Philadelphia College of Osteopathic Medicine (PCOM) is a private medical school with its main campus in Philadelphia, Pennsylvania, and additional locations in Suwanee, Georgia (PCOM Georgia) and Moultrie, Georgia (PCOM South Georgia).Founded in 1899, PCOM is one of the nation's oldest medical schools. PCOM also operates several healthcare centers in Philadelphia and an osteopathic care clinic in Suwanee, Georgia. Additionally, PCOM sponsors residency training programs, which train newly graduated physicians. The Center for Chronic Disorders of Aging, which aims to improve quality of life for elderly individuals, is located on the Philadelphia campus.
IntroductionWeight bias among physicians remains a significant barrier to equitable healthcare for patients with obesity. One possible contributing factor is the absence of a structured curriculum addressing weight bias within medical education.MethodsThis project explored medical students' and faculty members' understanding of weight bias and identified gaps within the medical school curriculum. Participants' responses were subsequently used to inform the development of e-learning modules for implementation within a medical school curriculum. Semi-structured focus groups were conducted with stakeholders, including medical students and faculty from a private osteopathic school of medicine. Transcripts of these discussions were analyzed using Colaizzi's method for qualitative analysis.ResultsFive key themes emerged: (1) curricular gaps and structural barriers to comprehensive weight bias and obesity education, (2) impact of clinical exposure on reinforcing or challenging bias, (3) need for targeted communication and clinical skills training, (4) value of experiential and interactive learning modalities, and (5) empathy, bias awareness, and holistic understanding of obesity.DiscussionThese findings highlight the need and desire for structured education on weight bias during medical school. Results also identified preferred educational features within an e-learning context that can deliver impactful and engaging education. Integrating targeted e-learning and experiential strategies into the medical school curriculum is a promising educational modality to improve core knowledge, build empathy, and improve communication techniques, promoting an inclusive, patient-centered focus among future physicians when treating patients with obesity.
Abstract. Objectives:. To describe a novel percutaneous technique utilizing a curved intramedullary implant for fixation of complex anterior pelvic ring fractures and to report preliminary clinical outcomes from a retrospective case series. Design:. Retrospective case series. Setting:. Single academic Level I trauma center. Patients/Participants:. Nine female patients (mean age 74.8 years, range 53–89 years) with anterior pelvic ring injuries treated with percutaneous trans-symphyseal fixation using a curved intramedullary device between June 2023 and December 2024. All patients were treated by a single orthopaedic trauma surgeon and followed for a minimum of 6 months. Intervention:. Percutaneous intramedullary fixation of the superior pubic ramus crossing the pubic symphysis and terminating in the contralateral ramus using a novel flexible, curved implant. Main Outcome Measurements:. Operative time, estimated blood loss, implant complications, fracture union, and discharge disposition. Results:. The novel technique was successfully performed in all 9 patients. Average total surgical time was 106.3 minutes, with a mean of 54.8 minutes dedicated to the anterior fixation. Average estimated blood loss was 132.2 mL. All fractures progressed to union with no cases of implant failure or surgical site infection. Assistive measures were required in 3 of 9 cases. Discharge disposition was favorable, with 5 of 9 patients discharged to home or acute rehabilitation. No complications related to the anterior implant were noted. Conclusions:. This retrospective review suggests that trans-symphyseal curved intramedullary fixation is a feasible and safe technique for managing anterior pelvic ring fractures, including fragility and high-energy patterns. The method provides stable fixation while minimizing operative time, blood loss, and surgical exposure. Further studies are warranted to compare this technique against established modalities in larger cohorts. Level of Evidence:. Level IV—Therapeutic study.
The older adult population is rising, resulting in a larger number of adults residing in nursing homes. Skin cancer is most commonly diagnosed in older adults. Yet, these individuals often face limited access to advanced dermatologic care, in addition to unique risk factors such as inadequate sun protection and reduced mobility. This review aims to map the current evidence on skin cancer risk and diagnosis, as well as prevention strategies among older adults residing in nursing homes. A search was conducted on PubMed using the algorithm: ((nursing home) OR (assisted living) OR (elderly living facility)) AND (skin cancer), where 269 papers were retrieved. Inclusion criteria included full-text primary sources published from 2015 to 2025. Exclusion criteria included duplicates, reviews, animal studies, and studies not about skin cancer in nursing home settings. Title review narrowed the search to 38 papers. Following abstract screening, five final papers were included. A comprehensive review of the included studies demonstrated that there is a high prevalence of skin cancer among nursing home residents. There were a total of 4785 participants among the five papers, and skin cancer prevalence varied from 15 to 40% across studies. Nearly half of the diagnosed cases were basal cell carcinoma, a quarter were squamous cell carcinoma, and the final quarter was unspecified. Factors that contribute to the prevalence of skin cancer include age, immobility, incontinence, and a lack of appropriate sun protection. Additionally, systematic barriers, such as limited access to specialized dermatologic services, the absence of standardized screening practices, and limited staff training, increase the risk of delayed diagnosis and inadequate management of skin cancer in nursing home patients. Skin cancer in older adults, particularly those in long-term care, is also shaped by psychosocial challenges such as personality traits that influence distress, reduced quality of life, and delays in seeking treatment, highlighting the importance of early detection and supportive care interventions. To improve outcomes for this vulnerable population, there is a need to implement routine skin assessments, strengthen staff education on dermatologic care, and increase timely specialist referrals for proper detection and treatment of skin cancer.
We present a case of a 51-year-old male with a colonic adenocarcinoma that presented as a full-thickness rectal prolapse with external haemorrhoids. This patient had no significant medical or surgical history and presented to the emergency department with a rectal prolapse which had become incarcerated and increasingly painful over the previous 2 weeks. A computed tomography (CT) abdomen and pelvis appeared benign, demonstrating a full-thickness rectal prolapse with no definite rectal mass. A colonoscopy was performed, revealing anterior rectal mucosal edema, fibrosis, and a possible mass. This prompted the patient to be taken to the operating room for a low anterior resection of the rectum and sigmoid. A 10.5 × 8.2 × 1.9 cm rectal mass was noted and pathology revealed colonic adenocarcinoma. This case highlights the importance of performing a colonoscopy in patients with atypical rectal prolapse, even when the physical exam and CT appears benign.
