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 […]

Case Presentation: A 45‐year‐old man presented with 3 months of symmetrical upper and lower limb weakness, paresthesias, and a 40‐pound weight loss. He had no cranial nerve deficits or visual changes. He had global hyperreflexia with pronounced fasciculations and atrophy of proximal lower and upper extremities with decreased sensation to fine touch. Nontender, firm nodules […]

Background: Fall for hospitalized patients can cause significant injury and have devastating long term consequences for patients with 33% resulting in injury, 4-6% causing serious injury (1). Information is available regarding risk factors for falls and specific patient or nursing centric interventions to prevent falls, but there is little known about the physician perspective in […]

Background: Early and sustained mobilization of patients throughout admission is a goal we all strive to achieve. Inpatient immobility leads to the development of medical complications such as pressure ulcers, acute venous thrombosis, nosocomial infections, decreased muscle mass, and overall functional decline. Additionally, patients become deconditioned from their baseline and require potentially preventable additional services […]

Case Presentation: This is a 36‐year‐old African American man who suffered from a 1‐year history of progressive decline in kidney function (lithium‐induced nephrotoxicity) leading to discontinuation of the lithium. However, during the hospital stay, he was minimally symptomatic, mainly nocturia. His medical history was remarkable for hypertension and schizophrenia. His medications were valsartan, paliperidone, and […]

Case Presentation: A 63‐year‐old man with a history of locally advanced (T4 — deep muscle invasion, N2b — multiple ipsilateral neck lymph nodes, M0), left‐sided base‐of‐tongue squamous cell cancer presented to the emergency room with multiple episodes syncope over several weeks. He was treated with chemoradiation 6 months prior to current admission. Follow‐up imaging after […]

Background: Over 35 million patients are hospitalized annually in the United States, with patients experiencing functional deconditioning due to acute illness and hospital acquired limitations on their mobility such as bed rest orders and lack of timely assessment of their functional status. Other contributing factors include medical devices such as chest tubes, drains, IV lines, […]

Case Presentation: A 42‐year‐old woman with multiple sclerosis presented with cough, fever, and malaise. The patient had been admitted 2 weeks prior with similar symptoms; she was given a diagnosis of community‐acquired pneumonia and discharged with oral antibiotics, but symptoms persisted. Her multiple sclerosis was controlled on natalizumab without functional limitations. Medical history was otherwise […]

Background: Hospital readmissions within 30 days of discharge have gained national attention and account for more than $17 billion in avoidable U.S. Medicare expenditures each year. (1) In 2011 alone, there were approximately 3.3 million adult 30-day all-cause hospital readmissions, costing the US $41.3 billion.(2) As such, efforts have been made to create algorithms to […]