Background: The American Board of Internal Medicine suggests residents participate in a minimum of five abdominal paracentesis (AP), central venous catheter (CVC) placements, and lumbar punctures to ensure “adequate knowledge and understanding” of procedures performed by practicing internists. Competency in these procedures is poorly defined and difficult to assess. To address the need for well-supervised, [...]

Background: Catheter-associated urinary tract infection (CAUTI) is a common and clinically important hospital-associated infection throughout the world. A few data from Japan exist regarding the prevalence and appropriateness of urinary catheters in hospitalized patients but no interventions have been proven to decrease unnecessary urinary catheter use in Japan. Our aim of this study is to [...]

Background: Midlines are peripheral vascular devices inserted in the veins of the upper extremity with the tip located at or below the axillary vein. Complications associated with peripherally inserted central catheter (PICC) along with documented overuse has led to emerging interest and increasing use of midlines. However, whether midlines are safer than PICCs is not [...]

Background: Vascular access devices (VADs) play an integral role in the treatment of patients, since they can be utilized for the administration of intravenous medications (including antibiotics and chemotherapy), and often on a long term basis. A peripherally inserted central catheter (PICC) is a type of VAD, which is frequently utilized in different populations. Once [...]

Background: Peripherally inserted central catheters (PICCs) are an increasingly common vascular access device, with more than 4000 devices placed per year at our institution. Though these devices are generally considered safe and effective, they are not without risks, particularly of catheter-related infection and thrombosis. These risks increase exponentially with increasing number of lumens. At our [...]

Background: Catheter Associated Urinary Tract Infection (CAUTI) is the most common hospital acquired infection and constitutes upto 40% of all Healthcare Associated infections. Urinary catheter is used in 15% to 25% of hospitalized patients and often utilized for inappropriate indications. Daily risk of Urinary Tract Infection (UTI) is 3 to 7% with the use of [...]

Case Presentation: A 36 years old female with past medical history of IV drug abuse, presented with dyspnea, nasal congestion, tactile disturbances, diarrhea, body aches and generalized weakness for 1 day. She was recently treated for tricuspid valve endocarditis. A Transthoracic Echocardiogram (TTE) obtained at that time showed ejection fraction (EF) of 55-60%. On presentation, [...]

Case Presentation: 73-year-old male with past medical history of seizure disorder, non insulin dependent diabetes mellitus, hyperlipidemia presents for evaluation of pain and swelling of right lower extremity, found to have deep venous thrombosis involving multiple veins of right lower extremity, occlusive in nature. Past medical history significant for two similar episodes of VTE (venous [...]