Thymic Epithelial Neoplasms: Radiologic-Pathologic Correlation.

Thymic epithelial neoplasms, as classified by the World Health Organization, include thymoma, thymic carcinoma, and thymic carcinoid. They are a rare group of tumors and are often diagnosed incidentally in the work-up of parathymic syndrome, such as myasthenia gravis, or when mass effect or local invasion causes other symptoms. In each of these scenarios, understanding the radiologic-pathologic relationship of these tumors allows clinical imagers to contribute meaningfully to management decisions and overall patient care.

Manifesto on united airways diseases (UAD): an Interasma (global asthma association - GAA) document.

Objective: The large amount of evidence and the renewed interest in upper and lower airways involvement in infectious and inflammatory diseases has led Interasma (Global Asthma Association) to take a position on United Airways Diseases (UAD).

Methods: Starting from an extensive literature review, Interasma executive committee discussed and approved this Manifesto developed by Interasma scientific network (INES) members.

Results: The manifesto describes the evidence gathered to date and defines, states, advocates, and proposes issues on UAD (rhinitis, rhinosinusitis and nasal polyposis), and concomitant/comorbid lower airways disorders (asthma, chronic obstructive pulmonary disease, bronchiectasis, cystic fibrosis, obstructive sleep apnoea) with the aim of challenging assumptions, fostering commitment, and bringing about change.

Using Computer-Assisted Instruction to Increase Otolaryngology Education During Medical School.

Introduction: A quarter of all complaints seen in adult primary care and half of all complaints seen in pediatric primary care are otolaryngology related. Even though half of all medical students enter primary care fields, there is no standardized curriculum for otolaryngology during medical school. Due to increasing limitations on specialty teaching during general medical education, computer-assisted instruction has been suggested as a format for increasing exposure to otolaryngology.

Risks associated with cesarean delivery during prolonged second stage of labor.

Background: Data regarding maternal and fetal morbidities are limited to surgical morbidity per each additional hour in the second stage of labor.

Objective: This study aimed to quantify perinatal morbidities associated with cesarean delivery by duration of the second stage of labor.

Study Design: Our work is a retrospective cohort study of cesarean deliveries during the second stage of labor using the Consortium on Safe Labor database.

Isolated Carpal Dislocation of the Pisiform with Distal Radius Fracture in Two Adults: A Rare Entity.

 Pisiform dislocations are an extremely rare injury. There are reports in the literature of isolated dislocations, but to our knowledge there are no reports of distal radius fractures with associated pisiform dislocations.  We present two cases of isolated pisiform dislocation and distal radius fracture in the adult population.

Surgical resection of T4 colon cancers: an NCDB propensity score-matched analysis of open, laparoscopic, and robotic approaches.

Historically, T4 tumors of the colon have been a contraindication to minimally invasive resection. The purpose of this study was to conduct a National Cancer Database analysis to compare the outcomes after curative treatment for T4 colon cancer between robotic, laparoscopic, and open approaches. The US National Cancer Database was queried for patients with T4 adenocarcinoma of the colon who underwent curative resection.

COVID-19 and the Case for Medical Management and Primary Care.

Hospitals and health systems suffer an over-reliance on elective surgeries to remain profitable. As a result, systems report record losses, while demand for emergency room, hospital, and intensive care beds have surged. Studies have admitted that many surgeries are unnecessary, and physician leaders admit that profit plays a role in driving such needless cost and risk.

The robotic colorectal experience: an outcomes and learning curve analysis of 502 patients.

Aim: This study aimed to present our experience with robotic colorectal surgery since its establishment at our institution in 2009. By examining the outcomes of over 500 patients, our experience provides a basis for assessing the introduction of a robotic platform in a colorectal practice. Specific measures investigated include intraoperative data and postoperative outcomes for all operations using the robotic platform.

Brain Injury Medicine Fellowship Applicant Survey: Trends in the Brain Injury Medicine Fellowship Application Process Between 2016 and 2019.

There is a lack of research regarding trends in the brain injury medicine fellowship match process. The objectives of this study were to (1) identify recent trends in the brain injury medicine fellowship application process, (2) provide meaningful information to future fellowship candidates, and (3) provide fellowship programs information on fellowship candidates' values. A cross-sectional study was conducted, in which a survey was sent to brain injury medicine applicants involved in the match process from 2016 to 2019.

Length of Neuromuscular Re-education Therapy and Growth Parameters in Premature Infants.

Objective: Neuromuscular re-education (NMRE) therapy including bracing, containment, facilitation techniques, joint compression, weight (WT) bearing, and myofascial release has been shown to improve neurodevelopmental maturation in premature infants. This study aimed to examine the association of NMRE with growth parameters including WT and length (L) at 36 weeks postmenstrual age (PMA) and at discharge.

Study Design: We analyzed data of infants <34 weeks gestational age (GA) or <1,800 g birth weight (BW) to examine the association of NMRE with growth parameters using correlation coefficient analysis.

Asymmetry of medullary veins on multiphase CT-angiography in patients with acute ischemic stroke.

Background: It was previously demonstrated that decreased cortical venous drainage is a predictive factor of poor clinical outcome in patients with an acute ischemic stroke. The aim of this investigation is to test the hypothesis that the decline in blood flow in medullary veins (MV) on CT angiogram (CTA) of patients with acute ischemic stroke (AIS) can also be predictive of clinical outcome.

