Gastrointestinal Subepithelial Lesions: Evolution in Management and Endoscopic Resection Techniques.

Purpose Of Review: Subepithelial lesions (SELs) are tumors originating from the gastrointestinal (GI) tract wall (muscularis mucosa, submucosa, or muscularis propria) and are covered by overlying mucosa. They are typically incidental findings during routine endoscopy. This article reviews the latest advancements in endoscopic techniques and devices used to resect subepithelial lesions.

Bouveret Syndrome: A Rare Cause of Gastric Outlet Obstruction and Treatment Options.

Bouveret syndrome is an uncommon condition that leads to gastric outlet obstruction. Diagnosis and treatment may get delayed due to non-specific presentation and rarity of the condition, which is associated with high morbidity and mortality. We present a case of a 62-year-old female who presented with epigastric pain and nausea and was diagnosed with Bouveret syndrome.

Congenital Diaphragmatic Hernia With Poor Clinical Outcome: Key Lessons To Be Learned.

Congenital diaphragmatic hernia (CDH) refers to the abnormal protrusion of abdominal contents (stomach, intestine) into the thoracic cavity, leading to the underdevelopment of the lungs (pulmonary hypoplasia). It is a critical neonatal condition that presents significant challenges in both diagnosis and management, especially in resource-limited countries. This case report describes a term female baby born via normal vaginal delivery to a mother with no prenatal care.

A Tale of 102,726 Messages: Characterizing the Modern Urologist's Portal Message Burden After Common Urologic Surgeries.

Introduction: We aimed to characterize patient portal messaging use after urologic surgery to identify administrative burden and evaluate postoperative clinical associations.

Methods: Epic was queried for all urologic surgeries performed at the Mayo Clinic enterprise between 2019 and 2022. Data from the highest volume procedures were extracted including patient-generated portal messages to their provider and emergency department (ED) visits within 6 months of surgery.

Screening and Surveillance of Colorectal Cancer: A Review of the Literature.

Colorectal cancer (CRC) has the highest mortality rate among men and is the second highest among women under fifty, with incidence and mortality rates rising in younger populations. Studies indicate that up to one-third of patients diagnosed before fifty have a family history or genetic factors, highlighting the need for earlier screening. Contrariwise, diagnosis in healthy subjects through screening strategies enables early-stage detection of the tumor and better clinical outcomes.

Phytocompounds targeting epigenetic modulations: an assessment in cancer.

For centuries, plants have been serving as sources of potential therapeutic agents. In recent years, there has been a growing interest in investigating the effects of plant-derived compounds on epigenetic processes, a novel and captivating Frontier in the field of epigenetics research. Epigenetic changes encompass modifications to DNA, histones, and microRNAs that can influence gene expression.

Program Directors' Perspectives on Residency Applications in the Post‒United States Medical Licensing Examination Step 1 Era: A Case for Standardized Letters of Recommendation?

Introduction: The United States Medical Licensing Examination (USMLE) Step 1 test evolved into a key metric utilized by program directors (PDs) in assessing candidates for residency. The transition to a USMLE Step 1 binary pass/fail scoring system has resulted in a loss of an important objective assessment. With national movements toward pass/fail systems for clerkship grading and trends toward abandonment of class ranking, assessing residency applications has become increasingly challenging.

Ayurveda and Yoga management of chronic alcoholism sequelae - A case report.

Alcohol has always been a component in the dietary pattern of human civilization. It is widely used in society for celebration and socialization. Alcohol abuse is among the most serious problems in public health characterized by uncontrolled drinking which causes physical and emotional dependence on alcohol.

From acute abdomen to hormonal crisis: Case report on a long-delayed Sheehan's syndrome diagnosis.

Introduction: Sheehan's syndrome (SS) is a rare cause of hypopituitarism resulting from postpartum haemorrhage and pituitary necrosis. It remains an underdiagnosed condition, especially in developing countries due to poor obstetric care and home deliveries. This case report highlights the significance of recognizing atypical presentations of SS, such as pancytopenia, to aid in early diagnosis and management.

Excision of recurrent penile schwannoma with neurovascular bundle sparing: A novel surgical approach.

Penile schwannomas are rare, often painless lesions usually growing on the dorsum of the penis. A young and otherwise healthy male with recurrent painful penile schwannomas and decreased libido was successfully treated with surgical excision. Through fine dissection of the nerve fascicles leading to the primary schwannoma, the lesion was successfully removed without compromising erectile or ejaculatory function.

Implementing traditional ayurveda treatment as a primary care management in a survivor of gas geyser syndrome - A case report.

Domestically, gas geysers are used in developing countries like India to supply hot water in bathrooms. These are of low economic value, with no requirement of electricity and easy installation, hence they are high in demand. A female patient of 14 year visited to a private Ayurved clinic on 27/12/2021 with complaints of difficulty in dysgraphia, dyslexia, dysphonia and fall (sometimes) while walking on uneven and unknown pathway.

Identification of preferred reminder systems and patient factors to promote adherence in the management of urinary incontinence.

Objective: To investigate comfort level and preferences of automated reminder systems (mail, email, text message, phone call, patient-portal message, and/or smartphone application) to promote adherence to recommended therapies for patients seeking care for urinary incontinence (UI) at our urology clinic in Phoenix, Arizona.

