Characteristics of COVID-19 Breakthrough Infections among Vaccinated Individuals and Associated Risk Factors: A Systematic Review.

We sought to assess breakthrough SARS-CoV-2 infections in vaccinated individuals by variant distribution and to identify the common risk associations. The PubMed, Web of Science, ProQuest, and Embase databases were searched from 2019 to 30 January 2022. The outcome of interest was breakthrough infections (BTIs) in individuals who had completed a primary COVID-19 vaccination series.

Cutaneous Manifestation as Initial Presentation of Metastatic Breast Cancer: A Systematic Review.

Metastatic breast cancer initially may present with cutaneous lesions. The goal of this systematic review was to evaluate available reports where the initial discovery of primary breast cancer occurred through the diagnosis of metastatic cutaneous lesions. We aimed to better understand these cases and the role of dermatologists in their diagnosis.

Improving Patient Experience by Teaching Empathic Touch and Eye Gaze: A Randomized Controlled Trial of Medical Students.

Background: Empathy is critical for optimal patient experience with health-care providers. Verbal empathy is routinely taught to medical students, but nonverbal empathy, including touch, less so. Our objective was to determine whether instruction encouraging empathic touch and eye gaze at exit can impact behaviors and change patient-perceived empathy.

Airway Hygiene in COVID-19 Pneumonia: Treatment Responses of 3 Critically Ill Cruise Ship Employees.

BACKGROUND COVID-19, the disease entity caused by the novel severe acute respiratory coronavirus 2 (SARS-CoV-2), continues to pose a major therapeutic challenge for clinicians. At present, an effective treatment regimen and vaccination has not been established. Many patients develop severe symptoms requiring endotracheal intubation and a prolonged stay in the Intensive Care Unit (ICU).

Treatment of Severe COVID-19 with Tocilizumab Mitigates Cytokine Storm and Averts Mechanical Ventilation During Acute Respiratory Distress: A Case Report and Literature Review.

COVID-19, caused by the novel severe acute respiratory coronavirus 2 (SARS-CoV-2), emerged in Wuhan, China, in 2019 and has resulted in the current pandemic. The disease continues to pose a major therapeutic challenge. Patient mortality is ultimately caused by acute respiratory distress syndrome (ARDS).

Philip Drinker versus John Haven Emerson: Battle of the iron lung machines, 1928-1940.

The "iron lung," originally known as the Drinker respirator, was developed in 1928 by Dr Philip Drinker and Dr Louis Agassiz Shaw to improve the respiration of polio patients. In 1931, John Haven Emerson, an inventor from Cambridge, MA, enhanced the design of the Drinker respirator and introduced a new and highly improved model of the iron lung that was cheaper and significantly lighter. Dr Drinker eventually filed a lawsuit against Emerson for alleged patent infringement.

Breast Cancer Suspicion in a Transgender Male-to-Female Patient on Hormone Replacement Therapy Presenting with Right Breast Mass: Breast Cancer Risk Assessment and Presentation of a Rare Lesion.

There has been an increasing use of hormonal therapy among male-to-female (MtF) transgender individuals. This long-term hormone replacement therapy (HRT) renders MtF individuals a unique patient subgroup in terms of breast cancer risk. This case describes a MtF transgender who presented with a breast lesion concerning for malignancy following hormonal replacement therapy.

Wire in the heart: fracture and fragment embolization of retrievable inferior vena cava filter into the right ventricle.

We report a case of a 58-year-old female who was found to have a fractured limb of her IVC filter in her right ventricle during a cardiac catheterization. A 25 mm radioopaque thin linear structure was seen in the proximal portion of the right ventricle. It was fixed and did not migrate or change position during investigations.

Idiopathic bilateral adrenal hemorrhage in a 63-year-old male: a case report and review of the literature.

Adrenal hemorrhage is a largely uncommon condition typically caused by a number of factors including infection, MI, CHF, anticoagulants, trauma, surgery, and antiphospholipid syndrome. Yet, idiopathic bilateral hemorrhage is rare. The authors present a case of a 63-year-old male who presented with abdominal pain that was eventually diagnosed as bilateral adrenal hemorrhages due to an unknown origin.

Minor trauma causing stroke in a young athlete.

A 17-year-old Caucasian male presented with sudden dizziness, ataxia, vertigo, and clumsiness lasting for a couple of hours. He had a subtle trauma during a wrestling match 2 days prior to the presentation. A CT Angiogram (CTA) and MRI showed left vertebral artery dissection (VAD).

Predictors of mortality for nursing home-acquired pneumonia: a systematic review.

