Background: Roflumilast, a FDA–approved, once–daily, oral, selective phosphodiesterase–4 inhibitor, has been shown to reduce the risk of chronic obstructive pulmonary disease (COPD) exacerbations in patients with severe COPD associated with chronic bronchitis and a history of exacerbations. Exacerbations (flare–ups) of moderate or severe severity may require alterations in treatment and can cause hospitalization for patients, [...]

Background: Recruiting new hospitalists is expensive and turnover remains a challenge. Monitoring morale may help leaders improve retention. There are no published instruments that quantify hospitalist morale. Our study describes the Hospitalist Morale Assessment (HMA), a validated and reliable instrument that aims to identify program strengths and weaknesses by quantifying hospitalists’ contentment with their work. [...]

Background: Dronedarone is an antiarrhythmic drug approved by the FDA in 2009.Small–vessel vasculitis has not been previously reported in association with dronedarone. Methods: 71 year old male was admitted with 1 week history of generalized skin rash, decreased appetite and lower abdominal and back pain. Other medical history included Paroxysmal Atrial Fibrillation and Stevens–Johnson syndrome [...]

Background: Since 1996, Hospital Medicine grew faster than any other specialty in the history of medicine, and now reaches institutions around the world. The Core Competencies of Hospital Medicine, published by the Society of Hospital Medicine, provide standards of expected knowledge, skills, and attitudes hospitalists should achieve to successfully practice Hospital Medicine. The primary aims [...]

Background: Carbon monoxide (CO) poisoning is the most common cause of death from poisoning in the United States. Cardiovascular complications and their contribution to acute outcomes are yet to be defined. Methods: We retrospectively reviewed the cardiovascular manifestations in 47 patients presenting with CO poisoning during the period from January 2009 to September 2011 in [...]

Background: American Heart Association (AHA) guidelines for the use of telemetric EKG monitoring focus primarily on patients admitted with cardiac diagnoses. There is limited data to guide the use of telemetry in patients admitted with general medical diagnoses, such as GI bleed or pulmonary embolism. Methods: We carried out a prospective, observational study of adults [...]

Background: Roflumilast, a once–daily oral selective phosphodiesterase–4 inhibitor, has been shown to reduce the risk of chronic obstructive pulmonary disease (COPD) exacerbations in patients with severe COPD associated with chronic bronchitis and a history of exacerbations. Moderate or severe exacerbations of COPD typically require alterations in treatment and can result in hospitalization. One possible symptom [...]

Background: COPD is a leading cause of mortality in the US, and COPD exacerbations increase mortality risk, hospitalizations, and healthcare costs, accelerate disease progression, and decrease quality of life. Exacerbations increase in frequency with more severe COPD and a history of exacerbations predicts risk of future exacerbations. Therefore, in patients with severe COPD and a [...]

Background: Nurse Practitioners (NPs) and Physician Assistants (PAs) have been shown to be cost–effective substitutes for physicians with similar outcomes in primary care and surgical settings. The Veterans Health Administration (VHA) is one of the earliest and largest employers of NPs and is the largest single employer of PAs in the US. 42% of academic [...]

Background: The electronic health record (EHR) is recognized as a key component of the modern practice of medicine. Despite numerous advantages, EHR have enabled frequent copy–paste events (CPE). While previous studies show that CPE occur in up to 54% of progress notes, the significance of these CPE is unclear. We hypothesized that the frequency and [...]