Background: Like all large academic medical centers (AMCs), we face capacity challenges. On most days, bed occupancy is often greater than 90% and long boarding times in the Emergency Department (ED) leads to poor patient experience, care delays and risk for adverse outcomes. While many AMCs have approached this problem by acquiring new facilities or [...]

Background: Recent widespread adoption of electronic health records (EHRs) has dramatically increased the amount of information quickly accessible to clinicians. Given recent pushes for interoperability and consumer generated data in EHRs, the volume of information will continue to grow. The result is clinicians who experience information overload and lack the time and ability to comprehensively [...]

Background: Preventive care is a crucial but underutilized component of optimal population health management. Of eligible patients, 69.0% have received pneumococcal vaccine, 24.1% zoster vaccine, and 30.0% hepatitis B vaccine. Cancer screening rates are similarly low, with 12.5% screened for lung cancer and 71.6% for colorectal cancer. Gaps in preventive care are even larger in [...]

Background: Midlines are peripheral vascular devices inserted in the veins of the upper extremity with the tip located at or below the axillary vein. Greater appreciation of complications associated with peripherally inserted central catheters (PICC) and the diffusion of catheter appropriateness criteria has led to expanded use of these devices. However, single center studies comparing [...]

Case Presentation: A 34-year-old female with a history of focal epilepsy diagnosed during childhood complicated by status epilepticus, anxiety, depression, ADHD, and history of chronic hyponatremia presented to the hospital at 25 weeks gestation with complaints of recurrent seizures. During the admission process she had multiple witnessed generalized tonic-clonic seizures with nystagmus requiring multiple rounds [...]

Case Presentation: A 40-year-old female presented in June of 2023 with emesis and a fever of 38.9 °C. She complained of epigastric pain radiating to the back. The patient reported no recent travel. She worked in a daycare and had a pet dog. She had not hiked or camped recently. She walked her dog at [...]

Case Presentation: A 65-year-old female with uterine carcinosarcoma was hospitalized for ascites, dyspnea, and fatigue. Initial findings revealed peritoneal carcinomatosis with massive ascites, potential liver metastases, and acute kidney injury (AKI) with creatinine 6.6 mg/dL (baseline 0.9) with oliguria. She declined dialysis. High urate (14.5 mg/dL) prompted administration of rasburicase due to an initial concern [...]

Case Presentation: A 43-year-old man with no significant past medical history presented with 3–4 days of rapidly progressive right upper extremity pain, swelling, and bullae. Symptoms began with a bulla at the antecubital fossa and extended distally and proximally. He also developed bilateral thigh and hip cramping with difficulty walking. He denied trauma or IV [...]

Case Presentation: We report a case of a 52-year-old woman with chronic pain, depression, and poorly controlled diabetes who presented with acute hypoxic respiratory failure secondary to multifocal Streptococcus pneumoniae pneumonia and empyema. During a protracted ICU course requiring mechanical venitation and tracheostomy, she exhibited persistent neurological abnormalities including dystonia and tremor, which, along with [...]

Case Presentation: A 75-year-old man with advanced urothelial carcinoma on enfortumab vedotin and pembrolizumab presented with new muscle weakness. His weakness began two weeks prior as cramping in his lower extremities and progressed upwards, leading to difficulty raising his head. He also noted progressive dyspnea on exertion and lower extremity edema. On exam, he had [...]