Prospective development and validation of a volumetric laser endomicroscopy computer algorithm for detection of Barrett's neoplasia.

Background And Aims: Volumetric laser endomicroscopy (VLE) is an advanced imaging modality used to detect Barrett's esophagus (BE) dysplasia. However, real-time interpretation of VLE scans is complex and time-consuming. Computer-aided detection (CAD) may help in the process of VLE image interpretation.

Bioinformatics analysis integrating metabolomics of mA RNA microarray in intervertebral disc degeneration.

To explore the potential functions and mechanism of .methyladenosine (mA) abnormality of RNAs in nucleus pulposus from the intervertebral disc degeneration (IDD). We performed rat model, mA epitranscriptomic microarray, bioinformatics analysis and metabolomics.

Spectrum of biopsy proven renal diseases in Central China: a 10-year retrospective study based on 34,630 cases.

Chronic kidney diseases have become a major issue worldwide. The spectrum of biopsy proven renal diseases differs between locations and changes over time. It is therefore essential to describe the local epidemiological trends and the prevalence of renal biopsy in various regions to shine new light on the pathogenesis of various renal diseases and provide a basis for further hypothesis-driven research.

Metabolic Alkalosis: A Brief Pathophysiologic Review.

Metabolic alkalosis is a very commonly encountered acid-base disorder that may be generated by a variety of exogenous and/or endogenous, pathophysiologic mechanisms. Multiple mechanisms are also responsible for the persistence, or maintenance, of metabolic alkalosis. Understanding these generation and maintenance mechanisms helps direct appropriate intervention and correction of this disorder.

Newsletters in Medical Education.

Medical online newsletters are an important component of communication between learners and educators. The ease of creation and distribution has broadened the appeal and growth of online formats. This manuscript details the history of the modern newsletter as it relates to the nephrology community.

Limitations of transoesophageal echocardiogram in acute ischaemic stroke.

Objective: The role of transoesophageal echocardiography (TOE) in identifying ischaemic stroke aetiology is debated. In 2018, the American Heart Association/American Stroke Association (AHA/ASA) issued class IIa recommendation for echocardiography, with the qualifying statement of use in cases where it will alter management. Hence, we sought to determine the rate at which TOE findings altered management in cases of confirmed ischaemic stroke.

Textiloma Mimicking a Recurrent High-Grade Astrocytoma: A Case Report.

 Textiloma (Txm) is a nonmedical term that has been given to foreign body-related inflammatory pseudotumor arising from retained nonabsorbable cotton matrix that is either inadvertently or deliberately left behind during surgery, which may trigger an inflammatory reaction. This report describes a case of Txm mimicking a recurrent high-grade astrocytoma.  We, here, present the case of a 69-year-old female with a 6-month history of progressive left-sided weakness.

Refractory Gastroesophageal Reflux Disease and Functional Heartburn.

This report discusses the potential mechanisms that might underlie refractory GERD and functional heartburn, and how to distinguish among those mechanisms using a systematic evaluation that includes careful medical history, endoscopy with esophageal biopsy, esophageal manometry, and esophageal multichannel intraluminal impedance-pH monitoring. The report provides an approach to patient management that depends on the underlying mechanism identified by this systematic evaluation.

Curcumin Attenuates Both Acute and Chronic Immune Nephritis.

Curcumin is known to have immunomodulatory potential in addition to anti-oxidant, anti-inflammatory and anti-carcinogenic effects. The aim of the present study is to investigate the therapeutic effects of curcumin on immune-mediated renal disease in an anti-glomerular basement membrane (GBM) model (representing acute kidney Injury, AKI) and murine lupus model (representing chronic kidney disease, CKD). In the AKI model, female anti-GBM 129/svj mice were administered with curcumin right before disease induction.

Training with cognitive load improves performance under similar conditions in a real surgical task.

Background: Enhancing cognitive load while performing a bimanual surgical task affects performance. Whether repeated training under this condition could benefit performance in an operating room was tested using a virtual reality simulator with cognitive load applied through two-digit math multiplication questions.

