Faculty Bibliography

Medical education conferences have become a routine way to disseminate scholarly activity in the form of workshops, posters, or oral reports. Curricular developments, assessment tools, teaching innovations, and faculty development initiatives are just some examples of the submission types to medical education conferences. Just as it is important to uphold rigor and standards to the examination of medical education research publications, it is essential to have guidelines from which medical education conference abstracts are appraised, and there is a lack of written recommendations for this in the literature. We propose 12 tips to guide reviewers of such medical education conference abstracts with our structured approach.

PURPOSE/OBJECTIVE:To report the clinical and multimodal imaging (MMI) findings and long-term follow-up of stellate nonhereditary idiopathic foveomacular retinoschisis (SNIFR) contiguous with midperipheral retinoschisis (MPRS) and to describe a severe SNIFR variant termed CARPET (Central Anomalous Retinoschisis with mid-PEripheral Traction). DESIGN/METHODS:Retrospective case series. SUBJECTS/METHODS:Eleven patients (15 eyes) with SNIFR contiguous with MPRS in at least one eye at baseline or final follow-up. METHODS:MMI features, including cross-sectional and en face macular and peripheral spectral-domain optical coherence tomography (OCT) and OCT angiography, were reviewed in all cases at baseline and at the final follow-up visit. MAIN OUTCOME MEASURES/METHODS:Various courses (including progression, regression, or stability) of MPRS or SNIFR over time were evaluated. RESULTS:MPRS exhibited centripetal progression to SNIFR in 5 eyes of 3 patients with follow up of 67, 60, and 27 months, respectively, with maintenance of excellent visual acuity (range: 20/25-20/20) in 4 of these 5 eyes. In 2 eyes of 2 patients (including 1 eye with initial centripetal progression of MPRS to SNIFR), MPRS contiguous with SNIFR spontaneously resolved with long-term follow-up (77 and 48 months, respectively). SNIFR contiguous with MPRS partially regressed after 48 months in one patient, and was stable after 54 months in another. A distinctive midperipheral microvasculopathy, associated with MPRS that was contiguous with SNIFR, was identified in 7 eyes of 4 patients. Finally, 3 eyes of 3 patients exhibited additional unique features, including central neurosensory detachment and outer lamellar macular hole, which were associated with significant midperipheral traction, representing a severe variant subtype of SNIFR that we refer to as CARPET. Two of these 3 eyes progressed with short-term follow-up of 6 and 2 months, respectively, while the schisis resolved and vision improved after pars plana vitrectomy in the third case. CONCLUSIONS:MPRS can progress to SNIFR over multiple years of follow-up. SNIFR with MPRS can also spontaneously resolve or remain stable. MPRS can additionally be complicated by a midperipheral inner retinal microvasculopathy. Finally, CARPET may represent a unique and severe variant form of SNIFR driven by midperipheral vitreoretinal traction and associated with significant vision loss.

We present a case highlighting innominate vein reconstruction for resection of Hurthle cell carcinoma with complex vascular invasion. A 69-year-old man presented with a rapidly enlarging neck mass, dysphagia and dysphonia. Workup demonstrated a 11.2 × 7.0 × 6.5 cm Hurthle cell carcinoma invading the oropharynx and superior mediastinum. We proceeded with left thyroid lobectomy and modified left radical neck dissection. Median sternotomy, resection of the left clavicular head, and partial resection of the left manubrium were performed to circumferentially expose the innominate vein. Tumor thrombus was extruded from the innominate vein followed by patch angioplasty, which remains patent 14 months postoperatively.

Allergic Contact dermatitis (ACD) is effectively diagnosed and treated through the identification of causative allergens via patch testing (PT). Selection of allergens, along with the application and interpretation of PT results, necessitates specialized education and training. Our objective was to investigate the extent to which contact dermatitis (CD) education and PT training are components of the curriculum in Allergy and Immunology (A/I) training programs in the United States, and to assess where knowledge gaps may exist. A voluntary 16 item survey was sent to Program and Associate Program Directors (PDs) in A/I associated with the American Academy of Allergy, Asthma, and Immunology (AAAAI) in 2021. A total of 23 out of 84 (27%) A/I training programs responded. Of the responding programs, 22% did not have a faculty member who performs PT and 25% do not have fellows perform PT. However, programs that performed more patch tests tended to use custom and expanded series, used the patient's personal products, and provided patients with a personal avoidance plan (loadings > 0.65). With respect to scholarly activity, 30% of programs had published an article on CD in the last 3 years. In conclusion, the key findings of our survey include that programs that perform PT are more likely to provide expanded and customized panels, provide patients with an individualized avoidance plan, and present scholarly activity on the topic. Given the importance of CD in allergy practices, our results indicate that more instruction in this topic is needed in A&I fellowship programs.

Atopic dermatitis (AD) is a common, chronic inflammatory skin disease that affects both children and adults. Atopic dermatitis is characterized by pruritus, erythema, induration, and scale, which can present with other conditions that may mimic or complicate AD; often leading to diagnostic challenges. Differential diagnoses include seborrheic dermatitis, contact dermatitis, psoriasis, infections, inflammatory/autoimmune disorders, cutaneous T-cell lymphoma, and immunodeficiency-related dermatoses; to name a few. This review article focuses on AD and its associated cutaneous comorbid diseases. Familiarity with the spectrum of these diseases and their distinguishing features is crucial for diagnostic accuracy and to optimize patient management.

