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Botulinum Toxin Type A Injections For Refractory Abdominal Dystonia: A Case Report, William J. Naber Ii, Jodi M. Wilhelm, Kurt A. Kuhlman, Gabriel Howard

Graduate Medical Education Research Journal

Background: A 58-year-old male with chronic bilateral treatment resistant abdominal spasms secondary complications of ascites/ alcoholic cirrhosis. Spasms would occur 4-5 times/day, lasting minutes to hours despite a 2-year course of therapeutic and pharmacological interventions. Due to treatment refraction, 6 uniformly spaced botulinum toxin type A (BTX-A) injections were placed per side, using electromyography for audible intramuscular syringe placement confirmation, while visual confirmation was made via ultrasound. During the initial trial, 6 evenly spaced injections were performed bilaterally, uniformly distributing 80U/side. Injections began bilaterally just medial to the junction of the inferior rib cage border/ anterior axillary line and progressed …

Irrigation For Cerumen Removal Causing Meningitis – Case Report, Steven Tenny, Pashayar Lookian, Andre Wakim, Daniel Surdell

Graduate Medical Education Research Journal

Introduction: Cerumen impaction is a common problem seen in primary care clinics. There are a variety of methods to deal with impacted cerumen including water irrigation but meningitis after water irrigation cerumen removal has not been previously reported.

Methods: We describe the case of a 59-year-old female with otitis media who developed meningitis with empyema after water-jet irrigation for impacted cerumen.

Results: Our patient presented 24-hours after water-jet irrigation for impacted cerumen with worsening headaches. Workup included positive CSF cultures and empyema on MRI consistent with meningitis. She also had ear drainage from the treated ear which was positive for …

An Overview Of Neurology Residency Training In Epilepsy At The University Of Nebraska Medical Center, Daniel Crespo Artunduaga, Mohamed Taha, Arun Swaminathan

Graduate Medical Education Research Journal

Neurology residency offers a comprehensive training program over 4 years in management of various neurological disorders. Epilepsy represents a common condition managed by neurologists and forms a core curriculum in the training of neurology residents. We conducted an anonymous survey among the trainees at our neurology program to identify knowledge and treatment gaps and help us modify our training regimens to provide high impact and good quality training to our trainees. We conducted a 35-question survey to determine various aspects of our neurology residents’ training to identify and overcome shortfalls. Our program requirements are rigorous and match up with those …