Mantle cell lymphoma of the prostate gland treated with holmium laser enucleation.

Mantle cell lymphoma of the prostate is rare and is seldom encountered in general urologic practice. It either arises primarily from the prostate or is a result of metastatic spread from another site. This specific type of lymphoma has an aggressive course and may respond poorly to traditional chemotherapy with frequent relapses.

Severe palmar-plantar erythrodysesthesia and aplasia in an adult undergoing re-induction treatment with high-dose cytarabine for acute myelogenous leukemia: a possible drug interaction between posaconazole and cytarabine.

High-dose cytarabine is recommended for re-induction chemotherapy in patients less than 60 years of age with acute myelogenous leukemia. This case describes a patient receiving high-dose cytarabine for re-induction and subsequently developed tingling and numbness in her hands and feet followed by severe pain, swelling, and erythema consistent with a diagnosis of palmar-plantar erythrodysesthesia. Furthermore, the patient's hemoglobin, platelets, and neutrophils did not recover after over 30 days post high-dose cytarabine.

Learner Perspectives of a Surgical Educators Faculty Development Program Regarding Value and Effectiveness: A Qualitative Study.

Background: The BaylorScott & White Health Division of Plastic Surgery began a faculty development program designed to train clinicians to be better educators. The program consisted of presession reading, 11 small group didactic sessions, and individually chosen educational projects. Cross-discipline collaboration was pursued by enrolling faculty and students from diverse departments.

The writing retreat: a high-yield clinical faculty development opportunity in academic writing.

Background: The need for consistent academic productivity challenges junior clinician-scholars, who often lack the aptitude to ensure efficient production of manuscripts.

Intervention: To solve this problem, an academic division of a major medical center developed an off-site writing retreat. The purpose of the retreat was not to teach writing skills, but to offer senior mentor assistance with a focus on the elements of manuscript writing.

An alternative practice model: residents transform continuity clinic and become systems thinkers.

Background: A changing health care environment has created a need for physicians trained in health system improvement. Residency programs have struggled to teach and assess practice-based learning and improvement and systems-based practice competencies, particularly within ambulatory settings.

Intervention: We describe a resident-created and resident-led quality and practice-improvement council in an internal medicine continuity clinic.

Prevalence of anemia after Roux-en-Y gastric bypass surgery: what is the right number?

Background: The reported prevalence of anemia after malabsorptive bariatric surgery has varied from 5% to 64% in the post-Roux-en-Y gastric bypass (RYGB) population, owing to the small study sample sizes and generally poor follow-up in surgical referral practices. The present study estimated the prevalence of anemia in the post-RYGB population and determined whether an integrated healthcare system with a shared electronic medical record could improve postoperative follow-up.

Methods: The medical records from 1009 sequential patients who had undergone RYGB from 2000 to 2005 were retrospectively analyzed.

A case of disseminated intravascular coagulation associated with a prosthetic heart valve.

Malfunctioning prosthetic heart valves have been previously associated with nonimmune hemolytic anemia; however, disseminated intravascular coagulation has not previously been noted as a complication in the absence of infective endocarditis. The authors report the case of an 81-year-old woman who developed disseminated intravascular coagulation associated with a dysfunctional prosthetic heart valve.

Rituximab in severe skin diseases: target, disease, and dose.

New clinical indications for rituximab seem to appear every day. This review will trace the use of this monoclonal antibody from lymphoid malignancy, to classic autoimmune disease, and specifically severe autoimmune skin diseases. The history leading to different dosing schema with associated pharmacokinetic data will be discussed.

The patient panel conference experience: what patients can teach our residents about competency issues.

Purpose: In 2007, the Scott & White/Texas A&M HSC College of Medicine began requiring all internal medicine residents to attend quarterly patient panel conferences, during which former Scott & White patients speak frankly about their inpatient and outpatient experiences. The main purpose of this mixed-methods pilot study was to determine whether residents' competency education could be enhanced via the conferences.

Method: Of the 54 internal medicine residents in the residency program, 31, 39, and 41 participated in three patient panel conferences, respectively, between December 2007 and August 2008.

Phase II study of an alternate carboplatin and gemcitabine dosing schedule in advanced non-small-cell lung cancer.

We conducted a phase II single-institution trial in a homogenous patient population with advanced non-small-cell lung cancer to determine whether changing the carboplatin schedule in the carboplatin/gemcitabine doublet would enhance tolerability and/or results. Thirty patients with stage IIIB (with malignant effusion) or stage IV disease received gemcitabine 1100 mg/m2, days 1 and 8 plus carboplatin at an area under the curve of 5 on day 8. Cycles were repeated every 28 days, up to 6 cycles.