Background: Community acquired severity scores are well known and used routinely in predicting mortality and risk of inpatient and ICU admission in suspected bacterial pneumonia patients. However such scores have not been studied in patients with influenza infection and influenza pneumonia. We attempted to validate one such score, CURB65 and and identify other scores that [...]

Background: Community acquired severity scores are well known and used routinely in predicting mortality and risk of inpatient and ICU admission in suspected bacterial pneumonia patients. However such scores have not been studied in patients with influenza infection and influenza pneumonia. We attempted to validate one such score, CURB65 and and identify other scores that [...]

Background: Nearly half of incorrect procedures occur outside the operating room, and failure to conduct a robust time-out is a frequent root cause. Mannequin-based simulation (MBS) has been shown to improve self-confidence and performance of time-outs, but is expensive, time-consuming, and difficult to scale up effectively for large groups of medical learners. Screen-based simulation (SBS) [...]

Background: Lumbar puncture and paracentesis are core competencies in internal medicine, but residents frequently report discomfort performing these procedures unsupervised. Simulation-based training (SBT) has previously been shown to improve resident performance of lumbar punctures on patients, but outcomes after paracentesis SBT have only been assessed on simulators. We hypothesized that SBT would improve internal medicine [...]

Background: Tissue pathology plays an integral role in the diagnosis of various conditions, especially malignancy. Traditionally biopsy procedures, including core needle biopsy (CNB), have been performed by specialists under imaging guidance. They are traditionally done in special procedure rooms/suites–which come with an added cost of nursing staff, transportation and equipment. Meanwhile hospitalists are increasingly becoming [...]

Background: Small-bore pulmonary drains (PD) have been proven effective at replacing the previous large-bore chest tubes for resolution of pneumothorax (PTX), and management of complicated (CPEs) and recurrent pleural effusions (RPEs). The placement of these drains has traditionally been performed by Surgeons, Intensivists/Pulmonologists, and Interventional Radiologists. Our institution (large academic center) sought to determine whether [...]

Background: Ultrasound-guidance has become the standard for bedside procedures in the emergency and inpatient settings due to its perceived impact on first attempt success and complications. Prior literature on paracentesis notes a 10% rate of overall complications, 5% rate of technical problems, and a 1% rate of bleeding. However, existing cohorts often include outpatients or [...]

Background: Procalcitonin (PCT) is a precursor peptide to calcitonin produced by the thyroid parafollicular cells, and the intestinal and lung neuroendocrine cells. PCT is a proinflammatoy marker specific to bacterial infections, and was initially used clinically to guide antibiotic therapy in lower respiratory tract infections. PCT has seen its role expanded to aid with initiation, [...]

Background: Vitamin K antagonists (VKA) remain widely used in the treatment of venous thromboembolism (VTE). During surgical interventions, the prevention of recurrent VTE must be weighed against the increased bleeding risk conferred by anticoagulation. There is a lack of strong evidence to guide the optimal periprocedural management of anticoagulation in patients with prior VTE, and [...]

Background: With standard diagnostic methods, the etiologic pathogen of community acquired pneumonia (CAP) is detected in ≤ 50% hospitalized CAP patients. In our previous studies using a diagnostic “bundle”, we were able to detect etiologic pathogens in ≥ 70 % of the patients. Our bundle consisted of a nasopharyngeal swab for Biofire film array, that [...]