Medicine and Health Sciences Commons^™

Topical Lifitegrast Therapy For Dry Eye Disease, Lama Assi, Salim C. Lutfallah, Tsz Wing Yim, Su Hsun Liu, Sharon J. Duffy, Jayne Weiss

School of Medicine Faculty Publications

Objectives: This is a protocol for a Cochrane Review (intervention). The objectives are as follows:. To assess the effectiveness and safety of topical lifitegrast therapy alone or in combination with artificial tears, compared with a placebo, artificial tears alone, or no treatment for dry eye disease.

Evidence And Consensus-Based Imaging Guidelines In Birdshot Chorioretinopathy: Multimodal Imaging In Uveitis (Muv) Taskforce Report 8, Jose S. Pulido

Wills Eye Hospital Papers

PURPOSE: To develop consensus-based imaging guidelines for diagnosing and monitoring birdshot chorioretinopathy (BSCR).

DESIGN: Consensus-based approach guided by literature and an expert committee using a nominal group technique (NGT).

METHODS: An expert committee of 5 international uveitis specialists reviewed 15 well-documented representative BSCR cases with comprehensive imaging data. Cases with active and inactive disease were included. Imaging, including color fundus photography (CFP), fundus fluorescein angiography (FFA), indocyanine green angiography (ICGA), optical coherence tomography (OCT), fundus autofluorescence (FAF), and OCT angiography (OCTA) were reviewed. Using a structured NGT approach, consensus-based recommendations were developed for specific disease characteristics, biomarkers of activity, and …

Protocol For Assessing Mobilization Of Peritoneal B Cells To The Pre-Metastatic Omentum In An Orthotopic Mouse Model Of Ovarian Cancer, Wonjae Lee, Hironari Akasaka, Honami Naora

Faculty, Staff and Student Publications

The omentum is a visceral adipose tissue that undergoes dynamic immunological changes prior to and following metastasis. Here, we present a protocol for assessing the mobilization of peritoneal B cells to the pre-metastatic omentum in a mouse ovarian cancer model. We describe steps for isolation and adoptive transfer of peritoneal donor B cells and their detection in the omentum of recipient mice. This protocol could be utilized to study the mobilization of peritoneal B cells to the omentum in other pathological contexts. For complete details on the use and execution of this protocol, please refer to Lee et al.

Protocol For Establishing Genetically Engineered Murine Lung Organoids Mimicking Cell Plasticity And Regeneration, Bongjun Kim, Jae-Il Park

Faculty, Staff and Student Publications

Lung endothelial cells (LuECs) play crucial roles in lung regeneration and support lung organoids (LOs). However, detailed guidelines for LO culture using LuECs have not been reported yet. Here, we present an efficient protocol for generating and culturing murine LOs that mimic regeneration. We describe steps for the isolation of LuECs and lung epithelial cells, followed by LO culture. We also describe how to establish genetically engineered LOs using viral transduction. For complete details on the use and execution of this protocol, please refer to Kim et al.

Characterization And Clinical Implications Of P53 Dysfunction In Patients With Myelodysplastic Syndromes, Matteo Zampini, Elena Riva, Luca Lanino, Elisabetta Sauta, Rita Antunes Dos Reis, Rosa Maria Andres Ejarque, Giulia Maggioni, Alberto Termanini, Alessandra Merlotti, Alessia Campagna, Lorenzo Dall'olio, Austin Kulasekararaj, Michela Calvi, Clara Di Vito, Arturo Bonometti, Daoud Rahal, Giorgio Croci, Emanuela Boveri, Umberto Gianelli, Maurilio Ponzoni, Rossella Caselli, Serena Albertazzi, Gabriele Todisco, Marta Ubezio, Laura Crisafulli, Alessandro Frigo, Enrico Lugli, Ettore Mosca, Pamela Acha, Serena Ghisletti, Francesco Nicassio, Armando Santoro, Maria Diez-Campelo, Francesc Solé, Lionel Ades, Uwe Platzbecker, Valeria Santini, Pierre Fenaux, Torsten Haferlach, David Sallman, Guillermo Garcia-Manero, Domenico Mavilio, Daniel Remondini, Gastone Castellani, Saverio D'Amico, Amer M Zeidan, Rami Komrokji, Shahram Kordasti, Francesca Ficara, Matteo Giovanni Della Porta, Calr Consortium

Faculty, Staff and Student Publications

Purpose: Tumor Protein 53 (p53) expressed from gene TP53 is a seminal tumor suppressor. We aimed to characterize mutational and nonmutational mechanisms of p53 dysfunction in myelodysplastic syndromes (MDS) and to investigate their clinical effect.

