Hanlentz2771

2, Specificity = 64.7, PPV = 83.8, NPV = 58.9) and ADC

(Sensitivity = 63.8, Specificity = 82.4, PPV = 89.2, NPV = 50) were calculated in differentiating adenocarcinoma metastases from GEP-NET metastases.

The lower ADC and ADC

values of liver metastases suggest GEP-NET rather than adenocarcinomas. ADC and ADC

values obtained from liver metastases may be used to differentiate NETs from adenocarcinomas.

The lower ADC and ADCmean values of liver metastases suggest GEP-NET rather than adenocarcinomas. ADC and ADCmean values obtained from liver metastases may be used to differentiate NETs from adenocarcinomas.

Perception is an essential skill leading to expertise in diagnostic radiology. We determined if practicing "Where's Waldo?" images improves accuracy and speed with which first and second year radiology residents detect abnormalities on chest radiographs (CXRs).

Residents at three institutions were pretested using 50 CXRs, identifying locations of potential abnormalities. They were then split into trained (examining 7 "Where's Waldo?" images over three weeks) and control groups (no "Where's Waldo?"). They were then re-tested on the 50 CXRs. At one site, visual search parameters were acquired. Data were analyzed with repeated measures ANOVAs.

There was no significant difference in performance for trained vs control (F = 0.622, p = 0.436), with both improving significantly on post-test (F = 4.72, p = 0.037). Session time decreased significantly for both groups from pre to post-test (F = 81.47, p < 0.0001) and the decrease was significantly more (F = 31.59, p < 0.0001) for the trained group than the control group as well as for PGY with PGY3 having a larger average decrease in session time than PGY2. Eye-tracking data also showed significant increases in per image search efficiency with training.

Practicing "Where's Waldo?" or similar nonradiology search tasks may facilitate the acquisition of radiology image search but not detection skills, impacting reading efficiency more than detection accuracy.

Practicing "Where's Waldo?" or similar nonradiology search tasks may facilitate the acquisition of radiology image search but not detection skills, impacting reading efficiency more than detection accuracy.

Relatively little data exist on factors associated with radiologists' burnout versus other medical specialties. We compared self-reported burnout among academic medical center radiologists versus nonradiologist peers to inform initiatives to increase wellbeing and professional satisfaction.

In 2017, our large urban academic medical center administered the Stanford Physician Wellness Survey to faculty in fifteen clinical departments (fourteen academic, one community-based). Faculty rated burnout via Likert scale (0-no burnout; 1-occasional stress/no burnout; 2-one or more burnout symptoms; 3-persistent burnout symptoms; 4-completely burned out); burnout defined as >=2. Responses in 11 domains (professional fulfillment, emotional exhaustion, interpersonal disengagement, sleep difficulties, self-compassion, negative work impact on personal relations, perceived appreciation, control over schedule, organizational/personal values alignment, electronic health record, perceived quality of supervisory leadershiadiologists may reduce burnout.

Compared to nonradiologist colleagues, radiologists were less likely to find work meaningful and more likely to feel unhappy and undervalued in the workplace and by leadership. Initiatives to increase perceived appreciation, leadership relationships, and meaningfulness of work for radiologists may reduce burnout.

The diagnosis and treatment of mesenteric cysts (MC) is a challenge due to rarity, lack of specific symptoms and variability in location and size. Mesenteric cysts are rare surgical entities that occur approximately in 1 200,000-1 350,000 hospitalizations.

A 47-year-old female patient presented in August 2018 with occasional abdominal pains and an abdominal swelling palpable in the lower right quadrant. A CT scan with contrast enhancement confirmed a 11 cm mass with liquid content in the right iliac fossa, clearly separate from other intra-abdominal structures. The mass was completely excised laparoscopically. The patient was discharged on the third postoperative day. She was symptom-free at 30-day follow-up. Histology demonstrated a solitary non-pancreatic cyst of the mesentery with negative cytology for neoplastic cells.

The origin of mesenteric cysts (MC) is uncertain. Imaging (by ultrasonography, CT, and MRI) can be diagnostic. Therapy for these cysts should be performed if they are symptomatic or cause complications. The treatment of choice is complete surgical excision. see more The advent of laparoscopy has allowed the excision of these cysts without laparotomy in the expert hands of surgeons with good experience in advanced laparoscopy. Laparoscopy is not a standard for the presence in the literature of only case reports.

MC are commonly asymptomatic and discovered incidentally. If symptomatic, surgical excision is considered the cornerstone intervention and laparoscopic resection is feasible, causing less pain, a shorter postoperative stay, and quicker recovery of the patient than open operation. Further studies with a higher level of evidence are needed.

MC are commonly asymptomatic and discovered incidentally. If symptomatic, surgical excision is considered the cornerstone intervention and laparoscopic resection is feasible, causing less pain, a shorter postoperative stay, and quicker recovery of the patient than open operation. Further studies with a higher level of evidence are needed.

The Neurofibromatosis type I (NF1) is an autosomal dominant syndrome that affects 1/3000-1/4000 individuals. Patients with this condition are predisposed to different tumors, like neurofibromas, optic nerve gliomas, gastrointestinal stromal tumors (GIST) and breast cancers.

