Curēus
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Introduction Self-directed learning in medical professions is established as an effective method of training in certain modalities. Furthermore, simulation technology is becoming widely used and accepted as a valid method of training for various medical skills, with ultrasound being one of the best studied. The use of point-of-care ultrasound (PoCUS) in the practice of emergency medicine is well established, and PoCUS is a core competency of the Royal College of Physicians and Surgeons of Canada emergency medicine standards. ⋯ Conclusion We were unable to demonstrate the achievement of competence in PoCUS in medical learners engaged in our combined self-directed simulation-based training program. This is in contrast to the considerable literature supporting self-directed learning and simulation-based learning for other skills. Feedback from faculty, curriculum integration, and alignment with clinical experience may be beneficial.
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Hereditary hemorrhagic telangiectasia (HHT) is described as a vascular defect, causing recurrent visceral and mucocutaneous bleeding. It is an autosomal dominant disease and has variable expressivity. The phenotypic presentation is dependent on the type of gene defect. ⋯ We describe the case of a 69-year-old male who presented with GI bleeding and a history of HHT and recurrent deep vein thrombosis (DVT). We discuss the diagnostic guidelines and treatment options for patients with HHT. Furthermore, we also discuss the challenge in treating patients with co-existing GI bleeding and DVT, as in our case.
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Due to the inherent stability of the hip joint, hip dislocations constitute a relatively small proportion of all the traumatic dislocations encountered in the emergency department. Among them, the anterior type of hip dislocation is less common than the posterior type of dislocation. Anterior dislocations are usually associated with an injury to other, nearby structures like the acetabulum and femoral head. ⋯ The joint was reduced promptly with traction-countertraction under sedation, and the associated fracture was subsequently fixed with two 6.5 mm partially threaded, cannulated, cancellous screws. The patient was symptom-free at the last follow-up of one year with a full range of hip joint motion, and without any evidence of osteonecrosis or osteoarthritis. The mechanism of greater trochanter fracture in such injuries and its management has been discussed.
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Background Burn scars frequently tend to have pathological discolorations, which is manifested in the development of persistent erythema. Affected people suffer from psychological and physiological issues when they are restricted or rejected in their daily life. In this context, medical needling seems to be an efficient therapy for erythematous scars with a relatively low-risk rate of postoperative complications. ⋯ Examined scars showed a significant reduction of erythema and were less reddened after treatment. Based on the outcomes of objective measurements, medical needling achieves a normalization of the skin color and an adjustment to healthy skin after repetitive treatments. Conclusion Medical needling seems to be a suitable therapy approach for treating erythematous, hypertrophic burn scars.
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Pseudo-pneumothorax occurs after inappropriately diagnosing a pneumothorax based on a chest X-ray. This can be attributed to skin folds, bed sheets, previous pneumothorax, heating blankets, clothes, and other circumstances that may mimic the radiographic findings of a pneumothorax. We present a case where a patient underwent a tube thoracostomy due to the diagnosis of a pneumothorax that was not, in fact, present. The unnecessary intervention was complicated by hemoptysis and cardiac arrest.