United front: Emergency management managers, public health, and infection prevention.

Introduction: Response to infectious diseases-related events may present a challenge to cooperative disaster management and emergency preparedness strategies. The primary objective of this investigation was to identify areas of strength and areas needing improvement in emergency management (EM) coordination between public health (PH) and infection prevention (IP) officials during disasters. A secondary objective was to evaluate education and training among EM, PH, and IP as they relate to increasing the number of mutually supportive relationships.

Mixed reality applications in upper extremity surgery: the future is now.

Mixed reality refers to the integration of virtual reality into the real-world environment. This digital content can be interacted with in real time. The emergence of mixed reality technology has been made possible by the introduction of head-mounted displays, which are being utilized across multiple surgical specialties.

Accuracy, Quality, and Misinformation of YouTube Abortion Procedural Videos: Cross-Sectional Study.

Background: The internet is often the first source patients turn to for medical information. YouTube is a commonly used internet-based resource for patients seeking to learn about medical procedures, including their risks, benefits, and safety profile. Abortion is a common yet polarizing medical procedure.

Impact of rapid blood culture identification PCR panel on optimal antibiotic use in methicillin-susceptible bacteremia.

Unlabelled: Rapid identification of methicillin-susceptible (MSSA) bacteremia may optimize antibiotic use and clinical outcomes. The study objective was to assess the impact of the BioFire® blood culture identification (BCID) polymerase chain reaction (PCR) panel on antibiotic use and clinical outcomes in patients with MSSA bacteremia. This was a retrospective chart review of adult inpatients with MSSA bacteremia during the pre-PCR (June 2018-December 2019) and post-PCR (June 2020-December 2021) implementation periods.

Initiating an Insulin Safety Campaign to reduce the incidence of glycemic harm events for hospitalized adults 65 and older.

Background: During calendar years 2021 through 2023, our health system admitted 200,837 persons 18 years and older with diabetes, of which 61% (n = 123,393) were 65 years and older with orders for insulin administration. The incidence of diabetes among hospitalized persons 65 and older continues to increase in the United States, with 24 million adults 65 and older with diabetes reported in 2020. Insulin, a high-risk medication, has the potential for adverse drug events, which can cause significant harm to patients, potentially resulting in death.

The effect of humeral tray thickness on glenohumeral loads in a reverse shoulder 'smart' implant.

Purpose: The aim of this study was to observe the effects of changing humeral tray thickness on the resultant of intraoperative glenohumeral joint loads using a load-sensing system (LSS).

Methods: An rTSA was performed on fresh frozen full-body cadaver shoulders by using an internal proprietary LSS on the humeral side. The glenohumeral loads (Newtons) and the direction of the resultant force applied on the implant were recorded during four standard positions (External rotation, Extension, Abduction, Flexion) and three "complex" positions of Activity Daily Life ("behind back", "overhead reach" and "across chest").

The Atypical Presentation of Ifosfamide-Induced Renal Tubular Acidosis.

Antineoplastic agents are often associated with a wide range of side effects, caused by either direct toxicity or indirect through their metabolism. Ifosfamide is a cytotoxic, antineoplastic medication that is known to cause a direct tubular injury with an associated normal anion gap metabolic acidosis due to type 1 or type 2 renal tubular acidosis (RTA). The manifestations and approach to its diagnosis have been well established.

Digital pathology, deep learning, and cancer: a narrative review.

Background And Objective: Cancer is a leading cause of morbidity and mortality worldwide. The emergence of digital pathology and deep learning technologies signifies a transformative era in healthcare. These technologies can enhance cancer detection, streamline operations, and bolster patient care.

Tubulointerstitial Nephritis and Uveitis: A Case Report.

Tubulointerstitial nephritis and uveitis (TINU) is a rare disease of unknown pathogenesis that is characterized by tubulointerstitial nephritis and uveitis. Currently, there are over 250 reported cases of TINU syndrome. TINU syndrome typically presents with mild uveitis and nephritis that is self-limited; however, in this case, the symptoms were severe making it different from previous case reports.

Spontaneous Remission of Acquired Generalized Lipodystrophy Presenting in the Postpartum Period.

Acquired generalized lipodystrophy (AGL) is a rare condition characterized by the diffuse loss of adipose tissue resulting in hyperglycemia, severe insulin resistance, and sequelae of metabolic disease. Here, we report the case of a 32-year-old woman who developed uncontrolled hyperglycemia and significant weight loss within 2 months postpartum. Upon endocrine evaluation, she was found to have generalized loss of adiposity, hypoleptinemia, and persistent hyperglycemia despite aggressive insulin administration.

