Gastrointestinal Stromal Tumor (GIST) in a Young Adult: A Rare Presentation and a Multidisciplinary Approach.

A gastrointestinal stromal tumor is a rare gastrointestinal tumor of mesenchymal origin. We present a rare case of a 32-year-old male patient with a history of iron deficiency anemia who presented with nocturnal cramping abdominal pain, nausea, non-bloody vomiting, loss of appetite, and weight loss. The patient had no significant family history of cancer.

Thirty-day hospital readmission in females with acute heart failure and breast cancer: A retrospective cohort study from national readmission database.

Background: Breast Cancer and cardiovascular diseases are amongst the two leading causes of mortality in the United States, and the two conditions are connected in part because of recognized cardiotoxicity of cancer treatments. The aim of this study is to investigate the predictors risk factors for thirty-day readmission in female breast cancer survivors presenting with acute heart failure.

Methods: This is a retrospective cohort study of acute heart failure (AHF) hospitalization in female patients with breast cancer in 2019 using the National Readmission Database (NRD), which is the largest publicly available all-payer inpatient readmission database in the United States.

A Rare Case of Peritoneal Dialysis-Associated Peritonitis Caused by Neisseria sicca.

Peritonitis is a critical complication in peritoneal dialysis, often leading to peritoneal dialysis (PD) treatment failure. We present a rare case of (NS)-related peritonitis in a 47-year-old male with multiple comorbidities. Despite NS's infrequent association with infections, prompt diagnosis and antibiotic therapy based on International Society for Peritoneal Dialysis (ISPD) guidelines led to a favorable outcome.

Mixed Plate Ductal Intrahepatic Cholangiocarcinoma Mimicking Hepatocellular Carcinoma.

Cholangiocarcinoma (CCA) refers to malignancies of the bile ducts that arise in the intrahepatic, perihilar, or distal (extrahepatic) biliary tree, excluding the gallbladder and ampulla of Vater. Although rare, the majority of these cancers are locally advanced at presentation, making them extremely fatal. We present a case of a 65-year-old man who came in for abdominal pain and ascites and was found to have portal vein thrombosis.

Small Cell/Neuroendocrine Prostate Cancer: A Rare Treatment-Resistant Variant Presenting as Acute Onset Severe Back Pain.

Adenocarcinoma of the prostate is the most frequent subtype of prostate cancer. Being an androgen-driven disease, androgen deprivation therapy (ADT) is one of the mainstay treatments for prostatic adenocarcinoma. ADT however can induce androgen resistance and can cause neuroendocrine differentiation of the cells and subsequently can lead to the emergence of neuroendocrine prostate cancer (NEPC).

Evaluation of a large-scale aptamer proteomics platform among patients with kidney failure on dialysis.

Background: Patients with kidney failure suffer high mortality, and we currently lack markers for risk stratification for these patients. We carried out a quality control study of a modified aptamer assay (SomaScan v.4.

Left Ventricular Noncompaction in Concomitance With Heroin Use Disorder.

Left ventricular noncompaction (LVNC) is a rare congenital condition defined by the presence of prominent trabeculations in the myocardial layer of the left ventricle. The clinical presentation is varied as some patients are asymptomatic and others have symptoms of decompensated heart failure, arrhythmias, or thromboembolism. We present the case of a 42-year-old female with a past medical history of asthma and substance use disorder who presented to the Emergency Department following a syncopal event.

COVID-19-Associated Nephropathy: A Devastating Complication.

With the rapid emergence and prevalence of SARS-CoV-2 worldwide, cases of COVID-19-associated nephropathy (COVAN) from collapsing focal segmental glomerulosclerosis (cFSGS) have been reported, and the associations between the two are actively being studied. Creating appropriate treatment guidelines for COVAN requires further understanding of the pathophysiology of this type of kidney injury. This case report outlines the case of a 77-year-old patient admitted to the hospital for COVID-19 infection with a subsequent renal biopsy indicating cFSGS, adding to the data exploring the relationship between COVID-19 infections, cFSGS and the associated risk factors.

Methotrexate-Induced Lymphoproliferative Disorder Complicating Into Spontaneous Tumor Lysis Syndrome and Disseminated Intravascular Coagulation.

Lymphoproliferative disorder (LPD) is a severe adverse outcome of methotrexate (MTX) administration in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). The immunosuppression caused is attributed to pathogenesis. Hence, discontinuation is the treatment.

A Fatal Case of Systemic Calciphylaxis in the Gastrointestinal Tract: A Case Report and Literature Review.

Calciphylaxis is an infrequent yet lethal disease often associated with end-stage kidney disease (ESKD). The most common sites include proximal and distal extremities and the trunk, with few reported in the penis and very few as gastrointestinal (GI) disease. We report a case of systemic calciphylaxis in a middle-aged male, presenting with a colostomy leak and parastomal abscess.

Antimitochondrial Antibody-Negative Primary Biliary Cholangitis: A Retrospective Diagnosis.

Primary biliary cholangitis (PBC) is an inflammatory cholestatic disease that tends to worsen, leading to hepatic cirrhosis and portal hypertension. We present a case of a middle-aged female who presented with progressively worsening generalized itch; the examination was significant only for urticarial rash and facial swelling. Investigation revealed direct hyperbilirubinemia, mildly elevated transaminase, and significant elevation of alkaline phosphatase.

