Besieged in the Bronx: Lessons from an in-hospital mass casualty.

Background: An active shooter in a hospital is an emergency extraordinaire. We report a single institution's response to the largest active shooter mass casualty event in American History.

Methods: Review of notification, flow of prioritized patients, and key elements of the day's dynamic after a hospital attack by a lone gunman were commenced.

The Cause of Severe Metabolic Acidosis With Vomiting in a Neonate.

We present a 22-day-old male born full term who presented with worsening non-projectile, non-bilious vomiting and failure to thrive (FTT) and was admitted to the pediatric intensive care unit (PICU) for severe metabolic acidosis with an elevated anion gap. Despite changing the formula, the patient continued to have spit-ups after feeds since birth. Before this admission, his vomiting worsened with every feed, which was now forceful along with two days of loose stools.

Flow-Sizing Critical Care Resources.

Objectives: To describe the factors affecting critical care capacity and how critical care organizations (CCOs) within academic centers in the U.S. flow-size critical care resources under normal operations, strain, and surge conditions.

Abdominal Calcifications in a Patient From the Congo Basin with History of Snake Meat Consumption: Radiographic Evidence of Prior Infection.

We report a case of a 60-year-old asymptomatic male with history of consumption of uncooked snake meat while living in the Congo basin and prior imaging showing multiple abdominal calcifications. Patient had multiple subepithelial colonic lesions identified during screening colonoscopy and microscopic examination of the lesions demonstrated a calcified nodule in the submucosa with overlying normal mucosa. However, no parasite was identified within the calcified nodule.

Predictors and Outcomes of Extracorporeal Membrane Oxygenation in COVID-19 Patients With ARDS: A Propensity-Matched Analysis of National Inpatient Sample.

Extracorporeal membrane oxygenation (ECMO) is a significant treatment modality for COVID-19 patients on ventilators. The current data is limited for understanding the indicators and outcomes of ECMO in COVID-19 patients with acute respiratory distress syndrome (ARDS). The National Inpatient Sample (NIS) database from 2020 was queried in this study.

Vitamin D and polycystic ovary syndrome (PCOS): a review.

A common health problem known as polycystic ovarian syndrome (PCOS), is characterized by irregular periods, an excess of androgen production, and polycystic ovaries. It is one of the most prevalent endocrine disorders in women of reproductive age, affecting 4-20% of women worldwide. Numerous studies have found a connection between the onset and symptoms of PCOS and Vitamin D insufficiency.

Outcomes of Acute Mesenteric Ischemia in Patients With COVID-19: A Nationwide Database Study.

Introduction Initially regarded as primarily a respiratory illness, coronavirus disease 2019 (COVID-19) has since been recognized as a complex disease affecting multiple systems. A COVID-19 infection can cause a hypercoagulable state leading to thrombotic complications in various systems. Acute mesenteric ischemia (AMI) has been reported as a rare complication of COVID-19, carrying a significant mortality rate.

Recurrence of digital papillary invasive adenocarcinoma.

Adenocarcinoma is extremely uncommon in the digits with an incidence of 0.08 per 1 000 000 people per year, known as digital papillary adenocarcinoma (DPA). This disease is commonly described pathologically as malignancy of the sweat glands.

Percutaneous coronary intervention versus coronary artery bypass grafting among patients with left ventricular systolic dysfunction: a systematic review and meta-analysis.

Unlabelled: Current guidelines have shown the superiority of coronary artery bypass grafting (CABG) over medical therapy. However, there is a paucity of data evaluating the optimal revascularization strategy in patients with ischemic left ventricular systolic dysfunction (LVSD).

Objective: The authors aimed to evaluate the clinical outcomes of postpercutaneous coronary intervention (PCI) and CABG among patients with LVSD.

Expansion of a Pharmacist-Led Culture Follow-Up Program to Real-Time Notification of Multidrug-Resistant Microbiology Results in the Emergency Department.

There are currently limited published data for a pharmacist-led multidrug-resistant (MDR) culture follow-up program through a collaborative drug therapy management (CDTM) agreement in the emergency department (ED). The objective of this study was to assess the impact of a pharmacist-led culture follow-up program for MDR microbiology results on ED revisit rate. A single-center quasi-experimental retrospective study was conducted comparing the outcomes before (December 2017 to March 2019) and after (April 2019 to July 2020) implementation of the ED MDR Culture program.