Stump appendicitis.

Stump appendicitis is a rare and late complication following appendectomy and can often be overlooked. Our case details a 42-year-old male who presented to the Emergency Department with right-sided lower abdominal pain, nausea, and vomiting. A computed tomography scan of his abdomen and pelvis demonstrated a tubular, fluid-filled structure with surrounding inflammatory changes at the level of the patient\u27s appendectomy clips with a 2.3-cm calcified intraluminal stone. Findings were concerning for stump appendicitis with appendicolith. He was admitted and taken to the operating room for a laparoscopic stump appendectomy. Stump appendicitis should always be considered in the differential diagnosis to prevent potentially serious complications

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Gamified Simulation of Gastrointestinal Emergency in Preclinical Medical Student Education

Background: Incorporating gamification into medical training is an innovative way to deliver simulated experiences and maintain student focus. This study aimed to develop a simulated case of small bowel obstruction that utilized gamification to foster skills in teamwork, problem-solving, and patient management for second year medical students. Methods: Prior to simulation, students would be given a 5 question assessment related to small bowel obstruction. Additionally, learners will be evaluated for confidence with statements rated on a 5 point Likert scale. Following the simulation, student knowledge and confidence will again be evaluated. To develop a gamified simulation, an escape room was used, which began with 5 stations in which students solved puzzles to determine that their patient had a partial bowel obstruction. In Phase II, students accurately placed a foley catheter and nasogastric tube using trainers. Then students worked together to complete a simulation of total bowel obstruction and developed a treatment plan. Successful treatment allowed the students to exit the escape room for debrief. Conclusion: Although gamification research is still in its infancy, early studies have shown that its use has the potential to improve knowledge, skills, and satisfaction when compared to traditional education modalities