Pulmonary Arterial Tumor Embolism From Recurrent Metastatic Renal Cell Carcinoma on FDG PET/CT.

A 55-year-old man with renal cell carcinoma extending into the renal vein/inferior vena cava (status post nephrectomy and inferior vena cava thrombectomy, pT3bN0M0), and perioperative pulmonary bland thromboembolism (resolved with 3-month of anticoagulation), followed by 3.5 years of complete remission, developed new incidental pulmonary arterial filling defects on a surveillance CT examination (asymptomatic, normal d -dimer, no deep vein thrombosis). Despite anticoagulation, the filling defects not only persisted but also demonstrated intense FDG activity on a restaging PET/CT performed 4 months later for new pulmonary oligometastasis.

ASLPrep: a platform for processing of arterial spin labeled MRI and quantification of regional brain perfusion.

Arterial spin labeled (ASL) magnetic resonance imaging (MRI) is the primary method for noninvasively measuring regional brain perfusion in humans. We introduce ASLPrep, a suite of software pipelines that ensure the reproducible and generalizable processing of ASL MRI data.

Associations between neighborhood socioeconomic status, parental education, and executive system activation in youth.

Socioeconomic status (SES) can impact cognitive performance, including working memory (WM). As executive systems that support WM undergo functional neurodevelopment during adolescence, environmental stressors at both individual and community levels may influence cognitive outcomes. Here, we sought to examine how SES at the neighborhood and family level impacts task-related activation of the executive system during adolescence and determine whether this effect mediates the relationship between SES and WM performance.

FlywheelTools: Data Curation and Manipulation on the Flywheel Platform.

The recent and growing focus on reproducibility in neuroimaging studies has led many major academic centers to use cloud-based imaging databases for storing, analyzing, and sharing complex imaging data. Flywheel is one such database platform that offers easily accessible, large-scale data management, along with a framework for reproducible analyses through containerized pipelines. The Brain Imaging Data Structure (BIDS) is the standard for neuroimaging data, but curating neuroimaging data into BIDS can be a challenging and time-consuming task.

Biliary Tract Carcinogenesis Model Based on Bile Metaproteomics.

To analyze human and bacteria proteomic profiles in bile, exposed to a tumor vs. non-tumor microenvironment, in order to identify differences between these conditions, which may contribute to a better understanding of pancreatic carcinogenesis. Using liquid chromatography and mass spectrometry, human and bacterial proteomic profiles of a total of 20 bile samples (7 from gallstone (GS) patients, and 13 from pancreatic head ductal adenocarcinoma (PDAC) patients) that were collected during surgery and taken directly from the gallbladder, were compared.

Leveraging multi-shell diffusion for studies of brain development in youth and young adulthood.

Diffusion weighted imaging (DWI) has advanced our understanding of brain microstructure evolution over development. Recently, the use of multi-shell diffusion imaging sequences has coincided with advances in modeling the diffusion signal, such as Neurite Orientation Dispersion and Density Imaging (NODDI) and Laplacian-regularized Mean Apparent Propagator MRI (MAPL). However, the relative utility of recently-developed diffusion models for understanding brain maturation remains sparsely investigated.

Accelerated cortical thinning within structural brain networks is associated with irritability in youth.

Irritability is an important dimension of psychopathology that spans multiple clinical diagnostic categories, yet its relationship to patterns of brain development remains sparsely explored. Here, we examined how transdiagnostic symptoms of irritability relate to the development of structural brain networks. All participants (n = 137, 83 females) completed structural brain imaging with 3 Tesla MRI at two timepoints (mean age at follow-up: 21.

A Comparison of the Learning Curves of Laparoscopic Liver Surgeons in Differing Stages of the IDEAL Paradigm of Surgical Innovation: Standing on the Shoulders of Pioneers.

Objective: To compare the learning curves of the self-taught "pioneers" of laparoscopic liver surgery (LLS) with those of the trained "early adopters" in terms of short- and medium-term patient outcomes to establish if the learning curve can be reduced with specific training.

Summary Of Background Data: It is expected that a wider adoption of a laparoscopic approach to liver surgery will be seen in the next few years. Current guidelines stress the need for an incremental, stepwise progression through the learning curve in order to minimize harm to patients.

Evaluation of osseous metastasis in bone scintigraphy.

Bone scintigraphy (BS) is an imaging tool commonly used for screening patients with cancer, especially those with high prevalence of osseous metastases including the breast, prostate, lung, thyroid, and kidney, which account for 80% of osseous metastasis. BS has been shown to be of value in the initial and subsequent treatment strategy of various malignancies. The purpose of this article is to evaluate the technical and imaging aspects of BS and to examine the present research into improved detection of osseous metastasis.

