Background: Penicillin discovered in 1928 by Sir Alexander Fleming, beginning of the antibiotic revolution. Penicillin as helped increase average life Span in USA from 47 years to 78.8 years. Beta lactam account to about 40% of total antibiotic use every year. 10% of patients in U.S. report penicillin allergy, but 9 out of 10 patients [...]

Background: Literature regarding resident education in transitions of care is limited, particularly in geriatric populations. The University of Colorado performed a pilot of a virtual multidisciplinary conference call between providers on the geriatric inpatient unit of the University of Colorado Hospital and its Seniors Clinic. Residents rotating on the Acute Care of the Elder (ACE) [...]

Background: In medical care for older patients, the presence of potentially inappropriate medications (PIMs) is associated with increased adverse outcomes [1, 2]. A wide range of medications with anticholinergic properties affects cognitive states of older patients have been regarded as PIMs [1, 3]. We purposed to assess clinical impact of anticholinergic cognitive burden on clinical [...]

Background: Atrial fibrillation (AF) is strongly age-dependent, and with a growing geriatric population, the incidence and prevalence of AF is expected to increase in the United States. As a result, the number of patients at risk of a thromboembolic event due to AF is also expected to increase. Although bleeding associated with mechanical falls is [...]

Background: Pregnant patients labeled with a penicillin allergy (PcnA) and charted as Group B streptococcus (GBS) positive can spread this infection to their baby during a vaginal delivery resulting in serious illness for their newborns. GBS is the most common cause of infectious morbidity and mortality in the neonatal period during the first week of [...]

Background: In the United States, 32 million people have a documented penicillin allergy and up to 20% of hospitalized patients’ records describe a penicillin allergy (PcnA). Less than 10% of patients with reported penicillin allergy have true clinically relevant PcnA when objectively tested through rigorous skin testing (1-3). Clinicians subsequently avoid appropriate penicillin or penicillin [...]

Background: After discharge from an acute care hospitalization, cancer patients may choose to pursue rehabilitative care in a skilled nursing facility (SNF). Our objective was to examine receipt of anti-cancer therapy, death, readmission, and hospice use of cancer patients who discharge to a SNF compared to those who discharge home or home with home health [...]

Background: We have presented our experience with a novel percutaneous approach for axillary artery implant of intra-aortic balloon pumps. The axillary approach permits up-right posture and ambulation, but such enhanced mobility may predispose to higher risk of IABP malposition with unique complications. We present a few complications here. Methods: We conducted a retrospective review of [...]

Background: Palliative care in seriously ill patients has been shown in some studies to improve satisfaction, symptoms, inpatient mortality rates, healthcare utilization and cost. While inpatient palliative care has been shown to improve symptoms and quality of life measures, the literature on its association with 30-day readmissions have been mixed for heart failure hospitalizations. We [...]

Background: Central line-associated bloodstream infection (CLABSI) is a morbid and potentially lethal complication. National policies related to CLABSI mandate public reporting of this adverse event, with hospitals receiving penalties based on their CLABSI rates. Contemporary data suggest that peripherally inserted central catheters (PICCs) placed outside critical care settings are a large contributor to hospital CLABSI [...]