Clinical Significance of Tumor Location for Ureteroscopic Tumor Grading in Upper Tract Urothelial Carcinoma.

Although previous literature shows tumor location as a prognostic factor in upper tract urothelial carcinoma (UTUC), there remains uninvestigated regarding the impact of tumor location on grade concordance and discrepancies between ureteroscopic (URS) biopsy and final radical nephroureterectomy (RNU) pathology. In this international study, we retrospectively reviewed the records of 1,498 patients with UTUC who underwent diagnostic URS with concomitant biopsy followed by RNU between 2005 and 2020. Tumor location was divided into four sections: the calyceal-pelvic system, proximal ureter, middle ureter, and distal ureter.

"Faith and a sunny day": Association of patient frailty with strain experienced by informal caregivers of older adults with non-muscle-invasive bladder cancer.

Introduction: Few studies have evaluated the potential effects of aging-related conditions like frailty in older adults with cancer on informal caregivers. Our objective was to evaluate the association between the sum total of the aging-related conditions of older adults with non-muscle-invasive bladder cancer (NMIBC) and the strain reported by their informal caregivers.

Materials And Methods: We conducted an explanatory sequential mixed methods cross-sectional survey study that recruited 81 dyads of older adults with NMIBC (age ≥ 65 at diagnosis) and their informal caregivers.

Effectiveness comparison of genicular nerve ablation for knee osteoarthritic versus post-total knee arthroplasty pain.

Background: Genicular nerve radiofrequency ablation (GNRFA) is a popular and effective procedure to treat arthritic knee pain. For refractory arthritic pain that fails conservative treatment, total knee arthroplasty (TKA) has been an excellent option. Unfortunately, 15-30% of people who undergo a TKA continue to experience pain and stiffness in the knee.

Initial Experience with Disposable Single-Use Cholangioscope During Laparoscopic Common Bile Duct Exploration.

For patients with choledocholithiasis, laparoscopic common bile duct exploration (LCBDE) is more cost effective than endoscopic retrograde cholangiopancreatography (ERCP) and results in shorter hospital length of stay. As LCBDE can be technically challenging to perform, utilizing a disposable single-use cholangioscope (DSUC) for LCBDE through a cystic ductotomy has several advantages, such as potentially avoiding a choledochotomy and expanding access to cholangioscopes as a DSUC is disposable and does not require infrastructure for cleaning or maintenance. An IRB-approved, retrospective chart review from 2021 to 2023 was conducted for patients who underwent concurrent laparoscopic cholecystectomy (LC) and LCBDE with a DSUC (SpyGlass™ Discover, Boston Scientific, Natick, MA) for the management of choledocholithiasis diagnosed either preoperatively or during intraoperative cholangiogram (IOC).

Educator's blueprint: A how-to guide for creating high-quality slides.

Didactics are the primary modality in which educators disseminate knowledge. The accompanying slides are a critical element, which can enhance or distract from the corresponding presentation. This Educator's Blueprint provides 10 strategies for creating high-quality presentation slides.

Sex-based utilization and outcomes of cold-stored whole blood for trauma resuscitation: Analysis of a prospective multicenter study.

Background: Resuscitation with cold-stored whole blood (WB) has outcome benefits, but benefits varied by patient sex is unknown. There are also concerns about alloimmunization risk for premenopausal females given WB, leading to some protocols excluding this cohort. We sought to analyze WB utilization, outcomes, and disparities by patient sex.

Paediatric trigger thumb: Diagnostic pearls.

Aim: The purpose of this study is to report diagnostic pearls and review the clinical presentation and outcomes of surgical treatment of paediatric trigger thumbs.

Methods: A retrospective review of medical records and imaging studies was performed on children with trigger thumbs from January 2009 to December 2019.

Results: Sixty-four trigger thumbs in 52 consecutive patients were treated.

Detection of benign granular cell tumor of the breast via F-PSMA-PET/CT in a patient with very high-risk prostate cancer: A case report.

Incidental extra-prostatic prostate-specific membrane antigen (PSMA) uptake on initial staging positron emission tomography/computed tomography (PET/CT) scans poses diagnostic challenges, as it can be associated with various benign and malignant lesions. We present the case of a 68-year-old man with very high-risk prostate cancer who was incidentally discovered to have a benign granular cell tumor in the breast initially detected on PSMA-PET/CT. Imaging studies and biopsy were pivotal in the diagnosis, as the tumor's appearance was concerning for breast carcinoma.

A Case of Basal Ganglia Intraparenchymal Hemorrhage Following Lumbar Spinal Surgery.

We report on a rare case of basal ganglia intraparenchymal hemorrhage with intraventricular extension occurring after a lumbar spinal surgery. A 65-year-old female presented for an elective L4-L5 lumbar laminectomy and posterior spinal fixation. Her initial operation was complicated by a cerebrospinal fluid (CSF) leak repaired with a dural synthetic graft.

