Background: Despite their elevated baseline risks for infection and thrombosis, hospitalized medical patients with active malignancy commonly receive multi-lumen peripherally inserted central catheters (PICCs). We sought to assess the relationship between number of catheter lumens and risk of PICC-related complications among patients with active malignancy. Methods: Trained abstractors collected patient level information, including number of [...]

Background: It has been unclear about prevalence and in-hospital mortality of severe hypophosphatemia among hospitalized medical patients. Predictors for in-hospital mortality have not yet been determined in terms those may include serum nadir phosphate level, hemolytic complication from hypophosphatemia, or baseline disease as a cause of hypophosphatemia . Methods: A retrospective cohort study was conducted [...]

Case Presentation: A 29 year old male with HIV/AIDS only intermittently taking antiretroviral therapy (ART), Pneumocystis jirovecii (PJP) pneumonia actively being treated with trimethoprim-sulfamethoxazole (TMP-SMX) and prednisone, and cutaneous Kaposi sarcoma all diagnosed one month ago at an outside clinic presented to the hospital with worsening cough and shortness of breath. Initial vitals were notable [...]

Background: Cancer screening guidelines based on age, biological sex, and degree of risk are intended to diagnose malignancies early and in the outpatient setting. Despite these efforts, malignancies are often diagnosed while patients are admitted to the hospital. These diagnoses are made either incidentally or after the onset of a clinical condition that necessitates an [...]

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 60-year-old, Guatemalan female without prior medical history presented with a transient, erythematous, burning, rash involving her extremities and torso (Figure 1). Additional symptoms included fatigue, chills, joint pain, early satiety and weight loss. Blood counts, metabolic panel and serum protein electrophoresis were normal. C-reactive protein (13 mg/L, normal (N)

Case Presentation: A healthy 50 year-old high school teacher with a past surgical history significant for elective bilateral breast augmentation presented to clinic for a 2-month history of dry cough unresponsive to steroids. She reported a constellation of symptoms including worsening non-exertional dyspnea, low grade fevers, night sweats, unintentional 30lb weight loss, fatigue, dry skin, and [...]

Case Presentation: A 65-year-old man with a history of nasal polyps was admitted to the hospital with a lactate of 10 mmol/L (0.5-2.2 mmol/L). He reported drenching night sweats and a 10-pound weight loss over the last 2-3 months. He noted orthostatic and ambulatory dizziness, as well as left-sided tinnitus, sinus pain, and nosebleeds over [...]

Case Presentation: 59-year-old female with no significant past medical history presented to the hospital with worsening dizziness, vertigo, and diplopia in the right eye. Vital signs were unrevealing. On physical exam, she appeared nontoxic but uncomfortable with eyes closed resting on the bed. The neurologic exam revealed severe nystagmus in the right eye, intact CN [...]

Case Presentation: A 79 year old African American female with non-ischemic cardiomyopathy, EF 35-40%, hypertension, chronic kidney disease, hypothyroidism, mild pulmonary hypertension, obesity, and mixed hyperlipidemia, presented with worsening dizziness and bipedal edema for 2 weeks. Patient reported stopping diuretics and carvedilol due to persistent hypotension for several months. Patient noted unintentional weight loss of [...]