Background: Sleep disruptions are prevalent among ward patients and are associated with a number of negative health outcomes, including elevated blood pressures and delirium. Overnight vital signs are an especially bothersome disruptor and can deplete crucial health care resources. Although vital sign checks every 4 hours are often routine, there are limited data to support […]

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: Service excellence in the U.S. hospitals, as measured by patient satisfaction scores, is receiving more attention, with the results being reported publicly and affecting reimbursement rates. Ideally, accurate feedback could be given to individual providers to improve their performance; however, the current survey methods have significant shortcomings that limit their usefulness. Methods: We developed […]

Background: For patients with atrial fibrillation (AF) who undergo percutaneous coronary intervention (PCI), antithrombotic therapy including oral anticoagulants (OAC) and antiplatelets are indicated. The optimal combination is not known. We investigated the efficacy and safety of different antithrombotic strategies in patients with AF undergoing PCI. Methods: PUBMED and EMBASE were searched through September 2019 for […]

Background: In July 2011, the Accreditation Council for Graduate Medical Education (ACGME) mandated new residency work‐hour restrictions. These changes limited the maximum hours of continuous clinical responsibilities from 30 to 16 hours for interns, 24 hours for upper‐level residents. Our objective was to determine how inpatient staffing of non–critical care teaching services within pediatric residency […]

Background: Cancer-associated thrombosis (CAT) is a common complication in patients with malignancy. Management of venous thromboembolism (VTE), in these patients, is challenging due to the high risk of recurrence and inherent risk of bleeding in this population. Direct oral anticoagulants (DOACs) have emerged as a treatment options for CAT. As yet there have not been […]

Case Presentation: A 29‐year‐old male with a history marijuana and cocaine use presented with abdominal pain of three weeks duration. The pain was associated with nausea, emesis, dark urine, night sweats and fever. He denied recent travel or sick contacts. On admission he was mildly tachycardic and afebrile. On physical exam he had left upper […]

Case Presentation: A 55-year-old female presented with headaches and intermittent fevers. On initial examination, she had left hand weakness. Laboratory findings revealed leukocytosis; brain MRI demonstrated multiple bilateral cerebral infarcts. Initial workup was concerning for embolic stroke which initiated our search for a cardioembolic source. No significant abnormalities were seen on transthoracic echo (TTE) and […]

Case Presentation: A 64‐year‐old Japanese man was admitted because of the low‐grade fever and progressive shortness of breath on exertion for two months. He also developed visual disturbance one month prior to admission and ocular steroid therapy has been instituted based on the diagnosis of uveitis. About a year ago, he had right lower leg […]

Case Presentation: A 62-year-old male with past medical history of type 2 diabetes mellitus, coronary and peripheral arterial disease, heart failure with reduced ejection fraction, history of peripheral arterial embolism, history of stroke, vascular dementia and hypertension who presented with sudden onset of shortness of breath associated with cough and chest pain for one day. […]