Extra-adrenal Pheochromocytoma of the Urinary Bladder in an Adolescent Female Patient.

Pheochromocytoma is a catecholamine-secreting tumor that arises from the medullary chromaffin cells but can rarely be extra-adrenal in origin. We present a case of a 16-year-old female patient with uncontrolled hypertension, despite being on lisinopril and metoprolol, and associated left-sided chest pain, recurrent headaches, and an unintentional weight loss of 10 pounds in one month. Laboratory work-up showed a markedly elevated plasma metanephrine level of 4463.

Gabapentin as an Adjunctive Therapy in Managing Visceral Hyperalgesia, Severe Feeding Intolerance, and Malnutrition in an Infant: A Case Presentation and Literature Review.

A two-month-old developmentally normal full-term female presented with severe feeding intolerance, progressive weight loss, and persistent fussiness, leading to multiple emergency department visits and eventual hospitalization. Initial evaluations, including laboratory tests and imaging, were unremarkable, prompting a series of diagnostic and therapeutic interventions. A multidisciplinary approach, including empiric gastroesophageal reflux disease (GERD) therapy, was started.

Clinical Diagnoses and Characterization of Patients With Amyloid-Negative Amyloid-Beta, p-Tau, and Neurofilament Light Chain (ATN) Profiles.

The novel amyloid-beta, p-Tau, and neurofilament light chain (ATN) classification scheme has become a promising system for clinically detecting and diagnosing Alzheimer's disease (AD). In addition to its utility in Alzheimer's diagnosis and treatment, the ATN framework may also have clinical relevance in identifying non-Alzheimer's pathologies. In this study conducted at Broadlawns Geriatric and Memory Center, 92 amyloid-negative profiles out of 182 patients with an ATN framework were categorized into subjective cognitive impairment (SCI), non-amnestic mild cognitive impairment (non-amnestic MCI), amnestic MCI, Alzheimer's dementia, vascular dementia, mixed dementia, unspecified dementia, or other memory changes based on diagnoses written in the chart.

Loeffler's Syndrome Induced by the Transmigration of Strongyloides stercoralis to the Lungs: A Case Report and Literature Review.

Loeffler's syndrome is a rare, benign respiratory disease usually associated with peripheral eosinophilia, first described by Wilhelm Loeffler in 1932. It is caused by the larvae of helminths such as hookworms, , and S that transmigrate through the lungs during the active phase of infection. We present a case of a 53-year-old man who complained of a productive cough with intermittent hemoptysis and left-sided posterior chest pain.

Corynebacterium minutissimum as a Rare Cause of Tibial Osteomyelitis: A Case Report and Literature Review.

Osteomyelitis is commonly caused by pathogens like , but rare organisms such as , typically associated with superficial skin infections, can also be implicated. Recognizing these atypical pathogens presents diagnostic and therapeutic challenges, especially in the presence of orthopedic hardware. We conducted a literature review yielding 25 studies and encompassing 797 patient cases, which highlights the emerging role of species in osteomyelitis, particularly following trauma or surgical interventions.

Facial Skincare Routine Adherence in the General Population.

Introduction The COVID-19 pandemic sparked an interest in skincare with the closure of spas and salons. Skincare, one of TikTok's most popular dermatology-related hashtags, received hundreds of millions of views. The American Academy of Dermatology (AAD) shared facial cleansing recommendations; however,  how many people follow them is unclear.

The Incidence of Early Postoperative Complications Following Modified Radical Mastectomy in Breast Cancer Patients.

Introduction Breast cancer is considered the most common malignant tumor in women, and incidence rates have risen progressively over the last decades. Modified radical mastectomy (MRM) is an effective treatment option. This research sought to establish the frequency, causes, and distribution of postoperative complications that are associated with MRM in the Pakistani population suffering from breast cancer.

Timing of Carpal Tunnel Syndrome Treatment Based on Social Deprivation.

Introduction: This study sought to investigate the impact of the area deprivation index (ADI) on the treatment timeline from carpal tunnel syndrome (CTS) to carpal tunnel release (CTR). We hypothesize that increased social deprivation will correlate with increased time between care milestones from presentation to surgery.

