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Introduction:The inverse relationship between benign prostate hypertrophy and incidence/severity of prostate cancer is well documented in the clinical literature. However, this phenomenon i...

The importance of clinical skills, including obtaining patient history and performing physical examination, has been de-emphasized in the modern medical school curriculum. With advancements in diagnostic technologies, the clinical presentation of diseases in medical textbooks has been simplified, diminished, and largely replaced with detailed pathophysiology and laboratory findings. The implementation of the United States Medical Licensing Exam (USMLE) Step 1 has also contributed in pushing medical education toward classroom-based learning rather than emphasizing clinical experience. Clinical skills competency is crucial to accurately diagnose patients and simultaneously lowers health care costs by not relying on unneeded diagnostic tests. To address this gap in medical knowledge, a group of students at Texas Tech University Health Sciences Center, Lubbock, Texas, have created a website documenting classic clinical disease descriptions written by some of the renowned physicians from the 19th and 20th centuries, including Osler, Flint, Gowers, etc. This website will continue to grow and will be a useful tool for professors, physicians, and medical students.

Three dimensional (3D) printed cardiac models are useful for WATCHMAN device procedural planning, sizing, and complication reduction. These models also provide accurate representation of dynamic heart anatomy, helping practitioners determine their procedural approach and select proper device sizing. While the efficacy of 3D models obtained from Computed Tomography and Transesophageal Echocardiography over 2D Transesophageal Echocardiography imaging for WATCHMAN procedural planning has been demonstrated, this project aims to directly compare 3D Computed Tomography versus 3D Transesophageal Echocardiography and determine which is more favorable. Computed Tomography and Transesophageal Echocardiography 2D imaging studies from patients that underwent LAA WATCHMAN closure device implantation we used as templates for 3D cardiac models. These 3D models were scored using a 10-point Likert questionnaire. Scoring was conducted by a diverse team that included cardiologists, research specialists, medical students, and 3D printing technicians. Three dimensional models developed using Computed Tomography demonstrated favorability over 3D models by all qualitative measures. Scoring indicates that Computed Tomography based 3D models are superior tools for WATCHMAN sizing, multi-level medical education, and physician preparedness. To our knowledge, this is the only study that compares 3D models crafted from each imaging modality, and we hope that it encourages future use of 3D modeling techniques based on Computed Tomography scans.

Pediatric opsoclonus-myoclonus and ataxia syndrome (OMAS) is a neurologic disorder characterized by disturbances in eye movement, muscle jerks, ataxia, sleep, and mood. In approximately 50% of cases, it is a paraneoplastic syndrome associated with a neuroblastoma. In the remaining cases, it is believed that the tumor is occult, has involuted, or there is a preceding immune-stimulating event. While neuroblastomas can be associated with other paraneoplastic syndromes, supraventricular tachycardia (SVT) is rarely reported in the literature, and to our knowledge, this is the first case of SVT secondary to idiopathic OMAS. Confounding treatment toxicity, including intravenous immunoglobulin and other immunomodulatory drugs, should be screened for possible cardiovascular side effects in OMAS patients. The development of cardiac arrhythmias during OMAS treatment is not a contraindication to therapy. In these patients, arrhythmias should be controlled with vagal maneuvers or antiarrhythmics as needed while OMAS treatment is completed.

Systemic lupus erythematosus (SLE) is an autoimmune disease with varying dermatological findings. We review a unique presentation of SLE with a literature review. A previously healthy early adolescent female presented with painful, oral mucosal bullae filled with sanguineous fluid. She endorsed a tender right knee, but examination revealed no additional abnormalities. CBC demonstrated severe pancytopaenia. Further workup, including Coombs positive RBCs and positive ANA, anti-Smith, and anti-dsDNA antibodies, confirmed Lupus as the aetiology of this patient’s presentation. A form of blistering SLE and resultant thrombocytopaenia was likely responsible for the patient’s oral manifestations. After receiving 60 g intravenous immunoglobulin and 3 days high-dose pulse corticosteroids, her dermatological symptoms resolved. Although cases of blistering SLE with mucosal bullae have been described in the literature, this is the first documented case of haemorrhagic mucosal bullae as the presenting symptom of thrombocytopaenia in SLE in a paediatric patient.

Purpose The negative correlation between BPH-size and incidence of prostate cancer (PCa) is well-documented in the literature, however the exact mechanism is not well-understood. The present study uses histo-anatomical imaging to study prostate volume in correlation to prostate capsule thickness, and glandular epithelial cell density within the peripheral zone (PZ). Materials and Methods Specimens were selected from radical prostatectomies ranging from 20 to 160 mL based on ease of anatomical reconstruction by the slides. A total of 60 patients were selected and underwent quantitative measurements of prostate capsule thickness and glandular epithelial density within the PZ using computer-based imaging software. Pearson's correlation and a stepwise multiple linear regression analysis was conducted to determine the relationship between these measured parameters and the clinical characteristic of these patients. Results Pearson's correlation analysis revealed a strongly significant, negative correlation between prostate volume and glandular epithelial cell density (r(58)=−0.554, p, Graphical Abstract

The coronavirus disease 2019 (COVID-19) is a pandemic disease, originated in Wuhan City, China. It is caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) and its biology is still poorly understood. Currently, there are no vaccines and drugs/or agents that can reduce severity of this new disease. Recent data suggest that patients with age-related comorbidities, including cardiovascular disease, diabetes, obesity, hypertension, chronic kidney disease, and dementia are highly susceptible to severe respiratory illness due to coronavirus infection. Recent research also revealed that aged individuals with elevated baseline inflammation cause defects in T and B cells, leading to decreased body’s immune response to viral infection. In the current article, we discuss the effects of SARS-CoV-2 on age-related chronic diseases, such as diabetes, obesity, and Alzheimer’s disease. Our article also highlights the interaction between coronavirus and immune cells, and how COVID-19 alters mitochondrial activities in host cells. Based on new and compelling evidence, we propose that mitochondrial fission is inhibited while fusion is promoted, causing mitochondrial elongation and providing a receptive intracellular environment for viral replication in infected cells. Further research is still needed to understand the cross talk between viral replication in mitochondria and disease progression in patients with COVID-19.