Methods: Anonymous surveys were distributed in English to adult patients with UI from 4/2019-5/2019. Patient demographics, UI type, and access to and use of the Internet, smartphone and patient-portal were assessed.

Parental Leave Policies in the Top 20 US Hospitals: A Call for Inclusivity and Improvement.

Objective: To evaluate and compare parental leave policies from the top United States (US) hospitals with a focus on inclusivity of all types of parents.

Methods: In September and October of 2021, the parental leave policies of the top 20 US hospitals, ranked by the 2021 US News & World report, were evaluated. Parental leave policies were obtained and reviewed through the hospitals' public websites.

Synthesis and applications of MXene-based composites: a review.

Recently, there has been considerable interest in a new family of transition metal carbides, carbonitrides, and nitrides referred to as MXenes (TiCT) due to the variety of their elemental compositions and surface terminations that exhibit many fascinating physical and chemical properties. As a result of their easy formability, MXenes may be combined with other materials, such as polymers, oxides, and carbon nanotubes, which can be used to tune their properties for various applications. As is widely known, MXenes and MXene-based composites have gained considerable prominence as electrode materials in the energy storage field.

Health related quality of life in post-acute coronary patient.

The study aimed to assess the effects of lifestyle-modification counselling on behavioural outcomes among patients after myocardial infarction. This was a quasi-experimental study, conducted at the Armed Forces Institute of Cardiology (AFIC), Rawalpindi, from December 2018 to February 2019, on 50 post-myocardial infarction (post-MI) patients. Knowledge, attitude, and practice regarding lifestyle was assessed using a self-designed, pre-tested, validated questionnaire.

Transition of amyloid/mutant p53 from tumor suppressor to an oncogene and therapeutic approaches to ameliorate metastasis and cancer stemness.

The tumor suppressor p53 when undergoes amyloid formation confers several gain-of-function (GOF) activities that affect molecular pathways crucial for tumorigenesis and progression like some of the p53 mutants. Even after successful cancer treatment, metastasis and recurrence can result in poor survival rates. The major cause of recurrence is mainly the remnant cancer cells with stem cell-like properties, which are resistant to any chemotherapy treatment.

Financial Toxicity for Female Patients with Urinary Incontinence.

Purpose Of Review: Urinary incontinence (UI) is a common global condition that has been noted to disproportionately affect women. In this review, the authors present discussion of factors contributing to cost of care and various modalities of cost-effective care for UI for female patients.

Recent Findings: We found insurance and out-of-pocket (OOP) costs strongly impact of costs for patients.

Establishment of Transcriptional Gene Silencing Targeting the Promoter Regions of GFP, PDS, and PSY Genes in Cotton using Virus-Induced Gene Silencing.

Virus-induced gene silencing (VIGS) by deploying viral-based vectors such as tobacco rattle virus (TRV) is a homology-based gene silencing technique in post-transcriptional gene silencing (PTGS) and transcriptional gene silencing (TGS) to validate the function of particular genes. The study presented here showed the induction of DNA methylation in the promoter regions of three phenotypic marker genes in different cotton accessions, including two endogenous genes such as phytoene desaturase (PDS) and phytoene synthase (PSY), and an exogenous gene, such as green fluorescent protein (GFP). First, DNA methylation was established in transgenic GFP cotton where methylation persisted up to S generation.

The role of in-person focus groups in the management of urinary incontinence in women from a mixed-methods, randomized pilot study.

Purpose: To assess the quantitative and qualitative components of in-person focus groups as a potential intervention for female patients with urinary incontinence.

Methods: Women over the age of 18 seeking treatment for UI were randomized to standard care with focus group participation or to standard care alone. All participants completed validated questionnaires: MESA, UDI-6, OAB-SAT-q, PGI-S, PGI-I, SQoL-F, PHQ-9, IPAQ at the beginning and conclusion of the study.

Characterization of urethral diverticula in males.

Introduction: Urethral diverticulum in a male is a rare entity and the literature is limited to case reports and small case series. The aim of our study is to characterize this disease in patients from three Mayo Clinic locations.

Materials And Methods: Chart analysis was performed of patients across all three Mayo Clinic sites that had International Classification of Diseases (ICD) codes corresponding to urethral diverticulum or urethral diverticulectomy via CPT code.

Characterization of Urethral Diverticula in Women.

Objective: Urethral diverticulum is a rare, yet important condition for the female pelvic surgeon. We aimed to characterize the women who have been seen for this condition across the three Mayo Clinic locations.

Methods: Medical record review was performed for patients across all three Mayo Clinic sites (Rochester, Arizona, Florida) that had International Classification of Diseases, Ninth Revision, (ICD-9) and International Classification of Diseases, Tenth Revision, (ICD-10) codes corresponding to urethral diverticulum (ICD-9, 599.

Zinc-induced hypocupremia and pancytopenia, from zinc supplementation to its toxicity, a case report.

According to one estimate, zinc supplementation is widely used in the USA by almost 37% of the elderly population above age 71. Zinc has perceived benefits of immune system enhancement without realizing the harmful effects when used in excess. One of its under-recognized side effects is hypocupremia or copper deficiency due to excessive gastrointestinal losses as excessive zinc in the gut competes with copper for absorption.