Background: Postmyocardial Infarction Syndrome (PMIS), also called Dressler syndrome or Post-pericardiotomy Syndrome, refers to a heterogeneous group of autoimmune-mediated conditions of pericardial, epicardial and myocardial inflammation following myocardial infarction. Generally considered to be rare in the reperfusion era, the features and risk factors of PMIS are less well characterized in the contemporary era. This study [...]

Background: With the rising prevalence of persons who inject drugs, we are increasingly confronted with the challenge of managing them in the hospital setting as they are at an increased risk of leaving the hospital prematurely. There is limited data on the factors associated with leaving against medical advice (AMA) in persons who inject drugs [...]

Background: Inpatient addiction consultant services are an innovative and proliferating tool used to confront the opioid epidemic. As healthcare systems seek to address gaps in care for patients with substance use disorder (SUD), the inpatient setting is increasingly understood as a unique opportunity for counseling, referral for treatment, and initiation of medication assistance treatment (MAT) [...]

Background: Background Fatalities caused by drug-overdose have increased in recent years across the US and are now the leading cause of injury-related death in the United States. Drug related deaths with cointoxicants are being seen more often and the increase in prevalence of opioid overdoses with possible concomitant medication use is a public health concern [...]

Background: Discharges against medical advice (AMA) account for 0.8-2.2% of all national discharges and represents an extreme in non-compliance. Patients who elect to leave AMA have increased rates of mortality, morbidity and readmission rates. Literature on this topic, to date, has focused on AMA in the context of specific admitting diagnoses or discharges from certain [...]

Case Presentation: A 74-year-old female, with no significant past medical or travel history, developed sepsis 2 days after undergoing debulking surgery for stage IIIc ovarian carcinoma. Blood cultures were positive for gram-negative bacilli and the organisms identified as Enterobacter spp. with blaIMP MBL (Verigene). Antimicrobial susceptibility testing demonstrated high-level resistance to all penicillins, ureidopenicillins, cephalosporins, [...]

Case Presentation: A healthy 39-year-old man was admitted to the hospitalist service for an extensive rash that was suspicious for Stevens-Johnson Syndrome (SJS). He presented with diffuse bullae and desquamation of the pelvis and lower extremities (Image A). One week prior to admission, the patient applied topical Nigella sativa oil (colloquially known as black cumin [...]

Case Presentation: A 37-year old male with PMH of HIV on HAART presented with episodes of seizure, syncope and altered mental status. Vital signs and physical examination were unremarkable. Laboratory results revealed sodium level 113, serum osmolarity 243, urine osmolarity 429 and urine sodium 113. Lab findings along with patient appearing euvolemic on exam suggested [...]