Background: The United States sees over 35 million hospital discharges a year with a 20% readmission rate. Unplanned readmissions amount to 20 billion dollars annually. Efforts to prevent readmissions impact patient’s overall morbidity/mortality and alleviate the financial burden on health care systems. To that effect, the United States health care reform, under the Affordable Care [...]

Background: The number of individuals with Alzheimer’s disease and related dementias (ADRD) in the U.S is projected to reach 16 million by 2050. Currently, they account for 3.2 million hospital admissions per year and over 75% of hospitalized persons with ADRD display Behavioral and Psychological Symptoms of Dementia (BPSD). The study aimed to evaluate management [...]

Background: Hypertension is a significant risk factor for cardiovascular disease. According to the Centers for Disease Control and Prevention (CDC) half of all United States citizens with hypertension (HTN) do not have their blood pressure under control. As such, HTN remains a large public health challenge, especially in patients with other comorbidities such as diabetes [...]

Background: Most patients hospitalized with community-acquired pneumonia (CAP) can be safely treated with 5-days of antibiotic therapy. However, many are not. We aimed to determine whether a hospitalist-focused collaborative could reduce excessive antibiotic use in patients hospitalized with CAP through a combination of collaboration with antibiotic stewardship, data feedback, pay-for-performance, and sharing best practices. Methods: [...]

Case Presentation: A 23-year-old male with past medical history of anxiety disorder presented with nausea and multiple episodes of vomiting for 2 days. He also had generalized abdominal pain that was cramp-like in nature. There was no abdominal distention, however the patient reported constipation. He passed flatus during this episode. Noteworthy was the patient’s 10 [...]

Case Presentation: Fibro-muscular dysplasia is a segmental, non-atherosclerotic, non-inflammatory vascular disease of unknown etiology usually found in small and medium-sized arteries. Renal arteries (60–75%) are most commonly involved, followed by the cervico-cranial arteries (25–30%). FMD of cervico-cranial arteries in absence of renal artery involvement is much rarer. We present a case of symptomatic fibro-muscular dysplasia [...]

Case Presentation: 64-year-old female is admitted for workup and management of subacute, progressive dyspnea, pleuritic chest pain, dry cough, and new oxygen requirement. History is significant for plaque psoriasis on adalimumab (initiated 3 months prior to presentation), ulcerative colitis status post proctocolectomy, sicca symptoms, Raynaud’s phenomenon, GERD, maternal history of rheumatoid arthritis, and a 50-pack-year [...]

Case Presentation: A 58-year-old man presented with two days of confusion, tremors and seizures. Past medical history included schizophrenia, epilepsy, HCV infection and right hemiparesis due to ischemic strokes. He initiated dasabuvir, ombitasvir, paritaprevir and ritonavir (Viekira Pak) three days earlier. His epilepsy had been well controlled on lamotrigine for years. Review of systems was [...]

Case Presentation: A 91 year-old female with history of atrial fibrillation on coumadin, hypertension, prior stroke, myeloproliferative disease, polycythemia vera and recently diagnosed macular degeneration presented with complaints of visual hallucinations for two weeks. She was in her usual state of health when she developed sudden onset of vivid visual hallucinations including people coming in [...]