Medical Image of the Week: Bronchopulmonary Sequestration

By: Chaddha U, Damaghi N, Prosper A, Cha C-F

Abstract: No abstract available. Article truncated at 150 words. A 49-year-old woman was incidentally found to have a lung mass on a pre-operative chest x-ray done prior to an elective cholecystectomy (Figure 1). Chest computed tomography, ordered to further characterize this mass revealed a left lower lobe lobulated, cystic opacity with a feeding artery from the aorta, consistent with bronchopulmonary sequestration (BPS) (Figure 2). Given that she has not had any complications of BPS we elected to manage her conservatively with observation. BPS is a rare congenital malformation of the lower airways characterized by abnormal lung tissue that does not communicate with the tracheobronchial tree and receives its blood supply from the systemic circulation (1). Our patient’s BPS was intralobar in location, occurring within a normal lobe but lacking its own visceral pleura. The posterior basal left lower lobe is the most common intralobar location. Among cases that escape clinical detection in infancy, BPS comes to light in childhood …



Gottlieb, the FDA and Dumbing Down Medicine

By: Robbins RA

Abstract: No abstract available. Article truncated at 150 words. In the last few weeks several events have occurred that might impact drug approval in the US. President Donald Trump's pick for FDA commissioner, Dr. Scott Gottlieb. Gottlieb, like many of Trump’s picks for administration healthcare positions, is a physician. He also has experience as deputy FDA commissioner from 2005-7.  However, his confirmation hearing before the Senate Committee on Health, Education, Labor and Pensions alarmed some who say his deep ties to the pharmaceutical industry will cause a conflict of interest (1). Others praised Gottlieb as the right man to lead the FDA. As opposed to Trump, Gottlieb denied any connection between vaccines and autism (1,2). Dr. Gottlieb called the issue "one of the most exhaustively studied questions in medical history," before saying, "There is no plausible link between vaccines and autism. At some point, we have to accept 'no' for an answer." However, Gottlieb did not give a straight …



Medical Image of the Week: Wolff-Parkinson-White Syndrome

By: Van Hook C, Demian C, Tangel D, Blair J, Patel L

Abstract: No abstract available. Article truncated at 150 words. A 38-year-old man developed sustained rapid heart rate while rock climbing. The patient reported that he had experienced rare bouts of self-limited palpitations in the past. Blood pressure on arrival to the emergency department was 112/ 65 mm Hg. The patient’s initial EKG demonstrated a regular, narrow complex supraventricular tachycardia, with a rate of 232 (Figure 1). Intravenous adenosine was administered with no change in his rate or rhythm. The patient then received amiodarone by intravenous bolus, with subsequent conversion to sinus rhythm (Figure 2). Wolff-Parkinson-White (WPW) syndrome is a congenital cardiac condition present in approximately 0.15% of the general population. WPW is characterized by the abnormal presence of conduction tissue that creates an accessory atrioventricular pathway and thus potentiates reentrant tachycardia (1). The classic resting EKG findings in WPW are: a shortened PR interval (less than 0.12 seconds), an indistinct initial upslope of the QRS complex (known as the …



The Impact of an Online Prematriculation Sleep Course (Sleep 101) on Sleep Knowledge and Behaviors in College Freshmen: A Pilot Study

By: Quan SF, Ziporyn PS

Abstract: College students have a high prevalence of poor sleep quality and sleep deficiency which negatively impacts their academic, mental and physical performance. A prematriculation course focused on improving sleep knowledge and behaviors may reduce sleep problems. “Sleep 101” is an online prematriculation course developed to educate incoming college freshmen about the importance of sleep in their lives and to recommend behaviors that will improve their sleep health. In a pilot program, “Sleep 101” was administered to freshman at four universities. The results of a voluntary survey after completion of the course indicated that there was an improvement in knowledge about sleep and the effects of caffeine use, and that students were less likely to drive drowsy and pull “all-nighters,” These pilot data suggest that an internet administered prematriculation course on the importance of sleep and the adoption of healthy sleep behaviors will be effective in reducing sleep problems among college students.



Medical Image of the Week: DISH with OPLL and C3 Fracture

By: Fletcher SR, Larson MC

Abstract: No abstract available. Article truncated after 150 words. A 54-year old man presented after a fall while intoxicated, during which a small frontal sinus fracture was sustained. Upon initial presentation, he was minimally responsive and eventually developed cardiopulmonary arrest. After intubation and return of circulation, he was immediately transferred from Mexico to an Arizona tertiary medical center, where his head and cervical spine CT showed severe diffuse idiopathic skeletal hyperostosis with ossification of the posterior longitudinal ligament (DISH with OPLL) and an unstable C3 fracture with posterior subluxation and severe canal narrowing (Figure 1). DISH, also known as Forestier disease, is a skeletal disorder, primarily affecting middle-aged and elderly patients, in which there is a buildup of calcified osseous tissue occurring in the ligaments of the spine. DISH is associated with ossifications occurring specifically in the posterior longitudinal ligaments of the spine, referred to as DISH with OPLL, which is twice as common in men compared to women …