Background: D-dimer is clinically useful for its high sensitivity and negative predictive value as a useful “rule out” test for venous thromboembolism. Nevertheless, the D-dimer assay is not specific and often elevated in states of systemic inflammation or illness.Stasis of blood flow, Endothelial injury, and hypercoagulability are the tenets of thrombus formation. When any one [...]

Background: In-hospital venous thromboembolism (VTE) remains an important preventable cause of morbidity/mortality. Multiple risk assessment models (RAMs) for VTE in hospitalized medical patients have been developed, validated, and endorsed by several national societies. Despite evidence and guidelines supporting risk stratification for VTE prevention, data suggest that prophylactic measures are not appropriately utilized. In a nation-wide [...]

Background: We evaluated whether a catheter-to-vein ratio (CVR) of >45% increases the risk of venous thromboembolism [VTE] and catheter occlusion associated with peripherally inserted central catheters (PICCs). Methods: From August 2020 to April 2022, trained abstractors collected demographic and clinical data on patients receiving PICCs while admitted at 52 hospitals participating in the Michigan Hospital [...]

Case Presentation: A 59 y/o male who presented to the hospital with a 2 week history of subjective fevers, generalized fatigue, and non-bloody diarrhea. Past medical history was notable for indeterminate ulcerative colitis (UC) and was being managed with azathioprine and mesalamine. He was recently prescribed antibiotics and developed diarrhea shortly after. He denied any [...]

Case Presentation: A 72-year-old female with chronic kidney disease and recently diagnosed IgG lambda monoclonal gammopathy presented to clinic with six months of progressive weakness and failure to thrive. She reported breathlessness after several steps, a 10-kilogram weight loss, frequent falls, lightheadedness, easy bruising, and dysphagia. There was concern for light chain (AL) amyloidosis, before [...]

Case Presentation: A 41-year male with prior history of hypogonadism presented 11-days after positive COVIDtest with shortness of breath and no prior Covid vaccination. On presentation, patient wastachypneic with breathing rate 32/minute and was observed to be in acute hypoxic respiratoryfailure with oxygen saturation <50%, arterial blood gases showing Ph-6.93, partial pressure ofoxygen-53mmHg, and carbon-dioxide-85mmHg. [...]