Northern Westchester Hospital (NWH), now known as Northwell Health, is a not-for-profit, 245-bed, all-private-room facility in Mount Kisco, New York that was founded in 1916. It serves residents of Northern Westchester, Putnam County and southern Dutchess County, as well as parts of Fairfield County, Connecticut.With more than 700 physicians, Northern Westchester Hospital provides a wide range of patient-centered services through its emergency department, Women's Imaging Center, Cancer Treatment and Wellness Center, Level III Neonatal Intensive Care Unit (NICU), clinical trials program, and Gamma Knife center. Northern Westchester Hospital is a designated training and case observation center for the da Vinci Surgical System in colorectal surgery. NWH breast surgeons provide microvascular surgery using the Novadaq SPY Imaging System. A number of bariatric surgical procedures are performed, including a modified bariatric technique known as stomach intestinal pylorus-sparing surgery (SIPS).Actor Christopher Reeve died at NWH on October 10, 2004.
Abstract:Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are major drivers of morbidity, mortality, disease progression, and healthcare utilization worldwide. Evolving definitions of COPD and exacerbations, along with emerging evidence on risk stratification and treatment optimization, have prompted updates in clinical practice, most recently reflected in the 2026 Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. This review summarizes contemporary perspectives on AECOPD, with a focus on updated definitions, epidemiology, predictors, clinical impact, and current pharmacological and nonpharmacological management strategies, including emerging preventive therapies. A narrative review of published literature, international guidelines, and major clinical trials was conducted, emphasizing evidence relevant to the assessment, treatment, and prevention of AECOPD. Particular attention was given to severity classification and guideline-directed therapeutic approaches. AECOPD is associated with substantial short- and long-term mortality, accelerated lung function decline, increased cardiovascular risk, and high readmission rates. The 2026 GOLD guidelines lower the threshold for high-risk classification, recognizing that even a single moderate exacerbation increases future risk. Acute management remains centered on short-acting bronchodilators, short courses of systemic corticosteroids, and antibiotics when indicated, with treatment of intensity guided by clinical severity and physiological derangements. Adjunctive supportive measures and early postdischarge interventions are critical to improving outcomes. While biologics, macrolides, Roflumilast, and Ensifentrine have no established role in the acute setting, they play an important role in exacerbation prevention as part of individualized, biomarker-informed maintenance strategies. AECOPD should be viewed as a sentinel event that necessitates both effective acute management and reassessment of long-term therapy. Early intervention, severity-based treatment, and postexacerbation optimization of maintenance therapy are essential to reduce recurrence, limit disease progression, and improve survival and quality of life in patients with COPD.
BACKGROUND:Nasolabial folds (NLFs) are common age-related facial lines, often treated with dermal fillers. Princess FILLER Lidocaine (PFL; now saypha filler Lidocaine) and Juvéderm Ultra XC (JUXC) are both hyaluronic acid-based fillers used for this purpose. OBJECTIVES:The aim of the authors of this study is to evaluate the effectiveness and safety of PFL in reducing NLF severity compared with JUXC using a split-face study design. METHODS:In this randomized, subject- and investigator-blinded multicenter study, patients with moderate-to-severe NLFs received PFL on one side of the face and JUXC on the other. Baseline NLF severity was assessed using the 5-point NLF-Severity Rating Scale (NLF-SRS). Follow-up assessments occurred at Weeks 12, 24, 36, and/or 48. The primary endpoint was the proportion of NLF-SRS responders at Week 24. Secondary endpoints included assessments by photographic reviewers and treating investigators, along with Global Aesthetic Improvement Scale (GAIS) ratings. Safety was monitored by adverse event reporting and patient diaries. FACE-Q questionnaires evaluated patient satisfaction. Repeat treatment was permitted at Week 36 or 48 if needed. RESULTS:At Week 24, PFL demonstrated noninferiority to JUXC (82.2% vs 81.9% responders; difference 0.37%, P < .0001). Secondary assessments confirmed this finding. Adverse events occurred in 24.4% of patients post PFL, with most being mild to moderate. Serious treatment-emergent adverse events were rare (1.1%). CONCLUSIONS:PFL is a noninferior alternative to JUXC for treating moderate-to-severe NLFs, with comparable efficacy, safety, and patient satisfaction. LEVEL OF EVIDENCE: 1 (THERAPEUTIC):For image description, please refer to the figure legend and surrounding text.
