Impacts of the COVID-19 Pandemic on United States Emergency Medicine Education: A Council of Residency Directors in Emergency Medicine (CORD) Task Force Survey-Based Analysis.

Introduction The COVID-19 pandemic presented unpredicted challenges to Emergency Medicine (EM) education. The rapid onset of the pandemic created clinical, operational, administrative, and home-life challenges for virtually every member of the medical education community, demanding an educational and professional response at all levels including undergraduate medical education (UME), graduate medical education (GME), and faculty. The Council of Residency Directors in Emergency Medicine (CORD) COVID-19 Educational Impact Task Force was established in 2021 to examine these effects and the response of the EM educational community.

A Challenging Diagnosis of Febrile Pancytopenia in a Patient With a History of Autoimmune Disease.

Pancytopenia is a hematologic condition characterized by a decrease in all three peripheral blood cell lines. There are many causes of pancytopenia, and the proper approach is required for accurate diagnosis. Brucellosis and systemic lupus erythematosus (SLE) are both diseases that can initially present as pancytopenia, both of which require a targeted workup to diagnose.

Perinephric Abscess Extending to the Psoas Muscle and Causing a Nephro-Cutaneous Fistula.

We present a case of a 76-year-old male with dementia transferred from a nursing home with a fever and an abscess on his back. Workup revealed an extensive perinephric abscess, which extended to his psoas muscle, with an additional fistula to his back where the abscess was noted. The extent and tracking of the perinephric abscess were unusual as well as the organisms isolated, and species.

The Role of Glutathione in Prevention of COVID-19 Immunothrombosis: A Review.

Immunothrombosis has emerged as a dominant pathological process exacerbating morbidity and mortality in acute- and long-COVID-19 infections. The hypercoagulable state is due in part to immune system dysregulation, inflammation and endothelial cell damage, as well as a reduction in defense systems. One defense mechanism in particular is glutathione (GSH), a ubiquitously found antioxidant.

Impact of Geriatric Events on Clinical Outcomes and Resource Utilization of Acute Coronary Syndrome Hospitalizations.

Background The effect of geriatric events (GEs) on outcomes of acute coronary syndrome (ACS) admissions is poorly understood. We evaluated the prevalence and impact of GEs on clinical outcomes and resource utilization of older patients admitted with ACS. Methods Using the 2018 National (Nationwide) Inpatient Sample, we analyzed all elective hospitalizations for ACS in older adults (age ≥ 65 years) and a younger reference group (age 55-64).

Previous corticosteroid exposure associates with an increased pneumonia mortality among HIV-negative patients: a global research network with a follow-up multicenter case-control study.

Background: HIV-negative patients have substantial mortality from pneumonia (PJP). We lack predictors of HIV-negative PJP-associated mortality.

Objective: We aim to characterize the role of prior corticosteroid exposure in PJP-related mortality.

A rare adverse event of atorvastatin inducing leukocytoclastic vasculitis with ANCA-negative (Anti-Neutrophil cytoplasmic antibody) case report and literature review.

Leukocytoclastic vasculitis is an entity associated with drugs, infections, cryoglobulinemia, and connective tissue diseases but can also be idiopathic, systemic, or organ localized. Moreover, LCV associated with drugs is a rare disorder. When it is present usually has an elevation of anti-neutrophil cytoplasmic antibody, most likely anti-myeloperoxidase, which can be helpful to orient the diagnosis.

Partnering for Integrated Care: A Learning Collaborative for Primary Care and Oral Health Teams.

Purpose: The Teaming and Integrating for Smiles and Health (TISH) Learning Collaborative was developed to help health care organizations accelerate progress in integrating delivery of oral and primary care. By providing expert support and a structure for testing change, the project aimed to improve the early detection of hypertension in the dental setting and of gingivitis in the primary care setting, and to increase the rate of bidirectional referrals between oral and primary care partners. We report its outcomes.

Weekend Effect on Mortality, Access to Renal Replacement Therapy, and Other Outcomes Among Patients With End-Stage Renal Disease: A Retrospective Analysis of the Nationwide Inpatient Sample.

Background: A large body of research has been conducted on the "weekend effect," which is the reportedly increased risk of adverse outcomes for patients admitted to the hospital on weekends versus those admitted on weekdays. This effect has been researched in numerous patient populations, including sub-populations of end-stage renal disease (ESRD) patients, with varying conclusions.

Objectives: To assess whether differences in in-hospital mortality, access to renal replacement therapy (RRT), time to RRT, and other important outcomes exist in patients with ESRD or patients on RRT admitted on the weekend versus weekdays.

Two for the Price of One: A Case of Methicillin-Resistant Staphylococcus aureus (MRSA) Brain Abscess With Atypical Lymphoplasmacytic Infiltrate With Underlying Clonal Lymphoproliferative Process in a Patient Infected With HIV.

Multiple etiologies can coexist and trigger CNS symptoms in individuals infected with HIV. This article reviews a case of a cerebellar mass in an HIV patient who, on biopsy, grew methicillin-resistant (MRSA) and by pathology, showed an atypical lymphoplasmacytic infiltrate concerning a clonal lymphoproliferative process, which may be a precursor of CNS lymphoma. The patient, a 36-year-old male with multiple comorbidities including HIV Infection, presented to the hospital for evaluation of a one-week course of headache and photophobia.

