[Operative management of penoscrotal elephantiasis].

Enormous oedema of the male genitals, such as penoscrotal elephantiasis, is a very rare condition. It is usually a result of recurrent inflammation, trauma or malignancy, although the main cause is lymphatic filariasis. Furthermore, it is a challenging condition for both patient as well as the attending healthcare team.

Electric field distribution predicts efficacy of accelerated intermittent theta burst stimulation for late-life depression.

Introduction: Repetitive transcranial magnetic stimulation (rTMS) is a promising intervention for late-life depression (LLD) but may have lower rates of response and remission owing to age-related brain changes. In particular, rTMS induced electric field strength may be attenuated by cortical atrophy in the prefrontal cortex. To identify clinical characteristics and treatment parameters associated with response, we undertook a pilot study of accelerated fMRI-guided intermittent theta burst stimulation (iTBS) to the right dorsolateral prefrontal cortex in 25 adults aged 50 or greater diagnosed with LLD and qualifying to receive clinical rTMS.

Hydranencephaly following carbon monoxide poisoning during pregnancy: An uncommon and potentially fatal complication in infant.

Background: Hydranencephaly is a rare malformation of the brain system with an incidence of 0.5 per 1000 births. Its principal etiologies are bilateral occlusion of the internal carotid arteries and congenital infections.

Impact of Chronic Pain and Perceived Opioid Benefit on Value Domains.

Non-pharmacological chronic pain treatments increasingly incorporate values-based approaches as an alternative to opioid therapy. Chronic pain and opioid use may differentially impact value domains such as family or work, and there is little guidance on how to implement values-based treatment to address pain and comorbid opioid use. This study aims to characterize ways in which chronic pain and values interact.

[Successful laparoscopic robot-assisted surgical treatment of bilateral ureterosciatic hernias (Lindbom's hernia) and pelvic kidney].

Ureterosciaic hernia is a rarely described pathology that represents a diagnostic and therapeutic challenge for the treating physician. In this case report, we present a patient with symptomatic bilateral ureteroschial hernias and a pelvic kidney on the left. The definitive surgical treatment of the hernias was performed in the robotic-assisted laparoscopic technique.

Transverse Relaxation Anisotropy of the Achilles and Patellar Tendon Studied by MR Microscopy.

Background: T * anisotropy affects the clinical assessment of tendons (magic-angle artifact) and may be a source of T *-misinterpretation.

Purpose: To analyze T *-anisotropy and T *-decay of Achilles and patellar tendons in vitro at microscopic resolution using a variable-echo-time (vTE) sequence.

Study Type: Prospective.

A Project ECHO and Community Health Worker Intervention for Patients with Diabetes.

Background: Both community health workers and the Project ECHO model of specialist telementoring are innovative approaches to support primary care providers in the care of complex patients with diabetes. We studied the effect of an intervention that combined these 2 approaches on glycemic control.

Methods: Patients with diabetes were recruited from 10 federally qualified health centers in New Mexico.

A process-based approach to understanding and managing triggered seismicity.

There is growing concern about seismicity triggered by human activities, whereby small increases in stress bring tectonically loaded faults to failure. Examples of such activities include mining, impoundment of water, stimulation of geothermal fields, extraction of hydrocarbons and water, and the injection of water, CO and methane into subsurface reservoirs. In the absence of sufficient information to understand and control the processes that trigger earthquakes, authorities have set up empirical regulatory monitoring-based frameworks with varying degrees of success.

Results of Intravitreal Anti-Vascular Endothelial Growth Factor Therapy in Inflammatory Choroidal Neovascularization.

Purpose: To report the visual outcomes of intravitreal (IVT) anti-vascular endothelial growth factor (anti-VEGF) in inflammatory choroidal neovascularization (iCNV).

Methods: A retrospective study of 43 eyes of 38 patients with active choroidal neovascularization (CNV) related to ocular inflammatory disease, treated with IVT injections of anti-VEGF (bevacizumab, ranibizumab, or aflibercept), with or without associated systemic anti-inflammatory therapy, at Fattouma Bourguiba University Hospital, Monastir, Tunisia (24 eyes of 23 patients) and at Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy (19 eyes of 15 patients) from January 1, 2013, to December 31, 2018.

