Nephrotic Syndrome in Adult Patients With COVID-19 Infection or Post COVID-19 Vaccine: A Systematic Review.

Nephrotic syndrome is a condition characterized by damage to podocytes that results in significant proteinuria, edema, hyperlipidemia, and hypercoagulability. Infections and malignancies are frequently associated with nephrotic syndrome. The COVID-19 virus has been associated with several atypical presentations of upper respiratory infections and acute kidney injury.

Phase III Prospectively Randomized Trial of Perioperative 5-FU After Curative Resection for Colon Cancer: An Intergroup Trial of the ECOG-ACRIN Cancer Research Group (E1292).

Background: Studies suggest that adjuvant chemotherapy should be initiated at the earliest possible time. The Eastern Cooperative Oncology Group (ECOG) and Intergroup evaluated the effect of perioperative fluorouracil (5-FU) on overall survival (OS) for colon cancer.

Patients And Methods: This phase III trial randomized patients to receive continuous infusional 5-FU for 7 days starting within 24 h after curative resection (arm A) or no perioperative 5-FU (arm B).

FDA-Approved Pharmacotherapy for Weight Loss Over the Last Decade.

Obesity is a recently defined illness whose diagnosis and treatment continue to be stigmatized. Currently, due to lifestyle changes brought on by technological advancements and the wide availability and affordability of high-calorie foods, millions of people around the world suffer from obesity and/or its sequelae. Finding adequate prevention and treatment options would therefore lead to massive improvements in the duration and quality of life of affected individuals.

Neuroendocrine Carcinoma of the Esophagus With Liver Metastasis: A Case Report.

Neuroendocrine carcinoma (NEC) of the esophagus is a rare and aggressive malignancy. It is challenging to manage NEC due to its rarity. NEC may be asymptomatic or present with various symptoms such as dysphagia, abdominal discomfort, weight loss, melena, hot flushes, or diarrhea.

Effects of COVID-19 on Surgical Delays in Patients with Breast Cancer in NYC Public Hospitals: A Multicenter Study.

Background: Increased time to surgery (TTS) is associated with decreased survival in patients with breast cancer. In early 2020, elective surgeries were canceled to preserve resources for patients with coronavirus disease 2019 (COVID-19). This study attempts to measure the effect of mandated operating room shutdowns on TTS in patients with breast cancer.

Food to Overcome Outcomes Disparities: A Randomized Controlled Trial of Food Insecurity Interventions to Improve Cancer Outcomes.

Purpose: Food insecurity is prevalent among low-income immigrant and minority patients with cancer. To our knowledge, this randomized controlled trial is the first to prospectively examine the impact on cancer outcomes of food insecurity interventions, with the goal of informing evidence-based interventions to address food insecurity in patients with cancer.

Methods: A three-arm randomized controlled trial was conducted among food-insecure (18-item US Department of Agriculture Household Food Security Survey Module score ≥ 3) patients with cancer (N = 117) at four New York City safety net cancer clinics.

Comparison of COVID-19 outcomes in patients with Type 1 and Type 2 diabetes: A systematic review and meta-analysis.

Background And Aims: This systematic review and meta-analysis aimed to evaluate the current evidence available to investigate clinical outcomes between patients with type 1 and type 2 diabetes.

Methods: MEDLINE (Pubmed), Scopus, Web of Science, Cochrane library, Google scholar and Clinicaltrials.gov were searched.

Coronary Artery Calcium Score directed risk stratification of patients with Type-2 diabetes mellitus.

Background And Aims: This study aimed to review the available data on the role of coronary artery calcium (CAC) scoring as the preferred adjunct modality to improve risk prediction and reduce the incidence of major adverse cardiac events and mortality in T2DM patients.

Methods: We reviewed the findings of 21 studies.

Results: This study revealed that the CAC scoring system could enhance cardiovascular disease (CVD) risk stratification and positively affect the medical management of patients with T2DM.

Increased Attendance During Rapid Implementation of Telehealth for Substance Use Disorders During COVID-19 at the Largest Public Hospital System in the United States.

Objective: The objective of this study is to examine differences between; telehealth and in-person visits during COVID-19 and in a pre-COVID-19 reference period; COVID-19 televisit completion for patients with varying engagement in treatment during the reference period.

