Progressive Cutaneous Cholesterol Emboli Syndrome.

Cholesterol emboli syndrome is a rare syndrome of tissue ischemia and necrosis caused by the embolization of cholesterol crystals from atherosclerotic plaques, leading to vascular occlusion. This report documents a case of cholesterol emboli syndrome in a 72-year-old male with multiple cardiovascular risk factors including end-stage renal disease, atrial fibrillation, hypertension, hyperlipidemia, and type 2 diabetes. We describe this patient's atypical presentation with upper extremity rather than lower extremity digital ischemia as a presenting sign and significant subsequent functional decline exacerbated by his comorbidities.

Perceptions of X+Y Scheduling Among Combined Internal Medicine-Pediatrics Residency Trainees: A Qualitative Program Evaluation.

Objective: The study aims to elicit perceived benefits and downsides of X+Y scheduling for combined Internal Medicine-Pediatrics (Med-Peds) residents via focus groups.

Methods: Five focus groups were conducted with Med-Peds residents in participating programs which utilized X+Y scheduling. Onefocus group was held per participating institution.

Safety and predictors of the success of lumbar punctures performed by a medicine procedure service.

Background: Medicine procedure services (MPS) increasingly perform bedside procedures, including lumbar punctures (LPs). Success rates and factors associated with LP success performed by MPS have not been well described.

Objective: We identified patients undergoing LP by an MPS September 2015 to December 2020.

The Implementation of X + Y Scheduling in Combined Internal Medicine-Pediatrics Residency Programs: Practical Considerations for Program Leadership.

The X + Y scheduling approach, or block scheduling, is common among internal medicine residency programs. With the beginning of a pilot program through the American College of Graduate Medical Education in 2018, pediatrics and internal medicine-pediatrics (Med-Peds) residency programs have been able to adopt X + Y scheduling as well. The X + Y scheduling approach presents unique challenges and opportunities for combined Med-Peds residencies.

Focusing on Diversity: A Regional Internal Medicine Residency Viewpoint on Underrepresented Minority Support, Retention, and Mentoring.

Background: While the overall percentage of residents who withdraw (2.7%) or take extended leave (1.0%) are low, subgroup analysis has found that minority physicians are approximately 30% more likely to withdraw from residency than their white counterparts and 8 times more likely to take extended leave of absence.

Skeletal muscle metastasis from signet ring cell esophageal adenocarcinoma.

Symptomatic skeletal muscle metastasis from esophageal adenocarcinoma is rare. Here we report the case of a 49-year-old man who presented with right thigh pain, and was found to have symptomatic psoas muscle metastasis as the presentation of esophageal adenocarcinoma. The primary tumor was notable for signet ring cells (SRC), a poor prognostic indicator as well as a predictor of biologic aggressiveness.