Methods: This is a retrospective review of patients diagnosed with CTS who underwent CTR at a single academic institution.

Using Osteopathic Manipulative Therapy to Treat Irritable Bowel Syndrome and Severe Refractory Gastroesophageal Reflux Disease: A Case Report.

Both Irritable Bowel Syndrome (IBS) and Gastroesophageal Reflux Disease (GERD) pose significant healthcare burdens on the general population of America. Though first-line medications are available, concomitant burdens of polypharmacy, side effects, and inadequate control exist. Osteopathic Manipulative Treatment (OMT) is a hands-on, physical manipulation technique that offers a personalized and direct approach to modifying the body's neuromuscular and viscerosomatic activity leading to decreased symptomatic burden with minimal side effects.

Pneumonia and Anemia in Rural Midwestern Missouri: A Retrospective Analysis.

Introduction: Pneumonia and anemia are prevalent medical conditions with significant implications on patient health, resulting in numerous hospitalizations and deaths. Various studies have been done on the mortality rates of pneumonia and anemia individually. However, fewer describe the mortality of patients diagnosed with pneumonia superimposed on anemia.

Optic Perineuritis Secondary to CNS Involvement of Lymphoma.

CNS lymphoma is a rare form of non-Hodgkin lymphoma that primarily affects the brain, spinal cord, leptomeninges, or eyes, leading to severe neurological or ophthalmological complications. This case report details a 44-year-old male with human immunodeficiency virus and diffuse large B-cell lymphoma who experienced permanent vision loss due to optic perineuritis, a rare presenting symptom indicative of underlying CNS involvement. Despite previous remission, imaging revealed focal enhancements suggesting CNS lymphoma, highlighting diagnostic and management challenges in relapsed lymphoma, especially in immunocompromised patients.

Blastomycosis Awareness: A Crucial Reminder Amidst the Fifth Pneumonia Episode.

Blastomycosis is a rare fungal infection endemic to North America and parts of Africa. It can be challenging to diagnose until it reaches a critical stage. We present a blastomycosis case in Alabama, emphasizing the importance of early recognition and management.

Myocarditis as a Possible Underlying Cause for Mid-Ventricular Takotsubo Cardiomyopathy: A Case Report.

Our case report characterizes a rare presentation of mid-ventricular Takotsubo cardiomyopathy (TTC) in a patient with suspected myocarditis as an underlying cause. Mid-ventricular TTC is a rare variant of TTC presenting with overlapping symptoms and physical exam findings of acute coronary syndrome, which often leads to misdiagnosis as myocardial infarction. Our case is of a 77-year-old female patient with a history of hyperlipidemia, right breast ductal carcinoma in situ, and diverticular disease who presented to the emergency department for evaluation of chest pain radiating to the jaw with associated nausea and vomiting.

Cultural Effects on the Performance of Older Haitian Immigrants on Timed Cognitive Tests.

Background: Ignoring the cultural factors that can affect performance on cognitive tests may result in use of tests that have not been validated for that group. One example is testing of Haitian Creole speaking adults who are increasingly affected by Alzheimer's disease and related dementias, for whom few tests have been validated.

Aims: Our purpose is to describe differences in timed test performance between Haitian Creole and English-speaking participants and explore factors that may account for any differences in results found.

An Omega-Hierarchical Extension Index for Second-Order Constructs With Hierarchical Measuring Instruments.

An index extending the widely used omega-hierarchical coefficient is discussed, which can be used for evaluating the influence of a second-order factor on the interrelationships among the components of a hierarchical measuring instrument. The index represents a useful and informative complement to the traditional omega-hierarchical measure of explained overall scale score variance by that underlying construct. A point and interval estimation procedure is outlined for the described index, which is based on model reparameterization and is developed within the latent variable modeling framework.

Queuing Theoretic Analysis of Dynamic Attribute-Based Access Control Systems.

Access resolution in Attribute-based Access Control (ABAC) is primarily through the enforcement of an ABAC policy. However, incremental user-specific authorizations are also often added to supplement the attribute-based accesses. As this auxiliary list of authorizations grows, enforcement becomes increasingly more inefficient, since both the ABAC policy and the specific authorizations are to be evaluated.

