Endoscopic Through-the-Scope X-Tack Helix Suturing System for Complete Closure of a Large Full-Thickness After Surgical Gastric Perforation.

Gastric perforation is considered a surgical emergency managed operatively; however, endoscopic repair techniques have gained popularity as they are cost-effective, improve mortality, and decrease hospital stay and recurrence. With increased prevalence of gastric defects postoperatively and after invasive endoscopic procedures, various endoscopic techniques were developed over the years, but special consideration should be given to the defect type, size, and location. Our case highlights the use of X-Tack through-the-scope suturing for closing a large, full-thickness gastric perforation in a difficult location where OverStitch is not feasible.

Calcium Carbonate (Tums)-Associated Hypercalcemic Crisis.

Hypercalcemic crisis due to severe decompensated hypercalcemia represents a life-threatening medical emergency leading to renal failure and altered mental status. Hypercalcemic crisis most commonly results from hypercalcemia of malignancy, undiagnosed primary hyperparathyroidism, granulomatous diseases, and medication-induced hypercalcemia. Commonly prescribed medications like thiazide diuretics, lithium therapy, and teriparatide are among the medications known to cause hypercalcemia.

Pause at Your Own Peril: A Case Series on Rebound Pulmonary Hypertension.

Severe pulmonary arterial hypertension (PAH) is associated with high morbidity and mortality. Therapeutic approaches for intermediate- and high-risk pulmonary arterial hypertension have now shifted toward initial combination management, often including parenteral epoprostenol and iloprost and early assessment for a lung transplant. After the initiation of therapy, usually various combinations of different classes of medication, it is important to consider the potential interruption in therapy causing rebound PAH.

Starting and maintaining a hospital-based ostomy support group.

Ostomy surgery alters body image; this process can be distressing for patients, who must transition through a type of grieving process. Attending an ostomy support group provides an atmosphere of acceptance, a feeling of being able to cope, and mutual respect. The WOC nurse employed by an acute care facility is well positioned to facilitate such a group.

Cytokeratin 19 immunolocalization in cell block preparation of thyroid aspirates. An adjunct to fine-needle aspiration diagnosis of papillary thyroid carcinoma.

Context: Immunohistochemical staining for cytokeratin 19 (CK-19) is a useful ancillary technique for diagnosing papillary thyroid carcinoma (papillary carcinoma) in histologic specimens. Although similar results have been obtained on aspirate smears, to our knowledge the utility of CK-19 immunolocalization in cell block preparations as an adjunct to fine-needle aspiration diagnosis of papillary carcinoma has not been examined.

Objective: The purpose of this study was to determine whether CK-19 immunostaining of cell block preparations of thyroid aspirates is a useful ancillary technique for diagnosing papillary carcinoma.

Aspiration cytology of pediatric solitary papillary hyperplastic thyroid nodule.

Context: Solitary papillary hyperplastic thyroid nodules (SPHTNs) are frequently encountered in children and teenagers. Although the histologic features are well described, to the best of our knowledge, cytologic findings have not been reported.

Objectives: To review the cytologic features of histologically proven SPHTNs and to identify the potential diagnostic pitfalls in cytologic diagnosis.