Results: The mean age was 35.

[Robot-assisted laparoscopic bladder diverticulum resection (RABDR)].

Aims: Since October 2018, urinary bladder diverticulum resections at our Department of Urology have been carried out with robot assistance and with minimal invasivion, Paediatrical urological and robot-assisted minimally invasive urological surgery for the Bamberg Social Foundation were performed with the DaVinci robotic system. The aim of the present study was to record the surgical results of our patients and to compare these if necessary with available data on optimal diagnostic and therapy.

Methods: In this retrospective analysis, we included all patients who received RAHDR between October 2018 and March 2020.

Kaempferol alleviates calcium oxalate crystal-induced renal injury and crystal deposition via regulation of the AR/NOX2 signaling pathway.

Background: Calcium oxalate (CaOx) crystal deposition and crystal-induced renal tubular epithelial cell injury have been found to fundamentally contribute to the formation of CaOx nephrolithiasis.

Purpose: In the current work, we aim to study the role and mechanism of kaempferol in CaOx crystal kidney deposition and crystal-induced renal injury.

Study Design: Mice models and HK-2 cells were used to investigate the effect of kaempferol in CaOx crystal-induced renal injury and crystal deposition in the kidney and its underlying mechanism by a series of experiments.

A Telementoring Intervention Leads to Improvements in Self-Reported Measures of Health Care Access and Quality among Patients with Complex Diabetes.

Individuals living with complex diabetes experience limited access to endocrine care due to a nationwide shortage of endocrinologists. Project ECHO (Extension for Community Healthcare Outcomes) is an innovative, scalable model of health care that extends specialty care to medically underserved areas through ongoing telementorship of community primary care providers. We evaluated the effects of an endocrine-focused ECHO program (Endo ECHO) on patients with type 1 and complex type 2 diabetes, and report here on changes in patient-reported measures of health care access and quality from baseline to one year aft er program enrollment.

[Uretero-iliac artery fistula as a urological emergency].

Uretero-iliac artery fistulae represent a urological emergency with considerable mortality. We present 2 cases of a uretero-iliac artery fistula. Nowadays, minimally-invasive endovascular therapy seems to be the treatment of choice.

Reproducibility of an Automated Quantitative MRI Assessment of Low-Grade Knee Articular Cartilage Lesions.

Objective: The goal of this study was to assess the reproducibility of an automated knee cartilage segmentation of 21 cartilage regions with a model-based algorithm and to compare the results with manual segmentation.

Design: Thirteen patients with low-grade femoral cartilage defects were included in the study and were scanned twice on a 7-T magnetic resonance imaging (MRI) scanner 8 days apart. A 3-dimensional double-echo steady-state (3D-DESS) sequence was used to acquire MR images for automated cartilage segmentation, and T2-mapping was performed using a 3D triple-echo steady-state (3D-TESS) sequence.

[A rare case of renal ectopic thyroid tissue].

We present a rare case of ectopic thyroid tissue found during robotic nephrectomy of a kidney with a suspected malignant tumour. Such cases of ectopic thyroid tissue are extremely rare in the literature. If ectopic thyroid tissue occurs, it is usually found in the neck region or in the upper mediastinum.

Up regulation of Rho-associated coiled-coil containing kinase1 (ROCK1) is associated with genetic instability and poor prognosis in prostate cancer.

Background And Objectives: Overexpression of the cytoskeleton-modulating kinase ROCK1 has been associated with unfavorable outcome in many cancers, but its impact in prostate cancer is largely unknown.

Results: A weak ROCK1 staining was found in >90% of normal, and cancerous prostate tissues, but was generally stronger in cancer cells as compared to adjacent normal glands. In cancer, ROCK1 staining was considered weak, moderate, and strong in 22%, 53%, and 18% of cases respectively.

