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Abdominal Compartment Syndrome and Ischemic Colon After Milk‐and‐Molasses Enema for Fecal Disimpaction in a Patient with Functional Constipation

Case Presentation: Patient is an 8‐year‐old male with no significant medical history other than a long‐standing history of constipation who presented to a school‐based clinic with abdominal pain and fecal incontinence. He was diagnosed with [...]

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The Perilous Pearl

Case Presentation: A 41‐year‐old white woman was evaluated in an outpatient clinic 4 hours after her friend observed that she had slurred speech and facial droop for 30–40 seconds that spontaneously resolved. She denied any [...]

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Leser–Trelat Syndrome and Glioblastoma

Case Presentation: A 77‐year‐old African American man with no significant medical history was admitted for progressive memory loss and confusion. A CT without contrast was performed as part of the dementia workup, which showed bilateral [...]

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Livin' with Liven (Levamisole‐Induced Vasculopathy Ecchymosis/necrosis)

Case Presentation: A 50‐year‐old woman with recurrent cocaine abuse and chronic hepatitis C presented to the hospital with a 3‐day history of rapidly expanding purpuric lesions on her bilateral cheeks, ears, and right thigh. She [...]

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It's Not Reefer Madness!

Case Presentation: A 25‐year‐old man, diagnosed with systemic lupus erythematous (SLE) 6 months prior and undergoing a workup for LUPUS NEPHRITIS, was brought to the emergency department by his family for weakness and altered mental [...]

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HIV‐Induced Thrombotic Microangiopathy — a Different Approach to Treatment

Case Presentation: A 44‐year‐old African American man with AIDS and noncompliant with highly active antiretroviral therapy (HAART) presented with altered mental status. He also had history of uncontrolled hypertension, pneumocystis jiroveci pneumonia, lichen simplex chronicus, [...]

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Making Pain Visible and Actionable: The Live View Reporting Tool

Background: Pain management is a key quality indicator in hospital satisfaction surveys throughout the United States. Inadequate pain management contributes to longer inpatient length of stay, medical complications, inadequate healing, and dissatisfaction with the hospital [...]

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Implementation of Hospital‐Based Clinical Performance Metrics Teaching Sessions for Medicine Residents on Duke General Medicine

Background: Medicine residents have limited exposure to some of the common topics in quality improvement and clinical performance. One identified need in their education was promoting knowledge of how inpatient clinical performance is measured. Purpose: [...]

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Ipads for Hospitalized Patients: The Inpatient Technology Outreach Unifying Communication and Health (In‐Touch) Pilot Project

Background: For many patients, hospitalization involves substantial inactive time between provider visits, tests, and treatments. This time could be used to engage patients in discharge preparation by (1) learning about their health conditions and (2) [...]

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Value of Clinical Judgment in Detection of Clinical Deterioration: A Prospective Blinded Validation of the Patient Acuity Rating Score in Comparison with the Modified Early‐Warning Score

Background: Failure and delay in identifying clinical deterioration in hospitalized ward patients can result in adverse outcomes. Although many hospitals have instituted rapid response teams to quickly treat and triage unstable patients, early and reliable [...]

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Association Between a Hospital's Quality Performance for In‐Hospital Cardiac Arrest and Common Medical Conditions

Background: Public reporting on hospital quality has been widely adopted for a few medical conditions. Broadening the scope of these efforts to include cardiac arrest is now being considered. Given growing evidence that hospital organization [...]

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Vaccination Rates in Chronic Kidney Disease Patients — Missing the Target!

Background: According to the National Kidney Foundation, 14 million Americans suffer from chronic kidney disease (CKD). Infectious diseases are the second most common cause of death in patients with CKD, and vaccination reduces the mortality [...]

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Attending Use of the Electronic Health Record and Implications for House‐Staff Supervision: Preliminary Results from a Mixed‐Methods Study

Background: With current health information technology, the electronic health record (EHR) is accessible to review clinical information from remote locations. Although patterns of remote EHR access by residents have been described, little information exists regarding [...]

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Post–Cardiac Arrest Care: Do Physicians Resuscitate Younger Patients More Aggressively?

Background: It is very common for physicians to adopt aggressive treatment strategies when dealing with younger patient populations. This usually leads to more use of resources and often results in better outcomes. Thus, we sought [...]

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Clinical Predictors of Adverse Outcomes in Severe Sepsis Patients with Intermediate Lactate Level

Background: Determining what clinical variables are associated with adverse outcomes in severe sepsis with an intermediate lactate level (2–4 mM) may assist clinicians to better triage and manage these patients who immediately may not need [...]

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