Linear lichen planus pigmentosus of the face with histological findings of lichen planopilaris - an uncommon variant of lichen planus.

Lichen planus pigmentosus and lichen planopilaris are two clinically and histologically distinct forms of lichen planus. Lichen planus pigmentosus presents with sudden onset hyperpigmented macules and patches, predominantly in darker skin phototypes. On the other hand, lichen planopilaris is a scarring follicular variant of lichen planus that presents with progressive, permanent patches of alopecia. It is not uncommon for different variants of lichen planus to clinically coexist with each other. However, to our knowledge, there has been no previous reporting of linear lichen planus pigmentosus of the face with histological features of lichen planopilaris. We herein present a hybrid case of these two entities.

An Inexpensive, Portable Shield to Improve Healthcare Worker Safety During Intubation Procedures.

Healthcare workers (HCW) are exposed to risk of infection during intubation procedures, in particular, in the prehospital setting. Here, we demonstrate a novel shield that can be used during intubation to block aerosols and droplets from reaching the HCW. The device is mounted on the patient's head and provides a barrier between patient and HCW. It incorporates a self-sealing port through which an endotracheal tube can be inserted. The port "floats" in the plane of the shield to facilitate maneuvering of the endotracheal tube. The shield is fabricated from transparent materials to enable the HCW to visualize the procedure. Using two complementary imaging methods, background oriented Schlieren imaging and laser sheet droplet imaging, we show that the device prevents detectable transmission of gas flow and droplets through the shield both before and after endotracheal tube insertion.Clinical Relevance- This device has the potential to protect HCWs from infections during intubation procedures, especially in the prehospital setting.

Can a Multidisciplinary Endocrine Clinic be Beneficial for Patients and Surgeons?

BACKGROUND: Multidisciplinary clinics are expected to improve patient care by enhancing efficiency for both patients and care providers. We hypothesized that while these clinics are an efficient use of time for patients, they can limit a surgeon's productivity. METHODS: A retrospective review was performed for patients evaluated in a Multidisciplinary Endocrine Tumor Clinic (MDETC) and Multidisciplinary Thyroid Cancer Clinic (MDTCC) from 2018 to 2021. Time from evaluation to surgery and prevalence of surgery were evaluated. Patients were compared to those evaluated in a surgeon-only endocrine surgery clinic (ESC) from 2017 to 2021. Chi-square and t-tests were used to test significance. RESULTS: Patients referred to the ESC underwent surgery more often than those referred to either multidisciplinary clinic (ESC 79.5%, MDETC 24.6%, MDTCC 7%; P < .001) but had a significantly longer delay between appointment and operation (ESC 19.9 days, MDETC 3.3 days, MDTCC 16.4 days; P < .001). Patients had a longer wait from referral to appointment for the MDCs (ESC 22.6 days, MDETC: 44.5, MDTCC 33; P < .05). There was no significant difference in miles traveled by patients to any clinic. CONCLUSION: Multidisciplinary clinics can provide fewer appointments and faster time to surgery for patients but may lead to longer wait time from referral to appointment and fewer overall surgeries than endocrine surgeon-only clinics.

The University of Alabama at Birmingham Surgery Community Network: Tackling the Challenges of Rural Surgery.

Over the past 5 years, The University of Alabama at Birmingham (UAB) Department of Surgery has taken a keen interest in the practice of surgery in rural Alabama and has established the UAB surgery community network. Our goal is to improve the delivery of surgical care in rural areas through active recruitment of rural surgeons, the development of research around rural surgery practice, and the expansion of a surgery network throughout the state. Here, we will present the challenges faced by rural surgery, our early work to address these challenges, and offer a plan for moving forward.

Interaction between the BDNF rs11030101 genotype and job stress on cognitive empathy.

BACKGROUND: Empathy refers to an individual's ability to experience the emotional and cognitive processes of another person during social interactions. Although many studies have examined the effects of genetic variation on emotional empathy, little is currently known about whether genetic factors may influence cognitive empathy. This study investigated the relationship between BDNF rs11030101 genotype, job stress, and empathy, especially cognitive empathy, in a Chinese Han population. METHODS: A cross-sectional design was used and 340 participants were recruited from a university in Beijing. Interpersonal Reactivity Index (IRI) was used to measure empathy. Job stress was measured using House and Rizzo's Job Stress Scale. The BDNF rs11030101 was genotyped in all participants. RESULTS: Gender and age were associated with various IRI subscales (p < 0.001). After controlling for gender, age and education level, BDNF rs11030101 genotype had no main effect on all empathy subscales (p > 0.05). Job stress was negatively associated with Perspective Taking (p = 0.006) and positively associated with Personal Distress (p < 0.001). In addition, the BDNF rs11030101 genotype modulated the relationship between job stress and Fantasy (p = 0.013), indicating that T allele carriers had higher Fantasy scores at higher job stress and lower Fantasy scores at lower job stress than AA homozygotes. This interaction was only present in women. LIMITATIONS: The sample size and single-nucleotide polymorphism are limited, and the cross-sectional design should be improved. CONCLUSIONS: Female university faculty with the BDNF rs11030101 T allele may utilize higher emotional job demands, thereby fostering their cognitive empathy.