Background: Recent studies suggest that glucose gel is effective for treating neonatal hypoglycemia, thus it may reduce neonatal intensive care unit (NICU) admissions. The purpose of this study is to compare NICU admissions and care for hypoglycemia pre- and post-implementation of a glucose gel protocol for the management of neonatal hypoglycemia. Methods: This is a [...]

Case Presentation: 42 year old male with history of alcoholism and chronic tophaceous gout on allopurinol, presented with acute left elbow pain and swelling. Exam showed synovitis of left wrist and elbow, distal interphalangeal joint (DIJ) and right knee and tophi  on left DIJ.  Arthrocentesis of left elbow revealed purulent fluid with leukocytosis (5000,000/mm3) and [...]

Case Presentation: A 70-year-old male with a history of hypertension and alcohol use disorder was referred to our ED for persistently elevated lipase. Two weeks prior he was admitted to an outside hospital for alcohol induced pancreatitis. On presentation, he reported bilateral ankle pain. Vitals were unremarkable. Physical examination was significant for bilateral erythematous, edematous [...]

Case Presentation: 35-year-old Caucasian gentleman who was diagnosed with alpha-1 antitrypsin deficiency (PiZZ) 2 years ago. Two weeks prior to the hospitalization, he noticed skin nodules on both sides of the abdominal wall and in the upper thighs. He also noticed a lesion that looked like a boil on his right shin, started draining and [...]

Case Presentation: A 41- years- old male with no medical problems but daily alcohol and tobacco abuse developed sudden right and then left foot pain with swelling 2 weeks before admission. Diagnosis of gout was diagnosed at another hospital and he was treated with steroids with no symptom relief; the right wrist swelling prompted empiric [...]

Case Presentation: A 65-year-old man with a past medical history of gout and chronic pancreatitis complicated by pseudocyst presented with bilateral lower leg swelling, erythema, and pain for few weeks. The rash was also associated with bilateral lower extremity nodules that would spontaneously open and discharge white material. He was seen and treated in the [...]

Case Presentation: A 42-year-old woman with no past medical history presented to the emergency department with four days of facial swelling and progressive, painless skin lesions on her back and extremities. Six months prior to presentation, the patient reported dark patches on her bilateral lower extremities while experiencing fever and chills. A skin biopsy was [...]

Case Presentation: Inflammatory polyarthritis and panniculitis are rare sequela of pancreatic disorders. This condition has been termed Polyarthritis, Panniculitis and Pancreatitis (PPP) and occurs in less than 5% of patients with underlying pancreatic disease.  A 64 year old man presented with chronic erythematous, edematous, and tender subcutaneous nodules on all four extremities. He also had bilaterally [...]

Case Presentation: A 56 year-old woman with past medical history of gastritis and past surgical history of appendectomy and C-section presented with a six-month history of intermittent abdominal discomfort, non-bloody diarrhea, nausea and bloating that was significantly worsening during the week prior to admission. In a span of six months, the patient was noted to [...]

Background: Information about how genetic testing is used in the NICU and how it changes clinical management is limited. In addition, genetic testing strategies are rapidly evolving, and having a baseline understanding of our current testing strategies and their clinical utility is important. Among infants admitted to children’s hospitals NICU, about 10-30% have a congenital [...]