Background
Inlay total shoulder arthroplasty (iTSA) serves as a stemless shoulder reconstruction option. While current literature has demonstrated improved patient reported outcomes (PROs) with minimal postoperative revisions and high rates of return to activity, supporting long-term evidence is limited. The purpose of this study was to evaluate the trends in PROs following iTSA over an eleven-year period.

Methods
A historical cohort of our institutional database was used to investigate outcome trends. Inclusion criteria consisted of patients with advanced osteoarthritis treated with iTSA. Patients had preoperative PROs and a minimum of one follow-up assessment between 1-11 years. Outcomes assessments included WOOS%, ASES, activities of daily living (ADLs), VAS pain, patient satisfaction, and range of motion (ROM). Descriptive analyses were conducted using Stata (v.15, College Station, TX). Join-point regression analysis (version 5.0.2, National Cancer Institute) was used to explore trends in functional outcomes, pain relief, and ADLs to determine whether a change in temporal trend was statistically significant. WOOS%, ASES, ADLs, and VAS pain were entered into the model and were assessed at five timepoints: preoperative, 1 year, 2-3 years, 4-7 years, and 8-11 years.

Results
Since 2011, 583 shoulders were treated with iTSA at our institution and 97 met the inclusion criteria, with 10 patients being bilateral. The mean age was 63.7 years ± 10.5 (31 females, 66 males). The average length of follow-up was 60.5 months ± 37.8. Along the postoperative period of up to 2-3 years, there was significant improvement in WOOS% (84.97 AYPPC), ASES (78.22 AYPPC), and VAS pain (-74.50 AYPPC), after which gains were sustained. ADLs improved over time, but there was no significant change in the trend. The median PROs improved at all five timepoints: WOOS% [26(16-40), 85(56-95), 93(77-97), 89(75-97), 92(77-97)], ASES [27(17-40), 83(67-93), 88(68-95), 87(70-97), 90(78-98)], VAS pain [8(6-9), 1(0-3), 1(0-2), 0(0-3), 0(0-0)] and ADLs [4(2-6), 8(6-10), 9(6-10), 8(6-8), 9(6-10)]. Mean ROM improved by 46.49 degrees ± 37.28 on forward elevation and 26.95 degrees ± 18.90 on external rotation.  Mean patient satisfaction on a scale of 1-10 (10=best) for each follow-up timepoint was 8.6 ± 2.4, 9.2 ± 1.6, 8.7 ± 1.8, and 9.6 ± 0.7 respectively (p <0.001). 

Conclusion
iTSA demonstrated significant improvement in pain relief and functional outcomes within 2-3 years, after which gains were sustained over an eleven-year period. ROM improved and patient satisfaction remained high over time. These findings support the use of stemless shoulder reconstruction as a reliable solution for advanced shoulder osteoarthritis. 

Clinical Improvements After Inlay Total Shoulder Arthroplasty are Sustained: A Long-term Follow-up Trending Analysis

Abstract Title
Double Trouble in the Gut: Unraveling the Tangled Tale of Eosinophilic Esophagitis and 
Inflammatory Bowel Disease
Background
Eosinophilic esophagitis (EoE) and inflammatory bowel disease (IBD) are both immunologically 
mediated gastrointestinal disorders. While previous studies have suggested a possible association 
between these conditions, results have been inconsistent.
Methods
We conducted a retrospective cohort study using the TriNetX database, examining IBD patients
from 2013 to 2022. We stratified the data by type of IBD, age, sex, and race to assess the incidence 
and risk factors of EoE in patients with IBD. Additionally, we evaluated the 5-year clinical 
outcomes of patients with concurrent EoE and IBD compared to those with either condition alone.
Propensity score matching was performed for age, sex, race, BMI, smoking, PSC, steroid use, 
other autoimmune diseases, IBD medications, and surgery history. Risk was quantified using 
adjusted odds ratios (aOR) with 95% confidence intervals (CI).
Results
Among 234,582 patients with IBD (mean age 45.4, female sex 52.5%, White race 74.8%, CD 
52.8%), the risk of EoE was higher in the IBD cohort (aOR: 2.88, CI: 2.59-3.19) compared to the 
non-IBD cohort. Following subgroup analysis in the UC cohort, younger age (<40) and male sex 
were associated with a higher risk of EoE, while in the CD cohort, younger age, male sex, obesity, 
and history of CD-related surgery were significant risk factors. For the clinical outcomes study, 
853 patients with UC and EoE and 1,162 with CD and EoE were matched with control cohorts. 
The UC-EoE cohort showed an increased risk of IV steroid use (aOR: 1.46, CI: 1.19-1.79) but no 
difference in oral steroid use, advanced therapy initiation, or colectomy. The CD-EoE cohort 
demonstrated higher risks of IV steroid use, advanced therapy use, and PSC, with no significant 
difference in colectomy rates. In another analysis of 887 patients with EoE and IBD, the EoE-IBD 
cohort exhibited a lower risk of a composite outcome of esophageal dilation and/or Dupilumab use 
(aOR: 0.39, CI: 0.29-0.52), with no difference in esophageal dilations alone or food impactions.
Conclusion
Our study reveals a roughly threefold increased risk of EoE in patients with IBD. Additionally, 
patients with coexisting EoE and IBD experience worse clinical outcomes, particularly those with 
CD, highlighting the need for close outpatient monitoring and follow-up. Interestingly, patients 
with EoE and IBD may benefit from immune-modifying therapies used for IBD, resulting in more 
favorable outcomes compared to those with EoE alone.

