Enhanced Care for Pediatric Patients With Generalized Lichen Planus: Diagnosis and Treatment Tips.

The rarity of generalized lichen planus (LP) in children often leads to misdiagnosis or delayed treatment, impacting the patient's quality of life. We describe the utility of a punch biopsy to confirm the diagnosis of LP in a 7-year-old girl. The inclusion of an intramuscular corticosteroid injection in the treatment plan offered prompt symptom relief.

Rethinking Measures and Mortality Attribution in Health Care: The Diabetes and Endocrinology Example.

This study investigated the accuracy of mortality attributions assigned by the US News and World Report (USNWR) to the diabetes and endocrinology specialty. We reviewed medical records of all consecutive Medicare fee-for-service inpatients at Mayo Clinic, Florida (Jacksonville, Florida) with a Medicare Severity Diagnosis Related Group included in the USNWR Diabetes & Endocrinology specialty cohort admitted from November 2018 to April 2022, with documented mortality in our institution's electronic health record within 30 days of the index admission. A clinician adjudicated the primary cause of death, categorizing it as diabetes or endocrine, cancer, failure to thrive, or other.

The Infinite Corridor.

Description This photograph was chosen as a visual representation of the poem "Theory of a Well Mind" to capture the essence of the poem's exploration of the human psyche and the journey toward mental wellness. The corridor, with its repeating arches and vanishing point, symbolizes the cyclical nature of thoughts, emotions, and actions that the poem delves into. Just as the corridor seems to stretch into infinity, the poem reflects on the seemingly endless and challenging process of personal growth and self-discovery.

Theory of a Well Mind.

Description In psychiatry residency, we have a didactic within our curriculum that focuses on psychotherapy. This subject culminates in our third year when our program's psychotherapy supervisor asks each of us to create our own personal theory. It allowed us to explore and apply what we had learned up until this point and formulate our own understanding of why people are the way that they are, how people change, and how to facilitate that growth through our theory.

Disseminated Varicella-Zoster Virus Presenting With Pneumonitis and Diffuse Alveolar Hemorrhage in an Immunocompetent Patient.

Varicella pneumonitis is typically seen in individuals with risk factors such as male gender, smoking history, and immunocompromised state and is often associated with disseminated infection, whereas primary varicella-zoster virus (VZV) infection usually involves a diffuse vesicular rash and rarely progresses to viral pneumonia. VZV pneumonitis accompanied by disseminated VZV infection is associated with a high mortality rate and may progress to diffuse alveolar hemorrhage in severe cases. In addition to cutaneous lesions, patients typically develop dyspnea, cough, tachypnea, chest pain, fever, and hemoptysis.

Refractory Homicidal Ideation in a Young Adult Male With High-Functioning Autism Spectrum Disorder and Schizophrenia.

Persistent homicidal ideation (HI), while not common among psychiatric disorders, can occur within multiple diagnoses in the Diagnostic and Statistical Manual of Mental Disorders. There is a growing global and national concern for homicide and homicide-related deaths. In this case report, we discuss refractory homicidal ideation in an 18-year-old male with the diagnoses of autism spectrum disorder (ASD) and schizophrenia and a history of Tourette's syndrome and highlight the interplay of comorbidities and challenges in effective management and treatment.

A Case of Anomalous Right Coronary Artery With Catastrophic Presentation.

Anomalous coronary artery is a rare but potentially life-threatening alteration in the coronary vascular system that is related to an increased risk of myocardial ischemia, ventricular arrhythmias, heart failure, and sudden cardiac death (SCD). Here, we present the case of a young male who presented to the hospital after a witnessed sudden cardiac arrest. Bystander cardiopulmonary resuscitation was started immediately, and normal sinus rhythm was achieved after electrical cardioversion three times.

Response of FGFR-2 Positive Adenoid Cystic Carcinoma to Futibatinib: A Case Report.

Adenoid cystic carcinoma (ACC) is an uncommon and aggressive head and neck cancer mainly affecting minor salivary glands. It affects more women than men in their 60s and 70s. The tumor is typically locally aggressive and has a high rate of distant metastatic disease.

Efficacy of oral anticoagulants in chronic kidney disease and hemodialysis patients with atrial fibrillation: a systematic review and meta-analysis.

Introduction: This meta-analysis seeks to evaluate the efficacy of direct oral anticoagulants (DOACs) versus vitamin K antagonists (VKA) in individuals with chronic kidney disease (CKD), end-stage renal disease (ESRD), and undergoing hemodialysis (HD) who also have atrial fibrillation (AF).

Evidence Acquisition: A comprehensive search of MEDLINE, clinicaltrials.gov, EMBASE, and Cochrane Database for relevant studies reporting the usefulness of OAC therapy for CKD, ESRD, and HD patients with AF was conducted from its inception until 1 May 2023.

Lifestyle Medicine for the Health Care Worker, Workplace, and Community Well-Being: A Butterfly Effect.

Description Burnout is a prevalent and expensive problem in the US, and the National Plan For Health Workforce Well-Being included a goal to institutionalize well-being as a long-term value. Lifestyle Medicine (LM), an evidence-based practice using behavioral interventions to treat, prevent, and reverse certain chronic conditions, can achieve this goal. Implementing small changes in the workplace that support lifestyle medicine has a butterfly effect on both workplace and community well-being.

Great expectations: A multisite, randomized controlled open-label trial of a novel patient expectations communication tool.

Objectives: In emergency medicine (EM), discerning patient expectations to inform patient-centered care poses unique challenges. We devised a novel questionnaire to facilitate clinicians' understanding of patients' expectations for their visit.

Methods: We conducted a multisite, randomized controlled trial.

Hydralazine-Induced Antineutrophilic Cytoplasmic Antibody (ANCA)-Associated Vasculitis Presenting as Crescentic Glomerulonephritis.

Hydralazine is a vasodilator medication commonly used for treating hypertension. While generally well-tolerated, in rare cases it can induce autoimmune reactions, including anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis. This case report presents a patient who developed ANCA-associated vasculitis resulting in crescentic glomerulonephritis (CrGN) following long-term hydralazine therapy, highlighting the importance of considering this rare adverse effect in patients with unexplained renal decline.