Background: Public reporting on hospital quality has been widely adopted for a few medical conditions. Broadening the scope of these efforts to include cardiac arrest is now being considered. Given growing evidence that hospital organization and culture can have hospital‐wide effects on quality of care, it is unknown if a measure of inpatient survival after […]

Background: ST-segment elevation myocardial infarctions (STEMI) is a significant cause of morbidity and mortality in the United States. Inter-hospital transfers (IHT) are becoming the standard for treatment of ST-elevation myocardial infarctions (STEMIs) as specialized care is often concentrated at tertiary centers. The American Heart Association and the American College of Cardiology (AHA/ACC) recommends door-to-balloon time […]

Background: Chronic opioid therapy has grown more prevalent over the last 2 decades, as have concerns about effectiveness and adverse events. Although a robust literature is emerging regarding outpatient management of pain conditions and chronic opioid therapy, there is little to guide management during hospitalization of patients on chronic opioid therapy. Some practitioners are concerned […]

Background: ST elevation MI is an acute event that mandates immediate intervention. Often, resources play a major role to enable prompt intervention. Our study aims to elaborate any differences that may exist between weekend and weekday outcomes at a national level. Methods: We conducted a retrospective analysis of the Nationwide Inpatient Sample (HCUP-NIS) database. Patients […]

Case Presentation: A 19 year old female with a history of systemic lupus was found at home unresponsive by family and brought to a local ED. At the ED she was hyperthermic to 106F and hypotensive then transferred to Vidant Medical Center fevers and septic shock. Of note she had recently been discharged from Duke […]

Case Presentation: A 78 year old man presented with neck pain, fever, and malaise for 3 days. He noted progressively worsening pain and stiffness of the anterior neck bilaterally. He reported right- sided headache and subjective fevers but denied any photo or phonophobia. He had no sick contacts or recent travel. Past medical history included […]

Case Presentation: A 62yo female with history of Combined Variable Immunodeficiency (CVID), Cirrhosis and Immune Mediated Colitis presented to the hospital with a 7-10 days history of confusion, ataxia, polyuria, and polydipsia. Her medications included Budesonide (9mg po once daily). Patient had no history of diabetes, and non-fasting blood glucose where in normal range 3 […]

Case Presentation: An 8 week old female born 33 4/7 weeks was referred by her primary care provider (PCP) for evaluation of failure to thrive (FTT).  At birth, she required a 2 week NICU stay for phototherapy as well as “feeding and growing”.  She did not require respiratory support and was ultimately discharged home in […]

Case Presentation: A 65 year-old man with a past medical history of CAD s/p CABG, ischemic cardiomyopathy with EF 35%, bicuspid aortic valve stenosis s/p aortic valve replacement, and asbestosis presented to the ER for evaluation of anterior neck swelling, dyspnea on exertion, dysphagia, and a 30 lb unintentional weight loss over 5 months. On […]

Case Presentation: A 37 year-old right-handed man presented to the emergency department with sudden onset of painless right upper extremity swelling and discoloration following an intense weight lifting session. His past medical history was significant for papillary thyroid carcinoma diagnosed two years earlier and thyroidectomy. He recently began an exercise program including upper arm weight […]