Background: Antipsychotics are frequently used in the hospital setting for managing both acute and chronic neuropsychiatric disorders. However, antipsychotics have been associated with higher rates of adverse events, including mortality, due to their association with QT prolongation, which can lead to fatal cardiac arrhythmias such as torsade de pointes, earning a black box warning for use in dementia related psychosis. Yet, [...]

Background: Transjugular intrahepatic portosystemic shunt (TIPS) creation is a commonly utilized procedure used for patients with chronic liver disease and resistant portal hypertension. Previous studies have explored the trends and short-term outcomes in TIPS procedures. This study aims to further compare short-term in-hospital outcomes of patients with chronic kidney disease when undergoing TIPS. Methods: This [...]

Background: Transjugular intrahepatic portosystemic shunt (TIPS) creation is a commonly utilized procedure used for patients with chronic liver disease and resistant portal hypertension. Previous studies have explored the trends and short-term outcomes in TIPS procedures. This study aims to further compare short-term in-hospital outcomes of patients with coagulation disorders when undergoing TIPS. Methods: This retrospective [...]

Background: Transjugular intrahepatic portosystemic shunt (TIPS) creation is a commonly utilized procedure used for patients with chronic liver disease and resistant portal hypertension. Previous studies have explored the trends and short-term outcomes in TIPS procedures. This study aims to further compare short-term in-hospital outcomes of patients with diabetes mellitus (DM) when undergoing TIPS. Methods: This [...]

Background: Delirium is a common clinical syndrome, particularly among elderly patients in the inpatient hospital setting, and carries considerable associated morbidity. These patients can display symptoms of inattention, agitation, and restlessness, often necessitating the use of chemical or physical restraints to ensure the safety of the patient and staff. Unfortunately, these interventions are not without [...]

Background: Antipsychotics are frequently used in the hospital setting for managing both acute and chronic psychiatric disorders. However, antipsychotics have been associated with higher rates of mortality due to their cardiovascular risk factors, such as QT prolongation. This study aimed to determine the association between cumulative dose of antipsychotics (first and second-generation) and QT prolongation, [...]

Background: It is common practice to monitor QTc interval in hospitalized patients newly started on antipsychotics. While some guidelines exist for frequency of ordering EKGs in the outpatient setting, these may not apply to inpatients due to comorbid electrolyte disturbances or addition of other new medications. There are no evidence-based guidelines for QTc monitoring frequency [...]

Background: Antipsychotics can prolong QTc interval and lead to development of the fatal arrhythmia Torsade de Pointes. Accordingly, serial EKG monitoring of QTc in patients newly started on antipsychotics has become common practice in hospitals. By current standards, medical management of antipsychotic therapy is clinically indicated when QTc > 500ms and/or there is an increase [...]

Case Presentation: A 47-year-old woman with migraines, bipolar disorder, and hypothyroidism presented with a 2-day headache that was not improving with sumatriptan. She also complained of generalized weakness, dizziness, nausea, and vomiting. Workup revealed diabetic ketoacidosis, with blood glucose 530 mg/dL, venous pH 7.02, bicarbonate of 8 mmol/L, and anion gap 29. The patient had [...]

Case Presentation: A 63 year-old woman with a history of liver transplant presented to a rural hospital for evaluation of rigors, nausea and vomiting. Her post-transplant course had been complicated by HCV recurrence treated successfully with interferon and ribavirin; cirrhosis, and refractory gastric variceal bleeding for which she received a transjugular intrahepatic portosystemic shunt (TIPS) [...]