Textbook outcome in distal pancreatectomy: A multicenter study.

Background: Textbook outcome is an interesting quality metrics tool. Information on textbook outcomes in distal pancreatectomy is very scarce. In this study we determined textbook outcome in a distal pancreatectomy multicenter database and propose a specific definition of textbook outcome-distal pancreatectomy that includes pancreatic fistula.

International Liver Transplantation Society Global Census: First Look at Pediatric Liver Transplantation Activity Around the World.

Background: Over 16 000 children under the age of 15 died worldwide in 2017 because of liver disease. Pediatric liver transplantation (PLT) is currently the standard of care for these patients. The aim of this study is to describe global PLT activity and identify variations between regions.

Pancreatic mucinous cystic neoplasms located in the distal pancreas: a multicenter study.

Background: Mucinous cysts of the pancreas (MCN) are infrequent, usually unilocular tumors which occur in postmenopausal women and are located in the pancreatic body/tail. The risk of malignancy is low. The objective is to define preoperative risk factors of malignancy in pancreatic MCN and to assess the feasibility of the laparoscopic approach.

Characteristics and clinical outcomes of patients hospitalized with laboratory-confirmed COVID-19-Puerto Rico, March-August 2020.

Hispanics are the majority ethnic population in Puerto Rico where we reviewed charts of 109 hospitalized COVID-19 patients to better understand demographic and clinical characteristics of COVID-19 and determine risk factors for poor outcomes. Eligible medical records of hospitalized patients with confirmed COVID-19 illnesses were reviewed at four participating hospitals in population centers across Puerto Rico and data were abstracted that described the clinical course, interventions, and outcomes. We found hospitalized patients had a median of 3 underlying conditions with obesity and diabetes as the most frequently reported conditions.

Distal pancreatectomy with multivisceral resection: A retrospective multicenter study - Case series.

Background: Multivisceral resection (MVR) is sometimes necessary to achieve disease-free margins in cancer surgery. In certain patients with pancreatic tumors that invade neighboring organs these must be removed to perform an appropriate oncological surgery. In addition, there is an increasing need to perform resections of other organs like liver not directly invaded by the tumor but which require synchronous removal.

Interobserver agreement in distinguishing large adrenal adenomas and adrenocortical carcinomas on computed tomography.

Purpose: Large adrenal masses pose a diagnostic dilemma. The purpose of this study was twofold: first, to assess the degree of interobserver agreement in evaluating the morphology of pathologically proven adrenal adenomas and adrenocortical carcinomas larger than 4 cm in diameter; and second, to identify morphologic characteristics that correlated with the pathologic diagnosis.

Materials And Methods: For this blinded, retrospective study, we collected cases of 25 adrenal adenomas and 33 adrenocortical carcinomas measuring larger than 4 cm.

Kommerell's Diverticulum in an Aberrant Right Subclavian Artery: First Case Reported in a Male of Puerto Rican Descent.

A Kommerell's diverticulum is a rare embryologic defect of the aortic arch. The majority of the patients having this defect present with dysphagia, dyspnea, and syncope, or a combination of any 2 or all 3. For symptomatic cases, surgical correction is always the standard of care.

Results of Upfront Therapy for Marginal Zone Lymphoma.

Background: Marginal zone lymphomas (MZLs) are indolent disorders composed of 3 subtypes: extranodal marginal zone lymphoma (MALT), splenic marginal zone lymphoma (SMZL), and nodal marginal zone lymphoma (NMZL). Early-stage MALT is treated with radiotherapy or antibiotics, and advanced MALT and NMZL are managed with either watch and wait or chemotherapy. SMZLs are treated with splenectomy or rituximab.

Cutaneous/subcutaneous mesenchymal proliferations of the breast.

Cutaneous mesenchymal "spindle cell" lesions arising in the vicinity of the breast represent a complex clinical and diagnostic scenario which may overlap histopathologically and immunohistochemically with mammary spindle cell proliferations, potentially impacting management and overall prognostication. In this review, we suggest a pattern-based approach to assist in the evaluation of these lesions. A comprehensive description of each entity is accompanied by a cutaneous and mammary differential diagnosis.

An aggressive non-small cell lung cancer in nonsmokers: A case report of an unusual presentation of micropapillary lung adenocarcinoma.

We describe a case of an unusual fast growing lung micropapillary-predominant adenocarcinoma in a nonsmoker male patient without pre-existing lung disease. Adenocarcinomas have been described to be slow growing tumors, however our patient presented a fast-growing rate over a period of 21 days. When the patient failed broad spectrum antibiotic coverage, malignancy became part of the differential diagnosis.

Indolent Lymphomas That Present With Clinically Aggressive Features: A Subset of Low-Grade Lymphomas With a Behavior Inconsistent With the Histologic Diagnosis.