Double Trouble in the Gut: Unraveling the Tangled Tale of Eosinophilic 
Esophagitis and Inflammatory Bowel Disease

Background
Though rare, power outages in the operating room happen, perhaps at increased frequency due to more extreme weather related to climate change. These situations are dangerous and anesthesiologists must be prepared to manage them. However, evidence suggests that anesthesiologists are insufficiently prepared to manage a power outage and 85% desire more training. This problem could be solved during residency, yet many programs overlook power outage training. Thus, the objective of this study was to fill this training gap by designing a power outage simulation for anesthesiology residents and then assess whether the simulation improved confidence in power outage management.

Methods
Our team designed a high-fidelity power outage simulation for PGY-3 and PGY-4 anesthesiology residents. The simulation case involved an intraoperative power loss during an inguinal hernia repair of a patient under general anesthesia. This scenario took place within a simulated operating room at an academic simulation center and included a mannequin as the patient under general anesthesia, a surgeon actor, and a simulation specialist. After the simulation, a debriefing focused on power outage management specifics was led by an anesthesiology faculty member. Once debriefing concluded, the residents completed five-point Likert scale surveys to assess before and after confidence in several aspects of intraoperative power loss management including operating room management, monitoring vital signs, and patient disposition planning. Data were analyzed using a two-tailed paired t-test.

Results
Twenty-two anesthesiology residents completed the simulation over two years. Residents' mean confidence in managing a patient in the operating room during a power outage improved by 1.23 points (p=0.001), confidence in monitoring vital signs during a power outage improved by 1.37 points (p=0.001), and confidence in planning appropriate patient disposition during a power outage improved by 0.88 points (p=0.001). After the simulation, 100% of residents strongly agreed or agreed that they could confidently manage a patient in the operating room during a power outage, compared to just 45.5% before the simulation.

Conclusion
It is essential to address anesthesiologists’ desire for further power outage training and this simulation seems to fill the power outage training gap. After participating, residents felt confident in their power outage management skills. Other residency programs may consider implementing this simulation. A limitation of the study is that it relied solely on self-reported measures to ascertain simulation effectiveness; thus, future research could involve conducting objective performance assessments such as standardized tests or direct observation of clinical practice.

Power Outage: A Simulation Case for Anesthesiology Residents

Open-book pelvic fractures are an uncommon orthopedic emergency that requires prompt recognition and treatment. A 37-year-old male was involved in high-energy trauma, resulting in an open-book pelvic fracture with bilateral sacroiliac joint diastasis, bilateral superior and inferior pubic rami fractures, a comminuted sacral fracture, and a traumatic hernia. On presentation, he was hemodynamically unstable, with bruising in the right hemipelvis. Acute treatment included a cervical collar, transfusion protocol, central venous access, and pelvic binder. Trauma and orthopedic services were consulted to manage the patient with an interdisciplinary approach. The patient initially underwent external fixation with concomitant exploratory laparotomy. Definitive treatment concluded with colorectal anastomosis, diverting loop ileostomy creation, abdominal closure, open-reduction internal fixation (ORIF) of the pelvis, and removal and reapplication of external fixation.

