Background: Many hospitals do not have the means to supervise daily physical therapy (PT) for elderly inpatients. PT delivered in a group setting has the potential to allow hospitals to consolidate resources and extend PT services to more elderly patients within the hospital. However, little to no efforts have been made in implementing the delivery [...]

Background: New onset third degree or complete heart block (CHB) is a medical emergency and usually requires permanent pacemaker. CHB can be caused by cardiac ischemia or non-ischemic conditions such as infiltrative diseases or fibrosis. The purpose of this study was to analyze the clinical characteristics associated with ischemic versus non ischemic causes of complete [...]

Background: The Centers for Medicare & Medicaid Services (CMS) started penalizing hospitals with “excess” 30-day readmissions, as determined by observed-to-expected ratio, for patients discharged after treatment for an acute exacerbation of chronic obstructive pulmonary disease (AECOPD). An understanding of modifiable determinants of 30-day readmission will likely help in developing interventions to reduce preventable AECOPD readmissions. [...]

Background: Increased asthma and obesity prevalence are independently associated with health disparities.  This study sought to examine the relationship between these two conditions, particularly within the pediatric population at a major inner city teaching hospital. Methods: Patients aged 3 to 18 with a diagnosis of bronchial asthma and at least one hospital encounter for an [...]

Background: Ultrasound-guided thoracentesis and paracentesis are frequently performed for both diagnostic and therapeutic indications. While the risk of aspiration is low, our institution has historically required patients to be fasting for 4 hours prior to the procedure. In the hospital setting, unnecessary fasting requirements could contribute to missed patient meals and procedure delays. Here, we [...]

Background: Frequent readmissions pose a challenge to hospitals across the country. They are associated with increasing healthcare costs and display a failure to effectively care for certain groups of patients. The Centers for Medicare and Medicaid Services (CMS) apply a penalty towards hospitals with higher than expected 30-days readmission rates. In response, hospitals have implemented [...]

Background: The quality of communication between physicians and nurses plays an important role in patient safety and provider job satisfaction. Efforts to improve the effectiveness of MD-RN communication have traditionally disseminated new programs such as staff training or communication tools, rather than improve established routines such as morning rounds. Having MDs and RNs round together [...]

Case Presentation: A 23-year-old female with a history of acne presented with abdominal pain and bloody diarrhea for 1 day. The pain was crampy in nature and located in her lower abdomen, without radiation or modifying factors.  She was passing frequent watery bowel movements with a small amount of blood. She denied any recent travel, [...]

Pneumopericardium is a medical condition in which air is present within the pericardial space.  This condition has been recognized most commonly in preterm neonates. In adults, pneumopericardium may occur spontaneously or in conjunction with hemopericardium or pericardial effusion. Also, it may follow penetrating wounds to the chest or upper abdomen, or wounds or fistulous communications [...]

Case Presentation: A 42-year-old African American woman with a history of hypertension, morbid obesity, and obstructive sleep apnea presented to the emergency department with a 12-hour history of left-sided abdominal pain, nausea and vomiting. At presentation her medications included hydrochlorothiazide, acetaminophen, ibuprofen, and lisinopril. Her first dose of lisinopril 5mg was 12 hours before the [...]