Case Presentation: A 17 y.o. female with systemic lupus erythematosus (SLE) presented with several weeks of worsening migratory polyarthralgia, as well as sporadic fevers, night sweats, and chills. Prednisone was begun 3 weeks prior for a presumed SLE flare, given elevated anti double-stranded DNA (anti-dsDNA) and erythrocyte sedimentation rate (ESR) and hematuria, but provided no [...]

Background: ST-segment elevation myocardial infarctions (STEMI) is a significant cause of morbidity and mortality in the United States. Inter-hospital transfers (IHT) are becoming the standard for treatment of ST-elevation myocardial infarctions (STEMIs) as specialized care is often concentrated at tertiary centers. The American Heart Association and the American College of Cardiology (AHA/ACC) recommends door-to-balloon time [...]

Background: ST elevation MI is an acute event that mandates immediate intervention. Often, resources play a major role to enable prompt intervention. Our study aims to elaborate any differences that may exist between weekend and weekday outcomes at a national level. Methods: We conducted a retrospective analysis of the Nationwide Inpatient Sample (HCUP-NIS) database. Patients [...]

Background: Systemic Sclerosis (SSc) is an autoimmune condition characterized by widespread skin fibrosis and/or end-organ damage. Previous studies have reported variable outcomes of the disease process, with males and patients of certain ethnicities suffering from the severe form of the disease leading to end-organ damage and an increase in mortality (1,2). The aim of this [...]

Background: The global impact of the COVID-19 pandemic has been profound, with significant disparities in infection and mortality rates, particularly in high-risk populations. Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that complicates patient management in the context of COVID-19, given the increased risk of infections and limited guidance on pharmacological management. Methods: This [...]

Background: The Antinuclear Antibody test (ANA) is a test often positive in patients with autoimmune rheumatologic disorders. However, ANA testing can also be positive in non-rheumatic conditions and in healthy individuals1. Prior studies have focused on the clinical utility of positive ANA testing in the outpatient setting by non-rheumatologists, but less is known about its [...]

Background: ST-segment elevation myocardial infarction (STEMI) is a cardiac emergency that requires timely reperfusion preferably with cardiac catheterization. The coronavirus disease-2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV2), has adversely impacted the delivery of healthcare to patients with STEMI. Several process changes were observed across the world during this period, including alternative cardiac [...]

Background: The “July effect” is a perceived increased risk of medical errors that occurs when US medical graduates begin residencies. There is substantial variability in results across studies of the “July effect” on patients who are admitted for heart attacks. Furthermore, studies that do show statistically significant increase in mortality at the start of residency [...]

Case Presentation: A 60-year-old man with type 2 diabetes presented with dyspnea and chest pain for 5 days during the COVID-19 pandemic. He arrived in acute hypoxic respiratory failure, with an oxygen saturation of 45% on room air. Physical exam revealed coarse lung sounds bilaterally and accessory muscle use. Initial labs were notable for leukocytosis [...]

Case Presentation: A 45 year-old woman presented with 4 hours of lower back pain, after a fall from standing. She did not report a loss of consciousness, and did not injure her head. She had no neurological deficits, nor bladder of bowel dysfunction. She denied any chest pain or dyspnea. A standard 12 lead EKG [...]