Background: Clostridium difficile–associated diarrhea (CDAD) increases the risk of hospital mortality. Factors associated with recurrence of CDAD in clinical trials include renal impairment (RI), inflammatory bowel disease (IBD), and advanced age (>65 years old). These factors may also affect mortality risk. How these factors modify the effect of CDAD on mortality is unknown. Failure to […]

Background: Cellulitis and erysipelas are common types of skin and soft‐tissue infection, resulting in more than 600,000 hospitalizations per year. Because both infections often present with unilateral lower‐extremity pain, redness, and swelling, deep vein thrombosis (DVT) is often considered a part of the differential diagnosis and compression ultrasound (CUS) is often ordered to assess its […]

Background: Despite their proven benefit, mammographic screening rates continue to be low among women of lower socioeconomic status and who are ethnic minorities. Efforts to increase early detection in these groups of women have been largely unsuccessful. This study explored the receptivity to inpatient breast cancer screening as a novel approach to increasing mammographic screening […]

Background: Internists play an increasingly important role in the medical management of orthopedic surgery cases. A randomized controlled trial of patients undergoing total hip and knee replacement found that those who were comanaged by internal medicine hospitalists had fewer minor complications than patients managed by orthopedists only. Length of stay (LOS) was unchanged in this […]

Background: The transition of care between providers constitutes a vulnerable point in the care of a hospitalized patient. Poor‐quality or inadequate handoffs have been identified as a nidus for adverse clinical events. As shift restrictions have necessitated change in the practice of medicine, there are a greater number of inpatient handoffs in a single day. […]

Background: Work‐hour restrictions are intended to improve resident education and patient care. This study quantifies the time interns and residents spend on direct patient care, indirect patient care, computer tasks, and education. Methods: This is a prospective time–motion study at an academic medical center. The team consists of 2 interns, 1 resident, every fourth night […]

Background: The American Gastroenterology Association (AGE) states that 2 of 3 features must be present in order to diagnose acute pancreatitis (AP): (1) characteristic abdominal pain, (2) serum amylase and or lipase activity 3 times the upper limit, and/or (3) characteristic computed tomography scan (CTS) findings. However, the yield of CT scanning early in the […]

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 intensive care. We hypothesized that there are clinical variables available at hospital admission that are associated with the outcome of […]

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 that treatment may be provided in the outpatient setting. However, this tool only considers acute findings that reflect severity of […]

Background: Cardiac monitoring is often overutilized. The 2004 American Heart Association (AHA) practice standards categorized indications for electrocardiographic monitoring in hospitalized patients based on the potential therapeutic benefit. This study sought to evaluate whether the AHA recommendations could safely guide the selection of patients for cardiac monitoring in a noncritical setting. Methods: Clinical data were […]