Background: One of the key components of the Institute for Healthcare Improvement’s 100,000 Lives campaign was developing rapid response systems. The adult data regarding their effectiveness is equivocal. There is paucity in the literature with respect to pediatric rapid response team (PRRT) impact on cardiopulmonary arrest rates, pediatric intensive care unit transfers and mortality. This [...]

Background: Pharmacologic prophylaxis is recommended for general medical inpatients (GMI) at risk of DVT; this includes GMI who are not fully ambulating. However, full ambulation is not well defined in the current literature. In addition, it is unknown whether encouraging patients to ambulate while in the hospital has any effect. We provide a description of [...]

Background: Hospitalized patients are often subject to numerous, and sometimes daily, blood draws to obtain complete blood counts (CBC). Frequent phlebotomies can cause discomfort and pain, which adversely affects patient satisfaction. In addition, these laboratory values do not necessarily translate into management changes and are contributing to significant hospital expenses. Blood product transfusions represent a [...]

Background: For pregnant women with pre–existing diabetes, tight glycemic control is recommended to reduce the risk of fetal anomalies, macrosomia, delivery complications, stillbirth, and neonatal hypoglycemia. We performed a systematic review to determine the comparative effectiveness and safety of the main options for achieving tight glycemic control during pregnancy—multiple daily injections (MDI) of insulin or [...]

Background: Acute lower gastrointestinal bleeding (LGIB) accounts for about 30 percent of episodes of gastrointestinal bleeding. It encompasses a wide spectrum of symptoms ranging from trivial hematochezia to massive hemorrhage with shock. Identifying those who will later develop severe bleeding is a challenge. Strate and colleagues have identified predictors of severity in patients with acute [...]

Background: Proton pump inhibitors and H2receptor antagonists (PPI/H2RA) are frequently prescribed in hospitalized patients with cirrhosis. There are conflicting reports regarding the risk of spontaneous bacterial peritonitis (SBP) in hospitalized patients with cirrhosis using acid–suppressive therapy. We performed a meta–analysis to evaluate the association between acid–suppressive therapy and the risk of SBP. Methods: We searched [...]

Background: Fidaxomicin, recently approved for the treatment of C. difficile associated diarrhea, demonstrates bactericidal activity against C. difficile and was superior in clinical trials to vancomycin (VAN) in its sustained clinical response. In this study, we showed its mechanism of antimicrobial activity to be via inhibition of RNA polymerase (RNAP). Since this mechanism may also [...]

Background: Fidaxomicin was recently approved for the treatment of Clostridium difficile associated diarrhea. This is a novel narrow spectrum antibacterial agent that demonstrates potent bactericidal activity against C. difficile. In recent clinical trials with over 1100 CDI subjects, FDX was shown to be superior to vancomycin in providing sustained clinical response (response without recurrence of [...]

Background: Simulation–based training has been extensively evaluated in non–medical disciplines, and has been shown to have value in procedure–based medical education. However, fewer data are available with respect to the role of simulation in teaching clinical decision making. In this study, we compared simulation–based instruction to conventional lecture–based didactic instruction of clinical management of common [...]

Background: Asthma and obesity are chronic conditions with incidences that have increased substantially in the pediatric population in New York City and nationally over the past several decades. According to the New York State Department of Health, New York City children aged 0–4 have disproportionately high asthma hospitalization rates of 10.18/1000 children, which is 1.6 [...]