Patients and methods: We analyzed a cohort of 6,204 patients with MDS and subsets of patients with available information on RNA sequencing of tumor cells (n = 109), high-dimensional phenotype of immune cells (n = 77), and multiomics analysis (RNA sequencing and proteomics) on single cells (n = 15). An independent validation was performed on 914 patients.

Results: Biallelic TP53 inactivation was a powerful driver …

Usp37 Counteracts Hltf To Protect Damaged Replication Forks And Promote Survival Of Brca1-Deficient Cells And Parp Inhibitor Resistance, Mengfan Tang, Siting Li, Ziqiang Zhu, Chao Wang, Shuai Ding, Huimin Zhang, Min Huang, Sarah Keast, Zhen Chen, Ling Yin, Litong Nie, Dan Su, Xu Feng, Junjie Chen

Faculty, Staff and Student Publications

Poly(ADP-ribose) polymerase inhibitors (PARPi) have greatly improved survival of cancer patients harboring BRCA1 mutations. However, therapy resistance develops via either restoration of homologous recombination or replication fork stabilization. Therapeutic targets to overcome PARPi resistance are critically needed. We identified the deubiquitinase USP37 as a key determinant of PARPi toxicity in BRCA1-deficient cells via whole-genome CRISPR screens. USP37 ablation enhanced PARPi sensitivity in BRCA1-deficient cells and also overcame PARPi resistance due to 53BP1 loss. USP37 interacts with and deubiquitinates replication protein A (RPA) at stalled replication forks to limit excessive RPA accumulation, progressive RPA exhaustion, and the conversion of RPA-coated single-stranded …

Protocol To Analyze Trna And Rrna Processing Using Biotin-Labeled Probes, Sseu-Pei Hwang, Katherine Barondeau, Catherine Denicourt

Faculty, Staff and Student Publications

Mature tRNAs and rRNAs are derived from larger precursor transcripts through intricate endo- and exonuclease processing steps. Here, we present a protocol to analyze rRNA and tRNA processing using total RNA extracted from human cells. We describe steps for separating RNA by denaturing electrophoresis, followed by northern blotting. We detail procedures for detecting pre-rRNA intermediates or specific tRNA species using biotin-labeled probes imaged via fluorescence or chemiluminescence. This non-radioactive, high-sensitivity assay enables the investigation of rRNA and tRNA expression dynamics. For complete details on the use and execution of this protocol, please refer to Hwang et al.

Primary Mouse Choroidal Endothelial Cell Culture, Qiuhua Yang, Yongfeng Cai, Qian Ma, Yuqing Huo

Faculty, Staff and Students Publications

The study of choroidal endothelial cells is essential for understanding the pathological mechanisms underlying choroidal neovascularization and other vision-threatening disorders. Traditional methods for isolating and culturing primary endothelial cells often yield mixed populations or require specialized equipment, limiting their widespread use. Here, we present a straightforward protocol for isolating and culturing primary mouse choroidal endothelial cells. This protocol involves enzymatic digestion of choroidal tissue, magnetic-activated cell sorting (MACS) to enrich CD31+ endothelial cells, and optimized culture conditions to promote cell proliferation and maintain endothelial phenotype. The protocol is strategic, reproducible, and requires minimal specialized equipment, making it accessible for researchers …

Demographics, Clinical Features And Genetics Of Common Inherited Arrhythmias In Oman, Kadhiya Al Azri, Ismail Al Abri, Maryam Al Shehhi, Maria Al Hinai, Tahlil Al Amri, Narjis Al Sheala, Ammar Al Shabibi

Journal of the Saudi Heart Association

Objectives:

Inherited arrhythmia syndromes (IAS) are a group of rare disorders that result from genetic mutations in several genes including congenital long QT syndrome, Brugada syndrome (BrS), short QT syndrome, and Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT). Affected individuals may have various symptoms including sudden cardiac death (SCD). Few reports have highlighted long QT syndrome from the Arbian Gulf region. The current study aims to describe demographics of children and adults with inherited arrhythmia syndromes; report the presenting clinical features, genetic mutations and management strategies.

