Primary intracranial sarcoma, DICER-1 mutant, with hemorrhagic presentation: A case report.

Background: Primary intracranial sarcomas (PIS) are rare tumors with mesenchymal origins. These tumors have a heterogeneous clinical presentation and are associated with a poor prognosis.

Case Description: This report highlights the complexities associated with PIS by focusing on a 26-year-old male with recurrent tumor growth facing unique challenges regarding diagnosis and treatment options .

Efficacy and safety of 'dropless vitrectomy surgery' and comparison of outcomes to standard of care topical therapy.

Objective/background: To compare the effectiveness of intravitreal injection of triamcinolone acetonide/moxifloxacin (Tri-Moxi) with the standard eye drop regimen for controlling postoperative inflammation, intraocular pressure, infections, macular thickness, and visual acuity (VA) in patients undergoing pars plana vitrectomy for various retinal disorders.

Subject/methods: In this retrospective longitudinal study, patients who underwent vitrectomy using intravitreal Tri-Moxi at the end of surgery (Group 1) were compared with those who received standard topical steroid antibiotics (Group 2) in terms of intraocular inflammation, intraocular pressure, macular thickness based on optical coherence tomography, and visual acuity.

Results: In total, 162 consecutive eyes (group 1 [81 eyes]; group 2 [82 eyes]) were included.

Patient Surgical Outcomes When Surgery Residents Are the Primary Surgeon by Intensity of Surgical Attending Supervision in Veterans Affairs Medical Centers.

Objective: Using health records from the Department of Veterans Affairs (VA), the largest healthcare training platform in the United States, we estimated independent associations between the intensity of attending supervision of surgical residents and 30-day postoperation patient outcomes.

Background: Academic leaders do not agree on the level of autonomy from supervision to grant surgery residents to best prepare them to enter independent practice without risking patient outcomes.

Methods: Secondary data came from a national, systematic 1:8 sample of n = 862,425 teaching encounters where residents were listed as primary surgeon at 122 VA medical centers from July 1, 2004, through September 30, 2019.

Giant primary intracranial multi-fossa leiomyosarcoma involving the frontal sinus, ethmoid air cells, anterior fossa, middle fossa, and intraventricular space: A case report and literature review.

Background: Leiomyosarcomas (LMSs) is a type of sarcoma that arises from smooth muscle and generally presents in the abdomen. Although intracranial LMS has been identified before, most reported presentations have been in immunocompromised patients. Here, we present an intracranial LMS in an immunocompetent patient.

Opacification of a scleral-sutured Akreos AO60 intraocular lens in the absence of concurrent or subsequent surgery: a case series.

Scleral-fixated intraocular lenses (SCIOLs) are an increasingly used option to place intraocular lenses in patients with compromised capsules. Akreos A060 is an acrylic hydrophilic lens that is commonly used for patients in need of SCIOL. As with other hydrophilic lenses, the Akreos A060 lens is associated with a risk of developing postoperative opacifications.

Assessing Physician Resident Contributions to Outpatient Clinical Workload.

Background: Graduate medical education is centered in hospitals despite a care system where patients mostly receive their care in an outpatient setting. Such gaps may exist because of inadequate funding for residency positions in community and hospital-based clinics.

Objective: Determine if physician residents' contribution to outpatient workload offsets their costs for supervision, salary, and fringe benefits as residents acquire skills to become independent practitioners.

Molecular Classes and Growth Hormone Treatment Effects on Behavior and Emotion in Patients with Prader-Willi Syndrome.

Prader-Willi syndrome (PWS) is a complex genetic disorder with three genetic classes. Patients with PWS are characterized by severe hypotonia, developmental delay, behavioral problems, learning disabilities and morbid obesity in early childhood if untreated. Data were collected through Rare Disease Clinical Research Network (RDCRN) from four study centers which evaluated patients with PWS.

Coronary artery aneurysm, ectasia and stenosis in a 53-year-old man with HIV infection.

The impact of long-standing human immunodeficiency virus infection (HIV) and potent anti-retroviral therapy on the coronary circulation is unknown; however, scattered reports are emerging of coronary aneurysms in this population. We report what we believe to be the first described case of both coronary stenosis and coronary artery aneurysms in a person living with HIV and discuss management options.

Successful delivery of subretinal aflibercept (new surgical technique) for the treatment of submacular hemorrhage in idiopathic polypoidal choroidal vasculopathy.

Submacular hemorrhage (SMH) is often a result of trauma, wet age-related macular degeneration or IPCV and frequently leads to blindness secondary to extreme toxicity of hemoglobin products on photoreceptors. We describe a new technique of subretinal aflibercept injection during pars plana vitrectomy for the treatment of SMH in idiopathic polypoidal choroidal vasculopathy (IPCV). A 55-old male presented with sudden loss of vision (HM) secondary to massive subretinal hemorrhage associated with IPCV.

Medical Student Perception of Lifestyle Medicine and Willingness to Engage in Lifestyle Counseling: A Pilot Study of Allopathic and Osteopathic Medical Students.

. This study assessed medical students' perception of lifestyle medicine and readiness to engage in lifestyle counseling. .

Influence of molecular classes and growth hormone treatment on growth and dysmorphology in Prader-Willi syndrome: A multicenter study.

Prader-Willi syndrome (PWS) is a complex genetic disorder with three molecular classes but clinical ascertainment is based on distinctive features. The prevalence of dysmorphic features was studied in 355 PWS participants (61% deletion, 36% maternal disomy [UPD], and 3% imprinting defects) from the National Institute of Health PWS Rare Diseases Clinical Research Network. The effect of growth hormone (GH) treatment on growth and dysmorphic features was compared.

