Background: Antibiotics targeted against C. difficile bacteria are necessary, but insufficient, to achieve a durable clinical response because they have no effect on C. difficile spores that germinate within a disrupted microbiome. ECOSPOR-III evaluated SER-109, an investigational, biologically-derived microbiome therapeutic of purified Firmicute spores for treatment of recurrent CDI. Methods: Adults ≥18 years with recurrent [...]

Background: For 6 months in 2018, a major quaternary-care teaching hospital underwent closure of operating rooms (OR) and cardiac catheterization laboratory (CCL) due to flooding/sterilization issues and planned upgrades. Surgery and interventional cardiology trainees were reassigned to other teaching hospital sites of Yale School of Medicine, with the anticipated impact on Medicine/subspecialties not fully known. [...]

Background: Thirty-day readmission rates are increasingly used among hospitals as a quality of care indicator since research has shown that higher than expected readmission rates often lead to poor patient outcomes and high financial costs. Causes of readmission tend to be multifactorial and possibly variable dependent on systems. To investigate predictors of 30-day readmission rates, [...]

Case Presentation: A 69-year-old male with CKD Stage III and psoriatic arthritis on adalimumab (40 mg every 2 weeks) and methotrexate (20mg weekly) presents to the hospital after routine labs revealed macrocytic anemia and neutropenia. The patient was treated for right hand cellulitis 10 days ago in an urgent care setting with a dose of [...]

Case Presentation: An 80- year old immunocompetent Vietnamese man with hypertension, atrial fibrillation, and prostate cancer in remission was admitted for progressive vision loss and headaches. 6 weeks before presentation he began to have persistent, disabling left fronto-temporal headaches. 2 weeks prior he developed sudden left sided vision loss. Outpatient left temporal artery biopsy was [...]

Case Presentation: A 66-year-old man with a history of stage IIId melanoma, who received 6 cycles of Nivolumab, presented with anorexia and persistent large-volume diarrhea. Initial workup included a non-elevated white blood cell count of 6.9 k/mm3 and a creatinine of 1.6 mg/dL from baseline creatinine of 0.8 mg/dL. CT imaging of the abdomen showed [...]

Case Presentation: A 64-year-old woman with a history of ankylosing spondylitis, Crohn’s disease, asthma, and prior diagnosis of drug-induced lupus presents for a diffuse pruritic rash. Six days prior, she developed a single flat violaceous lesion limited to her left jaw and urticaria on her chest. She was started on prednisone 60 mg by her [...]

Case Presentation: A 48-year-old male with a history of hypertension and type 2 diabetes was sent to the emergency department for a “prostate x-ray” by his primary care physician due to elevated creatinine, hyponatremia, and two-day history of gross hematuria. The patient denied dysuria, fevers, chills, night sweats, and cough. He did note weight loss [...]

Case Presentation: Gradenigo’s Syndrome, an extremely rare complication of untreated otitis media, is characterized by suppurative otitis media, pain in the distribution of the trigeminal nerve, and abducens nerve palsy (1). Its pathophysiology involves spread of bacterial infection from the middle ear to the petrous apex of the temporal bone and surrounding structures. Untreated, it [...]

Case Presentation: Two months after chronic use of an abdominal binder made for weight loss and waist shaping, a 38 year-old woman presented with anuria and amenorrhea. The patient also reported nausea, bilious vomiting, extreme sensitivity to smell, and a chronic penny-like taste in the mouth. She was found to have end-stage renal disease. Workup [...]