Vitiligo is a common acquired depigmenting disorder characterized by the development of white macules and patches due to the loss of melanocytes. Patients with vitiligo can be stigmatized by society, making the disease a source of psychological stress that can considerably affect quality of life. The goal of vitiligo treatment is to obtain skin repigmentation in the majority of cases, and less commonly to depigment the remaining normal skin. There is no consistent, long-term, durable therapy for vitiligo for all patients, highlighting the unmet need for new safe and effective therapies to control this disease. Recently, JAK inhibitors have been explored as a promising novel treatment option in vitiligo. The JAK and signal transducers and activators of transcription (STAT) pathway is an attractive therapeutic target because IFN-γ–dependent cytokines produced through this pathway have been implicated in the pathogenesis of disease. This literature review describes vitiligo pathophysiology, explains the usefulness of the JAK inhibitors for treatment, and summarizes published case reports, case series, and open-label studies. Research outlined here shows JAK inhibitors in patients with vitiligo have a favorable safety profile and effectively produce repigmentation of lesions, especially with concomitant ultraviolet exposure. Additional studies are required to confirm efficacy, establish safety, and investigate durability of repigmentation.

Tranexamic acid (TXA) is an antifibrinolytic agent commonly used for the treatment or prevention of bleeding. Indications for TXA are diverse, including heavy menstrual bleeding, trauma, postpartum hemorrhage, traumatic brain injury, and surgical site bleeding. Despite decades of use and a robust body of evidence, hesitancy using TXA persists in many clinical settings. This illustrated review describes the history, pharmacology, and practical considerations of TXA use. We also describe the major landmark randomized controlled trials of TXA and their implications. Finally, we review the evidence around common controversies surrounding TXA such as the risk of thrombosis, prescription along with combined hormonal contraceptives, and use in patients with gross hematuria.

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Purpose: Due to the coronavirus disease 2019 pandemic, all Canadian Resident Matching Service interviews for internal medicine subspecialty programs were conducted virtually for the first time. This study explored the perceptions and experiences of internal medicine residents, subspecialty medicine program directors, and interviewers during virtual interviews. Methods: We invited all Canadian third-year IM residents, subspecialty program directors, and interviewers who participated in the 2020 medical subspecialty medicine interviews to complete a branching survey with a section for residents and one for program directors and interviewers. We distributed the anonymous survey after the submission of the rank order lists, to not affect residency match outcomes. Qualitative data were open-coded thematically and quantitative data were cleaned and then statistically analyzed using descriptive statistics and Analysis of Variance tests. Results: 62 residents, 59 program directors, and 113 interviewers responded to the survey with representation from almost all Canadian medical faculties and medical subspecialties. Strengths of virtual interviews included reduced cost, stress, pandemic infection risk, and carbon footprint. Weaknesses of virtual interviews included decreased ability to connect personally and informally, and inability to tour medical facilities and cities. A majority of both resident respondents (59.6%) and program directors/interviewer respondents (54.6%) supported conducting interviews virtually in the future. Conclusions: This study showed that the majority of both sampled residents and program directors/interviewers would prefer to conduct medicine subspecialty match interviews virtually in the future, and provides suggestions on how to improve the virtual interviews for the next iteration.

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