Background: Current risk stratification tools, primarily used for CAP, are suboptimal in predicting nursing home acquired pneumonia (NHAP) outcome and mortality. We conducted a systematic review to evaluate current evidence on the usefulness of proposed predictors of NHAP mortality.

Methods: PubMed (MEDLINE), EMBASE, and CINAHL databases were searched for articles published in English between January 1978 and January 2014.

Molecular, phenotypic aspects and therapeutic horizons of rare genetic bone disorders.

A rare disease afflicts less than 200,000 individuals, according to the National Organization for Rare Diseases (NORD) of the United States. Over 6,000 rare disorders affect approximately 1 in 10 Americans. Rare genetic bone disorders remain the major causes of disability in US patients.

Bullosis diabeticorum: rare presentation in a common disease.

A 27-year-old African American male presented with a sudden onset of blisters. He had a past medical history of uncontrolled diabetes mellitus type I, diabetic vasculopathy, and neuropathy. The physical examination revealed nonerythematous skin denudations on both elbows and lateral aspect of arm bilaterally.

Putting patients first: a novel patient-centered model for medical enterprise success.

This article introduces a new way of viewing patient-customers. It encourages a greater emphasis on patients' needs and the importance of considering dimensions of the patient experience to better serve them. It also draws from examples in the general business world as they can be applied to medical enterprises.

Partnerships in medical business: a framework for choosing the right key players.

At a time when more and more physicians are opting for shared practices and embarking on business ventures, partnerships play a key role. The fate of a medical business is largely contingent upon the success of the partnership. In this article, the author introduces a practical framework for deciding whether to take on a partnership.

Knowledge of modifiable risk factors of Coronary Atherosclerotic Heart Disease (CASHD) among a sample in India.

Background: The prevalence of Coronary Atherosclerotic Heart Disease (CASHD) is increasing in India. Several modifiable risk factors contribute directly to this disease burden. Public knowledge of such risk factors among the urban Indian population is largely unknown.

Internal Hernias and Nonclosure of Mesenteric Defects During Laparoscopic Roux-en-Y Gastric Bypass.

Background: Internal hernias have been described after laparoscopic Roux-en-Y gastric bypass (LRYGB) as a major problem. Thus, many routinely close defects during LRYGB. In our technique, we do not close any defects.

Patient perception of medicare fee schedule of laparoscopic procedures.

Introduction: It seems that public perception is that physicians receive substantial payments for procedures. This investigation explores patient perception and opinion of Medicare reimbursements to surgeons related to laparoscopic surgery. Our hypothesis was that patients think the surgeon Medicare fee schedule is higher than actuality.

In search of a treatment for Alzheimer's disease and potential immunonosuppresive therapeutic interventions.

Alzheimer's disease (AD) is a serious neurodegenerative disease of aging. Recent projections of the dramatic increase in AD incidence worldwide by 2050 reveal its magnitude as a world-wide health crisis and underscore the urgent need to understand the etiology of AD in order to develop therapeutic interventions. A popular debate among scientists has traditionally pitted those in support of Beta amyloid protein as a causative factor ("Baptists") against others who implicate tau hyperphosphorylation ("Tauists").

Utilizing video on myocardial infarction as a health educational intervention in patient waiting areas of the developing world: A study at the emergency department of a major tertiary care hospital in India.

Objective: To study the effect of health educational video instruction on increasing patients' knowledge in a hospital waiting area of a developing country.

Methods: An educational video on signs, symptoms, and risk factors of myocardial infarction (MI) was played in an Emergency Department (ED) patient waiting area of an urban tertiary care hospital in India. Participants (n = 217) were randomly assigned to two groups: an intervention group that viewed the MI video (n = 111) and a control group that did not view the video (n = 106).

Laparoscopic repair of a staple-line disruption after an open uncut Roux-en-Y gastric bypass.

The technique of gastric bypass has undergone an evolution over the last 20 years, although it is often individualized based on surgeon preference. Whereas many surgeons divide and separate the gastric pouch from the distal bypassed stomach, some surgeons choose to staple, but not cut and separate the pouch. Staple-line failure resulting in a gastrogastric fistula and weight regain is a worrisome complication.

Patients who are delayed from undergoing bariatric surgery do not have improved weight loss.

Background: Many patients have a prolonged wait time between initial surgeon visit and actual surgery day. Whereas there are various reasons for this, few have examined if patient wait time for bariatric surgery has any affect on weight loss. This investigation studies the hypothesis that patients who wait longer for bariatric surgery do not have improved weight loss over those with shorter wait times.