Background: Chest pain and related symptoms are the number two reason patients visit emergency departments in the United States, often leading to routine hospitalization or observation. Improving utilization management of patients presenting to the emergency department with chest pain is an important goal for hospitals. Use of 5th generation troponins and risk stratifying tools can [...]

Background: The role of bedside ultrasound to evaluate traumatic cardiac injury and aortic aneurysm rupture is well established. However, there is a lack of robust data to support the accuracy of use of immediate ultrasonography procedures at the point of care to detect other cardiovascular conditions. Aim of this umbrella meta-analysis was to evaluate a [...]

Background: In 2016, the United States resettled 96,900 refugees. In addition to its share of US resettled refugees, New Mexico was among the 10 states with the largest share of undocumented migrants (85,000) in 2014. As a humanitarian effort, refugee resettlement programs give priority to the most vulnerable cases, leading to a community in need [...]

Background:  Transthoracic echocardiography (TTE) is one of the most popular tests in healthcare. Studies of Medicare beneficiaries for example have shown that each year approximately 20% undergo at least one TTE. Repeat TTE defined as TTE done within one year of a prior TTE represent 24-42% of all studies. In the present study we derive [...]

Case Presentation: This patient was a 32 year old male with one week of fevers, coughing, and shortness of breath. On examination, the patient was tachycardic with an oxygen saturation of 85%. He had increased work of breathing with accessory muscle use, but no crackles or wheezing. Complete blood count showed leukocytosis. CT angiogram showed [...]

Case Presentation: A 64 year old male presented with a three day history of fever, hand soreness and rash.  On the day of presentation, he had just returned from the Caribbean, however denied any history of ill contacts, recent hiking or contact with large bodies of water.  There were no known allergies, recent changes in [...]

Case Presentation: A 49 year-old man with a recent diagnosis of myasthenia gravis presented with 3 days of fever up to 103, rhinorrhea, frontal headache, mild lower extremity weakness, a mildly productive cough, and a leukocytosis to 16. As he had been started on prednisone and azathioprine 10 days prior to his presentation, he underwent [...]

Case Presentation: A 40 year-old male with a past medical history of HIV presented with two days of fever, emesis and diarrhea. Two weeks prior he had seen his PCP and had a CD4 650cells/mcL with an undetectable viral load. He was started on Abacavir/Dolutegravir/Lamivudine and had been taking it as directed. On admission he [...]

Case Presentation: A 54-year-old female with no significant past medical history presented with lip swelling and shortness of breath following shellfish ingestion. She denied chest pain. Due to concern for angioedema, she received intramuscular epinephrine, intravenous methylprednisolone, diphenhydramine and famotidine. A 12-lead electrocardiogram revealed 2 mm ST segment elevation in leads II, III and aVF [...]

Case Presentation: A 70 year old WM with a history of myasthenia gravis on prednisone for about 1 year prior to admission was admitted with fever, rash and pyuria. Two weeks prior to admission he was started on Azathioprine as his prednisone was being tapered. About 5 days PTA he developed a pustular rash, transient [...]