Adaptation of a positive youth development program in the community of Guangaje, Cotopaxi, Ecuador.

This study explores the adaptation of a Positive Youth Development (PYD) programme for the Indigenous Quichua community in Guangaje, Ecuador, which faces chronic poverty and low educational attainment. In May, June 2023 we conducted focus groups with school teachers and indigenous community leaders, parents and middle school, high school and college students. We found a disconnect between students' aspirations for higher education and adults' emphasis on practical and vocational training.

Takotsubo Cardiomyopathy Associated With Influenza A and a Ground-Level Fall.

Our case involves a 92-year-old female who presented to the emergency department due to a ground-level fall and difficulty breathing. She was found to have influenza A, elevated troponin, and decreased left ventricular ejection fraction. However, cardiac catheterization did not reveal any coronary artery stenosis, supporting a diagnosis of takotsubo cardiomyopathy (TC).

Disseminated Histoplasmosis Mimicking Macrophage Activation Syndrome in a Patient With Rheumatoid Arthritis.

Infections caused by typically do not produce symptoms. However, in individuals who are immunocompromised, progressive disseminated histoplasmosis may occur. A 67-year-old female, with lengthy history of immunosuppression due to management of rheumatoid arthritis, reported a two-month history of fatigue, headaches, and intermittent fevers following hip surgery.

A Case of Saphenous Vein Graft Aneurysm Treated With Percutaneous Coiling.

In adults, coronary artery bypass grafting (CABG) is a commonly performed surgery. Oftentimes, saphenous veins from the lower extremity are used as the graft vessels. A rare complication of this procedure is the formation of saphenous vein graft (SVG) aneurysms.

A Case of Multiple Vein Thrombosis Following Pacemaker Implantation.

Pacemakers are implanted as part of the treatment process of conditions including symptomatic bradycardia and certain types of heart block. One complication associated with pacemaker implantation is upper extremity deep venous thrombosis (UEDVT), which can subsequently lead to pulmonary embolism, limb loss, or death. We present the case of an 88-year-old male who developed UEDVT in his left subclavian, axillary, brachial, and basilic veins shortly after dual chamber pacemaker implantation for treating symptomatic heart block.

A Case of Ceftaroline-Associated Thrombocytopenia.

Ceftaroline is a fifth-generation cephalosporin that can be used for the treatment of serious infections caused by methicillin-resistant (MRSA). A rare adverse effect of ceftaroline therapy is thrombocytopenia. Our case involves a 45-year-old male with active intravenous drug usage who presented with persistent fever, lower back pain, and left elbow pain.

Evaluating the safety and efficacy of baricitinib for the treatment of moderate-to-severe atopic dermatitis.

Introduction: New biologic and small molecule therapeutics have emerged for the treatment of moderate-to-severe atopic dermatitis (AD), including oral Janus kinase (JAK) inhibitors such as baricitinib. While JAK inhibitors are commonly used to treat rheumatoid arthritis and inflammatory bowel disease, these agents are relatively new in the field of dermatology.

Areas Covered: In this review, we outline the efficacy and safety data of phase III randomized controlled trials investigating the use of baricitinib for moderate-to-severe AD.

A Case of Hand-Foot-and-Mouth Disease in an Adult Male.

Hand-foot-and-mouth disease (HFMD) is commonly seen in infants and children; less frequently, it may be seen in adults as well. The disease is usually associated with viral infections, including many variants of enteroviruses and coxsackieviruses. We discuss the case of a 39-year-old male who presented with constitutional symptoms, fever, and lesions on his hands, feet, and mouth.

A Unique Presentation of 3-Methylcrotonyl-CoA Carboxylase Deficiency.

3-methylcrotonyl-CoA carboxylase deficiency is an autosomal recessive disorder resulting in impaired leucine metabolism. The condition is typically diagnosed with newborn screening; patients diagnosed at a later stage generally present with symptoms including metabolic disturbances, seizures, failure to thrive, or delayed development. We present the case of a child diagnosed at 12 months of age who was noted to have recurrent viral infections and nonspecific gastrointestinal symptoms of vomiting, hematochezia, and gaseous distention of the abdomen.

Global Pseudo-Atrial Flutter on Electrocardiogram and the Importance of Clinical Correlation.

Parkinson's disease is a condition in which tremors, rigidity, bradykinesia, difficulties with sleep, autonomic symptoms, and mood disturbances can be present. We present an intriguing case in which such tremors appear as a global pseudo-atrial flutter on electrocardiogram (ECG). A 73-year-old Caucasian female presented to the cardiology clinic for management of atrial flutter diagnosed by ECG in a primary care setting.

Expert Consensus Statement on Proficiency Standards for Dermoscopy Education in Primary Care.

