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Palliative Care Initiated in the Emergency Department: A Cluster Randomized Clinical Trial.
JAMA
January 2025
Department of Emergency Medicine, Henry Ford Health, Detroit, Michigan.
Importance: The emergency department (ED) offers an opportunity to initiate palliative care for older adults with serious, life-limiting illness.
Objective: To assess the effect of a multicomponent intervention to initiate palliative care in the ED on hospital admission, subsequent health care use, and survival in older adults with serious, life-limiting illness.
Design, Setting, And Participants: Cluster randomized, stepped-wedge, clinical trial including patients aged 66 years or older who visited 1 of 29 EDs across the US between May 1, 2018, and December 31, 2022, had 12 months of prior Medicare enrollment, and a Gagne comorbidity score greater than 6, representing a risk of short-term mortality greater than 30%.
Hypomorphic RAG2 Deficiency Promotes Selection of Self-Reactive B Cells.
J Clin Immunol
January 2025
Center for Immunity and Immunotherapies, Seattle Children's Research Institute, Seattle, WA, USA.
Reduced function or hypomorphic variants in recombination-activating genes (RAG) 1 or 2 result in a broad clinical phenotype including common variable immunodeficiency (CVID) and even adult-onset disease. Milder RAG variants are less characterized. Here we describe the longitudinal course of a milder combined RAG deficiency in 3 of 7 siblings sharing the same RAG2 mutations over a 50-year study.
View Article and Find Full Text PDFBreak through the mold: Hyper-IgE syndrome as a vehicle for invasive aspergillosis.
Respir Med Case Rep
December 2024
Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Nebraska Medical Center, Omaha, NE, USA.
Hyperimmunoglobulin E syndrome (HIGES) is a rare immunodeficiency characterized by high levels of immunoglobulin E (IgE) in the setting of various clinical features such as cutaneous candidiasis, asthma, recurrent rashes, and fungal infections. This case describes a 70-year-old male with cachexia and dyspnea found to have a cavitary lesion and aspergilloma, with remarkably high IgE and positive 1,3-β-D-glucan and Aspergillus testing. Herein, we describe the aforementioned case, review the available literature, and hypothesize the connection between invasive fungal infections and HIGES.
View Article and Find Full Text PDFVaricella-zoster virus presenting with nasal tip necrosis.
JAAD Case Rep
January 2025
Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin.
A Comparative Review of the Terms Epipharyngitis and Nasopharyngitis in Medical Literature.
Cureus
December 2024
Department of Radiology, Oregon Health and Science University, Portland, USA.
This review explores the usage of the term "epipharyngitis" in medical literature, particularly in non-English-speaking contexts. The term, although rarely used in contemporary English-language medical literature, may lead to confusion due to its overlap with more commonly used terms like "nasopharyngitis." This review aims to trace the origins of the term, analyze its usage across different languages, and discuss the implications of term differences in clinical practice and medical education.
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