A 78-year-old female patient affected by NF1 in May 2018 during follow-up for a carcinoma of the right breast had persistent anemia requiring regular blood transfusions. She presented with NF 1 with disseminated cutaneous neurofibromas, asthma, hypothyroidism, arterial hypertension and uterine prolapse. She had performed gastroscopy and colonoscopy both negative for neoplastic lesions. She was subjected to chest and abdomen CT which revealed the presence of an ileal lesion of 6.5 × 4 cm suspected of GIST. The patient underwent laparoscopic ileal resection in 120 min and was discharged on the sixth postoperative day.

NF1 is caused by biallelic loss of a tumor suppressor gene. Most GISTs are localized in the stomach and small intestine. Surgery is the first line of treatment for localized disease. The main goal of surgery is complete excision with negative margins. The association between breast cancer and intestinal GIST in NF1 is reported only from two previous studies.

It is a rare case of association of breast cancer and ileal GIST in NF1. Laparoscopic resection of intestinal GIST has shown in some studies to have oncological outcomes comparable to laparotomy. Furthermore, laparoscopy is associated with better perioperative outcomes and shorter hospital stays. Further studies with a higher level of evidence are needed.

It is a rare case of association of breast cancer and ileal GIST in NF1. Laparoscopic resection of intestinal GIST has shown in some studies to have oncological outcomes comparable to laparotomy. Furthermore, laparoscopy is associated with better perioperative outcomes and shorter hospital stays. Further studies with a higher level of evidence are needed.

A true left sided gallbladder (T-LSG) is a rare finding mostly discovered incidentally during laparoscopy and often associated with several anatomic anomalies; surgical approach may be challenging with an increased risk of intra-operative injuries and conversion to open.

A 76 years old woman presented with acute cholecystitis. The left sided gallbladder was unexpectedly discovered as an intra-operative finding. Laparoscopic cholecystectomy was carried out using our usual trocar set-up without the need of intra-operative cholangiography or conversion to open.

LSG is reported to be associated with a higher risk of intraoperative bile duct injuries (up to 7.3%) due to anomalies of the bile duct, portal vein, and other structures. Achieving the Critical View of Safety by opening Calot's triangle is essential to avoid bile duct injuries.

Experienced surgeons could safely approach LSG laparoscopically, also in emergency setting, without major changing in their surgical technique with limitation of diathermy use and prudent dissection of anatomical structures to avoid biliary injuries. Intra-operative cholangiography is not mandatory.

Experienced surgeons could safely approach LSG laparoscopically, also in emergency setting, without major changing in their surgical technique with limitation of diathermy use and prudent dissection of anatomical structures to avoid biliary injuries. Intra-operative cholangiography is not mandatory.

The importance of unilateral diaphragmatic agenesis (DA) in adults for performing a laparoscopic cholecystectomy has not been well described in literature.

A 60-year-old female patient entered our ward in March 2019 for laparoscopic cholecystectomy after 6 months history of epigastric pain and multiple episodes of biliary colic treated conservatively. She never complained of pulmonary symptoms. Preoperative chest Computed tomography (CT) was negative for diaphragmatic or pulmonary pathologies. Laparoscopic cholecystectomy was performed in 60 min with intraoperative detection of a thoracoabdominal communication with partial right hemidiaphragm agenesis. A chest CT and x-ray were performed in the postoperative period with progressive reduction of an asymptomatic small pneumothorax. The patient was discharged at home without complications on the fifth postoperative day. Thoracopulmonary surgery examination was performed without indications for diaphragmatic repair.

DA is a rare condition and usually occurs in early neonatal period. The congenital form occurs in 1 out of 2200-12500 live births and is traditionally divided into anterior (Morgagni's 10%) and posterolateral (Bochdalek's 90%) hernias. Chest and abdomen CT with coronal and sagittal reconstructions is the most effective and useful imaging technique for the diagnosis of diaphragmatic hernia. In literature there are former two case reports of asymptomatic DA in cholelithiasis in which laparoscopic cholecystectomy was performed effectively.

In adults with partial DA, laparoscopic cholecystectomy can be performed successfully. A conservative management only with gallstones dissolution therapy can be used if laparoscopy cannot be done. Further studies with a higher level of evidence are needed.

In adults with partial DA, laparoscopic cholecystectomy can be performed successfully. A conservative management only with gallstones dissolution therapy can be used if laparoscopy cannot be done. Further studies with a higher level of evidence are needed.

Nonalcoholic fatty liver disease (NAFLD) is a chronic liver disease, which causes serious health problems worldwide. Hyperleptinemia and inflammatory stress are crucial in the progression of NAFLD. However, the relationship between leptin and immune cells or hepatocytes is still unclear.

This study aimed to clarify the regulatory mechanism of leptin-mediated disease progression through immune cells and its relationship with hepatocytes.

An NAFLD rat model was established to verify the relationship between hyperleptinemia and CD8+ T lymphocytes and cytokines in liver tissue. CD8+ T lymphocytes isolated from blood mononuclear cells were co-cultured with macrophages or hepatocytes stimulated with leptin or treated with granzyme inhibitors to observe target cell morphology and expression of pivotal protein family members.

CD8+ T lymphocyte infiltration positively correlated with blood leptin, IL-18 and IL-1β levels and was related to macrophage recruitment and differentiation in a rat model of NAFLD. Leptin could induce activated caspase-1 and caspase-3 in hepatocytes and trigger hepatocyte pyroptosis.