Racial Disparity and Trend of Food Scarcity Amid COVID-19 Pandemic in the United States.

An increase in households with food insecurity has been reported during the COVID-19 pandemic, but the trend of food insecurity during the pandemic remains unclear. Using Household Pulse Survey (HPS) data over 34 weeks from June 2020 to September 2021 (nationally representative samples of US adults in the households from the US Census Bureau), we examined racial disparity and trends of food scarcity amid the COVID-19 pandemic. The time series plots illustrated that the food scarcity rate was incremental until December 2020 and began improving thereafter across all racial groups.

Outcomes with use of extra-corporeal membrane oxygenation in high-risk pulmonary embolism: a national database perspective.

High-risk pulmonary embolism (PE) patients can be managed with systemic lysis, catheter-based therapies, or surgical embolectomy. Despite the advent of newer therapies, patients with high-risk PE remain with a 50-60% short-term mortality risk. In such patients, extracorporeal membrane oxygenation (ECMO) is increasingly utilized for hemodynamic support.

A prospective comparative study of the functional results associated with the use of Björk flap tracheostomy versus standard tracheostomy.

Background: Placement of a tracheostomy for patients requiring prolonged mechanical ventilation (PMV) improves patients' comfort, decreases dead space ventilation, allows superior airway hygiene, and reduces the incidence of ventilator-associated pneumonia. Controversy still exists regarding the role of standard tracheostomy (ST) as opposed to the less frequently done Björk flap tracheostomy (BFT). This study compares the functional outcomes of these two techniques.

Parent and Physician Preference for Anxiolytic Medication Prior to Laceration Repair in Young Children.

Objectives Pediatric laceration repair is a daunting process for parents and physicians. The repair could take place quickly if the child is calm and relaxed.This study aimeds to evaluate parental and physician preference for anxiolytic medication administration prior to laceration repair, with a pre-and post-repair survey on parents' and physicians' initial preference and follow-up perception.

Maternal Cardiovascular Outcomes of Pregnancy in Childhood, Adolescent, and Young Adult Cancer Survivors.

This review focuses on the maternal cardiovascular risk and outcomes of pregnancy in childhood, adolescent, and young adult cancer survivors who are achieving survival to their prime reproductive years. Childhood, adolescent, and young adult cancer survivors are a growing population and have increasing needs for reproductive care over decades of life. Female cancer survivors have an overall higher risk of maternal cardiovascular events compared to those without a history of cancer.

Acute Generalized Exanthematous Pustulosis in a Setting of Cutaneous Lymphoma.

Acute generalized exanthematous pustulosis (AGEP) is a rare dermatological manifestation of the adverse drug reaction that occurs for a varied duration after the receipt of certain drugs. It manifests as an acute onset of generalized exanthematous pustular reaction with an edematous base. It has a characteristic clinical presentation and rapid resolution soon after the removal of the offending drug.

Case Report: A rare case of symptomatic bradycardia secondary to aripiprazole in a patient with bipolar disorder type I.

It is well known that typical antipsychotic drugs have been implicated as a cause of ventricular arrhythmias and cardiac arrest; studies have shown that conventional antipsychotics increase the risk of hospitalization for ventricular arrhythmias or cardiac arrest nearly 2-fold. However, atypical antipsychotics are not associated with an increased risk of hospitalization for ventricular arrhythmias or cardiac arrest. The use of atypical antipsychotics increased since they were first discovered and now are the mainstay of treatment, but with their broad use, heart effects have been documented, such as prolonged QT interval.

A Case Report about Glycogenic Hepatopathy.

Introduction: Glycogenic hepatopathy is a rare complication of uncontrolled diabetes mellitus that presents with hepatomegaly and transient elevation in serum aminotransferase enzymes. The underlying pathophysiology involves excessive accumulation of intrahepatic glycogen. Glycogenic hepatopathy is usually underdiagnosed because it is difficult to differentiate from other entities, such as the nonalcoholic fatty liver.

Testosterone and Covid-19: An update.

There is overwhelming evidence to suggest that male gender is at a higher risk of developing more severe Covid-19 disease and thus having poorer clinical outcomes. However, the relationship between testosterone (T) and Covid-19 remains unclear with both protective and deleterious effects on different aspects of the disease suggested. Here, we review the current epidemiological and biological evidence on the role of testosterone in the process of SARS-CoV-2 infection and in mediating Covid-19 severity, its potential to serve as a biomarker for risk stratification and discuss the possibility of T supplementation as a treatment or preventative therapy for Covid-19.

The importance of CT Urography in early diagnosis of anatomical variations in urogenital tract: case presentation.

Anatomic variations in the urogenital tract have generally been diagnosed through intravenous urography as a modality of choice. In recent years, computerized tomography (CT) urogram has replaced the traditional intravenous imaging of the genitourinary tract. Hematuria, tumoral mass, obstructive uropathy, and congenital collecting system abnormalities are indications for CT imaging.