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Metastatic Mixed Adeno-Neuroendocrine Carcinoma of the Colon to the Liver with Multiple Peritoneal Deposits: A Case Report.

Am J Case Rep 2021 Apr 15;22:e929099. Epub 2021 Apr 15.

Department of General Surgery, Colorectal Surgery Section, King Fahad Specialist Hospital, Dammam, Saudi Arabia.

BACKGROUND Metastatic mixed adeno-neuroendocrine carcinoma (MANEC) is a rare malignancy. It is characterized by the presence of both neuroendocrine and epithelial components, each of which constitute at least 30% of the lesion to establish the diagnosis. CASE REPORT A 48-year-old man presented with a 1-month history of right upper-quadrant pain and unintentional weight loss of 18 kg. Read More

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Hybrid Polyoxometalate Salt Adhesion by Butyltin Functionalization.

ACS Appl Mater Interfaces 2021 Apr 15. Epub 2021 Apr 15.

Department of Chemistry, Oregon State University, Corvallis, Oregon 97331, United States.

Polyoxometalate (POM)-based ionic liquids, with nearly infinite compositional variations to fine-tune antimicrobial and physical properties, function as water purification filters, anticorrosion/antibacterial coatings for natural stones, self-repairing acid-resistant coatings, catalysts, and electroactive, stable solvents. By combining hydrophobic quaternary ammonium cations (QACs; tetraheptylammonium and trihexyltetradecylammonium) with butyltin-substituted polyoxotungstates [(BuSn)(α-SiWO)] via repeated solvent extraction-ion exchange, we obtained phase-pure hybrid POM salts (referred to as such because they melt above room temperature). If the solvent extraction process is performed only once, then solids with high salt contamination and considerably lower melting temperatures are obtained. Read More

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Men's Health: Scrotal and Testicular Conditions.

FP Essent 2021 Apr;503:23-27

University of Michigan Medical School Department of Family Medicine, 300 North Ingalls St NI4C06, Ann Arbor, Michigan 48109-5435.

Scrotal and testicular conditions include benign masses, infections, testicular torsion, and testicular cancer. Common palpable benign scrotal masses include spermatocele, varicocele, and hydrocele. Most patients with these masses require no treatment. Read More

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The Relationship of Vitamin D Deficiency with Severity and Outcome of Acute Stroke.

Rom J Intern Med 2021 Apr 13. Epub 2021 Apr 13.

M.D., General Physician, Tonekabon Branch, Islamic Azad University, Tonekabon, Iran.

: There are currently conflicting results regarding the link between vitamin D deficiency and increased risk for stroke and its poor prognosis. The present study aimed to assess the relationship between vitamin D deficiency and prognosis of acute stroke.: This bi-center cross-sectional study was performed on 140 consecutive patients who referred to two general hospitals in Iran with the diagnosis of acute stroke. Read More

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EUS-guided Anastomosis Complication in a Patient with Roux-en-Y Gastric Bypass: Dehiscence of the Surgical Anastomosis During Endoscopic Mucosal Resection Across EUS-guided Jejunum-gastric Anastomosis with Lumen Apposing Metal Stent.

Obes Surg 2021 Apr 14. Epub 2021 Apr 14.

Service de Chirurgie Digestive, Hôpital Avicenne, APHP, Bobigny, France.

Introduction: Roux-en-Y gastric bypass (RYGB) is one of the most common surgical procedures for the management of morbid obesity. However, RYGB poses technical difficulties in exploring the gastric remnant and in performing endoscopic biliary interventions due to altered anatomy. Recently, EUS guided gastro-gastric anastomosis to access the excluded stomach has been introduced in order to allow direct trans-gastric interventions. Read More

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Does the development and implementation of a procedure-specific proforma for skin lesion surgery improve quality of operation notes?

JPRAS Open 2021 Jun 15;28:103-109. Epub 2021 Mar 15.

St George's University Hospitals NHS Foundation Trust, Blackshaw Road, Tooting, London SW17 0QT, UK.

