Brain Freeze: Pembrolizumab-Induced Autoimmune Encephalitis in Triple-Negative Breast Cancer.

This case report presents the first known instance of pembrolizumab-induced autoimmune encephalitis in a 41-year-old female patient with stage IIIc triple-negative breast cancer. The patient developed expressive aphasia three days after starting pembrolizumab in combination with chemotherapy, prompting comprehensive evaluations that ruled out infectious or metastatic causes. A diagnosis of pembrolizumab-associated autoimmune encephalitis was established following a lumbar puncture and MRI.

Geo-Spatial Analysis of Acute Ischemic Stroke Reperfusion Treatment in India: An Assessment of Distribution and Access to Centers.

Background: Stroke is a leading cause of global mortality and disability, with a disproportionately high burden in low- and middle-income countries. Access to intravenous thrombolysis (IVT) and endovascular treatment (EVT) remains extremely limited.

Aims: We evaluated the spatial distribution and geographic accessibility of stroke centers in India.

A Case of Statin-Induced Necrotizing Autoimmune Myopathy.

Statins, commonly used for hyperlipidemia and more importantly having proven efficacy in lowering cardiovascular risk, are a very popular class of medications. Side effects are usually mild, and the class as a whole is generally well-tolerated by patients. However, one rare and more serious side effect is statin-induced autoimmune necrotizing myopathy.

Beyond the symptoms: Team-based learning for social determinants in emergency medicine training.

Background: Emergency departments serve as the front line for individuals facing acute health needs, often compounded by social determinants of health (SDoH). Integrating SDoH into emergency medicine care is vital for promptly addressing health concerns and averting future crises. This curriculum adopts a team-based approach to train emergency medicine residents in identifying and addressing SDoH, thereby delivering comprehensive and equitable care.

A Very Bad Hair Day: Minoxidil Ingestion Causing Shock and Heart Failure.

Minoxidil is a potent directly acting vasodilator previously used in treatment-resistant hypertension. It possesses several serious side effects including fluid retention, worsening of heart failure, reflex tachycardia, angina, myocardial infarction, pericardial effusion, and hypotension. It is currently reserved for treating alopecia and readily available over the counter as a topical formulation.

Trends and predictors of unfilled emergency medicine residency positions: A comparative analysis of the 2023 and 2024 Match cycles.

Background: The emergency medicine (EM) landscape has evolved due to the increasing number of programs paired with fewer applicants. This study analyzed the characteristics of EM residency programs associated with unfilled positions during the 2024 Match and compared them with data from the 2023 Match to identify persistent and emerging trends influencing these outcomes.

Methods: In this cross-sectional, observational study, we investigated factors associated with unfilled EM residency positions in the 2024 Match.

Thymic Carcinoma Presenting as a Mediastinal Mass Resembling a Cardiac Tumor.

Thymoma and thymic carcinomas are a few of the rarest malignancies seen in humankind. They are mostly seen in the Asian population, many of which are reported in the Southeast Asia region like Japan, China, Vietnam, etc. They usually can be a sequela of other underlying conditions such as myasthenia gravis or some unknown mutations that express later in life.

Anti-HMGCR (Hydroxy-3-Methylglutaryl-CoA Reductase) Myopathy: A Rare Cause of Proximal Muscle Weakness.

Idiopathic inflammatory myopathy (IIM) represents a rare group of autoimmune conditions resulting in muscle weakness and includes polymyositis, dermatomyositis, immune-mediated necrotizing myopathy (IMNM), overlap myositis, and inclusion body myositis. Anti-3-hydroxy-3-methylglutaryl-CoA reductase (HMGCR) antibody IMNM represents a rare but increasingly recognized subtype of IIM. Here we report a case of a 65-year-old woman on rosuvastatin who presented with two months of progressive proximal muscle weakness, significant truncal weakness, and elevated creatine kinase concerning for rhabdomyolysis and inflammatory myopathy.

Novel MIR143HG::PLAG1 gene fusion identified in a rectal myxoid leiomyosarcoma.

Myxoid leiomyosarcoma (MLS) is a rare but well-documented tumor that often portends a poor prognosis compared to the conventional leiomyosarcoma. This rare sarcoma has been reported in the uterus, external female genitalia, soft tissue, and other locations. However, a definite rectal MLS has not been reported.

Next Level of Care Protocols in Radiology: Improving Patient Access to Care.

Objective: To introduce a novel next level of care (NLC) protocol used in our breast imaging practice to bypass additional imaging and image-guided biopsy orders and to examine the impact of NLC on breast biopsy wait times compared with thyroid biopsy wait times, which do not use NLC.

Methods: Our institutional review board deemed this retrospective analysis to be exempt. NLC was implemented for breast imaging in late 2014.