Background: The Centers for Disease Control and Prevention recommended in 2006 to test all patients for HIV without requiring counseling or written consent. The CDC suggested “opt‐out” testing to increase adoption. In 2007, California removed the legal requirement for written consent. However, the volume of HIV tests in the University of California, San Francisco infectious […]

Background: Patients often need arthrocentesis for diagnostic and therapeutic reasons while on chronic warfarin therapy. Often the procedure is delayed or avoided because of concern about bleeding. The aim of this retrospective study was to determine the safety of arthrocentesis in patients on chronic oral warfarin therapy with INR ≥ 2.0. Methods: We reviewed the […]

Background: Venous thromboembolism (VTE) is a source of morbidity and mortality for high‐risk populations. The risk of VTE in homebound patients is unknown, and therefore it is unclear whether they should be offered VTE prophylaxis when feasible. The purpose of this retrospective cohort study was to estimate the incidence of venous thromboem‐bolism (VTE) in homebound […]

Background: Bone marrow examination is useful in the diagnosis and staging of hematologic disease, as well as in the assessment of overall bone marrow cellularity. The procedure can be a difficult experience for the patient. Pain and anxiety may play a role in the experience. The purpose of the study was to assess practices for […]

Background: Low‐molecular‐weight heparins are the most commonly used for thromboembolic disease prophylaxis, probably because of their security profile and once‐daily administration. Contrary to therapeutic doses, prophylactic recommended doses are fixed (40 mg once a day for enoxaparin). Dosing in extreme body weights has little evidence, especially in patients with low weight. The aim of the study […]

Background: The cohesiveness of the discharge process is critical for ensuring the safety and quality of transition of patient care from the inpatient setting to the next level of care. The discharge process is often viewed as chaotic by the health care team as well as patients and families. A few reasons why the discharge […]

Background: Hospital care accounts for more than 30% of health care expenditures in the United States. In an effort to reduce inappropriate admissions, we implemented hospital medicine attending screening of non–intensive care unit (ICU) medicine admissions. Methods: We conducted a before and after study at our urban, academic safety‐net hospital. From January to June 2008, […]

Background: Observational studies have reported significant protective associations between 25‐hydroxyvitamin D [25(OH) D] and all‐cause and cardiovascular (CV) mortality. We believe that these associations have nonlinear relationships and 25(OH) D probably offers greater protection at lower serum levels. To study this hypothesis, we examined the relationship between 25(OH) D and all‐cause and CV mortality in […]

Background: Patients hospitalized for medical illness are at an increased risk of developing venous thromboembolism (VTE). The present study retrospectively assessed the incidence and time course of symptomatic VTE events following hospitalization in a large, real‐world patient population. Methods: Administrative claims data derived from the Thomson Reuters MarketScan® Inpatient Drug Link File were used to […]

Background: Hyponatremia (HN) is the leading electrolyte abnormality among hospitalized patients. In the absence of symptoms, HN is often overlooked as a condition that warrants aggressive intervention. However, a careful history often reveals symptoms associated with HN. Although HN is common, little is known regarding the influence of HN on patient outcomes and health care […]