Bernard-Soulier syndrome (BSS) is an extremely rare inherited blood clotting disorder that is characterized by giant platelet cells, thrombocytopenia, and prolonged bleeding time. Selleckchem SM-102 In 1948, Jean-Bernard and Jean-Pierre Soulier described the first male patient who presented with repeated episodes of bleeding throughout his life and eventually died at the age of 28 years from an intracranial hemorrhage sustained after a bar fight. BSS involves a defect of the GPIb-IX-V complex, an essential platelet receptor complex that principally binds with the von Willebrand factor (vWF). However, it has multiple other functions in inducing thrombosis and hemostasis.Over the past two decades, simulation has moved into the forefront of medical education. Top healthcare systems and schools are seeking simulation center managers for their expertise in simulation, not only for the training of staff within the walls of the simulation lab, but for the identification of latent safety threats within the health system (in situ simulations), testing preparedness for rarely used equipment and protocols, translational outcomes improving patient care, improving patient safety, decreasing medicolegal risk, improving recruitment and retention of staff, and the development of novel educational methods. There are many different roles and responsibilities of a simulation center manager. These leaders provide leadership to carry out the overall institution’s strategic mission, and goals focused on improving the knowledge, skills, and abilities of healthcare professional learners and, ultimately, patient care. They must maintain simulation best practices such as the International Nursing Association for Clinical Simulation in Learning (INACSL) standards. Simulation center managers are qualified to be the leader of the simulation center from their academic preparation, clinical experience, leadership experience, educational experience, simulation related training, and experience. These experiences vary, but the manager must show evidence of the skills and experience needed to meet the needs of the program.Alexia is an acquired disorder resulting in the inability to read or comprehend written language. The affected individuals remain capable of spelling and writing words and sentences but are unable to comprehend what was written by themselves. This is differentiated from the mechanical inability to read, such as visual impairment and educational factors resulting in illiteracy. Alexia is usually a result of brain injury/damage, most often from cerebral vascular accidents affecting the dominant hemisphere. It is often associated with other comprehension deficits such as agraphia (inability to write), acalculia (inability to do arithmetics), and aphasia (spoken language and language recognition deficit). Alexia is also known as “word blindness” or “agnosic alexia” and is a rare condition, first described by Dejerine in 1887. This condition involves the inability to read with retention of writing skills, speech production, and comprehension.Reading is a skill unique to humans and is crucial for living in the world today. Learning to read is one of the first teaching points of elementary school. Children are many times cast into expected long-term education success tiers based on their ability to learn to read. Dyslexia (developmental dyslexia) is when children have a difficult time learning to decode words. Decoding is the accuracy or fluency one develops when reading aloud. These children struggle with sounding out words and recognizing “sight words.” They have poor reading fluency and a difficult time with spelling. These children typically do not struggle with oral or nonverbal abilities. It is important to note that the reading disability cannot be accounted for by decreased educational opportunities or low intellectual capacity.Tarantulas are well known to be the largest spiders in the world. Contrary to popular belief, tarantulas are not one species of arachnid. There are over 900 different species that comprise the family Theraphosidae within the Mygolamorphae suborder, which itself includes over 2500 species of arachnid. Tarantulas can be found endemically in tropical and subtropical regions around the world and are popular as pets. While all tarantulas have venom, new world tarantulas additionally have urticating hairs located on their abdomen. Exposure to these hairs can cause intense inflammatory reactions.Anti-tubercular medications rifampin, isoniazid, pyrazinamide, and ethambutol are FDA approved for the treatment of mycobacterium tuberculosis. The combination and duration on which medications to use for therapy rely on whether the patient has active or latent disease. A feared complication of tuberculosis therapy is multi-drug-resistant tuberculosis(MDR-TB). MDR-TB is distinguished from its resistance to first-line medications isoniazid and rifampin. Therapy for MDR-TB is steadily advancing, and suggestions are continually changing. Second-line drugs that are in common use for MDR-TB are kanamycin, capreomycin, and amikacin via injections. Fluoroquinolones such as levofloxacin, moxifloxacin, and gatifloxacin and are also amongst the common second-line agents used when drug resistance develops to the first-line agents. Drugs that have recently received FDA approval for the multi-drug resistance TB are pretomanid, used in sequence with bedaquiline, and linezolid. A more dangerous and uncommon type of MDR-TB is extensively multi-drug resistant tuberculosis(XDR-TB). This infection characteristically shows the resistance to first-line medications rifampin and isoniazid, one second-line aminoglycoside, and either of the fluoroquinolones.Mammary duct ectasia (MDE) is a non-proliferative inflammatory disorder of the large duct (milk duct) of the breast; as such, it affects nipple and areola complex. In MDE, focal dilatation of the lactiferous duct system is due to endoluminal changes, as well as the loss of duct wall elastin, leading to abnormally dilated and tortuous lactiferous ducts with associated periductal inflammation and fibrosis. The patient commonly presents with intermittent nipple discharge of varying colours (ranging from white, to green/black, to grey), as well as pain and tenderness of the nipple and areola. Other symptoms can include an inverted nipple or a palpable breast “lump,” though, in many instances, MDE is asymptomatic. MDE can mimic more serious conditions, such as breast malignancy, or other benign processes such as mastitis. The clinical manifestations of mammary duct ectasia overlap with another benign inflammatory condition known as periductal mastitis, a condition that occurs at the nipple-areola complex (more commonly in smokers), and sometimes the two conditions cannot be distinguished from each other on clinical assessment, with the final diagnosis possible only after histopathologic examination of the excised duct tissue with the affected surrounding tissue.