A young man presenting with encephalopathy and seizures secondary to SARS-CoV-2.

COVID-19 has now emerged from a respiratory illness to a systemic viral illness with multisystem involvement. There is still a lot to learn about this illness as new disease associations with COVID-19 emerge consistently. We present a unique case of a neurological manifestation of a patient with structural brain disease who was COVID-19 positive and developed mental status changes, new-onset seizures and findings suggestive of viral meningitis on lumbar puncture.

Thyroid storm obscured by acute asthma exacerbation and concurrent H1N1 influenza.

We present an uncommon case of H1N1 triggered thyroid storm in a patient with previously undiagnosed Grave's Disease. This case illustrates the challenges of diagnosing thyroid storm in the emergency department and the importance of including it in the differential when treating more common diagnoses that fail to respond to usual therapies. Thyroid storm is an endocrinologic emergency and requires prompt recognition and treatment.

Posterior infundibular dissection: safety first in laparoscopic cholecystectomy.

Background: Laparoscopic cholecystectomy is still fraught with bile duct injuries (BDI). A number of methods such as intra-operative cholangiography, use of indocyanine green (ICG) with infrared imaging, and the critical view of safety (CVS) have been suggested to ensure safer Laparoscopic cholecystectomy (LC).To these, we add posterior infundibular dissection as the initial operative maneuver during LC.

A paraneoplastic syndrome exacerbated by checkpoint inhibition therapy.

Polymyalgia rheumatica is a disease characterized by systemic inflammation of the proximal muscles and pain in the hips and shoulders, but when this disease occurs contemporaneously with malignancy, there is a possibility of it being a paraneoplastic syndrome. With the advent of immunotherapies to treat various cancers, immune-related adverse events from these therapies are recognized as de novo findings or as flares of an underlying existing rheumatic disease. In this report, we present a case of polymyalgia rheumatica presenting as a paraneoplastic syndrome that was exacerbated during therapy with immune checkpoint inhibitors for recurrent melanoma.

Bowel perforation from malignant atrophic papulosis treated with eculizumab.

We present the case of a 57-year-old man with known cutaneous manifestations of malignant atrophic papulosis, also known as Köhlmeier-Degos disease, who developed an almost-fatal small bowel perforation following a parathyroidectomy. He required two surgical interventions during his initial hospitalization and was started on eculizumab. Despite these therapies, the patient developed recurrent bowel perforations and ultimately died.

Lung ultrasound in early SARS-CoV-2 pneumonia and the LUS-CoV criteria.

There is a scarcity of data on lung ultrasound (LUS) in SARS-CoV-2 pneumonia. As with many other pulmonary conditions, ultrasound may be a better diagnostic tool than routine chest radiography. In an era where computed tomography scanning is deferred because of the potential for cross-contamination, we evaluated the ability of LUS to detect a pattern of lung injury in SARS-CoV-2 pneumonia.

The implementation of lenvatinib/everolimus or lenvatinib/pembrolizumab combinations in the treatment of metastatic renal cell carcinoma.

: There are 400,000 new cases of Renal Cell Carcinoma (RCC) and 175,000 deaths worldwide every year. Currently available frontline therapies to treat RCC have less toxicity than previously employed therapeutic agents, but drug resistance is still a clinically significant problem. Drug resistance occurs through angiogenic escape by the activation of pathways that are independent of the VEGF targets of most first-line therapies.

Comparative analyses of attitude, knowledge, and recollection of preoperative counseling regarding pelvic mesh among women with or without a mesh-related complication.

Purpose: Our objective was to compare the recollection of preoperative counseling regarding mesh for pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI) among women with or without a mesh-related complication (MRC). We hypothesized that the patients who had MRC would better recollect counseling regarding complications associated with mesh.

Methods: We conducted a retrospective cohort study among women who had prior implantation of synthetic, non-absorbable mesh for POP and/or SUI at least 3 months prior who presented with or without a MRC.

Surgical Faculty Perception of Service-Based Advanced Practice Provider Impact: A Southwestern Surgical Congress Multicenter Survey.

Background: A previous single-center survey of trauma and general surgery faculty demonstrated perceived positive impact of trauma and surgical subspecialty service-based advanced practice providers (SB APPs). The aim of this multicenter survey was to further validate these findings.

Methods: Faculty surgeons on teams that employ SB APPs at 8 academic centers completed an electronic survey querying perception about advanced practice provider (APP) competency and impact.

Multicenter assessment of surgical outcomes in adult spinal deformity patients with severe global coronal malalignment: determination of target coronal realignment threshold.

Objective: The impact of global coronal malalignment (GCM; C7 plumb line-midsacral offset) on adult spinal deformity (ASD) treatment outcomes is unclear. Here, the authors' primary objective was to assess surgical outcomes and complications in patients with severe GCM, with a secondary aim of investigating potential surgical target coronal thresholds for optimal outcomes.

Methods: This is a retrospective analysis of a prospective multicenter database.

Nasal angiomyolipoma causing persistent nasal congestion.

Angiomyolipomas are benign tumors composed of blood vessels, adipose tissue, and smooth muscle. Usually, these lesions are located in the kidney and are found in association with tuberous sclerosis. The current case describes the rare presence of an angiomyolipoma within the nasal vestibule, leading to nasal obstruction.

