Transient Neurological Deficits in a Patient With Prior DeBakey Type 1 Aortic Dissection.

Aortic dissection is a life-threatening emergency that occurs when the aortic wall layers are separated. It is important to recognize that aortic dissections can have an atypical presentation with neurological deficits and not typical findings of chest pain or thoracic symptoms. Our patient presented with headache, vertigo, and transient neurologic deficits.

Pseudoaneurysm in the Axillary Tail of the Breast After A Core Needle Biopsy.

We present the case of a forty-year-old asymptomatic female with no personal or family history of breast cancer, who underwent a core needle biopsy (CNB) following the identification of a focal asymmetry in the right breast on screening mammography. Eight months later, a prominent adjacent vascular structure with a round outpouching was detected on breast ultrasound, confirmed as a post-biopsy pseudoaneurysm. Breast pseudoaneurysms, although exceedingly rare, result from inadvertent vessel puncture during core needle biopsies, particularly when larger gauge needles are used.

Use and feasibility of a Lynch Syndrome predictive model for inherited colorectal and endometrial cancer in a low-middle income country.

While universal tumor testing for Lynch Syndrome (LS) is recommended in all new diagnoses of colorectal cancer (CC) and endometrial cancer (EC), the cost and availability of this test in low-resource settings poses challenges. The PREdiction Model for gene Mutations (PREMM) is a clinical algorithm designed to assess the risk of an individual carrying estimates one's risk of carrying a LS mutation. This study aims to assess the feasibility of using PREMM to screen for LS risk in Guatemala.

Navigating the Interplay of Sickle Cell Vasculopathy and Moyamoya Cerebrovascular Changes: A Case Report.

Sickle cell disease (SCD) is a hereditary hemoglobinopathy that can lead to progressive vasculopathy, increasing the risk of cerebrovascular complications. Moyamoya syndrome (MMS), a rare disorder characterized by stenosis of the internal carotid arteries, can occur in SCD patients due to chronic endothelial damage and inflammation. The coexistence of these conditions can result in severe cerebrovascular complications, presenting unique diagnostic and therapeutic challenges.

First-Generation Low-Income Individuals in Medicine: A Scoping Review.

Purpose: This comprehensive scoping review of the medical literature on first-generation low-income (FGLI) individuals in medicine aimed to synthesize the highest levels of evidence to inform medical education stakeholders.

Method: Database searches were conducted in Academic Search Premier, Education Research Premier, ERIC, Ovid MEDLINE, Ovid Embase, Professional Development Collection, PubMed, Scopus, Google Scholar, and Web of Science Core Collection from database inception through March 15, 2023. English-language articles on first-generation or low-income individuals in medicine from U.

Evidence-Based Clinical Practice Guidelines on Regenerative Medicine Treatment for Chronic Pain: A Consensus Report from a Multispecialty Working Group.

Purpose: Injectable biologics have not only been described and developed to treat dermal wounds, cardiovascular disease, and cancer, but have also been reported to treat chronic pain conditions. Despite emerging evidence supporting regenerative medicine therapy for pain, many aspects remain controversial.

Methods: The American Society of Pain and Neuroscience (ASPN) identified the educational need for an evidence-based guideline on regenerative medicine therapy for chronic pain.

Metastatic Rectal Cancer in a 52-Year-Old Woman: Advocating for Proactive Screening.

We present a case of metastatic rectal cancer in a 52-year-old woman, initially manifested as an acute asthma exacerbation. The patient was referred to the colorectal surgery team due to the discovery of a rectal mass after she sought treatment for shortness of breath following Clorox (cleaning product) exposure. Imaging revealed a right upper lobe nodule alongside a significant rectal mass, leading to a diagnosis of stage 4 colorectal cancer via colonoscopy and flexible sigmoidoscopy.

Prevalence of methicillin-resistant Staphylococcus aureus (MRSA) harboring mupirocin and biocide resistance genes in a large health care system.

Background: We aimed to determine the prevalence of genes associated with high-level mupirocin and biocide resistance in methicillin-resistant Staphylococcus aureus (MRSA) isolates among hospitalized patients and to characterize their genomic and epidemiologic features.

Methods: Study conducted on an integrated health system. Clinical cultures with MRSA from hospitalized patients collected between March 1, 2023, and January 20, 2024 underwent prospective whole-genome sequencing, including assessment for the presence of markers of resistance against mupirocin (mupA) and biocides (qac).

Cyclooxygenase 2 Inhibitors for Headache After Elective Cranial Neurosurgery: Results from a Systematic Review of Efficacy of Cyclooxygenase 2 Inhibitors for Headache After Acute Brain Injury.

Headache management after acute brain injury (ABI) is challenging. Although opioids are commonly used, selective cyclooxygenase 2 inhibitors (COXIBs) may be promising alternatives. However, concerns about cardiovascular effects and bleeding risk have limited their use.

Operational description of rare diseases: a reference to improve the recognition and visibility of rare diseases.

Improving health and social equity for persons living with a rare disease (PLWRD) is increasingly recognized as a global policy priority. However, there is currently no international alignment on how to define and describe rare diseases. A global reference is needed to establish a mutual understanding to inform a wide range of stakeholders for actions.

Consensus on a Patient-Centered Definition of Atopic Dermatitis Flare.

Importance: Flare is a term commonly used in atopic dermatitis (AD) care settings and clinical research, but little consensus exists on what it means. Meanwhile, flare management is an important unmet research and treatment need. Understanding how various therapies might comparatively improve AD flares as a measure of treatment effectiveness may facilitate shared decision-making and enable assessment of effectiveness within and outside clinical settings.

A Case Report on Spontaneous Coronary Artery Dissection and Its Potential Correlation With Fibromuscular Dysplasia.

This is a presentation of a common symptom, acute chest pain, with a rare etiology and the relevant implications of spontaneous coronary artery dissection (SCAD) and fibromuscular dysplasia (FMD). In a tertiary hospital in South Florida, during the fall of 2023, an adult female patient with acute chest pain was admitted to the internal medicine ward. The ECG demonstrated no acute ischemic changes.

Xylazine-Induced Necrotic Skin Ulcers in a Fentanyl-Injecting Individual in South Florida, United States: A Case Report.

Xylazine, commonly referred to as "Tranq," is an alpha-2-adrenergic receptor agonist that is FDA-approved only as a sedative and tranquilizer for veterinary use. However, its use as an adulterant in various illicit drugs, including fentanyl, has been on the rise, leading to its street name, "Tranq-Dope." Intravenous injection use of xylazine produces distinctive skin ulceration with accompanying necrosis, which can be considered virtually pathognomonic.

Coronary drug-coated balloons: A comprehensive review of clinical applications and controversies.

Drug-coated balloons have emerged as a promising therapeutic option in the treatment of cardiovascular disease. This review article provides an overview of the concept of drug-coated balloons and their clinical applications in both de novo and treated coronary artery disease. A summary of key clinical trials and registry studies evaluating drug-coated balloons is presented for reference.