Background: In a previous randomized trial we found that shorter ward rotations reduced attending physician burnout at rotation-end. This improvement was offset, however, by negative education outcomes among trainees. Therefore solutions to burnout other than simply shortening rotations are needed to preserve the educational mission. We examined additional data collected (but not yet presented) to [...]

Background: In a previous randomized trial we found that shorter ward rotations reduced attending physician burnout at rotation-end. This improvement was offset, however, by negative education outcomes among trainees. Therefore solutions to burnout other than simply shortening rotations are needed to preserve the educational mission. We examined additional data collected (but not yet presented) to [...]

Background: Many patients with chronic obstructive pulmonary disease (COPD) have suboptimal peak inspiratory flow rate (sPIFR) because of lung hyperinflation, hypoxemia, and muscle wasting, preventing effective use of dry powder inhalers commonly used to treat COPD. sPIFR and airflow limitation interaction may be responsible for excess symptoms in patients with COPD. Here we characterize baseline [...]

Background: Research suggests that COPD patients with low peak inspiratory flow rate (PIFR,

Case Presentation: A 68-year-old male with osteoarthritis, status post bilateral knee replacement in 2014, presented with two weeks of flu-like symptoms, generalized weakness, and shortness of breath. Upon admission, the patient was noted to have a tender, swollen right knee with laboratories revealing neutrophilia with bandemia. Computed tomography (CT) of the joint revealed punctate gas [...]

Case Presentation: Fibro-muscular dysplasia is a segmental, non-atherosclerotic, non-inflammatory vascular disease of unknown etiology usually found in small and medium-sized arteries. Renal arteries (60–75%) are most commonly involved, followed by the cervico-cranial arteries (25–30%). FMD of cervico-cranial arteries in absence of renal artery involvement is much rarer. We present a case of symptomatic fibro-muscular dysplasia [...]

Case Presentation: Background: Patients with catheter-associated UTI may have flank pain, suprapubic or costovertebral tenderness. The purple color of urine in patients with a UTI is due to metabolic products of biochemical reactions formed by bacterial enzymes in the urine.Case Presentation: An 84-year-old man with a past medical history of metastatic prostate cancer complicated by [...]

Case Presentation: FC is a 67-year-old female with prior history of diabetes, hypertension, and hyperlipidemia. She was initially admitted for three days of watery diarrhea. During her hospitalization, she suddenly suffered PEA arrest, and received CPR and ACLS algorithm for 26minutes before achieving ROSC. Patient was subsequently intubated. Her post-arrest neurologic exam was notable for [...]

Background: Many modern electronic medical record (EMR) systems permit application of templates to hospital After Visit Summaries (AVS). A need remains for enhancement of the document’s completeness and readability to enable successful patient self-management. Such advancements must balance with provider usability of EMR tools. This study evaluates the impact of a novel EMR tool, disappearing [...]

Case Presentation: IntroductionSudden cardiac arrest (SCA) remains a major cause of morbidity and mortality, particularly in elderly patients with multiple comorbidities. We present a case of an elderly patient who developed pulseless electrical activity (PEA) shortly after receiving haloperidol, without preceding changes in telemetry readings.Case PresentationA 78-year-old man presented to the emergency department after a [...]