Imaging Concordance With Vein Sampling for Primary Aldosteronism: A Cohort Study and Literature Review.

Introduction: Adrenal venous sampling (AVS) is used to distinguish unilateral from bilateral aldosterone hypersecretion as a cause of primary aldosteronism (PA). Unilateral disease is treated with adrenalectomy and bilateral hypersecretion managed medically.

Methods: We performed a single institution retrospective cohort study of adult patients undergoing adrenalectomy for PA from July 2013 to June 2022.

Excellent Response to Therapy Occurs for Most Patients With Thyroid Cancer Treated With Lobectomy.

Introduction: American Thyroid Association (ATA) Guidelines for Management of Thyroid Nodules and Thyroid Cancer indicate that thyroid lobectomy (TL) or total thyroidectomy (TT) are appropriate surgery for low- and intermediate-risk well-differentiated thyroid carcinoma. We sought to determine outcomes of TL or TT by ATA response to therapy (RTT) classification.

Methods: This is a single-institution retrospective cohort study of adults with unilateral suspicious or malignant thyroid nodules under 4 cm from January 2016 through December 2021.

ERAS implementation in an urban patient population undergoing gynecologic surgery.

Background: Enhanced recovery after surgery (ERAS) protocols improve outcomes. We investigated ERAS implementation in a population with comorbid conditions, inadequate insurance, and barriers to healthcare undergoing gynecologic surgery.

Objective: To investigate ERAS implementation in publicly insured/uninsured patients undergoing gynecologic surgery on hospital length of stay (LOS), 30-day hospital readmission rates, opioid administration, and pain scores.

Thyroid Cancer: Global Burden and Trends.

The incidence of thyroid cancer continues to increase, representing the 5th most common cancer type in the USA today (Sherman, Lancet 361(9356):501-11, 2003). The current study sought to analyze the global burden of thyroid cancer utilizing the publicly accessible GLOBOCAN database. An estimated 586,202 cases of thyroid cancer were reported in 2020, making thyroid cancer the 10th most common cancer worldwide.

The impact of patient age on practice patterns and outcomes for primary hyperparathyroidism.

Background: Management of asymptomatic primary hyperparathyroidism (PHPT) in older patients (age >50) is controversial. The 4th International Workshop on the Management of Asymptomatic PHPT recommends surveillance for older patients who lack objective signs of disease, whereas The American Association of Endocrine Surgeons (AAES) guidelines recommend consideration of parathyroidectomy for patients of any age with subjective constitutional, neuropsychiatric, or cognitive symptoms. Therefore, the primary objective of this study was to evaluate the association between patient age and both practice patterns and outcomes in the management of patients with sporadic PHPT.

Complete Molar Pregnancies with a Coexisting Fetus: Pregnancy Outcomes and Review of Literature.

 The objective of the study was to review the obstetric outcomes of complete hydatidiform molar pregnancies with a coexisting fetus (CHMCF), a rare clinical entity that is not well described.  We performed a retrospective case series with pathology-confirmed HMCF. The cases were collected via solicitation through a private maternal-fetal medicine physician group on social media.

Increasing Readiness for Early Integrated Palliative Oncology Care: Development and Initial Evaluation of the EMPOWER 2 Intervention.

Context: Early integrated palliative care improves quality of life, but palliative care programs are underutilized. Psychoeducational interventions explaining palliative care may increase patients' readiness for palliative care.

Objectives: To 1) collaborate with stakeholders to develop the EMPOWER 2 intervention explaining palliative care, 2) examine acceptability, 3) evaluate feasibility and preliminary efficacy.

Patient Reported Outcome Measures of Health-Related Quality of Life and Asthenia after Thyroidectomy.

Background: After thyroidectomy some patients experience a chronic fatigue syndrome called asthenia. The purpose of this study was to determine the post-operative health related quality of life (HRQOL) and risk of asthenia in patients undergoing thyroidectomy.

Methods: A single institution prospective observational cohort study of adults undergoing thyroidectomy from September 2016 to July 2019 with four HRQOL surveys: preoperative baseline, 2 wk-, 6 mo- and 12 mo-postoperatively.

Phase II clinical trial of metformin as a cancer stem cell-targeting agent in ovarian cancer.

