Background: The Coronavirus disease 2019 (COVID-19) pandemic caused a staggering 200 million cases with over 4 million deaths globally as of August 2021. COVID-19 is associated with lung inflammation and pulmonary fibrosis. Inhaled corticosteroids (ICS) are used to improve lung function by reducing inflammation, edema, mucus secretion, and inhibiting various cytokine activities. However, there is [...]

Background: In 2020, melanoma exhibited the 5th highest incidence rate of all cancers in the US. While metastatic melanoma constitutes only 4% of new melanoma cases, the 5-year survival rate of metastatic melanoma is 27% [1]. Immune Checkpoint Inhibitors (ICIs) were the first drugs to significantly improve the 5-year survival of late-stage melanoma patients; these [...]

Background: Coronavirus disease 2019 (COVID-19) is an acute viral illness affecting multiple systems caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Ever since its first detection in Wuhan, China in Nov 2019, SARS-CoV-2 has infected over 220 million people causing more than 4.5 million deaths worldwide and the numbers are increasing. [1] Dexamethasone, a steroid [...]

Background: The 2015 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines recommend the use of systemic corticosteroids in the treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD). Although prior guidelines did not recommend a dose or route, current guidelines recommend oral (PO) prednisone over intravenous (IV) methylprednisolone for non-ICU AECOPD hospitalizations, given [...]

Background: Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity, mortality, and cost with the greatest proportion incurred treating acute exacerbations of COPD (AECOPD). While guidelines recommend oral steroids for the treatment of AECOPD, parental corticosteroids are still used in the inpatient setting; such use is associated with high costs and adverse effects. The [...]

Background: There is literature to suggest there is a subtype of COPD patients in which eosinophils may play an important role. Data suggests that this subset of patient are more prone to develop exacerbations, but also have a higher likelihood of responding to inhaled corticosteroid therapy. The objective of this study is to determine if [...]

Background: The use of intraoperative dexamethasone has been on the rise because of its ability to reduce postoperative nausea, vomiting, pain and accelerate post-operative recovery. Use of intraoperative dexamethasone can result in uncontrolled hyperglycemia in the postoperative period especially in patients with a diagnosis of diabetes. The extent and duration of post-operative steroid-induced hyperglycemia is [...]

Background: Pneumocystis jirovecii pneumonia (PJP) is an opportunistic infection associated with lymphopenic conditions including HIV/AIDS, hematologic malignancy1, organ transplantation2, and lymphocyte-suppressive therapies such as high dose glucocorticoids3,4. PJP prophylaxis, which is highly effective, is indicated when the incidence of PJP exceeds the rate of adverse events due to prophylaxis.4,7 Guidelines from the American Thoracic Society [...]

Case Presentation: A 73-year-old male with history of type 2 diabetes and one-month prior admission for acute renal failure in the setting of stage IV chronic kidney disease presented with symptomatic anemia found to have splenomegaly. A renal biopsy revealed features of membranoproliferative glomerulonephritis and necrotizing crescentic lesions with IgM kappa deposition, suspicious for cryoglobulinemic glomerulonephritis. Immunofixation [...]

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 [...]