Material and Method:

This is a descriptive retrospective study that included Omani children and adults with …

Efficacy And Safety Of Olezarsen In Dyslipidemia: A Systematic Review And Dose-Response Meta-Analysis Of Randomized Controlled Trials, Christopher D. Tristan, Risalina Myrtha, Matthew A. Wijayanto, Erlangga M. Kynaya, Muhammad F. Hamka, Nathania E. Sudiono, Muhammad A. Rusyidi, Muhana F. Ilyas

Journal of the Saudi Heart Association

Olezarsen emerged as a novel promising Apo-C3 inhibitor for dyslipidemia. However, its dose-response relationship remains uncertain. This review aims to evaluate the lipid-lowering effect of olezarsen, safety measures, and dose-response effects to determine the optimal dose. A systematic search was conducted across Scopus, PubMed, ScienceDirect, and CENTRAL on January 2, 2025. Randomized controlled trial (RCT) comparing olezarsen with placebo in dyslipidemia was included. The Rob 2.0 tool was implemented to assess quality. R-studio and STATA were used to conduct statistical analysis. From a total of 194 documents at initial search, four RCTs involving 361 patients were included in the present …

Nosocomial Sepsis Triggered By Pluralibacter Gergoviae In A Pediatric Intensive Care Unit: A Case Report And Literature Review, Abdulrahman Özel, Nurettin Onur Kutlu, Servet Yüce, Cenk Özdalgiçoğlu, Meltem Erol

Journal of Pediatric Infectious Diseases

Pluralibacter gergoviae is a rare opportunistic gram-negative bacillus in humans and exhibits resistance to preservatives in cosmetic products. In this case report, we present nosocomial P. gergoviae sepsis that developed through contamination from a cleaning product in a previously healthy child without known chronic diseases, pediatric intensive care unit care. Contamination with the same microorganism was detected even in unused samples of the cleaning product, leading to a recall of these items. This report highlights the case of hospital-acquired P. gergoviae sepsis to emphasize the importance of adherence to antiseptic protocols by health care work as well as the necessity …

New Insights On The Clinical Significance Of Mycoplasma Pneumoniae-Dna Load In Mycoplasma Pneumoniae Pneumonia, Chen Yu, Lin Chenxi, Huang Rui, Chen Qi, Zhang Min, Chen Ling, Lai Xingqian

Journal of Pediatric Infectious Diseases

Objective: This study aimed to assess the consistency of MP-DNA load in the respiratory tracts, its correlation with Mycoplasma pneumoniae pneumonia (MPP) manifestations, and its predictive value for refractory M. pneumoniae pneumonia (RMPP).

Methods: A retrospective study was performed on a cohort of MPP cases, including 215 patients with positive nasopharyngeal aspirate (NPA) MP-DNA and 59 with positive bronchoalveolar lavage fluid (BALF) MP-DNA. Patients were categorized into two groups based on MP-DNA load: low-load (≤106/mL) and high-load (>106/mL). The consistency of MP-DNA load in NPA and BALF was determined by Spearman’s correlation coefficient. Clinical, laboratory, and radiological data were …

Comparison Of Delta Neutrophil Index And Inflammatory Markers In The Diagnosis Of Late-Onset Neonatal Sepsis In Preterm Infants, Aybuke Yazici, Hayriye Gozde Kanmaz Kutman, Gulsum Kadioglu Simsek, Betul Siyah Bilgin, Fuat Emre Canpolat, Bedia Dinc, Serife Suna Oguz

Journal of Pediatric Infectious Diseases

Objective: To assess the performance of the relatively new hematological marker delta neutrophil index (DNI) and other inflammatory markers in proven sepsis of the very preterm infant.