Methods: We retrospectively reviewed a database of patients with AIS who were evaluated by multiphase CTA and enrolled individuals with AIS and evidence of occlusion of the intracranial internal carotid artery, the M1 or M2 segment of the middle cerebral artery, or combination of two occlusions.

Acquired haemophilia a secondary to multiple myeloma: management of a patient with a mechanical mitral valve.

A 77-year-old man with a mechanical mitral valve on warfarin presented with an acute drop in haemoglobin and large spontaneous haematoma. He was found to have a new coagulopathy with initial labs notable for a prolonged activated partial thromboplastin time (APTT). Further workup revealed factor VIII levels less than 1%, abnormal mixing studies and elevated Bethesda titres, which was consistent with an acquired factor VIII inhibitor.

Beliefs and preferences regarding biological treatments for severe asthma.

Background: Severe asthma is a serious condition with a significant burden on patients' morbidity, mortality, and quality of life. Some biological therapies targeting the IgE and interleukin-5 (IL5) mediated pathways are now available. Due to the lack of direct comparison studies, the choice of which medication to use varies.

The Impact of Conversion to Laparotomy in Rectal Cancer : A National Cancer Database Analysis of 57 574 Patients.

Background: Data regarding the effect of conversion from minimally invasive surgery (MIS) to laparotomy in rectal cancer is limited. This study examines the impact of conversion from laparoscopic or robotic-assisted techniques to open resection on oncologic outcomes in a large population database.

Methods: The National Cancer Database from 2010 to 2016 was reviewed for all cases of invasive adenocarcinoma of the rectum or rectosigmoid junction managed surgically.

The Association Between Race, Obesity, and Sperm Quality Among Men Attending a University Physician Practice in Washington, DC.

A decades-long decline in sperm counts in Western countries has coincided with an increase in obesity rates, prompting study into their association. Few of these studies have incorporated men of color, the sperm health of whom is relatively unknown. The present exploratory study evaluated the association between body mass index (BMI), race, ethnicity, and sperm parameters among a diverse sample of U.

Trends in utilization, conversion rates, and outcomes for minimally invasive approaches to non-metastatic rectal cancer: a national cancer database analysis.

Background: This study examined utilization and conversion rates for robotic and laparoscopic approaches to non-metastatic rectal cancer. Secondary aims were to examine short- and long-term outcomes of patients who underwent conversion to laparotomy from each approach.

Methods: The National Cancer Database (NCDB) was reviewed for all cases of non-metastatic adenocarcinoma of the rectum or rectosigmoid junction who underwent surgical resection from 2010 to 2016.

Authorized Agent-Controlled Analgesia for Pain Management in Critically Ill Adult Patients.

Background: Patient-controlled analgesia is commonly used for adult patients requiring parenteral opioid analgesia in the postoperative setting. However, many patients are unable to use patient-controlled analgesia because of physical or cognitive limitations. Authorized agent-controlled analgesia, in which a nurse or family member activates the patient-controlled analgesia device, has been studied in the pediatric population but has received little attention in adults.

Racial disparities in breast cancer hereditary risk assessment referrals.

For poorly understood reasons, Black non-Hispanic (BNH) women meeting National Comprehensive Cancer Network (NCCN) criteria for genetic testing for breast cancer risk are less likely than White non-Hispanic (WNH) women to undergo testing (Armstrong, Micco, Carney, Stopfer, & Putt, JAMA, 293, 1729 and 2005). We compared physician referral rates and uptake for genetic testing of BNH and WNH women meeting select NCCN criteria (breast cancer under age 50, two primary breast cancers, triple-negative disease under age 60) in the Cancer Center at George Washington University (GWCC) between 2015 and 2018. Of the 723 BNH and WNH patients treated for breast cancer at GWCC, 28% met study criteria for genetic counseling referral (n = 252; BNH n = 115, WNH n = 137).

Burning Mouth Syndrome and Contact Dermatitis.

: Burning mouth syndrome (BMS) is a condition that remains a diagnostic challenge and is frequently difficult to treat. Rather than being a singular entity, more recent research has suggested that the diagnosis of BMS encompasses a family of syndromes. Of this family, type 3 has been identified as being related to contact dermatitis.

Early contributions by Otolaryngologists in head and neck reconstructive surgery.

Purpose: Examination of contributions of Otolaryngologists to head and neck reconstructive surgery.

Methods: Historical Evaluation.

Results: Otolaryngology-Head and Neck Surgery as a surgical specialty has come to dominate the related fields of head and neck cancer ablative surgery as well as reconstruction as a result of those leaders who established our profession.

10 proven strategies to help patients maintain weight loss.

Patients' chances of keeping off weight long-term improve with evidence-based interventions, such as a sound diet, more exercise, and attention to more thoughtful eating habits.

Postgraduate Diploma in Emergency Medicine in India.

Background: In India, and other low- and middle-income countries (LMICs), the majority of emergency care is provided by frontline providers without specialty training in emergency medicine. In order to fill this need, we developed the Indian Postgraduate Diploma in Emergency Medicine (PGDEM), a 1-year skills-focused course for practicing doctors. This article describes the curriculum development and implementation as well as the follow-up survey conducted to gauge the impact of the course.