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Draft a comprehensive differential diagnosis for acute substernal chest pain in a 45-year-old male with hypertension and hyperlipidemia, diaphoresis, exertional onset, and normal initial ECG/troponin; include life-threatening causes first, key distinguishing features, and immediate diagnostic next steps.

Draft a detailed differential diagnosis for new-onset unilateral throbbing headache with visual aura and brief monocular vision loss in a 32-year-old female on oral contraceptives; include red-flag symptoms, stroke/TIA considerations, and recommended initial workup.

Draft an assessment and plan for stage-2 hypertension (BP 162/98) in an obese 52-year-old with suspected obstructive sleep apnea; include ASCVD risk estimate, lifestyle prescriptions, first-line pharmacotherapy with drug/dose/targets, baseline labs/monitoring, and 4–6 week follow-up.

Draft an assessment and plan for type 2 diabetes follow-up with A1c 9.2% on metformin 1,000 mg BID and eGFR 65; compare adding a GLP-1 receptor agonist vs an SGLT2 inhibitor, address weight loss goals, hypoglycemia education, vaccinations, and micro/macrovascular screening.

Draft a history and physical for a patient presenting with chest pain, including HPI using OLDCARTS, pertinent ROS, PMH/meds/allergies, FH/SH, focused cardiac/pulmonary exam, initial labs and imaging orders, prioritized differential, HEART score risk stratification, and early management.

Draft a history and physical for a new patient with progressive exertional dyspnea, orthopnea, and bilateral leg edema; include differential (heart failure, COPD, PE, anemia, renal disease), targeted exam maneuvers, and first-line diagnostics and management.

Draft a progress note for COPD follow-up two weeks after an acute exacerbation treated with prednisone and antibiotics; include symptom trajectory, CAT score (if available), inhaler technique/adherence, oxygen needs, spirometry plan, smoking cessation counseling, and return precautions.

Draft a progress note for post-operative day 2 after total knee arthroplasty; include pain control strategy, DVT prophylaxis, PT/OT milestones, wound status, bowel/urinary function, labs/vitals review, complications screening, and discharge readiness.

Draft a discharge summary for community-acquired pneumonia admission; include admission/discharge dates, presenting symptoms, radiology/labs, pathogen if identified, inpatient therapies and response, discharge medications with durations, pending tests, follow-up appointments, and return precautions.

Draft a discharge summary for myocardial infarction managed with PCI and drug-eluting stent placement; include cath findings, complications, inpatient course, discharge medications (DAPT, statin, beta-blocker, ACEi/ARB), cardiac rehab referral, and follow-up plan.

Draft discharge instructions for a patient hospitalized with acute decompensated heart failure; include daily weights, sodium and fluid restriction amounts, medication list with dosing, signs of worsening heart failure, follow-up appointments, and lab monitoring plan.

Draft discharge instructions for an asthma exacerbation; include controller and reliever regimen, steroid taper schedule, spacer technique, trigger avoidance, a written asthma action plan, return precautions, and follow-up timing.

Draft a patient handout on managing high blood pressure in plain language; explain what BP numbers mean, key lifestyle steps (DASH diet, sodium limits, alcohol moderation), home BP monitoring instructions, medication adherence tips, and when to call the doctor.

Draft a patient handout for type 2 diabetes education in plain language; cover A1c goals, the plate method, physical activity targets, self-monitoring of blood glucose, hypoglycemia signs and the 15-15 rule, foot care basics, and a vaccination checklist.

Draft a summary of the latest CDC and WHO guidelines for managing community-acquired pneumonia in adults, including empiric antibiotic choices, duration of therapy, and follow-up recommendations.

Draft a plain-language overview of the ADA and AACE guidelines for diabetes management, focusing on A1c goals, weight management, and the use of GLP-1 receptor agonists and SGLT2 inhibitors.

Draft a summary of the 2024 USPSTF breast cancer screening recommendations, including updated screening intervals, risk-based approaches, and the role of MRI for high-risk patients.

Draft a concise summary of NCCN guidelines for melanoma management, including staging, surgical margins, adjuvant therapy, and checkpoint inhibitor recommendations.

Draft treatment alternatives for community-acquired MRSA skin infections in patients allergic to sulfa drugs; include oral and IV options, dosing, and duration.

Draft treatment alternatives for patients with type 2 diabetes who are unable to tolerate GLP-1 receptor agonists due to nausea; include medication substitutions and lifestyle recommendations.

Draft a summary of options for treating refractory depression, comparing ketamine infusions, transcranial magnetic stimulation (TMS), and electroconvulsive therapy (ECT).

