Metastatic ovarian sex-cord stromal tumor with annular tubules in a patient without Peutz-Jeghers syndrome.

Sex-cord stromal tumors (SCSTs) with annular tubules (SCTATs) are a small class of ovarian lesions that possess histologic features of both Sertoli and granulosa cells. Approximately one-third of patients with SCTAT also have Peutz-Jaghers syndreome, which makes these cases especially rare. Patients with non-PJS-associated SCTAT make up the remaining two-thirds; 20% of these cases have a metastatic presentation.

Somatosensory evoked potential monitoring during anterior cervical discectomy and fusion.

Study Design: A retrospective, multicenter clinical review was conducted.

Objective: To examine our experience using somatosensory evoked potential (SSEP) monitoring during anterior cervical discectomy and fusion (ACDF) to determine if monitoring of the spinal cord with SSEPs was helpful in identifying reversible causes of neurologic impairment while performing the procedure.

Summary Of Background Data: Recent studies have strongly supported the use of SSEP monitoring during complicated and upper-cervical spine surgery.

Common scenarios to clarify the interpretation of cardiac markers.

The authors present a practical approach for physicians in clinical practice to use cardiac troponins in the interpretation of heart disease and myocardial damage. Laboratory results that fall within the intermediate area of facility-specific cutoff reference values for elevated troponin levels confer lower risks to patients than do higher levels of cardiac troponin. Perhaps not surprisingly, the actual anatomy of the vessels at cardiac catheterization does not correlate well with the troponin level.

Decreased laboratory testing for lecithin-to-sphingomyelin ratio and phosphatidylglycerol after fetal lung maturity assessment from lamellar body count in amniotic fluid.

The objectives of this study were to do inexpensive lamellar body count (LBC) in amniotic fluid, to do statistical analysis to evaluate cutoff values for fetal lung maturity (FLM) and fetal lung immaturity (FLI), to derive a threshold for obtaining a lecithin-to-sphingomyelin (L/S) ratio and phosphatidylglycerol percentage (%PG), and to determine the potential cost savings to the hospital if they use this new method. Testing (LBC, L/S ratio, and %PG) was done on 123 specimens of amniotic fluid. Receiver operating characteristic (ROC) curve, discriminant, linear regression, chi2, and cost analyses were used to evaluate the laboratory and financial parameters.

The posteromedial process fracture of the talus: a case report.

Injuries to the ankle tend to be some of the most common injuries seen in practice. Of these ankle injuries, fractures of the posteromedial process of the talus are often misdiagnosed as ankle sprains because of poor visualization on routine ankle radiographs. The examining physician must have a heightened awareness of this injury to accurately diagnose and treat this fracture.

Plan faster, healthier recovery after orthopedic surgery.

Two hospitals--one community and one urban--use clinical pathways to streamline patient care. They lower the average length of stay by 41% and 30%, respectively, and shrink clinical and surgical complications.