Background: Sepsis is a common and life-threatening complication of infection that disproportionately affects patients with chronic comorbidities. Timely fluid resuscitation is a key initial management strategy for reducing sepsis mortality; however, patients with serious comorbidities are often excluded from clinical trials. The Surviving Sepsis guidelines suggest that patients meeting severe sepsis criteria should be administered […]

Background: Mitochondrial disease (MD) refers to a group of clinically heterogeneous disorders that result from dysfunctional oxidative phosphorylation and subsequent cellular incapability to meet energy demands. Mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), myoclonus, epilepsy, ataxia with ragged red fibers (MERRFs), chronic progressive ophthalmoplegia, Kearns–Sayre syndrome, and sensory ataxia neuropathy dysarthria ophthalmoplegia are among […]

Background: As hospitals work to reduce avoidable hospital readmission rates, health care delivery systems more broadly have been working to develop efficient, effective health care delivery models under the rubric of accountable care organizations (ACOs). As the principal providers of inpatient‐based care, hospitalists can build on their quality improvement experience in transitions of care to […]

Background: The discharge summary functions as the most common form of communication between hospitalists and outpatient physicians when hospitalized patients are discharged. Unfortunately, discharge summaries frequently lack important information and are not made available to those who need them. Such communication deficiencies adversely affect patient care and may contribute to increased rates of rehospitalization. Purpose: […]

Background: In patients hospitalized with heart failure (HF) exacerbations, physicians routinely supplement potassium to maintain levels ≥4.0 mEq/L. The evidence basis for this practice is relatively weak. We aimed to evaluate the association between serum potassium levels and outcomes in patients hospitalized with HF. Methods: We identified patients admitted with acute HF exacerbations to hospitals […]

Background: Donor blood transfusion has been a frequently used treatment modality for a wide variety of clinical situations in hospitalized patients for decades. Despite it being one of the most commonly performed medical procedures, with 15 million units of red blood cells transfused every year in the United States, its proof of safety and efficacy […]

Background: We have presented our experience with a novel percutaneous approach for axillary artery implant of intra-aortic balloon pumps. The axillary approach permits up-right posture and ambulation, but such enhanced mobility may predispose to higher risk of IABP malposition with unique complications. We present a few complications here. Methods: We conducted a retrospective review of […]

Background: Over 5 million people in the United States are diagnosed with heart failure (HF) and many continue to be hospitalized for exacerbations of this disease. An estimated 20 million Americans have been diagnosed with some form of thyroid disease. Thyroid hormones significantly impact cardiac muscle functions and elevated levels of thyroxine (T4), as seen […]

Background: The diagnostic process can be difficult but is an important aspect of the work for most physicians. Although there has been much cognitive research into defining type I and type II thinking, this process continues to be misunderstood and sometimes mistrusted. A diagnostic error can be defined as a diagnosis that is wrong, missed, […]

Background: Palliative care in seriously ill patients has been shown in some studies to improve satisfaction, symptoms, inpatient mortality rates, healthcare utilization and cost. While inpatient palliative care has been shown to improve symptoms and quality of life measures, the literature on its association with 30-day readmissions have been mixed for heart failure hospitalizations. We […]