Medical Specialties Commons^™

Development And Evaluation Of The Agitation In Alzheimer's Screener For Caregivers (Aasc): A Clinical Tool To Screen For Agitation., Carolyn Clevenger, W Clay Jackson, Jared Stroud, Malaak Brubaker, Mehul Patel, Iwona Bucior, Emily Bratlee-Whitaker, T Michelle Brown, Sheri Fehnel, Sue Peschin, Jeffrey Cummings, George Grossberg

Ambulatory and Primary Care Articles

OBJECTIVE: Although agitation is a common neuropsychiatric symptom in Alzheimer's dementia, it can be challenging to recognize and diagnose. Caregivers of individuals with Alzheimer's dementia are often the first to encounter agitation behaviors but may struggle to recognize and communicate symptoms to healthcare professionals (HCPs). Here, we describe the development and evaluation of the Agitation in Alzheimer's Screener for Caregivers (AASC), a practical screening tool to identify agitation symptoms and facilitate caregiver-HCP communication.

METHODS: The AASC was developed based on the International Psychogeriatric Association (IPA) criteria for agitation in cognitive disorders, input from multidisciplinary experts, and qualitative interviews with caregivers …

Esophageal Gastrointestinal Stromal Tumor With, Bradley Kruithoff, Lauren Beard, David Liebner, Swati Satturwar, Matthew Lamb

Oncology Articles

Gastrointestinal stromal tumors (GISTs) are rare mesenchymal neoplasms typically involving the upper gastrointestinal tract. Most GISTs are driven by activating mutations in the KIT or PDGFRA genes, which are primary molecular markers for diagnosis and treatment. In addition, CD117 and DOG1 (discovered on GIST 1) are important immunohistochemical diagnostic markers of GISTs. Esophageal GISTs are exceptionally rare, and those driven by BRAF gene fusions are even more uncommon. This report describes a 69-year-old woman who underwent surgical resection of an esophageal GIST harboring an MKRN1-BRAF gene fusion, offering insight into future treatment and surveillance strategies.

Flawed Design And Selection Bias In Critical Care Randomized Controlled Trials (Rcts): The Patient Safety Risk Of The "Rct Mimic"., Lawrence A Lynn

Ambulatory and Primary Care Articles

Over three decades, randomized controlled trials (RCTs) for critical care syndromes such as acute respiratory distress syndrome (ARDS), sepsis, and community acquired pneumonia (CAP) have repeatedly produced non-reproducible results, at times leading to high-impact reversals of global protocols when later studies revealed harm. These trials enroll patients using expert-derived threshold sets intended to define the syndrome. This analytic review presents the first historical and formal methodological review and mathematical analysis of such RCT using causal symbolic modeling (cSM), directed acyclic graphs (DAGs), and do-calculus. The review includes landmark publications, task-force threshold sets, and case examples, including the 2025 REMAP-CAP corticosteroid …

Longitudinal Quality Improvement Project To Increase Colorectal Cancer Screening For An Underserved Population In A Resident Physician-Led Primary Care Clinic., Vivek Vardhan Jasti, Sarah N Grebennikov, Mariah Barlow, David Y Lo, Shail M Govani, Miram Chan, Aimee E Willett, Christopher Barlow

Medical Education Articles

BACKGROUND: The overall rates of colorectal cancer (CRC) in the US population have been declining steadily over the past 30 years, in large part due to timely cancer screenings. Despite the emergence of new screening modalities, a large portion of the population has not completed CRC screening in accordance with guidelines. Adequate and timely screening can prevent or detect CRC in earlier stages. Various factors have been identified that influence screening completion. Lower screening rates have been associated with the underserved population, especially in the immigrant community and patients with inadequate access to healthcare. In the USA, primary care clinics …

Elevated Lactate In Aml Bone Marrow Contributes To Macrophage Polarization Via Gpr81 Signaling., Celia A Soto, Maggie L Lesch, Jennifer L Becker, Azmeer Sharipol, Amal Khan, Xenia L Schafer, Zhewen Li, Amanda R Streeter, Michael W Becker, Joshua C Munger, Benjamin J Frisch

