Pleural complications in patients with renal cell carcinoma undergoing percutaneous cryoablation: A retrospective analysis of its incidence and risk factors.

Rationale: Observations from our clinical practice indicate a notable occurrence of pleural complications post-percutaneous renal cryoablation (PRC).

Objective: To identify the incidence of pleural complications following PRC and potential risk factors associated with post-procedural pleural complications.

Materials And Methods: This was a retrospective cohort analysis of patients undergoing PRC at two tertiary hospital systems between 2016 and 2022.

A 36-Year-Old Male With Left-Sided Neck Pain and Progressive Dyspnea.

A 36-year-old male with no significant medical history presented to the ED with progressive left-sided neck and facial pain for the last 7 days. The patient also reported subjective fevers, chills, difficulty opening his mouth, and anorexia for the last 1 week. He denied cough, chest pain or tightness, shortness of breath, skin rashes, dysphagia, or odynophagia.

A 24-year-Old woman with recurrent pneumothoraces.

Lymphangioleiomyomatosis (LAM) is an abnormal proliferation of smooth muscle-like cells and may occur sporadically or in association with tuberous sclerosis complex. Patients are typically female, nonsmoking and may have cystic lung disease with pneumothorax. Diagnosis can be made by compatible imaging findings with a history of tuberous sclerosis complex, or in conjunction with vascular endothelial growth factor-D 800 pg/ml or greater, a highly specific finding.

Transcranial Magnetic Stimulation in Primary Care: Indications, Risks, and Outcomes.

The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.

Is 1 Day of Focused Training in Echocardiographic Assessment Using Subxiphoid-Only (EASy) Examination Enough? A Tertiary Hospital Response to the COVID-19 Crisis and the Use of the EASy Examination to Support Unit-Wide Image Acquisition.

Objectives: We assessed the efficacy of 1-day training in echocardiography assessment using subxiphoid-only (EASy) followed by supervised image interpretation and decision-making during patient rounds as a novel approach to scaling up the use of point-of-care ultrasound (POCUS) in critically ill patients.

Design: Retrospective analysis of medical records and EASy examination images.

Setting: Tertiary care academic hospital.

Sarcoidosis associated pleural effusion: A case series and review.

Sarcoidosis is a multisystem disease most commonly affecting the lungs but also can rarely manifest as pleural effusions. Sarcoidosis associated pleural effusion occurs in around 1% of patients with sarcoidosis. Pleural fluid is typically exudative, lymphocyte predominant, with high pleural protein levels and normal or mildly elevated lactate dehydrogenase.

A rare case of infected urinothorax.

Urinothorax is a rare cause of pleural effusion. Infected urinothorax is even rarer. Here we present a case of infected urinothorax from renal mass causing obstructive uropathy.

Impact of deep transcranial magnetic stimulation on insomnia outcomes in patients with treatment-resistant depression: a retrospective study.

Unlabelled: Deep transcranial magnetic stimulation (dTMS) is an Food and Drug Administration-approved treatment for treatment-resistant depression (TRD). Our study aims to examine the impact of baseline insomnia severity on mood outcomes of dTMS and the impact of dTMS on comorbid insomnia in patients with treatment-resistant depression using a retrospective analysis. Twenty-five patients with treatment-resistant depression who underwent dTMS were divided into two groups: "low insomnia" and "high insomnia," depending on Insomnia Severity Index scores at baseline.

Kratom use and mental health: A systematic literature review and case example.

Objective: This review aims to synthesize and critically evaluate the existing literature on kratom use and its possible association with induction of psychotic and manic symptoms, in order to identify potential areas for future research that would improve our understanding of the risks of kratom consumption.

Methods: An electronic search was performed using five major databases: including PubMed, Scopus, Google Scholar, Web of Science, and PsycINFO. keywords such as kratom, Mitragyna speciosa, mania, psychosis, bipolar disorder, schizophrenia, schizoaffective, case report, and case series.

A 74-Year-Old Man With Dyspnea.

A 74-year-old man presented to the ED with progressive dyspnea, orthopnea, and bilateral leg swelling for 2 months. He denied cough, hemoptysis, fever, night sweats, or weight loss. He had history of COPD and chronic atrial fibrillation.

