The American journal of the medical sciences
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Review Case Reports
Dermatomyositis Developed After Exposure to Epstein-Barr Virus Infection and Antibiotics Use.
Dermatomyositis is an inflammatory disorder involving muscle and skin. Similar to many other autoimmune diseases, environmental factors appear to trigger the onset of disease in some cases. ⋯ Dermatomyositis associated with doxycycline or levofloxacin use has not yet been described in the literature, while reports of dermatomyositis after Epstein-Barr virus infection have been rare and limited to juvenile dermatomyositis or in association with cancer. It is important for clinicians to be aware of this rare association so that the diagnosis and treatment can be exercised promptly.
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The academic half day (AHD) has emerged in recent years as an alternative to the traditional noon conference model of didactic teaching in graduate medical education. However, the effects of this change on learners are not fully understood. This study aimed to assess the effects of the AHD on attendance, satisfaction, perceived value and wellness of resident physicians. ⋯ The AHD significantly improved resident time in conference, resident satisfaction and perceived educational value of the core conference series compared to a noon conference model. While challenges will exist with any educational conference model, the AHD appears to be a highly attractive approach to medical resident education.
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Fahr's disease is a sporadic or familial neurodegenerative disorder characterized by symmetrical calcification of cerebral structures, particularly the basal ganglia, cerebellar dentate nuclei and surrounding white matter, in the absence of metabolic causes of calcification. We report the case of a previously fit, high functioning 58-year-old man who developed catastrophic irreversible neuropsychiatric collapse after sepsis despite appropriate antimicrobial treatment. Cranial computed tomography revealed extensive diffuse calcifications located in unusual areas. ⋯ Important diagnostic considerations in the septic patient who develops neurological complications, namely sepsis-associated encephalopathy and antibiotic-associated encephalopathy, are discussed. The patient remains severely handicapped 6 months after the acute event. Patients with clinically silent neurodegenerative/neuropsychiatric conditions, such as Fahr's disease, may present with florid and unpredicted neurological features in the context of systemic illness.
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Review Case Reports
Inflammatory Demyelinating Pseudotumor With Liver Dysfunction: IgG4 Related Disease With Primary Biliary Cholangitis.
Immunoglobulin G4 related disease (IgG4-RD) is a recently recognized immune-mediated disease which is far from understanding. A case of inflammatory demyelinating pseudotumor had been confirmed as IgG4-RD according to pathology features and clinical context. ⋯ This is the first report in which mass lesions in the brain parenchyma were caused by IgG4-RD while liver dysfunction was due to primary biliary cholangitis. The clinical features of IgG4-RD are miscellaneous, and the accumulation of case reports might enrich clinicians experience and broaden their horizons about this condition.
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The association between grit, defined as perseverance and passion for long-term goals, and professional burnout has not been studied in internal medicine residents. Our objective was to examine whether internal medicine residents' scores on a grit scale were associated with various measures of burnout. ⋯ Grit appeared to be an independent predictor of burnout in internal medicine residents in this sample, with lower grit scores associated with higher burnout scores. By measuring grit early in residency, programs can potentially identify residents at risk for symptoms of burnout, specifically emotional exhaustion, and implement targeted interventions.