Oncology Articles

Interactions between acute myeloid leukemia (AML) and the bone marrow microenvironment (BMME) are critical to leukemia progression and chemoresistance. In the solid tumor microenvironment, altered metabolite levels contribute to cancer progression. We performed a metabolomic analysis of AML patient bone marrow serum, revealing increased metabolites compared to age- and sex-matched controls. The most highly elevated metabolite in the AML BMME was lactate. Lactate signaling in solid tumors induces immunosuppressive tumor-associated macrophages and correlates with poor prognosis. This has not yet been studied in the leukemic BMME. Herein, we describe the role of lactate in the polarization of leukemia-associated macrophages (LAMs). …

Patient And Procedural Factors Associated With Same-Day Discharge Following Pulsed Field Ablation For Atrial Fibrillation: Insights From The Disrupt-Af Registry., Amin Al-Ahmad, Jose Osorio, John Day, Jeremiah Wasserlauf, Devi Nair, Robert Eckart, Dwayne Campbell, Jonathan Dukes, Frank Cuoco, John Costello, Jason Zagrodzky, David Kessler, Gustavo Morales, Anil Rajendra, Saumil Oza, Amr Barakat, Anthony Magnano, Anish Amin, Joshua Silverstein, Amit Thosani, Susan M Bezenek, Paul Zei, Chang Dai, Andrea Natale, Rodney Horton

OhioHealth Research Institute Articles

BACKGROUND: Same-day discharge (SDD) after catheter ablation for atrial fibrillation (AF) may improve patient satisfaction and optimize healthcare resources. Pulsed field ablation (PFA) offers a favorable safety profile, potentially enabling broader adoption of SDD strategies.

OBJECTIVE: To evaluate site-level practice patterns and participant- and procedure-related factors associated with SDD after de novo PFA for AF.

METHODS: We analyzed data from participants in the DISRUPT-AF registry, a prospective, multicenter study evaluating ablation acute outcomes with a pentaspline PFA catheter. We examined participant and procedure characteristics associated with both SDD planning and success.

RESULTS: SDD was preplanned for 81% (1203) of all …

From Standard To Stratified: Modeling Ntcp And Ear To Personalize Daily Mv-Cbct In Radiotherapy., Duong Thanh Tai, Luong Tien Phat, Tran Trung Kien, Duong Tuan Linh, Nguyen Ngoc Anh, Nguyen Quang Hung, Peter Sandwall, Parham Alaei, David Bradley, James C L Chow

Oncology Articles

PURPOSE: To evaluate the cumulative radiobiological impact of daily megavoltage cone-beam computed tomography (MV-CBCT) imaging dose based on normal tissue complication probability (NTCP) and excess absolute risk (EAR) of secondary malignancies among radiotherapy patients treated for breast, pelvic, and head & neck cancers. This study investigated whether MV-CBCT imaging dose warrants protocol personalization according to patient age, anatomical treatment site, and organ-specific radiosensitivity.

METHODS: This retrospective study included cohorts of breast (n = 30), pelvic (n = 17), and head & neck (n = 20) cancer patients undergoing radiotherapy with daily MV-CBCT. Imaging dose distributions employing two common MV-CBCT protocols …

Novel Leadless Atrial And Ventricular Pacing System With Subcutaneous Implantable Cardiac Defibrillator: A Case Of Cross-Platform Device Compatibility., Nicholas Bradley, Ankur Shah, Anish Amin

Heart and Vascular Articles

No abstract provided.

