Faulknerrutledge1812
Multiple endocrine neoplasia type 1 (MEN1) or Wermer's syndrome is a genetic disease characterized by involvement of multiple endocrine glands, primarily involving parathyroid, pancreas, and pituitary. Other additional features include foregut carcinoids; non-functioning adrenal tumors; and skin lesions such as lipomas, collagenomas, and angiofibromas. Here, we describe our experience in managing a patient who presented to us with spontaneous episodes of hypoglycemia and was diagnosed with insulinoma. Detailed clinical and biochemical evaluation unraveled the diagnosis of MEN1 in the patient and her family members who constituted a large kindred. This case highlights the importance for evaluation of MEN1 in a patient or his/her family members in the setting of clinical and biochemical suspicion. In addition, we have also discussed the utility of the latest diagnostic and therapeutic modalities for management of MEN1.Objective The purpose of this study was to determine the impact of the coronavirus disease 2019 (COVID-19) pandemic on the practice of hand and upper extremity surgeons. read more Methods We assessed how the pandemic affected the practice on multiple fronts including professional, personal, and practice aspects. The survey was conducted through an online questionnaire that had six sections demographics, clinic, elective surgery, emergency surgery, urgent surgery, and human resources. The survey was sent to 586 Kleinert Society members who are all practicing hand and upper extremity surgeons. Results We received 35 responses from the United States and 53 from the rest of the world. Based on our findings, the clinic volume was reduced by >50% in the early stages, subsequently returning to a level that was 25-50% lower than pre-COVID-19 times in later stages. A corresponding decrease in elective surgeries was also noted. The need for preoperative COVID-19 tests added to the logistics of surgery, causing delays of three to surgeons to continue their service while taking care of their personal health.Intravenous catheters account for the majority of cases of upper extremity deep vein thrombosis (UEDVT), with a higher incidence in patients suffering from malignancy. Sequelae of UEDVT are similar to that of lower extremity DVT, comprising post-thrombotic syndrome and pulmonary embolism. While there are several treatment options for UEDVT including systemic anticoagulation, catheter-directed thrombolysis, and percutaneous mechanical thrombectomy, due to the absence of consistent guidelines regarding its management, treatment is often individualized based on patient characteristics, clinical factors, and technical considerations. We present a case of a 49-year-old female suffering from breast cancer with a central venous catheter (CVC) who came to the clinic with UEDVT and CVC malfunction and was successfully treated with mechanical thrombectomy using the ClotTriever System (Inari Medical, Irvine, CA). To our knowledge, this is the first report of the ClotTriever System being used to treat UEDVT and simultaneously salvage the CVC in a single session.Weight-bearing magnetic resonance imaging (MRI) is a unique modality in diagnostic imaging that allows for the assessment of spinal pathology in ways considered previously inaccessible or insufficient with the conventional MRI technique. Due to limitations in positioning within the MRI machine itself, difficulties would be posed in determining the underlying cause of a patient's pain or neurological symptoms, as the traditional supine position utilized can, in many cases, alleviate the severity of presented symptoms. Weight-bearing MRI addresses this concern by allowing a clinician to position a patient (to a certain degree) into flexion, extension, rotation, or side-bending with an axial load that can mimic physiologic conditions in order to replicate the conditions the patient experiences in order to give clinicians a clearer understanding of the anatomical relationship of the spine and surrounding tissues that may lead to a particular presentation of symptoms. These findings can then guide treatment approaches that are better tailored to a patient's needs in order to initiate treatment earlier and shorten the duration of treatment necessary for patient benefit. The goal of this review is to describe and differentiate weight-bearing MRI from conventional MRI as well as examine the advantages and disadvantages of either imaging modality. This will include assessing cost-effectiveness and improvements in clinical outcomes. Further, the advancements of weight-bearing MRI will be discussed, including potentially unique clinical applications in development.
Herein, we aimed to compare the scientometric data of hematology journals, and compare the publication models, especially the scientometric data of journals with all-open access(OA) and hybrid-OA publication models.
Data were obtained from Scimago Journal & Country Rank and Clarivate Analytics InCites websites. Fifty-four journals indexed in Science Citation Index (SCI) and SCI-Expanded were evaluated. Bibliometric data and impact factor (IF), scientific journal rank (SJR), eigenfactor score (ES), and Hirsch (h)-index of the journals were obtained. United States dollar (USD) was used as the requested article publishing charge (APC). Statistics Package for the Social Sciences (SPSS, IBM Corp., Armonk, NY) version 23.0 was used for data analysis.
As a publication model, Hybrid-OA was the most common. One journal had subscription-only, and two journals had a free-OA model. Nine journals had a mandatory OA with the APC model and 42 journals used a hybrid model. TheMedian OA fee was 3400 USD. Hybrid-OA jndomized to follow citation per publication according to the OA model would better shed light on the data in this area.A previously well female presented with a history of progressive functional decline. She had a known history of generalized seropositive myasthenia gravis on long-term mycophenolate mofetil and pyridostigmine. MRI of her brain reported multiple cerebral abscesses based on radiological features. The patient was commenced on intravenous antibiotics, but there was no clinical or radiological response to treatment. Decision was made for a stereotactic biopsy. Intraoperative tissue cultures were negative for infection. However, histology reported B-cell lymphoma with morphological features changes typically seen in corticosteroid-treated lymphoma - an unexpected finding as no steroids were administered as part of her treatment. Owing to the unusual diagnosis, the case is presented in corroboration with current literature.