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Intraoperative pathology consultation during urological surgery: Impact on final margin status and pitfalls of frozen section diagnosis.

Authors:
Hiroshi Miyamoto

Pathol Int 2021 Jun 21. Epub 2021 Jun 21.

Departments of Pathology & Laboratory Medicine and Urology, University of Rochester Medical Center, Rochester, New York, USA.

Despite recent improvements in diagnostic and surgical techniques in urological oncology, positive resection margin remains a significant concern for surgeons. Meanwhile, intraoperative pathology consultation with frozen section assessment (FSA), particularly for histological diagnosis of the lesions incidentally found or enlarged or sentinel lymph nodes, generally provides critical information which enables immediate decision making for optimal patient care. The intraoperative evaluation of surgical margins is also often requested, although there are some differences in its application between institutions and surgeons. Read More

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Primary Hyperparathyroidism Masquerading as Acute Pancreatitis.

Horm Metab Res 2021 Jun 21;53(6):377-381. Epub 2021 Jun 21.

Dayanand Medical College and Hospital, Tagore Nagar, Ludhiana, Punjab, India.

Acute pancreatitis as an initial manifestation of primary hyperparathyroidism (PHPT) is a rare occurrence and timely diagnosis of PHPT is crucial in preventing repeat attack of pancreatitis. The study aimed at evaluating the clinico-radiological profile of patients admitted with acute pancreatitis as the index presentation of PHPT and to determine the factors associated with development of severe pancreatitis. This series included retrospective analysis of medical records of 30 patients admitted with acute pancreatitis as initial manifestation of PHPT. Read More

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Calcitonin Stimulation Tests: Rationale, Technical Issues and Side Effects: A Review.

Horm Metab Res 2021 Jun 21;53(6):355-363. Epub 2021 Jun 21.

"C.I. Parhon" National Institute of Endocrinology, Bucharest, Romania.

Calcitonin (CT) stimulation tests have great value and could help to: differentiate thyroid causes of elevated CT apart from non-thyroid sources, determine whether the patients with slightly elevated basal CT could/could not be candidates for surgery, and indicate the right moment for prophylactic thyroidectomy in children with MEN syndromes when with normal basal CT. This triggered the requests for development of CT stimulation tests, taking into consideration their safety and aimed us to write a systematic review of literature regarding the rationale, technical issues, and side effects of CT stimulating tests used for diagnosis of MTC. After a thorough review of the literature, we classified the reported side effects by severity, as defined by United States Food and Drug Administration. Read More

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Precision medicine in Fabry disease.

Nephrol Dial Transplant 2021 Jun;36(Supplement_2):14-23

Internal Medicine D, Department of Nephrology, Hypertension and Rheumatology, Interdisciplinary Fabry Center Münster, University Hospital Münster, Münster, Germany.

Fabry disease (FD) is a rare X-linked lysosomal storage disorder caused by mutations in the α-galactosidase A (GLA) gene, leading to a deficiency in α-galactosidase A. The lysosomal accumulation of glycosphingolipids, primarily globotriaosylceramide (Gb3) and its deacylated form, globotriaosylsphingosine (lyso-Gb3), results in progressive renal failure, cardiomyopathy associated with cardiac arrhythmia and recurrent cerebrovascular events, significantly limiting life expectancy in affected patients. In male patients, a definitive diagnosis of FD involves demonstrating a GLA deficiency in leucocytes. Read More

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Precision medicine approaches for diabetic kidney disease: opportunities and challenges.

Nephrol Dial Transplant 2021 Jun;36(Supplement_2):3-9

Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

The prevalence of end-stage kidney disease (ESKD) continuously increases worldwide. The increasing prevalence parallels the growth in the number of people with diabetes, which is the leading cause of ESKD. Early diagnosis of chronic kidney disease (CKD) in patients with diabetes and appropriate intervention is important to delay the progression of kidney function decline and prevent ESKD. Read More

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Precision medicine in immunoglobulin A nephropathy: still a journey ahead.

Nephrol Dial Transplant 2021 Jun;36(Supplement_2):24-30

Division of Nephrology and Clinical Immunology, RWTH Aachen University Hospital, Aachen, Germany.