Contemporary Chronic Limb-Threatening Ischemia Care In The United States-Part 1: A Path Toward Multispecialty Collaboration., Eric A Secemsky, Ehrin J Armstrong, Venita Chandra, Raghu Kolluri, Parag J Patel, Peter A Schneider, Niten Singh

Heart and Vascular Articles

Care for patients with chronic limb-threatening ischemia (CLTI) is complex, and it is most effective when conducted with collaboration across multiple specialties. A recent upward trend in major limb amputation among patients with CLTI warrants a renewed effort to optimize care for this multifaceted condition. The Vascular InterVentional Advances (VIVA) Foundation, a not-for-profit 501(c)(3) organization, convened a Vascular Leaders Forum in 2024 to initiate an open, multispecialty discussion about the state of CLTI care in the United States and current challenges around delivery and access to such care. The forum comprised representatives from vascular surgery, interventional cardiology, interventional radiology, vascular …

Contemporary Chronic Limb-Threatening Ischemia Care In The United States-Part 2: Designing Clinical Device Trials., Eric A Secemsky, Ehrin J Armstrong, Venita Chandra, Raghu Kolluri, Saher S Sabri, Niten Singh

Heart and Vascular Articles

Head-to-head research comparing invasive revascularization strategies for chronic limb-threatening ischemia (CLTI) is sparse, partly due to challenges in conducting randomized controlled trials in the CLTI space. These include the expense of head-to-head trials, optimizing patient selection criteria for real-world applicability, and identifying optimal study end points. The Vascular InterVentional Advances (VIVA) Foundation, a 501(c)(3) not-for-profit organization, convened a Vascular Leaders Forum to initiate an open, multispecialty collaborative discussion of these challenges and ways to optimize the design of medical device trials in CLTI. This article summarizes the current landscape of clinical studies of CLTI revascularization strategies and options for designing …

Scai Position Statement On Intracardiac Echocardiography To Guide Structural Heart Disease Interventions., Mackram F Eleid, Christine J Chung, Matthew J Daniels, V Vivian Dimas, Andrew M Goldsweig, Harsh Golwala, Eric M Horlick, Matthew J Price, Carlos E Sanchez, John T Saxon, Markus D Scherer, Gilbert H L Tang, Dee Dee Wang, Omar K Khalique

Heart and Vascular Articles

As structural heart disease interventions rapidly evolve, demand for minimally invasive intraprocedural imaging techniques has increased. Intracardiac echocardiography (ICE) has emerged as a valuable imaging modality, offering real-time, high-resolution visualization of cardiac structures without the need for general anesthesia. This position statement from the Society for Cardiovascular Angiography & Interventions outlines the clinical applications, advantages, limitations, and implementation strategies for ICE in guiding transcatheter structural heart disease procedures. The document details standardized ICE imaging protocols and views for interventions involving the mitral, tricuspid, and pulmonary valves, as well as left atrial appendage occlusion atrial septal defect, and patent foramen ovale …

Responsible Adoption Of Multimodal Artificial Intelligence In Health Care: Promises And Challenges., Ghazal Azarfar, Sara Naimimohasses, Sirisha Rambhatla, Matthieu Komorowski, Diana Ferro, Peter R Lewis, Darren Gates, Nawar Shara, Gregg M Gascon, Anthony Chang, Muhammad Mamdani, Mamatha Bhat

Ambulatory and Primary Care Articles

Clinicians rely on various data modalities-such as patient history, clinical signs, imaging, and laboratory results-to improve decision making. Multimodal artificial intelligence (AI) systems are emerging as powerful tools to process these diverse data types; however, the clinical adoption of multimodal AI systems is challenging because of data heterogeneity and integration complexities. The 2024 Temerty Centre for AI Research and Education in Medicine symposium, held on June 17, 2024, in Toronto, Canada, explored the potential and challenges of implementing multimodal AI in health care. In this Review, we summarise insights from the symposium. We discuss current applications, such as those used …

A Reversal In Fortunes: A Case Of Triumphant Retrograde Intubation., Vishal Tharani, Nickolas Meier

Ambulatory and Primary Care Articles

A 48-year-old male presented to the emergency department in respiratory distress, with a history of poorly controlled asthma and a remote history of pulmonary embolus. After failing a non-invasive ventilation trial and numerous treatments for presumed status asthmaticus, he was planned for intubation. During the procedure, a large supraglottic mass was visualized, obstructing the airway and preventing successful orotracheal intubation via video laryngoscopy. Securing the airway was complicated by cardiac arrest, likely hypoxia-driven. The patient underwent a successful retrograde intubation followed by post-cardiac arrest stabilization. This case highlights the technique and its role in difficult airway management.

