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1.
NEJM Evid ; 3(6): EVIDmr2400089, 2024 Jun.
Article En | MEDLINE | ID: mdl-38804788

AbstractMorning Report is a time-honored tradition where physicians-in-training present cases to their colleagues and clinical experts to collaboratively examine an interesting patient presentation. The Morning Report section seeks to carry on this tradition by presenting a patient's chief concern and story, inviting the reader to develop a differential diagnosis and discover the diagnosis alongside the authors of the case. This report examines the story of a 52-year-old man who sought evaluation for a chronic nasal lesion that had eroded into his nasal septum. Using questions, physical examination, and testing, an illness script for the presentation emerges. As the clinical course progresses, the differential is refined until a diagnosis is made.


Nasal Septum , Humans , Male , Middle Aged , Diagnosis, Differential , Chronic Disease , Nasal Septum/pathology , Nasal Septum/diagnostic imaging
2.
Infect Control Hosp Epidemiol ; 45(3): 380-383, 2024 Mar.
Article En | MEDLINE | ID: mdl-37929617

We evaluated the prevalence and treatment of asymptomatic bacteriuria (ASB) in 17 critical-access hospitals. Among 891 patients with urine cultures from September 2021 to June 2022, 170 (35%) had ASB. Also, 76% of patients with ASB received antibiotics for a median duration of 7 days, demonstrating opportunities for antimicrobial stewardship.


Bacteriuria , Humans , Bacteriuria/drug therapy , Bacteriuria/epidemiology , Prevalence , Anti-Bacterial Agents/therapeutic use , Urinalysis , Hospitals
3.
Article En | MEDLINE | ID: mdl-38028895

The ability to provide feedback to a colleague is a key skill required for professional growth and patient safety. However, these conversations are limited by time constraints, differences in values, and a culture of "noninterference." This advocacy-inquiry-identify-teach framework creates an organized approach to initiating successful "challenging" conversations with peers.

4.
Infect Control Hosp Epidemiol ; 44(5): 813-816, 2023 05.
Article En | MEDLINE | ID: mdl-35225185

Nonspecific respiratory symptoms overlap with coronavirus disease 2019 (COVID-19). Prompt diagnosis of COVID-19 in hospital employees is crucial to prevent nosocomial transmission. Rapid molecular SARS-CoV-2 testing was performed for 115 symptomatic employees. The case positivity rate was 2.6%. Employees with negative tests returned to work after 80 (±28) minutes.


COVID-19 , SARS-CoV-2 , Humans , COVID-19/diagnosis , COVID-19 Testing , Return to Work , Hospitals
5.
NEJM Evid ; 1(1): EVIDmr2100037, 2022 01.
Article En | MEDLINE | ID: mdl-38319160

A 66-Year-Old Man with Fever and ConfusionA 66-year-old man with Parkinson's disease and hypertension presented to the ED with fever and confusion after returning to the U.S. from Cambodia. He was febrile with diaphoresis and rigors. What was the diagnosis?


Confusion , Fever , Humans , Male , Aged , Confusion/etiology , Confusion/diagnosis , Fever/etiology , Fever/diagnosis , Cambodia , Diagnosis, Differential , Parkinson Disease/diagnosis , Parkinson Disease/complications , Travel
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