For several years, medical schools in the United States have been urged to integrate public health and population science into their curricula. The first‐year Gross Anatomy course at Mayo Clinic serves as a teaching platform for many non‐technical skills that include professionalism, patient communication and near‐peer teaching that aim to meet core ACGME requirements. As part of the standard Gross Anatomy curriculum, students are assessed on a laboratory based learning activity referred to as a “bedside presentation,” where each small group is assigned a clinical condition and asked to present a hypothetical case as it relates to the anatomy and radiology on their cadaver. The objective of this study is to assess whether first‐year medical students’ knowledge of global health disparities and national population health improved after a longitudinal curriculum revision that combined public health concepts with the bedside presentation. Students first learned to examine a major cause of morbidity and/or mortality on a global/population level following which each team was asked to present a hypothetical patient (relating to their assigned cadaver) with an acute condition associated with the disease or behavior that they had researched earlier. Teams focused on associated anatomic and radiographic findings and used full‐body CT scans and corresponding anatomic parts to illustrate the effects of the disease. Pre‐course data indicate that students have a 50% understanding of population health trends. We anticipate that first‐year medical students will have an improved awareness of public health problems globally and in the United States after completing this activity in Gross Anatomy.
Endovascular treatment of distal thoracic aortic transection associated with severe thoracolumbar spinal fracture
Endovascular repair has become the first line of treatment in most patients with blunt aortic injury. The most common mechanism is deceleration injury affecting the aortic isthmus distal to the origin of the left subclavian artery. Injuries of the distal thoracic aorta are uncommon. We report the case of a 25-year-old male patient who presented with paraplegia and distal thoracic aortic pseudoaneurysm associated with severe thoracolumbar vertebral fracture and displacement after a motocross accident. Endovascular repair was performed using total percutaneous technique and conformable C-TAG thoracic stent-graft (WL Gore, Flagstaff, AZ). Following stent-graft placement and angiographic confirmation of absence of endoleak, thoracolumbar spinal fixation was performed in the same operative procedure. This case illustrates a multispecialty approach to complex aortic and vertebral injury and the high conformability of newer thoracic stent-grafts to adapt to tortuous anatomy.