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Necrolytic Acral Erythema Associated with Hepatitis C

Case Presentation: A 42 y/o Hispanic female with a history of IV drug abuse and dermatitis since 2005 with recurrent episodes of cellulitis presented to the hospital with severe edema, erythema and pain of the [...]

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Disseminated Mac Infection in a Patient with Anti Ifn Gamma Autoantibody

Case Presentation: A 43‐year‐old female was admitted to our hosipital experiencing fever, cough, dyspnea, generalized lymphadenopathy and weight loss. She had been examined previously in another hospital and subsequently treated for community acquired pneumonia for [...]

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Deeper Than Skin; What Lies Beneath the Chronic Urticaria?

Case Presentation: A previously healthy 51‐year‐old man presented to our institution with a 6‐month history of intermittent rash. He described his rash as 2‐3 centimeter raised, red, pruritic lesions occurring on the face, extremities, back [...]

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Unintended Consequences of Increasing Pharmacologic Venous Thromboembolic Prophylaxis in Hospitalized Medical Patients

Background: The Joint Commissions’ core measure on VTE prevention has added more pressure to increase the rate of VTE prophylaxis in hospitalized medical patients. One potential unintended consequence of this is an increase in the [...]

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Use of Standardized Patients to Assess and Improve Hospitalist Communication

Background: Strong physician communication skills can enhance the patient experience and improve patient satisfaction but data consistently reveal dissatisfaction with physician‐patient interactions with little evidence examining specific deficiencies among physicians. Further, few communication improvement strategies [...]

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A “Works in Progress” Session to Promote Scholarship in an Academic Hospitalist Group

Background: Academic hospital medicine groups frequently work in clinical care, quality improvement (QI), and medical education, but may not emphasize or have the training to conduct traditional clinical research. However, dissemination of scholarly work is [...]

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Factors Associated with Failure of Observation Care

Background: When patients present to emergency departments too sick to be sent home, hospitals increasingly provide observation services, meaning extended outpatient visits expected to last under 48 hours during which patients are treated and reassessed. [...]

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Analysis of Enoxaparin Dose Titration at a Large, Tertiary Teaching Facility

Background: Enoxaparin, a low‐molecular weight heparin (LMWH), is frequently used in place of unfractionated heparin (UFH) for anticoagulation. LMWH have been favored by expert groups in many clinical settings given their advantages over UFH, including [...]

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Severity of Stroke Risk in Atrial Fibrillation Does Not Correlate with the Use of Stroke Prophylaxis

Background: An individual’s risk of atrial fibrillation‐related stroke can be estimated with the use of a CHADS2 score with higher scores correlating with a greater risk of cardioembolic stroke. Current clinical guidelines recommend the use [...]

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A New Role for Pharmacy Technicians in Medication History Taking and Management

Background: Medication reconciliation is crucial for patient safety. Patients are often uncertain of the medications they are taking and physicians may not have time to take thorough medication histories. A pharmacy technician (PT), by conducting [...]

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Impact of Geographic Rounding and Multi‐Disciplinary Rounds on Coordination of Care and Discharge Times

Background: Initial studies demonstrate that locating the majority of a physician’s patients on a designated unit (geographic rounding) can enhance physician efficiency and facilitate physician nurse communication. Further benefits can include better patient satisfaction, improved [...]

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Inappropriate Initiation of Antibiotics for Asymptomatic Bacteriuria in Patients Admitted from the Emergency Deptartment

Background: Unnecessary treatment of asymptomatic bacteriuria (AB) is an individual and public health problem and a target for antibiotic stewardship. Although there is clear evidence against treating AB in most patients, the definition of “asymptomatic” [...]

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Readmission Intuition: Can Physicians Accurately Predict Readmissions at the Time of Initial Admission?

Background: Unplanned patient readmissions are undesirable from both a clinical quality and a financial perspective. Identifying patients at risk of readmissions allows targeting of interventions aimed at reducing readmission rates. Several algorithms for predicting readmission [...]

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Echo‐Ing Change: The Effect of an Electronic Medical Record on Transthoracic Echocardiogram Ordering

Background: The use of transthoracic echocardiograms (TTEs) has increased dramatically, particularly over the last ten years. There is a perceived lack of harm in performing a non‐invasive TTE, though high cost and overdiagnosis are important [...]

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Ed to Hospital Handoffs: Physicians’ Experiences, Perceptions, and Attitudes

Background: Transfer of care between healthcare providers is a vulnerable time for patient safety, and ED admission handoffs are subject to unique structural and contextual challenges. The ED admission process involves changes in provider, department, [...]

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