Mid-ventricular Takotsubo Cardiomyopathy With Coexisting Myocardial Bridge.

Typical takotsubo cardiomyopathy (TCM) is a reversible form of myocardial injury that presents with a characteristic ballooning abnormality of the left ventricular apex. Typical TCM has been associated with myocardial bridging; however, mid-ventricular variant TCM has not. We describe a rare case of mid-ventricular variant TCM with a coexisting left anterior descending artery myocardial bridge and discuss management strategies. Furthermore, we propose potential pathophysiological mechanisms that may contribute to the symptomatic presentation of both conditions as a manifestation of common etiological factors.

A Case of Disseminated Superficial Actinic Porokeratosis Successfully Treated With Topical Lovastatin/Cholesterol Gel.

Disseminated superficial actinic porokeratosis (DSAP) is a disorder of abnormal keratinization for which there is no standard treatment. Treatment modalities that have traditionally been utilized with varying success include ablative therapies, topical pharmacologic treatments, surgical excision, and retinoids. The underlying pathophysiology of DSAP is secondary to genetic mutations in the mevalonate biosynthesis pathway, and thus topical lovastatin/cholesterol presents a promising treatment modality for this condition. We present a case of familial DSAP successfully treated with topical lovastatin/cholesterol gel and provide a brief review of the existing literature surrounding this novel therapy.

A Prospective Open-Label Study for Treatment of Infraorbital Hollows Using a Volumizing Hyaluronic Acid Filler.

This study aimed to prospectively evaluate the effectiveness, patient satisfaction, and early adverse events of using the hyaluronic acid filler VYC-20L for the treatment of infraorbital hollowing. A total of 21 participants underwent injection of VYC-20L. FACE-Q satisfaction surveys before and after treatment along with early adverse events surveys were conducted. Pre- and posttreatment photos were graded, and the Allergan Infraorbital Hollows Scale was used to assess the difference in infraorbital hollowing. The results showed infraorbital hollowing improvement with VYC-20L was significant (p < 0.001). FACE-Q Satisfaction with Eyes scores on average were 27 points higher after treatment (p < 0.001). The mean FACE-Q Satisfaction with Decision score was 74.1%. The most common short-term adverse symptoms were tenderness (67%), swelling (62%), and bruising (52%). This study concludes that VYC-20L is an effective nonsurgical treatment option for infraorbital hollowing with high patient satisfaction.

A Comparative Study of Acute Alcoholic Hepatitis vs. Non-Alcoholic Hepatitis Patients from a Cohort with Chronic Alcohol Dependence.

The rate of alcoholic hepatitis (AH) has risen in recent years. AH can cause as much as 40-50% mortality in severe cases. Successful abstinence has been the only therapy associated with long-term survival in patients with AH. Thus, it is crucial to be able to identify at-risk individuals in order to implement preventative measures. From the patient database, adult patients (age 18 and above) with AH were identified using the ICD-10 classification from November 2017 to October 2019. Liver biopsies are not routinely performed at our institution. Therefore, patients were diagnosed with AH based on clinical parameters and were divided into "probable" and "possible" AH. Logistic regression analysis was performed to determine risk factors associated with AH. A sub-analysis was performed to determine variables associated with mortality in AH patients. Among the 192 patients with alcohol dependence, there were 100 patients with AH and 92 patients without AH. The mean age was 49.3 years in the AH cohort, compared to 54.5 years in the non-AH cohort. Binge drinking (OR 2.698; 95% CI 1.079, 6.745; p = 0.03), heavy drinking (OR 3.169; 95% CI 1.348, 7.452; p = 0.01), and the presence of cirrhosis (OR 3.392; 95% CI 1.306, 8.811; p = 0.01) were identified as characteristics more commonly found in the AH cohort. Further, a higher inpatient mortality was seen in those with a probable AH diagnosis (OR 6.79; 95% CI 1.38, 44.9; p = 0.03) and hypertension (OR 6.51; 95% CI 9.49, 35.7; p = 0.02). A higher incidence of mortality was also noted among the non-Caucasian race (OR 2.72; 95% CI 4.92; 22.3; p = 0.29). A higher mortality rate despite a lower incidence of alcohol use among non-Caucasian patients may indicate healthcare disparities.

Assessment of Research Interests of First-Year Osteopathic Medical Students.

CONTEXT: According to a 2014 survey, 59% of students entering allopathic medical school reported previous research experience. However, limited data exist on the amount of research experience that students have before entering osteopathic medical school. A strong understanding of the research skills and level of interest of first-year osteopathic medical students is essential for developing research programs at osteopathic medical schools. Limited data exist on the amount of research experience that students have before starting osteopathic medical school. A strong understanding of the research skills and level of interest of first-year medical students is essential for developing research programs at osteopathic medical schools. OBJECTIVE: To determine the amount of previous research experience of first-year osteopathic medical students, their level of interest in participating in research during medical school, the factors influencing their interest in research, and their research fields of interest. METHODS: First-year osteopathic medical students (class of 2019) at the Western University of Health Sciences, College of Osteopathic Medicine of the Pacific in Pomona, California (WesternU/COMP), and Pacific-Northwest in Lebanon, Oregon (WesternU/COMP-Northwest), campuses were surveyed about their previous research experiences and whether they were interested in participating in research during medical school. Surveys were administered through an anonymous online portal. Responses were evaluated for evidence of interest in conducting research. RESULTS: Of the 346 osteopathic medical students invited to participate in the study, the response rate was 77% (N=266). A total of 167 from WesternU/COMP and 99 from the WesternU/COMP-Northwest responded. More than 215 students (81%) reported they had participated in research before entering medical school. In addition, 200 students (75%) either expressed a strong interest in participating in research during medical school or were currently conducting research. Among research areas, clinical research was the overwhelming favorite, with 218 students (82%) expressing interest. CONCLUSION: First-year osteopathic students may have comparable amounts of research experience as allopathic medical students. Although these findings are limited to 2 campuses of 1 osteopathic medical school, they suggest that first-year osteopathic medical students are highly motivated to participate in research while in medical school.