prescribed NSAIDS and Medrol dose pack for sciatica. [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Maythurner Syndrome: Under Recognized Variant

HM2012 Abstract Number: 98034

Up in the Air: A Medical Emergency or False Alarm?

Case Presentation: A 42–year–old woman with Angelman syndrome, severe cognitive impairment, and seizure disorder presented with changes in mental status. She was nonverbal at baseline; her caregivers had noted less interaction, poor appetite, and 4 [...]

By | 2012-04-01T01:00:14+00:00 April 1st, 2012|Uncategorized|Comments Off on Up in the Air: A Medical Emergency or False Alarm?