Background: Central nervous system medication (CNS med) use among older adults is associated with high morbidity and mortality. This study described patterns of CNS medication use, and identified people most likely to have CNS medications initiated or deprescribed around hospitalization. Methods: Retrospective cohort study using electronic health record data from 3-hospitals. Patients aged 65 years […]

Background: Asthma is one of the most common chronic medical conditions affecting around 300 million people worldwide. It is a disorder of the airways characterized by recurrent symptoms of airway obstruction and inflammation. Invasive mechanical ventilation for patients admitted to the hospital with asthma is challenging with higher complications and higher rates of patient-ventilator asynchrony, […]

Background: Hospitalists routinely precept third year medical students on general internal medicine wards. One of the key patient care tasks for students is to present and interpret common laboratory test abnormalities. Formal training in interpreting routine diagnostic tests is lacking for students transitioning from preclinical to clinical years. We designed and implemented a module on […]

Case Presentation: A 70-year-old male with medical history significant for rheumatoid arthritis presented to the emergency department with several days of odynophagia, oral ulcers, skin lesions and epistaxis. He was treated for foot cellulitis with TMP-SMX for one week prior to admission. The patient had been receiving 10 mg SQ weekly injectable MTX for Rheumatoid […]

Background: Hospitalists are at the forefront of the opioid epidemic. Over half of hospitalized patients are exposed to opioids during their admission, most of whom are opioid naïve.1 Patients discharged on opioids have a 15% chance of long-term use after one year.2 There is significant variation in provider opioid prescribing practices, even within the same […]

Case Presentation: A 61-year-old man with no notable health history was admitted to the hospital for a month-long history of dysphagia and weight loss. The patient had been in his usual state of health until around six months ago when occasional back pain developed, which he attributed to his prolonged truck-driving. Four months prior to […]

Case Presentation: A 23 yo Indian M with a history of transfusion-dependent β-thalassemia major, extramedullary hematopoiesis (EMH), iron overload, and myeloneuropathy presented with mid-back pain, bilateral lower extremity (BLE) weakness and pain with acute-on-chronic paresthesias, gait imbalance, and recent falls. He complained of constipation, but denied saddle paresthesia, urinary retention, or bowel incontinence. Symptoms progressively […]

Background: Up to 45% of Americans do not fill prescriptions because of cost. Medication non-adherence annually leads to $100-$300B in excess morbidity and mortality. To better inform medication cost effects on a potentially vulnerable patient population, our primary aim was to measure annual patient out-of-pocket outpatient medication cost for patients without prescription drug insurance coverage […]

Case Presentation: A 60-year-old farmer with a past medical history significant for antiphospholipid syndrome, atrial fibrillation (AF), and longstanding rheumatoid arthritis on infliximab therapy presented to the ED with weakness and dyspnea. History from family and recent rheumatology visit revealed a history of non-compliance and self-injection with livestock glucocorticoids due to self-diagnosed rheumatoid vasculitis and […]

Case Presentation: A 40-year-old Hispanic man with no past medical history presented with right thigh pain and swelling for three weeks. He had a 10 pound weight loss over the past few months. He also noted melena two months ago with recent recurrence. No recent trauma or skin infections were reported. Vital were notable for […]