Immunoglobulin A nephropathy (IgAN) is the most common primary glomerular disease worldwide and since its first description extensive research has identified a number of key central pathogenetic contributors, including genetic, immunological and environmental factors. Along with its multifaceted pathophysiology, the clinical presentation of IgAN varies, ranging from mild forms with only minor urinary findings and preserved renal function to cases that rapidly progress to end-stage renal disease. Because of this, early identification of patients at risk for a progressive course is urgently needed. Read More

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Control Beliefs among People with Dementia: A Systematic Review.

Dement Geriatr Cogn Disord 2021 Jun 21:1-19. Epub 2021 Jun 21.

Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.

Introduction: Dementia diseases are still incurable, and in order to assist in living well with the disease, researchers are increasing their attention to the value of control beliefs. Control beliefs are associated with coping and psychological well-being; however, knowledge on how they relate to well-being outcomes in people with dementia is limited. This review aimed to synthesize knowledge about control beliefs in this group to guide future interventions and research. Read More

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Prospective Study of Fertility Preservation in Young Women With Breast Cancer in Mexico.

J Natl Compr Canc Netw 2021 Jun 21:1-8. Epub 2021 Jun 21.

2Joven & Fuerte, Programa para la Atencion e Investigacion para Pacientes Jovenes con Cancer de Mama en Mexico, Ciudad de Mexico.

Background: Despite the risk of treatment-related infertility, implementation of fertility-preservation (FP) strategies among young patients with breast cancer is often suboptimal in resource-constrained settings such as Mexico. The "Joven & Fuerte: Program for Young Women With Breast Cancer" strives to enhance patient access to supportive care services, including FP measures through alliances with assisted-reproduction units and procurement of coverage of some of these strategies. This study describes patients from Joven & Fuerte who have preserved fertility, and assesses which characteristics were associated with the likelihood of undergoing FP. Read More

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Septic arthritis of native joints due to Mycobacterium avium complex: A systematic review of case reports.

Semin Arthritis Rheum 2021 Jun 9;51(4):813-818. Epub 2021 Jun 9.

Pali Momi Medical Center, Hawai'i Pacific Health, 98-1079 Moanalua Road, Suite 300, Aiea, Honolulu 96701, HI, USA. Electronic address:

Introduction: While MAC native joint septic arthritis is historically considered a rare entity, the number of reported cases have increased in recent decades. However, no comprehensive review of this topic has been conducted.

Objectives: To conduct a systematic review of cases of MAC native joint septic arthritis reported in the literature and summarize the presentations, baseline characteristics, risk factors, diagnosis, treatment, and treatment outcomes. Read More

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Association between individual and country-level socioeconomic factors and work participation in spondyloarthritis including psoriatic arthritis: Analysis of the ASAS-perSpA study.

Semin Arthritis Rheum 2021 Jun 9;51(4):804-812. Epub 2021 Jun 9.

Department of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands; Department of Rheumatology, Zuyderland Medical Center, Heerlen, the Netherlands. Electronic address:

Objective: To examine whether associations between socioeconomic factors and work outcomes in spondyloarthritis (SpA) differ across axial (axSpA), peripheral SpA (pSpA) and psoriatic arthritis (PsA), and whether associations for individual-level socioeconomic factors are modified by country-level factors.

Methods: Patients with a physician diagnosis of SpA within working age (18-65 years) were included. Associations between individual- (age, gender, education, marital status) and country-level factors (Human Development Index, Health Care Expenditure (HCE), Gross Domestic Product, percentage unemployed) with work outcomes (employment status, absenteeism, presenteeism) were assessed using multivariable mixed-effects models. Read More

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Deep learning for diagnosing osteonecrosis of the femoral head based on magnetic resonance imaging.

Comput Methods Programs Biomed 2021 Jun 5;208:106229. Epub 2021 Jun 5.

Longwood Valley Medical Technology Co. Ltd, China.

