Spontaneous aortic thrombosis in neonates: a case report and review of literature.

Neonatal aortic thrombosis is a rare occurrence but can be life-threatening. Most aortic thrombosis in neonates is related to umbilical artery catheters. A case of a neonate with a spontaneous aortic thrombosis is described here along with a comprehensive review of the literature for cases of neonatal aortic thrombosis not related to any intravascular device or procedure. The aetiologies of these spontaneous thromboses and the relevance of hypercoagulable disorders are discussed. The cases were analysed for odds of death by treatment method adjusted for era. The reference treatment method was thrombolysis and anticoagulation. No other treatment modality had significantly lower odds than the reference. Surgery alone had higher odds for death than the reference, but this may be confounded by severity of case. The management recommendations for clinicians encountering neonates with spontaneous neonatal aortic thrombosis are discussed.

Formation and Evaluation of an Academic Elective for Residents in a Combined Internal Medicine-Pediatrics Residency Program.

Background Recently, there has been increasing focus on skills that are crucial for success in residency that is not explicitly taught. Specifically, the four domains of teaching skills, evidence appraisal, wellness, and education on structural racism have been identified as topics that are important and underrepresented in current resident education curriculums, largely due to time constraints. Methods A task force consisting of one post-graduate year 2 (PGY-2) resident, one PGY-4 resident, the Associate Program Director, and the Program Director of the Internal Medicine-Pediatrics residency program was formed to explore current deficiencies in resident curriculum and to research possible solutions. As an intervention, we created and executed a four-week academic elective with dedicated time for upper-level residents to learn and explore the four domains of resident teaching, evidence-based clinical practice, wellness, and anti-racism work. The elective included several clinical sessions dedicated to implementing the skills taught in the elective. The month-long elective completed in January 2021. All residents evaluated each lecture or experience based on how valuable it was to their education on a Likert scale from 1 to 7, with 1 defined as "not valuable at all" and 7 defined as "extremely valuable." Results Residents rated the overall value of teaching in each domain highly. Education and activities in wellness lectures were found to have the highest value-added material (6.20 ± 0.41, n = 18), followed by residents-as-teachers lectures (5.93 ± 0.25, n = 48), anti-racism (5.57 ± 1.11, n = 9), and evidence-based clinical practice (5.18 ± 0.50, n = 43). In addition, each domain was found to have at least one high-yield topic. Conclusions We were able to create and execute an academic elective with dedicated time for upper-level residents to develop and utilize valuable skills in teaching, evidence appraisal, wellness, and anti-racism. Future work will focus on refining the curriculum based on resident evaluations and expanding this elective to the Internal Medicine and Pediatrics categorical programs at our institution.