Frontal lobe intra-axial schwannoma harboring a CHD7::VGLL3 fusion and heterozygous TSC2 p.F1510del mutation in a young child.

Background: Brain intraparenchymal schwannoma is a rare clinical entity, generally curable with adequate resection.

Methods And Results: We describe a case in a male patient first presenting at 19 months of age, the youngest reported age for this lesion. It also appears to be the first case connected to a germline TSC2 p.

Sex-Based Differences in Endovascular Thrombectomy Outcomes for Large Ischemic Stroke: A SELECT2 Subanalysis.

Background: Several social and biological factors are shown to differentially affect stroke outcomes between men and women. We evaluated whether clinical outcomes and endovascular thrombectomy (EVT) treatment effects differed between the sexes in patients presenting with large ischemic stroke.

Methods: The SELECT2 trial (A Randomized Controlled Trial to Optimize Patient's Selection for Endovascular Treatment in Acute Ischemic Stroke) was a randomized controlled trial assessing the efficacy and safety of EVT in patients with large strokes across the United States, Canada, Europe, Australia, and New Zealand between October 2019 and September 2022.

Facial Contouring Through Jaw Exercises: A Report of Two Cases Examining Efficacy and Consumer Expectations.

This study examines the efficacy of jaw exercising products for facial contouring. The two individuals used a commercially available jaw exerciser for approximately three months, following the provided instructions. Neither case reported noticeable changes in jaw appearance based on subjective measurements.

Vitamin B12-induced acneiform eruption.

Cutaneous acneiform eruptions are a side effect of many medications, including vitamin B12 therapy. However, reports of vitamin B12-induced acne are rare. We present a 67-year-old woman with a new diagnosis of pernicious anemia who developed a sudden acneiform eruption on the face after treatment with high-dose vitamin B12.

The Validation of the Sinclair Compassion Questionnaire (SCQ) and SCQ Short Form in an English-Speaking U.S. Population: A Patient-Reported Measure of Compassion in Healthcare.

Compassion is recognized as a key component of high-quality healthcare. The literature shows that compassion is essential to improving patient-reported outcomes and fostering health care professionals' (HCPs) response and resilience to burnout. However, compassion is inherently difficult to define, and a validated tool to reliably quantify and measure patients' experience of compassion in healthcare settings did not exist until recently.

Orthopedic Surgery Meets Serious Illness Care: Palliative Care and Advance Care Planning for the Orthopedic Surgeon.

» Advance care planning and palliative care can improve care for orthopedic patients.» The "surprise question" is a useful prognostication tool and trigger for palliative care referral.» Engage in routine advance care planning conversations.

Symmetric, Bilateral Auricular Calcifications in Twins With Noonan Syndrome.

Noonan syndrome (NS) is a rare, genetic multisystem disorder often presenting with associated craniofacial abnormalities. The authors report an identical twin pair with classical features of NS including short stature, mild ptosis, hypertelorism, down-slanting palpebral fissures, low-set angulated ears, and giant cell tumors in the craniofacial skeleton. Interestingly, these patients also presented with bilateral, symmetric, dystrophic auricular calcifications.

From Headache to Handled: Advanced In-Basket Management System in Primary Care Clinics Reduces Provider Workload Burden and Self-Reported Burnout.

Background:  The electronic health record (EHR) has been associated with provider burnout, exacerbated by increasing In-Basket burden.

Objectives:  We sought to study the impact of implementing a team-based approach to In-Basket management on a series of primary care ambulatory sites.

Methods:  We performed a workflow analysis of the transition to the Advanced In-Basket Management (AIM) nurse team triage for six family medicine clinic locations in a large health system.

Poor adherence to proper Barrett's esophagus screening and surveillance guidelines in patients with newly diagnosed esophageal adenocarcinoma.

Background: Screening for Barrett's esophagus (BE) remains controversial, even for high-risk populations. Our study aimed to evaluate the proportion of patients diagnosed with esophageal adenocarcinoma (EAC) who were not screened for BE or did not receive recommended BE surveillance screening. We then evaluated the relationship between cancer staging and screening/surveillance opportunities.