Varicella-zoster virus causing a ring-like cerebral lesion in AIDS.

We report a 50-year-old man with a possible stroke 3 months earlier, recurrent shingles outbreaks, and male-who-has-sex-with-men status who presented to the emergency department with worsening confusion, lower-extremity weakness, gait imbalance, and incontinence. Given his clinically immunocompromised state, the patient was started on intravenous acyclovir. A human immunodeficiency virus (HIV) test returned positive, magnetic resonance imaging of the brain showed a ring-enhancing lesion, and lumbar puncture was positive for varicella-zoster virus.

Omadacycline for treatment of skin infection.

can be difficult to treat because of inherent resistance to many available antimicrobials. We present a case of a multidrug-resistant skin infection in a 52-year-old woman who presented with a 3- to 4-week history of painful, erythematous nodules on the bilateral lower extremities. She demonstrated dramatic improvement at her 4-week follow-up on omadacycline.

Safety and efficacy of male urethral slings for management of persistent stress urinary incontinence after holmium laser enucleation of the prostate.

Holmium laser enucleation of the prostate gland (HoLEP) is an alternative to the traditional transurethral resection of the prostate, especially for large-volume prostates. One complication is urinary incontinence, which is usually stress urinary incontinence (SUI). Little data exist on surgical interventions for SUI after HoLEP.

Amiodarone Toxicity Presenting with Acute Onset of Systemic Inflammatory Response Syndrome and Multiorgan Failure Mimicking Sepsis.

BACKGROUND Amiodarone, an anti-arrhythmic medication, has been associated with the development of multiple organ toxicities. Most of these toxicities develop insidiously. However, in rare cases, these toxicities manifest with more acute symptoms.

Advocacy and Collaboration: Advancing Cancer Prevention and Screening.

Background: Cancer prevention and screening is a significant part of the cancer care continuum. Nurses are trusted professionals who can bring stakeholders together and serve diverse groups.

Objectives: This article describes how nurses can advance cancer prevention and screening initiatives in industry, education, legislative advocacy, research, survivorship, and program development and support.

What lies beneath: Cutaneous involvement of mantle cell lymphoma underlying an insect-bite-like reaction.

Mantle cell lymphoma (MCL) is an uncommon subtype of mature B-cell non-Hodgkin lymphoma characterized by specific morphologic, immunophenotypic, and genetic characteristics, namely the t(11;14)(q13;q32) chromosomal translocation with resultant cyclin D1 overexpression. MCL has a generally aggressive course and is often widely disseminated at the time of diagnosis. Skin involvement is exceedingly rare and is seldom the first manifestation of MCL.

Low-Dose Computed Tomography: Effects of Oncology Nurse Navigation on Lung Cancer Screening.

Background: Low-dose computed tomography (LDCT) lung cancer screening is an evidence-based and reimbursable strategy to decrease lung cancer and all-cause mortality in qualifying patients, but there remains low use and variation in providers' LDCT screening, ordering, and referring knowledge.

Objectives: The purpose of this quality improvement project was to examine the effects of oncology nurse navigation on assisting patients and ensuring optimal LDCT lung cancer screening.

Methods: Oncology nurse navigators conducted LDCT provider education and navigated 133 eligible patients to LDCT during a five-month intervention time period.

Spontaneous sphenoid meningoencephalocele with sepsis.

Streptococci bacteremia is an unusual source of sepsis from spontaneous cerebrospinal fluid (CSF) rhinorrhea due to sphenoid meningoencephalocele. A spontaneous cause of CSF rhinorrhea should be on the differential along with trauma and congenital and neoplastic lesions. Moxifloxacin 400 mg daily for 2 weeks has a satisfactory CSF penetration to treat bacteremia due to CSF rhinorrhea.

Malignant melanoma of the cecum and small intestine.

Malignant melanoma is the most lethal skin cancer. While it represents about 5% of all cutaneous malignancies for men and women, melanoma accounts for the most skin cancer deaths Symptomatic gastrointestinal involvement from primary malignant cutaneous melanoma is uncommon and represents only 1% to 4% of melanoma cases but is found in 60% of autopsies in patients who have had a primary cutaneous melanoma. We present a case of metastatic melanoma in a 61-year-old man with initial symptomatic cecal melanoma and subsequent jejunal involvement discovered during endoscopy.

Advanced heart failure with reduced ejection fraction.

Patients suffering advanced heart failure with reduced ejection fraction (HFrEF) account for a large portion of patients admitted to hospitals worldwide. Mortality and 30-day readmission rates for HFrEF are now a focus of value-based payment models, making management of this disease a priority for hospitals, physicians, and payers alike. Angiotensin-converting enzyme inhibitors have been the cornerstone of therapy for decades.

A nanotrap improves survival in severe sepsis by attenuating hyperinflammation.

Targeting single mediators has failed to reduce the mortality of sepsis. We developed a telodendrimer (TD) nanotrap (NT) to capture various biomolecules via multivalent, hybrid and synergistic interactions. Here, we report that the immobilization of TD-NTs in size-exclusive hydrogel resins simultaneously adsorbs septic molecules, e.