Background: Operation notes often have omissions and are difficult to locate in patients notes despite clear guidance from the Royal College of Surgeons (RCS) 'Good Surgical Practice' 2014 outlining what should be included in operation notes. Procedure-specific proformas are rarely used by Plastic surgeons despite being utilised by other specialities. With an alarming rise of incidence of skin malignancies there has been an increase in the number of skin lesions referred to Plastic surgeons for excision. Read More

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Giant splenic cyst with expectant management in pregnancy: A case report and review of the literature.

Case Rep Womens Health 2021 Apr 9;30:e00305. Epub 2021 Mar 9.

Department of Surgical Sciences, Città della Salute e della Scienza, Sant'Anna Hospital, Turin, Italy.

A 22-year-old primigravida was diagnosed with an 18-cm splenic cyst during routine third-trimester routine ultrasound examination. She was referred to a tertiary obstetric hospital and after multidisciplinary consultation, expectant management was decided on. Induction of labour was performed at term and she delivered vaginally with vacuum extractor application without complications. Read More

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Cerebral Aneurysms with Internal Carotid Artery Agenesis: A Unique Case Similar to Moyamoya Disease and Literature Review.

Neurol Med Chir (Tokyo) 2021 Apr 15. Epub 2021 Apr 15.

Department of Neurosurgery, Kashiwaba Neurosurgical Hospital.

Internal carotid artery (ICA) agenesis/aplasia is occasionally accompanied with cerebral aneurysms caused by hemodynamic stress. If the aneurysms are located around the circle of Willis, they are managed with clipping or coil embolization. Herein, we report a case of ICA agenesis with perforating artery aneurysms treated successfully with revascularization. Read More

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Handheld transabdominal ultrasound, after limited training, may confirm first trimester viable intrauterine pregnancy: a prospective cohort study.

Scand J Prim Health Care 2021 Apr 14:1-8. Epub 2021 Apr 14.

Department of Clinical Science, University of Bergen, Bergen, Norway.

Objectives: Handheld point-of-care abdominal ultrasound (POCUS) may be used by primary care physicians while vaginal ultrasound is limited to use in specialist care. We aimed to compare abdominal handheld ultrasound to vaginal ultrasound in determining first trimester viable intrauterine pregnancy and estimate gestational length.

Design: Prospective cohort study. Read More

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Outcome of Surgical Interventions and Deliveries in Patients with Bleeding of Unknown Cause: An Observational Study.

Thromb Haemost 2021 Apr 14. Epub 2021 Apr 14.

Department of Haematology, Erasmus University Medical Centre, Rotterdam, The Netherlands.

Background:  The most optimal management for patients with bleeding of unknown cause (BUC) is unknown, as limited data are available.

Objective:  Evaluate management and outcome of surgical procedures and deliveries in patients with BUC.

Materials And Methods:  All patients ≥12 years of age, referred to a tertiary center for a bleeding tendency, were included. Read More

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Comparative analysis of glucose and carcinoembryonic antigen in diagnosis of pancreatic mucinous cysts: a systematic review and meta-analysis.

Gastrointest Endosc 2021 Apr 11. Epub 2021 Apr 11.

GRUBI-Grupo de Revisões Sistemáticas, Universidade da Beira Interior, Covilhã, Portugal; Centro de Matemática e Aplicações (CMA-UBI), Universidade da Beira Interior, Covilhã, Portugal.

Background And Aims: Pancreatic cystic fluid (PCF) analysis is useful to distinguish between different cyst types and guide management. The aim of our study was to compare the diagnostic accuracy of glucose level with carcinoembryonic antigen (CEA) in PCF for mucinous cyst diagnosis.

Methods: We identified studies with PCF obtained by endoscopic ultrasound (EUS) before surgery, with cysts classified as mucinous and nonmucinous according to surgical specimens. Read More

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The IMPACT trial: human papillomavirus, cervical cytology and histopathological results from the baseline and 1-year follow-up phase.

Am J Obstet Gynecol 2021 Apr 11. Epub 2021 Apr 11.

Ventana Medical Systems Inc./Roche Tissue Diagnostics, Tucson, AZ.

Background: An increase in human papillomavirus (HPV) test volumes is expected in the near future as HPV-based screening protocols are expected to become more broadly adopted.

