Accuracy and reliability of electronic versus CDC surveillance criteria for non-ventilator hospital-acquired pneumonia.

Nonventilator hospital-acquired pneumonia (NV-HAP) is one of the most common healthcare-associated infections, but most hospitals do not track it. We created a pilot electronic definition for NV-HAP and compared its accuracy to Centers for Disease Control and Prevention (CDC) criteria. Kappa values for the electronic definition and CDC criteria versus "true" pneumonia were similar: 0.

Identification of Racial Inequities in Access to Specialized Inpatient Heart Failure Care at an Academic Medical Center.

Background: Racial inequities for patients with heart failure (HF) have been widely documented. HF patients who receive cardiology care during a hospital admission have better outcomes. It is unknown whether there are differences in admission to a cardiology or general medicine service by race.

Development and Assessment of Objective Surveillance Definitions for Nonventilator Hospital-Acquired Pneumonia.

Importance: Hospital-acquired pneumonia is the most common health care-associated infection in the United States. Most cases occur in nonventilated patients, but many hospitals track hospital-acquired pneumonia only in ventilated patients because of the complexity and subjectivity of conducting surveillance for large numbers of nonventilated patients.

Objective: To propose and assess potentially objective, efficient, and reproducible surveillance definitions for nonventilator hospital-acquired pneumonia (NV-HAP) using routine clinical data stored in electronic health record systems.

Smear Campaign: Misattribution of Pancytopenia to a Tick-Borne Illness.

We report the case of a 51-year-old woman presenting with a targetoid rash and pancytopenia after a tick bite. Initial evaluation was notable for severe neutropenia on the complete blood cell count differential, a positive Lyme IgM antibody, and a peripheral blood smear demonstrating atypical lymphocytes. While her pancytopenia was initially attributed to tick-borne illness, peripheral flow cytometry showed 7% myeloblasts, and a bone marrow biopsy confirmed 60% blasts.

Patient Perspectives on the Need for and Barriers to Professional Medical Interpretation.

Background: Individuals with limited English proficiency (LEP) constitute an increasing share of the patient population in American healthcare settings. Few studies have described the patient's perspective on barriers to medical interpretation and experiences in the clinical setting.

Methods: We conducted focus groups with 22 LEP Spanish-speaking adults.

The natural history of the benign thyroid nodule: what is the appropriate follow-up strategy?

Background: Long-term monitoring of benign thyroid nodules is not addressed in the present American Thyroid Association guidelines. The objective of this study was to determine the appropriate nature and length of follow-up for patients with a benign thyroid nodule.

Study Design: A retrospective review was performed of all patients referred to single endocrine surgeon for evaluation of thyroid nodules between 2006 and 2012.