JAMA Clinical Challenge  October 30, 2023 Coin-Shaped Opacities in the Stomach Neil Shadbeh Evans, Paul Aronowitz, Timothy E. Albertson JAMA. 2023;330(20):2016-2017. doi:10.1001/jama.2023.19032 Case A50-year-old man with end-stage kidney disease receiving hemodialysis was admitted to the hospital for treatment of calciphylaxis and foot cellulitis. His home medications included sevelamer and hydrocodone-acetaminophen (10...

Basics of Volumetric Capnography ‑ Part 2: Single Beath CO2 Analysis Anatomical dead space, alveolar dead space, and CO2 elimination: Learn how they can give you an insight into the patient's lung condition. Single breath CO2 analysis: insight into the patient‘s lung condition The volumetric capnogram can also be divided into three areas: Area X ‑ CO2 elimination Area Y ‑ Alveolar dead space Area Z ‑ Anatomical dead space The size of the areas, ...

JAMA Clinical Challenge  October 6, 2023 Peripheral Blasts in a Patient Receiving Chemotherapy Sabin Kshattry, Terri L. Parker, Scott F. Huntington JAMA. 2023;330(16):1581-1582. doi:10.1001/jama.2023.17117 Case An 80-year-old man with stage II bladder carcinoma (T2NXM0) and atrial fibrillation treated with apixaban presented to the emergency department with 1 week of fatigue and 2 days of dyspnea on exertion. One week p...

JAMA Clinical Challenge  October 6, 2023 Peripheral Blasts in a Patient Receiving Chemotherapy Sabin Kshattry, Terri L. Parker, Scott F. Huntington JAMA. 2023;330(16):1581-1582. doi:10.1001/jama.2023.17117 Case An 80-year-old man with stage II bladder carcinoma (T2NXM0) and atrial fibrillation treated with apixaban presented to the emergency department with 1 week of fatigue and 2 days of dyspnea on exertion. One week prior to presentation, he recei...

Guide to Statistics and Methods  Surgical Education Research January 3, 2024 Practical Guide to Common Flaws With Surgical Education Research Dimitrios Stefanidis, Laura Torbeck, Amy H. Kaji JAMA Surg. Published online January 3, 2024. doi:10.1001/jamasurg.2023.6675 Introduction Over the past 2 decades, surgical education literature has seen tremendous growth driven by changes in graduate medical education,...

IMAGES IN CLINICAL MEDICINE Constrictive Pericarditis Meghan Nahass, John Kassotis N Engl J Med 2023; 389:2087DOI: 10.1056/NEJMicm2301671 A 69-year-old woman presented to the emergency department with a 3-year history of dyspnea on exertion. She had a history of focal pleural plaques that had been attributed to asbestos exposure that occurred during her work at an insulation-manufacturing company. Physical examination was notable for signs of volume overlo...

IMAGES IN CLINICAL MEDICINE Transverse Leukonychia (Mees’ Lines) Annabel M. Follows, George A. Follows N Engl J Med 2023; 389:e48DOI: 10.1056/NEJMicm2304533 A 30-year-old man presented to the hematology clinic with a 4-month history of white lines across his fingernails. Five months before presentation, he had received a diagnosis of primary mediastinal large B-cell lymphoma and began to receive systemic chemotherapy. The nail changes had first appeared mi...

IMAGES IN CLINICAL MEDICINE Venous Thoracic Outlet Syndrome Sang Jun Park, Hyun Jin Cho N Engl J Med 2023; 389:e32DOI: 10.1056/NEJMicm2301198 A 36-year-old woman was referred to the thoracic surgery clinic after she had presented with a 3-week history of swelling and bluish discoloration of the left arm and hand that occurred when she raised her arms (Panel A). The symptoms started after she had spent 10 days typing at a desk. Computed tomography of the ch...

Abdominal Pain and Hypotension in a 70-Year-Old Woman Educational ObjectiveBased on this clinical scenario and the accompanying image, understand how to arrive at a correct diagnosis. Case A 70-year-old woman with hypertension, atrial fibrillation, congestive heart failure, and gallstones presented to the emergency department with 3 days of nausea, vomiting, and abdominal pain. She reported no hematemesis, hematochezia, or melena and had no history of abdominal s...

Abdominal Pain and Hypotension in a 70-Year-Old Woman Educational ObjectiveBased on this clinical scenario and the accompanying image, understand how to arrive at a correct diagnosis. Case A 70-year-old woman with hypertension, atrial fibrillation, congestive heart failure, and gallstones presented to the emergency department with 3 days of nausea, vomiting, and abdominal pain. She reported no hematemesis, hematochezia, or melena and had no history of abdominal s...