Objective: The IMproving Primary screening And Colposcopy Triage (IMPACT) trial, a prospective, multicenter US cervical cancer screening trial, was conducted to obtain FDA approvals for the new high-throughput cobas HPV for use on the cobas 6800/8800 Systems (cobas HPV) for detecting cervical precancer and cancer (cervical intraepithelial neoplasia of grade 2 or worse [≥CIN2] and grade 3 or worse, [≥CIN3]). Here the baseline demographics, HPV, cervical cytology and histolpathologic results are presented. Read More

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Preoperative computed tomography-guided localization of lung nodules with needle placement: a series of cases.

Rev Col Bras Cir 2021 9;48:e20202890. Epub 2021 Apr 9.

- Hospital Nossa Senhora das Graças, Serviço de Cirurgia Torácica - Curitiba - PR - Brasil.

Objective: to report the preoperative localization of pulmonary nodules with the placement of a guidewire oriented by Computed Tomography.

Methods: the nodules were marked using a needle in the shape of a hook or another in the shape of a Q, guided by tomography. The choice of the location for the marking was the shortest distance from the chest wall to the nodule. Read More

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The Impact of Implementing 24/7 Cardiac CTA Interpretation in the Emergency Department on Patient Care: Retrospective Analysis of a Single-Center Experience.

AJR Am J Roentgenol 2021 Apr 14:1-7. Epub 2021 Apr 14.

Department of Radiology, Vancouver General Hospital, University of British Columbia, 899 W 12th Ave, Vancouver, BC, V5Z 1M9, Canada.

The objective of our study was to provide insight on the diagnostic validity of cardiac CTA (CCTA) to identify obstructive coronary artery disease (CAD) and patients who require urgent intervention, compared with those who require same-admission coronary catheterization (CC), and to help elucidate the necessity of a 24/7 CCTA service. We retrospectively reviewed 658 consecutive CCTA examinations performed of emergency department (ED) patients who presented with acute chest pain from October 1, 2013, to February 28, 2018. Patients were categorized by CAD severity on CCTA. Read More

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Large solitary scalp metastasis of renal cell carcinoma: A case report.

Niger J Clin Pract 2021 Apr;24(4):629-631

Department of Medical Oncology, Acibadem Mehmet Ali Aydinlar University School of Medicine, Istanbul, Turkey.

Renal cell carcinoma (RCC) can metastasize to various organs of the body. The skin is an uncommon site for metastasis. However, if metastasis to skin occurs, scalp is a common area. Read More

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Management of scaphoid fractures with CT scanning and virtual fracture clinic pathway reduces need for face-to-face clinic appointments.

Ann R Coll Surg Engl 2021 Apr 14. Epub 2021 Apr 14.

Maidstone and Tunbridge Wells NHS Trust, UK.

Introduction: Early diagnosis is key to managing scaphoid fractures effectively. Computed tomography (CT) imaging can be effective if plain radiographs are negative. With increasing pressure on face-to-face clinics, consultant-led virtual fracture clinics (VFCs) are becoming increasingly popular. Read More

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Transient Aberrancy during AV Nodal Reentrant Tachycardia: What is the Mechanism?

J Cardiovasc Electrophysiol 2021 Apr 13. Epub 2021 Apr 13.

Arrhythmia & Electrophysiology Center, IRCCS - MultiMedica Group, Via Milanese 300, 20099 Sesto San Giovanni, Milan, Italy.

A 38-year-old male was referred to our center for recurrent paroxysmal supraventricular tachycardia. Basal 12-lead ECG and echocardiogram did not reveal abnormalities. Electrophysiological study was performed, and multipolar diagnostic catheters were introduced via the femoral veins and positioned at the His bundle region and within the coronary sinus (CS). Read More

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Our newborn hearing screening results.

Suleyman Erdogdu

North Clin Istanb 2021 12;8(2):167-171. Epub 2021 Mar 12.

Department of Otorhinolaryngology, University of Health Sciences, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey.

Objective: The aim of the study was to evaluate the results of neonatal hearing screening in our hospital with the help of literature and to question and reveal the risk factors to gain healthy individuals and to raise awareness for all health workers and the public who are interested in this subject.

