Giant Mesenchymal Hepatic Hamartomas With Adrenal Involvement Precipitating Respiratory Failure: A Myxomatous Mystery in a Three-Month-Old.

The combination of placental mesenchymal dysplasia and hepatic mesenchymal hamartomas is an extremely rare finding. We present the case of a three-month-old female born at 35 weeks gestation with a history of placental mesenchymal dysplasia who presented with non-bilious, non-bloody emesis, and episodes of respiratory distress due to multiple enlarging abdominal cystic lesions. The patient's presentation was unique due to both liver and adrenal solid and cystic lesions.

Wireless High-Frequency Peripheral Nerve Stimulation for Chronic Refractory Knee Pain Post-total Knee Replacement.

The number of joint replacement surgeries, especially knee replacement surgeries, is rising with the rising geriatric population. Chronic unremitting knee pain post-total knee replacement surgery is a common phenomenon. Usually, the pain responds to conservative measures, including physical therapy and medical management.

A transfacet approach to the lumbar nerve root canal: technical note.

Background: Intraforaminal and extraforaminal nerve root compressions caused by disk herniation or stenosis are relatively common causes of lumbar radiculopathy. Currently, the two available surgical treatment methods are decompression from the spinal canal or lateral decompression via the Wiltse approach.

Objective: To describe a novel transosseous approach to the lumbar nerve root canal.

E-vape and E-Cigarettes-Associated Lung Injury (EVALI) in the COVID-19 Pandemic: A Diagnostic Dilemma and Therapeutic Challenge.

E-vape and e-cigarettes-associated lung injury (EVALI) is a diagnostic dilemma and even more obscure during the coronavirus disease 2019 (COVID-19) pandemic. A rise was seen in EVALI cases at the beginning of the COVID-19 pandemic. Still, the non-specific presentation, or the overlapping symptoms of COVID-19 and EVALI, can negate the possible diagnosis of EVALI because of a clinician's predisposition toward infectious etiologies, and it becomes even more challenging during a viral pandemic.

Reporting Outcomes of Pediatric Intensive Care Unit Patients to Referring Physicians via an Electronic Health Record-Based Feedback System.

Background: Many critically ill children are initially evaluated in front-line settings by clinicians with variable pediatric training before they are transferred to a pediatric intensive care unit (PICU). Because clinicians learn from past performance, communicating outcomes of patients back to front-line clinicians who provide pediatric emergency care could be valuable; however, referring clinicians do not consistently receive this important feedback.

Objectives: Our aim was to determine the feasibility, usability, and clinical relevance of a semiautomated electronic health record (EHR)-supported system developed at a single institution to deliver timely and relevant PICU patient outcome feedback to referring emergency department (ED) physicians.

Atypical teratoid rhabdoid tumor in the cerebellum of a 7-year-old boy presenting with headache after a fall.

A 7-year-old boy presented to a community emergency department (ED) after sustaining a minor fall. Although he was found to have a normal neurologic examination, additional history revealed the patient had been having mild intermittent headaches and dizziness in the months preceding the fall. The emergency clinicians ordered neuroimaging, which demonstrated a right cerebellar mass, ultimately diagnosed as atypical rhabdoid/teratoid tumor.

Teamwork in hip preservation: the ISHA 2019 Annual Scientific Meeting.

Hip preservation surgery is now an established part of orthopedic surgery and sports medicine. This report describes the key findings of the 11th Annual Scientific Meeting of International Society for Hip Arthroscopy-the International Hip Preservation Society-in Madrid, Spain from 16 to 19 October 2019. Lectures, seminars and debates explored the most up-to-date and expert views on a wide variety of subjects, including: diagnostic problems in groin pain, buttock pain and low back pain; surgical techniques in acetabular dysplasia, hip instability, femoroacetabular impingement syndrome, labral repair and reconstruction, cartilage defects, adolescent hips and gluteus medius and hamstring tears; and new ideas about femoral torsion, hip-spine syndrome, hip capsule surgery, impact of particular sports on hip injuries, registries, robotics and training for hip preservation specialists.

A Novel and Practical Method of Performing Atrioventricular Nodal Ablation via a Superior Approach in Patients with Refractory Atrial Fibrillation Undergoing Cardiac Resynchronization Device Implantation.

Atrioventricular node (AVN) ablation is a strategy to manage patients with drug-refractory atrial fibrillation (AF) and heart failure in whom cardiac resynchronization therapy (CRT) device implantation has been prescribed. This study describes a practical method to perform these two procedures using the same surgical site. Twenty-seven patients were indicated for AVN ablation and concurrent CRT device implantation while presenting with AF and rapid ventricular response (RVR) refractory to medical therapy.

