Asthma-Related ED Visits Among Children in the United States: A Cross-Sectional Analysis of Associated Factors Using the National Hospital Ambulatory Medical Care Survey (NHAMCS), 2006-2020.

Background Asthma remains a leading cause of ED visits among children in the United States. Despite clinical advancements, disparities in asthma care and control persist, particularly among socioeconomically and racially marginalized populations. Objective This study examines trends and sociodemographic factors associated with asthma-related ED visits in children using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 2006 to 2020.

Radiographic Convergence: A Case of Pneumomediastinum, Pneumothorax, Pneumopericardium, and Subcutaneous Emphysema.

Spontaneous pneumomediastinum (SPM) is a rare, self-limiting condition that can be complicated by pneumothorax, pneumopericardium, and subcutaneous emphysema. This case describes a 25-year-old man with a chronic marijuana use history who developed SPM after a recent respiratory infection. Imaging showed significant pneumomediastinum, pneumopericardium, and small pneumothoraces bilaterally.

Safety and Efficacy of Dupilumab, Omalizumab, and Mepolizumab in Moderate-to-Severe Asthma: A Systematic Review.

Biologic therapies such as dupilumab, omalizumab, and mepolizumab have significantly revolutionized the treatment options for moderate-to-severe asthma, particularly in patients with type 2 inflammation. This systematic review aims to compare the FDA black box warnings and safety profiles of these three biologics, emphasizing adverse event risks and clinical implications for practice. A comprehensive literature search was conducted across PubMed, Embase, Cochrane Library, ClinicalTrials.

Unmasking the Hidden Threat: a Case and Review of Primary Hyperparathyroidism-Induced Pancreatitis Diagnosed in Pregnancy.

Unlabelled: Primary hyperparathyroidism is a very well-documented and understood endocrine pathology that includes the overproduction of parathyroid hormone, leading to an exaggerated effect of hypercalcemia. However, its prevalence leading to pancreatitis, specifically in pregnant patients, is underreported and widely undiagnosed. In this case, we present a case of a 23-year-old female in her second pregnancy who presented with pancreatitis after already being treated and diagnosed with pancreatitis in her first pregnancy.

The Modern Role of Neonatal PICCs Subspecialty.

This perspective review examines the evolving role of neonatal peripherally inserted central catheters (n-PICCs) as a distinct subspecialty within neonatal vascular access. n-PICCs are indispensable for delivering long-term intravenous therapies in critically ill neonates. The review explores ethical considerations, equitable access to vascular access technologies and prioritisation of patient safety in procedural training.

Characteristics of Pediatric Emergency Department Visits in the Past 22 Years in the United States (1997-2019).

Background: Pediatric emergency department (ED) visits are an important indicator of children's health and healthcare access. Understanding the factors influencing these visits, including socioeconomic status, insurance coverage, and geographic location, is essential for improving pediatric care delivery.

Objective: This study aims to analyze the characteristics of pediatric ED visits in the United States over 22 years (1997-2019), focusing on factors such as poverty levels, health insurance status, geographic region, and frequency of ED visits.

The 3 Stations of the Needle: A systematic approach for ultrasound guided venous and arterial puncture.

Point-of-care ultrasound-guided (POCUS) venous and arterial access involves accurately guiding a needle from the skin surface through subcutaneous tissue to the target vessel. The success of this procedure relies heavily on the operator's ability to locate and direct the needle tip, which can lead to multiple puncture attempts and iatrogenic complications. A literature review revealed a lack of comprehensive protocols addressing the sonographic details necessary for effective needle identification and vessel cannulation.

Aggressively Quick: A Case of Negative Radiographic Evidence Progressing to a Large Lobulated Lung Mass In Six Months.

Unlabelled: We present the case of a 61-year-old male with a past medical history of diabetes, hypertension, obstructive sleep apnea, obesity hypoventilation syndrome, and chronic obstructive pulmonary disease (COPD), who developed a rapidly growing lung mass after previously having no radiographic evidence of cancer 6 months earlier. The patient initially presented for what appeared to be a COPD exacerbation, and imaging at that time showed no sign of any lung mass. Six months later, the patient returned with dyspnea and was found to have a large lobulated lung mass, possibly extending into the mediastinum.

POCUS using the neo-ECHOTIP protocol plus the retract, advance, and position (RAP) technique to improve lower extremity catheter positioning in neonates.

BackgroundInternational guidelines recommend point-of-care ultrasonography (POCUS) in neonatology for diagnostic, therapeutic, and procedural purposes. However, there are few standard protocols for using POCUS to confirm lower extremity catheter tip positioning.MethodsIn this prospective study, subcutaneously tunneled femorally inserted central catheters (ST-FICCs) were placed in eligible neonates according to physician orders.

Retrospective review of the development and implementation of a bedside tunneled dialysis catheter program.

Background: The decision to place a subcutaneously tunneled catheter is an infection prevention strategy for long term venous access allowing the proceduralist to access a vein and relocate the catheter exit site to a region on the body where care and maintenance can be safely performed. Subcutaneously tunneled centrally inserted dialysis catheter (ST-CIDC) placement is commonly performed in patients with renal disease and is traditionally performed with fluoroscopy in the interventional radiology suite or the operating theater. However, today's interventional radiologists and surgeons perform advanced invasive procedures that can be time-consuming resulting in delays in the scheduling of elective tunneled catheter placements.

