Case Presentation: An unvaccinated 56-year-old man with a past medical history of hypertension, insulin dependent diabetes, sleep apnea, and obesity presented to the emergency department with complaints of dyspnea, cough, fevers, and diarrhea for the past 5 days. Initial work up was significant for COVID-19, a normal troponin level, elevated inflammatory markers, creatinine of 1.57, […]

Case Presentation: A 78 year old previously healthy male presented to the hospital with 1 week of worsening confusion, shuffling gait, headache, and diarrhea. On admission, he was only oriented to person with no focal neurological deficits. Initial vitals were significant for a temperature of 49.2 oC. Imaging on admission including a chest x-ray, CT […]

Case Presentation: A 27-year-old Hispanic man with a history of hyperlipidemia and smoking (marijuana and tobacco) was initially seen by Urology for a right palpable testicular mass that enlarged over the past 2 months prior to presentation. Our patient denied a history of familial testicular cancer and a history of undescended testes. He reported no […]

Background: Non-beneficial treatment can be defined as medical interventions that are ineffective in achieving a patient’s desired goals or subject patients to discomfort without significant clinical benefit. At times, critically-ill patients are declined Intensive Care Unit (ICU) admission due to perceived lack of benefit but continue to be medically managed on the general medical floor. […]

Background: Since the onset of the novel coronavirus (COVID-19) pandemic, ongoing research exploring risk factors and adverse outcomes in COVID-19 patients has been conducted. This study examined common comorbidities observed in patients diagnosed with COVID-19 and admitted to St. Catherine of Siena Medical Center in Smithtown, N.Y. The impact of these comorbidities on level of […]

Background: A robust QI curriculum provides residents with the knowledge of QI methodologies and allows them to participate in a longitudinal QI initiative, demonstrating the skills required to implement, analyze, and present a full PDSA cycle. Limitations to having all residents in a training program be meaningful participants in ambitious QI projects are in large […]

Case Presentation: A 31-year-old man with rheumatoid arthritis (on adalimumab, methotrexate, and prednisone) presented with a 3-day history of fatigue, severe asymmetrical weakness of the lower extremities (left > right), and painful vesicular rash spanning multiple dermatomes in the left > right lower extremities (Image 1). There was no evidence of myelopathy or meningismus on […]

Background: There is recognition by educational regulatory bodies that physicians need to have some level of leadership skills. In 2007 the Residency Review Committee for Family Medicine approved a new requirement for training in leadership during family medicine residency. Seven years later in 2014, the Journal of Graduate Medical Education published the relationship between physician […]

Case Presentation: A 47-year-old male presented with distal extremity and facial weakness. Physical exam and electroencephalogram showed myopathy with myotonic features and a distal predominance, characteristic of myotonic dystrophy type 1. Patient denied any chest pain, shortness of breath, presyncope, syncope, and palpitations. Due to associated risk of cardiac-related complications, a baseline electrocardiogram (ECG) was […]

Background: Transitions of care from one service to another are a precarious time with risk of adverse events, medical errors, and clinician dissatisfaction. Every handoff involves transferring information and responsibility for a patient from one physician to another. The appropriateness of transfer is critical to safe patient care. The transfer process from an intensive care […]