Somervillebunn4599

long term learning outcomes. Copyright © 2020, Abdellatif et al.Congenital hypoplasia of depressor angularis oris muscle (CHDAOM) is an uncommon cause of asymmetric crying facies in neonates. Although its etiology is mostly unknown, it has been increasingly recognized as a marker for the presence of other less easily identifiable congenital abnormalities associated with genetic syndromes such as DiGeorge and Cayler syndrome. We report a unique case of a male neonate that highlights the necessity of judicious and accurate clinical documentation with the presence of CHDAOM to avoid unnecessary forms of subsequent work-up. Copyright © 2020, Parfianowicz et al.Restrictive cardiomyopathy (CM) usually develops and progresses slowly, over a course of years. The rapid development of idiopathic restrictive CM immediately following a liver transplant is unusual. selleck chemical We describe the case of a patient who developed idiopathic restrictive CM fairly rapidly following a liver transplant. It progressed within a few months to the point where the patient required scheduled paracenteses and dialysis. The morphological definition of restrictive CM consists of bi-atrial dilation with non-dilated and non-hypertrophic ventricles. A cardiac biopsy may be needed when the underlying cause is not evident. When a cardiac biopsy is not able to identify a specific cause, then the word "idiopathic" is used to describe the CM. Copyright © 2020, Ahmed et al.Creutzfeldt-Jakob disease (CJD) is the most common human prion disease presenting with subacute cognitive decline. Common MRI findings for CJD include the T2 prolongation signal of the putamen and head of caudate. Diffusion-weighted MRI (DW-MRI) is considered to be the most sensitive technique for the detection of CJD-related abnormalities, especially for cortical changes. We report the case of a 77-year-old female who presented with dizziness, visual hallucination, and a rapid decline in her mental state shortly after a right knee surgery. Brain MRI with contrast showed cortical and subcortical T2 fluid-attenuated inversion recovery (FLAIR) hyperintensities in bilateral posterior temporal lobes and the left occipital lobe without an associated enhancement, suggestive of posterior reversible encephalopathy syndrome (PRES). Workup including metabolic, infectious, and vasculitic panels were all within normal limits. A few days later, she developed persistent myoclonus, and a continuous electroencephalogram (EEG) revealed multifocal epileptiform and generalized discharges, forming multifocal periodic discharges and generalized periodic discharges (GPDs). Cerebrospinal fluid (CSF) analysis was positive for 14-3-3 and elevated T-tau protein consistent with a diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD). This is a rare case of CJD presenting with a brain MRI resembling PRES. CJD may have various features on MRI, and a high degree of suspicion is required to confirm the diagnosis. Copyright © 2020, Bittar et al.It has been estimated that there are greater than 100,000 individuals in the US with sickle cell disease. Hepatic sequestration is a known sequelae of sickle cell disease that rarely leads to extreme hyperbilirubinemia (total serum bilirubin greater than 20 mg/dl). Our 26-year-old male patient, though compliant with regular transfusion exchanges, presented with hepatic sequestration, with minimal symptoms and hyperbilirubinemia up to approximately 40 mg/dl. The severity of asymptomatic hepatic sequestration seen in our patient has never been reported in the literature. This mandates a low threshold to screen for sickle cell complications and promptly treating these patients admitted to the hospital with exchange transfusions. Copyright © 2020, Raza et al.Rates of undiagnosed youth human immunodeficiency virus (HIV) remain problematically high across the United States and internationally. In addition, youth HIV test rates remain consistently low, and youth with HIV remain undiagnosed for longer periods of time as compared with older populations. Youth HIV remains especially persistent among African American adolescents and emerging adults, who are less likely to have consistent access to primary care and thus to HIV testing and prevention education. Therefore, increasing youth HIV test rates has become an important priority in emergency departments and other settings. At the same time, many young patients may not disclose risk behaviors or even engage in discussions of HIV testing when they interact with healthcare providers because they may fear being stigmatized. Technology-based interventions present valuable opportunities to reframe risk reporting and discussions of testing by designing computer-mediated interactions that young sexual and racial minority participants find non-judgmental and less threatening. If designed in accordance with empirically tested theories of instructional design/multimedia learning and established models of behavior change, technology-based interventions can increase the number of HIV tests offered to young people and offer testing in nonthreatening ways that more young people will accept. The current paper describes a hyper-iterative methodology used to develop the Mobile Augmented Screening (MAS) tool, a technology-based intervention designed to destigmatize HIV and increase HIV test rates among youth. Copyright © 2020, Aronson et al.Objectives To identify the etiology of non-cystic fibrosis bronchiectasis (NCFB), to assess the clinical presentation, radiological findings, and microbiological profile of patients presenting with a diagnosis of bronchiectasis in a tertiary care center of Pakistan. Methods This was a prospective observational cohort study where patients with a diagnosis of bronchiectasis proven by high-resolution computed tomography (HRCT) were evaluated for etiology, clinical characteristics, microbiology, radiology, spirometric profile, and in-hospital outcomes. Results During the study period, 196 patients were diagnosed with NCFB. The majority of the patients were men 76.5% (n = 150) and 83.6% (n = 163) of the total patients were younger than 60 years of age. The majority of these patients (58.7%, n = 111) had a duration of symptoms between 5-10 years. The etiology of bronchiectasis was identified in 92.9% of cases. Post-infectious bronchiectasis was the most common cause (67.8%, n = 133), followed by chronic obstructive pulmonary disease (COPD) (9.