Perioperative Management of Patients on Maintenance Medication for Addiction Treatment: The Development of an Institutional Guideline.

With a brief summary of selected literature identified by a multidisciplinary panel of subject matter experts, the authors share their experience with the development of an institutional perioperative pain management guideline for patients on maintenance medication for addiction treatment (MAT), stressing the importance of perioperative continuation of opioid agonists such as methadone and partial agonists such as buprenorphine; and the discontinuation of opioid antagonists, such as naltrexone. The authors' protocol is appended as an example of a standardized approach to perioperative management of patients on MAT.

A rare isolated cutaneous metastatic mass after colon cancer resection.

Metastatic cutaneous lesions from colorectal in origin are extremely rare, and especially without any visceral metastasis. Due to its poor response to chemotherapy, it is a poor prognostic indicator with a 1-6 month(s) death rate. Routine screening colonoscopy should be highly encouraged.

Platelet-Rich Plasma: A Comprehensive Review of Emerging Applications in Medical and Aesthetic Dermatology.

Platelet-rich plasma (PRP) has been integrated into numerous treatment regimens for medical and aesthetic dermatology. While some of these approaches are well-established, many uses are underreported in the literature. We sought to identify and summarize the emerging dermatologic applications for PRP by conducting a comprehensive PubMed search of studies published between 2000 and 2020.

Large Middle Cerebral Artery Ischemic Stroke in a Therapeutically Anticoagulated Patient With Severe SARS-CoV-2 Infection.

Introduction: Coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with hypercoagulability which can predispose infected patients to both arterial and venous thromboembolic complications. Despite therapeutic anticoagulation, there remains a risk of ischemic strokes, which may lead to adverse patient outcomes. Only a few cases are described in the literature regarding SARS-CoV-2 positive patients developing thrombotic ischemic strokes despite therapeutic anticoagulation.

Harnessing the Power of Kiwifruit for Radiosensitization of Melanoma.

Background: Melanoma is the deadliest variant of skin cancer and its incidence continues to increase. There are limited treatment options for advanced and metastatic cases of melanoma, despite advances in immunotherapy and chemotherapy. Melanoma is notorious as a radioresistant tumor.

A Rare Case of Trichilemmal Carcinoma: Histology and Management.

Trichilemmal carcinoma (TC) is a rare cutaneous tumor thought to be derived from the follicular outer root sheath (ORS). It often manifests as a nondescript skin-colored or pink papule on the hair-bearing, sun-exposed anatomic sites of elderly patients. Trichilemmal carcinoma shows many histologic features reminiscent of follicular ORS-notably, its glycogen-rich clear cells, trichilemmal keratinization, and similar immunostaining profile.

Hepatic Abscess as Early Presentation of Perforated Diverticulitis.

A hepatic abscess is a rare condition which can have multiple etiologies, including biliary disease, intra-abdominal collections (appendicitis, diverticulitis, and inflammatory bowel disease), abdominal surgery, liver transplantation, and liver trauma. The diagnosis is primarily based on imaging findings of ultrasound and computed tomography scan. Management includes antibiotics and percutaneous drainage or surgical drainage of the abscess.

Hemoperitoneum identified by focused assessment with sonography for trauma following cardiopulmonary resuscitation.

It is generally recognized that lives are saved by administering high-quality cardiopulmonary resuscitation (CPR) to patients in cardiac arrest. A focused assessment with sonography for trauma (FAST) examination is an effective and non-invasive method for detecting rare complications of CPR, such as hemorrhage from abdominal visceral injury. We report the case of a 56-year-old female suffering from intra-abdominal hemorrhage caused by a liver laceration following CPR.

Differential BET Bromodomain Inhibition by Dihydropteridinone and Pyrimidodiazepinone Kinase Inhibitors.

BRD4 and other members of the bromodomain and extraterminal (BET) family of proteins are promising epigenetic targets for the development of novel therapeutics. Among the reported BRD4 inhibitors are dihydropteridinones and benzopyrimidodiazepinones originally designed to target the kinases PLK1, ERK5, and LRRK2. While these kinase inhibitors were identified as BRD4 inhibitors, little is known about their binding potential and structural details of interaction with the other BET bromodomains.

