Temporal Trends of Fungal Infections in Cirrhotic Patients: A Retrospective Cohort Study 2016-2020.

Background: Patients with cirrhosis are susceptible to infections due to abnormalities in humoral and cell-mediated immunity. Fungal infections are associated with delayed diagnosis and high mortality rates, emphasizing the importance of performing fungal cultures and maintaining elevated levels of suspicion in this patient population.

Methods: This retrospective cohort study analyzes cirrhotic patients readmitted with bacterial and fungal infections and investigates outcomes, including in-hospital mortality and hospital resource utilization.

Simulated Patient as a Learner: Medical Volunteers Gain Knowledge by Participating in a Wilderness Medicine Training Session.

Introduction: -A multifaceted approach to wilderness medicine education and training is necessary to provide a high-quality learning experience, often requiring innovative instructional techniques. Using volunteers to act as patients in medical education is a well-established practice that helps teach crucial skills. However, more is needed to know if there is potential knowledge acquisition through participation.

Exploring the impact of surgeon-reported gender on palliative care utilization in geriatric trauma patients.

Introduction: Geriatric trauma research increasingly supports the use of Palliative Care (PC). We surveyed trauma surgeon for perspectives on PC usage. Significant gender differences were identified, necessitating post-hoc investigation.

Clinical Outcomes Following Optical Coherence Tomographic Versus Intravascular Ultrasound-Guided Percutaneous Coronary Intervention: A Meta-Analysis of Randomized Controlled Trials.

Background: Optical coherence tomography (OCT) and intravascular ultrasound (IVUS) are adjunctive intracoronary imaging modalities used to optimize coronary stent implantation. However, the impact of OCT versus IVUS on clinical outcomes and periprocedural complications is unclear.

Aims: To perform a meta-analysis of all vetted randomized controlled trials comparing OCT-guided versus IVUS-guided percutaneous coronary intervention.

SARS-CoV-2 Prevalence in a Delivering Refugee Population: Refugee Status, Payor Type, Race, and Vaccination Status.

Underserved communities were disproportionately affected during the coronavirus (COVID-19) pandemic. Limited data exist on the impact of COVID-19 among refugee populations because refugee status is not often classified in electronic medical record (EMR) systems, unlike race or primary language. The study aim was to evaluate the PCR-based prevalence of SARS-CoV-2 in a delivering population over the first 2 years of the pandemic by refugee status, ethnicity, insurance, and vaccination status.

Not From Around Here: Evaluation of In-Person Interviews in an Urban General Surgery Residency Program.

Objective: This study used a program evaluation approach to investigate the perceptions of utilizing in-person applicant interviews for a general surgery residency program.

Design: The study utilized de-identified data routinely collected during the residency program applicant interviews in the General Surgery Residency Program during the fall of 2023. Applicant and faculty/resident exit interview questionnaires were developed to evaluate perceptions of in-person interviewing; the questions were informed by domains for considering the appropriateness and feasibility of continuing in-person interviews as identified by the institution's Graduate Medical Education Committee.

Unleashing surgical skills: Ultra-high fidelity trauma thoracotomy training on knowledge donor platform.

Background: Resuscitative thoracotomies are a time-sensitive emergency surgical procedure with an immediate risk of mortality. We hypothesize that a high-fidelity whole-body donor simulation model, referred to as a Knowledge Donor (KD), with mechanical lung ventilation and expired human blood perfusion could increase learner confidence in performing this critical procedure.

Methods: General surgery residents and faculty were invited to participate in KD training.

Intermediate-sized follicular thyroid cancer surgical trends before and after the 2015 American thyroid association guideline changes.

In 2015, the ATA updated the guidelines to advocate for a lobectomy for tumors <1.0 ​cm and total thyroidectomy for tumors >4.0 ​cm.

Marijuana may lead to increased platelet activity in trauma patients.

Introduction: Delta-9-tetraydrocannabinol (THC) usage is associated with venous thromboembolic events (VTE) in trauma patients. We hypothesized that THC ​+ ​trauma patients would have less platelet inhibition than THC - patients using thromboelastography with platelet mapping (TEG-PM).

Methods: Results from initial TEG- PM assays and patient's UDS were reviewed between 2019 and 2023.

Desert Medicine.

Deserts are defined by their arid nature, characterized by little rainfall, and often featuring vast stretches of sandy terrain with sparse vegetation. The resulting variations in temperature, humidity, and topography predispose patients to medical conditions that practitioners in both rural and urban deserts must recognize and manage. This article will equip medical practitioners with the essential knowledge and tools to navigate these complexities, including a description of specific environmental considerations and challenges encountered while providing care in these desert locations, common conditions associated with extreme heat and solar radiation, and animal encounters.

Promising immunomodulators for management of substance and alcohol use disorders.

Introduction: The neuroimmune system has emerged as a novel target for the treatment of substance use disorders (SUDs), with immunomodulation producing encouraging therapeutic benefits in both preclinical and clinical settings.

Areas Covered: In this review, we describe the mechanism of action and immune response to methamphetamine, opioids, cocaine, and alcohol. We then discuss off-label use of immunomodulators as adjunctive therapeutics in the treatment of neuropsychiatric disorders, demonstrating their potential efficacy in affective and behavioral disorders.

Pharmacotherapies for the Treatment of Progressive Supranuclear Palsy: A Narrative Review.

Progressive supranuclear palsy (PSP) is a neurodegenerative disorder resulting from the deposition of misfolded and neurotoxic forms of tau protein in specific areas of the midbrain, basal ganglia, and cortex. It is one of the most representative forms of tauopathy. PSP presents in several different phenotypic variations and is often accompanied by the development of concurrent neurodegenerative disorders.

Electrical Storm/Refractory Ventricular Tachycardia.

Audience: This simulation case was created for emergency medicine (EM) residents at all levels of training.

Background: Cardiac electrical storm (ES) is commonly defined as three or more episodes of sustained ventricular tachycardia, ventricular fibrillation, or three shocks from an implantable defibrillator within a 24 hour period.1 This can occur in up to 30-40% of patients with implantable defibrillators; however, it may also present in a wide variety of patients, including those with structural heart disease, myocardial infarction, electrolyte disturbances, and channelopathies.

Management of irradiated post-mastectomy wound dehiscence with synthetic electrospun fiber matrix: a case report.

Breast-conserving surgery (BCS) is a well-established standard treatment option alternative to mastectomy for patients with early breast cancer that consists of a lumpectomy followed by adjuvant radiotherapy. However, irradiated tissues are at an increased risk of wound healing complications when post-treatment surgical management is required. The management of an irradiated wound dehiscence can be challenging, as it often requires a multimodal treatment approach that includes more invasive interventions when compared to a traditional surgical wound dehiscence.

Search engine optimization and its association with readability and accessibility of diabetic retinopathy websites.

Purpose: This study investigated whether websites regarding diabetic retinopathy are readable for patients, and adequately designed to be found by search engines.

Methods: The term "diabetic retinopathy" was queried in the Google search engine. Patient-oriented websites from the first 10 pages were categorized by search result page number and website organization type.