Myeloid sarcoma as a manifestation of acute myeloid leukemia.

We report a case of a 43-year-old man who presented with dyspnea because of large bilateral pleural effusions and imaging findings of a large periaortic mass with compression of the esophagus and left atrium. Subsequent soft tissue biopsy was consistent with myeloid sarcoma, and bone marrow biopsy was consistent with acute myeloid leukemia. He was started on induction and subsequent consolidation chemotherapy with complete remission and shrinkage of the tumor.

Influenza A-induced rhabdomyolysis with acute renal failure following a deep tissue massage.

We describe a unique case of severe influenza A-induced rhabdomyolysis in a previously healthy 39-year-old man, who developed symptoms immediately following a 2-hour deep-tissue massage and improved with oseltamivir and intravenous fluids. This case describes a possible temporal association between tissue damage secondary to deep tissue massage and the subsequent exacerbation of rhabdomyolysis in the setting of an influenza A infection. Biological evidence of muscle cell viral invasion with massage supports the possibility of elevated influenza A pathogenicity.

Proximal pulmonary artery embolization for recurrent hemoptysis after bronchial artery embolization.

Proximal pulmonary artery (PA) embolization is a dramatic interventional radiology procedure performed to control recurrent, life-threatening hemoptysis. Distal PA embolization procedures are commonly performed, and preoperative proximal PA embolization procedures have been reported, but to the best of our knowledge there has not been a reported case of a proximal PA embolization to treat hemoptysis. Here, we present a case of a complete proximal PA embolization that effectively resolved recurrent hemoptysis in a patient with a lung tumor following a failed bronchial artery embolization.

An Analysis of Gender Bias in Plastic Surgery Resident Assessment.

Background: Previous studies have shown men and women attending physicians rate or provide operating room (OR) autonomy differently to men and women residents, with men attendings providing higher ratings and more OR autonomy to men residents. Particularly with the advent of competency-based training in plastic surgery, differential advancement of trainees influenced by gender bias could have detrimental effects on resident advancement and time to graduation.

Objective: We determined if plastic surgery residents are assessed differently according to gender.

Multicenter assessment of outcomes and complications associated with transforaminal versus anterior lumbar interbody fusion for fractional curve correction.

Objective: Few studies have compared fractional curve correction after long fusion between transforaminal lumbar interbody fusion (TLIF) and anterior lumbar interbody fusion (ALIF) for adult symptomatic thoracolumbar/lumbar scoliosis (ASLS). The objective of this study was to compare fractional correction, health-related quality of life (HRQL), and complications associated with L4-S1 TLIF versus those of ALIF as an operative treatment of ASLS.

Methods: The authors retrospectively analyzed a prospective multicenter adult spinal deformity database.

Digital Papillary Adenocarcinoma in the Dorsal Proximal Ring Finger.

Digital papillary adenocarcinoma (DPA) is a rare and aggressive tumor arising from the eccrine sweat glands. It is found on the hands and feet and most commonly occurs on the volar and distal finger tips. In this report, we describe a DPA in a 45-year-old woman who presented with a slowly enlarging mass on the dorsal aspect of her proximal ring finger.

Nonpharmacologic Pain Management Among Hospitalized Inpatients: A Randomized Waitlist-Controlled Trial of Standard Virtual Reality (CGI VR) Versus Video Capture VR (360 degrees 3D/Stereoscopic Video Capture VR).

Objectives: Nonpharmacologic pain management strategies are needed because of the growing opioid epidemic. While studies have examined the efficacy of virtual reality (VR) for pain reduction, there is little research in adult inpatient settings, and no studies comparing the relative efficacy of standard animated computer-generated imagery (CGI) VR to Video Capture VR (360 degrees 3D/stereoscopic Video Capture VR). Here, we report on a randomized controlled trial of the relative efficacy of standard CGI VR versus Video Capture VR (matched for content) and also compared the overall efficacy of VR to a waitlist control group.

Postoperative prophylactic antibiotics for retropubic mid-urethral slings.

Objectives And Hypothesis: The primary objective is to measure the difference in urinary tract infection (UTI) rates within 6  weeks of placement of a retropubic mid-urethral sling (RMUS) in the setting of various postoperative prophylactic antibiotic regimens. UTI rates were measured by antibiotic prescriptions to treat UTI and/or culture. Secondary aims included determining risk factors for postoperative UTI.

Eosinophilic pancreatitis presenting as possible malignancy.

Eosinophilic pancreatitis is a rare form of chronic pancreatitis that is often mistaken for malignancy due to nonspecific presenting symptoms and noncontributory auxiliary exams. This clinical case report highlights a unique presentation of chronic pancreatitis. A middle-aged man developed abdominal pain, and repeat imaging showed an interval increase in size of a known pancreatic lesion.

Kounis syndrome presenting as ST elevation acute myocardial infarction.