Background And Objective: Early-stage osteonecrosis of the femoral head (ONFH) can be difficult to detect because of a lack of symptoms. Magnetic resonance imaging (MRI) is sufficiently sensitive to detect ONFH; however, the diagnosis of ONFH requires experience and is time consuming. We developed a fully automatic deep learning model for detecting early-stage ONFH lesions on MRI. Read More

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Lack of active SARS-CoV-2 virus in a subset of PCR-positive COVID-19 congregate care patients.

J Clin Virol 2021 Jun 4;141:104879. Epub 2021 Jun 4.

Departments of Immunology and Microbial Disease, Albany Medical Center, Albany, NY, United States. Electronic address:

Highly sensitive nucleic acid amplification tests (NAATs) designed to detect SARS-CoV-2 RNA are the standard of care for the diagnosis of COVID-19. However, the accuracy of these methods for the quantitation of active virus rather than non-infectious RNA fragments that can persist for extended periods of time has been unclear. This issue is particularly relevant for congregate care patients who are unable to return to their home residence until fully negative by NAATs. Read More

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Spatio-temporal distribution and agroecological factors associated with canine leptospirosis in Great Britain.

Prev Vet Med 2021 Jun 6;193:105407. Epub 2021 Jun 6.

Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire, United Kingdom.

Leptospirosis is an important global zoonotic disease that affects a wide range of mammalian species. Canine leptospirosis outbreaks have been reported after metereological events such as flooding (eg. in Brazil and the United States of America) suggesting an environmental association, but there has been no such study in Great Britain (GB). Read More

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Depression in a youth population-based sample from Brazil: Prevalence and symptom structure.

J Affect Disord 2021 Jun 5;292:633-641. Epub 2021 Jun 5.

Department of Psychiatry, School of Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Child and Adolescent Psychiatry Division, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil. Electronic address:

Background: We aimed to examine the occurrence of major depressive disorder (MDD) in a population-based youth sample, assessing both categorical and dimensional presentations of the disorder and its clinical and sociodemographic correlates.

Methods: We analyzed cross-sectional data from the latest assessment of the 1993 Pelotas Birth Cohort (n = 3,780), a population-based study from Brazil that followed individuals up to age 22 years. We estimated point-prevalence for categorical diagnosis of MDD and comorbid diagnoses using DSM criteria in a structured interview by trained psychologists. Read More

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"Old people problems", uncertainty and legitimacy: Challenges with diagnosing Parkinson's disease in Kenya.

Soc Sci Med 2021 Jun 17;282:114148. Epub 2021 Jun 17.

Department of Anthropology, Durham University, Durham, United Kingdom.

Very little is known about the experience of people living with Parkinson's disease (PD) in low- and middle-income countries, such as those in sub-Saharan Africa. The number of specialists in the region is low and awareness is limited among the population and healthcare professionals. Drawing on ten months of ethnographic fieldwork in urban and rural Kenya with 55 people living with PD (PwP), 23 family members and 22 healthcare professionals from public and private clinics, we set out to understand the experience of diagnosis among PwP in Kenya. Read More

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Intracranial Hypertension Recurrence Risk After Wean of Intracranial Pressure-Lowering Medication.

Pediatr Neurol 2021 Jun 18;121:40-44. Epub 2021 Jun 18.

Department of Ophthalmology, Nationwide Children's Hospital, Columbus, Ohio. Electronic address:

Background: The proportion of children with recurrent signs and symptoms of intracranial hypertension after medication wean has been reported to be between 18% and 50%. Few studies have reported intracranial hypertension recurrence risk in children while adjusting for each individual's observed follow-up time after medication wean. In addition, the role of intracranial hypertension etiology on the risk of disease recurrence has not been widely studied. Read More

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Cancer diagnosis using generative adversarial networks based on deep learning from imbalanced data.

Comput Biol Med 2021 Jun 12;135:104540. Epub 2021 Jun 12.

Department of Electrical and Computer Engineering, University of Virginia, Charlottesville, VA, 22904-4743, USA. Electronic address:

Background And Objective: Cancer is a serious global disease due to its high mortality, and the key to effective treatment is accurate diagnosis. However, limited by sampling difficulty and actual sample size in clinical practice, data imbalance is a common problem in cancer diagnosis, while most conventional classification methods assume balanced data distribution. Therefore, addressing the imbalanced learning problem to improve the predictive performance of cancer diagnosis is significant. Read More

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Spinal cord glioblastoma multiforme in a patient with Noonan syndrome: A clinical report.