Does adoption of new technology increase surgical volume? The robotic inguinal hernia repair model.

Robotic Inguinal Hernia repair has been associated with higher costs but shorter length of stay. Robotic surgery is an appealing option for patients undergoing elective hernia surgery however given the high startup, maintenance and operating costs, the adoption of robotic technology may not guarantee increased profitability. Our hypothesis is that the introduction of robotic technology increases the overall surgical volume of inguinal hernia repairs within a hospital as compared to non-robotic hospitals.

Differences in the relationship between diabetes and prostate cancer among Black and White non-Hispanic men.

Purpose: Studies finding lower incidence rates of prostate cancer among men with diabetes have been primarily conducted in White non-Hispanic (WNH) populations. The purpose of this analysis is to compare the relationship between diabetes and prostate cancer among Black (BNH) and White non-Hispanic men.

Methods: We used Surveillance, Epidemiology, and End Results (SEER)-Medicare data from 2011 to 2015 to compare incidence rates and tumor characteristics between BNH and WNH men by diabetes status.

Detection of Central Retinal Artery Occlusion by Point-of-Care Ultrasound in the Emergency Department: A Case Series.

Central retinal artery occlusion (CRAO) is a rare, but serious, diagnosis that can lead to blindness, most often due to thromboembolic disease. In the emergency department (ED), CRAO can present as acute, painless loss of vision. Physicians need quick ways to rule in this diagnosis due to the time-sensitive nature of the event.

Influence of Pennsylvania liquor store closures during the COVID-19 pandemic on alcohol withdrawal consultations.

Introduction: Alcohol withdrawal syndrome (AWS) is a serious consequence of alcohol use disorder (AUD). Due to the current COVID-19 pandemic there was a closure of Pennsylvania (PA) liquor stores on March 17, 2020.

Methods: This is a retrospective, observational study of AWS patients presenting to a tertiary care hospital.

Cerebrovascular Accident and SARS-CoV-19 (COVID-19): A Systematic Review.

Background: While the most common neurologic symptoms reported in patients affected by SARS-CoV-2 are headache, dizziness, myalgia, mental fog, and anosmia, there is a growing basis of published peer-reviewed cases reporting stroke in the setting of SARS-CoV-2 infection. The peer-reviewed literature suggests an increased risk of cerebrovascular accident (CVA) in the setting of COVID-19 infection.

Methods: We searched 3 databases (PubMed, MEDLINE, and CINAHL) with search terms COVID-19, novel coronavirus, stroke, and cerebrovascular accident.

Chest Pain from Pneumopericardium with Gastropericardial Fistula.

Introduction: Gastropericardial fistula, a connection between the upper gastrointestinal tract and pericardium, is a rare clinical finding most commonly associated with postsurgical complications, as well as direct tissue invasion from gastric cancer. . We report a case of a 58-year-old Caucasian woman with metastatic colon cancer treated with FOLFOX, a combination chemotherapy regimen, and bevacizumab who presented with chest pain.

AngioVac Removal of an Isolated Infected Pulmonary Valve Papillary Fibroelastoma.

The AngioVac (Angiodynamics) system is indicated for the removal of right-sided venous soft thrombi and emboli. This is the first report that demonstrates the AngioVac system can be extended to the extraction of right-sided cardiac tumors, in the current case, a pulmonary valve papillary fibroelastoma infected with and species. ().

Hyperacute hyponatremia mimicking acute ischemic stroke.

We present a case of hyperacute hyponatremia with stroke like symptoms on presentation. Symptoms included confusion, left-sided facial droop, right-sided hemiparesis, dysarthria and aphasia, with an NIH stroke score of 5. Sodium level at the time of presentation was 119 mmol/L which dropped acutely from 138 mmol/L seven hours prior.

Stimulant Therapy Utilization for Neurocognitive Deficits in Mild Traumatic Brain Injury.

Context: There are 3.8 million mild traumatic brain injuries (mTBIs) that occur each year in the United States. Many are left with prolonged life-altering neurocognitive deficits, including difficulties in attention, concentration, mental fatigue, and distractibility.