Effectiveness of cholangioscopy guided biopsy versus ERCP guided brushings in diagnosing malignant biliary strictures.

Background: Evaluation of lesions of the biliary tract are essential to diagnose given the dismal outcomes of cholangiocarcinoma. Historically, these diagnoses were made using brush biopsies obtained under Endoscopic Retrograde Cholangiopancreatography (ERCP). To increase the accuracy of biliary biopsies, SpyGlassTM Discover cholangioscopy guided biopsy has been developed, providing greater tissue yield and direct visualization of the biliary epithelium.

Grey matter volume differences across Parkinson's disease motor subtypes in the supplementary motor cortex.

Parkinson's Disease (PD) is the second most prevalent neurodegenerative disease worldwide due to loss of dopaminergic neurons projecting from the basal ganglia (BG). It is associated with various motor symptoms that are grouped into subtypes, each with different clinical presentations and disease progressions. Neuroimaging biomarkers focusing on regions a part of motor circuits projecting from the BG can distinguish and improve overall subtyping.

High grade phyllodes tumor with osteosarcomatous differentiation: Case report and review of the literature.

Phyllodes tumors (PTs) are rare fibroepithelial malignancies of the breast, accounting for less than 1% of malignant breast tumors. PTs are usually solitary tumors but can be associated with other malignancies, such as DCIS or invasive carcinomas and sarcomas. Osteosarcomatous differentiation of a malignant phyllodes tumor is rare, and differentiation of this rare breast tumor from other entities is of vital importance to clinicians due for appropriate treatment and prognosis.

Limited ability of the renal ablation-specific (MC)2 risk scoring system to predict major adverse events from percutaneous renal microwave ablation.

Purpose: To access if the (MC)2 scoring system can identify patients at risk for major adverse events following percutaneous microwave ablation of renal tumors.

Methods: Retrospective review of all adult patients who underwent percutaneous renal microwave ablation at two centers. Patient demographics, medical histories, laboratory work, technical details of the procedure, tumor characteristics, and clinical outcomes were collected.

Radiation Exposure during Prostatic Artery Embolization: A Single Institution Review.

Prostate artery embolization is a minimally invasive treatment for benign prostatic hyperplasia, and imaging is indispensable for the technical success of this procedure; however, imaging is a major source of radiation exposure for patients and healthcare providers. Radiation emission during prostate artery embolization procedures at a single institution was evaluated to determine radiation exposure with the goal to work toward minimizing exposure. All patients at a single institution that underwent outpatient unilateral/bilateral prostate artery embolization between 4 January 2019 and 16 November 2021 were retrospectively evaluated; data collected included body mass index, prostate volume, and indications for prostate artery embolization.

Utility of the RENAL Nephrometry Scoring System in Predicting Adverse Events and Outcomes of Percutaneous Microwave Ablation of Renal Tumors.

Purpose: To assess the utility of the radius, exophytic/endophytic, nearness to collecting system or sinus, anterior/posterior, and location relative to polar lines (RENAL) nephrometry scoring system at predicting adverse events and outcomes in percutaneous microwave ablation (MWA) of renal tumors.

Materials And Methods: A retrospective review of 116 patients who underwent MWA from 2004 to 2018 at 2 large university hospitals was conducted. Patient demographics and tumor characteristics were collected.

Obstructive sleep apnea and white matter hyperintensities: correlation or causation?

Obstructive sleep apnea (apnea) is thought to cause small vessel ischemic episodes in the brain from hypoxic events, postulated as white matter hyperintensities (hyperintensities) identified on MRI which are implicated in cognitive decline. This study sought to evaluate these correlations. A retrospective evaluation of adults who underwent polysomnography (4/1/2016 to 4/30/2017) and a brain MRI prior to apnea diagnosis or within a year post-diagnosis was completed.

Ruptured Splenic Artery Pseudoaneurysm Causing Hemorrhage Into a Pancreatic Pseudocyst.

This case report describes fatal exsanguination due to splenic artery hemorrhage into a pancreatic pseudocyst with cystogastrostomy in a 46-year-old woman. The decedent had a complicated medical history including necrotizing pancreatitis, giant pseudocyst formation after cystogastrostomy procedure, and coiling of a hemorrhagic splenic artery. While hospitalized, she underwent embolization of a ruptured splenic artery pseudoaneurysm.

Community-Acquired, Extended-Spectrum β-Lactamase-Producing and Extensively Drug-Resistant in a 28-Year-Old Pyelonephritis Patient Lacking Risk Factors.

While is a common cause of urinary tract infections and pyelonephritis, there are few documented cases of extended-spectrum β-lactamase (ESBL)-producing and extensively drug-resistant (XDR) isolates from the community resulting in infection requiring hospitalization, especially in individuals lacking risk factors. In the United States, exposure to ESBL-producing is typically nosocomial, whereas patients from developing countries often encounter ESBL-producing in the community through the consumption of contaminated food or water. Considering the rarity at which XDR isolates are encountered, there is also a scarcity of literature describing the successful treatment of ESBL-producing XDR Here we present a case of an otherwise healthy 28-year-old female delicatessen worker infected with ESBL-producing and XDR without recent travel, antibiotic use, or healthcare contact, who required admission to the intensive care unit (ICU) with pyelonephritis and septic shock.

Glyphosate and Polyoxyethyleneamine Ingestion Leading to Renal, Hepatic, and Pulmonary Failure.

Glyphosate is an organophosphorus compound and the active ingredient in commonly used herbicides, whereas polyoxyethyleneamine (POEA) is a nonionic surfactant often coupled with glyphosate in these herbicides to increase their efficacy. Cases of glyphosate-POEA ingestion have shown a variety of outcomes, ranging from skin and mucosal surface irritation to death. Here, we report mortality after ingestion of at least 237 mL of an herbicide confirmed to contain both glyphosate and POEA.

Hepatic lobe torsion: A rare disease necessitating surgical management.

Background: Accessory liver lobes and other congenital liver abnormalities are rare and most often asymptomatic. However, these abnormalities can result in liver torsion, requiring surgical resection.

Case Report: We report a case of a 72-year-old woman with hepatic lobe torsion.

Delayed Gastric Emptying Post-Esophagectomy: A Single-Institution Experience.

Objective: Delayed gastric emptying (DGE) is a common functional disorder after esophagectomy in patients with esophageal carcinoma. Management of DGE varies widely and it is unclear how comorbidities influence the postoperative course. This study sought to determine factors that influence postoperative DGE.

Peritoneal loose bodies and the differentiation of fatty abdominal and pelvic lesions.

Peritoneal loose bodies (PLBs) have been sparingly documented within the surgical and radiologic literature, with 38 cases reported to date. A 67-year-old male presented to urology for the management of an asymmetric prostatic nodule. Imaging incidentally identified a well-circumscribed mass of low T2 signal intensity with a small fatty core in the left lower quadrant close to the sigmoid colon; malignancy was in the differential.