Identification of the Sensory Dependent Locations of the Shoulder Joint to Optimize Surgical Approaches and Reduce Postoperative Pain: A Systematic Review.

Introduction: Treatment of post-surgical pain is predicated by an understanding of pain generators. The purpose of this review is to identify sensory dependent areas of the shoulder and discuss their correlation in treating postoperative pain.

Materials And Methods: Pubmed, Embase, and Cochrane Database of Systemic Reviews were searched (key terms: "Nociception" or "sensory pain receptors" or "pain map" or "neuroanatomy and shoulder" or "rotator cuff") to identify studies in the current literature (1966-2018) regarding sensory innervation of the shoulder and rotator cuff.

Allergic fungal sinusitis masquerading as cavernous sinus thrombosis.

Allergic fungal sinusitis (AFS), a noninvasive form of fungal sinusitis, is rarely seen in immunocompetent patients. Involvement of sphenoid sinus can result in proptosis and loss of vision. We report AFS masquerading as posterior cavernous sinus syndrome.

Molecular subtype and growth hormone effects on dysmorphology in Prader-Willi syndrome.

Prader-Willi syndrome (PWS) affects 1/15,000-1/30,000 live births and is characterized by lack of expression of paternally inherited genes on 15q11.2-15q13 caused by paternal deletions, maternal uniparental disomy (UPD), or imprinting defects. Affected individuals have distinct physical features, and growth hormone (GH) deficiency occurs in some individuals with PWS.

Early Diagnosis in Prader-Willi Syndrome Reduces Obesity and Associated Co-Morbidities.

Prader-Willi syndrome (PWS) is an imprinting genetic disorder characterized by lack of expression of genes on the paternal chromosome 15q11-q13 region. Growth hormone (GH) replacement positively influences stature and body composition in PWS. Our hypothesis was that early diagnosis delays onset of obesity in PWS.

A randomized pilot efficacy and safety trial of diazoxide choline controlled-release in patients with Prader-Willi syndrome.

Introduction: Prader-Willi syndrome (PWS) is a complex genetic condition characterized by hyperphagia, hypotonia, low muscle mass, excess body fat, developmental delays, intellectual disability, behavioral problems, and growth hormone deficiency. This study evaluated the safety and efficacy of orally administered Diazoxide Choline Controlled-Release Tablets (DCCR) in subjects with PWS.

Method: This was a single-center, Phase II study and included a 10-week Open-Label Treatment Period during which subjects were dose escalated, followed by a 4-week Double-Blind, Placebo-Controlled Treatment Period.

Birth seasonality studies in a large Prader-Willi syndrome cohort.

Prader-Willi syndrome (PWS) is generally due to sporadic paternal deletions of the chromosome 15q11-q13 region followed by maternal disomy 15. Advanced maternal age is more commonly seen in those with maternal disomy 15. Environmental factors (e.

Effective Educational Videos in Emergency Medicine.

Video is a popular format for teaching and learning online. Emergency medicine (EM) has been a leader in online learning and EM educators may wish to use video to teach. The creation of online video content is fraught with pitfalls that may make videos less effective.

Incidence of implantable Collamer lens-induced cataract.

Objective: Although the literature on the implantable Collamer lens (ICL) suggests an increasing rate of anterior subcapsular cataract (ASC) development with increasing age and decreasing anterior chamber depth (ACD), the exact correlation is not known. We performed a retrospective observation study of 1653 eyes and calculated the incidence of ICL removal with cataract extraction and intraocular lens placement (CE-IOL) as a result of ASC, in correlation to patient's age and ACD.

Design: Retrospective observation study.

Multicentre study of maternal and neonatal outcomes in individuals with Prader-Willi syndrome.

Introduction: Prader-Willi syndrome (PWS) is a complex genetic disorder associated with three different genetic subtypes: deletion of the paternal copy of 15q11-q13, maternal UPD for chromosome 15 and imprinting defect. Patients are typically diagnosed because of neonatal hypotonia, dysmorphism and feeding difficulties; however, data on the prenatal features of PWS are limited.

Objective: The aim of the study was to identify and compare frequencies of prenatal and neonatal clinical features of PWS among the three genetic subtypes.

Medical Graduates, Truthful and Useful Analytics With Big Data, and the Art of Persuasion.

The authors propose that the provision of state-of-the-art, effective, safe, and affordable health care requires medical school graduates not only to be competent practitioners and scientists but also to be policy makers and professional leaders. To meet this challenge in the era of big data and cloud computing, these graduates must be able to understand and critically interpret analyses of large, observational datasets from electronic health records, third-party claims files, surveys, and epidemiologic health datasets.The authors contend that medical students need to be exposed to three components.

Oxytocin treatment in children with Prader-Willi syndrome: A double-blind, placebo-controlled, crossover study.

Prader-Willi syndrome (PWS) is a rare, complex multisystem genetic disorder which includes hypothalamic dysfunction, hyperphagia, cognitive and behavioral problems, increased anxiety, and compulsive behaviors. Individuals with PWS have a deficit of oxytocin producing neurons in the paraventricular nucleus of the hypothalamus. Oxytocin plays a role in regulation of feeding behaviors, social interactions, and emotional reactivity, which are all issues that significantly affect the quality of life for individuals with this syndrome.