Clin Neurol Neurosurg 2021 Jun 1;207:106725. Epub 2021 Jun 1.

Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States; Department of Neurosurgery, University at Buffalo, Buffalo, NY, United States; Department of Neurosurgery, John R. Oishei Children's Hospital, Buffalo, NY, United States. Electronic address:

Introduction: Currently, there are only 3 reported cases of central nervous system malignancies in patients with Noonan syndrome in the literature, all of which are intracranial pathologies. To our knowledge, there are no cases of spinal cord glioblastoma multiforme reported in the literature.

Case Description: We describe the case of a 12-year-old girl with Noonan syndrome who presented with back pain and new onset neurological deficits and was found to have a spinal cord lesion. Read More

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Whole-exome sequencing in osteosarcoma with distinct prognosis reveals disparate genetic heterogeneity.

Cancer Genet 2021 Jun 9;256-257:149-157. Epub 2021 Jun 9.

Deptartment of Orthopaedic Oncology Surgery, Beijing Jishuitan Hospital, Peking University, Beijing 100035, China. Electronic address:

The genomic profiles of osteosarcoma (OS) patients have been extensively investigated; however, the genetic prognostic biomarkers still remain unclear. In the present study, we analyzed the mutational profiles of pre-treatment primary tumor samples from 33 OS patients using whole exome sequencing (WES). These 33 OS patients were divided into two groups according to clinical outcomes: a good prognosis group involving 21 patients with tumor free survival, and a poor prognosis group involving the remaining12 patients who had lung metastases at initial diagnosis. Read More

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Paranasal mucoceles in children with cystic fibrosis: Management of a not so rare clinical condition.

Am J Otolaryngol 2021 Jun 16;42(6):103107. Epub 2021 Jun 16.

Unit of Pediatric Otorhinolaryngology, Spedali Civili, Brescia, Italy. Electronic address:

Purpose: Paranasal mucocele (PM) is reported as a complication in children with cystic fibrosis (CF) in up to 4% of patients. The objective of this study was to identify PMs in the personal large series of children with CF and to assess their diagnosis and treatment.

Material And Methods: Medical records of children with CF and PM who were admitted and treated by means of endoscopic nasal surgery between 2004 and 2020 were retrospectively reviewed. Read More

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A rare case report: Cutaneous Candida tropicalis infection disguised as a sacral decubitus rash in an immunocompetent individual.

J Infect Public Health 2021 May 29;14(8):1018-1020. Epub 2021 May 29.

School of Medicine, Texas Tech University Health Sciences Center (TTUHSC) at the Permian Basin, TX, USA. Electronic address:

Candida infection is seen in patients with weak or disrupted host responses. Cutaneous candidiasis typically affects the intertriginous areas and presents with a red plaque surrounded by satellite lesions. Diagnosis of cutaneous candidiasis is made by visual inspection followed by potassium hydroxide normal saline microscopic preparation (wet mount) and polymerase chain reaction identification or culture of fungal organism. Read More

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Primary acinic cell carcinoma of mandible, report of a case and literature review.

Int J Surg Case Rep 2021 Jun 9;84:106065. Epub 2021 Jun 9.

School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. Electronic address:

Introduction And Importance: Acinic cell carcinoma (ACC) is a rare low-grade salivary gland malignancy that accounts for approximately 17% of all salivary gland malignancies. The most common site affected by ACC is the parotid gland followed by the submandibular glands, minor salivary glands, and sublingual glands. Also, it could hardly be observed in unusual sites such as the jaw bones. Read More

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Inflammatory myophibroblastic tumor of the proximal ileon in a patient with complicated umbilical hernia: A case report and literature review.

Int J Surg Case Rep 2021 Jun 8;84:106091. Epub 2021 Jun 8.

Hospital Civil Dr. Juan I. Menchaca, Mexico.

