A Young Man in a Rural Breast Clinic

This article reports a case from Rwanda of muscular cysticercosis presenting as a painful “breast” lump in a young male patient. Sonographic evaluation revealed a hypoechoic mass deep to the breast tissue likely within the pectoralis muscle, rather than the breast. Subsequent excisional biopsy resulted in the diagnosis of cysticercosis

The Patient-Centered Medical Home for Refugee Children in Rhode Island

Purpose. To describe a “medical home” for pediatric refugees and its ability to provide culturally competent care, to partner with and train medical interpreters, and to improve health screening and follow-up adherence rates of pediatric refugees immigrating to Rhode Island. Methods. A retrospective chart review of refugees was performed. Background information, initial laboratory data, whether patients completed the recommended follow-ups scheduled at 1, 3, 6, and 12 months, and completion of tuberculosis treatment were recorded. Results. Since its initiation, 104 refugee children have attended the clinic ranging in age from 5 months to 18 years. Since the initiation of the medical home for refugee children in 2007, initial screening rates have gone up to 99-100% compared to a low of 41% in 2003–2006 prior to the establishment of the medical home. There was a 43% reduction in missed appointments in 15-month follow-up. Conclusion. The refugee “medical home” allows refugees to benefit from a comprehensive system for disease detection and ongoing primary health care

Pituitary necrosis and vasospasm following removal of craniopharyngioma

We report a case of vasospasm complicating delayed pituitary necrosis after craniopharyngioma resection in an 18-year old female. This is the first reported case that utilizes aggressive blood pressure management, fluid optimization, and rheologic doses of mannitol to successfully treat severe symptomatic vasospasm