Hand washing with soap and water is significantly more effective at removing C. difficile spores from the hands of volunteers than are ABHRs. Residual spores are readily transferred by a handshake after use of ABHR.

Sarcoidosis is a systemic, clinically heterogeneous disease characterized by the development of granulomas. Any organ system can be involved, and patients may present with any number of rheumatologic symptoms. There are no U.S. Food and Drug Administration–approved therapies for the treatment of sarcoidosis. Diagnosing sarcoidosis becomes challenging, particularly when its complications cause patients’ symptoms to mimic other conditions, including polymyositis, Sjögren syndrome, or vasculitis. This review presents an overview of the etiology of and biomarkers associated with sarcoidosis. We then provide a detailed description of the rheumatologic manifestations of sarcoidosis and present a treatment algorithm based on current clinical evidence for patients with sarcoid arthritis. The discussion will focus on characteristic findings in patients with sarcoid arthritis, osseous involvement in sarcoidosis, and sarcoid myopathy. Arthritic conditions that sometimes coexist with sarcoidosis are described as well. We present two cases of sarcoidosis with rheumatologic manifestations. Our intent is to encourage a multidisciplinary, translational approach to meet the challenges and difficulties in understanding and treating sarcoidosis.

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Background Vaccines against SARS-CoV-2 virus have been available since December 2020. Vaccination rates amongst hospitalized patients at our institution remained low at about 40%, thus we sought to understand the drivers of vaccine hesitancy in our patient population. Methods All unvaccinated adult patients admitted to our hospital were asked to participate in a survey to assess COVID-19 vaccine hesitancy. Updated vaccination status was collected at the end of the study. Results 97 patients agreed to participate, of which 34% were SARS-CoV-2 positive on polymerase chain reaction (PCR) testing. Of the 64 participants eligible to receive the vaccine, 57.8% were agreeable but only 27% received the vaccine before discharge. Conclusion Many patients are willing to receive the vaccine and hospitalization provides a unique opportunity to interact with patients who have been otherwise unaware, unable, or unwilling to pursue vaccination outside of the hospital.

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Introduction: Cardiac amyloidosis (CA) portends a poor prognosis in heart failure (HF) patients. While CA is being diagnosed with an increasing frequency, it is not known whether the knowledge of a diagnosis of CA influences HF readmissions or hospital length of stay (LOS). Methods: Data on HF readmission and hospital LOS was collected for patients undergoing Technetium pyrophosphate (PYP) imaging for CA between January 2018 to December 2020 from our institution’s Business Intelligence reports. CA was confirmed by a combination of PYP imaging and assessment of monoclonal proteins. Number of readmissions per patient per year and the mean cumulative LOS per year were calculated for those with and without confirmed CA. Date of confirmatory testing was used as a cut-off for comparison of HF readmission and LOS prior to and after diagnosis of CA. Results: A total of 112 patients underwent PYP imaging during the study period, of which 30 (27%) had CA (transthyretin=26; light-chain=4). Patients with CA were similar in proportion of African Americans (90%) and gender (57% women) compared to those without CA, but were older on average (76.7 vs 69.4 years, p=0.002). Patients with CA had more frequent HF readmissions prior to and after their diagnosis compared to those without CA (Figure). While both had similar LOS prior to confirmatory testing, LOS was significantly higher in CA patients following diagnosis. Patients without CA saw a significant decline in HF readmission and LOS after performance of confirmatory testing, contrasting with CA patients whose readmissions rates and LOS remained unchanged before and after confirmation of the diagnosis. Conclusions: Patients with CA have more frequent HF readmissions and a higher annual LOS when compared to those without CA. Confirmation of CA diagnosis has no effect on these outcomes. Patients with CA may require more tailored interventions to reduce their acute care healthcare utilization.