Sepsis following hysteroscopic myomectomy.

Hysteroscopy and hysteroscopic myomectomy in general have low complication rates. Two patients underwent hysteroscopic myomectomy for prolapsing submucous myomas after UAE. The onset of prolapsing myoma occurred at varying times between completion of UAE and myomectomy, resulting in bacteremia for both patients.

The genetic landscape of programmed death ligand-1 (PD-L1) alterations in head and neck cancer.

Objectives: Nivolumab has recently been shown in the phase III clinical trial CheckMate-141 to have superior survival rates compared to the current standard of care chemotherapy for recurrent or metastatic platinum-resistant head and neck squamous cell carcinoma (HNSCC). Nivolumab targets the immune inhibitory receptor programmed cell death 1 (PD-1). Programmed cell death ligand 1 (PD-L1) genomics have been poorly characterized in the context of HNSCC, including expression levels of PD-L1 in individual tumors as well as related up or down-regulated genes that might function as co-targets.

Deterministic direct aperture optimization using multiphase piecewise constant segmentation.

Purpose: Direct aperture optimization (DAO) attempts to incorporate machine constraints in the inverse optimization to eliminate the post-processing steps in fluence map optimization (FMO) that degrade plan quality. Current commercial DAO methods utilize a stochastic or greedy approach to search a small aperture solution space. In this study, we propose a novel deterministic direct aperture optimization that integrates the segmentation of fluence map in the optimization problem using the multiphase piecewise constant Mumford-Shah formulation.

Clinical review: Early morning cortisol levels as a predictor of remission after transsphenoidal surgery for Cushing's disease.

Introduction: We describe the use of serum cortisol and ACTH levels on postoperative d 1 and 2 as remission predictors after transsphenoidal surgery for Cushing's disease (CD).

Methods: Morning cortisol and ACTH levels were drawn daily after surgery; glucocorticoids were withheld until evidence of hypocortisolemia. Early remission was defined retrospectively as a subnormal morning cortisol level [< or =140 nmol/liter (< or =5 microg/dl)] on postoperative d 1 or 2 and sustained remission as subsequent eucortisolemia.

Guidelines in pulmonary medicine: a 25-year profile.

Objective: We attempted to identify clinical practice guideline and pathway articles in the area of pulmonary medicine published in peer-reviewed journals since 1974.

Design: Review.

Data Sources: MEDLINE, the Cochrane Database, Best Evidence, and Abstracts of Clinical Care Guidelines from January 1974 to December 1998.