Reducing Waste at the Bedside: A Resident-Led Project to Decrease Waste and Cost From Diagnostic Paracentesis.

Physicians have a responsibility to reduce the environmental harms from health care waste. Residents contribute to waste during bedside procedures. To calculate waste and estimated cost reduction with the introduction of a novel resident-designed paracentesis kit at a single academic center in Texas in 2023.

Pediatric COVID-19 Vaccination in the Inpatient Setting.

Background And Objectives: The inpatient setting is often underutilized as a venue for providing pediatric vaccines. During the 2019 novel coronavirus (COVID-19) pandemic, our hospital began a vaccination program to provide access to COVID-19 vaccines for eligible pediatric inpatients. Our objective was to describe the establishment and assess the impact of a COVID-19 vaccination program for pediatric inpatients.

A rare occurrence of Anaplasma-associated peritonitis.

Anaplasmosis or human granulocytic anaplasmosis is a tick-borne illness caused by the bacteria, Anaplasma phagocytophilum, resulting from an infected tick bite. Examination of a blood smear within the first week of exposure may show microcolonies of anaplasmae (morulae) in the cytoplasm of neutrophils that are highly suggestive of anaplasmosis but not definitive. We present the first case describing Anaplasma-related peritonitis and morulae in peritoneal fluid granulocytes in a peritoneal dialysis patient who developed anaplasmosis.

Disseminated Complex Myositis in a Patient With Graft-Versus-Host Disease.

complex (MAC) is a ubiquitous environmental pathogen that was infrequently reported as a cause of disease before the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome epidemic. We present a case of MAC pyomyositis and bacteremia in a 59-year-old man with chronic lymphocytic leukemia in remission after an allogenic stem cell transplant. His posttransplant course was complicated by graft-versus-host disease, requiring treatment with oral steroids and ruxolitinib.

Retinoic acid signaling acts as a rheostat to balance Treg function.

Regulatory T cells (Tregs) promote immune homeostasis by maintaining self-tolerance and regulating inflammatory responses. Under certain inflammatory conditions, Tregs can lose their lineage stability and function. Previous studies have reported that ex vivo exposure to retinoic acid (RA) enhances Treg function and stability.

Creation of an ex-vivo bovine kidney flow model for testing embolic agents: work in progress.

Objectives: To develop an ex- vivo perfusion flow model using a bovine kidney for future testing of embolic agents in an inexpensive and easy way.

Methods: Six bovine adult kidneys were used for this study. Kidneys were cannulated and perfused via a roller pump.

Mouse models of growth hormone insensitivity.

Growth hormone (GH) induces pleiotropic effects on growth and metabolism via binding and subsequent activation of the growth hormone receptor (GHR) and its downstream signaling pathways. Growth hormone insensitivity (GHI) describes a group of disorders in which there is resistance to the action of GH and resultant insulin-like growth factor I (IGF-I) deficiency. GHI is commonly due to genetic disorders of the GH receptor causing GH receptor deficiency (e.

Evaluation of Integrated Interventional Radiology Residency Websites.

Rationale And Objectives: In the transition to the integrated interventional radiology residency model, residency websites are important resources of program information for prospective applicants. The objective of this investigation was to evaluate the availability and comprehensiveness of integrated interventional radiology residency websites.

Materials And Methods: A complete list of programs participating in the 2018 integrated interventional radiology match was collected using the online Fellowship and Residency Electronic Interactive Database and Electronic Residency Application Service.

Pain location and widespread pain in youth with orthopaedic conditions: Exploration of the reliability and validity of a body map.

Background: Pain location and widespread pain are important but underexamined dimensions of paediatric pain. Body map tools to assess pain location in youth have been used for several decades, but few studies have established reliability and validity of these measures. The purpose of this study was to explore the reliability and validity of a pain body map among youth with orthopaedic conditions before surgery.

Development of a Multidisciplinary Pediatric Surgery Fellowship.