BACKGROUNDEpidemiologic studies suggest that metformin has antitumor effects. Laboratory studies indicate metformin impacts cancer stem-like cells (CSCs). As part of a phase II trial, we evaluated the impact of metformin on CSC number and on carcinoma-associated mesenchymal stem cells (CA-MSCs) and clinical outcomes in nondiabetic patients with advanced-stage epithelial ovarian cancer (EOC).

Surgical Approach to Endocrine Hypertension in Patients with Adrenal Disorders.

Increased hormonal secretion of aldosterone, cortisol, or catecholamines from an adrenal gland can produce a variety of undesirable symptoms, including hypertension, which may be the initial presenting symptom. Consequences of secondary hypertension can result in potential cardiovascular and cerebrovascular complications at higher rates than in those with essential hypertension. Once a biochemical diagnosis is confirmed, targeted pharmacotherapy can be initiated to improve hypertension and may be corrected with surgical intervention.

Infectious diseases mimicking ovarian carcinomatosis.

Infectious diseases can present similar to ovarian cancer and occur concomitantly with ovarian pathology. With increased worldwide travel and migration of populations, infections endemic to developing countries can emerge in the United States. We present 2 cases of infectious diseases mimicking ovarian carcinomatosis.

Myxoid leiomyosarcoma of the Bartholin gland.

Background: Myxoid leiomyosarcomas originating from the Bartholin gland are exceedingly rare. Only one other case of a Bartholin gland myxoid leiomyosarcoma has been reported.

Case: Our patient presented with a 10 cm mass on her vulva, which was presumed to be a Bartholin gland cyst.

Metformin targets ovarian cancer stem cells in vitro and in vivo.

Purpose: Studies in non-gynecologic tumors indicate that metformin inhibits growth of cancer stem cells (CSC). Diabetic patients with ovarian cancer who are taking metformin have better outcomes than those not taking metformin. The purpose of this study was to directly address the impact of metformin on ovarian CSC.

Gardasil™ HPV vaccination: surveillance of vaccine usage and adherence in a military population.

Objectives: To investigate the usage patterns and adherence rates with the quadrivalent HPV (qHPV) vaccine at Naval Medical Center San Diego.

Methods: This retrospective, cross-sectional study was conducted by using AHLTA (Electronic Health Record of DoD) to identify all qHPV recipients between 2006 and 2009. Charts were reviewed to extract demographic variables and immunization schedules for association analysis.

Nerve-sparing radical hysterectomy using modern bipolar electrosurgical instruments based on the ForceTriad energy platform.

Objective: To describe and evaluate a novel technique of nerve-sparing radical abdominal hysterectomy with pelvic lymphadenectomy (NSRH/PLND) using the bipolar Ligasure Atlas sealer/divider and Bissenger bipolar shears.

Methods: Retrospective study of 4 consecutive patients who underwent NSRH/PLND for stage IB1-IIB cervical carcinoma was conducted. Resection of the cardinal and uterosacral ligaments was performed with the Ligasure Atlas.

Recurrent postpartum anaphylaxis with breast-feeding.

Background: Anaphylaxis associated with breast-feeding is a rare but potentially life-threatening event.

Case: This woman reported anaphylaxis with three previous pregnancies while breast-feeding. With her fourth pregnancy she was treated with corticosteroids and antihistamines after delivery.

Changes in lung permeability and lung mechanics accompany homeostatic instability in senescent mice.

Aging and lung disease are recognized factors that increase mortality risk in subjects exposed to ambient particulate matter (PM). In an effort to understand the mechanisms of enhanced susceptibility, the present study examined an inbred mouse model of senescence to 1) determine changes in lung permeability as animals approach the end-of-life and 2) characterize age-dependent changes in lung mechanics in presenescent and terminally senescent mice. The clearance of technetium-99m (99mTc)-diethylenetriamine pentaacetic acid (DTPA) was used to test the hypothesis that lung permeability increases with age and enhances uptake of soluble components of PM principally during the period several weeks before death in AKR/J mice.

Methods to track leukocyte and erythrocyte transit through the bronchial vasculature in sheep.

Study of the underlying mechanisms of leukocyte recruitment in the airway circulation is a crucial aspect of understanding the pathology of inflammatory airways disease. However, few in vivo studies have focused on leukocyte kinetics through the systemic airway vasculature. Because the bronchial vasculature of the sheep shows anatomical similarity to that of the human as well as being easily accessible for perfusion, we developed methods to study leukocyte transit through the sheep bronchial circulation.