Propofol-Induced Hyperglycemia in the Critically Ill: An Unfamiliar Side Effect of a Common Anesthetic.

Hyperglycemia is associated with increased in-hospital morbidity and mortality, especially in critically ill intensive care unit (ICU) patients. Propofol, a common anesthetic used in the ICU, may cause hyperglycemia by inducing insulin resistance, reducing insulin-stimulated glucose uptake in muscles, and attenuating insulin-mediated suppression of hepatic glucose. We present the case of a 58-year-old female who was admitted for sepsis secondary to cellulitis but required intubation for respiratory failure.

Upper Extremity Pseudoparalysis: A Case Report of Bilateral Nursemaid's Elbows.

Radial head subluxation (RHS), commonly known as 'nursemaid's elbow,' typically presents in pediatric patients with acute-onset unilateral arm pain and pseudoparalysis. The classic mechanism of injury involves a longitudinal traction force pulling the radial head through the annular ligament. Bilateral RHS is exceedingly rare, with only a few cases documented in the literature; notably, all cases with a provided history and physical exam presented with the classic mechanism of injury, aiding in diagnosis and treatment.

Surgical Aortic Valve Replacement Using a Porcine Model: A Low-Cost Simulation for Surgical Trainees.

Simulation experiences are valuable to the training of future successful surgeons. These experiences introduce trainees to operational concepts through hands-on engagement within a low-stress environment to promote skill, information retention, and increased competency for future success in real-life scenarios. The study aimed to develop a low-cost, reproducible surgical simulation for teaching aortic valve replacement using porcine models.

A Rare Case of Cephalosporin Anaphylaxis-Induced Reverse Takotsubo.

This case report details an unusual occurrence of reverse takotsubo induced by cefazolin anaphylaxis. While anaphylactic reactions typically manifest with hypotension and bronchospasm, the development of takotsubo is a rare outcome. The patient experienced an episode of cefazolin-induced anaphylaxis during elective shoulder surgery, subsequently developing reverse takotsubo cardiomyopathy (rTTC) during her hospitalization.

A Distinct Instance of Palindromic Rheumatism Disguised as Polymyalgia Rheumatica.

In this case report, we highlight a rare case of palindromic rheumatism (PR) presenting as polymyalgia rheumatica (PMR). Many challenges and complexities are associated with diagnosing and treating PR. Literature reviews showed only a few case reports of this unique presentation.

Prolapse of a Large Degenerating Uterine Leiomyoma: A Case Report.

Uterine leiomyomas (ULs) are common benign tumors seen in a large percent of women that can be classified based on their location within the uterus. They can cause a number of pelvic complications and can be managed medically, but more often surgically. Uterine pyomyomas often occur postpartum, possibly from infarction, and can lead to degeneration and sepsis.

Posterior Reversible Encephalopathy Syndrome in a Late Postpartum Patient With a Rare Complication of Subarachnoid Hemorrhage.

Posterior reversible encephalopathy syndrome (PRES) is considered a neuroclinical syndrome of headache, confusion, visual changes, and seizures associated with neuroimaging findings of posterior cerebral white matter edema. Although the incidence of the syndrome is largely unknown, this condition is becoming increasingly recognized. The prognosis is generally good with most symptoms resolving within one week and lesions on imaging resolving in two weeks.

A Rare Organism Causing Cholecystitis With Bacteremia in a Breast Cancer Patient.

, a gram-negative, rod-shaped, anaerobic bacterium, is a rare cause of human disease. species have been known to mostly cause pulmonary disease in agricultural workers as they are native to select crops and wild animal furs. However, in very few documented cases, has been discovered as the source of nosocomial infections, usually in the setting of an immunocompromised host.

Abiraterone-Associated Mineralocorticoid Excess: A Case Report.

Abiraterone acetate causes an adrenocorticotropic hormone (ACTH)-mediated mineralocorticoid excess. We present a 77-year-old man with prostate adenocarcinoma who developed signs and symptoms of mineralocorticoid excess while on abiraterone and discuss its pathophysiology and treatment options. The patient developed hypokalemia, metabolic alkalosis, and hypertension, indicative of increased mineralocorticoid activity, confirmed by elevated ACTH, corticosterone, and deoxycorticosterone levels.

Building Interest in Cardiothoracic Surgery at an Osteopathic Medical School: Results of an Institutional Study and a Guide for Medical Schools.

Objective A previous study at this institution revealed a connection between interest group involvement and specialty interest while identifying the negative perceptions of cardiothoracic (CT) surgery. This study aimed to build interest and ameliorate the negative perceptions of CT surgery by exposing pre-clinical students to the field through engaging events. Methods Students at a US osteopathic institution who attended CT surgery committee events were invited to complete an online survey after each event.

Primary results from the CLEAR study of a novel stent retriever with drop zone technology.

