Background: Patients with a higher level of education, more access to medical information, and generous health insurance coverage may be more likely to participate in their medical decision making process. However, few studies directly measure what proportion of patients prefers to leave decisions about medical care up to their doctor. Further, very few studies provide [...]

Background: Pediatric hospitalists are frequently and increasingly asked to provide sedation for a variety of painful procedures in children. There are a wide variety of agents available for sedation including ketamine, fentanyl, ketofol, and nitrous oxide. Nitrous oxide is attractive agent because of rapid onset, ability to deliver the agent without intravenous access, and short [...]

Background: Frequently hospitalized patients are a large burden to the healthcare system, both in terms of hospital days and cost. For many patients, this is due to the severity of their underlying medical comorbidities. However, other patients may be driven to seek care due to comorbidities such as chronic pain and/or mental health disorders. This [...]

Background: Hospital medicine’s claim to fame has been shorter length of stay (LOS) and equal, if not better, adherence to quality measures without sacrificing patient satisfaction. Comparative studies highlighting these strong characteristics of hospital medicine have done so by comparing non– teaching hospitalist groups against either community primary care physicians or academic primary care physicians. [...]

Background: Cocaine is a well known risk factor for the development of early atherosclerosis and myocardial infarction (MI). Several studies in the medical literature have reported the increasing incidence of cocaine use in the American population and subsequent emergency room visits for acute coronary syndrome (ACS). In 2008, the American Heart Association (AHA) released guidelines [...]

Background: Practice Parameters for prognostication after out–of–hospital cardiac arrest, set forth by the American Academy of Neurology, stress the importance of the neurologic exam findings at 72 hours after successful resuscitation. Absent pupillary or corneal reflexes and absent or extensor motor response at 72 hours after arrest, are individual indicators of poor outcome. We sought [...]

Background: There are limited data regarding contemporary trends in management and outcomes of patients with COPD who develop acute myocardial infarction (AMI). The objective of this population–based study was to describe the management and short–term outcomes among patients with AMI with and without COPD between 1997 and 2007. Methods: The study population consisted of patients [...]

Background: Most studies of human metapneumovirus (hMPV) have been done in pediatric populations. Many of these studies compare hMPV with respiratory syncytial virus or are case reports of hMPV infection in the immunosuppressed. Though there have been reports of outbreaks in nursing homes, far less is known about hMPV infections in adults. This study characterized [...]

Background: There is an extensive literature on geographic variation in utilization intensity. Although system capacity (e.g. hospital bed, physician, and scanner density) has been implicated as a factor, the drivers of this variation have not been established. With a large expansion in the physician workforce underway, it is imperative to understand the extent to which [...]

Background: An estimated 1 million people in the US develop symptomatic venous thromboembolism (VTE) at a cost of $1.5 billion annually. The American College of Chest Physicians recommends treating deep vein thrombosis (DVT) outpatient whenever possible, and the British Thoracic Society recommends outpatient treatment for stable pulmonary embolism (PE). Background research at our institution identified [...]