Introduction: Inflammatory myofibroblastic tumors are neoplasms that occur infrequently, mainly affects children and young adults. It is an intermediate grade fibrotic multinodular neoplasm.

Description Of The Case: We present the case of a 47-year-old female patient, who underwent emergency umbilical hernioplasty, later developed intestinal obstruction secondary to an inflammatory myofibroblastic tumor. Read More

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Solitary submandibular soft tissue osteochondroma: A rare case report.

Int J Surg Case Rep 2021 Jun 9;84:106074. Epub 2021 Jun 9.

Division of Oral Pathology, Dept. of Oral Medicine and Oral Diagnostic Sciences, College of Dentistry, King Saud University, P.O. Box 14511, Riyadh, Saudi Arabia. Electronic address:

Introduction: Soft tissue osteochondromas are rare benign tumors containing bone and cartilage that form in mesenchymal tissues with no connection to adjacent bone, cartilage, or periosteum. They mimic endochondral ossification and are usually encased in a fibrous tissue capsule. The occurrence of the tumor is extremely rare in the maxillofacial region. Read More

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Well-differentiated liposarcoma of the cheek misdiagnosed for lipoma: A case report.

Int J Surg Case Rep 2021 Jun 16;84:106116. Epub 2021 Jun 16.

Oral and Maxillofacial Surgery Department, CHU Ibn Rochd, Casablanca, Morocco; Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco.

Introduction: Liposarcoma is the most common sarcoma entity and accounts for 17% to 30% of soft tissue sarcomas. There are several histological types including well-differentiated liposarcoma. This paper aims to underline the interest of immunohistochemical and cytogenetic studies to diagnose well-differentiated liposarcoma and to show the delicacy of performing a surgical procedure in the cheek area. Read More

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Adult small bowel obstruction due to congenital peritoneal belt: A case report.

Int J Surg Case Rep 2021 May 26;84:106016. Epub 2021 May 26.

Department of General Surgery at Habib, Thameur Hospital, Tunisia.

Introduction: Peritoneal bands on the virgin abdomen are an extremely rare etiology of occlusive syndrome. Congenital bridles can be in 0.7 to 2% a cause of small bowel obstruction. Read More

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Brain-based sex differences in autism spectrum disorder across the lifespan: A systematic review of structural MRI, fMRI, and DTI findings.

Neuroimage Clin 2021 Jun 9;31:102719. Epub 2021 Jun 9.

College of Health Solutions, Arizona State University, 975 S. Myrtle Ave, Tempe, AZ 85281, USA. Electronic address:

Females with autism spectrum disorder (ASD) have been long overlooked in neuroscience research, but emerging evidence suggests they show distinct phenotypic trajectories and age-related brain differences. Sex-related biological factors (e.g. Read More

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Amyloid-PET imaging offers small improvements in predictions of future cognitive trajectories.

Neuroimage Clin 2021 Jun 8;31:102713. Epub 2021 Jun 8.

Department of Epidemiology and Biostatistics, University of California San Francisco, United States. Electronic address:

Background: Amyloid β (Aβ) is thought to initiate a cascade of pathology culminating in Alzheimer's disease-related cognitive decline. Aβ accumulation in brain tissues may begin one to two decades prior to clinical diagnosis of Alzheimer's disease. Prior studies have demonstrated that Aβ detected in vivo with positron emission tomography with amyloid ligands (amyloid-PET) predicts contemporaneously measured cognition and future cognitive trajectories. Read More

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Differential trajectories of hypometabolism across cognitively-defined Alzheimer's disease subgroups.

Neuroimage Clin 2021 Jun 12;31:102725. Epub 2021 Jun 12.

Department of Medicine, University of Washington, Seattle, WA, USA.

Disentangling biologically distinct subgroups of Alzheimer's disease (AD) may facilitate a deeper understanding of the neurobiology underlying clinical heterogeneity. We employed longitudinal [F]FDG-PET standardized uptake value ratios (SUVRs) to map hypometabolism across cognitively-defined AD subgroups. Participants were 384 amyloid-positive individuals with an AD dementia diagnosis from ADNI who had a total of 1028 FDG-scans (mean time between first and last scan: 1. Read More

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