Longitudinal course of cognitive impairment in patients with atopic dermatitis.

Atopic dermatitis (AD) is a common inflammatory skin disease. Cognitive dysfunction was recently demonstrated to be increased in adults and children with AD. However, little is known about the longitudinal course of cognitive impairment in AD and its relationship with pruritus.

Impact of COVID-19 on Spinal Diagnosis and Procedural Volume in the United States.

Study Design: Retrospective analysis of a national database.

Objectives: COVID-19 resulted in the widespread shifting of hospital resources to handle surging COVID-19 cases resulting in the postponement of surgeries, including numerous spine procedures. This study aimed to quantify the impact that COVID-19 had on the number of treated spinal conditions and diagnoses during the pandemic.

Teaching perspectives on the communication of difficult news of genetic conditions to medical students.

Informing parents that their child has a diagnosis of Down syndrome (DS) is a common example of the delivery of unexpected or difficult news. Expectations and life planning will change, and if detected prenatally, discussions might include the option of pregnancy termination. Medical school curricula currently include training in breaking unexpected news; however, it is difficult to teach and assess.

Generalized Pustular Psoriasis: A Review of the Pathophysiology, Clinical Manifestations, Diagnosis, and Treatment.

Generalized pustular psoriasis (GPP) is a rare severe variant of psoriasis that is characterized by the abrupt widespread onset of small pustules accompanied by systemic manifestations of inflammation. It can arise in patients with a history of psoriasis as well as in those without, sometimes due to medication initiation or withdrawal, pregnancy, or infection. Generalized pustular psoriasis is thought to be driven primarily by innate immunity and unrestrained IL-36 cytokine activity.

Management of Psoriasis With Topicals: Applying the 2020 AAD-NPF Guidelines of Care to Clinical Practice.

Topical medications have high utility in the treatment of psoriasis because of their localized effect and ability to be used as both monotherapy and adjunctive therapy. The American Academy of Dermatology (AAD) and the National Psoriasis Foundation (NPF) published guidelines in 2020 regarding the management of psoriasis with topical therapies. These guidelines are a framework that assist clinicians treating psoriasis patients with topical agents including steroids, calcineurin inhibitors (CNIs), vitamin D analogues, retinoids (tazarotene), emollients, keratolytics (salicylic acid), anthracenes (anthralin), and keratoplastics (coal tar).

Leadership Diversity in the Association of Program Directors in Surgery: A Report of Progress.

Background: Across the last several years, numerous surgical departments and societies have focused on addressing the lack of diversity, equity, and inclusion (DEI) in the field. Since the Association of Program Directors in Surgery (APDS) Diversity and Inclusion Taskforce was created in 2017 (and solidified as a formal committee in 2018, herein referred to as the APDS-DIC), it has sought to address gaps in diversity at various phases of training and development from medical student to surgical leader.

Objective: In follow-up to a 2018 study that benchmarked leadership demographics of the APDS, this study analyzed how the APDS' efforts have aligned with recommended DEI strategies and whether this produced demographic changes in organizational leadership.

A novel SYNJ1 homozygous variant causing developmental and epileptic encephalopathy in an Afro-Caribbean individual.

Background: SYNJ1 encodes Synaptojanin-1, a dual-function poly-phosphoinositide phosphatase that is expressed in the brain to regulate neuronal synaptic vesicle dynamics. Biallelic SYNJ1 variants cause a spectrum of clinical manifestations, from early onset parkinsonism to developmental and epileptic encephalopathy.

Methods: Proband-only exome sequencing was used to identify a homozygous SYNJ1 pathogenic variant in an individual with epileptic encephalopathy.

Addition of Docetaxel to Androgen Receptor Axis-targeted Therapy and Androgen Deprivation Therapy in Metastatic Hormone-sensitive Prostate Cancer: A Network Meta-analysis.

Context: Randomized controlled trials (RCTs) have shown that addition of docetaxel or androgen receptor axis-targeted therapy (ARAT) to androgen deprivation therapy (ADT) or addition of ARAT to ADT and docetaxel improves overall survival (OS) in metastatic hormone-sensitive prostate cancer (mHSPC). However, it is unknown whether docetaxel, when given as part of triplet therapy, has an independent OS benefit.

Objective: To compare the efficacy of ADT plus ARAT with the triplet of ADT, ARAT, and docetaxel through a network meta-analysis (NMA) of RCTs in mHSPC.

Survey of confidence and knowledge to manage patellofemoral pain in readers versus nonreaders of the physical therapy clinical practice guideline.

Objectives: To compare beliefs of physical therapists (PTs) who read the clinical practice guideline (CPG) for the management of individuals with patellofemoral pain (PFP) to those who have not read the CPG.

Design: Cross-sectional study.

Setting: Online survey.

Citizenship and Social Responsibility in Surgery: A Review.