Ultrasound-guided pleural biopsy following a non-diagnostic thoracentesis for non-small cell lung cancer.

We report a case of a 65-year-old man with a cavitary lung mass and parietal-based pleural nodules in which a pleural ultrasound-guided approach yielded a definitive diagnosis of stage IV non-small cell lung carcinoma. Computed tomography-guided biopsy is often preferred approach for the majority of United States hospitals for sampling pleural nodules as compared to US. The advantages of an US-guided approach include [1]: increased portability [2]; decreased procedure time [3]; reduced reliance on dedicated ancillary support staff [4]; need for local anesthesia only [5]; lack of ionizing radiation exposure; and [6] cost reduction.

Evaluation, Treatment, and Referral of Treatment-Resistant Depression in Primary Care.

The Psychiatric Consultation Service at Massachusetts General Hospital sees medical and surgical inpatients with comorbid psychiatric symptoms and conditions. During their twice-weekly rounds, Dr Stern and other members of the Consultation Service discuss diagnosis and management of hospitalized patients with complex medical or surgical problems who also demonstrate psychiatric symptoms or conditions. These discussions have given rise to rounds reports that will prove useful for clinicians practicing at the interface of medicine and psychiatry.

The Role of Surgery in Stage I Small Cell Lung Cancer: A National VA Database Analysis.

Background: Historically, limited stage Small Cell Lung Cancer (SCLC) has been treated with concurrent chemoradiation (CRT). While current NCCN guidelines recommend consideration of lobectomy in node-negative cT1-T2 SCLC, data regarding the role of surgery in very limited SCLC is lacking.

Methods: Data from the National VA Cancer Cube were compiled.

Pressure-Dependent Pneumothorax and Air Leak: Physiology and Clinical Implications.

Pressure-dependent pneumothorax is a common clinical event, often occurring after pleural drainage in patients with visceral pleural restriction, partial lung resection, or lobar atelectasis from bronchoscopic lung volume reduction or an endobronchial obstruction. This type of pneumothorax and air leak is clinically inconsequential. Failure to appreciate the benign nature of such air leaks may result in unnecessary pleural procedures or prolonged hospital stay.

A 61-Year-Old Man With Shortness of Breath and Eye Swelling.

A 61-year-old man presented to the pulmonary clinic with symptoms of dyspnea and productive cough for the last 6 months. Within the last 2 months, he started noticing bulging of his eyes associated with blurry vision. He denied hemoptysis, fever, night sweats, weight loss, skin rash, and dry eyes or mouth.

A Case of Neuroleptic Malignant Syndrome Presenting as Anxiety.

Neuroleptic malignant syndrome (NMS) is a rare but potentially lethal complication of dopamine antagonist use. A 34-year-old male presented to the emergency department with a chief complaint of feeling anxious for the past several days. He presented with his family who helped provide history as he had become less communicative over the preceding two days.

A 21-Year-Old Hispanic Woman Presenting With Cutaneous and Pulmonary Nodules.

A 21-year-old Hispanic woman with no significant medical history presented with complaints of progressive skin lesions for 3 months, associated with dyspnea and scant hemoptysis for 1 week. She initially developed painless subcutaneous nodules on her right forearm, which progressed to superficial ulcers and gradually spread to involve bilateral arms, thighs, chest, abdomen, and gluteal region. The lesions spared the head, neck, palms, and soles.

Why do two procedures when one will do? Thoracic ultrasound guiding management of complex pleural space infections.

Complicated parapneumonic effusions and empyemas are associated with significant morbidity and mortality. When managing a potentially infected pleural space, current guidelines support performing diagnostic thoracentesis prior to consideration of chest tube insertion. We present a case demonstrating our clinical approach to the management of complicated parapneumonic effusions and empyemas, with patient presentation and initial point-of-care thoracic ultrasound assessment guiding consideration of immediate insertion of small-bore (14 F) chest tube.

Delayed presentation of fat embolism syndrome following elective total hip arthroplasty.

Fat embolism syndrome (FES) is a rare complication of long bone fractures with an incidence of 0.3%-1.3%.