Methods: Electronic medical record data were collected and analyzed with chi-squared or -tests to compare patient demographics. Generalized estimating equations for estimating the odds of outcomes were used, controlling for demographics.

T-wave Inversions in Cerebellar and Occipital Lobe Infarcts in the Setting of Deep Vein Thrombosis and Pulmonary Embolism Suggestive of Paradoxical Emboli: A Case Report.

Cardiological causes account for the majority of acute electrocardiographic (ECG) changes. The reason for this fear is the irreversibility of myocardial necrosis. Generally, various changes can be observed in the ECG, including ST-T changes, QTc prolongation, arrhythmias, and T-wave inversions.

The Impact of COVID-19 Infection on a Neurologically Compromised Male With Fahr's Disease Presenting With Acute Delirium and Aspiration Pneumonia: A Case Report.

Fahr's disease or idiopathic basal ganglia calcification is a rare, sporadic, genetically dominant, and inherited neurological condition that manifests with dysphagia and Parkinson's disease. The computed tomography (CT) scan is the method of choice to diagnose basal ganglia calcifications seen in Fahr's disease. This case report elaborates on the emergency management of a 58-year-old male patient with acute respiratory distress, acute delirium, schizophrenia, Fahr's syndrome, and history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease 2019 or COVID-19) infection.

Factors Impacting Stent Thrombosis in Patients With Percutaneous Coronary Intervention and Coronary Stenting: A Systematic Review and Meta-Analysis.

Stent thrombosis (ST) is a frequently reported complication in cardiac patients with percutaneous coronary intervention (PCI) that adversely impacts their prognostic outcomes. Medical literature reveals several baseline characteristics of PCI patients that may predict their predisposition to ST and its potential complications. Our systematic review and meta-analysis aimed to determine the diagnostic significance of these baseline parameters in terms of determining the risk of ST among adult patients with PCI.

Systemic Lupus Erythematosus vs. Mixed Connective Tissue Disease Disguised As Scabies.

Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that involves numerous body systems and may initially present as a malar or discoid rash. When there are features of other autoimmune disorders present, such as scleroderma or polymyositis, the term mixed connective tissue disorder (MCTD) may be used. The current literature illustrates that the diagnostic criteria for MCTD are unclear.

Endovascular Endocarditis Within the Superior Vena Cava of a Patient With a Tunneled Catheter for Hemodialysis.

Tunneled hemodialysis catheters, such as permacaths, are frequently used for vascular access in end-stage renal disease (ESRD) patients. The use of these catheters is associated with bloodstream infections, thromboses, and infective endocarditis. While valvular endocarditis is a more common entity, non-valvular endovascular endocarditis is less commonly reported in the literature.

Understanding pancreatic cancer stem cells and their role in carcinogenesis: a narrative review.

Objective: The purpose of this review article is to describe the pathogenesis of pancreatic cancer and to better understand the role of abnormal stem cells in the development of pancreatic cancer.

Background: Pancreatic cancer is a highly fatal disease that is caused by the uncontrolled proliferation of pancreatic exocrine or neuroendocrine glands. It is believed that pancreatic cancers arise from a small population of abnormal cancer stem cells (CSCs) that promote tumorigenesis, tumor metastasis and therapeutic resistance.

The Dilemma in the Management of Thromboembolic Disease in the Setting of Concomitant Aortic Pseudoaneurysm.

Ascending aortic pseudoaneurysm (AAP) is a rare and serious complication of cardiothoracic surgeries or blunt chest trauma. We present a patient with paroxysmal atrial fibrillation, acute right pontine stroke, and acute pulmonary embolism (PE) with an incidental AAP that precluded the use of anticoagulation and surgery. The case findings substantiate the need for a CT-based assessment of aortic pathology after coronary artery bypass grafting (CABG) in the asymptomatic patient to determine the most appropriate treatment modalities.

Life-Threatening Microangiopathy or Vitamin Deficiency: A Case Report of the Clinical Manifestations of Pseudo-Thrombotic Microangiopathic Anemia.

Hemolytic anemia with thrombocytopenia and organ damage raises suspicion for thrombotic microangiopathy (TMA), a pathology that results in thrombosis within the small vessels secondary to endothelial injury. While usually attributed to atypical hemolytic uremic syndrome (aHUS) or thrombotic thrombocytopenic purpura (TTP), an increasingly recognized and treatable entity is pseudo-thrombotic microangiopathic anemia (pseudo-TMA) secondary to severe vitamin B-12 deficiency. While TMA often requires expensive diagnostic testing and can lead to invasive treatment options such as plasma exchange, immunosuppression, and/or complement cascade blocking, pseudo-TMA requires only vitamin supplementation.

