Clinical Course of Isolated Recurrent, Persistent Complex Perianal Fistulas Without Luminal Crohn's Disease: A Multicenter Case Series of 24 Patients.

Background: Isolated complex perianal fistulas, without luminal evidence of inflammatory bowel disease in the gastrointestinal tract, pose diagnostic and treatment dilemmas for gastroenterologists and colorectal surgeons. For patients who develop recurrent complex fistulas, a presumptive diagnosis of Crohn's disease may be made. It is unclear whether these cases of isolated perianal disease in the absence of luminal inflammation truly represent isolated severe cryptoglandular fistulas or rather an early presentation of Crohn's disease.

Atraumatic Painful Pseudotendon of Flexor Carpi Radialis: A Literature Review and Case Report.

Introduction: Rupture of the flexor carpi radialis (FCR) tendon is a rare phenomenon that is often described in the setting of rheumatoid arthritis or following trauma. Pseudotendon formation is seen commonly among extensor tendons of the antebrachium, typically as a sequelae of traumatic injury, spontaneous rupture in rheumatism, or postoperatively. Less frequent is the presence of pseudotendon in flexor tendons of the forearm.

Metastasis of WHO Grade II Meningioma With Subsequent Pathological T12 Fracture: A Case Report.

Case: A 64-year-old woman with a history of World Health Organization Grade II (Ki-67 20%) atypical meningioma presented with T12 vertebral body burst fracture as a complication of metastatic meningioma (SSTR2+). Following disease progression, decompression surgery and stabilization through T10-L2 posterior thoracolumbar instrumented fusion was performed.

Conclusion: This is one of few documented cases of spinal metastatic meningioma causing pathological fracture and the first to detail surgical management and longitudinal follow-up.

Treatment of Acne Vulgaris With a 650-ms, 1064-nm Nd:YAG Laser: A Retrospective Study.

Background: The 650-ms, 1064-nm Nd:YAG laser device may provide superior efficacy and tolerability for the treatment of acne vulgaris over conventional treatments.

Aim: To evaluate the efficacy and tolerability of a 650-ms laser for the treatment of mild to severe facial acne vulgaris.

Patients/methods: Records of 225 subjects with mild to severe facial acne vulgaris and treated with a 650-ms laser were reviewed.

Strengths-Based Assessment and Inclusive Language for Patients With Intellectual and Developmental Disabilities.

Pediatric dermatology patients with intellectual and developmental disabilities (IDD) and comorbid cutaneous conditions often face barriers to effective healthcare due to differences in communication preferences and sensitivities to environmental factors. The clinical intake process serves as a potential intervention point to help better understand and meet patients' needs. Strengths-based assessment and considerations around identity-first versus person-first language are tools that can improve the clinical intake process in pediatric dermatology.

Occult Methemoglobinemia in a Medically-Complex 7-Year-Old Child and the Opportunity for Pharmacist Intervention in Pediatric Emergency Medicine.

Methemoglobinemia is a rare, yet life-threatening disorder that occurs due to an accumulation of methemoglobin in the blood. The clinical presentation often includes dyspnea, cyanosis, and hypoxemia that shows little improvement with the administration of supplemental oxygen. The US Food and Drug Administration (FDA) warns against the administration of benzocaine to those younger than 2 years of age and urges manufacturers to add a statement regarding the possible development of methemoglobinemia to the packaging of any products containing this ingredient.

An Update on Kawasaki Disease.

Purpose: To summarize advances in research on the epidemiology, pathogenesis, diagnosis, and treatment of Kawasaki Disease (KD), a systemic inflammatory illness of unknown etiology that affects children globally.

Recent Findings: The epidemiology of KD was affected by the COVID-19 pandemic and advances in molecular immunology and machine learning have enabled research into its pathogenesis. There is ongoing research into agents that can be used to intensify initial treatment and accumulating evidence supporting the use of certain rescue regimens for refractory disease over others.

The efficacy and safety of mirvetuximab soravtansine in FRα-positive, third-line and later, recurrent platinum-sensitive ovarian cancer: the single-arm phase II PICCOLO trial.

Background: Mirvetuximab soravtansine-gynx (MIRV) is a first-in-class, folate receptor alpha (FRα)-targeting antibody-drug conjugate with United States Food and Drug Administration approval for FRα-positive platinum-resistant ovarian cancer. PICCOLO is a phase II, global, open-label, single-arm trial of MIRV as third-line or greater (≥3L) treatment in patients with FRα-positive (≥75% of cells with ≥2+ staining intensity) recurrent platinum-sensitive ovarian cancer (PSOC).

