Outcomes of laparoscopic-assisted ERCP in gastric bypass patients at a community hospital center.

Background: Obesity is a prevalent issue in today's society, increasing the number of gastric weight loss surgeries (Bowman et al. in Surg Endosc. https://doi.

Cranial Nerve Palsies: A Rare, Long-Term Complication of Radiotherapy for Nasopharyngeal Carcinoma.

Unlabelled: Cranial nerves (CN) are believed to be relatively resistant to radiotherapy (RT); however, there have been case reports of cranial nerve palsy (CNP) following RT. We present a case of a gentleman with cranial nerve palsy of CN V and VII after RT for nasopharyngeal carcinoma (NPC).

Case Presentation: A 54-year-old male presented to our clinic with masticatory difficulty, facial hypoesthesia, and dysphagia.

Using topical imiquimod for the management of positive in situ margins after melanoma resection.

The treatment of melanoma in situ (MIS) is controversial with current standard of care being surgical excision with clear margins. Alternative topical therapy with imiquimod has been proposed in recent studies as a possible treatment for MIS. This study aimed to evaluate the use of topical 5% imiquimod as an alternative approach for the treatment of residual melanoma in situ after surgical resection of the primary lesion.

Iatrogenic May-Thurner syndrome after EVAR.

May-Thurner syndrome (MTS) is caused by compression of the left iliac vein between the right common iliac artery and the body of the fifth lumbar vertebra, resulting in hemodynamic compromise to venous return and intimal hyperplasia of the vein from chronic pulsatile compression. We report a case of MTS resulting from placement of an aortic stent graft for aneurysm repair. A higher index of suspicion and a more comprehensive initial venous duplex investigation, which should include the suprainguinal veins, should be considered in those patients with new onset of unilateral limb swelling after endovascular aneurysm repair (EVAR).

Broken heart syndrome, neurogenic stunned myocardium and stroke.

The diagnosis of stress cardiomyopathy is often made during coronary angiography. At this point hemodynamic parameters should be assessed; a right heart catheterization with measurement of cardiac output by Fick and thermodilution methods is helpful. Patients with acute neurologic pathology who develop left ventricular dysfunction (neurogenic stunned myocardium) may not be candidates for coronary angiography and in such cases real-time myocardial contrast echocardiography or nuclear perfusion scan can be used to exclude obstructive coronary disease.

Takotsubo cardiomyopathy followed by neurogenic stunned myocardium in the same patient: gradations of the same disease?

Takotsubo cardiomyopathy is a phenomenon of transient acute left ventricular dysfunction without obstructive coronary disease seen predominantly in postmenopausal women in the setting of acute emotional or physical stress. Neurocardiogenic injury from acute neurologic events such as intracranial bleeding can precipitate transient left ventricular dysfunction (termed 'neurogenic stunned myocardium') that may be indistinguishable from takotsubo cardiomyopathy. There is controversy about the diagnosis of takotsubo cardiomyopathy in the setting of acute neurologic disorders.