Allergic acute coronary syndrome, Kounis syndrome, is a rare cause of ST-segment elevation myocardial infarction triggered by an allergic reaction to a drug or environmental allergen, resulting in atheromatous plaque rupture or coronary artery vasospasm. We report three cases of Kounis syndrome presenting as ST-segment elevation myocardial infarction.

endocarditis in an immunocompetent host.

This case describes an 83-year-old immunocompetent woman who presented to the emergency department with complaints of nausea, vomiting, and dizziness. She was found to have evidence of embolic stroke secondary to endocarditis. This case emphasizes the challenge of diagnosing fungal endocarditis, as it can be difficult to culture, and the importance of broad differentials even in patients with no obvious risk factors.

causing native hip joint septic arthritis.

is a bacterium normal to oral and gastrointestinal flora that has been implicated in cases of discitis, osteomyelitis, and prosthetic joint infections, often involving dental procedures or periodontal disease. It is an extremely rare cause of infection outside of these circumstances. We describe a case of septic arthritis of the native hip joint due to .

Retropubic mid-urethral slings and de novo urinary urgency and frequency: The role of retropubic hematomas.

Aims: This is a prospective cohort study comparing de novo lower urinary tract symptoms (LUTS) in subjects undergoing a retropubic mid-urethral sling who either did or did not develop a postoperative retropubic hematoma within 6 weeks of surgery. The secondary objective was to measure the incidence and prevalence of retropubic hematomas, and subject characteristics associated with retropubic hematomas.

Methods: Eligible subjects were recruited before undergoing a retropubic mid-urethral sling with or without concurrent pelvic reconstructive surgery.

Clinical Efficacy of the Multilayered Skull Base Reconstruction Using In Situ Bone Flap in Endoscopic Endonasal Approach for Craniopharyngioma.

 The aim of the study is to summarize and analyze the efficacy of the multilayered skull base reconstruction using in situ bone flap in endoscopic endonasal approach (EEA) for craniopharyngiomas.  A retrospective review of 65 patients who underwent resection of their histopathology confirmed craniopharyngiomas performed at a single institution. Based on the team's understanding and mastery of skull base reconstruction techniques, patients were divided into two groups according to the methods of reconstruction in two periods.

Pharmaceutical procurement among public sector procurers in CARICOM.

Objective: To examine multiple aspects of the medicines in CARICOM procurement markets, including manufacturer headquarters location, regulatory history, and type (innovator versus generic); the proportion of World Health Organization (WHO) essential medicines; and the most expensive medicines procured.

Methods: An analysis of procurement information from selected CARICOM procurers. Four public sector procurement lists were obtained based on public availability or sharing of data from public sector procurers.

Blastic Plasmacytoid Dendritic Cell Neoplasm: A Case Series and Review.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare and aggressive hematologic malignancy that frequently has cutaneous manifestations. The diagnosis can be a challenge because of its heterogenous clinical presentation, ranging from a brown or violaceous solitary nodule or patch to mixed, disseminated lesions. Furthermore, BPDCN tumor cells express immunohistochemical markers in common with acute myeloid leukemia, which can lead to misdiagnosis.

Diagnosis and treatment of malignant-appearing arteriovenous malformation.

Arteriovenous malformations (AVM) are most commonly found in the gastrointestinal tract, and presentation can range from asymptomatic to massive gastrointestinal hemorrhage. This case highlights a unique presentation of AVMs. During a screening colonoscopy, a 5-cm mass was discovered in the transverse colon encompassing 25% to 50% of the circumference of the lumen.

Disseminated cryptococcal infection in a patient with glioblastoma multiforme on treatment with lomustine and bevacizumab.

This case describes a 48-year-old Hispanic man with a history of glioblastoma multiforme on active chemotherapy treatment and corticosteroids who presented to the emergency room with complaints of cough, fever, chills, fatigue, confusion, and somnolence. Workup yielded evidence of disseminated cryptococcal disease. The case highlights the importance of a broad differential in patients with a history of being immunocompromised.

Pedunculated sigmoid lipoma causing colo-colonic intussusception.

This case report describes a 52-year-old man who presented with 2 weeks of left lower quadrant pain and bloody stool. Computed tomography revealed a 4 cm, fat-density mass acting as a lead point for intussusception of the sigmoid colon. Surgical resection was successfully performed, and histologic evaluation confirmed the diagnosis of a pedunculated colonic lipoma.

Use of Web-Based Patient Portals in Patients With Atrial Fibrillation Is Associated With Higher Readmissions.

The impact of web-based patient portals on patient outcomes-specifically hospital readmissions in patients with atrial fibrillation (AF)-remains understudied. This single-center retrospective cohort study investigated the use of an online portal system (MyChart) by patients hospitalized from January 1, 2014 to June 30, 2017 for AF. During the study period, 11,334 unique AF admissions were identified; 50.