Multidisciplinary Approach to Managing Open-Book Pelvic Fractures in Trauma Care

Background
Stroke ranks as the fifth leading cause of death in the United States and is the primary contributor to neurological impairments and cognitive deficits, responsible for 5.2% of global deaths. Approximately half of stroke survivors suffer from long-term disabilities, making it a leading cause of disability worldwide. Currently approved treatments for ischemic stroke focus on restoring cerebral blood flow through intravenous thrombolysis and mechanical thrombectomy. Minocycline, a lipophilic protease inhibitor capable of crossing the blood-brain barrier, exhibits anti-inflammatory, antioxidant, and antiapoptotic properties both centrally and peripherally. This literature review aims to assess the efficacy and safety of Minocycline as an adjunctive therapy in treating ischemic stroke and improving post-stroke functional outcomes.
Methods
We searched PubMed, Google Scholar, and clinicaltrials.gov databases. We used a combination of keywords: acute ischemic stroke, Minocycline, neuroprotection, and neuroinflammation. We included full-text peer-reviewed scholarly articles published within the last decade, randomized controlled trials, and systematic reviews with meta-analyses. We excluded articles in languages other than English, experimental studies and animal studies.
Results
We systematically reviewed nine articles that met our predefined eligibility criteria and involved 1,010 participants. These studies assessed the effectiveness and safety of Minocycline by comparing groups treated with Minocycline to control groups using the National Institute of Health Stroke Scale. Across the nine studies, there was consistent evidence of substantial clinical improvement among patients treated with Minocycline. However, two of the studies indicated that although Minocycline was deemed safe, it did not result in improved outcomes for patients with acute stroke.
Conclusion
Minocycline shows promise in mitigating both immediate and prolonged effects of ischemic stroke, demonstrating efficacy with minimal adverse effects even at high dosages. Nonetheless, conflicting results in two studies suggest that small sample sizes might contribute to varying conclusions. Despite the scarcity of data from clinical trials, Minocycline could serve as a valuable adjunctive therapy, particularly for patients in remote areas lacking access to specialized stroke care or those unsuitable for intravenous thrombolysis. Additional randomized clinical studies on a large scale are needed to verify the Minocycline's neuroprotective effects and its potential to improve outcomes and reduce long-term disabilities in ischemic stroke patients.


The Role of Minocycline as Adjunctive Therapy in Acute Ischemic Stroke: Literature Review

Background: Atopic Dermatitis (AD) is a chronic, pruritic inflammatory cutaneous disease that affects people of all ages and demographics. In the United States, AD affects over 30 million people and 10.2% of adults. AD is known to be cumbersome and financially taxing, significantly affecting patients’ quality of life (QoL). As disease prevalence increases and new therapies arise, a better understanding of the socioeconomic burden becomes critical. The objective of this study is to assess the financial implications across various socioeconomic backgrounds and community types from the patient perspective within a single institution that serves rural, suburban, and urban areas.

Methods: A 22-question cross-sectional survey was conducted through telephone calls. Inclusion criteria included patients ≥18 years old with an ICD code for AD seen at our institution over the past 10 years. Patients were adults of varying ages, genders, races, and ethnicities. Patients self-reported information on their AD diagnosis, socioeconomic status, education level, affordability, expenses related to their AD, and factors affecting their QoL. Statistical analysis was performed using SPSS.

Results: Sixty-four patients participated in the survey, with a response rate of 78%. Responders were predominantly female (55%), with a mean age of 41. Participants were 48% White or Caucasian, 36% Black or African American, and 16% Asian or Asian American. Self-reported disease severity was labeled as mild (17%), moderate (33%), or severe (50%). Yearly income levels were reported as less than $50k (23%), $50-100k (14%), $100-150k (16%), more than $150k (20%), and 27% declined to answer. Thirteen respondents (21%) reported that they had been unable to afford their medications at some point, only three had household incomes of less than $50,000/year. Most respondents (36%) stated that over-the-counter treatments and supplies were the most expensive aspects of their AD care. The financial burden of AD for each income level did not differ significantly across income levels. Regarding education, 36% had less than a college degree, 42% earned a college degree, and 22% earned a postgraduate degree. Most individuals answered that they almost or completely understood their disease and treatment options when asked (81%). When asked to select up to three factors from a list that affect their QoL due to AD, 14 respondents identified financial burdens, five chose transportation, five selected access to medical care, and two indicated access to supplies. These factors did not vary significantly across different income groups.

