Background: Accumulating evidence suggests that peripherally inserted central catheters (PICCs) are associated with central line–associated bloodstream infection (CLABSI). Whether this risk is less than with traditional central venous catheters (CVCs) is unknown. We performed a systematic review and meta‐analysis of the literature to compare the risk of PICC‐related CLABSI to that of other CVCs. Methods: […]

Case Presentation: 78 year old woman with persistent non valvular atrial fibrillation was admitted with palpitation and dyspnea. She was in atrial fibrillation with rapid ventricular rate. Given symptomatic atrial fibrillation after rate control, decision was made for transesophageal echocardiogram (TEE) and elective direct current cardioversion (DCCV). She was successfully converted to sinus rhythm with […]

Case Presentation: As physicians, we frequently engage patients and families in goals of care discussions in the context of advanced serious illnesses. These discussions can be challenging for numerous reasons. We present an atypical case of a woman, who experienced acute onset of confusion, numbness, pre-syncope, chest pain, and abdominal pain, after initiating a discussion […]

Case Presentation: A 54 year old man with Hepatitis C without cirrhosis, complicated by porphyria cutanea tarda (PCT), presented with painful bruising and swelling of his legs and arms. There was no inciting trauma, he took no antiplatelet agents or anticoagulants and had no family history of coagulopathy.  He recently completed a course of pegylated […]

Case Presentation: A 58-year-old right-handed, nonsmoker, otherwise healthy male presented with episodes of vertigo and slurred speech. Vital signs were within normal range and his initial labs were noncontributory. Imaging revealed multifocal acute and subacute infarcts in the postero-occipital areas. Extensive workup did not reveal any arrhythmias, valvular abnormalities, patent foramen ovale, aortic or carotid […]

Case Presentation: A 63-year-old female, otherwise healthy, initially presented to the hospital for acute onset of chest pain and weakness for several hours. She described it as the worst pain of her life, located in the midsternal chest, associated with shortness of breath and nausea. This pain and discomfort started during an interrogation from the […]

Case Presentation: A 37-year old male with a history of hypertension presented for acute left sided flank pain while watching television. Additional symptoms included nausea, vomiting, and diaphoresis. He noticed dark-colored urine about 3 weeks ago followed by passing of blood clots in the urine for 2 weeks. He had no dysuria. He reported an […]

Case Presentation: A 27-year-old female with a history of PTSD, anxiety, and tobacco use initially presented to the emergency department with the worst headache of her life. Labs were significant for white blood cell count of 18.8 (normal 4.3 – 10.8 x 109 cells/L), troponin of 2.91 (