Elusive Unilateral Pleural Effusion: Keys to Clinching the Diagnosis.

Unilateral pleural effusions may sometimes be difficult to diagnose. The cause may vary widely, including congestive heart failure, chronic liver and kidney disease, various drugs, and underlying undiagnosed disorders of the lung and pleura. With advancements in chest imaging, new biomarkers, and less invasive methods for obtaining tissue samples, it may be possible to identify the cause of the unilateral pleural effusions whose etiology is unclear.

Racial Disparities in Parturient Urine Drug Screening at a Texas Level IV Maternal Care Centre: A Single-Centre Retrospective Study.

Objectives: We hypothesized that Black or African American (hereby referred to as Black) and Hispanic patients would have higher rates of urine drug screening (UDS) during pregnancy compared with White or Caucasian (herby referred to as White) patients at our hospital.

Methods: Patients who delivered at our hospital between 1 December 2020 and 31 May 2021 and between 1 December 2022 and 31 May 2023 and who were Black, Hispanic, or White were included in the final analysis. We performed separate bivariate analyses comparing White patients to either Black patients or Hispanic patients.

Differentiating Myelography Contrast from Intraventricular and Subarachnoid Hemorrhage Using Dual-Energy CT of the Head: A Case Report and a Review of Literature.

Single-energy computed tomography (SECT) head is a common diagnostic tool to evaluate for intracranial hemorrhage in emergency settings due to its widespread accessibility and non-invasive nature. However, SECT has densitometric evaluation limitations. For example, hyperdensities on SECT such as blood product and iodine contrast appear similarly.

The Discover In-Hospital Cardiac Arrest (Discover IHCA) Study: An Investigation of Hospital Practices After In-Hospital Cardiac Arrest.

Importance: In-hospital cardiac arrest (IHCA) is a significant public health burden. Rates of return of spontaneous circulation (ROSC) have been improving, but the best way to care for patients after the initial resuscitation remains poorly understood, and improvements in survival to discharge are stagnant. Existing North American cardiac arrest databases lack comprehensive data on the post-resuscitation period, and we do not know current post-IHCA practice patterns.

Apparent local anesthetic systemic toxicity following activation of an epidural catheter for cesarean delivery: diagnosis and management of an uncommon obstetric anesthesia complication.

We present a 25-year-old, gravida 2, para 1 woman who developed apparent local anesthetic systemic toxicity (LAST) following activation of an epidural catheter for an urgent cesarean delivery. The patient had a height of 150 cm, weight of 92 kg, body mass index of 41 kg/m, and calculated ideal body weight of 40 kg. A combined spinal epidural anesthetic was placed and the spinal component did not provide anesthesia to clamping of the abdomen.

Refining Cardiovascular Calcification in the Appraisal of Ischemic Heart.

Background: Even in asymptomatic patients, there is a high association of ischemia on myocardial perfusion scans in those with coronary artery calcification or valvular calcifications. Patients without coronary artery calcifications have exceeding-low rates of cardiovascular events. The absence of cardiovascular calcification, including coronary artery, valvular, and thoracic aorta is a strong negative predictor of myocardial ischemia.

A Rare Presentation of Indirect Hyperbilirubinemia: Coexistence of Multiple Gene Variants.

Indirect hyperbilirubinemia is a common clinical finding and rarely can be attributed to Crigler-Najjar syndrome type 2 or Gilbert syndrome. This case displays a rare presentation of indirect hyperbilirubinemia in a patient with multiple gene variants. We aim to discuss the complexity of multiple gene variants and its effect on the degree of observed hyperbilirubinemia.

Close outpatient follow-up associated with reduced readmission rates in patients with inflammatory bowel disease.

Background: Few studies have shown the effects of prompt outpatient follow-up in relation to reducing readmission rates in patients hospitalized with inflammatory bowel disease (IBD). Our study evaluated whether postdischarge follow-up was associated with fewer IBD-related readmissions.

Methods: This single-center retrospective study included 477 patients with Crohn's disease (CD) or ulcerative colitis (UC) who were readmitted to our tertiary care hospital from January 1, 2016, to June 1, 2022.