Conclusions: Our study found that one in five patients have been unable to afford treatment at some point. The understanding of disease and treatment options may not be based on education level but rather on health literacy. Understanding the socioeconomic impact of disease facilitates better resource allocation and knowledge of how we can better serve the evolving patient population.

The Influence of Finances and Education on Quality of Life in Atopic Dermatitis

ABSTRACT
Soldiers on the battlefield are affected by heavy body armor and excessive march load. It is well known, but the long-term effects of this extra weight on the musculoskeletal system of military veterans, specifically the lumbar spine, are unclear. In Iraq and Afghanistan, most body armors weighed over 33 pounds (15 kg). These armors were 3 times heavier than those used in Vietnam. Chiropractors at the Fargo VA Hospital are seeing more young veterans with non-traumatic lower back pain. This article presents a perspective on the impact of body armor weight and excessive carry load on lumbosacral disc herniation with radicular pain in military veterans.
This study is a retrospective case series. We used a convenient sampling method. We selected the first 10 military veterans who came to a Fargo VA chiropractor in late fall 2023. Each veteran filled out a VA Form 10-5345 to give us permission
to access their electronic health records. All 10 veterans also completed a survey. The survey asked about their active combat status, the type and weight of their body armor, how long they wore the armor each day, how much weight they
carried, and their opinion on the cause of their lower back pain (service related or not). The Fargo VA does not require an institutional review board for a case series.
This study found that military veterans experience lower back pain at an average age of 35 years. This is at least 5 years earlier than non-service men. Lower back pain with disc herniation typically occurs at the L4-L5 and L5-S1 disc levels. All 10 veterans in the study believe that their lower back pain is related to their service. Sixty percent of the participants in the study have a service-connected disability because of back pain.
For military veterans, onset of lower back pain from a disc herniation at a young age may be linked to carrying heavy
body armor and loads. However, the small sample size of this case series limits causal relationship inferences.

Body Armor and Lumbar Disc Herniation in Young Military Veterans:
A Case Series

Abstract Title: Unveiling the Cholestatic Phenotype: A Case of Autoimmune Hepatitis with Severe Hyperbilirubinemia 

Background: Autoimmune hepatitis (AIH) is defined by clinical, laboratory, and histologic findings as a hepatitic syndrome rather than a cholestatic syndrome. Cholestasis in AIH is typically due to associated primary biliary cirrhosis or primary sclerosing cholangitis. However, 8% cases of AIH have unexplained cholestasis (the Cholestatic-phenotype). In this case report, we described a patient who presented with cholestasis but was later diagnosed with AIH, responding well to steroid treatment. 

Case Presentation: A 52-year-old woman presented to the emergency department with a 15-day history of yellowing of the eyes and urine, accompanied by fatigue and pale-stools, following a brief febrile illness. Initial treatment with empirical antibiotics and supportive care at a local health center showed no improvement. Her medical history was unremarkable except for a similar episode of jaundice 4 years prior. Physical examination was normal, but laboratory tests revealed normocytic normochromic anemia, markedly elevated bilirubin (total 27 mg/dl, direct 15 mg/dl, indirect 12 mg/dl), and liver enzymes (AST-239 IU/L, ALT - 93 IU/L). Further evaluation showed a positive antinuclear antibody (ANA) profile with antibodies against SS-A, Scl-70 and Jo-1, but negative for anti-LKM, anti SMA and AMA. Liver ultrasound revealed altered liver echotexture without strictures or other abnormalities. Liver biopsy demonstrated features of auto-immune hepatitis(Figure 1), with interface hepatitis, cholestasis, chronic inflammatory infiltrates and portal fibrosis. Based on the Revised original scoring system for AIH, the patient had a pretreatment score of 15 (Simplifed scoring system score of 8) ,confirming the diagnosis. Treatment with azathioprine and prednisolone was initiated, with subsequent follow-up showing a positive response. Bilirubin levels normalized within two months. 

