Background: Treating alcohol withdrawal in the inpatient medical setting requires timely identification of the severity of alcohol withdrawal so appropriate treatment can be administered. Delayed or missed diagnosis can lead to increased morbidity and mortality, increased cost and length of stay, and ICU admissions. CIWA-Ar is the most commonly used scale, but it is lengthy [...]

Background: Delays in antibiotic administration in sepsis – particularly after the development of hypotension – are associated with increased mortality. Current guidelines recommend antibiotic initiation within one hour of sepsis recognition. However, it is not known how timing of hypotension relates to the timing of meeting sepsis diagnostic criteria and the initiation of treatment. We [...]

Background: Hospitalized patients are complex and often receive concurrent treatment for multiple diseases. Patients presenting with shortness of breath and infiltrates on chest x-ray may be treated for pneumonia, congestive heart failure (CHF) or both. Fluid and blood pressure management may be particularly challenging for these patients. Our goal was to define the impact of [...]

Case Presentation: A 78-year-old woman with amyotrophic lateral sclerosis presented with abdominal fullness. She had undergone tracheal tube intubation, mechanical ventilation and percutaneous gastrostomy 4 years previously because of difficulty in respiration and ingestion. Upon physical examination, her abdomen was distended with board-like rigidity and her legs were cyanotic. Her blood pressure was 96/71 mm [...]

Case Presentation: This is a 35-year old Indian female, living in the United States for the past several years, presented with chronic mid-epigastric and left upper quadrant pain radiating to the back, nausea, and bilious vomiting. She complained of oily loose stools for the past 2 months. Her medical history is notable for insulin-dependent diabetes [...]