Background: Paracentesis is a common procedure for patients with decompensated cirrhosis. In patients with cirrhosis and superimposed renal impairment, clinicians may hesitate to perform a large volume paracentesis, given concerns of intraabdominal fluid shifts resulting in further renal dysfunction. In this study, we aimed to answer whether greater ascites fluid removal was associated with 48-hour [...]

Background: Black patients have been shown to have worse physical function, higher likelihood of developing mobility limitations and higher rates of mobility loss and functional decline. Despite these functional disadvantages, Black patients are less likely to receive acute and post-acute rehabilitation services. These disparities have been described in community-dwelling, ambulatory, and surgical populations, and social [...]

Background: Patients in hospitals often face various physical constraints, such as being monitored, having internal or external catheters inserted, or being tethered to an IV pole. These limitations act as barriers to mobilization, contributing to the deconditioning of patients who initially mobilized independently or with assistance, leading to increased falls, excessive use of physical therapy [...]

Background: The Society of Hospital Medicine’s Choosing Wisely recommendations include avoiding repetitive Complete blood count (CBC) and serum electrolyte panels (SEPs). SEPs include basic and comprehensive metabolic panels (BMP, CMP respectively). Unnecessary routine lab can cause increased costs(1)(2), unnecessary downstream testing and procedures, hospital acquired anemia(2)(3)(4) and patient discomfort. Multiple QI project has been successful [...]

Case Presentation: Mr. A is a 48-year-old male with a past medical history of end-stage heart failure. He was transported from prison due to worsening dyspnea and was admitted to the hospital with acute kidney injury. He rapidly deteriorated, requiring transfer to the Intensive Care Unit (ICU) due to worsening shock requiring vasopressors. Mr. A’s [...]

Case Presentation: A 65 year-old female with past medical history of type 1 diabetes mellitus, renal transplant, breast cancer, sarcoidosis, and hypothyroidism presented with acute onset of severe pain, numbness, and weakness of bilateral upper and lower extremities. The patient developed rapidly progressive fatigue and weakness over three days following acute bronchitis six weeks prior. [...]

Case Presentation: A 45-year-old woman initially presented with sudden dizziness upon sitting up, followed by persistent holocranial pressure headaches, blurry vision, and visual distortions resembling a kaleidoscope effect. The patient has primarily received outpatient care for persistent headaches and has undergone frequent monitoring due to worsening cognitive decline for which she was referred to a [...]