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https://www.readbyqxmd.com/read/27896657/performing-the-difficult-cholecystectomy-using-combined-endoscopic-and-robotic-techniques-how-i-do-it
#1
Deepa Magge, Jennifer Steve, Stephanie Novak, Adam Slivka, Mellissa Hogg, Amer Zureikat, Herbert J Zeh
Laparoscopic cholecystectomy is the standard of care for cholelithiasis as well as cholecystitis. However, in the setting of Mirizzi syndrome or gangrenous cholecystitis where the critical view cannot be ascertained, subtotal cholecystectomy may be necessary. Using the robot-assisted approach, difficult cholecystectomies can be performed upfront without need for partial cholecystectomy. Even in the setting of Mirizzi syndrome where severe scarring and fibrosis are evident, definitive cholecystectomy and takedown of the cholechystocholedochal fistula can be performed in a safe and feasible fashion following successful endoscopic common bile duct stent placement...
November 28, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27896385/pictorial-review-the-pearls-and-pitfalls-of-the-radiological-manifestations-of-gallstone-ileus
#2
REVIEW
Phei Shan Chuah, John Curtis, Nikhil Misra, Dina Hikmat, Sumita Chawla
We present a pictorial review of a range of typical and atypical cases of gallstone ileus (GI), across a wide range of imaging modalities. GI is a complication of gallstone disease causing mechanical intestinal obstruction due to impaction of gallstone in the gastrointestinal tract. The spectrum of presentation can vary enormously, and we highlight the importance of accurate imaging diagnosis of GI especially early use of computed tomography. This will lead to timely and appropriate surgical intervention with the potential avoidance of unnecessary outcomes...
November 28, 2016: Abdominal Radiology
https://www.readbyqxmd.com/read/27875758/beyond-the-lymph-nodes-fdg-pet-ct-in-primary-extranodal-lymphoma
#3
REVIEW
Kin Man Sin, Stanton King Dat Ho, Brian Yung Kong Wong, Harry Gill, Pek-Lan Khong, Elaine Yuen Phin Lee
Extranodal lymphoma can be the primary presentation or secondary to systemic involvement of lymphoma. 2-(fluorine-18) fluoro-2-deoxy-d-glucose positron emission tomography with computer tomography (FDG-PET/CT) is useful in detecting extranodal sites during staging, treatment response assessment or recurrence detection in patients with lymphoma. In this article, we reviewed the imaging features and FDG avidity of primary extranodal lymphoma of various organs and systems on FDG-PET/CT, demonstrating the pearls and pitfalls of FDG-PET/CT in evaluating this disease entity and cross-referencing to other imaging modalities that aid in diagnosis and management...
November 16, 2016: Clinical Imaging
https://www.readbyqxmd.com/read/27857794/a-rare-case-of-white-pearls-in-brainstem
#4
Dipanker Singh Mankotia, Vivek Tandon, Hardik Sardana, Madhu Rajeshwari, Vaishali Suri, Bhawani Shankar Sharma
Intrinsic brainstem epidermoid is extremely rare, and only 14 cases have been reported. Authors report a classic case of brainstem epidermoid in a 14-year-old male child presenting with symptoms of brainstem involvement. The child underwent a successful surgical excision. The lesion was intrinsic and caused diagnostic dilemma based on conventional radiological images. Based on our experience in this case and a thorough review of literature, we are of the opinion that diffusion-weighted images are very important in establishing the diagnosis...
July 2016: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/27857455/imaging-in-spinal-posterior-epidural-space-lesions-a-pictorial-essay
#5
Foram B Gala, Yashant Aswani
Spinal epidural space is a real anatomic space located outside the dura mater and within the spinal canal extending from foramen magnum to sacrum. Important contents of this space are epidural fat, spinal nerves, epidural veins and arteries. Due to close proximity of posterior epidural space to spinal cord and spinal nerves, the lesions present with symptoms of radiculopathy and/or myelopathy. In this pictorial essay, detailed anatomy of the posterior epidural space, pathologies affecting it along with imaging pearls to accurately diagnose them are discussed...
July 2016: Indian Journal of Radiology & Imaging
https://www.readbyqxmd.com/read/27843094/metabolomics-predicts-neuroimaging-characteristics-of-transient-ischemic-attack-patients
#6
Francisco Purroy, Serafi Cambray, Gerard Mauri-Capdevila, Mariona Jové, Jordi Sanahuja, Joan Farré, Ikram Benabdelhak, Jessica Molina-Seguin, Laura Colàs-Campàs, Robert Begue, M Isabel Gil, Reinald Pamplona, Manuel Portero-Otín
BACKGROUND: Neuroimaging is essential for the diagnosis and prognosis of transient ischemic attack (TIA). The discovery of a plasmatic biomarker related to neuroimaging findings is of enormous interest because, despite its relevance, magnetic resonance diffusion weighted imaging (DWI) is not always available in all hospitals that attend to TIA patients. METHODS: Metabolomic analyses were performed by liquid chromatography coupled to mass spectrometry in order to establish the metabolomic patterns of positive DWI, DWI patterns and acute ischemic lesion volumes...
