Background: Glucagon-like peptide-1 (GLP-1) agonists are increasingly prescribed for obesity and type 2 diabetes, demonstrating efficacy in weight loss and glycemic control [1-3]. Beyond metabolic effects, these medications show protective effects against renal disease progression and reduce major adverse cardiovascular events [4]. GLP-1 agonists influence body composition through effects on both fat mass and fat-free [...]

Background: Accreditation Council for Graduate Medical Education (ACGME) program requirements for family medicine permit wide variability in adult inpatient medicine curricula. Family physicians compose a significant percentage of the hospitalist workforce, and the American Board of Family Medicine co-sponsors the Recognition of Focused Practice in Hospital Medicine. Previously published survey data describe certain residency characteristics [...]

Background: A priority of bedside electrocardiographic (ECG) monitoring is identification of ventricular tachycardia (VT), a lethal arrhythmia associated with morbidity and mortality. However, up to 87% of VT alarms could be false. In addition, little is known about the rate of mortality associated with VT. We assessed the rate of 30-day in-hospital mortality associated with [...]

Background: COVID-19 has placed an unprecedented strain on healthcare systems worldwide, increasing demand for critical care beds1. To address shortage of critical care beds, innovative methods to increase capacity are needed. At our large, urban academic safety-net hospital, patients with diabetic ketoacidosis (DKA) are admitted to critical care units for intravenous (IV) insulin administration and [...]

Background: Depending on the criterion applied, the systemic inflammatory response syndrome (SIRS) criteria and the Sequential Organ Failure Assessment (SOFA) criteria initially identify distinct populations that present to the emergency department (ED) with suspected sepsis (Prasad et al., SHM 2018). Our work has shown that 52% of patients meet SIRS criteria first and 48% meet [...]

Background: Medical Emergency Teams (METs) are utilized in an inpatient setting to identify patients who exhibit signs of clinical deterioration. Patients, family, or staff activate the team by calling a Code MET when there is a change in clinical status. Patients with End-Stage Renal Disease (ESRD) fare worse than age-, gender-, and race-matched populations. We [...]

Background: Chest radiographs (CXRs) aid in the evaluation of clinical status and assess the placement of new lines and tubes in patients in the Medical Intensive Care Unit (MICU). Despite studies documenting the safety of foregoing routine CXRs for stable, intubated patients and guidelines recommending against this practice, it remains standard in many ICUs. Purpose: [...]

Case Presentation: A previously healthy and ambulatory 34-year-old diabetic man presented with left-sided scrotal and groin cellulitis and was admitted to the hospital for intravenous antibiotic therapy. He was placed on appropriate pharmacoprophylaxis for venous thromboembolic disease and was observed ambulating on the unit. Despite one week of appropriate antibiotic therapy, he continued to have [...]

Case Presentation: 70 year old male admitted for a complicated UTI was placed on piperacillin / tazobactam empirically and subsequently developed abdominal distension and small bowel obstruction. He was admitted to the ICU for fulminant colitis secondary to severe Clostridium Difficile with concern for toxic megacolon. Labs showed a WBC of 34 along with an [...]