Large pulmonary arteriovenous malformation lost to follow-up with 10 years of asymptomatic interval growth: A case report.

Pulmonary arteriovenous malformations, previously considered a rare condition, have been increasingly identified in asymptomatic patients over the past 2 decades. Usually congenital and associated with hereditary hemorrhagic telangiectasia, these fistulae result in right-to-left shunting of blood by abnormal communication of pulmonary arteries and veins lacking capillary beds. Clinical findings of right-to-left shunting in the presence of feeding and draining vessels identified on imaging confirm the diagnosis, for which the first-line therapy is embolization. This report highlights the presentation and management of a large asymptomatic PAVM detected incidentally in a patient who was lost to follow-up for 10 years and represented with acute hypoxic respiratory failure secondary to a viral infection with an interval increase of PAVM size.

Bluegrass Biodesign: Why an Integrated Biomedical Engineering Curriculum is Crucial for Medical Education.

Background Medical education often overlooks the significance of design and innovation literacy, resulting in a knowledge gap in undergraduate medical education (UME) regarding formal training in these areas. Incorporating innovation into UME's core curriculum is crucial as future physicians will encounter evolving technologies, and fostering a transdisciplinary approach can enable collaborative problem-solving and improve patient health outcomes. Methodology We developed a comprehensive medical biodesign curriculum focused on innovation, including problem identification, prototype testing, and product commercialization. Participants were selected based on applications, interviews, and diverse criteria. A survey was conducted before and after the program to assess students' biodesign experiences and knowledge, with data analyzed using descriptive statistics and paired t-tests. Results Of the 41 participants, 24 (58.5%) completed both pre- and post-program surveys. These five-point Likert surveys showed a significant shift from pre-program to responses demonstrating increased "comfort levels in explaining and applying biodesign principles" (p < 0.0001). Specifically, the "comfort level in taking a product to market" increased from 33% to 67% (p = 0.01), while the "comfort level in applying the biodesign process" increased from 29% to 92% (p < 0.0001). Moreover, 58.3% of participants expressed interest in continuing their current projects, and 70.8% of students stated feeling confident in generating ideas and solutions with their team members. Conclusions The medical biodesign curriculum demonstrated success in exposing undergraduate medical and engineering students to the concepts of medical innovation and biodesign. The program has led to a significant improvement in students' knowledge and comfort levels in applying the biodesign process and taking a product to market. The high level of interest and participation in the program highlight the need for incorporating innovative training in UME to foster creativity and prepare future physicians to contribute to the advancements in healthcare.

Mommy's thumb: De Quervain's tenosynovitis in a new mother with cardiomyopathy.

Mommy's thumb is a lay term for de Quervain's tenosynovitis in mothers of newborn to young children. It is most commonly the result of carrying the child, leading to overuse of the wrist. Less commonly, it can also result from fluid retention resulting from lactational changes. We present a case report of a first-time mother presenting with bilateral de Quirvain's tenosynovitis which may be attributed to a previously undiagnosed cardiomyopathy leading to fluid retention.

Bilateral popliteal entrapment syndrome in a young athlete diagnosed with ultrasound.

Popliteal artery entrapment syndrome (PAES) occurs when the popliteal artery is compressed by abnormally developed or hypertrophied muscles adjacent to the popliteal fossa. When symptomatic, it most frequently presents with leg cramping while walking or running. We describe the case of an 18-year-old female runner presenting with claudication and exercise intolerance. After MRI was non-diagnostic, diagnostic ultrasound demonstrated that she had functional (Type VI) PAES. She subsequently underwent popliteal artery release surgery. Type VI PAES should be considered in young, healthy patients who present with claudication, particularly athletes.

Recurrent breast cancer diagnosis delayed by COVID-19 pandemic.

We describe the case of a 64-year-old female with a no relevant medical history. Screening mammography in March 2020 demonstrated calcifications in the right breast, and a diagnostic mammogram was recommended. In the months that followed, the patient experienced tissue changes in the right breast but avoided returning to the facility as the COVID-19 pandemic worsened. The patient returned for a diagnostic mammogram in September of 2020, which indicated suspicious lymph nodes and an increase in calcifications. Further analysis through ultrasound-guided core biopsy ultimately led to a right mastectomy and lymph node biopsy, which were performed in October 2020. Pathology results confirmed the diagnosis of invasive ductal carcinoma with lobular features.

Recurrent breast cancer diagnosis delayed by COVID-19 pandemic.

We describe the case of a 65-year-old female with a history of left-sided ductal carcinoma in situ in 2008. Mammography in January 2020 demonstrated calcifications in the previously affected breast. Subsequent stereotactic biopsy results were benign. In the months that followed, the patient experienced breast changes but avoided returning to the facility as the COVID-19 pandemic worsened. In August of 2020, the patient returned for a repeat mammogram, which indicated 2 suspicious masses in the left breast. Further analysis through ultrasound-guided core biopsy ultimately led to a left mastectomy and lymph node biopsy, which were performed in September 2020. Pathology results revealed multifocal invasive ductal carcinoma stage IIB.

"Rare place where I feel normal": Perceptions of a social support conference among parents of and people with Moebius syndrome.

BACKGROUND: Moebius syndrome is a rare congenital disorder resulting in impaired facial and eye movement. People with rare diseases like Moebius syndrome experience stigma and a lack of specialized information. Support conferences may provide important forms of social support for people with rare disorders. AIMS: To examine reasons for attending, benefits, and limitations of support conferences. METHODS AND PROCEDURES: 50 adults with Moebius syndrome and 57 parents of people with Moebius syndrome completed open-ended items in an online study. OUTCOMES AND RESULTS: Mixed- methods content analysis revealed that companionship and informational support were most frequently mentioned as reasons for and benefits of attending. Finances were the most frequently mentioned reason for not attending. Parents were more likely than people with Moebius to describe instrumental support as a conference benefit. When describing conference limitations, parents were significantly more concerned by lack of information relevance, while people with Moebius noted more often that conference attributes were not relevant to their age. CONCLUSIONS AND IMPLICATIONS: Being surrounded by others who share one's condition offers a unique opportunity for destigmatizing companionship support, which normalizes, reduces isolation, and promotes solidarity. Ways to increase facilitators and decrease barriers to accessing support for rare disorders should be investigated.

Physical Activity Participation of Disabled Children: A Systematic Review of Conceptual and Methodological Approaches in Health Research.

Physical activity (PA) participation is widely recognized as a critical component of health and development for disabled and non-disabled children. Emergent literature reflects a paradigm shift in the conceptualization of childhood PA as a multi-dimensional construct, encompassing aspects of physical performance, and self-perceived engagement. However, ambiguity remains around how participation as a health construct is integrated into PA research. The primary objective of the present mini-review is to critically examine current conceptual and methodological approaches to evaluating PA participation among disabled children. We conducted a systematic review of contemporary literature (published between 2000 and 2016). Seventeen articles met inclusion criteria, and their research approach was classified into guiding framework, definition of the key construct, and measurement used. The primary guiding framework was the international classification of functioning, disability and health. An explicit definition of PA participation was absent from all studies. Eight studies (47%) operationalized PA and participation as independent constructs. Measurements included traditional performance-based aspects of PA (frequency, duration, and intensity), and alternative participation measures (subjective perception of involvement, inclusion, or enjoyment). Approximately 64% of included articles were published in the past 2 years (2014-2016) indicating a rising interest in the topic of PA participation. Drawing from the broader discussion of participation in the literature, we offer a working definition of PA participation as it pertains to active, health-associated behaviors. Further description of alternative approaches to framing and measuring PA participation are offered to support effective assessment of health status among disabled children.