Strategies to reduce hepatitis C virus recurrence after liver transplantation.

Hepatitis C virus (HCV) is a major health problem that leads to chronic hepatitis, cirrhosis and hepatocellular carcinoma, being the most frequent indication for liver transplantation in several countries. Unfortunately, HCV re-infects the liver graft almost invariably following reperfusion, with an accelerated history of recurrence, leading to 10%-30% of patients progressing to cirrhosis within 5 years of transplantation. In this sense, some groups have even advocated for not re-transplanting this patients, as lower patient and graft outcomes have been reported.

Muscarinic antibodies and heart rate responses to dynamic exercise and to the Valsalva maneuver in chronic chagasic patients.

We have studied the cardiac chronotropic responses to the Valsalva maneuver and to dynamic exercise of twenty chronic chagasic patients with normal left ventricular function and no segmental wall abnormalities by two-dimensional echocardiogram. The absolute increase in heart rate of the patients (Δ = 21.5 ± 10 bpm, M±SD) during the maneuver was significantly diminished when compared to controls (Δ = 31.

Cardiac autonomic control mechanisms in the pathogenesis of chagas' heart disease.

Primary abnormalities of the autonomic nervous system had been postulated as the pathogenic mechanisms of myocardial damage, in patients with Chagas disease. However, recent investigations indicate that these abnormalities are secondary and amenable to treatment with beta-adrenergic blockers. Moreover, muscarinic cardiac autoantibodies appear to enhance parasympathetic activity on the sinus node.

Predictors of early graft survival after pediatric liver transplantation.

The objective of this study was to identify peritransplant predictors of early graft survival and posttransplant parameters that could be used to predict early graft outcomes after pediatric liver transplantation (PLT). The response of children to liver dysfunction after liver transplantation (LT) is poor. No data have been reported for early predictors of poor graft survival, which would potentially be valuable for rescuing children at risk after LT.

Auxiliary liver transplantation in children.

Purpose Of Review: Auxiliary liver transplantation (ALT) has developed as a technique for treating patients with acute liver failure. The surgical techniques of ALT have been refined and current patient survival appears to be similar to that observed with conventional liver replacement for acute liver failure.

Recent Findings: Our understanding of liver regeneration has improved with experience and it is possible to identify patient and disease groups that are more likely to regenerate and wean off immunosuppression after ALT.

[Antiadrenergic rescue therapy with amiodarone in children with severe left ventricular dysfunction secondary to scorpion envenomation].

Background: Children with scorpion envenomation have massive sympathetic activation and variable degrees of left ventricular systolic dysfunction.

Objective: To evaluate a rescue protocol for children with severe left ventricular dysfunction secondary to scorpion envenomation.

Methods: Four children, after scorpion envenomation, were subjected to a rescue protocol for acute left ventricular dysfunction: Endotracheal intubation and respiratory assistance, electrocardiograms, chest x-Ray, echocardiograms and blood samples for norepinephrine and troponin I serum levels.

Acutely decompensated systolic heart failure: effects of frequent doses of furosemide vs a single dose plus carvedilol on clinical status, neurohormonal activation and ventricular arrhythmias.

Beta blockers are contraindicated in patients with acutely decompensated heart failure. Current therapeutic strategies increase morbidity and mortality. We have compared the effects of frequent doses of diuretics vs a single dose of diuretics and cautious uptitration of carvedilol.

Temporary portocaval shunt in orthotopic liver transplantation: need for a standardized approach?

Maintenance of portal and systemic venous return during the anhepatic phase of liver transplantation (LT) improves hemodynamic stability. With the piggyback technique, caval return is maintained; however, temporary clamping of the portal vein is still necessary. The use of a temporary portocaval shunt (TPCS) has been proposed to minimize the effect of portal venous interruption.

Patterns of left ventricular hypertrophy in essential hypertension: should echocardiography guide the pharmacological treatment?

The experimental design of clinical studies, on the pharmacological treatment of essential hypertension, has ignored a fundamental issue: Hypertensive patients are not a homogenous population. The adaptation of the cardiovascular system to hypertension is structurally and functionally heterogeneous. Recent clinical investigations suggest that this heterogeneity can be minimized by echocardiography.

Mechanisms of neurohormonal activation in chronic congestive heart failure: pathophysiology and therapeutic implications.

Patients with chronic congestive heart failure have a sequential and incessant activation of those neurohormonal systems, which control body fluids, cardiac output and systemic blood pressure. Neurohormonal activation is initially selective and regional. Generalized activation is a late event in the natural history of congestive heart failure.