Methods: A total of 16,388 newborn infants were evaluated between October 2009 and January 2018. All newborns were screened with transient evoked otoacoustic emissions (TEOAEs) test. Read More

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The effect of pregabalin on postdural puncture headache among patients undergoing elective cesarean section: A randomized controlled trial.

Ann Med Surg (Lond) 2021 Apr 17;64:102226. Epub 2021 Mar 17.

Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran.

Introduction: Post-dural puncture headache (PDPH) is one of the most common problems of cesarean section. The present study aimed to evaluate the effect of pregabalin on PDPH among patients undergoing elective cesarean section.

Materials And Methods: This double-blind clinical trial was performed on 136 patients undergoing elective cesarean section referred to Shahid Motahari Teaching Hospital in Urmia in northwestern Iran from February 1 to December 20, 2020. Read More

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Iatrogenic common peroneal nerve injury during harvesting of semitendinosus tendon for anterior cruciate ligament reconstruction.

BMJ Case Rep 2021 Apr 13;14(4). Epub 2021 Apr 13.

Orthopedisch Centrum Oost Nederland, Hengelo, The Netherlands.

We present a case of iatrogenic injury to the common peroneal nerve (CPN) occurring due to harvesting of a hamstring graft, using a posterior mini-incision technique. A twitch of the foot was noted on retraction of the tendon stripper. After clinically diagnosing a CPN palsy proximal to the knee, the patient was referred to a neurosurgeon within 24 hours. Read More

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Outcomes of large panel genetic evaluation of breast cancer patients in a community-based cancer institute.

Am J Surg 2021 Apr 1. Epub 2021 Apr 1.

Legacy Medical Group (LMG), Department of Surgical Oncology, Portland, OR, 97227, USA. Electronic address:

Introduction: The use of restricted versus expanded panel genetic testing in breast cancer is controversial, with some institutions offering predominantly abbreviated gene panel testing. Our community program has offered larger panel testing for several years. We sought to evaluate the outcomes of large panel genetic testing and understand their impact on patient care. Read More

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Automated detection and segmentation of thoracic lymph nodes from CT using 3D foveal fully convolutional neural networks.

BMC Med Imaging 2021 Apr 13;21(1):69. Epub 2021 Apr 13.

Institute of Diagnostic and Interventional Radiology, Medical Faculty and University Hospital Cologne, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.

Background: In oncology, the correct determination of nodal metastatic disease is essential for patient management, as patient treatment and prognosis are closely linked to the stage of the disease. The aim of the study was to develop a tool for automatic 3D detection and segmentation of lymph nodes (LNs) in computed tomography (CT) scans of the thorax using a fully convolutional neural network based on 3D foveal patches.

Methods: The training dataset was collected from the Computed Tomography Lymph Nodes Collection of the Cancer Imaging Archive, containing 89 contrast-enhanced CT scans of the thorax. Read More

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Evolution of the gross tumour volume extent during radiotherapy for glioblastomas.

Radiother Oncol 2021 Apr 10. Epub 2021 Apr 10.

Department of Clinical Research, University of Southern Denmark, Odense, Denmark; Department of Oncology, Odense University Hospital, Odense, Denmark.

Background And Purpose: Tumour growth during radiotherapy may lead to geographical misses of the target volume. This study investigates the evolution of the tumour extent and evaluates the need for plan adaptation to ensure dose coverage of the target in glioblastoma patients.

Materials And Methods: The prospective study included 29 patients referred for 59. Read More

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The first single-incision plus one-port transverse colon resection using Senhance Digital Laparoscopy System: a case report.

Surg Case Rep 2021 Apr 13;7(1):89. Epub 2021 Apr 13.

Department of Gastroenterological Surgery, Saitama Medical University International Medical Center, 1397-1 Yamane, Hidaka-shi, Saitama, 350-1298, Japan.

Background: We have introduced the Senhance Digital Laparoscopy System and actively use for colorectal cancer surgery. Recently, we also try to perform surgery by reduce port as less invasive method. For the first time, we report a case of single-incision plus one-port transverse colectomy using Senhance system. Read More

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Traumatic physeal fractures in cats: a review of 36 cases (2010-2020).

