Background: Sleep deprivation has deleterious effects on immune function, wound healing, insulin resistance, pain, and even mortality. Patients in hospitals often suffer from sleep deprivation due to environmental noise and interruptions from staff. The American Academy of Nursing Choosing Wisely guidelines recommend not to “wake the patient for routine care unless the patient’s condition or [...]

Background: Sleep deprivation has deleterious effects on immune function, wound healing, insulin resistance, pain, and even mortality. Patients in hospitals often suffer from sleep deprivation due to environmental noise and interruptions from staff. The American Academy of Nursing Choosing Wisely guidelines recommend not to “wake the patient for routine care unless the patient’s condition or [...]

Background: Skin and soft tissue infection (SSTI) is a common pediatric diagnosis with substantial economic cost. SSTIs vary in severity and clinical presentation. Providers often fear missing serious systemic infection, causing potential overtesting. However, recent studies suggest that blood cultures (BCx) are not useful in management of simple cellulitis or abscess (uncomplicated SSTIs [uSSTI]), and [...]

Background: Disruptions in normal life routines (such as sleep, function, nutrition, etc.) that commonly occur as part of routine hospital care may be traumatic for acutely ill patients and lead to a generalized condition of high risk after discharge that has been described as “post-hospitalization syndrome.” We created the ARCHES cohort study to measure these [...]

Background: Baystate Children’s Hospital serves a population that is vulnerable to unsafe sleep practices. By July 2017, there were 6 cases of accidental infant deaths in Hampden County MA, attributed to unsafe sleeping practices, primarily due to co-sleeping. In Springfield, MA, infant mortality rate (9.2%) is double that of the state rate (4.4%). Rates of [...]

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: 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 [...]

Case Presentation: : A 34-year-old female with history of migrainous headaches presented with complains of sudden onset, throbbing type of headache radiating to the back of the ear. This was associated with sudden loss of vision in the right eye. She also mentioned night sweats and unintentional weight loss in the last couple of months. [...]

Case Presentation: A 37-year-old Hispanic female with no medical history presented to the hospital with bilateral lower extremity edema of 3-week duration. Concurrently, she also experienced dysphagia to solids associated with 30-lb weight loss and low-grade fever. Initial examination was significant for bilateral erythematous rash of lower extremities with 3+ pitting edema that extended from [...]

Case Presentation: A 57 year old Caucasian man with history of  porphyria cutanea tarda- recently started on therapeutic phlebotomy, COPD, alcohol abuse, hypertension was admitted to the hospital with recurrent syncopal spells of one day duration. He also endorsed bilateral hand pain and weakness, weight loss, dyspnea and headache. Vital signs were stable on arrival. [...]