Natural language processing of online support group postings reveals patients' perspectives on strategies for managing psoriasis.

Psoriasis is a chronic skin disorder, and patients encounter high physical and psychosocial burdens. Social media forums feature extensive patient-generated comments. We hypothesized that analyzing patient-posted comments using natural language processing would provide insights into patient engagements, sentiments, concerns, and support, which are vital for the holistic management of psoriasis. We collected 32,000 active user comments posted on Reddit. We applied Latent Dirichlet Allocation to categorize posts into popular topics and employed spectral clustering to establish cohesive themes and word representation frequency within these topics. We sorted posts into 29 significant topics of discussion and categorized them into four categories: management (37.48%), emotion (21.57%), presentation (19.79%), and others (3.57%). The frequent posts on management were diet (7.23%), biologics (6.95%), and adverse effects (3.88%). The emotion category comprised negative sentiments (11.02%), encouragement (5.49%), and gratitude (5.06%). The presentation topic included a discussion of scalp (5.69%), flare-timing (3.63%), and arthritis (2.64%). Others comprised differential diagnosis (5.01%), leaky gut (4.12%), and referrals (3.70%). This study identified patients' experiences and perspectives associated with psoriasis, which should be considered to tailor support systems to improve their quality of life.

A Systematic Review and Meta-Analysis Comparing Burn Healing Outcomes Between Silver Sulfadiazine and Aloe vera.

Burn wounds remain a prevalent problem in the developed and developing world. A multitude of remedies has been tested. This study evaluated the healing time of second- and third-degree burn wounds between silver sulfadiazine (SSD) and Aloe vera (AV). In July 2020, a systematic review of MEDLINE (Ovid) and PubMed (National Library of Medicine) was performed to identify studies that reported healing of second- and third-degree burns using either SSD or AV. Articles meeting the inclusion criteria were screened and carefully analyzed. Our goal was to report the healing time for these burns using SSD and AV. A total of eight studies published between 1988 and 2018 reporting healing of second- and third-degree burns using SSD and AV were included in this review. Six were cohort studies and two were randomized controlled trials. The studies included both animal and human subjects. The meta-analysis demonstrated that the mean time to wound healing favored AV (RR: -1.34, 95% CI: -1.8 to 0.9, p < 0.001). It would seem that time to healing benefitted those burns in which AV was utilized. In conclusion, increased consideration and emphasis should be placed on using AV to aid the healing of second- and third-degree burns.

Pneumothorax in the Setting of Spinal Surgery: A Case Report and Review of the Literature.

The purpose of this paper is to review the occurrence and management of a tension pneumothorax, which was exacerbated status post posterior spinal surgery. A retrospective review of intraoperative reports, imaging, and pertinent medical records was conducted for a patient who underwent posterior spinal surgery with a tiny apical pneumothorax, which subsequently developed into a major pneumothorax. The clinical signs imperative to recognition and prompt treatment are discussed. Our case report demonstrates that the unrecognized disruption of the pleural cavity during posterior spinal surgery caused the exacerbation of the patient's bilateral pneumothoraces. The patient was successfully treated with finger thoracostomy and chest tube insertion. In conclusion, posterior spinal surgery is an invasive procedure with the potential for serious complications such as the exacerbation of a previous non-surgical pneumothorax. A low index of suspicion is imperative due to the potentially lethal nature of pneumothoraces. Vital signs, pulmonary exam findings, portable radiography, and sonography equipment are all invaluable to the accurate diagnosis and early intervention of patients with pneumothoraces.

Pathologic Fracture as Presentation of Generalized Lymphangiomatosis in an Eight-Year-Old: A Case Report and Literature Review.

Pathologic fractures commonly occur secondary to abnormal skeletal physiology in the context of benign or malignant lesions. Rarely, pathologic fractures may occur in the context of a lymphatic abnormality, such as generalized lymphangiomatosis. This rare disorder is characterized by variable presentations in a broad age range of patients. By understanding the effect of widespread lymphatic anomalies on various organ systems, clinicians will be able to make this diagnosis earlier and with more certainty.