Background: Gamification and social incentives, such as family/peer engagement in goal-setting and feedback, are increasingly used by employers and health plans to promote physical activity and lose weight in outpatient settings but these approaches have not been used to improve mobility and reduce hospital-associated functional decline after hospital discharge. Methods: 12-week randomized, controlled trial of […]

Background: Medication discrepancies, defined as unexplained differences in documented medication regimens across different sites of care, are prevalent and an important contributor to adverse drug events among hospitalized and recently discharged patients. In November 2011, we implemented a Web‐based discharge module, including a new tool to reconcile medications at discharge. The goal of this study […]

Background: Anemia is a risk factor for cognitive impairment as a result of reduced delivery of oxygen to the brain from low hemoglobin (Hb) levels. In ambulatory patients, mild anemia (Hb 10-12g/dL) has been associated with reductions in patients’ cognitive function [1–3]. In hospitalized patients it is standard of care to maintain Hb levels far […]

Background: Recent changes in resident work hours have placed an increased emphasis on attending service and supervision of residents, especially at night. There are little data about how non–critical care pediatric inpatient teaching services are staffed at night and the responsibilities of those attendings. Our objective was to define the current attending staffing of pediatric […]

Background: Renal dysfunction is a complication in patients with decompensated cirrhosis. Due to the potential morbidity and mortality of these disorders in cirrhotic patients, it is important to ensure accurate clinical measurements of renal function. Standard creatinine-based estimated glomerular filtration rate (eGFR) equations have proven to be inaccurate in cirrhotic patients, as these patients have […]

Background: Atrial fibrillation (AF), the most common arrhythmia encountered in clinical practice, is managed by a variety of specialists. Current guidelines differ in their recommendations and may not adequately address management in the acute setting, leading to uncertainty regarding important clinical decisions. We sought to document practice pattern variation among cardiologists, emergency medicine physicians (EMs), […]

Background: Sickle cell disease (SCD) is characterized by lifelong, recurrent episodes of vaso-occlusive pain that often require inpatient hospitalization. Readiness for discharge is dictated by the patient’s pain intensity rated on the Numeric Rating Scale (0-10). Pain is an individualized multidimensional experience and a pain intensity score only measures one facet. Physical function is another […]

Case Presentation: A 61‐year‐old woman was admitted with acute jaundice. She was in her usual state of health until 2 weeks prior to admission, when she developed progressive jaundice, dull right upper quadrant pain, and lower‐extremity edema. Her medical history included a deep venous thrombosis while taking oral contraceptives and a pulmonary embolism after a […]

Case Presentation: A 73 year‐old Caucasian male with controlled non‐insulin dependent type II diabetes, hypertension, and hyperlipidemia, presented with 3 months of fatigue, night sweats, RLQ pain, and ∼20lb weight loss. Physical examination elicited RLQ tenderness. A CBC, BMP, PTT, and PT/INR revealed only a normocytic anemia (Hb=11.7, MCV=87). An Abdominal/Pelvis CT scan discovered a […]

Case Presentation: A 94-year-old female with a past medical history of cerebrovascular accident (no residual effects) presented with an intertrochanteric fracture of the right proximal femur after a mechanical fall. On arrival, the patient was afebrile, vital signs hemodynamically stable. On exam, the patient was alert and oriented x3 with no focal deficits, extremities warm […]