Background: Sepsis and septic shock, critical health concerns in the U.S., demonstrate varied mortality rates across different racial groups. This study examines the impact of race on mortality and complications in septic shock, providing insights into healthcare disparities. Methods: Using data from the National Inpatient Sample database (2016-2020), this retrospective analysis included 2,789,890 patients with [...]

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: Necrotizing fasciitis, a severe bacterial infection, poses significant health challenges with varied outcomes across different demographic groups. This study examines the gender and racial disparities in the incidence of complications, length of hospital stay, and healthcare costs associated with necrotizing fasciitis, focusing on key outcomes such as mortality, hemodialysis, hospital length of stay, and [...]

Background: While many physicians graduate from residency with competency to perform bedside procedures such as lumbar punctures (LPs) and paracentesis, the skillset often wanes after years in practice. Though a dedicated procedure service with full-time equivalent support may be a solution in settings where hospitalists need to perform numerous procedures per day, at our large [...]

Background: Hospital Medicine (HM) based procedure services have demonstrated improved outcomes for patients by reducing time to procedure, improving throughput, and decreasing length of stay. Notable barriers to service implementation and sustainability include staffing shortages, training, and payment models. Provision of bedside procedural care in the community teaching hospital setting may facilitate access to other [...]

Case Presentation: A 64-year-old female with decompensated alcoholic liver cirrhosis was admitted to the hospital for lower abdominal pain. The initial paracentesis polymorphonuclear (PMN) leukocyte count was 149 cells/mm3, but the patient was found to have E. coli urinary tract infection. During the course of her treatment, the patient developed pancreatitis and her hepatic encephalopathy [...]

Case Presentation: A 41-year-old Caucasian female with a significant past medical history of Factor V Leiden deficiency presented to our institution for evaluation of new-onset seizures that began while driving. No head trauma or other bodily harm was sustained. The patient was non-ill appearing and hemodynamically stable. The physical exam was otherwise unremarkable. Laboratory evaluations [...]