A 19 Year Old Male With HIV Presents With Diffuse Lymphadenopathy

Background In 1872, Moritz Kaposi first described an idiopathic multiple pigmented sarcoma of the skin;\u27\u27 now identified as Kaposi\u27s sarcoma (KS).\u27 While multiple forms ofKSexist, over9S% of the cases diagnosed in the US since 1981 are of the AIDS associated variety.2 Kaposi originally described KS as skin lesions that can progress to visceral involvement. However, in a small number of cases, KS can appear in the viscera without skin involvement. These alternate presentations of KS are difficult to diagnose; therefore, it is critical to recognize them when considering differential diagnoses, particularly in patients with HIV. Case Presentation An 18-year-old African American male with a history ofHIV presented with progressive worsening of diffuse and painful lymphadenopathy fore five weeks prior to admission. The patient was diagnosed with HIV in 2010 and due to insurance issues, was never treated with highly active antiretroviral therapy (HAART). His last CD4 count (approximately two weeks prior to admission) was 411 and he had no history of opportunistic infections. He first noticed swelling in his neck, under his armpits and in his groin five weeks prior, which had become progressively more painful. The patient denied fevers, chills or weight loss, but did report significant night sweats and episodes ofhemoptysis with dots. He denied shortness ofbreath or chest pain. He also denied recent travel, history of incarceration, homelessness or exposure to active tuberculosis infection

Implementation of a Residency Twitter Account to Provide Curricular Enrichment

Background The Problem With the goals of improving patient safety and resident well-being, the ACGME’s 2011 revision of duty-hour requirements included a 16-hour limit on continuous duty hours for postgraduate year 1 (PGY-1) trainees, increased supervision for junior trainees, as well as mandated rest periods between duty hours.1 These rules place limitations on the ability of trainees to attend scheduled educational activities during standard work hours; a recent study showed a decrease in resident availability for teaching conferences compared with the 2003 duty hour regulations.2 Residency training programs must develop alternative avenues for education and encouraging inquiry outside of traditional methods. A Modern Solution Social networking sites, such as Twitter, represent a promising opportunity for residency programs to foster collaborative learning and educational engagement both inside and outside of the hospital. After surveying our residents’ methods of obtaining medical knowledge, the chief medical residents at Thomas Jefferson University Hospital created a shared Twitter account entitled “@JeffIMChiefs” with the goals of disseminating clinical pearls from our daily conferences and inspiring continued learning by providing links to relevant research and review articles