Combination Nanomedicine Strategy for Preventing High-Risk Corneal Transplantation Rejection.

High-risk (HR) corneal transplantation presents a formidable challenge, with over 50% of grafts experiencing rejection despite intensive postoperative care involving frequent topical eyedrop administration up to every 2 h, gradually tapering over 6-12 months, and ongoing maintenance dosing. While clinical evidence underscores the potential benefits of inhibiting postoperative angiogenesis, effective antiangiogenesis therapy remains elusive in this context. Here, we engineered controlled-release nanomedicine formulations comprising immunosuppressants (nanoparticles) and antiangiogenesis drugs (nanowafer) and demonstrated that these formulations can prevent HR corneal transplantation rejection for at least 6 months in a clinically relevant rat model.

Effectiveness of the vacuum assisted aspiration AngioVac system in the removal of intravascular masses.

Background: Invasive procedures used to manage intravascular masses such as vegetation from endocarditis, deep vein thrombosis, and septic emboli are associated with high rates of complications and mortality, especially in patients with several pre-existing comorbidities. A minimally invasive technique that has become more popular in recent years is the AngioVac procedure. This single-centered, retrospective study focuses on patient presenting comorbidities and indications for the procedure as well as postprocedural outcomes.

Bilateral Symmetric Gastrocnemius Myositis Secondary to COVID-19.

As the coronavirus disease 2019 (COVID-19) pandemic perseverates on, more insight into the multidisciplinary manifestations of COVID-19 is being brought to the forefront. Musculoskeletal presentations range from mild creatinine kinase elevation and myalgias to severe rhabdomyolysis. We present a case of a patient who presented with symmetric myositis of bilateral gastrocnemius muscles secondary group.

Integrated secure messaging to enhance medical education: a mixed methods study.

Background: Instant messaging applications and texting are useful for educating and communicating with medical students; however, they present patient privacy concerns and do not address the challenge of student inclusion in patient care communication. EMR-integrated secure messaging offers an opportunity to include students on team communication, enhance their medical education, and ensure patient privacy.

Methods: Between July 2019 through March 2020, we performed a mixed method study to evaluate use of EPIC® Secure Chat as a means of enhancing student education and team communication.

Psychological impact of the COVID-19 pandemic on nursing students in the first wave: A cross-sectional survey.

Aim: The aim of the study was to evaluate the psychological impact on nursing students at the end of period of confinement during the first wave of the COVID-19 outbreak in Spain.

Design: A cross-sectional study reported in line with the STROBE guidelines.

Methods: Nursing students were invited to complete an online questionnaire at the end of the 2019-2020 academic year using convenience sampling.

Non-ST Segment Elevation Myocardial Infarction Secondary to Coronary Multi-Vessel Thrombosis in the Setting of COVID-19.

Coronavirus disease 2019 (COVID-19) has been shown to impact the cardiovascular system by causing congestive heart failure, arrhythmias, myocarditis, acute coronary syndrome (ACS), or nonischemic cardiomyopathy. The infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) triggers the overproduction of proinflammatory cytokines, generating systemic inflammation and a procoagulant state that can lead to cardiovascular morbidity and mortality. Symptomatology may not be discrete with presentation of chest pain, dyspnea, and fatigue, so careful consideration should be applied to cardiovascular complications.

Clinical Presentation and Outcomes of Myocarditis Post mRNA Vaccination: A Meta-Analysis and Systematic Review.

Background: Myocarditis is being increasingly reported as a potential complication of both Pfizer-BioNTech and Moderna vaccines for COVID-19. One thousand five hundred and twenty-two cases were reported as of September 02, 2021, as per CDC's (Centers for Disease Control) vaccine adverse event reporting system. Most of the published data is available in the form of case reports and series.

Post-mRNA COVID-19 Vaccination Myocarditis.

