Background: Vitamin K antagonists (VKA) remain widely used in the treatment of venous thromboembolism (VTE). During surgical interventions, the prevention of recurrent VTE must be weighed against the increased bleeding risk conferred by anticoagulation. There is a lack of strong evidence to guide the optimal periprocedural management of anticoagulation in patients with prior VTE, and [...]

Background: Atrial fibrillation (AF) is a very common condition which usually requires anticoagulation (AC). There are very clear indications of when to initiate AC but recommendations regarding bridging during elective surgery are not very clear. We here tried to answer this important question by calculating the risk of bleeding and stroke/systemic embolism (SE). Methods: We [...]

Background: Bridging anticoagulation is commonly prescribed to patients with atrial fibrillation who are initiating therapy or require interruption of anticoagulation for procedures. Current guidelines recommend bridging for patients at high risk of stroke, but no data guide this recommendation. Among patients with atrial fibrillation and one or more risk factors for thromboembolic stroke, the recently [...]

Case Presentation: A 27-year-old woman with history of hypertension, diabetes mellitus, hyperlipidemia, and family history of sudden cardiac death presents to the hospital with complaints of substernal chest pain and palpitations. She has a history of recurrent chest pain following multiple COVID-19 infections. Labs were unremarkable except uncontrolled glucose level. Electrocardiogram demonstrated normal sinus rhythm. [...]

Case Presentation: A 24-year-old male with past medical history of sickle cell trait, bicytopenia (with a negative outpatient hematology and oncology workup) and diagnosed acute rheumatic fever 7 months earlier (on prophylactic penicillin BID) presents to the emergency department with 3 weeks of fevers, night sweats, migratory arthralgias and painful subcutaneous nodules involving primarily the [...]

Case Presentation: INTRODUCTION: Disseminated gonococcal infection presents as either purulent monoarticular arthritis or as tenosynovitis, migratory polyarthralgia and vesiculopustular rash in young sexually active adults. We present an unusual case of disseminated gonococcal infection presenting as petechial rash, tenosynovitis and polyarthralgia with hypocomplementemia in a middle woman.CASE PRESENTATION: 46 years old woman medical history of [...]