Background: Heart failure (HF) and atrial fibrillation (AF) share several risk factors including coronary artery disease, hypertension, smoking, obesity, diabetes, and renal disease, as well as common pathophysiologic pathway involving activation of the renin–angiotensin–aldosterone system, maladaptive atrial remodeling and subsequent impaired conduction system. Some studies have supported the role of angiotensin converting enzyme inhibitors (ACEIs) [...]

Background: Though the advent of highly active anti-retroviral medications has improved survival in HIV infection, mortality from non-infectious complications such as pulmonary arterial hypertension (PAH) has increased. Also, studies have shown that PAH is the leading cause of hospitalization and death in patients with HIV associated PAH (HIV-PAH). However, not much is known about the [...]

Background: Since being introduced in the 1950s, midlines have since gained attention as an intravascular access option—particularly in patients requiring intravenous (IV) therapy for extended time periods. They provide an alternative to frequent venipuncture from peipheral intravenous catheters (PIV) and may reduce cost and increase patient satisfaction. The CDC and MAGIC guidelines currently recommend the [...]

Background: Approximately 1.6 million men and 800,000 women in the US are alcohol dependent and have an alcohol-use disorder. Half will experience withdrawal symptoms after decreased alcohol consumption. Complications including seizures and delirium tremens occur in 3-5% . Benzodiazepines are the gold standard for treatment of alcohol withdrawal but choice of drug regimens varies widely. [...]

Background: Depending on the criterion applied, the systemic inflammatory response syndrome (SIRS) criteria and the Sequential Organ Failure Assessment (SOFA) criteria initially identify distinct populations that present to the emergency department (ED) with suspected sepsis (Prasad et al., SHM 2018). Our work has shown that 52% of patients meet SIRS criteria first and 48% meet [...]

Background: Fatigability describes how fatigued a patient is at any given level of activity, and is measured as the degree of fatigue a patient experiences after performing a specific amount of activity. The National Institute of Aging has suggested that fatigability is an important measure in patients with conditions where fatigue is a prominent symptom, [...]

Background: Patients hospitalized with hematologic malignancy are particularly vulnerable to infection. Clostridium difficile infection (CDI) has become the most common cause of healthcare-associated infections in U. S. hospitals, and the excess healthcare costs related to CDI are estimated to be as much as 4. 8 billion dollars for acute care facilities alone. We sought to [...]

Background: Endovascular cardiac valve replacement continues to increase in popularity as it becomes more of a standard of care for valve replacements. As the number of ECVR grows each year, complications associated with these procedures may elevate the cost and limit the viability of these procedures in healthcare systems. Hospitalists need to be aware of [...]

Background: Hospital Readmission Reduction Program(HRRP) implemented by CMS as part of Affordable Care Act (ACA) applies financial penalties to hospitals that have higher-than-expected readmission rates for common conditions such as AMI, pneumonia, and HF. CMS extended this program to include COPD for the fiscal year (FY) 2015. While there has been a reduction in readmissions, [...]

Background: Opening new residency programs in community hospitals is one strategy to address physician shortage. Previous reports have shown better mortality outcomes in university based hospitals. However, less is known about teaching community hospitals. Disrupting well- established workflows in community hospitals is feared to cause an increased cost and possibly a slide in quality of [...]