Pre-rounding in hospital medicine: a narrative review.

Pre-rounding in hospital medicine is the practice of having junior physicians in the medical team come to work early to pre-clerk new and existing patients in advance, in order to formulate preliminary management plans, draft rounding notes and prepare for ward round presentations when the attending consultant and senior members of the team arrive. While pre-rounding is part of a long-standing tradition in the United States hospital-based practice, its adoption has been highly heterogeneous across the world, due to controversy over its purported benefits in patient care and post-graduate training. In this article, we sought to review the relevant literature on pre-rounding in hospital medicine and examine its current role in postgraduate training and practice, specifically evaluating its clinical and pedagogical utility.

Differential diagnosis of brain lesions in a metastatic endometrial carcinosarcoma patient.

The differential diagnosis of ring-enhancing brain lesions in a patient with metastatic malignancy may initially seem straightforward, and easily attributed to brain metastases. On rare occasions, the physician needs to avoid anchoring bias by re-evaluating the entire clinical context in which these ring-enhancing brain lesions are found. We report a case of cerebral toxoplasmosis mimicking brain metastases in a patient with metastatic cancer and without a prior history of human immunodeficiency virus.