Secondary Myiasis in an Immunocompetent Patient With Severe Chromoblastomycosis.

This is the case of chronic chromoblastomycosis (CBM) in a 61-year-old male from the Dominican Republic (DR) with extensive cutaneous eruptions over multiple areas of the body including bilateral lower extremities and the flank extending to the back. A 61-year-old male with a history of morbid obesity, chronic kidney disease stage III, and well-controlled hypertension presented to the family medicine clinic for the evaluation of chronic painful skin lesions on his legs and torso. The lesions began 19 years prior, following a flood in the Dominican Republic (DR) where he was living at the time.

ReNeu: A Pivotal, Phase IIb Trial of Mirdametinib in Adults and Children With Symptomatic Neurofibromatosis Type 1-Associated Plexiform Neurofibroma.

Purpose: Pharmacologic therapies for neurofibromatosis type 1-associated plexiform neurofibromas (NF1-PNs) are limited; currently, none are US Food and Drug Administration-approved for adults.

Methods: ReNeu is an open-label, multicenter, pivotal, phase IIb trial of mirdametinib in 58 adults (≥18 years of age) and 56 children (2 to 17 years of age) with NF1-PN causing significant morbidities. Patients received mirdametinib capsules or tablets for oral suspension (2 mg/m twice daily, maximum 4 mg twice daily), regardless of food intake, in 3 weeks on/1 week off 28-day cycles.

Fourth of July Hazards: A Case Report on a Blast Injury to the Right Hand in a 21-Year-Old Male.

Firework injuries pose a significant concern during celebrations, often resulting in severe trauma that can adversely affect an individual's functional capacity and quality of life. The case highlights a young male who sustained an unwarranted incident after a malfunctioning pyrotechnic device detonated while held in his dominant hand. The patient underwent amputation of several digits while also salvaging the fifth digit and thumb, for which an open reduction and internal fixation were performed.

AI-based Cleft Lip and Palate Surgical Information is Preferred by Both Plastic Surgeons and Patients in a Blind Comparison.

IntroductionThe application of artificial intelligence (AI) in healthcare has expanded in recent years, and these tools such as ChatGPT to generate patient-facing information have garnered particular interest. Online cleft lip and palate (CL/P) surgical information supplied by academic/professional (A/P) sources was therefore evaluated against ChatGPT regarding accuracy, comprehensiveness, and clarity.Methods11 plastic and reconstructive surgeons and 29 non-medical individuals blindly compared responses written by ChatGPT or A/P sources to 30 frequently asked CL/P surgery questions.

Carbohydrate Antigen (CA 19-9) Surge: Unraveling the Enigma of Elevated Levels in the Setting of Benign Etiologies.

Carbohydrate antigen 19-9 (CA 19-9) is widely recognized as a tumor marker primarily associated with pancreatic cancer. However, its elevation in benign pancreaticobiliary conditions complicates its diagnostic utility. We present the case of a 39-year-old male with no significant medical history who presented with symptoms of abdominal pain, nausea, vomiting, and diarrhea.

An Interesting Case of Asymptomatic Cholera in the Setting of Large Bowel Obstruction.

Vibrio cholerae is the culprit behind many endemics globally. Classically characterized by profuse diarrhea with a "rice water" description, cholera can be fatal if not treated promptly. However, infected individuals can present with little to no symptoms.

A Case Report and Literature Review of Gastric Stump Carcinoma: An Uncommon Entity Following the Billroth II Procedure.

Gastric stump carcinoma is a rare phenomenon and could occur in individuals after a distal gastric resection. Regardless of the surgical approach, it can lead to certain complications. However, the Billroth II gastrojejunostomy procedure has been noted to have some specifically interesting complications due to the anatomical changes it triggers.

An Interesting Presentation of Pneumomediastinum Secondary to Hyperemesis Gravidarum in the Second Trimester.

We present a rare case of pneumomediastinum in the setting of hyperemesis gravidarum. Pneumomediastinum is a condition characterized by the presence of air leaking into the mediastinum. Often secondary to trauma, there remains the potential for it to develop spontaneously.

Incidence of Pneumoperitoneum After Gastrostomy Tube Removal.

We present the case of an 88-year-old man with a previous medical history of severe colitis and colonic strictures who presented with hematemesis. The patient was found to have a lower esophageal ulcer without any signs of perforation. Esophagogastroduodenoscopy (EGD) revealed a scar in the greater curvature of the stomach from a previously removed gastrostomy tube two months prior.

Rare Direct Locoregional Brain Metastasis and Recurrence in Laryngeal Squamous Cell Carcinoma.

Laryngeal cancer is predominantly a squamous cell in origin that can present with voice changes and difficulty or pain with swallowing. It is more likely to cause local spread than distant ones. The prognosis depends on multiple factors, including the stage, tumor differentiation, extranodal extension, and adjuvant therapy.