Abstract: This article reviews the reasons to take a prebiopsy photograph and the consequences that can ensue when one is not taken. Electronic medical record systems compatible with mobile devices can record clinical photographs that comply with patient privacy regulations, making them the method of choice for dermatologic photo documentation. Correct photographic documentation technique also is critical and is reviewed with examples.
Abstract: Cervicofacial non-tuberculous mycobacterial infection should be a part of the differential diagnosis for immunocompetent children ages 1 to 5 years who present with painless submandibular or preauricular lymphadenopathy. Although a benign and self-limiting disease, patients can develop a chronically draining fistula if not diagnosed and treated promptly. The diagnostic process can be managed with a combination of microbiological studies, cytology, laboratory tests, and imaging studies. Surgical excision is the most definitive curative measure. Incision and curettage, medical management with antibiotic therapy, or observation are other treatment strategies that may be considered. Frontline clinicians play a pivotal role in identifying which children may have this condition and can facilitate prompt diagnosis and treatment of this uncommon disease.
Abstract: This article describes a framework for the development, implementation, and effect of advanced practice provider (APP) grand rounds. A team of certified registered nurse anesthetists (CRNAs), NPs, and physician associates/assistants (PAs) developed and operationalized a grand rounds initiative in 2019. Since January 2020, 34 live monthly learning sessions have been held in person and virtually. Surveys using Likert-scale questions were provided postattendance to attendees to assess educational growth and opportunities for improvement in future programming. Attendees also were offered an opportunity to give open-ended feedback. Recordings of each presentation were analyzed to identify content alignment with stated academic medical center system goals. Most attendees reported increased projected medical competence, performance, and perceived projected effect on patient outcomes after attending grand rounds. Grand rounds are a novel model for increasing PA, NP, certified nurse-midwife, and CRNA engagement; enhancing evidence-based medical knowledge; and advancing stated academic medical center system goals.
Abstract: Major depressive disorder (MDD) is a common psychiatric condition that causes considerable morbidity and disability. MDD is characterized by recurrent depressive episodes that can result in loss of productivity, job insecurity, social isolation, and suicidality. Primary care providers frequently provide the initial management of MDD; however, some patients do not respond to first- or second-line treatments, a condition called treatment-resistant depression (TRD). Understanding how to accurately diagnose and manage TRD is important for clinicians.
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