J Feline Med Surg 2021 Apr 13:1098612X211005886. Epub 2021 Apr 13.

Department of Clinical Science and Services, Queen Mother Hospital for Animals, The Royal Veterinary College, Hatfield, UK.

Objectives: The aim of this study was to describe the demography, aetiology, location and classification of physeal fractures in cats, and to describe their management and outcomes.

Methods: Clinical records and radiographs of cats referred for management of physeal fractures were retrospectively reviewed. Fractures of the proximal femoral physis were excluded. Read More

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Real-World Experience of Bamlanivimab for COVID-19: A Case-Control Study.

Clin Infect Dis 2021 Apr 13. Epub 2021 Apr 13.

Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

Background: COVID-19 has strained healthcare systems with patient hospitalizations and deaths. Anti-spike monoclonal antibodies, including bamlanivimab, have demonstrated reduction in hospitalization rates in clinical trials, yet real-world evidence is lacking.

Methods: We conducted a retrospective case-control study across a single healthcare system of non-hospitalized patients, age 18 years or older, with documented positive SARS-CoV-2 testing, risk factors for severe COVID-19, and referrals for bamlanivimab via emergency use authorization. Read More

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Severe erosive lesion of the glenoid in gouty shoulder arthritis: a case report and review of the literature.

BMC Musculoskelet Disord 2021 Apr 12;22(1):343. Epub 2021 Apr 12.

Department of Orthopedics, Inner Mongolia People's Hospital, No. 20 Zhao Wu Da Street, Inner Mongolia Autonomous Region, 010017, Hohhot, China.

Background: Gout is a metabolic disease characterized by recurrent episodes of acute arthritis. Gout has been reported in many locations but is rarely localized in the shoulder joint. We describe a rare case of gouty arthritis involving bilateral shoulder joints and leading to severe destructive changes in the right shoulder glenoid. Read More

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Digital Cholangioscopy-guided Cold Snare Resection of an Inflammatory Intraductal Pseudopolyp.

Dig Endosc 2021 Apr 12. Epub 2021 Apr 12.

Department of Gastroenterology and Hepatology, University Hospitals Leuven, Belgium.

Digital single-operator cholangioscopy (DSOC) has revolutionized the endoscopic diagnosis and treatment of various hepato-pancreaticobiliary diseases, such as indeterminate biliary strictures and large balloon dilation-refractory common bile duct (CBD) stones, using either a retrograde or antegrade approach. Direct visualization provided by DSOC has furthermore paved the road towards minimally invasive treatment of intraductal neoplasms, although little evidence is available in this specific context. A 70-year-old patient was admitted following several episodes of colicky abdominal discomfort, mixed liver function abnormalities and non-intentional weight loss. Read More

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Pancreaticobiliary maljunction in Turkish patients: a multicenter case series.

Surg Endosc 2021 Apr 12. Epub 2021 Apr 12.

Department of Gastroenterology, Turkiye Yuksek Ihtisas Hospital, Ankara, Turkey.

Background And Aims: Pancreaticobiliary maljunction (PBM) is a malformation in which the pancreatic and bile ducts join outside the duodenal wall. It is associated with various biliary and pancreatic diseases. In addition, patients with PBM carry a substantial lifetime risk of developing biliary or gallbladder carcinoma. Read More

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The Use of Chronic Total Occlusion (CTO) Wires for Perforation of Atretic Pulmonary Valve; Two Centers Experience.

Pediatr Cardiol 2021 Apr 12. Epub 2021 Apr 12.

Department of Pediatric Cardiology, Istanbul Health Scıence University, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Education and Research Hospital, Istasyonmahallesi Turgut Özal Bulvarı Küçükçekmece, 34303, Istanbul, Turkey.

Pulmonary valve atresia with intact ventricular septum (PA-IVS) can be treated either surgically or transcatheterly for eligible patients. Perforation of pulmonary valves using chronic total occlusion (CTO) guidewires has been reported as an alternative to radiofrequency (RF) perforation. We sought to report our experience with CTO guidewires for perforation of atretic pulmonary valves and subsequent balloon dilatation (with or without patent ductus arteriosus stenting) in patients with PA-IVS from two centers. Read More

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