Introduction: Psoriasis Area and Severity Index (PASI) and Physician's Global Assessment (PGA) are the most widely used outcome measures in clinical trials of biologics to treat psoriasis; however, these outcome measures vary in both their reliability and validity. As newer biologics approach complete clearance of psoriasis, it becomes important to have standardized, reproducible forms of measure to accurately compare treatment efficacy. The aim of this study was to evaluate the extent of and reasons for variation between PASI and PGA scores used in clinical trials. Methods: A literature search was conducted of clinical trials meeting the inclusion criteria: phase 2 or 3, evaluation of treatment efficacy in reducing psoriasis severity, and use of PASI 90/100 and sPGA or PGA 0/1 as primary end points. Results: Among the analyzed studies, 8 of 45 trials had a PASI-PGA variance of \ 5%, 4 of 45 trials had a variance of 5-10%, and 33 trials had a variance of [ 10%. The IMMvent and AMA-GINE trials were the only two trials showing 0 variation between the PASI and PGA scores, testing adalimumab and brodalumab, respectively. Ustekinumab showed the highest variance of 61.9% in the IXORA-S trial. Limitations of this paper include a relatively low number of studies assessed because of the paucity of literature available. Conclusions: The use of both PASI and PGA as equivalent assessment tools for complete clearance is redundant and subject to high variability. Novel severity assessments should be developed that reduce calculation variation and take into account patient-oriented symptoms.

Background: Due to the increasing prevalence of kidney transplantation, a greater awareness of variations in the surrounding vasculature is of surgical importance. During embryological development, both the renal and gonadal arteries arise from lateral mesonephric branches of the dorsal aorta. In adults, gonadal arteries are paired vessels that normally arise from the aorta at the level of the second lumbar vertebra. Methods: Routine cadaveric dissection completed by first-year medical students and dental students incidentally revealed anatomical anomalies. Results: We describe two cadaveric findings in male cases which demonstrate unilateral and bilateral variations of testicular arteries originating from an aberrant renal artery in one case and an accessory renal artery in the other. Conclusion: By increasing awareness of anomalous testicular arteries we hope to encourage the standardization of preoperative vasculature exploration to both minimize intra-operative risk to living male kidney donors and increase patients’ understanding of potential risks and complications prior to consenting to the procedure providing more accurate information prior to surgery.

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Background: The field of dermatology is constantly evolving and expanding to accommodate for increased demand. In order to maximize future productivity, it is important to recognize and understand how the desires of patients and the nature of physician visits have changed over time.  Objective: To evaluate and provide evidence-based reasoning for the changes occurring in the field of dermatology. Methods: Analysis of the 1991-2016 National Summary Tables from the National Ambulatory Medical Care Survey (NAMCS) was performed in order to identify several trends relating to dermatology visits. Results: Annual visit rates to dermatologists have increased by 68%, while visit length has increased by 39%. Drug visits have increased by 86%, while drug mentions increased by 370.2%. Limitations: Limitations of this paper include limited a narrow timeline for data points. Conclusion: As the field of dermatology will continue to expand in the future, dermatologists can expect to be busier than ever before. We expect that more patients will seek care, physician visits will be longer, and chief complaints and treatment options will continue to expand and vary.