The first recorded case of coronavirus disease (COVID-19) in New York City was on March 1, 2020, and by May 5, there were 171,723 confirmed cases with 13,724 confirmed deaths. 1 The Bronx had the highest rates of hospitalization and death related to COVID-19 compared to the other 4 boroughs in New York City. 2 Jacobi Medical Center, one of 11 acute-care facilities in the NYC municipal hospital system, is a 457-bed level 1 trauma center located in the Bronx with 3,225 healthcare workers. We began testing symptomatic employees on March 16 using the nasopharyngeal polymerase chain reaction (PCR) severe acute respiratory coronavirus virus 2 (SARS-CoV-2) test. In the first 6 weeks, we tested 1,264 employees, of whom 302 tested positive (23.9%). Recent reports showed that 12.2% of NYC healthcare workers had a confirmed positive SARS-CoV-2 PCR result. 3 Preliminary data reveal that 19.9% of NYC residents have antibodies to SARS-CoV-2 virus, and 27.6% of Bronx residents have antibodies. Given this high prevalence of antibodies in the Bronx, we predicted that our staff would have higher prevalence of antibodies, especially those staff working in areas of perceived risk, such as the emergency department and critical care areas. Once Abbott Labs (Abbott Park, IL) received the emergency use authorization for antibody testing using the SARS-CoV-2 IgG test, 4 we began a voluntarily testing all employees at our facility. This test has a reported sensitivity of 100% and specificity of 99.6% when performed 2 weeks after symptom onset. 5 Individuals were offered the IgG test as long as they were asymptomatic and had not had COVID-19 symptoms during the prior 2 weeks. A retrospective chart review was performed to answer the following questions:

Pseudoaneurysm formation caused by iatrogenic arterial injury during a regional anesthetic block is a rare complication. We report a case of a 56-year-old male patient who developed an axillary artery pseudoaneurysm caused by brachial plexus block performed for an upper extremity dialysis access operation. Successful repair of this pseudoaneurysm was achieved with endovascular stent graft exclusion. The repaired axillary artery with the stent graft remained patent after 10 years of follow-up. The successful long-term patency of this treatment and a strategy to potentially avoid this complication are discussed.

No abstract

Background: Human immunode ciency virus (HIV) infection and antiretroviral therapy have been associated with non-alcoholic fatty liver disease (NAFLD), but few studies have evaluated whether HIV infection is an independent risk factor for the development of hepatic steatosis and advanced liver brosis.Objectives: To study the prevalence and severity of hepatic steatosis and advanced brosis in people living with HIV and control outpatients.Methods: We conducted a cross-sectional analysis of relevant data from 875 pairs of individuals belonging to an HIV-dedicated outpatient clinic and an adult primary care clinic of an inner-city hospital.Hepatic Steatosis Index (HSI) and FIB-4 index were calculated as non-invasive measures of steatosis and brosis, respectively. A multivariate logistic regression analysis was performed to assess predictors of steatosis and advanced brosis.Results: The prevalence of hepatic steatosis, determined by HSI ≥36, was higher in HIV-negative subjects (71.5% vs. 65.4%, p=0.006). The prevalence of advanced brosis, determined by FIB-4 index ≥3.25, was higher in the HIV-positive group (7% vs. 1.7%, p <0.001). Multivariable analysis did not identify HIV infection to be an independent risk factor for hepatic steatosis (p=0.068) and advanced brosis.Conclusions: In this cohort, hepatic steatosis was more prevalent in non-HIV infected patients, while advanced brosis had a higher prevalence in people living with HIV. HIV infection was not found to be an independent risk factor for either hepatic steatosis or brosis.

No abstract