Ventricular Tachycardia in a Pediatric Patient with High-Risk Thrombotic Thrombocytopenia Purpura.

An 8-year-old previously healthy male was diagnosed with thrombotic thrombocytopenic purpura (TTP) and increased serum cardiac troponin I. Telemetry recorded non-sustained ventricular tachycardia, without ST-segment changes or other abnormalities on serial electrocardiogram. This case illustrates that cardiac monitoring by telemetry should be considered in high-risk TTP with elevated cardiac troponin.

Asset-based Community "Response": A Model Promoting Effective Student- Community Engagement in Disaster Scenarios.

BACKGROUND: In response to the coronavirus disease 2019 (COVID-19) pandemic, medical students organized grass-roots volunteer initiatives to address community-level needs. These required community partnerships and extra-institutional resources to effectively operate. Due to curricular constraints, these efforts often lacked familiarity and working knowledge of existing university infrastructure on how to engage with established community partnerships and resources. OBJECTIVES: The authors call for institutions to capitalize upon the response experience gained by medical students during the pandemic. This includes 1) formally integrating the infrastructure and community relationships established by student COVID-19 volunteer initiatives into existing university community-engagement systems, and 2) incorporating asset-based community development (ABCD) into medical student curricula as a framework for community engagement and disaster response. METHODS: A case study from the University of Nebraska Medical Center presents student COVID-19 response initiatives, their outcomes, and how their approach emulated the ABCD model. The ABCD model asserts that communities should use asset mapping to identify the skills and resources of community members, rather than using deficiency-oriented approaches. Further, the case study demonstrates how the use of an established ABCD model could have contributed to a more effective and efficient COVID-19 student response. CONCLUSIONS: Experiences at University of Nebraska Medical Center support the value of using a modified ABCD model to facilitate community relationships related to rapid health response. Formal integration of the ABCD model within a university's centralized office of community engagement will increase access and foster town-gown reciprocal relationships, empowering students, academic health centers, and surrounding communities in times of crisis and calm.

Tubal pregnancy in a case of unicornuate uterus with contralateral streak ovary and renal agenesis: A case report.

A 24-year-old woman presented to the emergency department with symptoms consistent with an ectopic pregnancy. Ultrasonographic evaluation reported no evidence of intrauterine pregnancy, a heterogenous mass in the left adnexa, and normal-appearing bilateral ovaries. The right kidney was imaged, though the left kidney was not visualized. Beta-HCG was reported below the discriminatory zone. Two days later, her ultrasound remained unchanged, and beta-HCG had not risen appropriately. Diagnostic laparoscopy revealed a dilated right fallopian tube with products of conception exuding from the fimbriated end. Laparoscopically, the patient's pelvic anatomy was found to be abnormal. There was no left fallopian tube and the uterus appeared unicornuate with absent left horn. A left streak ovary was present superior to the pelvic brim in the pericolic gutter, though the right ovary appeared normal and in the appropriate position. At follow-up, hysterosalpingography showed a right-sided unicornuate uterus without septation, a small tubular endometrial cavity, and a patent right fallopian tube. Defects of unification of the Mullerian ducts, such as unicornuate uterus, do not reduce the ability to achieve pregnancy, but do increase the risk of adverse outcomes and fetal malpresentation.