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He was discharged on apixiban and levetiracetam to follow-up for possible tumor recurrence. Cerebral venous sinus thrombosis can present with stroke-like symptoms, and CT perfusion studies can be normal. CT venography, MRI with gadolinium, and MR venography are sensitive imaging modalities for diagnosing dural sinus thrombosis and should be considered, especially for patients with hypercoagulable risk factors, MR venography being the most sensitive, preferred modality [2]. Additionally, it is important to recall the laterality of focal symptoms, as a history of cerebrovascular disease can be a confounding factor in diagnosis.Acquired copper deficiency is rare but often seen among patients with intestinal malabsorption syndromes. Often times, these patients can develop myeloneuropathies with copper deficiency as an elusive culprit. With early diagnosis and appropriate supplementation, many symptoms, such as myeloneuropathy, can be reversed entirely. Checking copper levels should be included in the workup of myeloneuropathies to prevent irreversible damage and improving morbidity and mortality.A 21-year-old male presented with a 2-week history of nausea and non-bloody, non-bilious vomiting, accompanied by diffuse chronic myalgia. The patient endorsed headaches, dizziness, and diplopia that had started one day prior to admission. The patient had consumed a meat-only diet for the prior year. The patient was found to have a high anion gap metabolic acidosis with a superimposed normal anion gap metabolic acidosis in the setting of a several-month history of ingesting multiple naturopathic substances as well as recent use of disulfiram for management of his chronic myalgia. Magnetic resonance imaging (MRI) of the brain demonstrated symmetric hyperintensity involving bilateral thalami, periventricular regions, putamina, pons and medulla, with sparing of the mammillary bodies, consistent with Wernicke's encephalopathy (WE). The patient was treated with intravenous thiamine, a balanced nutritional diet, and hydration. Over the ensuing four days, his metabolic derangements resolved and a repeat MRI demonstrated significantly decreased FLAIR signal abnormality.We present a case report describing a potential rare adverse reaction of the recombinant zoster vaccination. This patient is a 60-year-old female who was admitted for severe rhabdomyolysis after receiving the vaccine. The patient's symptoms and CPK improved with aggressive hydration over several days. The patient did not have any known or reported common risk factors for rhabdomyolysis and the Naranjo Score was used to determine the likelihood of an adverse drug reaction. This is a relevant case to discuss in order to make physicians aware of a possible rare and lethal adverse effect due to a common vaccination.This report describes what we believe is the first reported case of clinically significant cholestasis and acute liver injury within three days of meropenem therapy. An 83-year-old Hispanic female was admitted for sepsis of unknown origin and was started on intravenous meropenem. Three days following initiation of the antibiotic, the patient developed mixed hepatocellular and cholestatic liver injury with jaundice and pruritus. Possible causes of cholestasis were excluded after extensive investigations. A drug-induced liver injury was suspected and meropenem was discontinued. Following discontinuation of meropenem, the patient demonstrated symptomatic and laboratory improvements, and her liver enzymes and bilirubin levels were normalized.Naloxone-induced noncardiogenic pulmonary edema is a rare but reported entity that can occur following naloxone use in the reversal of opioid overdose. Proposed mechanisms include an adrenergic crisis secondary to catecholamine surge which causes more volume shift to pulmonary vasculature, subsequently leading to pulmonary edema. It appears to be more common when higher doses of naloxone are used. We present a case of a patient with opioid overdose came with altered mental status developed early features of pulmonary edema following the administration of multiple doses of naloxone. She responded well with the administration of diuretics and oxygen supplementation. Her oxygen requirements improved and didn't require mechanical ventilation.Objective Severe hypercalcemia is a medical emergency. Hyperparathyroidism, malignancy, vitamin D toxicity, infections such as tuberculosis, or systemic illness such as sarcoidosis are all possible etiologies. Among the less studied causes is dehydration. Our objective is to identify dehydration as an etiology of hypercalcemia. Methods Extensive literature review did not recognize dehydration as an etiology of hypercalcemia. We present a case of dehydration leading to severe hypercalcemia in a 60-years-old female with a presentation of altered mental status and corrected calcium level of 19 mg/dL in the absence of parathyroid abnormality, vitamin D toxicity, systemic disease, or malignancy. Results Dehydration caused hypercalcemia which led to a feed-forward mechanism and caused further worsening dehydration, worsening kidney function, and severe hypercalcemia. The patient responded very well to intravenous fluid and at the time of discharge had a serum calcium of 9.8 mg/dL with improved mental status back to the baseline. Conclusion Our literature review demonstrated many causes of hypercalcemia, with dehydration being exceptionally rare. It is our hope that this case report may serve as evidence of one such instance, allowing providers to keep a working differential of dehydration in severely elevated calcium levels.Introduction Since the approval of transcatheter aortic valve replacement (TAVR), nonagenarian group patients are being increasingly considered for TAVR. Therefore, we compared the clinical outcomes of surgical aortic valve replacement (SAVR) vs TAVR in nonagenarians with severe aortic stenosis. Methods A literature search was performed using MEDLINE, Embase, Web of Science, Cochrane, and Clinicaltrials.gov for studies reporting the comparative outcomes of TAVR versus SAVR in nonagenarians. The primary endpoint was short-term mortality. Secondary endpoints were post-operative incidences of stroke or transient ischemic attack (TIA), vascular complications, acute kidney injury (AKI), transfusion requirement, and length of hospital stay. Results Four retrospective studies qualified for inclusion with a total of 8,389 patients (TAVR = 3,112, SAVR = 5,277). Pirtobrutinib research buy Short-term mortality was similar between the two groups [RR = 0.91 (95% CI 0.76-1.10), p = 0.318]. The average length of hospital stay was shorter by 3 days in the TAVR group (p = 0.