The Revised Risk Analysis Index Outperforms The 5-Factor Modified Frailty Index In Predicting Postoperative Morbidity After Pilon Fracture Fixation., Gabriel Deoliveira, Amber Park, Arsalaan Sayyed, Aruni Areti, Nithin Gupta, Taylor Manes, Morgan Turnow, Benjamin Taylor, Jack W Weick

Trauma and Acute Care Articles

BACKGROUND: Pilon fractures often result from high energy mechanisms resulting in long-term morbidity and postoperative complications. While there is extensive literature investigating frailty scales as tools for preoperative risk stratification in orthopedic surgery, there is no literature regarding their use in fixation of pilon fractures. The objective of this study was to compare the predictive ability and discriminative accuracy of the Revised Risk Analysis Index (RAI-rev) and the 5-Item Modified Frailty (mFI-5) in 30-day postoperative outcomes following surgical fixation of pilon fractures.

METHODOLOGY: The ACS-NSQIP database was used to identify patients undergoing surgical fixation of pilon fractures from 2015 to …

Blistering Bulbs: The Hidden Dangers Of Garlic As A Home Remedy., Riley Bunstine, Christopher M Lloyd

Ambulatory and Primary Care Articles

We report a case of a 46-year-old male who developed a second-degree chemical burn after application of crushed raw garlic to his left wrist. When crushed, garlic activates the enzyme alliinase that converts alliin into allicin. In controlled concentrations, allicin has been shown to have a wide array of therapeutic benefits; however, its use as an unregulated home remedy carries a significant risk of toxicity. This patient applied crushed garlic to his left wrist and left this poultice in place for five hours, hoping to ease wrist pain from a previous car accident. Upon removal, he felt an intense burning …

Association Of Acute Kidney Injury Risk And Same-Day Discharge Practices After Percutaneous Coronary Intervention., Anezi Uzendu, Rayan El Zein, Jennifer A Rymer, Dan D Nguyen, R Angel Garcia, Nobuhiro Ikemura, Neel Butala, Howard M Julien, Saket Girotra, Dharam J Kumbhani, Oladipupo Olafiranye, Rebecca Young, Leo Brothers, John A Spertus

Heart and Vascular Articles

BACKGROUND: Same-day discharge (SDD) after percutaneous coronary intervention (PCI) may be altered when complications occur. We sought to determine whether risk of the most common complication, acute kidney injury (AKI), is associated with SDD in practice.

METHODS: Using the NCDR (National Cardiovascular Data Registry) CathPCI registry, we calculated the AKI risk for elective PCIs from 2018 to 2022 using the NCDR prediction model. Hierarchical logistic regression models were constructed to predict SDD with AKI risk and procedural variables as fixed effects, and site as a random effect. Trends in SDD rate across AKI risk categories were described and variability across …

Insights Into Early Adoption And Physician Learning Curve Of Pulsed Field Ablation In The United States., Amin Al-Ahmad, Daniela Hincapie-Tabares, Paul C Zei, Andrea Natale, David Kessler, Joe Gallinghouse, Weeranun Bode, Jose Osorio, Jonathan W Dukes, Robert Eckart, Anish Amin, Yoel Vivas, Luis Mora, Amit Thosani, Joshua Silverstein, Anil Rajendra, Gustavo Morales, Michael Manogue, Joseph Donnelly, Frank Cuoco, Darren Sidney, Robert Brewer, Jason Meyers, Mark D Metzl, Guru Mohanty, Michael Rehorn, Paari Dominic, John D Day, Nischala Nannapaneni, John Costello

OhioHealth Research Institute Articles

BACKGROUND: Pulsed field ablation (PFA) has been available in Europe since 2021. In the United States, PFA became commercially available in 2024, and practice patterns are expected to differ from those in Europe. The objective of this study was to describe acute procedural efficiency and safety outcomes, clinical workflow patterns, and the physician learning curve associated with PFA for paroxysmal and nonparoxysmal atrial fibrillation in the first US real-world registry.

