A decade-long analysis of gender, race, and ethnic representation of incoming cardiothoracic anesthesiology fellows.

PURPOSE OF REVIEW: This study calls attention to the necessity for increasing representation of minority groups among cardiothoracic fellowship programs. RECENT FINDINGS: Demographics in medicine are changing, with more women and varying ethnicities contributing to the physician pool. Despite this change, diversity among cardiothoracic anesthesia fellows has not mirrored this trend. SUMMARY: In November of 2022, medical student, anesthesia resident and cardiothoracic fellow demographics were analyzed from 2011 to 2021 to assess the changes in program diversity. Although male and female individuals have relatively similar representation in medical schools, female individuals only represent 34.8% of total US anesthesia residents. Cardiothoracic anesthesia fellowship programs continue to be male-sex dominant and white racial representation has consistently made up a majority of the total trainees. Increasing diversity amongst healthcare providers increases the likelihood of providing culturally competent care, thereby decreasing the healthcare gap in minority communities.

Vanishing Lung Syndrome: A Case Report and Systematic Review of the Literature.

Vanishing lung syndrome (VLS), also known as idiopathic giant bullous emphysema, is defined by the emergence of sizable bullae causing compression on healthy lung tissue. The elusive etiology of VLS mandates a diagnosis based on radiographic evidence showcasing giant bullae occupying at least one-third of the hemithorax in one or both lungs. This report presents a case of VLS in a 36-year-old female smoker devoid of any prior medical history. Additionally, we conducted a systematic review to discern the demographics, risk factors, and treatment modalities for individuals diagnosed with VLS.

An Aspirated Tooth Masquerading As Lung Cancer: A Unique Case Report.

Tooth aspiration, while commonly linked to predisposing conditions such as loose teeth, facial surgeries, or injuries, can also affect patients without apparent risk factors. Such small foreign body aspirations may go undiagnosed for many months as patients often tolerate the symptoms, such as chronic cough. However, the protracted course of unaddressed foreign body aspiration has the potential to resemble symptoms of malignancy, including persistent hemoptysis, weight loss, and fatigue. In this report, we detail the case of a 51-year-old man with underlying chronic obstructive pulmonary disease (COPD) whose history and symptoms initially suggested lung carcinoma. Further investigation uncovered an aspirated tooth as the culprit. The sequelae of pulmonary complications arising from endobronchial obstruction, such as post-obstructive pneumonia and atelectasis, as demonstrated in our case, further emphasize the importance of prompt detection and management of tooth aspiration.

Retraction: An Aspirated Tooth Masquerading As Lung Cancer: A Unique Case Report.

[This retracts the article DOI: 10.7759/cureus.55890.].

FLOTCH Syndrome: A Case of Leukonychia Totalis and Multiple Pilar Cysts.

FLOTCH (leukonychia totalis-trichilemmal cysts-ciliary dystrophy syndrome) syndrome is a rare genetic cutaneous disorder primarily characterized by multiple recurrent trichilemmal pilar cysts and leukonychia. It may be associated with ciliary dystrophy, koilonychia, and/or less frequently renal calculi and pancreatitis inherited in an autosomal-dominant fashion. We report the case of a 25-year-old Black woman who presented with white-colored fingernails and enlarging cysts in multiple locations including the scalp, rib cage, and forearm and was diagnosed with suspected FLOTCH syndrome. Pilar cysts in unusual locations along with distinct nail changes should prompt clinicians to consider further investigation for conditions such as FLOTCH syndrome.

The evolution of leadership: analyzing the presidents of American Dermatology Societies overtime.

Within organized dermatology, it is imperative that leaders embody a diverse group of individuals, reflective of the dermatologists they represent and the greater U.S. population. Despite women constituting more than half of the dermatologic workforce, they represent a leadership minority in dermatology society higher level positions. This gap is evident by fewer women holding presidency positions within prominent dermatological societies; however, a comprehensive comparison across multiple societies has yet to be made. Our study analyzes and compares demographic as well as academic metrics of presidents from 16 prominent dermatology societies spanning 22 years, 2000-2021. Data were collected using organization websites, which demonstrated 247 unique presidents over 22 years. Of these presidents, 175 (70.9%) were male and 72 (29.1%) were female. Surgically focused societies had 63 (87.5%) male presidents and nine (12.5%) female presidents, while clinically focused societies had 112 (64.0%) male presidents and 63 (36.0%) female presidents (P < 0.0002). The publication h-index, academic rank, chairmanship, and number of advanced degrees, and total number of years in practice prior to election did not significantly differ between male and female leaders. There was no statistically significant difference in the proportion of female presidents across all societies between 2000 and 2021 by Cochran Armitage Trend Test. However, between 2016 and 2021, 35% of presidents were female and a general trend toward more gender balance may be noticed. This equality goal should continue to be emphasized in organized medicine.