Lysozyme-induced nephropathy due to systemic granulomatous disease.

Lysozyme-induced nephropathy is a rare form of acute tubular injury that has almost exclusively been reported in patients with monocytic malignancies. Typically, patients will present in acute renal failure A renal biopsy is necessary to confirm the diagnosis and will demonstrate proximal tubular cells with hypereosinophilic granules, which are periodic acid-Schiff and Jones methenamine silver-positive. Immunohistochemical staining for lysozyme will also be present.

Reducing Facial Hospital-Acquired Pressure Injuries Related to Prone Positioning in the Intensive Care Unit.

Purpose: The purpose of this quality improvement (QI) initiative was to evaluate the effects of a repositioning intervention bundle on the occurrences and severity of hospital-acquired pressure injuries (HAPIs) of the face in patients with COVID-19-related acute respiratory distress syndrome (ARDS) managed by ventilation and placed in a prone position.

Participants And Setting: Eighteen critically ill, ventilated patients were placed in a prone position for extended periods (range, 1-13 days). The study setting was critical care units in a 504-bed nonprofit teaching hospital located in the Northeastern United States.

Pediatric and Adult Brain Death/Death by Neurologic Criteria Consensus Guideline.

Background And Objectives: The purpose of this guideline is to update the 2010 American Academy of Neurology (AAN) brain death/death by neurologic criteria (BD/DNC) guideline for adults and the 2011 American Academy of Pediatrics, Child Neurology Society, and Society of Critical Care Medicine guideline for infants and children and to clarify the BD/DNC determination process by integrating guidance for adults and children into a single guideline. Updates in this guideline include guidance related to conducting the BD/DNC evaluation in the context of extracorporeal membrane oxygenation, targeted temperature management, and primary infratentorial injury.

Methods: A panel of experts from multiple medical societies developed BD/DNC recommendations.

Antibody-Drug Conjugates: A Review of Approved Drugs and Their Clinical Level of Evidence.

Antibody-drug conjugates (ADCs) are an innovative family of agents assembled through linking cytotoxic drugs (payloads) covalently to monoclonal antibodies (mAbs) to be delivered to tumor tissue that express their particular antigen, with the theoretical advantage of an augmented therapeutic ratio. As of June 2023, eleven ADCs have been approved by the Food and Drug Administration (FDA) and are on the market. These drugs have been added to the therapeutic armamentarium of acute myeloblastic and lymphoblastic leukemias, various types of lymphoma, breast, gastric or gastroesophageal junction, lung, urothelial, cervical, and ovarian cancers.

Nodular Sarcoid Myositis Treated With Hydroxychloroquine Monotherapy.

Clinically significant granulomatous inflammation of skeletal muscle in sarcoidosis is rare. Glucocorticoids are generally considered the first-line treatment of sarcoidosis, but due to their side effect profile, the addition of steroid-sparing regimens has become increasingly more common. We report a patient with nodular sarcoid myositis who was successfully treated with antimalarial hydroxychloroquine alone.

Treatment of HER2+ breast cancer: a retrospective of disease prognosis with loss of HER2 amplification on residual disease after neoadjuvant treatment in a community hospital setting.

Neoadjuvant chemotherapy (NAC) with Anti-Human Epidermal Growth Factor Receptor 2 (Anti-HER2) agents increase rates of pathologic complete response (pCR) in stage II-III, HER2+ breast cancer (BC). Several retrospective studies show HER2 amplification discordance from biopsy to post-NAC residual disease (RD). This phenomenon has unclear prognostic significance.

Haemorrhagic complex pericarditis presenting with cardiac tamponade in an immunocompetent woman.

A young woman in her mid-40s was referred by her primary care physician for fever, worsening shortness of breath, pleuritic chest pain and tachycardia. CT angiogram of the chest revealed a large pericardial effusion. Echocardiogram confirmed tamponade physiology despite her being haemodynamically stable.

Early Diagnostic Measures to Confirm the Diagnosis of Human Prion Diseases.

Human prion diseases are a group of rare and fatal diseases without a cure. Symptoms include rapidly progressive dementia, ataxia, myoclonus, akinetic mutism, and visual disturbances. A broad differential is required to consider prion disease as a diagnosis and rule out other conditions.

ChatGPT and the clinical informatics board examination: the end of unproctored maintenance of certification?

We aimed to assess ChatGPT's performance on the Clinical Informatics Board Examination and to discuss the implications of large language models (LLMs) for board certification and maintenance. We tested ChatGPT using 260 multiple-choice questions from Mankowitz's Clinical Informatics Board Review book, omitting 6 image-dependent questions. ChatGPT answered 190 (74%) of 254 eligible questions correctly.