November 9, 2016: EBioMedicine
https://www.readbyqxmd.com/read/27815844/incidence-and-geographic-distribution-of-succinic-semialdehyde-dehydrogenase-ssadh-deficiency
#7
Savita Verma Attri, Pratibha Singhi, Natrujee Wiwattanadittakul, Jyotindra N Goswami, Naveen Sankhyan, Gajja S Salomons, Jean-Baptiste Roullett, Ryan Hodgeman, Mahsa Parviz, K Michael Gibson, Phillip L Pearl
The incidence of succinic semialdehyde dehydrogenase (SSADH) deficiency, an autosomal recessive inherited disorder of GABA degradation, is unknown. Upon a recent diagnosis of a new family of affected fraternal twins from the Punjabi ethnic group of India, case ascertainment from the literature and our database was done to determine the number of confirmed cases along with their geographic distribution. The probands presented with global developmental delay, infantile onset epilepsy, and a persistent neurodevelopmental disorder upon diagnosis at 10 years of age with intellectual disability, expressive aphasia, and behavioral problems most prominent for hyperactivity...
November 5, 2016: JIMD Reports
https://www.readbyqxmd.com/read/27787648/cerebrofacial-arteriovenous-metameric-syndrome-cams-a-spectrum-disorder-of-craniofacial-vascular-malformations
#8
Lauren O'Loughlin, Mari L Groves, Neil R Miller, Monica S Pearl
Cerebrofacial arteriovenous metameric syndrome (CAMS) is a recent classification of vascular malformations that encompasses a spectrum of phenotypic expression involving arteriovenous malformations (AVMs) of the cerebral, orbital, and facial region. Recognizing the embryologic basis of CAMS is important for diagnosing other AVMs along the same metameric level. Visual loss is the most common presentation prompting ophthalmologic evaluation followed by neuroimaging. We present two pediatric patients with ipsilateral optic nerve and chiasmal AVMs without cutaneous manifestations, characteristic of CAMS 2...
October 27, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27786246/hiv-associated-opportunistic-cns-infections-pathophysiology-diagnosis-and-treatment
#9
REVIEW
Lauren N Bowen, Bryan Smith, Daniel Reich, Martha Quezado, Avindra Nath
Nearly 30 years after the advent of antiretroviral therapy (ART), CNS opportunistic infections remain a major cause of morbidity and mortality in HIV-positive individuals. Unknown HIV-positive disease status, antiretroviral drug resistance, poor drug compliance, and recreational drug abuse are factors that continue to influence the morbidity and mortality of infections. The clinical and radiographic pattern of CNS opportunistic infections is unique in the setting of HIV infection: opportunistic infections in HIV-positive patients often have characteristic clinical and radiological presentations that can differ from the presentation of opportunistic infections in immunocompetent patients and are often sufficient to establish the diagnosis...
October 27, 2016: Nature Reviews. Neurology
https://www.readbyqxmd.com/read/27778385/congenital-milium-of-the-nipple
#10
Muriel Guarda Ferreira, Manuel Baptista Salgado
A 12-month-old girl presented with an asymptomatic, pearly nodule on the left nipple that had been present from birth and was currently 3 mm in diameter and growing. Assuming the diagnosis of congenital primary milium of the nipple, we took a "wait and see" approach. After 3 months, the pearl disappeared without any scarring.
October 25, 2016: Pediatric Dermatology
https://www.readbyqxmd.com/read/27718775/breaking-the-cycle-of-hair-breakage-pearls-for-the-management-of-acquired-trichorrhexis-nodosa
#11
Alessandra Haskin, Shawn G Kwatra, Crystal Aguh
Acquired trichorrhexis nodosa is a common cause of hair loss for patients of all ethnicities. It is especially prevalent in black patients with tightly curled hair types and can present unique diagnostic and therapeutic challenges due to structural differences in these hair types and the combination of various hair care and styling practices that contribute to hair damage. While scalp biopsies can help rule out other etiologies of hair loss, there is a paucity of histologic findings in acquired trichorrhexis nodosa, making this primarily a clinical diagnosis...
October 10, 2016: Journal of Dermatological Treatment
https://www.readbyqxmd.com/read/27704500/sleepiness
#12
Jeffrey M Ellenbogen
Sleep medicine can be a particularly rewarding clinical area for neurologists. After all, the driving organ of sleep is the brain. Many of the sleep disorders are primary brain disorders, whereas other sleep disorders (and their medications) influence brain function. But without an organized approach, even the engaged and motivated neurologist can easily become frustrated when dealing with patients whose concerns center on an undesirable degree of sleepiness. Lost in the thicket of information provided during the patient-doctor encounter, many physicians are unable to direct the history toward particular diagnostic hypotheses...
