Hemoptysis and Unilateral Pulmonary Infiltrates due to Severe Acute Mitral Regurgitation from Papillary Muscle Rupture.

Acute mitral regurgitation typically presents with dyspnea, chest pain, and hemodynamic instability. It is an uncommon cause of hemoptysis. We present a case of a patient presenting with dyspnea and hemoptysis without hemodynamic instability along with right-sided infiltrate on chest radiography a few days after an acute inferolateral STEMI who was found to have posterior papillary muscle rupture resulting in acute mitral regurgitation. Our case illustrates that the aforementioned symptoms and signs should raise concern for acute mitral regurgitation and prompt cardiac evaluation in the appropriate clinical setting as they may mimic acute pulmonary processes and delay critical diagnosis and treatment.

Rhodococcus Empyema in an Immunocompetent Patient.

Rhodococcus (R.) equi is a gram-positive, facultative intracellular coccobacilli that most commonly causes pulmonary infections in animals and, rarely, in immunocompromised humans. Infected patients typically experience severe pulmonic infections such as necrotizing or cavitary pneumonia. We describe a rare case of R. equi that was isolated from an empyema in a 66-year-old immunocompetent patient experiencing recurrent pleural effusions requiring multiple interventions.

Can Time to Treatment Reduce In-Hospital Mortality and Morbidity Among Surgical and Nonsurgical Elderly Patients With Sepsis.

Sepsis mortality remains high and efforts to reduce it are continuing. We collected data from our patients presented to the emergency department (ED) with sepsis and performed a retrospective analysis of 1079 patients seen in the ED with sepsis during 2018 and 2020, before and after implementation of the new CDC protocol. Statistical analysis was performed using Student's t-test and chi square test as well as Cox regression analysis. The patients were divided into pre-protocol (group 1) and post-protocol (group 2). A total of 1079 patients were included in the study. The mean age was 65 + 16.86 years, divided equally between gender (male 49%, female 51%). Patients with certain comorbidities showed statistically significant survival rate in the protocol group. The current protocol for sepsis when implemented will improve patients' survival, in both surgical and medical patients and significantly in those with comorbid conditions.

Reducing duplicate patient creation using a probabilistic matching algorithm in an open-access community data sharing environment.

In an open-access community data sharing environment, Intermountain Health Care (IHC) is managing the creation of duplicate patient records through a probabilistic matching algorithm that allows the threshold limits for the returned set to be dynamically assigned to the source system. For internal hospital systems, the rate of duplicate creation was cut 30% in the first 6 months. For IHC's first community data sharing partner, the rate of duplicate creation has been maintained below the acceptable range for the internal Health Plans rate.