METHODS: DISRUPT-AF (A Registry Based Collaborative to Measure Efficiency, Effectiveness, and Safety of Farapulse PFA Technology for AF) is a prospective, multicenter registry capturing patient-level data on first-time PFA procedures …

New Onset Of Comorbidities In People With Epilepsy In A National Healthcare Claims Database., Edward Faught, Emily Klatte, Clarence T Wade, Sean Stern, Wesley T Kerr

Neuroscience Articles

PURPOSE: This study evaluated the rate of new occurrence of select comorbidities in adults after events of uncontrolled epilepsy versus controlled epilepsy.

METHODS: The HealthVerity Marketplace Inovalon healthcare claims database was used. Adults (≥18 years) with an epilepsy diagnosis (ICD-10-CM G40*) prescribed at least one antiseizure medication (ASM) between January 1, 2015, and December 31, 2021, were included. Patients were categorized as having either a first-filled or third-filled ASM. The first ASM filled was defined as no ASMs filled for at least 1 year of enrollment. Uncontrolled epilepsy events within 1 year of new ASM initiation were: seizure-related inpatient or …

Use Of Osteopathic Manipulation Techniques For Management Of Acute Otitis Media In Pediatric Patients: A Scoping Review., Cory Hyun-Su Kim, Lauren R Mccray, Shaun A Nguyen, Carl Shermetaro, Wayne K Robbins

Ambulatory and Primary Care Articles

OBJECTIVE: To map and summarize the existing literature on the use of osteopathic manipulative techniques (OMT) in the management of acute otitis media (AOM) in pediatric patients, with an emphasis on reported outcomes and identifying gaps in the current evidence.

DATA SOURCES: CINAHL, PubMed, and SCOPUS.

REVIEW METHODS: A comprehensive literature search was conducted across multiple databases following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Studies were charted and summarized based on key characteristics, including study design, population, types of OMT applied, and reported outcomes on management of AOM and recurrent AOM …

The Epidemiology Of Us Upper Extremity Amputations: An Analysis Of The Global Burden Of Disease Database (1990-2019)., Ambrose Loc T Ngo, Cameron J Sabet, Gabrielle Dykhouse, Ayah Ibrahim, Taylor J Manes, Arsalaan Sayyed, Shaheryar Asad, Benjamin C Taylor

Surgery Articles

Background Upper extremity amputations (UEAs) are medically, psychologically, and functionally devastating. This study aimed to evaluate region- and sex-specific differences in unilateral and bilateral upper extremity amputations in the United States (US) from 1990 to 2019. Methods The Global Burden of Disease (GBD) database was used to analyze years lived with disability (YLDs), prevalence, and incidence rates per 100,000 people for upper extremity amputations in the US from 1990 to 2019. Data were stratified into four US Census Bureau-defined regions: Northeast, Midwest, South, and West. Differences between regions and sexes were assessed, with statistical significance defined as p< 0.05. Results Between 1990 and 2019, unilateral upper extremity amputations in the US showed a 34.51% decrease in YLDs, 34.34% in prevalence, and 37.38% in incidence. Bilateral amputations decreased by 51.32%, 48.94%, and 56.80%, respectively. Men consistently had higher YLDs, prevalence, and incidence rates for unilateral amputations (p< 0.001). Regionally, the Northeast had the highest mean YLDs, prevalence, and incidence, while the South had the lowest. Men also experienced significantly higher rates of both unilateral and bilateral amputations across all regions compared to women (p< 0.05). Conclusions From 1990 to 2019, the US experienced declines in YLDs, prevalence, and incidence of upper extremity amputations. Men had higher rates than women across all regions. The Northeast exhibited the highest rates, while the South had the lowest. These findings underscore notable gender and regional disparities in upper extremity amputation trends.

Leukoplakia: An Uncommon Presentation Of Acute Febrile Neutrophilic Dermatosis (Sweet Syndrome)., Suchita Sampath, Bryce Delong, Sahil Kapur, Matthew J Franklin

Ambulatory and Primary Care Articles

No abstract provided.

