Case Presentation: A 50-year-old woman with history of ESRD on PD, CHF, and recent invasive pulmonary aspergillosis on posaconazole presents with three days of gradually progressive shortness of breath and right-sided chest pain. The chest pain was associated with coughing and deep breathing, but non-exertional with no hemoptysis. The patient lived with her sister and [...]

Case Presentation: We describe a 55-year-old lady who presented with a three-day-history of right-sided ptosis, and ophthalmology. She also reported diplopia, subjective fevers, anorexia, and an unintentional weight loss of five pounds over the preceding ten days. She denied headaches, nausea, and vomiting. Her medical problems include HIV, on highly aggressive antiretroviral therapy, history of [...]

Case Presentation: Pachymeningeal enhancement (PME) is a radiological phenomenon describing the enhancement of the dura and outer layer of the arachnoid meninges best appreciated on contrast-enhanced MRI. We present a case of diffuse PME in the setting of a transient ischemic attack (TIA) which has been previously unreported. An 83-year old female with a history [...]

Case Presentation: A 51-year-old male with history of chronic lower back pain on opiates presented with acute abdominal pain along with nausea/vomiting. The patient was concerned about constipation secondary to opiate use and used a makeshift enema at home, after which he noted bleeding from the rectum. He presented for medical evaluation and on physical [...]

Case Presentation: Our patient is a 27 y/o male with PMHx of HIV (CD4 count 740, HIV viral load 100 copies/mL), Type I Diabetes who presented to the emergency room for tachycardia and fever. ED vitals notable for temperature of 39.1° C and heart rate of 108. White blood cells notable to be 13.8 thousand/mcL. [...]

Case Presentation: A 53-year-old female with a history of triple negative left breast mammary carcinoma post neoadjuvant carboplatin and taxol initially followed by dose- dense Adriamycin/Cytoxan was found to have leptomeningeal disease (LMD). She came to the hospital for planned systemic methotrexate. (MTX) The patient refused to get intrathecal MTX which was considered initially given [...]

Case Presentation: A 79-year-old patient with a history of esophageal cancer status post esophagectomy six years prior with neo-esophagus creation and chemotherapy currently in remission, was admitted for upper tract gastrointestinal (GI) bleeding. An esophagogastroduodenoscopy (EGD) demonstrated several non-bleeding gastric ulcers. Given stability and resolution of the bleeding, the patient was discharged home. Later that [...]

Case Presentation: A 54-year-old female with essential hypertension, hyperlipidemia, hypothyroidism and MGUS presented to Wheeling Hospital complaining of weakness, dyspnea on exertion and right lower extremity pain for two weeks. Patient was treated for a right gastrocnemius DVT, acute SARS-CoV-2 pneumonia and pulmonary emboli in right middle and lower lobe pulmonary artery branches with smaller [...]

Background: The advent of endoscopic ultrasound guided celiac plexus neurolysis (EUS-CPN) has provided immeasurable benefits for patients with pain from pancreatic malignancies. Here, we aim to characterize efficacy of various agents used in EUS-CPN for reducing pain secondary to pancreatic cancer by performing a systematic review and meta-analysis. Methods: Using predefined keywords, a search was [...]

Background: Oxygen saturation (SpO2) is often overestimated in darker skinned individuals (1–3), but the ideal method to quantify this phenomenon and measure its impact on clinical outcomes is unclear. Studying the distributions of SpO2 may not be the appropriate method because these distributions are influenced by clinicians’ real time efforts to maintain SpO2 in a [...]