AIM/OBJECTIVE:This study aimed to explore the efficacy of MRI-based radiomics models, employing various machine learning techniques, in the preoperative prediction of the digital subtraction angiography (DSA) classification of venous malformations (VMs). MATERIALS AND METHODS/METHODS:In this retrospective study, 160 VM lesions from 153 children were categorized into a training set (n=128) and a testing set (n=32). Radiomic features were extracted from preoperative MRI scans. Feature selection was executed using the intraclass correlation coefficient test, z-scores, the K-best method, and the least absolute shrinkage and selection operator. Diverse MRI sequences and machine learning methods underpinned the development of the radiomics models. The models' efficacy was evaluated using receiver operating characteristic curves and the area under the curve (AUC). RESULTS:Out of 4528 radiomic features derived from CET1 and T2 images, 9 features were significantly associated with DSA classification differentiation. The most effective model for predicting VMs' DSA classification incorporated these 9 features and employed a random forest classifier. This model achieved an AUC of 0.917 in the training set and an excellent discrimination AUC of 0.891 in the testing set. CONCLUSION/CONCLUSIONS:The random forest model, utilizing CET1 and T2 sequences, exhibited outstanding predictive performance in the preoperative distinction of VMs' DSA classification.

Patients with myeloproliferative neoplasms (MPNs) are at increased risk for cardiovascular disease. Although thrombosis is a well-recognized complication, emerging evidence indicates that nonthrombotic conditions, including heart failure (HF) and pulmonary hypertension (PH), are also prevalent and associated with adverse cardiovascular and hematologic outcomes. Clinical and preclinical data suggest a shared pathophysiology linking MPNs to the development and progression of cardiomyopathy, HF, and both precapillary and postcapillary PH. Recent studies further support a bidirectional relationship, in which HF and PH are associated with hematologic progression and vice versa. Elucidating the mechanisms underlying these interactions may uncover novel therapeutic targets and inform clinical management. Here, the authors review the pathophysiology and impact of HF and PH in patients with MPNs.

OBJECTIVES/OBJECTIVE:Achalasia is an esophageal motility disorder that impairs quality of life and is often missed (20-50%) on endoscopy. A newly developed computer-aided detection (CAD) software has shown high accuracy for achalasia diagnosis in preclinical settings. However, its benefit in a clinical setting remains unclear. METHODS:Between February and August 2023, 83 endoscopists from 27 centers assessed 50 randomized endoscopic videos (25 achalasia, 25 nonachalasia) without and with CAD. Endoscopists assessed videos without CAD, then with CAD after 2 months. The primary end-point was improvement in sensitivity for nonexperienced endoscopists (no endoscopic experience of achalasia). Sensitivity, specificity, and accuracy with and without CAD were compared using the McNemar test. RESULTS:Sensitivity for diagnosing achalasia increased significantly with CAD, rising from 74.2% (95% confidence interval [CI] 72.2-76.0%) to 91.2% (95% CI 89.9-92.4%) for all readers, showing a difference of 17.1% (95% CI 15.1-19.0%). Specifically, sensitivity improved from 66.9% (95% CI 63.6-70.0%) to 91.9% (95% CI 89.9-93.6%) among nonexperienced endoscopists, resulting in a difference of 25.0% (95% CI 21.7-28.4%), and from 79.5% (95% CI 77.1-81.8%) to 90.8% (95% CI 89.0-92.3%) among experienced endoscopists (endoscopic experience of at least one achalasia case), with a difference of 11.3% (95% CI 8.9-13.6%). Accuracy and specificity improved significantly with CAD assistance, regardless of reader's experience. CONCLUSION/CONCLUSIONS:CAD improves achalasia detection by 17%, confirming preclinical results. The benefit was higher for nonexperienced endoscopists. CAD assistance may lead to prompt and effective treatment, minimizing the risk of false-negative diagnosis in clinical practice. TRIAL REGISTRATION/BACKGROUND:This study was registered in the University Hospital Medical Information Network Clinical Trial Registry (https://www.umin.ac.jp/ctr/) number: UMIN000053047.

PURPOSE/OBJECTIVE:Offering the benefits of rigid fixation while minimizing soft tissue dissection, intramedullary implants have become a popular choice among hand surgeons. Their placement often requires traversing or passing in proximity to joint surfaces. This study aimed to assess the damage to the articular cartilage of the base of the proximal phalanx resulting from antegrade placement of threaded headless intramedullary nails. METHODS:A cadaveric study comparing two techniques for antegrade placement of threaded headless intramedullary nails was conducted in 56 digits. The first entailed a single 2.1 mm intramedullary nail placed via the dorsal base of the proximal phalanx, whereas the second used two 1.8 mm intramedullary nails inserted via the collateral recesses of the phalangeal base. All specimens were analyzed for articular surface damage with the cartilage defect measured as a percentage of total joint surface area. Damage to the extensor tendons was also assessed in a subset of specimens. RESULTS:No significant difference in the percentage of articular surface damage was observed, with an average 3.21% ± 2.34% defect in the single 2.1 mm nail group and a 2.71% ± 3.42% mean defect in the two 1.8 mm nails group. There was no articular surface injury in 18% of digits in each group. Damage to extensor tendons was seen in three (9.4%) specimens and in all cases involved either the extensor indicis proprius or extensor digiti minimi. CONCLUSIONS:Hardware insertion using either the dorsal base of the proximal phalanx or the collateral recesses of the phalangeal base both demonstrated minimal articular cartilage damage and infrequent injury to the extensor tendons. CLINICAL RELEVANCE/CONCLUSIONS:With proper technique for antegrade insertion into the proximal phalanx, the cartilage defect observed often encompasses only a small percentage of the overall joint surface area.