Background: Although procedural sedation has been proposed as a core competency for pediatric hospitalists (PHs), little sedation training is given during pediatric residency. Most PHs are trained on the job and may have received only a didactic lecture on procedural sedation medications along with supervised sedation training. In general, children who need procedural sedation are […]

Background: Transjugular intrahepatic portosystemic shunt (TIPS) creation is a commonly utilized procedure used for patients with chronic liver disease and resistant portal hypertension. Previous studies have explored the trends and short-term outcomes in TIPS procedures. This study aims to further compare short-term in-hospital outcomes of patients with diabetes mellitus (DM) when undergoing TIPS. Methods: This […]

Case Presentation: A 56‐year‐old white man presented to an outlying hospital with abdominal pain, melanotic stool. He had hemoglobin of 14 g/dL, white cell count of 19,000, and platelets count of 879,000. Initially the INR was 2, but he was not on anticoagulants. CT abdomen showed pancolitis and pericolic inflammation. He was commenced on IV […]

Background: Fingerstick blood glucose (FSBG) testing allows inpatient providers to adjust insulin in real time to protect patients from significant hypo- or hyperglycemia. Admitted diabetic patients are often placed on sliding scale insulin with four times per day FSBG testing, regardless of home insulin use. FSBG test materials cost $9 per use (1). We estimate […]

Case Presentation: A 66-year-old man with uncontrolled type 2 diabetes mellitus (hemoglobin A1c = 18.1%) presented with one month of worsening pleuritic chest pain, productive cough and 10-pound weight loss. He denied any gastrointestinal (GI) symptoms, including diarrhea or abdominal pain. He worked as a clinical nursing assistant. Patient denied any recent international travel, animal […]

Case Presentation: A 66-year-old man with uncontrolled type 2 diabetes mellitus (hemoglobin A1c = 18.1%) presented with one month of worsening pleuritic chest pain, productive cough and 10-pound weight loss. He denied any gastrointestinal (GI) symptoms, including diarrhea or abdominal pain. He worked as a clinical nursing assistant. Patient denied any recent international travel, animal […]

Case Presentation: A 35-year-old black male presented to the emergency department (ED) with acute onset diffuse abdominal pain, along with nausea and vomiting. Review of systems was positive for polyuria and polydipsia. The examination was unremarkable apart from a sizeable fungating lesion of the left lower extremity by the ankle measuring 12 x 8 cm. […]

Case Presentation: A previously active 54 year old female with a history of COPD experienced progressive worsening fatigue and two episodes of syncope over the course of 4 months. Transthoracic echocardiography showed a massive 4.9cm x 3.5cm left atrial mass occupying nearly 90% of her left atrium. Four days later she underwent a diagnostic coronary […]

Case Presentation: An 89-year-old year old woman with a history of type II diabetes mellitus, insulin-naïve and well-controlled on a regimen of metformin, sitagliptin, and dapagliflozin, presented with 3 days of nausea, vomiting, and poor intake of food and liquids. She had recently been prescribed cephalexin for a suspected UTI. She reported a subacute history […]

Case Presentation: A 13 y/o female presented with a 1 month history of painless left inguinal swelling and a 2 day history of worsening inguinal pain, diffuse pruritis, myalgias and fever.  On presentation she was febrile to 103.7oF, tachycardic to 136, and mildly hypotensive.  Exam was notable for a 6cm x7cm area of swelling and […]