Background: Cholangiocarcinoma is an uncommon cancer with a very bad prognosis despite advances made in treatment. Location intrahepatic versus extrahepatic – determines surgical options. In our study, we examined variations in outcomes between patients admitted to the hospital with intrahepatic versus extrahepatic disease. Methods: Data from the National Inpatient Sample (NIS) which is part of [...]

Background: Introduction: Colorectal cancer is the 4th most common cancer in the United States. It is the second most common cause of death in the united states. Despite universal advocacy for screening colonoscopies and early diagnosis, disparities in screening and diagnosis of colorectal cancer exist which affects outcomes. In this analysis, we determine racial disparities [...]

Background: The ratio of partial pressure of arterial oxygen to the fraction of inspired oxygen (P:F ratio) has known clinical utility. For example, it is a key component of the sequential organ failure assesment (SOFA) score which is a validated mortality predictor and the new operational defintion of sepsis. Yet, its use is limited because [...]

Background: Despite gender equality in medical school composition, gender-based disparities exist in multiple domains of healthcare, including: academic promotion tracks, leadership positions, scholarly production, and compensation. Patients also exhibit a gender bias, reporting a higher patient satisfaction with male physicians. However, some data suggests that women physicians actually deliver better outcomes. We sought to identify [...]

Background: Hospital Medicine (HM) practices have traditionally utilized an extended ‘7 on/7 off’ (7/7) schedule. Occupational Health studies suggest that such schedules can increase physiologic and psychologic stressors (Keller). Despite their prevalence, the effects of extended scheduling on physician well-being and performance are unknown. We sought to study the effect of 7/7 scheduling on well-being [...]

Background: Issues with the quality and safety of hospital care have been well-documented, and serve as the basis for improvement strategies and research. However, what is less understood are the perspectives of patients, families, caregivers, and other stakeholders regarding what they feel are the most important targets of improvement research. We systematically engaged a broad [...]

Background: Healthcare has become exponentially more complex with intricate systems of care delivery and large, diverse, subspecialized provider teams. Because of the multi-faceted nature and promise of effective leadership, many healthcare systems have turned to leadership development as a strategy to address the challenges this complexity brings. Leadership development programs have historically targeted traditional hierarchical [...]

Background: Revefenacin (REV), a once-daily, long-acting muscarinic antagonist for nebulized inhalation, was recently approved for maintenance treatment of chronic obstructive pulmonary disease (COPD). We present post hoc efficacy and safety data from three phase 3 trials in patients with moderate to very severe COPD by patient subgroup (<65 y, 65–75 y, >75 y). Methods: This [...]

Background: Many patients with chronic obstructive pulmonary disease (COPD) have suboptimal peak inspiratory flow rate (sPIFR) because of lung hyperinflation, hypoxemia, and muscle wasting, preventing effective use of dry powder inhalers commonly used to treat COPD. sPIFR and airflow limitation interaction may be responsible for excess symptoms in patients with COPD. Here we characterize baseline [...]

Background: Chronic pain is a healthcare problem that significantly affects the physical and mental health of patients and impact their quality of life. It can complicate many disorders and represents a common symptom of rheumatologic diseases. Patients with Scleroderma report pulmonary and gastrointestinal symptoms as the limiting factor on their daily functioning, however pain remains [...]