Background: Obesity is associated with many cardiopulmonary comorbidities independently associated with worse health outcomes in acute illness, yet the physiological mechanisms potentially making obese patients more susceptible to COVID-19 remain uncertain. Adiposity-derived immunosuppression, increased thrombogenic potential, and predilection towards inflammatory hyperreactivity have all been postulated as potential mediators of this phenomenon. Yet, the most obvious […]

Background: Interhospital transfers are shown to be associated with increased length of stay (LOS), mortality, and discharge to facility.[1,2] Delirium has been associated with similar outcomes.[3] Our prior data showed that interhospital transfers had 1.91 times the risk of delirium when compared to ED admissions. We hypothesized that an interaction between admission source, namely interhospital […]

Background: Fewer hospitalized patients are discharged per day on weekends as compared to weekdays.1 Hospital medicine groups have implemented quality improvement (QI) initiatives to increase weekend discharges, however, the factors contributing to lower rates of weekend discharges are not well-described.2 To better understand contributors to missed opportunities for weekend discharge, we analyzed patients discharged on […]

Background: Alcohol withdrawal syndrome is a clinical syndrome with clinical manifestations of anxiety, insomnia, irritability, disorientation, hallucinations, seizures, and autonomic hyperactivity. Delirium tremens is the most severe manifestation of alcohol withdrawal. Although benzodiazepines are currently the first line for treatment of alcohol withdrawal, barbiturates are increasingly used for treatment as an alternative[1–3]. We need strong […]

Background: Point-of-care ultrasound (POCUS) is being adopted by hospitalists and internal medicine (IM) residencies due to its impact on procedural safety, diagnostic accuracy and efficiency, provider and patient satisfaction, and its role as a teaching adjunct in medical education. Studies demonstrating impact on system efficiency and cost are few and mostly limited to the emergency […]

Background: Constraints on resources require healthcare systems to implement alternative and innovative means for delivering care. The COVID-19 pandemic amplified this issue throughout the world, leading to shortages of ventilators, hospital beds, and healthcare personnel. We report the results of an Acute Care at Home (ACH) program’s response to COVID-19, providing in-home hospital-level care to […]

Background: Identifying COVID-19 patients at risk for long lengths of stay (LOS) may help hospitals anticipate resource limitations. There are no large representative studies from US hospitals assessing factors associated with LOS. This information is vital for resource allocation for the current and potential future pandemics. In this study, we examine factors associated with longer […]

Case Presentation: A 30-year old woman with antiphospholipid antibody syndrome secondary to lupus with extensive arterial and venous thrombotic history presented to the emergency department with left lower extremity pain, coolness, and skin blanching for seven days. She had stopped taking her chronic anticoagulation medication two months prior to admission when she ran out of […]