Background: Primary care providers (PCPs) frequently address dermatologic concerns and perform skin examinations during clinical encounters. For PCPs who evaluate concerning skin lesions, dermoscopy (a noninvasive skin visualization technique) has been shown to increase the sensitivity for skin cancer diagnosis compared with unassisted clinical examinations. Because no formal consensus existed on the fundamental knowledge and skills that PCPs should have with respect to dermoscopy for skin cancer detection, the objective of this study was to develop an expert consensus statement on proficiency standards for PCPs learning or using dermoscopy.

What the children tell us: the COVID-19 pandemic and how the world should respond.

While the COVID-19 pandemic and associated mitigation measures have had a devastating impact on children and youth (CY), they were rarely consulted or their views incorporated into the approaches to address the pandemic.The main objective of this review is to present the voices and opinions of CY relative to the impact of the first year of the pandemic, on their lives and the lives of their families, and to present their recommendations as a call to action to adults and governments.The origin of this review was an iterative consultation process involving an international collective of Child Health professionals specialising in Child Rights.

Takotsubo cardiomyopathy after microwave ablation of hepatocellular carcinoma.

Takotsubo cardiomyopathy is a form of stress cardiomyopathy that can clinically mimic an acute ST-segment elevation myocardial infarction (STEMI). It involves transient anomalies in left ventricular wall motion secondary to myocardial stunning. Specific causes have still not been elucidated, and several mechanisms have been proposed, including catecholamine surges following intense emotional or physical stress.

Immediate complications and flow volume changes during treatment phases of bronchial thermoplasty: a single-center descriptive study.

Introduction: Bronchial thermoplasty (B.T.) is a therapeutic bronchoscopic procedure in which controlled thermal energy is applied to the airway wall to decrease smooth muscle mass.

Pediatric diabetic ketoacidosis presenting with brain abscess.

Objectives: Report a novel case of new-onset type 1 diabetes in a pediatric patient presenting with DKA and concurrent brain abscess.

Case Presentation: The following case report is that of a previously healthy 12 year-old girl presenting with new-onset type 1 diabetes with mild diabetic ketoacidosis and subsequently found to have a brain abscess. Over the course of her hospital stay, she developed seizures and was found to have a 1.

Atypical Presentation of Cerebral Palsy and Seizures: A Case Report on Rasmussen's Encephalitis in an Adolescent.

Rasmussen's encephalitis is a rare neurological disease first described in 1958 that is characterized by medico-refractory seizures, focal unilateral cerebral inflammation, and deficits such as hemiparesis. While we still do not have a full understanding of this disease, proposed theories behind its etiology include auto-immune manifestations, immune attack by T cells, and malfunctional alterations in genetic expression. It is classically considered a rare childhood malady with a median age of onset of six years, and cases in adolescents and adults are even rarer, representing up to 10% of all cases to date.

Opioid Use Disorder Increases 30-Day Readmission Risk in Inflammatory Bowel Disease Hospitalizations: a Nationwide Matched Analysis.

Background And Aims: The opioid epidemic has become increasingly concerning, with the ever-increasing prescribing of opioid medications in recent years, especially in inflammatory bowel disease [IBD] patients with chronic pain. We aimed to isolate the effect of opioid use disorder [OUD] on 30-day readmission risk after an IBD-related hospitalization.

Methods: We retrospectively extracted IBD-related adult hospitalizations and 30-day, any-cause, readmissions from the National Readmissions Database [period 2010-2014].

Opioid use disorder in admissions for acute exacerbations of chronic pancreatitis and 30-day readmission risk: A nationwide matched analysis.

Background: The opioid epidemic in the United States has been on the rise. Acute exacerbations of chronic pancreatitis (AECP) patients are at higher risk for Opioid Use Disorder (OUD). Evidence on OUD's impact on healthcare utilization, especially hospital re-admissions is scarce.

Leptomeningeal involvement by prostate carcinoma an ominous head of a well-known Hydra.

A 67-year-old male patient presents to the hospital complaining of severe nausea and vomiting failing oral antiemetics. He carries the history of initial diagnosis of stage III prostate cancer. He underwent radical prostatectomy followed by external beam radiation.

Pharmacology Update: Low-Dose Naltrexone as a Possible Nonopioid Modality for Some Chronic, Nonmalignant Pain Syndromes.

Pain can have a devastating effect on the quality of life of patients in palliative medicine. Thus far, majority of research has been centered on opioid-based pain management, with a limited empirical evidence for the use of nonopioid medications in palliative care. However, opioid and nonopioid medications such as nonsteroidal anti-inflammatory drugs have their limitations in the clinical use due to risk of adverse effects, therefore, there is a need for more research to be directed to finding an alternative approach to pain management in comfort care setting.