Background: Peripherally inserted central catheters (PICCs) are an increasingly popular choice in the acute care setting for intravenous therapy. However, compared to other catheters, PICCs are associated with a higher risk for venous thromboembolism and blood stream infection, with multi-lumen PICCs having higher complication rates than single lumen. Midline catheters are associated with a much [...]

Background: Evidence-based medicine and research are the backdrops to our everyday practice of medicine. Although there are defined steps in carrying research project to publication, there is paucity in the translation of research to practice.(1,2) Over 45% hospitalized patients report poor sleep during their most vulnerable time citing the hospital environment and sleep disruptions from [...]

Background: Currently, once-daily nebulized bronchodilator therapy is unavailable for patients with chronic obstructive pulmonary disease (COPD). Prior studies demonstrated that once-daily revefenacin (REV) doses of 88 and 175 µg produced significant bronchodilation in COPD patients. We report the pooled results of two replicate phase 3 efficacy trials. Methods: In these double-blind, placebo-controlled, parallel-group, 12-week trials [...]

Background: Patients with rare disorders or previously undocumented conditions with a genetic basis often go undiagnosed for many years despite extensive evaluations under skilled physicians in their communities and tertiary care centers. These patients are often high- volume consumers of healthcare and a frequent source of hospital admissions and readmissions. Without a clear diagnosis they [...]

Background: Clostridium difficile infections (CDI) is a notorious nosocomial threat to health and a leading cause of infectious diarrhea. It is associated with billions of dollars of US health care costs annually due to long hospital stays and readmissions. While CDI is mostly caused by toxin-producing strains, some strains do not express these proteins. These [...]

Background: Blood stream infection is associated with high mortality and morbidity. Blood cultures are considered the gold standard for diagnosing bacteremia in sepsis patients. However, blood culture results may take at least 12 to 24 hours for a positive result and may even be complicated by contamination. Procalcitonin (PCT) a biomarker for bacterial infection is [...]

Background: Opioids are widely prescribed for cancer and non-cancer related pain in hospitalized patients. The opioid usage increased roughly three times in the past two decades. Pain is a feeling of distress evoked by sensory stimuli with/without organ damage and an associated emotional experience. Considering the subjective nature of pain, the need for medication is [...]

Background: Viral respiratory illnesses are common and treatment in most cases is largely supportive. Although extended testing, using PCR to identify specific viruses, is available, targeted treatments are limited to the influenza viruses. Hence, respiratory viral panel (RVP) test results may not affect clinical management for many patients. Our institutional infectious disease guidelines recommend reserving [...]

Background: Serum magnesium is a commonly checked laboratory assay during hospital admissions. However, there is little evidence demonstrating benefit from ordering and repleting magnesium for most inpatients – including critically-ill patients. Methods: Laboratory and magnesium repletion ordering data from 2015-2016 was obtained directly from laboratory and pharmacy databases for inpatient encounters with at least one [...]

Background: Serum magnesium is a commonly checked laboratory assay. Unfortunately, there is little evidence demonstrating benefit from checking and repleting magnesium for the majority of inpatients – including those who are critically ill. Methods: An internet based survey was sent to internal medicine house staff and hospitalist services (including attending physicians and NPs/PAs) at Massachusetts [...]