Unlabelled: A new trend of myocarditis among young adults who received mRNA vaccines for COVID-19 is emerging. We present the case of a young adult who presented with chest pain 3 days after the second dose of Pfizer-BioNTech COVID-19 vaccine. He had elevated troponin I and C-reactive protein levels at the time of admission.

Lemmel's Syndrome Secondary to Common Bile Duct Compression by an Inflamed Duodenal Diverticulum.

A 50-year-old female presented with acute epigastric abdominal pain, diarrhea, nausea, and vomiting for two days. Laboratory data showed hyperbilirubinemia and leukocytosis. Abdominal imagining was concerning for a pancreatic head/uncinate process lesion concerning a pancreatic neoplasm.

Iatrogenic Iron Overload Causing Porphyria Cutanea Tarda in a Patient With a Rare Nonsense Heterozygous UROD Gene Mutation.

Porphyria cutanea tarda (PCT) is a rare dermatologic condition characterized by blistering of sun-exposed surfaces and elevated hepatic enzymes. It may infrequently occur as the primary presentation of underlying hemochromatosis. A 61-year-old female with anemia caused by chronic kidney disease and end-stage renal disease on hemodialysis presented with a bullous rash on her hands with associated pruritus.

Reliability and validity study of the Spanish adaptation of the "Student Satisfaction and Self-Confidence in Learning Scale" (SCLS).

The European Higher Education Area (EHEA) recommends the use of new educational methodologies and the evaluation of student satisfaction. Different instruments have been developed in Spain to evaluate different aspects such as clinical decisions and teamwork, however no instruments have been found that specifically evaluate student self-confidence and satisfaction during clinical simulation. The aim was to translate the Student Satisfaction and Self-Confidence in Learning Scale (SCLS) questionnaire into Spanish and analyse its reliability and validity and understand the level of satisfaction and self-confidence of nursing students with respect to learning in clinical simulations.

Reactive arthritis: an unusual presentation of acute colitis.

A 20-year-old Caucasian man with a history of psoriasis presented to the emergency department due to a 2-week history of severe polyarthralgia and a 3-week history of non-bloody diarrhoea. The initial workup 2 days prior in an urgent care clinic returned negative for all enteric pathogens including nucleic acid amplification test. Investigations revealed colitis on CT and pseudomembranous colitis on colonoscopy.

Posterior Reversible Encephalopathy Syndrome in a Patient With SARS-CoV-2 Infection Treated With Tocilizumab.

As the world has struggled to adapt to the coronavirus disease (COVID-19) pandemic, new evidence has emerged suggesting that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may manifest with a wide variety of neurologic symptoms. We present the case of a 70-year-old patient hospitalized for COVID-19 related pneumonia who was treated with off-label interleukin (IL)-6 inhibitor tocilizumab and eventually developed prolonged delirium. MRI findings were consistent with posterior reversible encephalopathy syndrome (PRES).

A Case of Diagnostic Difficulty: Transient Loss of Consciousness in Artery of Percheron Infarct.

The artery of Percheron (AOP) is a rare anatomical variant of the paramedian thalamic vessels in 7-10% of the general population. An AOP infarct can present with rare clinical manifestations like transient loss of consciousness (LOC) and lethargy, as was seen in the patient whose case is discussed in this report, due to the plethora of regulatory inputs and outputs by the thalamus, which cannot be compensated for because of the absence of anastomotic connections. The AOP supplies the reticular activating system (RAS), which regulates consciousness.

Maggot Wound Therapy Associated with Wohlfahrtiimonas chitiniclastica Blood Infection.

Maggot therapy is the intentional application of live, disinfected fly larvae to wounds for debridement and wound care. Although some studies suggest possible beneficial applications for wound healing, subsequent infection is a potential risk of treatment. We present a case of a 70-year-old male with chronic left temporal wound from squamous cell carcinoma treated with maggot therapy complicated by bacteremia with .

Posterior Fossa Progressive Multifocal Leukoencephalopathy Secondary to Rituximab.