Effectiveness of Helicobacter pylori eradication in preventing metachronous gastric cancer and preneoplastic lesions. A systematic review and meta-analysis.

Background: Helicobacter pylori is a significant risk factor for gastric cancer. Recent trials show eradication decreases the incidence of gastric cancer in patients with early-stage gastric cancer. However, data on gastric cancer prevention are inconsistent for patients with precancerous lesions such as atrophic gastritis and intestinal metaplasia.

Waldenström Macroglobulinemia: Unusual Presentation With Cast Nephropathy/Light Chain Tubulopathy.

Cast Nephropathy/Light chain tubulopathy is usually present in patients with multiple myeloma and is very rare in patients with Waldenstrom Macroglobulinemia. There are very few case reports mentioned in the literature. We present an interesting case of Cast Nephropathy and light chain tubulopathy in an 81-year-old female patient with Waldenstrom Macroglobulinemia who required medical attention for worsening renal failure.

Antibacterial Envelope Is Associated With Low Infection Rates After Implantable Cardioverter-Defibrillator and Cardiac Resynchronization Therapy Device Replacement: Results of the Citadel and Centurion Studies.

Objectives: This study sought to determine whether the nonabsorbable TYRX Antibacterial Envelope (TYRX) reduces major cardiovascular implantable electronic device (CIED) infections 12 months after implant.

Background: TYRX is a monofilament polypropylene mesh impregnated with minocycline and rifampin specifically designed to hold a CIED in place and elute antimicrobials over time. There are limited data on its ability to reduce CIED infections.

Assessing the Informed Consent Skills of Emergency Medicine Resident Physicians.

Background: Informed consent (IC) is an essential component of shared medical decision making between patients and providers in emergency medicine (EM). The basic components required for adequate consent are well described, yet little is published investigating whether EM residents demonstrate adequate IC skills.

Objective: The objectives were to assess the ability of EM residents to obtain IC for an invasive emergency procedure using a novel assessment tool and to assess reliability and validity of the tool.

TARGIT-R (Retrospective): North American Experience with Intraoperative Radiation Using Low-Kilovoltage X-Rays for Breast Cancer.

Background: Single-dose intraoperative radiotherapy (IORT) is an emerging treatment for women with early stage breast cancer. The objective of this study was to define the frequency of IORT use, patient selection, and outcomes of patients treated in North America.

Methods: A multi-institutional retrospective registry was created, and 19 institutions using low-kilovoltage IORT for the treatment of breast cancer entered data on patients treated at their institution before July 31, 2013.

Cryptococcal osteomyelitis: a report of 5 cases and a review of the recent literature.

Cryptococcus neoformans is a fungal pathogen associated with advanced HIV disease and other disorders associated with immune dysfunction. The pulmonary and the central nervous system are the most common manifestations of the disease. Localised osteomyelitis as the sole manifestation of extrapulmonary disease is rare.

The Art of Dressing Selection: A Consensus Statement on Skin Tears and Best Practice.

Purpose: To provide information about product selection for the management of skin tears.

Target Audience: This continuing education activity is intended for physicians and nurses with an interest in skin and wound care.

Objectives: After participating in this educational activity, the participant should be better able to:1.

Influence of a total joint infection control bundle on surgical site infection rates.

Quality improvement initiatives combined with pulsed xenon ultraviolet room disinfection were implemented to reduce surgical site infections (SSIs) in patients undergoing total joint procedures. After 12 months, knee SSIs were reduced from 4 to 0 (P = .03) and hip SSIs were reduced from 3 to 0 (P = .

Reengineering the radiology enterprise: a summary of the 2014 Intersociety Committee Summer Conference.

The current initiative to reform health care from both a quality and a cost perspective has already had a profound impact on the radiology enterprise. We have seen a decrease in the utilization of imaging studies, a reduction in reimbursement, a declining payer mix, shrinking incomes, a proliferation of performance indices, creation of radiology mega-groups, growth of national radiology companies, and increasing turf incursions. Our cheese is clearly on the move, and we must take action to reengineer the radiology enterprise.

The impact of the Patient Protection and Affordable Care Act on radiology: beyond reimbursement.

The 2014 ACR Forum focused on the noneconomic implications of the Affordable Care Act on the field of radiology, with specific attention to the importance of the patient experience, the role of radiology in public and population health, and radiology's role in the effort to lower overall health care costs. The recommendations generated from the Forum seek to inform ACR leadership on the best strategies to pursue to best prepare the radiology community for the rapidly evolving health care landscape.

IT infrastructure in the era of imaging 3.0.

Imaging 3.0 is a blueprint for the future of radiology modeled after the description of Web 3.0 as "more connected, more open, and more intelligent.