Lentiform Fork Sign Secondary To Metformin-Induced Encephalopathy.

The Lentiform Fork sign is an imaging finding on brain MRI described by bilateral, symmetric hyperintensities in the basal ganglia. It is described in the setting of metabolic acidosis of many etiologies and is a sign of vasogenic edema. Both imaging findings and symptoms are often reversible with correction of the acidosis and removal of any identifiable triggers.

Emotional Intelligence In The Inpatient Setting.

Emotional intelligence is crucial for hospitalists as it enhances their ability to manage complex patient interactions, collaborate with healthcare teams, and navigate the emotional demands of patient care. Physicians with high emotional intelligence are better equipped to recognize and respond to patients' emotions, fostering trust and improving communication, which can lead to better patient outcomes. Additionally, emotional intelligence helps physicians cope with stress, alleviate burnout, and manage difficult conversations with patients and families, contributing to a more compassionate and effective care environment.

Recurrent Vision Loss in a Patient with Giant Cell Arteritis while on High Dose Corticosteroids.

Giant cell arteritis (GCA) is a chronic vasculitis that can lead to permanent vision loss. In this case we describe a patient with permanent monocular vision loss from GCA, managed with long-term glucocorticoids, who presented with elevated erythrocyte sedimentation rate and acute visual loss. This patient was promptly given intravenous steroids, with initial improvement, however, she again experienced acute vision loss on the fourth day of treatment.

Challenges in Diagnosing Pantoprazole-Induced Drug Fever: A Case Report in a Critically Ill Patient.

Drug fever remains a diagnostic challenge in clinical practice. Proton pump inhibitors (PPIs), like pantoprazole, are rarely implicated in drug fever cases despite their widespread use. We present a case of a 56-year-old man hospitalized for acute hematemesis, who developed persistent fever despite antimicrobial therapy.

Complications Of Colchicine Initiation in a Patient with Chronic Kidney Disease.

We report a case of a 76-year-old female with stage 4 chronic kidney disease (CKD) who experienced multiple adverse events following the initiation of colchicine for a gout flare. Diarrhea led to further complications, including acute renal failure, hypercalcemia, and bradycardia. The patient additionally developed the less common toxicities of myelosuppression and presumed myopathy, resulting in prolonged hospitalization with persistent functional impairment at the time of discharge.

Comparison of Proxy and Self-Reported Functional Ability in Heart Failure Patients with Cognitive Impairment.

Background: Heart failure (HF) patients often experience cognitive impairment that negatively impacts self-management ability, predisposing these individuals to worse post-hospitalization outcomes. Patient proxies may have more insight into a patient's self-management capability especially in the context of patient cognitive impairment. Here, we incorporate proxy input to evaluate associations between patient- and proxy-reported capacity for instrumental activities of daily living (IADL) stratified along a patient's cognitive function in an older hospitalized heart failure population.

Small cell neuroendocrine carcinoma of vagina: Report of a unique case with literature review.

Small cell carcinoma (SCC) of vagina is extremely rare. The association between this tumor and high-risk HPV infection is unclear. To our knowledge, HPV status has been reported in only 3 previous cases of SCC of vagina.

Effect of Ketamine on Vasopressor Needs in Mechanically Ventilated Patients: A Retrospective Study.

Background: Ketamine has many recognized effects that may be beneficial in patients undergoing mechanical ventilation. While ketamine provides sedation and analgesia, it has additional sympathomimetic properties that may help support critically ill patients in shock. We hypothesized patients undergoing mechanical ventilation with continuous ketamine infusion as an adjunct to sedation agents would be associated with a lower vasopressor requirement.

Metastatic Merkel Cell Carcinoma.

Merkel cell carcinoma is a rare, aggressive skin cancer that affects mainly the sun exposed areas in the elderly, especially the head and neck. Immunohistochemical analysis is necessary to establish diagnosis. We describe an elderly male who presented with hematochezia and was incidentally noted to have liver lesion on abdominal imaging, which was subsequently diagnosed as Merkel cell carcinoma.

Outcomes of Elderly Patients Undergoing Left Atrial Appendage Closure.

Background Elderly patients have a higher burden of comorbidities that influence clinical outcomes. We aimed to compare in-hospital outcomes in patients ≥80 years old to younger patients, and to determine the factors associated with increased risk of major adverse events (MAE) after left atrial appendage closure. Methods and Results The National Inpatient Sample was used to identify discharges after left atrial appendage closure between October 2015 and December 2018.

Palliative Care Consultation Reduces Heart Failure Transitions: A Matched Analysis.

Background Palliative care supports quality of life, symptom control, and goal setting in heart failure (HF) patients. Unlike hospice, palliative care does not restrict life-prolonging therapy. This study examined the association between palliative care during hospitalization for HF on the subsequent transitions and procedures.