Patients And Methods: Participants received MIRV (6 mg/kg adjusted ideal body weight every 3 weeks) until progressive disease (PD), unacceptable toxicity, withdrawal of consent, or death.

Placental Mesenchymal Dysplasia with Unique Chromosomal Abnormality and Unusual Histopathology: A Case Report and Literature Review.

Placental mesenchymal dysplasia (PMD), rare vascular and connective tissue placental anomaly can be associated with fetal intrauterine growth restriction (IUGR), stillbirth, Beckwith-Wiedemann syndrome (BWS), some chromosomal abnormalities, or phenotypically and genetically normal fetuses [1]. We reviewed a PMD case from our institution characterized by a previously undescribed chromosomal abnormality along with an unreported histopathologic finding.

Predicting Survival and Recurrence of Lung Ablation Patients Using Deep Learning-Based Automatic Segmentation and Radiomics Analysis.

Purpose: To predict survival and tumor recurrence following image-guided thermal ablation (IGTA) of lung tumors segmented using a deep learning approach.

Methods And Materials: A total of 113 patients who underwent IGTA for primary and metastatic lung tumors at a single institution between January 1, 2004 and July 14, 2022 were retrospectively identified. A pretrained U-Net model was applied to the dataset of pre- and post-procedure CT scans to segment lung zones.

Shockwave for peripheral artery disease: an update on trial data.

Intravascular lithotripsy (IVL) is fast becoming the vessel preparation tool of choice given its excellent safety profile and associated positive outcomes. In this review, we aim to summarize the most recent trial data as it applies to IVL's utility within the various peripheral arterial beds, including facilitation of large bore vascular access, and elaborate on future directions of this innovative therapy.

Family Medicine in Times of War.

Wars and conflicts appear to be a fact of life for populations across the globe, often in places where family medicine functions as the backbone of the health care system. In these situations, family physicians are frequently called on to serve in expanded roles and are witnesses to the enormous mental and physical suffering of individuals, families, communities, and populations. This article examines the lessons family medicine can learn from current wars and other terrible conflagrations.

The effects of pre-operative anti-osteoporotic use on total joint arthroplasty complications: A national database study.

Background: The current study aims to analyze the effect of pre-operative non-bisphosphonate anti-osteoporotic drugs on complication and revision rates following total joint arthroplasty (TJA).

Methods: A retrospective cohort analysis of the PearlDiver (PearlDiver Technologies, Colorado Springs, CO) database was performed. The database was queried to identify all patients who underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA) with history of hip or knee osteoarthritis and either osteopenia or osteoporosis.

Increase in the Incidence of Type 2 Diabetes in Young Children During the COVID-19 Pandemic.

Objective: To describe the incidence of new onset type 2 diabetes (T2D) among children younger than 11 years old diagnosed during the COVID-19 pandemic (March 1, 2020-December 31, 2021) compared to those diagnosed during the pre-pandemic period (January 1, 2017-February 29, 2020) and to compare the metabolic parameters of those with T2D diagnosed before age 11 years with those diagnosed after age 11 years.

Methods: We conducted a retrospective cohort study of youth <21 years with new onset T2D treated at Hasbro Children's Hospital between January 1, 2017 and December 31, 2021. Patients diagnosed at age <11 years were compared to those ≥11 years.

Subjective Cognitive Concerns are Associated with Worse Performance on Mobile-App Based Cognitive Assessment: An Observational Study in Cognitively Normal Older Adults.

Background: Subjective cognitive concerns (SCC) may be among the earliest clinical symptoms of dementia. There is growing interest in applying mobile app-based cognitive assessment to remotely screen for cognitive status in preclinical dementia, but the relationship between SCC and relevant mobile assessment metrics is uncertain.

Objective: We characterized the relationship between SCC and adherence, satisfaction, and performance on mobile-app assessments in cognitively unimpaired older adults.

Bridging the Gap: A Pilot Study of a Health Care Transition Podcast Curriculum and Standardized Patient Case for Graduate Medical Education Trainees.

Introduction Pediatric to adult health care transition (HCT) is critical to maintaining the health and wellness of patients, and pediatric and adult providers often do not feel prepared to shepherd patients through this process. Methods  We designed an HCT curriculum consisting of nine podcasts paired with existing ambulatory experiential learning opportunities for internal medicine-pediatric residents (n=6). Before and after the curriculum we evaluated resident HCT self-assessment and resident performance working with a standardized patient (SP) and standardized parent in a novel objective structured clinical examination (OSCE) station designed to assess HCT skills.