Background: Rhabdomyolysis is a condition of rapid muscle breakdown resulting in myalgia, enzyme elevations, electrolyte imbalance. Released heme pigment may lead to tubular obstruction, vasoconstriction, and tubular epithelial cell injury, causing acute kidney injury (AKI) as a severe complication. Especially with predisposing conditions such as volume depletion. Early and aggressive fluid resuscitation is an essential [...]

Background: Alternative payment models have been proposed for lower extremity joint replacement surgeries to deliver well-coordinated and high quality care. It is speculated that while these payment models may lead to more cost effective care, institutions may “cherry pick” less costly and less complex patients to minimize financial risks. In this study, we aim to [...]

Background: Tobacco use is the most widespread preventable cause of cancer and is linked to 30% of cancer-related deaths.(1) Many smokers want to quit but are unsuccessful; tools such as nicotine replacement therapy (NRT) products can increase quit rates by 50-60%.(2) While smoking cessation is the ideal way to combat tobacco-related diseases, screening for diseases [...]

Background: The role of a hospitalist in treating nicotine withdrawal using counseling and medications during hospitalization can improve cessation rates of tobacco users. Clinical decision support and drug-condition alerts within the electronic medical record prompt the prescribing of medications for tobacco treatment and ease documentation of reimbursable counseling by physicians. Additionally, several hospitals have implemented [...]

Case Presentation: A 39 year-old female with a history of hypertriglyceridemia (HTG), IDDM2, and obesity presented to an outside hospital with severe epigastric abdominal pain and was diagnosed with recurrent hypertriglyceridemia-induced pancreatitis (HTGP). Intravenous insulin was started and she was transferred to our hospital for management. On arrival, she was tachycardic and tachypneic with a [...]

Background: In the inpatient setting, serum potassium (K) and magnesium (Mg) are frequently replaced for patients with values within the reference range (generally K 3.5-5.0 mEq/L, Mg 1.3-2.2 mEq/L) to target an arbitrary goal of 4 mEq/L for K and 2 mEq/L for Mg.(1,2) For certain high-risk non-pregnant adults, K and Mg replacement to these [...]

Case Presentation: Heyde syndrome is a rare multisystem disorder characterized by the triad of aortic stenosis (AS), gastrointestinal bleeding, and acquired von Willebrand syndrome (AVWS). The pathophysiology of AVWS in Heyde syndrome is thought to be due to the increased circulatory shear forces resulting from AS, leading to cleavage of large VWF multimers and loss [...]

Case Presentation: A 60-year-old man with a history of bilateral adrenalectomy for Cushing’s disease, who received hydrocortisone replacement (hydrocortisone 20 mg/day; 15 mg after breakfast and 5 mg in the afternoon) for 50 years, visited our emergency department with epigastric pain and palpitations. The symptoms manifested without any obvious cause when the patient was at [...]

Case Presentation: 81 year-old man with a history of atrial fibrillation on Warfarin and bioprosthetic aortic and mitral valves presented with dark urine and shortness of breath. He described progressive shortness of breath and reduced exercise tolerance, unable to walk upstairs to his apartment. His urine had become “the color of eggplant”. On exam, he [...]

Case Presentation: A 71-year-old man with history of coronary artery disease, aortic stenosis status post transcatheter aortic valve replacement (TAVR) two years ago, and ankylosing spondylitis presented to the emergency department for evaluation of 3 days of subjective fevers, worsening generalized weakness requiring one-person assist for ambulation, and tachycardia on his smart watch in the [...]