Background: Individuals with autoantibodies against melanoma differentiation-associated protein 5 (MDA-5) are reported to have a significant risk of developing rapidly progressive and fatal interstitial lung disease (ILD) in clinically amyopathic dermatomyositis patients (CADM). Previous cohort studies of dermatomyositis patients who have been systematically evaluated for the presence of anti-MDA5 antibodies and associated clinical features and [...]

Background: The possibility of outpatient evaluation of suspected transient ischemic attack has previously been considered in studies, and some have suggested that outpatient evaluation of suspected TIA may be safe and cost-effective in patients at lower risk of stroke as measured by the ABCD2 score. However, no consensus has been reached on the optimal strategy [...]

Background: Geographic information science and technology (GIST) is an academic field that explains the importance of geospatial data and analysis. GIST is a powerful tool that has been successfully implemented to help address a number of significant health issues ranging from disease management to improved services. In this study, we have used GIST to help [...]

Case Presentation: A 50-year-old male with history of gastric lap band, obstructive sleep apnea, hypertension, and type 2 diabetes presented with two months of worsening shortness of breath. He denied cough, fever, myalgias, diarrhea, loss of sense of taste or smell, or pleuritic chest pain. He had no history of asthma, COPD, or tobacco use. [...]

Case Presentation: A 68-year-old man with hypertension and osteoarthritis presented with fever, cough, dyspnea, and weight loss for 2 months. Prior to admission, he had received antibiotics for community-acquired pneumonia without improvement. Physical exam showed multiple ulcers at the base and sides of tongue, bilateral palmar erythematous papules with ulceration and scaling, bilateral erythematous plaques [...]

Case Presentation: This patient is a 74-year old male with CAD, HFpEF, HTN, Type 2 DM, CKD3, and obesity admitted for sepsis secondary to bilateral lower extremity purulent cellulitis, complicated by acute decompensated heart failure. He was started on cefepime 2 g twice daily and on vancomycin (vanco), dosed daily by level. After receiving only two doses of vanco 1g, the patient was found to have persistently elevated [...]

Case Presentation: A 40-year-old woman with no prior past medical history presented to the emergency room with several weeks of dysphagia, rash on her face, hands, chest, accompanied by fatigue, malaise, followed by progressively worsening shortness of breath. Over 8 weeks, she also developed a rash over her dorsal hands and upper chest wall, associated [...]

Case Presentation: 64-year-old female with a past medical history of cerebral palsy presented with recurrent fever. One week earlier, she had been hospitalized for sialadenitis and pneumonia and completed a 10 day course of antibiotics. Family reported recurrent fevers (Tm 102F) after discharge with associated mucosal ulcerations and chronic intermittent joint pain. She did not [...]

Case Presentation: A 42-year-old male with past medical history of morbid obesity and methamphetamine abuse presented to the ED with a chief complaint of the right hand and arm weakness, tremors, numbness, and tingling. Three days prior to the admission, the patient reported awakening nausea and vomiting. The following day, the patient stated his right [...]