Neurointerventional and Surgical Management of a Carotid Body Tumor: Case Report

Carotid body tumors are a rare type of head and neck tumor that can be safely resected with the help of pre-operative neuro-interventional embolization. This adjunct intervention helps reduce blood loss and to maintain a near bloodless surgical field that allows for good visualization of surrounding neurovascular elements. With the improvements of neuroimaging in the angiography suite and technologies surrounding neuro-interventional procedures, the complications of this procedure have decreased dramatically compared to what was reported in the 1980s-2000s.

Colon Cancer: What's New?

Colorectal cancer is the third most common cancer. Standard colonoscopy is the first-tier screening method. However, other non-invasive tests have shown high cancer detection rates. The age when screening is started is controversial: the U.S. Preventive Service Task Force (USPSTF) and the American College of Physicians (ACP) recommend the starting age of 50 while the American Cancer Society (ACS) recommends 45. In 2021, the American College of Gastroenterology (ACG) revised the guideline of the first screening age from 45–years old to 50-years-old. A recent study confirmed that the risk of colorectal cancer is lowered by a high fiber diet, low red meat intake, and consumption of yogurt. The detection of specific molecular and genetic characteristics of each patient’s cancer cells is the utmost important component of precision medicine. Many biomarkers of cancer cells are discussed along with their inhibitors. A recent study showed that three-month adjuvant chemotherapy is not inferior to six-month chemotherapy

An Unusual Presentation of Small Bowel Intussusception

Adult small bowel intussusception is a very rare entity that accounts for 5% of all cases of intussusception and 1%–5% of intestinal obstructions. It is more common in children but can occur in adults. It is an important etiology to consider when a patient presents with recurrent abdominal pain. The diagnosis can be challenging as symptoms are nonspecific and include abdominal pain, nausea and vomiting. This paper presents a rare case of duodenal intussusception, followed by a review of the literature discussing the diagnosis and treatment of adult intussusception.

Diagnosis of Testicular Cancer via Point-of-Care Ultrasound

Point-of-care ultrasound is an emerging diagnostic tool in Family Medicine practice. The case presented in this article exemplifies how point-of-care ultrasound can facilitate diagnosis onsite, expedite care and possibly improve prognosis.

Observational Study of the Effect of Moderate and High-Intensity Exercise on Insomnia

The purpose of this observational study is to determine whether moderate-intensity exercises improve the quality of sleep for subjects with insomnia. The duration of this observational study was four weeks. For the first two weeks of the observational study, subjects served as their own control and completed a sleep log. At the beginning of the third week, subjects were randomly split into (1) Group One with moderate-intensity exercise or (2) Group Two with high-intensity exercise. Two-tailed t-tests displayed significant improvements in quality of sleep with the implementation of both moderate and high-intensity exercise. However, Group One participants were found to feel significantly more well-rested than Group Two. The moderate-intensity exercise group showed improvement in quality of sleep, the number of awakenings, and restfulness. In comparison, the high-intensity exercise group demonstrated improvement in the number of awakenings and daytime sleepiness; although, without reported improvement in sleep quality. There were variables in participants’ sleeping environments, including changes in sleep location, travel, sleep-inducing medication, alcohol use, anxiety, unanticipated noise disturbances, and use of electronic devices before bed that was not controlled for in this observational study.

The Greatest Evil is Physical Pain

Physicians should continuously review their understanding of fundamental labels, definitions, and differentiation of medicine, especially when dealing with intricate pain management issues. The basic pathology of pain, the distinction of the different types of pain—nociceptive, neuropathic, acute, and chronic—and diagnosis methods are discussed. A summary of treatment methods for types of pain and important reminders regarding opioid use in pain management are also outlined.

Dysfunction of Sphincter of Oddi

Sphincter of Oddi Dysfunction (SOD) is a smooth muscle valve disorder regulating the flow of biliary and pancreatic secretions into the duodenum. SOD is categorized into three different types based on the Milwaukee classification system, with a prevalence of 1.5% in the general population. Type I patients have pain as well as abnormal liver enzymes and a dilated common bile duct. Type II SOD consists of pain and only one objective finding, and Type III consists of biliary pain only. The link between SOD and dyslipidemia is underappreciated. Increased biliary absorption of cholesterol in the form of biliary salts can increase the excretion and ultimately result in decreased serum cholesterol levels. It is important to consider SOD in patients with pain, elevated LFT’s and dyslipidemia despite statin therapy. In this article, a case of Type I SOD with recurrent pancreatitis is reviewed. This patient was initially diagnosed with acute pancreatitis secondary to hypertriglyceridemia. He had an additional episode of pancreatitis despite being on statin therapy with an improvement of triglycerides. SOD was then diagnosed with sphincterotomy after his second admission to the hospital. This resulted in the resolution of the patient’s symptoms and improvement of LFT’S. Manometry has long been considered the gold standard for diagnosis; however, it is not always available in low-resource settings. Therefore, endoscopic sphincterotomy is being considered for diagnosis as it can be diagnostic and therapeutic.

New-Onset Complete Heart Block Later Complicated by Decompensated Heart Failure Following COVID-19 Infection

Coronavirus disease 2019 (COVID-19) is caused by a strain of coronavirus known as severe acute respiratory syndrome coronavirus 2. Although respiratory illness remains the main concern regarding COVID-19 infection, multiple other organ systems have been reported to have also been affected, more prominently, the cardiovascular system.3 We present a 54-year-old male with a history of newly diagnosed diabetes mellitus type II and chronic kidney disease stage II who presented to the emergency department with progressive dyspnea, myalgias, fever, and malaise and was subsequently found to have complete heart block.

Severe Constipation in a Wheelchair-Bound, Elderly Woman

Constipation is a common household word. Effective remedies in most cases are also simple household remedies such as over-the-counter medicines, lifestyle modification, and a high fiber diet. In the hospital setting, constipation is multifactorial, with multiple etiologies explained in this case study. Complications can lead to abdominal pain and more serious complications like ischemic bowel, toxic megacolon, perforation, and even death. Causes of serious complications include diabetic gastroparesis, paralytic ileus, or surgical adhesions. These are explored in the paper and gives the reader a deeper realistic medical insight into the seriousness of the situation. Osteopathic techniques to treat constipation are discussed and demonstrated to the caregiver with great response.

An Innovative Vaccinator Training Program

Vaccinations offer the only real resolution to the pandemic. Masks and distance help keep the virus at bay, but they are not long-term solutions. Effective vaccines are now reaching millions in high-income countries, and, in time, they will reach underserved regions. The missing link in the vaccination chain will be trained people to administer them in local communities. Without trained workers, vaccination programs grind to a halt. Large organizations and governments can provide the vaccines, but where will low-resource countries find enough trained people to vaccinate the population? The objective of the program described here is to train people at the local level to move vaccines safely from central drop-off points to communities, to prepare the communities for vaccinations, to properly screen patients, to administer vaccinations, to monitor patients after the shot for adverse effects following injection (AEFI) and to educate the community on the need to get vaccinated and on vaccine safety. This program trains grassroots vaccinators to perform these tasks and offers refresher training to retired medical professionals called back into service to help with vaccinations. Each vaccinator will receive 20 hours of WiRED’s curriculum based on the World Health Organization’s (WHO) vaccination protocols. Further, students will receive an additional 20 hours of instruction on basic health, including human anatomy and physiology, principles of infectious disease control, and coronavirus infections. These frontline workers also will receive an additional five hours of clinical vaccination practice.