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: 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: 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: 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 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 […]

Case Presentation: A 77-year-old female with atrial fibrillation (AF) on flecainide, sinus node dysfunction (SND), and permanent pacemaker presents with frequent palpitations. EKG showed regular, wide-complex tachycardia with ventricular rate of 137 BPM. Device interrogation revealed atrial flutter with 1:1 AV conduction (AL11AV). Rhythm terminated with overdrive atrial pacing along with resolution of symptoms. Troponins […]

Case Presentation: A 82 year old Caucasian male with history of long standing well controlled diabetes mellitus type 2 since 2010, gastroparesis, and GERD presented to the ED with 2 episodes of “dark, tarry” stools for 1 day onset with resolution. On review of systems, the patient endorsed 32 pound weight loss over 6 months, […]

Case Presentation: A 21-year-old healthy Hispanic male presented to the hospital for evaluation of fever and sore throat for 4 weeks. He had no significant past medical history and he was not on any medications. His vital signs were within normal limits. Physical exam revealed icterus and no hepatosplenomegaly. The remainder of the physical exam […]

Case Presentation: A 63-year-old male presented with altered mental status of one day duration. The patient’s history was significant for CAD, CKD Stage 3, and a recent whipple procedure for cholangiocarcinoma complicated by abdominal abscess requiring percutaneous drainage and prolonged course of ertapenem (renally dosed). He was admitted to the hospital with encephalopathy after having […]