Methods: Infants with a gestational age of <32 weeks and examined for suspected late-onset sepsis (LOS) were evaluated retrospectively. Demographic characteristics, laboratory findings, and neonatal morbidity and mortality were compared between infants with blood culture-confirmed sepsis and clinical sepsis.

Results: The study included 358 infants, 90 with proven sepsis and 268 with clinical sepsis. The mean gestational ages in these groups were 28.2±2 and 28.2±2.1 weeks, and the mean birth weight was 1139±372 and 1148±370 g, respectively (p>0.05). The proven sepsis group had higher DNI (median 7.1% [range, 0.1-74] vs. 0.6% [range, 0.1-24.7%], p<0.01], CRP (median 5 [range, 1-38] mg/L vs. 1 [range, 1-15] mg/L, p<0.001), interleukin 6 (median 620 [range, 6.9-5500] pg/mL vs. 42.2 [range, 2.2-5500] pg/mL, p<0.01), and procalcitonin (median 6.2 [range, 0.26-86] μg/L vs. 0.6 [range, 0.06-25.7] μg/L, p=0.002). According to ROC analysis, interleukin 6 had the highest area under the curve (AUC) at 0.74 (95% CI 0.60-0.88, p<0.01). The AUC values were 0.73 (95% CI 0.59-0.88, p=0.01) for procalcitonin, 0.62 (95% CI 0.44-0.80, p=0.18) for DNI, and 0.66 (95% CI 0.50-0.82, p=0.05) for CRP.

Conclusion: The delta neutrophil index showed a statistically significant elevation …

Diagnostic Value Of Lncrna Fgd5-As1 Sponge Mir-223-3p In Infantile Pneumonia And Its Prognostic Effect On Rehabilitation, Hong-Ping Ren, Hong-Lin Wen, Ya-Nan Liu, Lin Cai

Journal of Pediatric Infectious Diseases

Objective: This study aimed to uncover the value of long non-coding RNA FGD5-AS1 (lncRNA FGD5-AS1) in the diagnosis of infantile pneumonia and explore its pathological mechanism in lung fibroblasts. This research may provide a potential biomarker for diagnosing patients and predicting their rehabilitation outcomes.

Methods: This study included 92 children with infantile pneumonia as the research object, and an equal number of healthy children were introduced as controls. The FGD5-AS1 content was detected using real-time quantitative polymerase chain reaction (RT-qPCR) assay. The diagnostic value of FGD5-AS1 was evaluated by receiver operating characteristic (ROC) and logistic analysis. The molecular mechanism of …

Hematological Parameters And Systemic Inflammatory Markers In Children With Viral Acute Lower Respiratory Tract Infections, Sadiye Sert, Fatma Sargin, Şerife Karaçal Say, Berna Erayman, Ebru Buldu

Journal of Pediatric Infectious Diseases

Objective: Viral acute lower respiratory tract infections (ALRTIs) are a leading cause of morbidity and mortality in children, particularly those under 5 years. Accurate diagnosis and timely management are crucial to improve outcomes. This study aimed to address the lack of comparative analysis between hematological and systemic inflammatory markers concerning established disease severity scores in children with viral ALRTIs. We sought to evaluate the correlations between these markers and severity scores to identify which parameters provide the most reliable predictive value for assessing the severity of ALRTI diagnoses in this population.

Methods: This retrospective cross-sectional study included 191 children hospitalized …

Evaluation Of Gastrointestinal Pathogens In Children With Inflammatory Bowel Disease Using Multiplex Polymerase Chain Reaction, Yeliz Çağan Appak, Özgür Appak, Betül Aksoy, Büşra Emi̇r, Ayça Arzu Sayiner, Maşallah Baran

Journal of Pediatric Infectious Diseases

Objective: Impaired gastrointestinal mucosa and immunosuppressant therapies increase the risk of secondary infection in patients with inflammatory bowel disease (IBD). This study evaluated the detection of pathogens in children with IBD using a gastrointestinal panel (GP). This is the first study to compare this method with clinical data from pediatric IBD patients.

Methods: Children with newly diagnosed IBD or experiencing disease flares were included. Demographic data, clinical and laboratory findings, treatments, treatment durations, and disease activity were analyzed. Stool samples were assessed using multiplex real-time polymerase chain reaction with QIAstat-Dx GP®. Results were compared between groups.