Importance: Social determinants of health have been shown to be key drivers of disparities in access to surgical care and surgical outcomes. Though the concept of social responsibility has received growing attention in the medical field, little has been published contextualizing social responsibility in surgery. In this narrative review, we define social responsibility as it relates to surgery, explore the duty of surgeons to society, and provide examples of social factors associated with adverse surgical outcomes and how they can be mitigated.

Mechanisms by which Early Eye Gaze to the Mouth During Multisensory Speech Influences Expressive Communication Development in Infant Siblings of Children with and without Autism.

Looking to the mouth of a talker early in life predicts expressive communication. We hypothesized that looking at a talker's mouth may signal that infants are ready for increased supported joint engagement and that it subsequently facilitates prelinguistic vocal development and translates to broader gains in expressive communication. We tested this hypothesis in 50 infants aged 6-18 months with heightened and general population-level likelihood of autism diagnosis (Sibs-autism and Sibs-NA; respectively).

Development of Obstetric Practice During the Early Islamic Era.

Art of healing was considered the most noble of human undertakings by Islamic scholars. Acquiring medical manuscripts from previous civilizations and translating them into Arabic proceeded at a great pace. This was followed by the emergence of several great physician scientists who examined these writings, corrected many, and proceeded to produce their own, with the addition of significant original paradigm-shifting contributions to all branches of science and medicine.

Therapeutic Misconception about Research Procedures: Does a Simple Information Chart Improve Understanding?

In phase I trials, some biospecimens are used both for research and patient care and some for research only. Some research participants have therapeutic misconception, assuming all biospecimens are for patient care. This study's aim was to test if a simple information chart would improve understanding of nontherapeutic research procedures.

Clinical and radiographic characteristics of diffuse astrocytic glioma, IDH-wildtype, with molecular features of glioblastoma: a single institution review.

Purpose: Genetic analyses of gliomas have identified key molecular features that impact treatment paradigms beyond conventional histomorphology. Despite at-times lower grade histopathologic appearances, IDH-wildtype infiltrating gliomas expressing certain molecular markers behave like higher-grade tumors. For IDH-wildtype infiltrating gliomas lacking traditional features of glioblastoma, these markers form the basis for the novel diagnosis of diffuse astrocytic glioma, IDH-wildtype (wt), with molecular features of glioblastoma (GBM), WHO grade-IV (DAG-G).

Low-Cost Model for Battlefield Wound and Hemorrhage Training.

Introduction: Exsanguination is the leading cause of preventable death on the battlefield and in austere environments. Multiple courses have been developed to save lives by stopping hemorrhage. Training for this requires simulation models; however, many models are expensive, preventing the further expansion of this life-saving training.

Exploring Family Medicine Residents' Experiences Teaching Medical Students.

Introduction: Near-peer teaching offered by residents is common in a medical students' educational career, so preparation of residents for their role as teachers is essential. Understanding resident perspectives on interactions with medical students may provide insight into this near-peer relationship and allow stakeholders to emphasize concepts that add value to this relationship when preparing residents to teach. This study presents the results from an inquiry focusing on a cohort of family medicine residents' experiences with medical students in their role as teachers.

Comparison of Guidelines for the Use of Interleukin-17 Inhibitors for Psoriasis in the United States, Britain, and Europe: A Critical Appraisal and Comprehensive Review.

Background: Interleukin (IL)-17 inhibitors are a newer class of biologic used to treat patients with moderate-to-severe plaque psoriasis and psoriatic arthritis.

Objective: We compared evidence-based clinical practice guidelines (CPGs) from leading dermatological organizations for the use of IL-17 inhibitors in psoriasis.

Methods: Guidelines from the Joint American Academy of Dermatology-National Psoriasis Foundation (AAD-NFP) Guidelines, British Association of Dermatologists guidelines (BAD), and European S3 group (ES3) were all reviewed and compared.

Gender-Affirming Care Curriculum in Family Medicine Residencies: A CERA Study.

Background And Objectives: Family physicians are positioned to provide care for transgender patients, but few are trained in this care during residency. This study examines associations between program directors' (PDs) perceptions/beliefs on transgender health care and inclusion of gender-affirming health care (GAH) in residency curriculum.

Methods: Questions regarding current training in GAH, provision of GAH, competency in GAH delivery, barriers to GAH training, resident desire for GAH training, access to GAH curriculum, and feelings/perceptions about GAH were included in the 2020 Council of Academic Family Medicine Educational Research Alliance (CERA) Program Director Survey.

Transgender Education in North American Family Medicine Clerkships: A CERA Study.

Background And Objectives: Transgender persons face many barriers to accessing health care, including identifying a knowledgeable physician. Medical schools have made curricular changes addressing cultural competence in transgender medicine, but changes are inadequate to graduate physicians competent in gender-affirming health care. The aim of this study was to assess the current state of education on the comprehensive health care of transgender patients, including gender-affirming health care (GAH) strategies (hormone therapy, surgical interventions) in US and Canadian family medicine clerkships (FM clerkships) in addition to the beliefs and actions of the directors making those curricular decisions.