The impact and efficiency of medical screening exams in forward treatment areas at New York City public hospitals during the initial COVID-19 surge.

Background: New York City (NYC) emergency departments (EDs) experienced a surge of patients because of coronavirus disease 2019 (COVID-19) in March 2020. NYC Health and Hospitals established rapid medical screening exams (MSE) and each hospital designated areas to perform their MSE. Five of the 11 hospitals created a forward treatment area (FTA) external to the ED to disposition patients before entering who presented with COVID-like symptoms.

Clostridium difficile Infection Complicated by Transformation of Myelodysplastic Syndrome to Acute Myeloid Leukemia With Leukostasis and Sweet's Syndrome.

Myelodysplastic syndrome (MDS) is a premalignant condition characterized by clonal proliferation and ineffective hematopoiesis. The subtype of MDS associated with deletion in the long arm of chromosome 5 is generally associated with older females and carries a good prognosis as it rarely transforms to acute myeloid leukemia. The mechanisms of leukemic transformation are still poorly understood and likely involve a variety of somatic mutations and epigenetic modifications.

Cross-sectional study evaluating the seroprevalence of SARS-CoV-2 antibodies among healthcare workers and factors associated with exposure during the first wave of the COVID-19 pandemic in New York.

Objective: Estimate the seroprevalence of SARS-CoV-2 antibodies among New York City Health and Hospitals (NYC H+H) healthcare workers during the first wave of the COVID-19 pandemic, and describe demographic and occupational factors associated with SARS-CoV-2 antibodies among healthcare workers.

Design: Descriptive, observational, cross-sectional study using a convenience sample of data from SARS-CoV-2 serological tests accompanied by a demographic and occupational survey administered to healthcare workers.

Setting: A large, urban public healthcare system in NYC.

The Appearance of an Underrecognized Congenital Heart Disease in a Patient With COVID-19 Pneumonia.

A 60-year-old woman presented to the emergency department with worsening shortness of breath and non-productive cough for 1 week, which was preceding a recent COVID-19 infection. At the time the patient thought this was part of the constellation of symptoms of COVID-19, so she stayed home until her symptoms worsened to the point of needing hospitalization. The patient was found to have a rare and complex congenital heart disease that led her to develop acute heart failure precipitated by COVID-19 pneumonia.

Liver Kidney Crosstalk: Hepatorenal Syndrome.

The dying liver causes the suffocation of the kidneys, which is a simplified way of describing the pathophysiology of hepatorenal syndrome (HRS). HRS is characterized by reversible functional renal impairment due to reduced blood supply and glomerular filtration rate, secondary to increased vasodilators. Over the years, HRS has gained much attention and focus among hepatologists and nephrologists.

Adrenal Insufficiency in patients with cardiogenic shock: A meta-analysis.

Background: Adrenal Insufficiency (AI) is rarely observed in patients with cardiogenic shock (CS). We aimed to identify the prevalence of AI in patients with CS and its effect on their clinical outcomes.

Aims: Our study aimed to determine the prevalence of AI in CS patients who underwent treatments for CS.

Diabetes Mellitus and COVID-19: Review Article.

Background And Aims: We aim to cover most of the current evidence on the mutual effect of diabetes & COVID-19 infection on each other and the management of the COVID-19 patients with diabetes.

Methods: We utilized databases to review the current evidence related to diabetes mellitus and COVID-19.

Results: We discussed the most recent evidence of diabetes milieus and COVID-19 regarding risk factors, management, complications, and telemedicine.

Brown Tumor With Spine Involvement at Multiple Levels in a Hemodialysis Patient.

Brown tumor of the bone or osteitis fibrosa cystica is a rare manifestation of hyperparathyroidism, most seen nowadays in association with secondary and tertiary hyperparathyroidism. Chronic kidney disease (CKD) and end-stage renal disease (ESRD) are the major culprits of secondary hyperparathyroidism (sHPTH). CKD is known to cause phosphate retention and a decrease in 1,25-dihydroxyvitamin D and ionized calcium levels, which in turn trigger the PTH secretion.