Delayed Diagnoses in Patients With Dizziness in the US Commonwealth of Virginia and the Tidewater Region.

Objective: In a region of approximately 1.7 million people (Tidewater, coastal Virginia), identify secondary diagnoses in persons with dizziness.

Methods: This cross-sectional study utilizing TriNetX included individuals in the region of interest diagnosed with dizziness between 2010 and 2020.

Tracheoesophageal Fistula as a Complication of Prolonged Ventilation in COVID-19: Description of Reconstruction and Review of the Literature.

Infection with COVID-19 pneumonia may necessitate intubation and mechanical ventilation. Viral inflammation and pressure necrosis may lead to scarring, stenosis, and in severe cases, fistula formation. Nonmalignant tracheoesophageal fistulas (TEF) represent a surgical challenge and may necessitate locoregional tissue transfer and tracheal resection to prevent recurrence and maintain airway patency.

Clinical characteristics and outcomes of children with newly diagnosed acute myeloid leukemia and hyperleukocytosis managed with different cytoreductive methods.

Background: Hyperleukocytosis in patients with acute myeloid leukemia (AML) has been associated with worse outcomes. For cytoreduction, leukapheresis has been used but its clinical utility is unknown, and low-dose cytarabine (LD-cytarabine) is used as an alternative method.

Methods: Children with newly diagnosed AML treated between 1997 and 2017 in institutional protocols were studied.

Contrast-induced generalized bullous fixed drug eruption resembling Stevens-Johnson syndrome.

A 59-year-old woman with end-stage renal disease presented for suspected Stevens-Johnson syndrome that was ultimately diagnosed as generalized bullous fixed drug eruption (GBFDE) secondary to the administration of iodinated nonpolar radiocontrast. The patient had three previous episodes of a generalized bullous eruption after a thrombectomy, fistulogram, and an arteriovenous fistula revision, all requiring radiocontrast administration. Biopsies taken after previous eruptions demonstrated full-thickness epidermal necrosis, and she was diagnosed with Stevens-Johnson syndrome thought to be due to allopurinol.

Darier disease with disseminated herpes simplex virus type 2 infection.

Darier disease (DD), also known as keratosis follicularis or Darier-White disease, is a rare autosomal dominant genodermatosis that presents as hyperkeratotic, warty papules affecting the seborrheic and intertriginous areas. Patients with DD are at risk of secondary infections including the rare complication of Kaposi varicelliform eruption (KVE), a widespread viral infection most commonly caused by herpes simplex virus (HSV). Darier disease with secondary KVE can lead to widespread systemic infection and death.

Protected-area monitoring dilemmas: a new tool to assess success.

Understanding factors that influence the success of protected areas in curbing unsustainable resource consumption is essential for determining best management strategies and allocating limited resources to those projects most likely to succeed. I used a law-enforcement and monitoring game-theory model from the political science literature to identify three key variables useful in predicting the success of a protected area: costs of monitoring for rule breakers, benefits of catching a rule breaker, and probability of catching a rule breaker if monitoring. Although assigning exact values for each of these variables was difficult, the variables had a strong predictive capacity even when coded as coarse ordinal values.