Results: Thirty-five patients with …

Abdominal Tuberculosis In Children, Melike Emiroglu, Gulsum Alkan, Meltem Kiymaz, Sadiye Kubra Tuter Oz, Hatice Turk Dagi, Mehmet Öztürk, Zeliha Esin Çelik

Journal of Pediatric Infectious Diseases

Objective: To provide an insight into the presentation, diagnosis and management of gastrointestinal tuberculosis in children.

Methods: We reviewed the medical records of children who were diagnosed with gastrointestinal tuberculosis, between October 2013 and October 2023. The analysis was performed using descriptive statistics.

Results: During the study period, 11 of 76 tuberculosis pediatric patients (14.5%) were diagnosed with gastrointestinal tuberculosis. Six of 11 patients (54.5%) were female. The median age of the patients was 60 months (51-205 months). Eight of 11 patients had intra-abdominal lymph node involvement, 3 of 11 patients had intestinal tuberculosis and 2 of 11 patients had …

Urgent Implementation Of Point-Of-Care Testing For Group A Streptococcal Infection In A Uk Children’S Emergency Department, Ruth Shorrocks, Philip J. Turner, Thomas Fanshawe, Umasha Ukwatte, Jim Gray, James Taylor, Liliana Graveto, Gail Hayward, Chris Bird

Journal of Pediatric Infectious Diseases

Objective: In late 2022, Western Europe and the United States experienced increased incidences of scarlet fever and life-threatening invasive group A strepto- coccal (iGAS) infections, especially among children. The outbreak was widely reported in the media in the United Kingdom, leading to increased emergency department (ED) attendances and threatened supplies of antibiotics. Our ED rapidly introduced point-of-care testing for GAS pharyngitis with the aim of rationalizing antibiotic prescribing.

Methods: We rapidly implemented the use of a molecular-based (polymerase chain reaction) point-of-care test for all children scoring 3 or higher on the McIsaac clinical prediction rule for GAS pharyngitis in children …

Epidemiology Of Acute Infectious Diarrhea-Associated Viruses In Children In Hangzhou, China, 2023, Ya-Jun Guo, Lin Li, Qin-Rui Lai, Wei Li

Journal of Pediatric Infectious Diseases

Objective: To investigate the epidemiological characteristics of children infected with diarrheal virus in Hangzhou, China, 2023.

Methods: From January 2023 to December 2023, 20,939 stool samples from children with acute infectious diarrhea were collected for detection of rotavirus A and human adenovirus, using Latex agglutination detection kits; 7584 stool samples were collected for detection of norovirus, using real‐time PCR reagent.

Results: 639 (3.0%, 639/20,939) tested positive for rotavirus A, and 1,201 (5.7%, 1,201/20,939) positive samples were detected by Colloidal gold method. The positive rates of norovirus were 42.2% (3,203/7,585). Among all age groups, the rotavirus A positive detection rate was …

Evaluation Of Pediatric Patients Diagnosed With Measles: A Retrospective Study In Istanbul, Zehra Yazi, Nahide Haykir Zehi̇r, Merve Akçay, Ufuk Yükselmiş, Ceren Çetin, Ayşe Karaaslan, Yasemin Akin

Journal of Pediatric Infectious Diseases

Objective: Measles, predominantly impacting the pediatric population, manifests symptoms encompassing fever, rash, rhinorrhea, cough, conjunctivitis, accompanied by infrequent yet plausible life-threatening complications.

Methods: This retrospective study conducted between January 2022 and July 2023 at a 1105-bed tertiary hospital in Istanbul, Türkiye, was focused on children diagnosed with measles and aged(PCR) were defined as definite measles cases.

Results: A total of 78 pediatric patients were diagnosed with measles, of whom 40 were evaluated as definite (51.3%) cases. Among the definite cases, 29 (72.5%) and 11 (27.5%) were girls and boys, respectively. Their median age was 78 (42–158) months. It was observed …

Rcpneoperu Trial: A Cluster Randomized Pilot Trial To Assess Traditional Neonatal Resuscitation Compared To Partially Virtual Training In Remote Areas., Carlos A Delgado, Enrique Gómez Pomar, Pablo Velásquez, Víctor Sánchez, Roberto Shimabuku, Luis Huicho

Pediatrics Faculty Publications

OBJECTIVE: To assess the effects of a neonatal resuscitation training program using traditional training and partial distance learning.

