January 2025 Medical Image of the Month: Psoriasis with Pulmonary Involvement

By: Jokerst C, Butt YM

Abstract: 

No abstract available. Manuscript truncated after 150 words. A 58-year-old man presented to our pulmonary service for a second opinion concerning his interstitial lung disease (ILD), which had been diagnosed as rheumatoid arthritis associated ILD. The patient had a positive rheumatoid factor (barely) at an outside institution, but no other test results or historical or physical exam findings to suggest rheumatoid arthritis. He was being treated with mycophenolate, but did not feel that he was improving. To the contrary, there had been a recent decline in his overall lung function. The only other relevant medical history is psoriasis. The patient is a lifelong nonsmoker. Resting pulse oximetry was 95% on room air with a brief desaturation to 88% during ambulation, which quickly recovered with rest. The patient’s vital signs were otherwise normal. Physical exam findings were normal aside from mild cutaneous findings of plaque psoriasis. Results from pulmonary function testing at an outside institution were available, revealing a …

URL: https://www.swjpcc.com/imaging/2025/1/2/january-2025-medical-image-of-the-month-psoriasis-with-pulmo.html 

January 2025 Critical Care Case of the Month: A 35-Year-Old Admitted After a Fall

By: VonEssen SG

Abstract: 

No abstract available. Manuscript truncated after 150 words. History of Present Illness

A 35-year-old was injured at work earlier that day. He fell approximately 10 feet while power washing a hog confinement pen from inside the bucket of a skid loader. He complained of pain in his left foot. He had struck his head but denied loss of consciousness. He was admitted to an outside hospital ICU for observation.

PMH, SH, and FH

He has no chronic medical conditions and has never been hospitalized.

He has never smoked and only drinks socially. He is single.

His mother died at 55 of heart disease. His father and 6 brothers and sisters are all healthy.

Physical Examination

He is 5’5” and weighs 193 pounds. There is a head laceration and he has tenderness in his left foot. Otherwise, his physical examination is normal.

Radiology

A foot x-ray reveals fractures of the left second and third metatarsals. Head CT was interpreted …

URL: https://www.swjpcc.com/critical-care/2025/1/1/january-2025-critical-care-case-of-the-month-a-35-year-old-a.html 

If You Want to Publish, Be Part of the Process

By: Quan SF, Shapiro C

Abstract: 

No abstract available. Manuscript truncated after 150 words. The edifice of academic journals is predicated on the process of peer review. Inevitably it is subject to the vagaries of the individual perspectives and biases of the reviewers. However, there has not been a useful, equitable or viable alternative that would secure a level of quality control in the research domain (1). Given the inevitable human components of range of knowledge, potential biases  and sometimes lazy thinking, it is certainly not a perfect system. Certainly, a worthy paper occasionally is rejected, or a badly flawed paper is accepted. However, in the absence of a better process, it is the gold standard.

Historically, peer review has been an altruistic endeavor. Researchers understood that their reviews contributed to the scientific process by improving the quality of reported information and providing an imprimatur to the reported findings (2); reviewing was an obligation to the scientific community (3). However, there are other benefits …

URL: https://www.swjpcc.com/editorials/2024/12/16/if-you-want-to-publish-be-part-of-the-process.html

Point-of-Care Ultrasound Bootcamp Training: A Pilot Program for Internal Medicine Residency

By: Ma M, Abbas F, Puebla Neira D, Merz J, Migotto W, Mathew M

Abstract: 

Background: The goal of the study was to develop a pilot program to assess point-of-care ultrasound (POCUS) knowledge and proficiency via a bootcamp-style education. The primary endpoints were to objectively identify trainees’ ability and interest to learn POCUS.

Methods: A POCUS education program was designed for 41 post-graduate-year-1 trainees’ orientation in an internal medicine residency program. Trainees were provided brief lectures on lower extremity veins, lung, and abdominal pathologies before proceeding to stations to practice ultrasound skills. An anonymous test was completed by each participant before and after they were provided lectures and practice time. The percent correct for each question before and after the intervention was compared using a paired t-test. The study was determined to be exempt by the University of Arizona IRB review.

Results: Primary outcomes found that 100% of the trainees improved on their knowledge of ultrasound based on a post-didactic assessment, and all questions except for one was statistically significant. The average pretest correct was 46% and posttest correct 84% (p<.001). Feedback on the sessions was assessed using Word Cloud. A higher number of trainees reported interest in applying POCUS to clinical practice after the session. The bootcamp was helpful when using videos, case examples, and small groups. Areas of improvement included providing more practice time, feedback on images obtained, and teaching cardiac ultrasound.

Conclusion: Internal medicine trainees were able to effectively learn the basics of POCUS, and they were more likely to use ultrasound after gaining knowledge.

URL: https://www.swjpcc.com/general-medicine/2024/12/14/point-of-care-ultrasound-bootcamp-training-a-pilot-program-f.html

December 2024 Medical Image of the Month: An Endobronchial Tumor

By: Jokerst CE, Stib MT, Rojas C, Gotway MB

Abstract: 

No abstract available. Article truncated after 150 words. A 61-year-old woman was for wheezing. She reported that the symptoms were sudden in onset and persisted for 2 months without improvement. There was no infectious prodrome, no history of an aspiration event, and the symptoms had no exacerbating or relieving factors. The patient reported a past medical history of reflux (controlled on omeprazole), dyslipidemia, hypertension, and migraine headaches. Her past surgical history includes remote histories of breast augmentation, hysterectomy and salpingo-oophorectomy, cholecystectomy, and urethral sling. The patient was a never-smoker with no history of illicit drug use, travel, or exposures. Family history was non-contributory. The patient medications included Crestor, Thiazide, Imitrex, Losartan, and Omeprazole. No known drug allergies.

Her vital signs were normal. Physical exam demonstrated an inspiratory wheeze which was diffuse and best appreciated anteriorly. A PA and Lateral chest x-ray was done at the time of initial referral (Figure 1). A CT scan was subsequently obtained (Figure …

URL: https://www.swjpcc.com/imaging/2024/12/2/december-2024-medical-image-of-the-month-an-endobronchial-tu.html