Correction: A Comprehensive Narrative Review Of The Challenges Surrounding Cutaneous Scc., Sarah C Beach, Austin S Cusick, Aaron S Farberg, Shannon C Trotter

Ambulatory and Primary Care Articles

No abstract provided.

Drug-Eluting Resorbable Scaffold Versus Balloon Angioplasty For Below-The-Knee Peripheral Artery Disease: 2-Year Results From The Life-Btk Trial., Brian G Derubertis, Ramon L Varcoe, Prakash Krishnan, Marc P Bonaca, David J O'Connor, Richard Pin, David C Metzger, Andrew Holden, Jen-Kuang Lee, Osamu Iida, Ehrin J Armstrong, Steven W C Kum, Raghu Kolluri, Danielle R Bajakian, Lawrence A Garcia, Mehdi H Shishehbor, Shawn Yu, Karine Ruster, Brad J Martinsen, Zsuzsanna Igyarto, Sahil A Parikh

Heart and Vascular Articles

BACKGROUND: Limited treatment options exist for infrapopliteal disease in patients with chronic limb-threatening ischemia (CLTI), a condition associated with a high risk of limb loss. Interventional management of diseased infrapopliteal vessels with percutaneous transluminal angioplasty (PTA) is associated with high rates of restenosis and reintervention. In the LIFE-BTK randomized controlled trial (Pivotal Investigation of Safety and Efficacy of BRS Treatment-Below the Knee), the drug-eluting resorbable scaffold (DRS) demonstrated superior 12-month efficacy compared with PTA in a selected CLTI population with predominantly noncomplex, mildly to moderately calcified lesions. This report presents the 2-year safety and efficacy outcomes of the Esprit BTK …

The Cardioprotective Effects Of Adiponectin In Diabetes., Tara Kazemi, Yuanjie Mao, Tina Zhang

Ambulatory and Primary Care Articles

PURPOSE OF REVIEW: Adiponectin, a hormone secreted by adipocytes, plays a crucial role in maintaining metabolic balance and supporting cardiovascular health. Although it is known for its protective effects, such as improving insulin sensitivity, reducing inflammation, and maintaining endothelial function, there are paradoxical associations between high adiponectin levels and increased cardiovascular mortality-referred to as the "adiponectin paradox"-which complicates its clinical interpretation. This review explores the cardioprotective effects of adiponectin in both type 1 and type 2 diabetes, focusing on its potential to regulate glucose metabolism and prevent cardiovascular complications.

RECENT FINDINGS: By reviewing key studies, the article evaluates adiponectin's diverse …

Temporal Trends In The Epidemiology Of Hip Osteoarthritis In The Usa, 1990-2019: A Cross-Sectional Time-Series Study Using Gbd Data., Arsalaan Sayyed, Gabrielle Lucia Dykhouse, Taylor J Manes, Cameron Sabet, Minali Gautami Nemani, Ambrose Loc Ngo, Ayah A Ibrahim, Phillip C Mckegg, Jignesh N Patel

Ambulatory and Primary Care Articles

OBJECTIVES: To evaluate temporal trends in the epidemiology of hip osteoarthritis (OA) in the USA from 1990 to 2019, with stratification by sex and geographic region.

DESIGN: Cross-sectional time-series analysis using secondary data from the Global Burden of Disease (GBD) study.

SETTING: US population-based analysis, stratified by the four US Census Bureau regions: Northeast, Midwest, South and West.

PARTICIPANTS: De-identified, aggregate population-level data representing all adults in the USA from 1990 to 2019, drawn from the GBD database.

PRIMARY AND SECONDARY OUTCOME MEASURES: Age-standardised rates per 100 000 population for years lived with disability (YLDs), prevalence and incidence of hip …

Management Of Recurrent Metastasis Of Renal Cell Carcinoma To The Parotid Gland After Nephrectomy., Kathryn Collins, Emily Cushing, Alex Ellerhorst, Christopher Selinsky

