In conclusion, the presented findings suggested that the Cu(TPZ)2 nanocomplex can be a promising hypoxia-targeted therapeutic, which could potentiate the efficacy of the existing chemo- and radiotherapy in PC.INTRODUCTION The purpose of this review is to outline some of the major considerations when transitioning to performing total hip and knee arthroplasty in the out- patient setting. The review will discuss patient selections, peri-operative management pathways, and outcomes related to outpatient total joint arthroplasty (TJA). PATIENT SELECTION Appropriate patient selection is key to successful outpatient TJA. Multiple indices have been proposed to estimate patient risk before undergoing outpatient TJA. Perioperative Management In order to provide a successful outpatient TJA experience, pre-operative education class and physical therapy session can set expectations and prepare the patient for the post-operative recovery at home. Specific anesthesia techniques focus on regional blocks, multi-modal pain control, and reduction of post-operative nausea and vomiting and rapid recovery protocols have been developed to provide early mobilization and physical therapy. OUTCOMES Nationwide analyses have found improved complication rates ranging from 1.3%-3% in outpatient TJA group compared to 3%-12% in the inpatient TJA group. Financial analyses have found significant cost savings for outpatient TJA mostly related to reduction in surgical floor care. CONCLUSION Outpatient TJA has the potential to improve patient experience with cost savings and no increased risk of complications in the appropriately selected patient population.CASE REPORT A 10-year-old male with T1DM and recent travel to North Carolina presented to an ED with 1 day of fever, vomiting, and headaches. He was discharged home with the presumptive diagnosis of viral gastroenteritis but returned nine hours later, agitated, and unable to speak. CSF showed pleocytosis. MRI brain was normal, and EEG showed intermittent seizures. He was started on antiepileptics. Antibiotics were discontinued after negative bacterial work-up. Repeat MRI brain one week later showed enhancement in the left cerebral cortex. IVIG was started due to concern for autoimmune encephalitis. Repeat lumbar puncture was positive for La Crosse virus IgM. DISCUSSION This is the first case of La Crosse encephalitis (LACe) reported in Rhode Island.1 La Crosse virus (LACv) is a ssRNA Bunyavirus transmitted by the eastern tree-hole mosquito typically between July and September. LACv is endemic to the upper Midwestern US and Appalachia. In 2018, 81 of 86 total cases reported by the CDC were pediatric. Children are more likely to present with vomiting, seizures, and focal cortical inflammation or cerebral edema on brain imaging. IgM may be negative early in the disease course. Treatment is antiepileptics and supportive care.A 41-year-old man presented to the emergency department with a painful and red left eye associated with chronic vision loss. He had a history of homelessness and polysubstance abuse including intravenous drug use. Fundus examination revealed several cream-colored lesions encroaching on the macula of the right eye, and a total retinal detachment with secondary neovascular glaucoma in the left eye. Further work-up with imaging and endobronchial ultrasound-guided fine needle aspiration revealed stage IV epidermal growth factor receptor (EGFR) mu- tant (L858R) lung adenocarcinoma with brain, bone, adrenal, lymph node and bilateral choroid- al metastases. Herein we present a case of metastatic lung cancer masquerading as endophthalmitis.With advances in the treatment of plasma cell disorders, there have also been improvements in the risk stratification of these diseases. There are currently no screening recommendations for monoclonal gammopathy of unknown significance (MGUS); however, new studies are analyzing the role of screening for patients age 40-75 who are African American or have a family history of multiple myeloma (MM). Patients with smoldering multiple myeloma (SMM) have an increased risk of progression to MM when compared to MGUS. Data have shown that evaluation of bone marrow biopsy, full body MRI and free light chain ratios can identify high-risk SMM patients. Current investigation into early initiation of treatment for patients with SMM who do not meet criteria for MM showed improvement in time to progression. By continuing to evaluate clinical markers of disease burden, physicians can risk stratify patients to identify those at highest risk for progression to MM.Acute myeloid leukemia (AML) is a malignancy of the stem cell precursors of the myeloid lineage (red blood cells, platelets, and white blood cells other than B and T cells). Like other malignancies, it is due to genetic variations that lead to neoplastic changes and clonal proliferation. AML remains a rare malignancy, accounting for only 1.2% of all new cancer diagnoses in the United States per year, but it accounts for close to one third of all leukemias diagnosed.* For much of the 20th and early 21st century treatment paradigms were unchanged with survival curves remaining stagnant for many decades. selleck compound Recent changes in our understanding of the genetic variations in the disease have led to some promising new therapies with hopes for improved outcomes in the future. Below we review the definitions, diagnosis and classification of AML and how this affects the evolving treatment paradigm of AML.Gastrointestinal cancers are some of the most common malignancies worldwide. Traditional chemotherapy has been disappointing in improving overall survival in patients with unresectable or metastatic disease. The dawn of immunotherapy has led to emerging strategies in incorporating immune checkpoint inhibition either as single agents or in combination when treating gastrointestinal cancers. In this review, a general overview of the state of immunotherapy in the treatment gastrointestinal cancers is first provided. Subsequently, a review of the FDA-approved uses of immunotherapy in gastric, gastroesophageal, hepatobiliary, pancreatic and colorectal cancers will be provided followed by a glimpse into future treatment directions.