Case Presentation: A 25-year-old woman with a remote history of intravenous drug use, last reported seven months prior, presented with two days of progressive cyanosis and pain of the medial right hand with associated paresthesia, hyperesthesia, and stiffness. Physical exam revealed well-demarcated cyanosis of the fourth, fifth, and medial third digits extending to the wrist [...]

Background: In 2010, the Patient Protection and Affordable Care Act (ACA) aimed to enhance health insurance access through subsidies and Medicaid expansion. The expansion was not adopted by all states, leading to variable coverage. The Centers for Medicare & Medicaid Services (CMS) releases a 3-year running average of 30-day risk-standardized mortality rates for Medicare patients [...]

Background: Point-of-care ultrasound (POCUS) of the inferior vena cava (IVC) can help to noninvasively predict the effectiveness of treatment for volume-sensitive conditions, such as acute heart failure and shock. Recently POCUS-IVC has also been used to iteratively tailor fluid treatment to patient-specific targets. In real-world clinical settings, such iterative assessments are necessarily obtained by multiple [...]

Background: Acute heart failure (AHF) exacerbations are a leading cause of hospitalization in the United States. Despite the frequency of AHF hospitalizations, there are inadequate data or practice guidelines on how quickly diuresis should be achieved. Methods: We conducted a pooled cohort study using data from three acute heart failure trials (DOSE, ROSE, and ATHENA-HF). [...]

Background: The traditional role of hospitalists is to provide care to patients hospitalized with acute medical conditions. Over the past few years, this has evolved to improve care transitions and stewardship of hospital resources. Many hospitals may embed hospitalists in the Emergency Department (ED) to improve patient flow into the hospital; however, there are sparse [...]

Background: Early risk stratification scores utilizing data available at the bedside have been used regularly to identify patients at greatest risk of poor outcomes from rapidly evolving conditions like sepsis. Little is known about how point-of-care scores developed for sepsis perform at predicting outcomes in large, heterogeneous cohorts of patients with COVID-19. Our objective was [...]

Background: Work engagement has been an ongoing subject of interest within many organizations as it reflects employee well-being and can affect productivity, work outcomes, emotional health, and physical health (1). Stress levels in the work environment can lead to deterioration of sleep and work engagement and increase burnout (2). Heartfulness meditation is a simple heart-based [...]

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 [...]

Case Presentation: A five-year-old boy with autism presented to the hospital with two-months of fatigue, lower extremity pain, and a petechial rash. Review of systems was notable for a two-kilogram weight loss, intermittent gingival bleeding and refusal to walk for one week. On admission he was afebrile with a heart rate of 160 beats per [...]

Case Presentation: A 25-year-old woman with a remote history of intravenous drug use, last reported seven months prior, presented with two days of progressive cyanosis and pain of the medial right hand with associated paresthesia, hyperesthesia, and stiffness. Physical exam revealed well-demarcated cyanosis of the fourth, fifth, and medial third digits extending to the wrist [...]