Theophylline use-a conundrum in modern medicine: a case report.

Background: The theophylline toxidrome presents with multisystemic involvement that includes cardiovascular, neurologic, metabolic, musculoskeletal, and gastrointestinal manifestations. Considering such a varied spectrum of presentations, it is often difficult to ascertain the diagnosis of this particular toxidrome. Review of home medications is an important step when working with a patient presenting as a toxidrome.

COVID-19-Related Left-Sided Ptosis.

The coronavirus disease 2019 (COVID-19) infection commonly presents with symptoms of fever, cough, and anosmia. However, there have been case reports of unusual symptoms associated with COVID-19. We encountered one such case where a 55-year-old male who tested positive for COVID-19 was noted to have, along with cough and vomiting, a new onset of left eyelid ptosis.

Immunotherapy: A Case Series.

Immunotherapy is on the rise as a treatment option for advanced melanoma, non-small cell lung carcinoma, renal cell carcinoma, and melanoma among others. It consists of two main classes being cytotoxic T lymphocyte antigen 4 (CTLA 4) inhibitors and programmed cell death 1 (PD 1) inhibitors. We report a case series of four patients who were started on either pembrolizumab or nivolumab for the treatment of melanoma or lung cancer.

COVID-19 Vaccine Acceptance Among Rural Appalachian Healthcare Workers (Eastern Kentucky/West Virginia): A Cross-Sectional Study.

Introduction The success of a vaccination program is dependent on vaccine efficacy and the number of people vaccinated. Healthcare workers are the first to receive the COVID-19 vaccine based on CDC phase 1a recommendations and are a point of contact for information for patients, so they must be well-educated on common misconceptions about the vaccine. Objective To identify acceptance/refusal rates of COVID-19 vaccine, reasons for refusal, and to understand the impact of demographics, work environment, and comorbidities on vaccine acceptance.

The Ugly Side of Colchicine.

We report a rare case of a 32-year-old male who ingested 32.4 to 54 mg of colchicine and presented after 44 hours. He developed progressive multiple organ failure with shock, acute kidney failure, troponemia, pancytopenia, absolute neutropenia, disseminated intravascular coagulation, acute liver failure, rhabdomyolysis, and lactic acidosis.

Recurrent Chylous Ascites Leading to Transudative Chylothorax Due to Bi-Ventricular Heart Failure.

Chylothorax is a pleural effusion of >110 mg/dL of triglycerides with a milky appearance with transudative being rare. In this article, we present a case of transudative chylothorax with concurrent chylous ascites that is secondary to congestive heart failure (CHF). A 70-year-old male with CHF with ejection fraction of 10%, coronary artery disease status post coronary artery bypass graft, sleep apnea, chronic kidney disease stage 3, and chronic obstructive pulmonary disease presented with worsening abdominal distention, shortness of breath, and increased lower extremities edema.

Point-of-care ultrasound for assessing arteriovenous fistula maturity in outpatient hemodialysis.

Background: Point-of-care ultrasound in end-stage renal disease is on the rise. Presently the decision to cannulate an arteriovenous fistula is based on its duration since surgery and physical exam. This study examines the effects of point-of-care ultrasound on decreasing the time to arteriovenous fistula cannulation, time spent with a central venous catheter, and the complications and infections that arise.