METHOD: Through an open cluster-randomized trial, the authors compared a traditional approach involving face-to-face theory and practice sessions using information and communication technology to offer theory and distance examination, followed by face-to-face practice. Twelve health facilities were allocated by blocked randomization. Comparisons were made adjusting for clustering in qualitative and quantitative data. The primary outcome was the percentage of infants with heart rates ≥100 per minute at the second minute after birth. The authors performed a cluster-level analysis for cluster randomized trials, …

Blood-Based Proteomic Profiling Identifies Osmr As A Novel Biomarker Of Aml Outcomes, Patrick K Reville, Bofei Wang, Jennifer Marvin-Peek, Bin Yuan, Yu-An Kuo, Araceli Garza, Jessica Root, Wei Qiao, Andrea Arruda, Ivo Veletic, Yiwei Liu, Nicholas J Short, Courtney D Dinardo, Tapan M Kadia, Naval G Daver, Philip L Lorenzi, Koji Sasaki, Steven Kornblau, Mark D Minden, Farhad Ravandi, Hagop M Kantarjian, Hussein A Abbas

Faculty, Staff and Student Publications

Inflammation is increasingly recognized as a critical factor in acute myeloid leukemia (AML) pathogenesis. We performed blood-based proteomic profiling of 251 inflammatory proteins in 543 patients with newly diagnosed AML. Using a machine learning model, we derived an 8-protein prognostic score termed the leukemia inflammatory risk score (LIRS). Individual proteins were evaluated in multivariable Cox models, and model performance was assessed by cumulative concordance index. Findings were validated in internal and external cohorts across 2 institutions. Blood-based LIRS significantly outperformed the European LeukemiaNet 2022 risk model and was independently prognostic of overall survival after accounting for known clinical and molecular …

Implementation And Effectiveness Of A Nurse-Enabled, Shared-Care Follow-Up Model For Early Breast Cancer Survivors (The Ibis-Survivorship Study): Protocol For A Stepped-Wedge Cluster Randomised Trial, Raymond J. Chan, Fiona Crawford-Williams, Bogda Koczwara, G. Bruce Mann, Elizabeth Eakin, Jane Turner, Meinir Krishnasamy, Louisa G. Collins, Helen Skerman, Karla Hemming, Nicolas H. Hart, Jon Emery, Bethany Crowe, Kerry Patford, Jane Mahony, Caroline Kristunas, Gillian Blanchard, Laura Healey, Jasotha Sanmugarajah, Rhea Liang, Paul Craft, Amy Shorthouse, Ruth Mccaffery, Mary Azer, Patsy Yates

Research outputs 2022 to 2026

Introduction Breast cancer is the most commonly diagnosed cancer among women worldwide. Survivors often experience physical and psychological effects arising from breast cancer and its treatment, which can last months and years, adversely impacting quality of life. As the number of early breast cancer survivors increases, models of specialist-led follow-up care in hospital settings are not sustainable and evidence suggests that they may not meet survivors’ needs. Nurse-enabled, shared-care, follow-up models between cancer specialist and primary care teams have potential to address this need. Methods and analysis The proposed research is a multicentre, prospective, pragmatic, stepped-wedge cluster-randomised trial designed to …

Risk Factors For Serious Bacterial Infections Among Young Infants With Hypothermia: Protocol For A Multicenter, Retrospective Case-Control Study, Sriram Ramgopal, Paul Aronson, Douglas Lorenz, Alexander Joseph Rogers, Andrea Tania Cruz

Faculty, Staff and Students Publications

Background: Hypothermia in young infants presenting to the emergency department (ED) may indicate a serious bacterial infection (SBI) such as a urinary tract infection, bacteremia, or bacterial meningitis. Improved understanding of the epidemiology of SBI in infants with hypothermia and the development of prediction models can help avoid unnecessary invasive procedures and antimicrobial exposure.