Abstract Background Myocardial calcification is typically a chronic process seen in long-standing conditions such as chronic kidney disease, where calcium-phosphate imbalance leads to metastatic calcification. In contrast, dystrophic calcification occurs acutely within necrotic cardiomyocytes and may develop rapidly, sometimes over days. While localized calcification can occur post-myocardial infarction, diffuse myocardial calcification is rare and has been reported in association with sepsis and myocarditis. Sepsis, a dysregulated host response to infection causing end-organ dysfunction, has been linked to sepsis-related myocardial calcification (SRMC), an exceedingly rare complication with fewer than 30 cases reported. Myocarditis, most often viral in etiology, can also cause myocardial injury predisposing to calcification. We present a unique case of rapid, diffuse myocardial calcification in a patient with concomitant Klebsiella pneumoniae sepsis and parainfluenza-associated myocarditis, with full manifestation detected within just four days. Case Presentation A 58-year-old man with hypertension, diabetes, and heavy alcohol use presented with fever, productive cough, and dyspnea. He was transferred from an outside hospital ICU for acute hypoxemic respiratory failure secondary to severe community-acquired pneumonia requiring intubation. Cultures grew Klebsiella pneumoniae bacteremia and parainfluenza virus on respiratory viral panel. On hospital day 1, he developed chest pain and ST-segment changes, underwent cardiac catheterization that showed non-obstructive coronary disease. Echocardiogram showed left ventricular ejection fraction (LVEF) of 52%. Myocarditis was suspected. By day 3, LVEF declined to 35-40%, requiring norepinephrine and phenylephrine for septic shock. On day 5, repeat CT chest revealed new left ventricular hyperattenuation consistent with myocardial calcification, absent on imaging 4 days prior. Throughout this time, calcium remained low-normal (7.7-9.2 mg/dL) and phosphate was initially elevated (6.7-7.6 mg/dL), then normalized. By day 9, repeat CT and echocardiography confirmed diffuse calcification with persistent hypokinesis but improved LVEF (49%). The patient clinically recovered and was discharged for outpatient heart failure follow-up. Discussion This case highlights hyper-acute diffuse myocardial calcification developing within four days in the setting of concomitant sepsis and viral myocarditis. Both sepsis-induced myocyte necrosis and myocarditis-related inflammation likely contributed synergistically to dystrophic calcification. While previously described SRMC cases often involve delayed detection, this report demonstrates one of the shortest intervals from onset to radiographic manifestation. Despite the grave prognosis typically associated with SRMC, our patient demonstrated significant recovery of cardiac function, suggesting early recognition and supportive management may improve outcomes. Continued follow-up is warranted to assess the long-term effects of persistent myocardial calcification. This abstract is funded by: None
Abstract Haploinsufficiency of A20 (HA20) is a rare loss-of-function genetic mutation causing immune system dysregulation leading to chronic inflammation and cell death.1, 2 It most commonly manifests with gastrointestinal and cutaneous lesions, while other organ systems are less commonly affected. Pulmonary complications, such are recurrent infections or nodules, are uncommon, with literature reporting an incidence of 9%, and even further challenging.3 We present a case of pulmonary complications of HA20, a rare manifestation of an orphan disease. The aim of this article is to provide data for diagnostic evaluation, including bronchoscopy and radiographic imaging, and offer suggestions for treatment and management.A 34-year-old man diagnosed with HA20 presented to our pulmonology clinic at referral of his immunologist with worsening cough. He has a history of recurrent lung infections, and at time of presentation receives regular HyQvia Human IgG and hyaluronidase infusion therapy via his immunologist. He was seen at multiple outpatient visits over the course of a year, and extensive diagnostic testing was obtained, including CBC analysis, sputum culture, high resolution CT, and bronchoscopy with cytological analysis. Bloodwork on initial evaluation revealed leukopenia and neutropenia [WBC count 2.34k/µL, ANC of 1370] as well as severe IgA deficiency [IgA <2 mg/dL] and significantly elevated quantitative IgG [IgG 2122 mg/dL]. High-resolution CT demonstrates cystic changes suggestive of cystic bronchiectasis or chronic cavitary disease, bilateral tree-in-bud nodules, and a 1.8cm spiculated obstructive nodule (Figure 1). Bronchoscopy revealed tracheobronchial erythema, and cytologic analysis of lavage returned fibrinopurulent exudate. Pathological analysis of lavage was negative for malignancy. Cultures were negative for high-risk organisms such as pseudomonas and non-tuberculoid mycobacterium and grew commensal flora. Although cultures were negative, the patient started on oral broad spectrum antibiotic due to his immunocompromised state for commensal flora. Azithromycin 250mg three times weekly was also prescribed based on evidence supporting its role in non-CF bronchiectasis with recurrent infections.4 He was also started on brensocatib 10mg orally once daily and a handheld oscillating positive expiratory pressure (PEP) flutter valve for pulmonary toileting. He remains a patient in our pulmonology clinic.Pulmonary complications of HA20 remain a poorly understood process with limited literature due to their rarity. Our case provides an example for diagnostic approach and offers suggestions for otherwise limited treatment guidelines. This abstract is funded by: None
