Background: Voriconazole is a triazole antifungal medication used for prophylaxis in transplant patients or to treat invasive fungal infections. Inflammation of the periosteum causing skeletal pain, known as periostitis, has been an infrequently observed side effect of long‐term voriconazole therapy. Because each molecule of voriconazole contains three fluoride atoms, previous reports have suggested a possible [...]

Background: Pediatric oncology patients are at a higher risk of developing febrile neutropenia. Likewise an advanced age ≥65 years is one of the predictors of the development of neutropenic fever in adult oncology patients. We hypothesized that pediatric patients have higher rate of febrile neutropenia and bacteremia compared to adult patients. Hence, in this study [...]

Background: Early diagnosis of tuberculous pleural effusion (TPE) remains difficult, especially in hospitalization. While some inflammatory markers in pleural effusion (PE) are helpful in diagnosis, the implication of anti‐inflammatory cytokines and effector molecules of cytotoxic T lymphocytes have never been investigated. Methods: Lymphocyte‐predominant exudative PE samples were assayed for inflammatory and anti‐inflammatory cytokines, and effector [...]

Background: Cardiac Troponins (cTn) are sensitive and specific diagnostic and prognostic markers of myocardial injury. The third Myocardial Infarction (MI) Global Task Force in 2012 de‐emphasized the use of other cardiac biomarkers. Creatine Kinase‐Myocardial fraction (CK‐MB) mass may be used as an alternative to cTn assay, when the latter is not available for MI decision, [...]

Background: Rising health care expenditures in the United States encourage physicians to provide quality patient care while eliminating wasteful spending. Reference laboratory tests represent a small percentage of a hospital’s total test volume, but a disproportionate percentage of laboratory costs. Our goal was to examine the effect of displaying inpatient reference laboratory test costs and [...]

Background: There has been a growing emphasis on increasing the value of healthcare by reducing unnecessary testing to decrease costs, though physician behavior has proven difficult to change. An event leading to reduced inpatient resources, such as with a natural or man‐made disaster, may cause physicians to be judicious about resource allocation and may provide [...]

Background: Clinicians check complete blood counts (CBC) multiple times over a hospitalization and sometimes multiple times in a single day, often with the goal of detecting a drop in the hemoglobin level. However, phlebotomy is associated with risks, including hospital‐acquired anemia, patient discomfort, and increased costs. The objective of our study was to determine on [...]

Background: Step‐down units, also known as transitional care or intermediate care units, are designed to care for patients with needs that fall between the intensive care unit and the general ward. Such units are capable of providing highly skilled care, primarily due to a lower patient to nurse ratio, and are often in significant demand [...]

Background: Nighttime care of general medicine patients at University Hospital utilizes a night float cross‐cover system, with a single physician‐intern as the primary coverage. On average, this night float physician cares for 85 to 90 patients. The number of calls this physician receives in a 12‐hour period is perceived to be large, but has never [...]

Background: Paracentesis, thoracentesis, and lumbar puncture are three of the most commonly performed inpatient medicine procedures (MP). Our hospital has no specific resource to outline safe practices and standardization of MP performance and documentation. As a result, laboratory tests were often ordered incorrectly, documentation lacked key information, and the entire procedure process became inefficient and [...]