A Review of Pityriasis Rosea in Relation to SARS-CoV-2/COVID-19 Infection and Vaccination.

Pityriasis rosea (PR) is an acute exanthematous disease, commonly preceded by a primary solitary herald patch followed by the onset of smaller scaly papulosquamous lesions within days to weeks. The exact cause of PR remains unclear; however, rash eruptions are thought to be associated with systemic reactivation of human herpesvirus 6 and 7 (HHV-6/7). Several cutaneous manifestations, including PR, have been reported secondary to SARS-CoV-2 infection and/or COVID-19 vaccination. The purpose of this review is to synthesize available data regarding PR in close association with SARS-CoV-2/COVID-19 infection and/or vaccination. A total of 154 patients were included in this study with 62 females and 50 males. PR was reported to occur more commonly in association with SARS-CoV-2/COVID-19 vaccination (102, 66.2%) than during infection (22, 42.3%) or post-infection (30, 57.7%). Interestingly, only 7.1% of patients were tested for concomitant HHV-6/7 past or current infection, with 4.2% testing positive or reporting a history of roseola infantum. While rare, clinicians should be aware of the possibility of patients developing PR associated with SARS-CoV-2/COVID-19 infection and/or vaccination, among other cutaneous reactions. Future studies exploring the link between PR and SARS-CoV-2/COVID-19 infection and/or vaccination would be beneficial, including direct examination of tissue and serological studies for evidence of COVID-19-induced HHV-6/7 reactivation.

Vitiligo Following COVID-19 Vaccination and Primary Infection: A Case Report and Systematic Review.

Vitiligo is an acquired pigmentation disorder with different theorized etiologies, although the exact pathogenesis is still largely unknown. It presents as well-demarcated white plaques throughout the body that result from the loss of melanocytes within the epidermis. Commonly, this condition presents alongside other autoimmune conditions, and it is associated with both genetic and non-genetic factors. We present a patient with no history of autoimmune disease who developed vitiligo after receiving her vaccines against COVID-19. This first occurred within 24 hours of receiving her first vaccine and then worsened after receiving her second vaccine. The depigmented rash was localized to the face, arms, and chest. She was treated with both oral and topical steroids, as well as topical tacrolimus cream. Despite adherence to treatment, the patient only reported subjective improvement in her skin lesions overall. While vitiligo arises sporadically, the temporal relationship between vaccinations and depigmentation makes a stronger case for the vaccine as the inciting factor for this patient, though coincidence is possible. A systematic review of the literature regarding the onset of vitiligo following both infection with and vaccination against COVID-19, this case offers a unique presentation that had a sudden onset and creates a learning opportunity for clinicians to investigate the potential relationship between the receipt of the vaccine and the onset of this skin condition. The goal of this report is to help clinicians be cognizant of the possibility of developing or worsening skin diseases after infection or vaccination so that they can be addressed and treated appropriately.

Asymptomatic colo-ovarian fistula amidst acute psychosis: a case report.

This paper presents a rare case of an asymptomatic colo-ovarian fistula in a 45-year-old female with acute psychosis and a history of bipolar disorder, seizure disorder and substance misuse. The intricate diagnostic challenges arising from the patient's complex medical history underscore the significance of a multidisciplinary approach. The absence of typical gastrointestinal symptoms and the presence of a tubo-ovarian abscess complicated the diagnosis of acute on chronic sigmoid diverticulitis and colo-ovarian fistula. Surgical intervention, including sigmoid resection, anastomosis and left salpingo-oophorectomy, led to successful resolution. This case highlights the need for further understanding of colo-ovarian fistula pathophysiology, improved diagnostic strategies, and the nuanced interplay between medical and psychiatric conditions in complex clinical scenarios.