Discussion: For patients with cholestasis, especially with elevated bilirubin and positive ANA profile, AIH should be one of the differential diagnosis. Even if the classic serological markers like anti LKM and anti-SMA are negative, biopsy is the key to confirm the diagnosis in patients with such atypical presentation. The standard treatment for AIH is immunosuppressive therapy using steroids and steroid sparing agent such as azathioprine. Steroids such as prednisolone reduces the inflammation acutely and azathioprine is used for long-term chronic therapy to maintain the remission without the fear of steroid dependence.

Unveiling the Cholestatic Phenotype: A Case of Autoimmune Hepatitis with Severe Hyperbilirubinemia

Introduction: 
Medical education utilizes standard clinical practice and recommends clinical
algorithms to inform trainee curricula. The use of race and ethnicity as a medical screening tool impacts medical outcomes by associating race with genetics without considering that race incorporates social, economic, and cultural variables that influence outcomes.
Methods: 
To evaluate underlying factors contributing to differences in hypertension prevalence, control, and treatment recommendations across race/ethnicities, a two-week elective course was developed for third- and fourth-year medical students. In this elective course, students performed self-directed literature-based research on hypertension health disparities. We then developed three videos that addressed the racial/ethnic impact on hypertension prevalence and control and incorporated the students’ research findings. The videos were presented at a lunch-and-learn
session open to the medical students and health professionals that was focused on health care inequities in hypertension. Pre- and post-survey data was collected to assess how the discussion changed participant knowledge and impressions of the role race plays in hypertension prevalence, control, and treatment.
Results: 
Survey results denoted that 100% of lunch-and-learn participants increased their
understanding of the impact of health inequities on hypertension. Overall, there were significant differences in knowledge gained and understanding of health disparities that influence hypertension treatment across participants from all genders and racial or ethnic groups. Notably, pre-survey results indicated that participants tended to agree that treatment guidelines incorporating race improve equity in the treatment of hypertension whereas post-session results
showed that participants were less likely to agree with this assertion.
Conclusions: 
Developing educational opportunities to discuss health inequities can influence
perceptions of patient care.


Addressing Health Disparities in Hypertension: A comprehensive medical elective and survey study among medical students and professionals.

Implicit bias happens automatically and without intention. Nevertheless, these thoughts affect a person’s judgements, considerations, and behaviors. It is well-demonstrated in the literature that physicians experience implicit bias toward their patients, which in turn contributes to health inequities. However, there is little research conducted on patients’ implicit bias towards their physicians. Previous studies report no statistical difference in patient satisfaction when controlled for physician gender, despite evidence from opposing studies that identify female physicians as establishing more patient-centered care. This spurs a clinically relevant discussion surrounding bias in patients’ evaluations. There are limitations in collecting this data, as patients must be in a controlled environment, yet unaware of the research being conducted. As a result, Objective Structured Clinical Examinations (OSCEs), in which medical students are graded and receive feedback from Standardized Patients (SPs), lend an ideal environment to study patient implicit bias. Our study examines the implicit bias of SPs toward their student doctors based on gender during OSCEs. Data from Kansas College of Osteopathic Medicine’s SP student doctor evaluations, obtained in OSCEs, was acquired and de-identified. Consent from SPs to conduct this research was obtained, yielding 576 comments for 90 first-year medical students across 8 OSCEs. A direct content analysis was performed on these comments. Guided by prior literature surrounding patients’ perception of physicians, feedback was coded into five categories: compassion, demeanor, communication, comfort delivery, and physical appearance. Within each category, feedback was further coded by male or female student doctor gender and positive or negative feedback sentiment. A chi-squared test for independence was performed on data in each category to explore the hypothesis: 

H0: There is no association between medical student gender and simulated patient feedback sentiment. 

HA: There is a significant association between female gender and positive feedback sentiment. 

Results displayed a significant association between female student gender and positive SP feedback regarding compassion (p = 0.017), as well as a significant association between female student gender and negative SP feedback regarding physical appearance (p = 0.038). There was no significant association found between medical student gender and SP feedback regarding student demeanor, communication, or comfort delivery. These findings aid understanding of how physicians’ genders correlate with patients’ perceptions of them, and which characteristics in a clinical encounter can be leveraged to significantly impact this impression.