Inequity in Washington state covid-19-related crowdfunding.

The first seven months of the US COVID-19 pandemic saw a massive increase in COVID-19-related crowdfunding campaigns. Despite their popularity, these campaigns were rarely successful in reaching their monetary goals, with nearly 40% of them not receiving a single donation. Previous research has indicated that crowdfunding has increased inequities and disparities in wealth, and this study set out to examine the situation in Washington State, an area greatly divided socio-economically, culturally, and geographically.

Complementary and Integrative Health Use in Binge Eating Disorder: A Cross-Sectional Mixed-Methods Study of Binge Eating Disorder Experts' Perspectives.

Introduction: Binge Eating Disorder (BED) has high lifetime prevalence rates, low treatment success rates, and high rates of treatment dissatisfaction, early discontinuation of care, and recurrence. Complementary and integrative health (CIH) interventions (non-mainstream practices used with conventional approaches for whole-person treatment) hold potential to overcome many treatment barriers and improve BED treatment outcomes. Some CIH interventions have empirical support for use in eating disorders.

Comparison of hand-assisted laparoscopic adrenalectomy laparoscopic adrenalectomy for large pheochromocytomas: a retrospective study.

Background: It remains uncertain whether hand-assisted laparoscopic adrenalectomy (HAL) has advantages in treating large pheochromocytomas (PHEOs). This study aimed to assess the feasibility and safety of HAL compared to laparoscopic adrenalectomy (LA).

Methods: We conducted a retrospective study on patients with PHEOs ≥6 cm who received HAL (n=16) and LA (n=20) at Shandong Provincial Hospital from January 2020 to January 2023.

Preoperative approach and technical considerations in parotid surgery.

Various approaches and techniques have been developed to address parotid neoplasms over the years. This article reflects on the integration, modification, and refinement of these techniques over a decade of clinical practice. This article provides a narrative description of the evolution of a head and neck oncologic surgeon's approach to parotid neoplasms.

Propensity analysis reveals survival disparities between T1a and T1b well-differentiated thyroid cancer based on surgery.

Background: With rising well-differentiated thyroid cancer (WDTC) incidence, the appropriate treatment choice remains controversial for T1 tumors <2 cm. This study analyzed differences in surgery refusal and survival outcomes between T1a (<1 cm) and T1b (1-2 cm) WDTC, examining the demographic and clinical characteristics associated with patients who decide to either undergo or refuse recommended surgery.

Methods: We studied 81,664 T1N0M0 WDTC patients in the Surveillance, Epidemiology, and End Results (SEER) registry [2000-2019].

The Efficacy of Lubiprostone in Patients of Constipation: An Updated Systematic Review and Meta-Analysis.

Background And Aim: Lubiprostone increases chloride and water secretion in the intestines, and several studies have demonstrated the efficacy of lubiprostone in treating functional constipation. Several new clinical trials have emerged since the previous meta-analysis conducted in 2020. We conducted this updated meta-analysis to assess clinical efficacy of lubiprostone in these patients.

Improving Collaborative Management of Multiple Mental and Physical Health Conditions: A Qualitative Inquiry into Designing Technology-Enabled Services for Eliciting Patients' Values.

People with multiple chronic conditions (MCC) face challenges planning health care collaboratively with primary care clinicians, particularly when their priorities conflict. These challenges intensify with symptoms of anxiety or depression. Elicitation of patients' values is promoted as a means to aligning patient and clinician priorities in primary care, and as a component of psychotherapy for anxiety and depression.

Three-dimensional convolutional neural network for leak detection and localization in smart water distribution systems.

Smart meters such as advanced metering infrastructure (AMI) can significantly improve identifying realistic sized leaks in water distribution networks (WDNs). However, to date, detection/localization methods for AMI systems are extremely limited. In this study, to examine the benefits of using AMIs for leak detection within distribution network, a three-dimensional (3D) convolutional neural network (CNN) deep learning (DL) model is proposed that can account for temporally and spatially distributed information of pressures.