Draft treatment options for advanced prostate cancer, including hormonal therapy, radiopharmaceuticals, and novel androgen receptor pathway inhibitors.

Draft a summary of recent research on mRNA vaccine technology beyond COVID-19, including applications in oncology and autoimmune disease prevention.

Draft an easy-to-understand overview of long COVID research, summarizing major symptoms, hypothesized mechanisms, and emerging treatment approaches.

Draft a summary of current research on Alzheimer’s disease biomarkers, including amyloid and tau imaging, and discuss how they influence diagnosis and trial design.

Draft an explanation of the interaction between warfarin and antibiotics such as ciprofloxacin or TMP-SMX, including INR effects and management recommendations.

Draft a summary evaluating drug interactions for patients taking Paxlovid and common cardiovascular drugs; include mechanism and recommended dose adjustments.

Draft a summary of the common and serious side effects of semaglutide, including GI intolerance, gallbladder disease, and thyroid-related warnings.

Draft an overview of potential side effects associated with long-term corticosteroid use, including osteoporosis, glucose intolerance, and adrenal suppression.

Draft a summary of essential lab tests to order in suspected acute pancreatitis, including amylase, lipase, liver enzymes, and metabolic panels, with interpretation guidance.

Draft laboratory workup recommendations for suspected hypothyroidism, including TSH, free T4, thyroid antibodies, and when to consider secondary causes.

Draft an explanation of which labs should be monitored in patients receiving methotrexate therapy, including CBC, LFTs, renal function, and frequency of monitoring.

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Research Article: Application of mirror reconstruction and 3D printing technology in the treatment of Sanders type IV calcaneal fractures

Date Published: 2025-08-28

Abstract:
To explore the clinical efficacy of an integrated workflow combining mirror reconstruction and 3D printing for Sanders type IV calcaneal fractures—a severely comminuted subtype with limited evidence-based solutions and to explore a new individualized and accurate method for the treatment of Sanders type IV calcaneal fractures. A retrospective analysis of the clinical data of 20 patients with Sanders type IV calcaneal fractures who were treated with mirror image reconstruction and 3D printing technology in the Department of Orthopedics of our hospital from April 2021 to July 2023 was performed. There were 16 males and 4 females; their ages ranged from 38 to 62 years, with an average of 48.00?±?1.84 years. All patients underwent clinical and radiological evaluation. The operation time, intraoperative blood loss, fracture healing time, and surgical complications were recorded. The width and height of the calcaneus, Böhler angle, and gissane angle were measured and compared before surgery, after surgery, and at the last follow-up. At the final follow-up, the American Orthopedic Foot and Ankle Society (AOFAS) ankle and hindfoot scores were used to evaluate hindfoot function, and the pain visual analog scale (VAS) was used to evaluate pain. All 20 patients in this group underwent successful operations. The operation time ranged from 52 to 75?min, with an average of 59.55?±?1.52?min. The volume of intraoperative blood loss ranged from 35 to 50?ml, with an average of 41.00?±?1.16?ml. All patients received satisfactory follow-up, with follow-up times ranging from 12 to 38 months and an average of 16.55?±?1.34 months. All the fractures healed, and the healing time ranged from 10 to 13 weeks, with an average of 11.55?±?0.211 weeks. Two patients developed symptoms of sural nerve injury after surgery, two patients developed subtalar joint stiffness after surgery, and two patients developed traumatic arthritis changes in the calcaneellar joint during the 1-year follow-up. At the final follow-up, the calcaneal length, width, height, Böhler angle, and Gissane angle were significantly greater than those before surgery ( p <?0.05). At the last follow-up, the AOFAS score ranged from 70 to 100 points, with an average of 88.15?±?2.04 points, of which 8 cases were excellent, 10 were good, and 2 were fair, with an excellent and good rating of 90%. The VAS score ranged from 0 to 3 points, with an average of 0.95?±?0.22 points. This integrated approach enables precise reduction with superior short-term outcomes, though long-term validation requires RCTs.

Introduction:
Sanders type IV calcaneal fractures represent <10% of calcaneal injuries, which often leads to complete loss of the calcaneal shape and severe soft tissue damage to the foot and ankle. It can also be accompanied by multiple injuries to the spine, pelvis, etc., making treatment very difficult ( 1 ). If treated improperly, various complications, such as traumatic subtalar arthritis and subtalar joint stiffness, are likely to occur, which may require subtalar joint fusion surgery ( 2 ). Therefore, open reduction…

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