Background: Challenges to revascularization of large vessel occlusions (LVOs) persist. Current stent retrievers have limited effectiveness for removing organized thrombi. The NeVa device is a novel stent retriever designed to capture organized thrombi within the scaffold during retrieval.

Reducing Maternal Mortality Rates in Alabama Through Patient Education: A Scoping Review.

Maternal mortality continues to rise in the United States and disproportionately affects those in Alabama. Lack of patient education on warning signs is a preventable cause of maternal mortality. This article aims to systematically quantify existing research investigating the effect of patient education on maternal outcomes.

A Rare Presentation of Perivalvular Abscess and Infective Valve Endocarditis as Multiple Cerebral Septic Emboli Mimicking Ischemic Stroke.

The perivalvular cardiac abscess is a severe condition associated with infective endocarditis, leading to significant morbidity and mortality if not diagnosed and managed promptly. Neurological complications, particularly stroke, can occur due to embolic events resulting from cardiac abscesses. A 63-year-old female with end-stage renal disease and multiple comorbidities presented with altered mental status.

Neurosarcoidosis: A Rare Presentation as a Seizure.

Neurosarcoidosis is a rare disorder that can develop in patients with a history of sarcoidosis or can develop even when sarcoidosis is not diagnosed. It is a granulomatous disease of the nervous system that causes different neurological disorders based on its location. However, diagnosing neurosarcoidosis remains a challenge as it mimics many other neurological disorders and does not have any biochemical markers of high specificity.

Myxedema Coma: A Grave Phenomenon Partially Reversed CKD Status With Treatment of Hypothyroidism.

Myxedema coma is a grave medical condition that warrants emergent medical management to avoid adverse effects and unfavorable outcomes. Intravenous thyroid hormones (T3 and T4), along with intravenous hydrocortisone and frequent vital monitoring, are the mainstays of the management of myxedema coma. The interplay between CKD and hypothyroidism is fascinating and can affect each other.

Aminotransferases in Relation to the Severity of Dengue: A Systematic Review.

A systematic review was conducted to investigate the relationship between aminotransferases and the severity of dengue infection, which is a prevalent and significant infection in tropical and subtropical regions. Aminotransferases are enzymes that are often elevated in dengue due to the liver's physiological and immunological response to the infection. This review focused on analyzing various studies that examined the correlation between aminotransferase levels and the severity of dengue.

Surgical Outcomes Following Robotic Single-Site Versus Multiport Hysterectomy for Treatment of Endometrial Cancer: A Systematic Review and Meta-Analysis.

Robotic single-site hysterectomy (RSSH) has emerged as a novel surgical approach for the treatment of endometrial cancer and atypical endometrial hyperplasia (AEH). Current research regarding the benefits of RSSH compared to robotic multiport hysterectomy (RMPH) for these indications has been inconclusive. Our team sought to compare surgical outcomes between these two approaches of robotic hysterectomy via systematic review and meta-analysis to ensure optimal surgical practices.

Recurrent Subclavian Steal Syndrome: A Novel Case of Vasculopathy.

Subclavian steal syndrome (SSS) refers to the phenomenon of retrograde flow in an ipsilateral branch of the subclavian artery due to hemodynamically significant stenosis or occlusion of the ipsilateral proximal subclavian artery. While SSS is usually asymptomatic, it can manifest as vertebrobasilar insufficiency (VBI), ischemia of the affected extremity, or cardiac angina when an internal mammary artery (IMA) is used as a bypass graft. The underlying etiology is most often atherosclerosis but can include Takayasu arteritis, thoracic outlet syndrome, cervical rib, and stenosis secondary to surgical repair of aortic coarctation or tetralogy of Fallot.

Real-world abdominal aorta aneurysm screening patterns among patients with new or worsening of symptomatic peripheral artery disease.

Background: Patients with peripheral artery disease (PAD) have an increased risk of abdominal aortic aneurysms (AAA), but it remains unclear whether practitioners are screening patients for AAA as part of routine PAD management.

Methods: The Patient-centered Outcomes Related to Treatment Practices in Peripheral Arterial Disease (PORTRAIT) Registry is an international prospective registry of patients with new or worsening PAD symptoms presenting to 16 specialty centers in the United States, Netherlands, and Australia, from June 2011 to December 2015. Patients were stratified by AAA screening or AAA positivity.

The Interplay of COVID-19 and Hereditary Angioedema: Preventing an Acute Attack.

Hereditary angioedema (HAE) is a rare inherited disease that is caused by the inactivation of the C1 esterase inhibitor. In this case report, we present a 51-year-old female previously diagnosed with HAE who tested positive for SARS-Cov-2 (COVID-19). The patient was treated symptomatically.

Contrast-Induced Neurotoxicity: An Inside Look at a Rare Presentation.

Imaging modalities frequently utilize iodinated-based contrast agents (IBCAs) to assist professionals in deficit identification and improve clinical outcomes for patients. However, they are not without risk. In patients with post-radiological neurological deficits, contrast-induced neurotoxicity (CIN) should be among the top differentials.