Assessing asymmetric enhancement on breast MRI: Besting the diagnostic challenge with imaging and clinical clues.

Breast magnetic resonance imaging (MRI) has the highest sensitivity for breast cancer detection compared to other breast imaging modalities such as mammography and ultrasound. As a functional modality, it captures the increased angiogenic activity of breast cancer through gadolinium-based contrast enhancement. Normal breast tissue also enhances, albeit in distinct patterns termed background parenchymal enhancement (BPE).

Evolving concepts in intracranial pressure monitoring - from traditional monitoring to precision medicine.

A wide range of acute brain injuries, including both traumatic and non-traumatic causes, can result in elevated intracranial pressure (ICP), which in turn can cause further secondary injury to the brain, initiating a vicious cascade of propagating injury. Elevated ICP is therefore a neurological injury that requires intensive monitoring and time-sensitive interventions. Patients at high risk for developing elevated ICP undergo placement of invasive ICP monitors including external ventricular drains, intraparenchymal ICP monitors, and lumbar drains.

Behind the scenes of EQA - characteristics, capabilities, benefits and assets of external quality assessment (EQA).

This is the first in a series of five papers that detail the role and substantial impact that external quality assessment (EQA) and their providers' services play in ensuring diagnostic (IVD) performance quality. The aim is to give readers and users of EQA services an insight into the processes in EQA, explain to them what happens before EQA samples are delivered and after examination results are submitted to the provider, how they are assessed, what benefits participants can expect, but also who are stakeholders other than participants and what significance do EQA data and assessment results have for them. This first paper presents the history of EQA, insights into legal, financing and ethical matters, information technology used in EQA, structure and lifecycle of EQA programs, frequency and intensity of challenges, and unique requirements of extra-examination and educational EQA programs.

Blood samples for ammonia analysis do not require transport to the laboratory on ice: a study of ammonia stability and cause of ammonia increase in samples from patients with hyperammonaemia.

Objectives: Prompt recognition of hyperammonaemia can avoid severe consequences of delayed treatment. Strict sample transport requirements present barriers to requesting and, if not achieved, rejection by the laboratory. Evidence is sparse on ammonia stability from studies using modern techniques or based in clinical settings.

Screening Criteria Evaluation for Expansion in Pulmonary Neoplasias (SCREEN) II.

Background: There is a need to expand eligibility criteria for lung cancer screening beyond age and smoking history. In this study, we sought to assess whether light-or-never-smokers and heavy smokers differ in molecular and immunologic markers based on conventional lung cancer screening criteria.

Methods: We conducted a retrospective review of lung cancer cases from 2005 to 2018 at a tertiary Canadian institution.

Liquorice-induced pseudohyperaldosteronism: a rare cause for severe hypertension.

This case report describes an adult man in his 50s with a history of type 2 diabetes and previously well-controlled hypertension, who presented with uncontrolled hypertension, muscle weakness and fatigue. Biochemical testing revealed hypokalaemia. There was no evidence of renal/renovascular disease.

Cerebral aspergillosis in a patient with chronic lymphocytic leukaemia complicated by Evans syndrome.

This case report presents a complex medical scenario involving early 60s female patient with a history of chronic lymphocytic leukaemia (CLL) complicated by Evans syndrome, characterised by autoimmune haemolytic anaemia and immune thrombocytopenia. The patient had received various treatments, including steroids, rituximab, cyclosporine and acalabrutinib. The patient's neurological symptoms began around 3 years prior to presentation, with shaking of her right leg, followed by shaking of both hands, particularly the left hand.

The Moreton Lecture Series: The Renin-Angiotensin-Aldosterone System-Physiology, Pathophysiology, and Pharmacological Inhibition.

The renin-angiotensin-aldosterone system (RAAS) is a complex regulator comprising hormones, proteins, and enzymes. The discovery of the RAAS and its pharmacological manipulation has been essential in the management of cardiovascular diseases, including hypertension. Beyond the benefits of hypertension, RAAS inhibition has implications for heart failure, atherosclerotic disease, and kidney disease.

Development and Validation of a Nomogram-Based Model to Predict Primary Hypertension Within the Next Year in Children and Adolescents: Retrospective Cohort Study.

Background: Primary hypertension (PH) poses significant risks to children and adolescents. Few prediction models for the risk of PH in children and adolescents currently exist, posing a challenge for doctors in making informed clinical decisions.

Objective: This study aimed to investigate the incidence and risk factors of PH in Chinese children and adolescents.

Utilization of dupilumab in an immunocompromised patient with extensive allergic fungal rhinosinusitis unsuitable for surgical intervention: A case report.

Introduction: Allergic fungal rhinosinusitis (AFRS) is a distinct subset of chronic rhinosinusitis characterized by a type I hypersensitivity to fungi. Immunocompromised patients are at increased risk for fungal infections. This case highlights the complexities of managing AFRS in patients not eligible for surgery.

"Innovative multidisciplinary care in pediatric magnet aspiration: A case report".

Introduction: Foreign body (FB) inhalation is a potentially life-threatening condition in children. Magnets, being rare, aspirated objects, pose significant threat due to their physical and magnetic properties.

Case Presentation: A 10-year-old girl with a history of magnet aspiration went into respiratory distress due to dislodgement of magnet to opposite main bronchus following failed attempt of removal via Rigid Bronchoscopy.

Cyst of the canal of Nuck in an adult female patient: A case report on surgical management.

Introduction: The cyst of the canal of Nuck is a rare cause of inguino-labial swelling in adult women, arising from an obliteration failure of the processus vaginalis during embryological development. Its rarity often leads to misdiagnosis and improper treatment. This article highlights its diagnosis and surgical management.

