A single-centre experience rolling out an antibiotic stewardship intervention prior to and during the SARS-CoV-2 pandemic 2019-2022.

Background: Antibiotics are prescribed to nearly one-half of patients with viral respiratory tract infections (RTI) in outpatient settings. This use is ineffective and may cause undue harm and excess cost from unnecessary antibiotic exposure. We implemented a multifaceted intervention to address inappropriate antibiotic prescribing for viral RTI.

SOD1-Related Cerebellar Ataxia and Motor Neuron Disease: Cp Variant as Functional Modifier?

We describe a novel superoxide dismutase (SOD1) mutation-associated clinical phenotype of cerebellar ataxia and motor neuron disease with a variant in the ceruloplasmin (Cp) gene, which may have possibly contributed to a multi-factorial phenotype, supported by genetic and protein structure analyses.

Pheochromocytoma-induced Subarachnoid and Intracerebral Hemorrhage.

Pheochromocytomas are rare adrenal tumors that are often diagnosed in workup for endocrine causes of refractory hypertension, as an incidental imaging finding, or in patients with classic symptoms of headache, palpitations, and/or diaphoresis. We describe a case of pheochromocytoma presenting in a 63-year-old woman with spontaneous and multifocal subarachnoid and intracerebral hemorrhage without underlying vasculopathy. The patient previously had no documented episodes of hypertension and took no regular medications.

Randomized Trial of Molnupiravir or Placebo in Patients Hospitalized with Covid-19.

BACKGROUND: Molnupiravir is an oral prodrug of β-D-N4-hydroxycytidine, active against SARS-CoV-2 in vitro and in animal models. We report data from the phase 2 component of MOVe-IN, a clinical trial evaluating molnupiravir in patients hospitalized with Covid-19. METHODS: We conducted a randomized, placebo-controlled, double-blind phase 2/3 trial in patients 18 years old and older requiring in-hospital treatment for laboratory-confirmed Covid-19 with symptom onset 10 or fewer days before randomization.

Long QT-Syndrome With Torsades de Pointes Managed Considering Financial Constraints Faced by the Patient.

Long QT syndrome (LQTS) is a rare arrhythmogenic condition characterized by abnormally long QT intervals on an electrocardiogram. The prevalence varies between 1 in 3000 and 1 in 10,000 but often remains undiagnosed. It is responsible for 3000 to 4000 sudden deaths among children and adults in the United States alone.

An Enigmatic Elevation of Troponin in a Patient With Seizures.

A 64-year-old African American male, with past medical history of hypertension, depression, and seizure disorder, presented with an episode of generalized tonic-clonic seizure. He was treated for seizures, and after 48 hours seizure-free, the patient started complaining of chest tightness and troponin levels were found to be 34.71 ng/mL.

COVID-19 in Seattle-Early lessons learned.

The coronavirus disease 2019 (COVID-19) pandemic has rapidly evolved and now dominates the attention and full efforts of the emergency medicine community, both domestic and abroad. Seattle is the site of the initial diagnosed COVID-19 cases and fatalities in the United States. We provide an overview of the system-level response of 6 Seattle emergency departments and the Washington state chapter of the American College of Emergency Physicians (ACEP) to the COVID-19 pandemic.

Mallampati class, obesity, and a novel airway trajectory measurement to predict difficult laryngoscopy.

Objectives/hypothesis: To determine whether Mallampati class correlates with Cormack-Lehane grade in obese adults, and investigate a novel airway trajectory measurement (ATM) to anticipate difficult laryngoscopy.

Study Design: Retrospective cohort plus a pilot study.

Methods: One hundred eighty-four nonobese and 160 obese adults underwent laryngoscopy.