Hypoglycemia in the hospital: systems-based approach to recognition, treatment, and prevention.

Hypoglycemia causes immediate adverse reactions and is associated with unfavorable clinical outcomes and increased health care costs. It is also one of the barriers to optimization of inpatient glycemic control. Prioritizing quality improvement efforts to address hypoglycemia in hospitalized patients with diabetes is of critical importance.

Insular variant of poorly differentiated thyroid carcinoma.

Objective: To present a case of an insular variant of poorly differentiated thyroid carcinoma (PDTC) and to review the literature related to diagnosis, natural history, and treatment of this unusual form of thyroid cancer.

Methods: We present the clinical, laboratory, and pathologic findings of the study patient and review English-language literature related to PDTC published between 1970 and the present.

Results: PDTC is a controversial and rare epithelial thyroid cancer, intermediate between differentiated thyroid carcinoma and anaplastic thyroid carcinoma that exhibits increased aggressiveness, propensity to local recurrence, distant metastases, and increased mortality.

Calcium channel blocker-associated small bowel angioedema.

Introduction: Isolated angioedema of the small intestine is a rare entity. The cases described have been related with angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, or C1 esterase inhibitor deficiency. We present a case of small intestine angioedema caused by calcium channel blockers (CCBs) and a review of the literature.

The positive impact of initiation of hospitalist clinician educators.

Objective: Although hospitalists have been shown to improve both financial and educational outcomes, their ability to manage dual roles as clinicians and educators has been infrequently demonstrated, particularly in the community setting where large numbers of residents train. We evaluated the impact of hospitalists on financial and educational outcomes at a mid-sized community teaching hospital 1 year after implementation.

Design: Two hospitalist clinician educators (HCEs) were hired to provide inpatient medical care while participating in resident education.