Measuring Brain Complexity During Neural Motor Resonance.

EEG mu-desynchronization is an index of motor resonance (MR) and is used to study social interaction deficiencies, but finding differences in mu-desynchronization does not reveal how nonlinear brain dynamics are affected during MR. The current study explores how nonlinear brain dynamics change during MR. We hypothesized that the complexity of the mu frequency band (8-13 Hz) changes during MR, and that this change would be frequency specific.

Orientation dependence and decay characteristics of T * relaxation in the human meniscus studied with 7 Tesla MR microscopy and compared to histology.

Purpose: To evaluate: (1) the feasibility of MR microscopy T * mapping by performing a zonal analysis of spatially matched T * maps and histological images using microscopic in-plane pixel resolution; (2) the orientational dependence of T * relaxation of the meniscus; and (3) the T * decay characteristics of the meniscus by statistically evaluating the quality of mono- and biexponential model.

Methods: Ultrahigh resolution T * mapping was performed with ultrashort echo time using a 7 Tesla MR microscopy system. Measurement of one meniscus was performed at three orientations to the main magnetic field (0, 55, and 90°).

The comparison of the performance of 3 T and 7 T T mapping for untreated low-grade cartilage lesions.

Objective: To investigate T mapping as a possible marker for low-grade human articular cartilage lesions during a one-year follow-up, possible changes during the follow-up and compare the reliability and sensitivity of these measurements on high-field (3 T) and ultra-high-field (7 T) MRI scanners.

Design: Twenty-one patients with femoral, tibial and patellar cartilage defect in the knee joint participated in the study. The MRI protocol consisted of morphological, as well as three-dimensional triple-echo steady-state (3D-TESS) T mapping sequences with similar parameters at 3T and 7T.

Leveraging Behavioral Health Expertise: Practices and Potential of the Project ECHO Approach to Virtually Integrating Care in Underserved Areas.

This column describes Project ECHO (Extension for Community Healthcare Outcomes), a teleconsultation, tele-education, telementoring model for enhancing primary care treatment of underserved patients with complex medical conditions. Numerous centers have adapted ECHO to support primary care treatment of behavioral health disorders. Preliminary evidence for behavioral health ECHO programs suggests positive impacts on providers, treatment planning, and emergency department costs.

ENDO ECHO IMPROVES PRIMARY CARE PROVIDER AND COMMUNITY HEALTH WORKER SELF-EFFICACY IN COMPLEX DIABETES MANAGEMENT IN MEDICALLY UNDERSERVED COMMUNITIES.

Objective: To determine whether participation in a multidisciplinary telementorship model of healthcare delivery improves primary care provider (PCP) and community health worker (CHW) confidence in managing patients with complex diabetes in medically underserved regions.

Methods: We applied a well-established healthcare delivery model, Project ECHO (Extension for Community Healthcare Outcomes), to the management of complex diabetes (Endo ECHO) in medically underserved communities. A multidisciplinary team at Project ECHO connected with PCPs and CHWs at 10 health centers across New Mexico for weekly videoconferencing virtual clinics.

Neural complexity as a potential translational biomarker for psychosis.

Background: The adaptability of the human brain to the constantly changing environment is reduced in patients with psychotic disorders, leading to impaired cognitive functions. Brain signal complexity, which may reflect adaptability, can be readily quantified via resting-state functional magnetic resonance imaging (fMRI) signals. We hypothesized that resting-state brain signal complexity is altered in psychotic disorders, and is correlated with cognitive impairment.

Increasing use of radical prostatectomy for locally advanced prostate cancer in the USA and Germany: a comparative population-based study.

Background: Current guidelines do not recommend a preferred treatment modality for locally advanced prostate cancer. The aim of the study was to compare treatment patterns found in the USA and Germany and to analyze possible trends over time.

Methods: We compared 'Surveillance Epidemiology and End Results' (SEER) data (USA) with reports from four German federal epidemiological cancer registries (Eastern Germany, Bavaria, Rhineland-Palatinate, Schleswig-Holstein), both from 2004 to 2012.