October 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27703871/conjunctival-lymphangioma-in-a-4-year-old-girl-revealed-tuberous-sclerosis-complex
#13
Florentina Joyce Freiberg, Erdmute Kunstmann, Thomas König, Juliane Matlach, Daniel Kampik
Background: To present a case of conjunctival lymphangioma in a 4-year-old girl with tuberous sclerosis complex. Methods/results: A 4-year-old girl presented with a relapsing cystic lesion of the bulbar conjunctiva in the right eye with string-of-pearl-like dilation of lymphatic vessels and right-sided facial swelling with mild pain. Best-corrected vision was not impaired. Examination of the skin revealed three hypomelanotic macules and a lumbal Shagreen patch. Magnetic resonance imaging (MRI) findings displayed minimal enhancement of buccal fat on the right side...
2016: GMS Ophthalmology Cases
https://www.readbyqxmd.com/read/27666087/automated-internal-classification-of-beadless-chinese-zhuji-fleshwater-pearls-based-on-optical-coherence-tomography-images
#14
Yang Zhou, Tiebing Liu, Yang Shi, Zhengwei Chen, Jianwei Mao, Wujie Zhou
Optical coherence tomography (OCT) has been applied to inspect the internal defect of beadless Chinese ZhuJi fleshwater pearls. A novel fully automated algorithm is proposed to classify between normal and defective sub-layer in nacre layer. Our algorithm utilizes the graph segmentation approach to estimate the up and down boundaries of defect sub-layers from flattened and cropped image, and also proposes the strategy for edge and weight construction in segmentation process. The vertical gradients of boundary pixels are used to make grading decision...
September 26, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27660311/clinical-challenges-in-the-diagnosis-and-management-of-postural-tachycardia-syndrome
#15
Pearl K Jones, Brett H Shaw, Satish R Raj
Postural tachycardia syndrome (POTS) is a multifactorial clinical syndrome defined by an increase in heart rate of ≥30 bpm on standing from supine position (or ≥40 bpm in children). It is associated with symptoms of cerebral hypoperfusion that are worse when upright and improve when in supine position. Patients often have additional symptoms including severe fatigue and difficulty concentrating. There are several possible pathophysiologic mechanisms including hypovolaemia, small-fibre peripheral neuropathy and hyperadrenergic states...
September 22, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27643909/dementia
#16
Peter A Ljubenkov, Michael D Geschwind
Dementia often is defined as a progressive cognitive disturbance leading to a loss of independent function. Most clinicians are familiar with the typical pattern of amnestic Alzheimer's disease, the most common neurodegenerative presentation of dementia. Atypical dementia presentations, including atypical Alzheimer's variants, however, may pose a diagnostic challenge for even experienced clinicians. In this article the authors discuss clinical "pearls" for the diagnosis of various neurodegenerative dementia syndromes...
August 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27643906/infectious-meningitis-and-encephalitis
#17
Amanda L Piquet, Jennifer L Lyons
The clinician who is evaluating a patient with a suspected central nervous system infection often faces a large differential diagnosis. There are several signs, symptoms, geographical clues, and diagnostic testing, such as cerebrospinal fluid abnormalities and magnetic resonance imaging abnormalities, which can be helpful in identifying the etiological agent. By taking a systematic approach, one can often identify life-threatening, common, and/or treatable etiologies. Here the authors describe some of the pearls and pitfalls in diagnosing and treating acute infectious meningitis and encephalitis...
August 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27643902/epilepsy
#18
Mackenzie C Cervenka, Peter W Kaplan
The accurate diagnosis and classification of seizures is critical in informing prognosis and determining appropriate antiseizure treatments for patients with epilepsy. The electroencephalogram is the gold standard for diagnosis. Obtaining a thorough history, performing a careful physical examination, and selecting appropriate diagnostic studies are also essential in determining the underlying seizure etiology. The authors provide clinical pearls and pitfalls in the diagnosis and management of epilepsy.
August 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27643901/clinical-pearls-in-tremor-and-other-hyperkinetic-movement-disorders
#19
Howard D Weiss
Hyperkinetic movements, such as tremor, myoclonus, chorea, and dystonia, occur in many neurologic and medical conditions. Accurate clinical evaluation is the important first step for the proper diagnosis and treatment of patients with abnormal movements.
August 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27616311/abnormal-spinal-cord-magnetic-resonance-signal-approach-to-the-differential-diagnosis
#20
Humberto Morales, Aaron Betts
T2-hyperintense signal abnormalities within the spinal cord on magnetic resonance imaging can evoke a broad differential diagnosis and can present a diagnostic dilemma. Here, we review and provide a succinct and relevant differential diagnosis based on imaging patterns and anatomical or physiopathologic correlation. Clues and imaging pearls are provided focusing on inflammatory, infectious, demyelinating, vascular, and metabolic involvement of the spinal cord.
October 2016: Seminars in Ultrasound, CT, and MR
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