Rare case of testosterone producing serous cystadenoma.

Postmenopausal virilization and symptoms of hyperandrogenism can be attributed to tumorous or nontumorous causes. Androgen secreting tumors can arise from either the ovarian sex cord/stromal cells or from the adrenal glands. Cystadenomas are relatively benign ovarian epithelial tumors that have rarely been implicated as the cause of hyperandrogenism. Histologically these tumors are classified as mucinous or serous. We present here a case of a 60-year-old postmenopausal female with symptoms of hyperandrogenism including hirsutism and virilization for one year. Labs were significant for high total testosterone levels persistently. On imaging, our patient was found to have a left adnexal cyst, which was subsequently removed and found to be of serous histology. Upon removal of the cyst, patients' total testosterone levels normalized. Our case highlights the importance of including cystadenomas in the differentials when evaluating for tumorous causes of hyperandrogenism.

Impact of Local and Demographic Factors on Early COVID-19 Vaccine Hesitancy among Health Care Workers in New York City Public Hospitals.

Despite the development of several effective vaccines, SARS-CoV-2 continues to spread, causing serious illness among the unvaccinated. Healthcare professionals are trusted sources of information about vaccination, and therefore understanding the attitudes and beliefs of healthcare professionals regarding the vaccines is of utmost importance. We conducted a survey-based study to understand the factors affecting COVID-19 vaccine attitudes among health care professionals in NYC Health and Hospitals, at a time when the vaccine was new, and received 3759 responses. Machine learning and chi-square analyses were applied to determine the factors most predictive of vaccine hesitancy. Demographic factors, education, role at the hospital, perceptions of the pandemic itself, and location of work and residence were all found to significantly contribute to vaccine attitudes. Location of residence was examined for both borough and neighborhood, and was found to have a significant impact on vaccine receptivity. Interestingly, this borough-level data did not correspond to the number or severity of cases in the respective boroughs, indicating that local social or other influences likely have a substantial impact. Local and demographic factors should be strongly considered when preparing pro-vaccine messages or campaigns.

The Implications of Extensive Drug-resistant Typhoid Fever: A Case Report.

Salmonella Typhi (S.Typhi) is the causative agent in typhoid fever. In Pakistan, an extensive drug-resistant (XDR) S.Typhi strain has emerged that is resistant to all recommended antibiotics, including third-generation cephalosporins. We report the case of a 29-year-old pregnant woman presenting with high-grade fever, lower abdominal pain, concerns of urinary burning, and increased urinary frequency lasting four days. Blood cultures confirmed XDR S. Typhi. This case highlights three important items: the emergence of the XDR typhoid strain in an unstudied community, the susceptibility of immunocompromised individuals to infectious diseases, and the role health care practitioners can play in controlling its spread regionally and globally.

Nutcracker Syndrome with Hypertension: A Case Report.

We describe the case of a young female who presented with hypertension, left flank pain, and hematuria. Workup was done to determine secondary causes of hypertension, which indicated renal artery stenosis. However, the renal angiography did not reveal any focal areas of stenosis. Further investigations revealed delayed renal vein emptying, suggesting extrinsic renal vein compression and leading to a diagnosis of nutcracker syndrome.