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I Can't Breathe Doc … and … !!

Case Presentation: A 77‐year‐old obese white man presented with episodic dyspnea and chest tightness. He had similar symptoms several times in the past 12 months, resulting in multiple ED visits. A detailed review of systems [...]

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Zonegran? More Like Zonegrain

Case Presentation: A 64‐year‐old man with a history of seizure disorder presented to the hospital with increased seizure activity. No preceding illness was noted. He had been treated with phenytoin and phenobarbital and was adherent [...]

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When the Proof Is Not in the Pudding

Case Presentation: A 73‐year‐old man presented with fever, cough, expectoration, and weight loss for 2 months. Chest CT demonstrated a moderately thick‐walled irregular cavitary lesion in the left lung upper lobe, suspicious for abscess versus [...]

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Type B Lactic Acidosis in Chronic Lymphocytic Leukemia

Case Presentation: A 71‐year‐old man with stage IV chronic lymphocytic leukemia (CLL), hypertension, and diabetes mellitus was admitted to the hospital medicine service for the evaluation of 2 weeks of generalized weakness, anorexia, and mild [...]

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When Opportunity Arises

Case Presentation: A 28‐year‐old woman presented with 3 days of fevers. She also noted headache and dyspnea on exertion. She denied cough, chest pain, vision changes, or neurologic deficits. She had grade III oligoastrocytoma status [...]

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Bugs, Drugs, or Immune System Flubs — What Causes Limbic Encephalitis? Moreover, What Causes Anti‐N‐Methyl‐D‐Aspartate Receptor Encephalitis?

Case Presentation: A 27‐year‐old woman, initially admitted to the inpatient psychiatry service for psychosis, progressed to catatonia, autonomic dysfunction, and respiratory failure requiring tracheostomy. Her medical history was significant solely for polysubstance abuse including methamphetamines. [...]

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Understanding the Root Cause of Pneumonia Readmissions at an Urban Medical Center

Background: Hospital readmissions continue to pose a challenge for many hospitals across the country. With the implementation of financial penalties for high rates of 30‐day readmissions in October 2012, hospitals stand to forfeit more than [...]

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Using a Facilitated Check‐In Rounds to Identify Diagnostic Errors and Assess Resource Utilization

Background: The diagnostic process can be difficult but is an important aspect of the work for most physicians. Although there has been much cognitive research into defining type I and type II thinking, this process [...]

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Development of Best‐Practice Guidelines for Improving the Quality of Provider Documentation in an Electronic Health Record

Background: Although there are a number of advantages to documenting in an electronic health record (EHR), such as legibility and accessibility, providers nationally have observed that aspects of the quality of provider documentation decline after [...]

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Development of the Tool to Assess Inpatient Satisfaction with Care from Hospitalists (Taisch)

Background: Service excellence in the U.S. hospitals, as measured by patient satisfaction scores, is receiving more attention, with the results being reported publicly and affecting reimbursement rates. Ideally, accurate feedback could be given to individual [...]

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Impact of a Web‐Based Discharge Ordering Module on the Quality of Medication Reconciliation

Background: Medication discrepancies, defined as unexplained differences in documented medication regimens across different sites of care, are prevalent and an important contributor to adverse drug events among hospitalized and recently discharged patients. In November 2011, [...]

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An Underappreciated Ethical Problem: Delays in Death Certificate Completion

Background: Death certificates are legal documents that permit families to finalize a multitude of end‐of‐life tasks. Physicians play a key role in generating these documents, in partnership with hospital staff, funeral directors, and state health [...]

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Resident Perceptions of the Educational and Clinical Benefit of a Rapid Response Team at an Academic Medical Center

Background: Medical training has become increasingly interprofessional with greater emphasis placed on residents working alongside nonphysician providers. Rapid response teams (RRTs) are often led by nurses and thus provide an opportunity to examine the clinical [...]

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Off‐Label Use of Ondansetron in Hospitalized Medical Patients: Prevalence, Patterns, and Predictors

Background: Hospitalists frequently prescribe ondansetron for nausea and vomiting. However, the Food and Drug Administration (FDA) has approved this agent only for prophylaxis of nausea and emesis related to chemotherapy or radiation therapy or for [...]

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Effect of Comorbidities on Clinical Outcomes in Patients with Low‐Risk Curb‐65

Background: The CURB‐65 score is widely used to risk‐stratify patients with community‐acquired pneumonia (CAP). When the score is less than 3, the patient is considered to have a low mortality risk, and current recommendations suggest [...]

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