Sarcoidosis of the Bile Duct.

Sarcoidosis is an inflammatory disease that affects multiple organs. The lungs are the most commonly involved organs. Although a large proportion of patients with sarcoidosis have liver involvement, bile duct involvement is rare.

A step-by-step approach to a frozen pelvis.

Objective: To demonstrate a step-by-step approach for restoration of pelvic anatomy in frozen pelvis using a systematic approach to make the steps reproducible, safe, and time efficient.

Design: Video presentation.

Setting: Academic medical center.

Strategies for Cost Optimization in Minimally Invasive Gynecologic Surgery.

Background: Cost and quality are important, complex, and intertwined surgical outcomes. Evidence suggests that major cost drivers include operating room time, length of stay, re-admission, surgical complications, and quality of pre-operative and operative care in general. Our practices shape both costs and quality of gynecologic surgery.

septic arthritis in an immunocompromised patient on haemodialysis with history of splenectomy and sarcoidosis.

A male adult in his mid-40s with end-stage renal disease (ESRD) on haemodialysis, with history of splenectomy and sarcoidosis, developed septic arthritis of the knee. Excision and drainage was performed and empiric antibiotics were initiated. Cultures were initially negative without clinical improvement.

Excision of Deep Endometriosis of the Rectosigmoid: Individualizing Care to the Presenting Pathology.

Study Objective: To highlight different surgical approaches for managing deep infiltrating endometriosis involving the rectosigmoid colon.

Design: Demonstration of specific surgical techniques with educational narrated video footage.

Setting: Bowel endometriosis is reported in 3.

Unmasking acute aortic root dissection in otherwise stable atypical chest pain.

In the absence of typical features and risks for life-threatening chest pain including aortic dissection, the obligation and urgency for their evaluation remains unimpeachable, more so when patients present in stable conditions suggestive of benign etiology. Better do the painstaking, rather than be undone by the pain.

Temporal Association between Influenza Vaccination Coverage and Ambulatory Antibiotic Use in Children.

In this population-based retrospective cohort study, increased influenza vaccination coverage was temporally associated with a reduction in ambulatory antibiotic use in children. After adjustment for yearly vaccine effectiveness, antibiotic prescription rate declined by 3/1000 person-months for each 1% increase in influenza vaccination coverage between 2012 and 2017 in South Carolina (P < 0.001).

Limitations of imaging screening tests in the detection of incomplete uterine septum or arcuate uterine anomaly.

Objectives: To determine the detection rates of hysterosalpingogram (HSG), transvaginal 2D ultrasound (TV 2D US), transvaginal 3D ultrasound (TV 3D US) in diagnosing of incomplete uterine septum (IUS) and significant arcuate uterine anomaly (AUA).

Methods: This retrospective cohort study included patients with infertility or recurrent pregnancy loss (516) that were found to have IUS (317) or significant AUA (199) on diagnostic hysteroscopy (DHS). We compared the detection rate of the various radiological tests in all patients with documented IUS or AUA on DHS.

Perfecting hysterosalpingography: Limitations to the use of disposable balloon catheter and its solution.

Objective: To revive the use of the Kahn Uterine Trigger Cannula to overcome limitations associated with technical difficulties during hysterosalpingography (HSG) using the disposable balloon HSG catheter.

Method: A case series was conducted of 17 patients who encountered technically difficult or incomplete HSG study while using a disposable HSG balloon catheter, also leading to false-positive findings. Nine patients underwent a repeat HSG using a Kahn Uterine Trigger Cannula (Group 1).

Persistent viremia in an immunocompetent patient with inherited chromosomally integrated HHV-6B.

Human herpesvirus-6 (HHV-6), the virus which causes roseola, has traditionally been associated with benign and self-limited childhood illness. However, HHV-6 establishes lifelong latency and can reactivate in immunocompromised adult patients. In about 1% of cases, it integrates into the human genome as inherited chromosomally integrated HHV-6 (iciHHV-6).

Omega-3 supplementation and heart failure: A meta-analysis of 12 trials including 81,364 participants.

Heart failure (HF) remains a leading cause of hospitalization and mortality. Marine omega-3 fatty acid supplements (omega-3 s) have shown efficacy in decreasing sudden cardiac death and improving the left ventricle ejection fraction percent (LVEF%). In this review, we evaluated the effect of marine omega-3 fatty acid supplements (omega-3 s) on HF hospitalization, recurrent HF hospitalization, and cardiovascular mortality in patients with heart failure.

Initial optimal medical therapy with or without invasive strategy for stable coronary disease: a meta-analysis and systematic review.

Introduction: There is a persistent controversy regarding the benefit and timing of angiography in patients with stable coronary artery disease (CAD). With this meta-analysis of randomized controlled trials (RCTs) the advantages of initial invasive strategy and medical therapy compared with only medical therapy.

Methods: We conducted a literature search of the following databases Pubmed/MEDLINE, Cochrane Library and Embase.

A Cause-Effect Relationship of Infliximab and Pulmonary Embolism: A Case Report.

Biological monoclonal antibodies such as infliximab have significantly remodeled inflammatory bowel disease's treatment course. Despite multiple side effects reported with infliximab, this medication has shown to be robust and practical. There is a paucity of cases reporting venous thromboembolism (VTE) occurrence during the treatment with infliximab.