With the rapidly changing landscape of medicine, physician assistants (PAs) have solidified their role as integral members of nearly every medical field. As PAs become leaders in smaller, more specialized fields, their duties encompass skills that they had not been exposed to in the broad, comprehensive, standard PA education. Consequently, participation in postgraduate PA education has rapidly expanded to keep up with the demand for additional training.

Fusobacterium Nucleatum: Atypical Organism of Pyogenic Liver Abscess Might be Related to Sigmoid Diverticulitis.

Context: Pyogenic liver abscesses (PLAs) are the most common form of liver abscesses in the United States. Most cases are caused by enteric bacteria and anaerobes. We report a case of PLA caused by a rare pathogen, Fusobacterium nucleatum, from an unusual primary site of infection.

False positivity of monospot test in an immunocompetent elderly woman with acute cytomegalovirus infection.

A 75-year-old woman presented with altered mental status, septic picture, and influenza-like symptoms. Initial investigations revealed atypical lymphocytosis, thrombocytopenia, elevated liver enzymes, and a positive monospot test result. Further investigation showed the Epstein-Barr virus viral capsid antibody IgM/IgG and Epstein-Barr virus DNA by polymerase chain reaction to be negative; however, interestingly her cytomegalovirus (CMV) IgM and IgG were positive, suggesting that her mononucleosis-like syndrome was due to acute CMV infection.

Hospitalized Patients' Perceptions of Resident Fatigue, Duty Hours, and Continuity of Care.

Background: Physicians' perceptions of duty hour regulations have been closely examined, yet patient opinions have been largely unstudied to date.

Objective: We studied patient perceptions of residency duty hours, fatigue, and continuity of care following implementation of the Accreditation Council for Graduate Medical Education 2011 Common Program Requirements.

Methods: A cross-sectional survey was administered between June and August 2013 to inpatients at a large academic medical center and an affiliated community hospital.

Prenatal Identification of Pierre Robin Sequence: A Review of the Literature and Look towards the Future.

Fetal ultrasonography is an important tool used to prenatally diagnose many craniofacial conditions. Pierre Robin sequence (PRS) is a rare congenital deformation characterized by micrognathia, glossoptosis, and airway obstruction. PRS can present as a perinatal emergency when the retropositioned tongue obstructs the airway leading to respiratory compromise.

A systematic examination of the effect of tissue glues on rhytidectomy complications.

Background: Fibrin glue has widespread use in multiple fields of surgery. There have been numerous studies on the use of fibrin glue in facelifts, with no consensus regarding differences in outcomes.

Objectives: This study compared the risk of hematoma, seroma, and the 24-hour drainage volume in all published prospective controlled trials.

LeFort I Osteotomy.

The LeFort I osteotomy is one of the most commonly used procedures to correct midface deformities. It allows for correction in three dimensions including advancement, retrusion, elongation, and shortening. It is indicated, often in conjunction with mandibular surgery, for class II and III malocclusion, facial asymmetry, obstructive sleep apnea, and maxillary atrophy.

Unveiling the hidden eagle: acute parotitis-induced eagle syndrome.

Context: A cervicofacial pain and foreign body sensation in pharynx associated with styloid process elongation is called Eagle syndrome. Typically, this syndrome is provoked by tonsillectomy or trauma. We report the first case of acute parotitis-induced Eagle syndrome.

A critical review of the classic metaphyseal lesion: traumatic or metabolic?

Objective: The purpose of this study was to review the hypothesis that classic metaphyseal lesions represent traumatic changes in abused infants and compare these lesions with healing rickets.

Materials And Methods: Using a PubMed search, a multidisciplinary team reviewed studies that reported the histopathologic correlation of classic metaphyseal lesions. Selective studies of growth plate injury and rickets were cross-referenced.

Report of a family with idiopathic knuckle pads and review of idiopathic and disease-associated knuckle pads.

Knuckle pads are a rare, frequently overlooked, thickening of the skin usually overlying the extensor surface of the proximal interphalangeal joints. They are well- circumscribed, benign lesions that generally do not require treatment. Idiopathic knuckle pads must be differentiated from similar appearing lesions or trauma-induced pseudo-knuckle pads.