Primary bladder neck obstruction in females: Case series from the Indonesian population.

Introduction: Primary bladder neck obstruction (PBNO) is a rare but significant cause of BOO and LUTS in females, with unclear etiology involving theories of fibrotic narrowing, tissue hyperplasia, or muscle abnormalities. Due to nonspecific symptoms, PBNO diagnosis remains challenging, and optimal surgical treatment needs to be better defined.

Case Presentation: We report two cases of females in their 50s with recurrent urinary retention managed by indwelling catheters.

Success History Adaptive Competitive Swarm Optimizer with Linear Population Reduction: Performance benchmarking and application in eye disease detection.

Eye disease detection has achieved significant advancements thanks to artificial intelligence (AI) techniques. However, the construction of high-accuracy predictive models still faces challenges, and one reason is the deficiency of the optimizer. This paper presents an efficient optimizer named Success History Adaptive Competitive Swarm Optimizer with Linear Population Reduction (L-SHACSO).

Solid pseudopapillary neoplasm of the pancreas in a 54-year-old woman: A case report and the literature analysis.

Introduction: Solid pseudopapillary neoplasm (SPN) is a rare pancreatic tumor typically occurring in young females. This case presents an instance of SPN in a 54-year-old Caucasian female, highlighting atypical age of onset and providing new insights into the tumor's clinical and histopathological diversity.

Case Report: A 54-year-old female with no significant past medical history presented with upper abdominal discomfort and weakness.

Taxonomic revision of the SK 15 mandible based on bone and tooth structural organization.

The hominin mandible SK 15 was discovered in April 1949 in Swartkrans Member 2, dated to ∼1.4 Ma. Albeit distorted on the right side, the left and right corpus of SK 15 are relatively low and thick, even compared to most Early to Middle Pleistocene Homo specimens.

Historic smallpox vaccination and Mpox cross-reactive immunity: Evidence from healthcare workers with childhood and adulthood exposures.

In recent years, human mpox has made multiple resurges, prompting public health professionals to consider factors that lead to the increased risk for the reemergence of other orthopoxviruses. Due to the genetic similarity between orthopoxviruses, vaccinia vaccines used to prevent smallpox transmission are also indicated and have been used for mpox infection prevention and control. In this study, cross-reactive immunity for mpox was observed among individuals with self-reported history of smallpox vaccination.

Coastal redox shifts over the past 167 years and preservation of total organic carbon and total nitrogen.

This study reconstructs the environmental history of Xincun Lagoon over the past 167 years using sediment core XCW, employing Cu/Zn as a proxy for redox changes. Time-series analysis of Cu/Zn ratios reveals a significant decline (linear regression slope = -0.00082, p < 0.

Sedimentary co-exposure to bis(2-ethylhexyl) phthalate and titanium dioxide nanoparticles aggravate ecotoxicity and ecological risks through disrupted bioenergetics in Caenorhabditis elegans.

Emerging contaminants in estuarine sediments, such as bis(2-ethylhexyl) phthalate (DEHP) and titanium dioxide nanoparticles (nTiO), pose ecotoxicological risks that may be exacerbated by co-contamination. This study investigated the impacts of DEHP, nTiO, and their combinations at environmentally relevant concentrations (1, 10, and 100 μg/g) on the soil nematode Caenorhabditis elegans in estuarine-like sediment (14.25‰ salinity).

Occurrence and health risk assessment of selected metals in commercially available infant formulas in Jordan.

Background: Infant formulas are the primary source of nutrition for infants and babies when breastfeeding is unavailable, as they are enriched with a variety of macro- and micronutrients to improve their nutritional value and satisfy the different needs of babies. Recently, there has been a rising concern about toxic metal levels in infant formulas, as highlighted by various studies. However, there are currently no sufficient studies focusing on toxic metal levels of infant formulas in Jordan.

A rare variant in the UQCRC1 gene, p.(Gly405Val) in three Austrian Parkinson's patients.

Background: Variants in the UQCRC1 gene have been proposed to cause autosomal dominant Parkinson's disease with neuropathy. However, definitive confirmation of UQCRC1 as an authentic Parkinson's gene remains elusive, as follow-up studies have not yet provided conclusive evidence.

Methods: 382 Austrian Parkinson's patients, particularly selected for familial and/or early onset cases, were Exome sequenced.

Disentangling Sources of Momentum Fluctuations in Xe+Xe and Pb+Pb Collisions with the ATLAS Detector.

High-energy nuclear collisions create a quark-gluon plasma, whose initial condition and subsequent expansion vary from event to event, impacting the distribution of the eventwise average transverse momentum [P([p_{T}])]. Disentangling the contributions from fluctuations in the nuclear overlap size (geometrical component) and other sources at a fixed size (intrinsic component) remains a challenge. This problem is addressed by measuring the mean, variance, and skewness of P([p_{T}]) in ^{208}Pb+^{208}Pb and ^{129}Xe+^{129}Xe collisions at sqrt[s_{NN}]=5.

The Importance of Sexual History-Taking Within Surgery.

Sexual and reproductive health is an essential part of comprehensive medical care. As the field of medicine becomes more specialized and siloed and the diagnostic work-up in surgery more advanced, the risk of anchoring diagnoses and partitioning of care increases. Thus, the fundamentals of a complete patient history and review of each body system remain critical in ensuring that surgeons establish a broad differential diagnosis; provide comprehensive, well-rounded care to patients; and create opportunities for patient counseling and interventions.