Background: Academic children’s hospitals are increasingly partnering with community hospitals to provide inpatient neonatal and pediatric care in the patient’s own community. Although some academic hospitals are hesitant to form these partnerships due to concern for decreasing incoming transfers, few studies report the true effect of such collaboration. Our strategy involved such a partnership that [...]

Background: There is literature to suggest there is a subtype of COPD patients in which eosinophils may play an important role. Data suggests that this subset of patient are more prone to develop exacerbations, but also have a higher likelihood of responding to inhaled corticosteroid therapy. The objective of this study is to determine if [...]

Background: Over 5 million people in the United States are diagnosed with heart failure (HF) and many continue to be hospitalized for exacerbations of this disease. An estimated 20 million Americans have been diagnosed with some form of thyroid disease. Thyroid hormones significantly impact cardiac muscle functions and elevated levels of thyroxine (T4), as seen [...]

Background: Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infection associated with lymphopenic conditions including HIV/AIDS, hematologic malignancy1, organ transplantation2, and lymphocyte-suppressive therapies such as high dose glucocorticoids3,4. PJP prophylaxis, which is highly effective, is indicated when the incidence of PJP exceeds the rate of adverse events due to prophylaxis.4,7 Guidelines from the American Thoracic Society [...]

Background: Choroidal melanoma, the most common primary intraocular malignancy in adults, is a dangerous cancer which can lead to blindness. Diagnosed at an average age of 65 & lacking identifiable environmental or genetic factors, melanoma of the eye can affect anyone. Commonly found on routine ophthalmological screening, patients are sent to quaternary hospitals for further [...]

Case Presentation: A 78-year-old woman with severe persistent asthma on a maximum dose of inhaled corticosteroids (ICS) was admitted for lethargy and skin nodules on her thighs. She had three hospital admissions in the past two months for reported pneumonia. She was found to have fever, left basilar crackles, and multiple violaceous, firm, tender subcutaneous [...]

Case Presentation: A 20-year-old male with past history of asthma presented initially with bloody diarrhea and subjective fever of one day’s duration. Upon evaluation vital signs revealed temperature of 103 F, and tachycardia. On physical examination there was generalized abdominal tenderness with normal bowel sounds. Thrombocytopenia was present with platelet count of 46 k/ul. Antibiotics [...]

Case Presentation: A 73-year-old female with PMH of iron deficiency anemia, laparoscopic cholecystectomy, and hernia repair had received iron transfusions as well as blood transfusion. Despite which, her hemoglobin remained low, 7.3gm/dl. She was fatigued, but denied abdominal pain, black stool, vomiting blood, fevers or chills. She had an upper endoscopy that was unremarkable as [...]

Case Presentation: A 47-year-old Hispanic female smoker presented with aone-week history of severe, intermittent substernal chest pain radiating tothe left arm. The pain was associated with palpitations and shortness ofbreath. She was afebrile with a heart rate of 100, a blood pressure of119/59, a fine tremor, and brisk reflexes. No lid lag or proptosis wasappreciated. [...]

Case Presentation: A previously healthy 38-year-old man presented with 8 days of intermittent colicky RUQ pain and jaundice. He denied any OTC or illicit drug use but did report daily alcohol use. On admission HAV, HBV, HCV, and HIV 1 & 2 screening, urine drug screen, and autoimmune workup were negative. Ceruloplasmin, serum copper, serum [...]