Curvularia Pneumonia Presenting as a Mass-Like Lesion.

Curvularia species of fungi are ubiquitous and mostly comprise plant or soil residents. Rarely pathogens, they are found in tropical and subtropical climates. On rare occasions, these fungi can be of clinical significance and lead to a variety of disease processes, mainly in immunocompromised individuals. Most infections are limited to allergic fungal rhinosinusitis; however, disseminated disease and invasive infections have been increasingly reported. There exist no therapeutic guidelines for invasive Curvularia infections currently, but amphotericin and various azoles have been used with varying degrees of success. We present a unique case of an immunocompetent 44-year-old female who presented with symptoms concerning for pneumonia and was found to have a mass-like lesion in the lung concerning for malignancy. Biopsy and histopathology of the lesion were consistent with invasive Curvularia pulmonary infection. We reviewed this case in the setting of reported literature concerning Curvularia with an emphasis on the epidemiology, pathology, diagnosis, and emerging management protocols of invasive Curvularia infections.

Very low-dose radiation therapy for management of inflammatory myofibroblastic tumor of the lung.

Inflammatory myofibroblastic tumor (IMT) is an uncommon chest pathology. Treatment primarily focuses on surgical resection for diagnostic and therapeutic purposes. However, there are instances in which alternative therapies with steroids, chemotherapy, or radiation are necessary. We discuss a case of recurrent IMT for which very low dose radiation proved an effective treatment.

Patients' perceptions of gastroenterologists' attire in the clinic and endoscopy suite.

Background: Studying the role of gastroenterologists' attire can provide insight into patients' perceptions and help us optimize the physician-patient relationship. In this study we assessed patients' preference concerning gastroenterologists' attire, and its influence on patients' trust, empathy and perceptions of the quality of care in the clinic and endoscopic suite. Methods: A cross-sectional survey was conducted from August 2016 to February 2017. A total of 240 consecutive patients who presented to the Gastroenterology Department at the University of Florida in Jacksonville both in the clinic and endoscopic suite were included in this study. The questionnaire applied included 8 questions concerning patients' preferences regarding gastroenterologists' attire and the impact the attire had on patients' trust, empathy and perceptions of quality of care. Results: Overall, 85% of patients preferred scrubs to formal dress clothes. The preference for scrubs was higher in the endoscopic suites (89% and 93%) compared to the outpatient office (66%, P<0.01). In addition, 82% of patients said they felt more comfortable speaking with gastroenterology doctors wearing scrubs and 85% of patients felt more confident about the skills of those gastroenterologists. Conclusions: Gastroenterologists' attire does influence patients' perception of the care they are receiving. There is an overall preference for the use of scrubs in the different settings of gastroenterology, both office and lab.

Postoperative home visits?

PURPOSE: Because most surgery patients now recover at home rather than in the hospital, we wanted to determine whether postoperative home visits by the operating surgeon would improve medical outcomes, and whether this innovation would strengthen resident training. METHODS: A surgeon who had performed 347 procedures during a 7-month period attempted to do a home visit to each patient within 48 hours after surgery. RESULTS: Many patients had to be disqualified for various reasons, leaving 143 candidates. Of these, 44 declined to be seen, and others could not be located, so that 82 were actually visited. There were no readmissions, and no findings that might have altered the course of postoperative treatment. CONCLUSIONS: These visits seemed to reinforce patient-physician relationships, but they did not influence medical outcomes. It was felt that a phone call would probably have done as well. In addition, because of new regulations governing resident working hours, it did not appear that this was a feasible educational experience.