Simulated Patient Implicit Bias of Medical Student Gender

Central nervous system lymphoma (CNSL) is a rare but aggressive subset of non-Hodgkin lymphoma (NHL). We present a case of a 48-year-old woman who presented with left-sided hemiparesis and facial droop. Patient has a past medical history of idiopathic thrombocytopenic purpura (ITP), retinal detachment, and subsequently tested positive for QuantiFERON-TB and IgG Toxocariasis. Initial imaging revealed multiple enhancing lesions, prompting concern for metastatic lesions or stroke. Extensive diagnostic workup including cerebrospinal fluid (CSF) analysis and biopsies led to the diagnosis of diffuse large B-cell lymphoma (DLBCL), the most common subtype. This case highlights the challenges in diagnosing CNSL, particularly in patients with concurrent medical conditions.

Approach to an Unclear Cause of Acute Weakness: A CNS Lymphoma Case Report 

Abstract Title
Atrial Fibrillation Presenting as Renal Infarction
Background
Renal infarction is caused by occlusion of renal artery or its branches, due to emboli from cardiac sources or in situ thrombosis. It presents as sudden flank or abdominal pain, with labs showing elevated LDH, hematuria, proteinuria. Prompt diagnosis is crucial to initiate timely revascularization therapies.

Case Presentation
A 78-year-old male with past medical history of hypertension, diabetes mellitus, hyperlipidemia, COPD, meningioma presented to the emergency department with complaints of pain in the left flank and umbilical region which started gradually over the past few days and was described as dull and non-radiating. Physical evaluation revealed stable vital signs with hypertension, chronic normocytic anemia, irregularly irregular pulse, Left costovertebral angle (CVA) tenderness, bilateral chronic hand tremors. No focal neurological deficits. Denies fever, nausea, vomiting, diarrhea, constipation, anorexia, alcohol use, changes with meal, similar pain, incontinence, dysuria, hematuria, changes with urine output, urinary frequency, chest pains, palpitations, syncope, orthopnea, PND, edema. Initial Diagnostic workup included negative troponin, COVID-19/flu/RSV tests, and a chest X-ray showing mediastinal widening. Further investigations with a CT angiography chest ruled out aortic aneurysm or dissection but noted a region of low density in the left kidney parenchyma suggestive of multiple cortical infarcts. Urinalysis was positive for microscopic blood and 1 RBC. An EKG demonstrated new-onset atrial fibrillation (Afib). Cardiology consulted recommended to start anticoagulation therapy for atrial fibrillation and electrophysiology with no immediate plan for cardioversion. Later, CTAP with and without contrast show findings consistent with multiple acute renal infarcts (ARI) in the left kidney. Urology was consulted and determined no surgical intervention was indicated, recommending anticoagulation to prevent further complications from kidney infarcts. The patient was educated about his condition and discharged with appropriate outpatient follow-up.

Discussion
ARI is potentially serious medical condition but its clinical presentation of is often
nonspecific, leading to delays in diagnosis and treatment. Autopsy studies suggest the incidence of renal infarction is 14 per 1000, or 1.4%. Other retrospective studies of ER admissions found an incidence of 0.004% to 0.007%. In our case, the patient's abdominal pain with no previous history of arrhythmias prompted further evaluation, revealing new-onset AFib on EKG and subsequent diagnosis of renal infarction on imaging. Afib can cause thrombotic complication to any body part, most commonly being ischemic stroke. Clinicians should suspect other systemic embolization phenomena in patients with Afib.


Underline digital video library

Clinical Improvements After Inlay Total Shoulder Arthroplasty are Sustained: A Long-term Follow-up Trending Analysis

Double Trouble in the Gut: Unraveling the Tangled Tale of Eosinophilic Esophagitis and Inflammatory Bowel Disease

Power Outage: A Simulation Case for Anesthesiology Residents

Multidisciplinary Approach to Managing Open-Book Pelvic Fractures in Trauma Care

The Role of Minocycline as Adjunctive Therapy in Acute Ischemic Stroke: Literature Review

The Influence of Finances and Education on Quality of Life in Atopic Dermatitis

Body Armor and Lumbar Disc Herniation in Young Military Veterans: A Case Series

Unveiling the Cholestatic Phenotype: A Case of Autoimmune Hepatitis with Severe Hyperbilirubinemia

Addressing Health Disparities in Hypertension: A comprehensive medical elective and survey study among medical students and professionals.

Simulated Patient Implicit Bias of Medical Student Gender

Approach to an Unclear Cause of Acute Weakness: A CNS Lymphoma Case Report

Internal Medicine Resident PGY-3

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