Objective: The aim of the study is to (1) describe the epidemiology of SBI and herpes simplex virus (HSV) among infants with hypothermia, (2) assess the role of biomarkers in predicting SBI, and (3) derive and internally validate a multivariable predictive model for SBI among infants …

Small Gifts, Big Questions: The Ethical Dilemma In Accepting Gifts In Medicine, Meiqi Luo, Md

The Medicine Forum

I remember discussing the topic of gift-giving by patients in a small group session in medical school. When asked whether it’s ethical for medical professionals to accept gifts from patients, I responded, “It depends on the value of the gifts.” If the gifts were of appropriate value and given purely out of appreciation, they serve to strengthen the physician-patient relationship. However, what I failed to realize was the difficulty in determining the value and intention of a gift. My personal experience of receiving gifts from a patient made me aware of such ethical ambiguities.

At the community clinic where I …

Navigating Care And Loss Through Aging, Disease, And Decision-Making In The Covid Era, Michael Predi, Do

The Medicine Forum

There is only one of the loved one you know.
Often it can be hard to let go.
Five years old the world became cold.
Lost my mother to breast cancer.
A cold wound that can’t be answered
Father raised you in a foreign land.
Drove you to school, combed your hair, gave you a life you could have never planned.
Taught me that I would catch a cold from the wind.
No arguing about modern medicine, my dad was thick skinned,
Here comes college, first generation, what an exciting time.
Get to medical school so exciting; here comes the …

Existential Pain, Kian Waddell

The Medicine Forum

A new type of pain
Never covered in a lecture
Not neuropathic, visceral, post-procedural, cancer, phantom pains,
But existential.

She didn’t want pain meds
And she had her reasons -
We didn’t push.

What she wanted was to talk
To be heard
For us to be silent and stop
Asking her every second
If she’d moved bowels, vomited, slept…

What she wanted was to talk.
What other medication is there for pain of the soul?

Eternal Light, Anurag Modak, Md

The Medicine Forum

The microscope is held aloft in a sea of darkness,
Illuminating the gyri and sulci of the exposed brain below.
Its harsh, sterile light creates a veritable barrier
So hot, so intense, it threatens to explode forth at any moment.

The screens scattered across the room provide companionship to this lonely machine
And I, residing amidst the sea of shadows,
Bear witness to its solitude
To the silence of the light.

I have seen vessels tied and aneurysms clipped,
And an eon has gone by…
There’s an air of anticipation,
An expectation of something more.

But, solace and quietude prevail …

Unmasking The Dvt Mimic: A Rare Case Of Diabetic Myonecrosis In A Young Patient, Avish Patel, Md, Paul Endres, Md, Alexander Marchese, Md, Dianna Cheney-Peters, Md

The Medicine Forum

Diabetic myonecrosis is an uncommon complication of diabetes mellitus, often falsely believed to be a deep vein thrombosis (DVT). Patients present with similar presentations of edema and focal tenderness that are most often unilateral in a proximal lower extremity.¹ When venous ultrasound is negative, magnetic resonance imaging (MRI) is the preferred diagnostic modality over muscle biopsy, given the potential complications.^2,3 Treatment includes rest, analgesia, and improved glycemic control.⁴ Given the rise of metabolic disorders and insulin resistance, it is important to be aware of this diagnosis to prevent overutilization of healthcare resources.⁵

Recurrent Post-Viral Rhabdomyolysis In A 36-Year-Old Male: A Case Report, Warda Naqvi, Md, David Walz, Md, Lucy Checchio, Md

The Medicine Forum

Rhabdomyolysis is a syndrome of skeletal muscle breakdown, releasing intracellular contents such as creatine kinase (CK) and myoglobin into the bloodstream, which can precipitate acute kidney injury (AKI).¹ While trauma, extreme exertion, and toxins are frequent culprits, infections, particularly viral illnesses, represent a less common but significant trigger.² Influenza and other respiratory viruses have been implicated in sporadic cases of rhabdomyolysis, often presenting with acute myalgias and elevated CK levels following a viral prodrome.³ In contrast, recurrent rhabdomyolysis is typically associated with inherited metabolic myopathies (e.g., McArdle disease) or autoimmune myositis, conditions often marked by distinct genetic …