Pellagra in Complex Clinical Settings: A Case Involving Bariatric Surgery, Whipple Procedure, and Alcohol Use Disorder.

Pellagra is a disease of niacin (vitamin B3) deficiency and is classically characterized by the triad of diarrhea, dermatitis, and dementia, and has the potential to cause death. Pellagra can be caused by either insufficient dietary intake or dysfunctional utilization of niacin. Because niacin can be found in nearly every food group (meat, dairy, vegetables, grains, etc.

The Role of Wellness and Well-being in Addressing Medical Student Burnout in the United States: A Scoping Review.

This scoping review explores factors that contribute to medical students' burnout and identifies the barriers hindering efforts to address burnout and interventions implemented to improve well-being. This scoping review was conducted using the Arksey and O'Malley York methodology. The Joanna Briggs Institute (JBI) guidelines guided the processes of data extraction, evaluation, and reporting of findings.

Successful Interventions to Improve Pediatric Vaccine Uptake in Hesitant Cohorts: A Scoping Review.

Vaccine hesitancy is a multi-faceted topic that encompasses many different etiologies and solutions. There remains limited literature regarding effective interventions to target these hesitant cohorts. The objective of our paper was to review existing publications that quantitatively measure if tested interventions resulted in an increase in pediatric vaccine uptake within populations that have been evaluated for vaccine hesitancy.

A Rare Presentation of a Neuroendocrine Tumor: A Case Report.

Neuroendocrine tumors (NETs) are slow-growing, rare malignancies that originate from neuroendocrine cells and may be classified as functional, secreting hormones that produce clinical symptoms, or non-functional, often remaining asymptomatic until advanced stages. Primary gastrointestinal NETs in the esophagus (E-NETs) are rare, accounting for only 0.4%-2% of esophageal malignancies.

Retention of a Copper T380A Intrauterine Device for 29 Years in a 64-Year-Old Female With Postmenopausal Bleeding.

Intrauterine devices (IUDs) are widely utilized, long-acting reversible contraceptives with established guidelines for timely removal. Prolonged IUD retention into the postmenopausal period is an uncommon phenomenon but may have various effects on the endometrium. We present the case of a 64-year-old female who presented with postmenopausal bleeding (PMB) and was incidentally found to have a copper T380A IUD retained in utero for 29 years.

Tinnitus.

Tinnitus is considered a symptom and not a diagnosis. It varies in its presentation from unilateral to bilateral and intermittent to constant. Typically, it is of unknown etiology but can be due to a secondary medical condition.

Writing an External Letter of Review for Promotion.

Academic promotion, representing achievement of a level of distinction in one's body of work, is an honorable accomplishment in a faculty member's career. External letters of review written by faculty at higher ranks are a critical component of the promotion portfolio. We discuss key considerations for writing external letters.

Gut Microbiome and Dietar Considerations.

The gut microbiome represents a complex microbial ecosystem that exerts direct and indirect effects on other organ systems and contributes to both health and disease. It is sensitive to various stimuli such as childhood immunity, medications, diet, stressors, and sleep. Modulating the gut microbiome can prevent and even treat certain disease states.

Attention-Deficit/Hyperactivity Disorder Across the Spectrum: From Childhood to Adulthood.

Attention-deficit hyperactivity disorder is a neurodevelopmental disorder involving dysregulation of multiple neural circuits, manifesting in symptoms such as inattention, impulsivity, and hyperactivity. Diagnosis requires onset of symptoms before age 12 years. However, symptoms often persist throughout lifetime, although they may change over time.

Alarming Trends: Mortality from Alcoholic Cirrhosis in the United States.

Background: Alcoholic cirrhosis is an advanced form of alcohol-related liver disease. In the United States, between 2010 and 2016, alcohol-related liver disease was the primary cause of nearly 1 in 3 liver transplants, surpassing hepatitis C.

Methods: We utilized the US Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research database to compare trends in mortality from alcoholic cirrhosis in the United States in 1999 and 2019.

An atypical presentation of type 1 diabetes.

Type 1 and type 2 diabetes have been described historically as occurring in distinct patient populations; however, atypical demographics are becoming more frequent as the prevalence of diabetes increases, crossing boundaries of ages. Some of these cases can be challenging to diagnose clinically as the patient symptomatology and progression can differ from the standard features of type 1 and 2 diabetes. Our case is an example of a patient whose type 1 diabetes presented atypically with characteristics often associated with type 2 diabetes.

Autosomal Dominant Polycystic Kidney Disease.

Autosomal Dominant Polycystic Kidney Disease is an inherited multisystemic disorder of the renal tubules with subsequent formation of multiple cysts and enlargement of the kidney, affecting various organs. Diagnosis is initially suspected in those with family history and/or individuals who develop hypertension early on (secondary hypertension) or certain symptoms. Renal function is initially preserved for years secondary to compensatory mechanisms.

Prevention of Hypertension Related to Cardiovascular Disease.

Hypertension, among the common conditions encountered in primary care, is known to have a causal link with cardiovascular disease. With new thresholds for diagnosing hypertension, its prevalence is expected to increase. Currently, a high percentage of patients have suboptimal or inadequately controlled blood pressure, thus placing them at risk for cardiovascular disease.

Metabolic Syndrome.

The United States is experiencing its greatest life expectancy ever. Nonetheless, the general health of the US population is far from at an all-time high. An important contributor to the pandemic of cardiovascular disease is that overweight and obesity are also the major determinants of metabolic syndrome, an all too common and all too serious clinical and public health challenge.