Progressive multifocal leukoencephalopathy (PML) is a rare fatal central nervous system disorder characterized by infection-induced demyelination of white matter due to the opportunistic reactivation of John Cunningham virus in an immunocompromised patient. PML is associated with many immune-mediated diseases, lymphoproliferative conditions, and immunosuppressive agents. In this case report, we present a 79-year-old female patient diagnosed with rheumatoid arthritis who developed posterior fossa PML while on rituximab.

A Short Case Report on Ruptured Sinus of Valsalva Aneurysm.

A 35-year-old woman without any history of congenital heart disease presented to our clinic with dyspnea on exertion. Transthoracic echocardiogram (TTE) showed an eccentric tricuspid regurgitant jet and increased right ventricular systolic pressure. Transesophageal echocardiogram (TEE) revealed a sinus of Valsalva aneurysm (SVA) arising from the noncoronary sinus that ruptured into the right atrium, leading to the formation of an aorto-right atrial fistula.

Reliability and validity study of the Spanish adaptation of the "Educational Practices Questionnaire" (EPQ).

The Educational Practices Questionnaire is an instrument for assessing students perceptions of best educational practices in simulation. As for other countries, in Spain, it is necessary to have validated rubrics to measure the effects of simulation. The objective of this study was to carry out a translation and cultural adaptation of the Educational Practices Questionnaire into Spanish and analyze its reliability and validity.

Chronic pain after groin hernia repair: pain characteristics and impact on quality of life.

Background: Chronic postsurgical pain (CPSP) after hernia repair research has mainly relied on unconfirmed self-reporting. We aimed to describe confirmed CPSP incidence, management, and quality of life (QoL) in a 2-year prospective study.

Methods: Multicenter study (GENDOLCAT) of 3890 patients undergoing 4 common surgical procedures in 23 hospitals to develop a risk model for CPSP; 2352 men underwent open hernia repair.

Integrating Geriatrics Knowledge into a Medical Student Clerkship Using Twitter Poll.

A controlled, prospective, 2-year cohort observational study was conducted to test whether weekly geriatric questions delivered through Twitter Poll could improve geriatrics knowledge during an internal medicine clerkship for third-year medical students. Pre- and post-rotation test results used a modified University of California, Los Angeles geriatric knowledge test that included questions linked to 26 Association of American Medical Colleges geriatric competencies for medical students. Data were analyzed using a general linear model repeated-measure design and Student t-test.

Anaesthesia management in epilepsy surgery with intraoperative electrocorticography.

Epilepsy surgery is a well-established treatment for patients with drug-resistant epilepsy. The success of surgery depends on precise presurgical localisation of the epileptogenic zone. There are different techniques to determine its location and extension.

Yttrium-90 radioembolization of hepatic metastases from colorectal cancer.

Liver metastases from colorectal cancer (CRC) result in substantial morbidity and mortality. The primary treatment is systemic chemotherapy, and in selected patients, surgical resection; however, for patients who are not surgical candidates and/or fail systemic chemotherapy, liver-directed therapies are increasingly being utilized. Yttrium-90 (Y-90) microsphere therapy, also known as selective internal radiation therapy (SIRT) or radioembolization, has proven to be effective in terms of extending time to progression of disease and also providing survival benefit.

A rare case of acquired hemophilia A associated with myelodysplastic syndrome.

84 year old male with past medical history of myelodysplastic syndrome (MDS) presented with progressive subcutaneous and muscle bleed in the right forearm and arm. Workup revealed elevated activated partial thromboplastin time (aPTT) - 71.8 seconds (normal 23 - 32 seconds) which was persistently elevated after mixing study (37.

Acute renal infarction secondary to calcific embolus from mitral annular calcification.

We report a case of a 62-year-old man who presented with right groin pain who subsequently was found to have a renal infarct secondary to calcific embolus from mitral annular calcification on CT and angiography. We briefly review the literature and discuss the importance of this entity in clinical practice.