Background: The expected presentation for low-grade lymphomas consists of disseminated lymphadenopathy with no constitutional symptomsk, and with bone marrow involvement, normal lactate dehydrogenase (LDH), low proliferative rate as determined by Ki-67, and positron emission tomography (PET) scan with low standardized uptake values (SUVs) < 14. However, it is not unusual for some cases to present with 1 or more clinically aggressive features. Because the clinical behavior of such patients has not been investigated, there are no data regarding their expected outcome.

Brachytherapy in pelvic malignancies: a review for radiologists.

Brachytherapy, also known as sealed source or internal radiation therapy, involves placement of a radioactive source immediately adjacent to or within tumor, thus enabling delivery of a localized high dose of radiation. Compared with external beam radiation which must first pass through non-target tissues, brachytherapy results in less radiation dose to normal tissues. In the past decade, brachytherapy use has markedly increased, thus radiologists are encountering brachytherapy devices and their associated post-treatment changes to increasing degree.

Outcomes in ethnic minority renal transplant recipients receiving everolimus versus mycophenolate: comparative risk assessment results from a pooled analysis.

Background: Everolimus (EVR) has demonstrated good efficacy after renal transplantation. Racial disparities in clinical outcomes after de novo renal transplantation are well documented; whether the efficacy of EVR varies based on recipient ethnicity is unknown. We conducted a comparative risk assessment of EVR by ethnicity.

New developments in the field of diffuse large cell lymphoma.

This update will focus on new developments which can impact the understanding and management of patients with DLCL. The latter disorder is mostly derived from B lymphocytes which can be further subdivided into those that originate from the germinal center versus those that arise from non-germinal center areas in the lymph node. The differences between these two types will be discussed.

[Early referrals of patients with bile duct lesion improve reconstructive surgery outcome].

Damage to the bile ducts caused during open cholecystectomy or laparoscopic cholecystectomy remains a major problem in the practice of surgery today. This is associated with a poor quality of life and increased morbidity. The incidence of bile duct damage varies with the type of damage and the type of surgery performed.

High incidence of non-neutropenic infections induced by rituximab plus fludarabine and associated with hypogammaglobulinemia: a frequently unrecognized and easily treatable complication.

Background: Rituximab is associated with low incidence of hypogammaglobulinemia and little morbidity. Our experience with the combination of rituximab + chemotherapy suggested the opposite.

Patients And Methods: We analyzed our experience with rituximab plus chemotherapy in 97 patients to determine: frequency and type of non-neutropenic infection (NNI); frequency and type of hypogammaglobulinemia; response to gammaglobulin therapy; and factors associated with NNI.

Mammographic features and correlation with biopsy findings using 11-gauge stereotactic vacuum-assisted breast biopsy (SVABB).

Background: Mammograms are assigned a BI-RADS (Breast Imaging Reporting and Data System) category, which indicates the level of suspicion for cancer.

Objectives: (i) To evaluate the use of BI-RADS categories in a non-academic radiology practice based in a community hospital compared with local radiology private offices; (ii) to determine positive predictive value (PPV), sensitivity and specificity of mammograms; and (iii) to explore the correlation of BI-RAD 3-5 and lesion description with diagnosis of cancer.

Patients And Methods: We performed 947 SVABBs (stereotactic vacuum-assisted breast biopsies) on 911 patients with BI-RADS 3-5.

Evaluation of Breast Imaging Reporting and Data System Category 3 mammograms and the use of stereotactic vacuum-assisted breast biopsy in a nonacademic community practice.

Background: Breast Imaging Reporting and Data System (BI-RADS) Category 3 represents 'probably benign' mammographic abnormalities requiring close follow-up, but biopsies sometimes are performed on Category 3 abnormalities. Controversy exists as to when these biopsies are justified. The goals of the current study were to evaluate the use of stereotactic vacuum-assisted breast biopsy (SVABB) for BI-RADS 3 lesions in a nonacademic community hospital-based practice, to evaluate the false- negative rate of Category 3 mammograms, and to determine whether any specific lesions misinterpreted as BI-RADS 3 abnormalities might commonly be associated with malignant disease.

Nutrition in advanced digestive cancer.

Purpose Of Review: The provision of nutrition to patients with advanced digestive cancer, especially those with obstruction, has been an issue discussed by physicians, administrators and patients themselves. There is no real consensus about this topic, perhaps because of the fact that this discussion involves medical, emotional, ethical, economical and legal considerations that are not easily encompassed by any single decision. On the other hand, the quality of life or survival of these patients must be thoroughly evaluated because one of the basic tenets of medicine has always been 'primum non nocere' ('above all, do not harm').