Method: 11 subjects were randomized to Control, VR and VR + CL groups.

Alterations in Doppler-derived renal venous stasis index during recompensation of right heart failure and fluid overload in a patient with pulmonary hypertension.

Renal congestion is becoming recognized as a potential contributor to cardiorenal syndromes. Adequate control of congestion with simultaneous preservation of renal function has been proposed as a central goal of the management of heart failure. We report our care of a 48-year-old woman suffering from right heart failure and massive fluid overload due to severe pulmonary hypertension secondary to a combination of left-heart disease and status after recurrent pulmonary embolisms.

Prevalence of 25-hydroxyvitamin D deficiency in the acute rehabilitation population following traumatic brain injury.

Objective: To determine the prevalence of vitamin D deficiency among individuals with traumatic brain injury (TBI) undergoing acute inpatient rehabilitation.

Setting: Inpatient rehabilitation.

Participants: Participants were admitted from November 1st, 2010 through June 30th, 2015 with diagnosis of mild-severe TBI and had serum 25 OH vitamin D levels checked upon admission.

Radiographic assessment of the subtalar joint: An evaluation of the Kellgren-Lawrence scale and proposal of a novel scale.

Objective: To evaluate the reliability of grading subtalar (ST) arthrosis on lateral weightbearing radiographs in a heterogenous patient population using the Kellgren-Lawrence (KL) scale, correlate these findings to advanced imaging (CT and/or MRI), and to validate a novel scale.

Materials And Methods: A random collection of 40 lateral weightbearing radiographs presenting to a foot and ankle clinic were reviewed by nine multi-disciplinary independent reviewers. Interobserver reliability was assessed for KL scores.

Using Global Criteria to Detect Malnutrition: Application in Disease States.

The accurate diagnosis and subsequent treatment of malnutrition is an essential component of nutrition care because of the known negative impacts of malnutrition on patient outcomes. The detection of malnutrition is influenced by disease-specific characteristics, practice settings, and the availability of resources. This article explores how malnutrition diagnosis through the application of the Global Leadership Initiative on Malnutrition global consensus on malnutrition diagnostic criteria is impacted by the unique characteristics of the heart failure, oncology, and trauma populations.

Doppler-Derived Renal Venous Stasis Index in the Prognosis of Right Heart Failure.

Background Persistent congestion with deteriorating renal function is an important cause of adverse outcomes in heart failure. We aimed to characterize new approaches to evaluate renal congestion using Doppler ultrasonography. Methods and Results We enrolled 205 patients with suspected or prediagnosed pulmonary hypertension (PH) undergoing right heart catheterization.

Update and review of adult polycystic kidney disease.

Autosomal dominant polycystic kidney disease is a common cause of end stage kidney disease. It is a progressive and unfortunately incurable condition that can lead to significant morbidity and kidney failure. Many more patients are diagnosed with this disease without any symptoms as the population is increasingly undergoing imaging for other problems and diagnostic workup.

Case report: Patiromer-induced hypercalcemia.

Patiromer is a novel potassium-binding compound which has recently received FDA approval. This ion exchange resin releases calcium when it binds potassium. We describe the development of hypercalcemia after initiation of patiromer.

Rethinking the definition of major trauma: The need for trauma intervention outperforms Injury Severity Score and Revised Trauma Score in 38 adult and pediatric trauma centers.

Background: Patients' trauma burdens are a combination of anatomic damage, physiologic derangement, and the resultant depletion of reserve. Typically, Injury Severity Score (ISS) >15 defines major anatomic injury and Revised Trauma Score (RTS) <7.84 defines major physiologic derangement, but there is no standard definition for reserve.

Barrett oesophagus.

Barrett oesophagus (BE), the only known histological precursor of oesophageal adenocarcinoma (EAC), is a condition in which the squamous epithelium of the oesophagus is replaced by columnar epithelium as an adaptive response to gastro-oesophageal reflux. EAC has one of the fastest rising incidences of cancers in Western countries and has a dismal prognosis. BE is usually detected during endoscopic examination, and diagnosis is confirmed by the histological presence of intestinal metaplasia.