Oncology Articles

Renal cell carcinoma accounts for 90% of malignant renal tumors, with common metastases to the lungs, bones, and brain. Head and neck metastases are uncommon, and the parotid gland is an exceedingly rare site (0.5%). Recurrent metastasis to bilateral parotid glands has been reported in the literature, but recurrent metastasis to the ipsilateral gland has not. This is a case about a 69-year-old female who presented to our clinic with the chief complaint of a slowly enlarging left neck mass. She had a history of clear cell renal cell carcinoma treated with nephrectomy 15 years prior. An MRI reviewed from …

Epidemiology Of Lower Extremity Amputations In The United States: An Analysis Of The Global Burden Of Disease Database From 1990 To 2019., Peter B Spencer, Cameron J Sabet, Gabrielle Dykhouse, Taylor J Manes, Phillip C Mckegg, Ambrose Loc T Ngo, Ayah Ibrahim, Jack Weick

Surgery Articles

BACKGROUND: Lower extremity amputations (LEAs) are medically, psychologically, and functionally devastating. The objective of our study was to evaluate region- and sex-specific differences of unilateral and bilateral LEAs across the United States (US) from 1990 to 2019.

METHODS: The Global Burden of Disease database was used to analyze years lived with disability (YLDs), prevalence, and incidence rates per 100,000 people for LEAs in the US from 1990 to 2019. Data were stratified into four US Census Bureau-defined regions: Northeast, Midwest, South, and West. Differences between regions and sexes were assessed, with statistical significance defined as p < 0.05.

RESULTS: From 1990 to …

Perioperative Antibiotic Administration Review: An Analysis Of Outpatient Surgeries At Ohiohealth Doctors Hospital., Rayyan Bhutta, Thomas Shneker, Samantha Currier, Alexander Caskey, Vincent Relli-Dempsey, Matthias Franzen, Samir Patel

Surgery Articles

INTRODUCTION: A vital part of preventing surgical site infections (SSIs) is perioperative antibiotic prophylaxis. Antibiotics must be administered within a certain window of time, usually 15 to 60 minutes prior to the surgical incision, for them to be effective. The most frequently utilized medication, cefazolin, can be administered quickly by intravenous push (IVP), but other medications, such as vancomycin and clindamycin, need longer infusion times. Antibiotic efficacy declines, and the risk of SSIs is increased when scheduling requirements are not followed. With special focus on time, dosage, and variation by surgery type, this study evaluates adherence to perioperative antibiotic administration …

Acute Care Of Patients With Moderate Respiratory Distress: Recommendations From An American College Of Emergency Physicians Expert Panel., Christopher W Baugh, Jim F Neuenschwander, Jesslyn Lenox, Jennifer Hoh, Kara Ward, Sara Muramoto, John Casey, Antonio Anzueto, Hajirah Ishaq, Jared Mount, Peter M Deblieux

Ambulatory and Primary Care Articles

INTRODUCTION: Patients with respiratory distress are frequently encountered in the emergency department (ED). Efforts to assess, initiate treatments, and stabilize these patients require a systematic and rapid response. Emergency physicians need a comprehensive and efficient approach for evaluating, treating, and managing patients presenting to the ED with moderate respiratory distress.

METHODS: The American College of Emergency Physicians convened an expert panel of academic and community emergency physicians, critical care specialists, respiratory therapists, hospitalists, and pharmacists to develop and subsequently disseminate consensus recommendations regarding the diagnosis and treatment of patients with moderate respiratory distress presenting to the ED.

RESULTS: A digital …

Dermatology Match Disparities: Analyzing Osteopathic Vs. Allopathic Student Outcomes Post-Acgme/Aoa Single Accreditation System (2020-2024)., Leo Wan, Karandeep Bawa, Aileen Park, Haaris Kadri, Austin Cusick, Shannon C Trotter

Medical Education Articles

CONTEXT: Dermatology remains one of the most competitive medical specialties, with successful candidates often demonstrating outstanding academic performance, extensive research experience, and strong letters of recommendation. The integration of the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) into a single accreditation system in 2020 was intended to streamline residency training, but it has raised concerns about how Doctor of Osteopathic Medicine (DO) applicants will perform in dermatology residency match.

OBJECTIVES: This study examines the differences in DO and MD match rates following the single graduate medical education (GME) accreditation system, focusing on the match …