Navigating the Depths of Cardiovascular Effects on Submariners.

The environment of the submariner is inherently endowed with several health risk factors, namely confinement, inactivity, caloric excess, and circadian disruption, among others, during deployment. Metabolic disturbances, increased cardiovascular risk, and sleep deprivation are associated with interrupting circadian rhythms due to routines contributing to physiological and cognitive abnormalities. Additionally, submariners face vitamin deficits of vitamin D and vitamin B12 due to little exposure to sunlight and poor nutrition.

Exercise in patients with epilepsy and neurostimulation devices - physical activity levels, barriers, and beliefs.

Exercise improves many comorbidities associated with epilepsy in addition to seizure control. Despite the ILAE consensus statement noting the positive effects of exercise in patients with epilepsy (PWE) and individual assessment of risks pertaining to these activities, many healthcare professionals, including neurologists, are unfamiliar with these guidelines. Neurostimulation is an increasingly prevalent treatment option for refractory epilepsy.

Atherosclerotic cardiovascular disease following a diagnosis of idiopathic inflammatory myopathy: analysis from a retrospective cohort in the TriNetX registry.

Objective: Idiopathic inflammatory myopathies (IIM) confer an increased risk of morbidity from atherosclerotic cardiovascular disease (ASCVD). While ASCVD risk has been studied in other countries, these results may not be applicable to patients with dermatomyositis (DM) and polymyositis (PM) in the United States. This retrospective analysis of a cohort of patients identified by ICD code from TriNetX investigated the incidence of ASCVD after International Classification of Disease (ICD) codes of DM, PM, dermatopolymyositis (DPM) or juvenile dermatomyositis (JDM).

Engineering Microgel Packing to Tailor the Physical and Biological Properties of Gelatin Methacryloyl Granular Hydrogel Scaffolds.

Granular hydrogel scaffolds (GHS) are fabricated via placing hydrogel microparticles (HMP) in close contact (packing), followed by physical and/or chemical interparticle bond formation. Gelatin methacryloyl (GelMA) GHS have recently emerged as a promising platform for biomedical applications; however, little is known about how the packing of building blocks, physically crosslinked soft GelMA HMP, affects the physical (pore microarchitecture and mechanical/rheological properties) and biological (in vitro and in vivo) attributes of GHS. Here, the GHS pore microarchitecture is engineered via the external (centrifugal) force-induced packing and deformation of GelMA HMP to regulate GHS mechanical and rheological properties, as well as biological responses in vitro and in vivo.

Adding "Unlikely" as a Clinical Qualifier Is Unlikely to Be of Help: A Retrospective, Single-Center, Cross-Sectional Cohort Study.

Clinical correlation is essential to accurate and efficient diagnosis and differential diagnosis in dermatopathology. Poor-quality clinical information can lead to failures and delays in patient care. Some clinicians use the term "unlikely" when submitting a specimen.

Select black men are potential candidates for prostate hemi-ablation based on radical prostatectomy histopathology for intermediate-risk prostate cancer-a multicenter SEARCH cohort study.

Importance And Objective: Partial gland ablation (PGA) is increasingly popular as a treatment for men with intermediate-risk prostate cancer (IR-PCa) to preserve functional outcomes while controlling their cancer. We aimed to determine the impact of race and clinical characteristics on the risk of upstaging (≥pT2c) and having adverse pathological outcomes including seminal vesicle invasion (SVI), extra prostatic extension (EPE) and lymph node invasion (LNI) at radical prostatectomy (RP) among men with IR disease eligible for PGA with hemi-ablation (HA).

Design: Retrospective analysis.

An evaluation of mitomycin-containing reverse thermal gel for the treatment of low-grade upper tract urothelial carcinoma.

Introduction: Endoscopic management of upper tract urothelial carcinoma (UTUC) is increasingly relevant with greater detection of low-grade disease and guidelines recommending kidney preservation for low-risk disease. Historically, laser or thermal ablation has served as the primary tool for endoscopic management of UTUC, however, chemoablation is rapidly being developed to serve as a primary or adjuvant treatment option, which warrants review.

Areas Covered: The current literature was reviewed to compare the outcomes and clinical utility of endoscopic treatment modalities for low-grade UTUC, with a focus on mitomycin-containing reverse thermal gel (UGN-101).

Voices of the accelerated: key themes when considering implementation of an accelerated medical school program.

In this rapid communication, accelerated undergraduate medical education is examined using prior literature as well as experiences of those who have completed or are in the process of completing accelerated medical curricula. The Consortium of Accelerated Medical Pathway Programs (CAMPP) hosts an annual multi-institutional conference for all its members. During the meeting in July 2023, a virtual panel was convened from multiple constituent programs ( = 4) including medical students ( = 2), resident physicians ( = 4), and faculty ( = 2).