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However, she was diagnosed with borderline PAH 2 years later. The lung uptake of 123I-MIBG was reduced before a reduction in %DLCO was observed. This report suggests that the lung uptake of 123I-MIBG may be useful for the early diagnosis of pulmonary artery hypertension.Transient global amnesia (TGA) is a neurological disorder characterized by sudden onset of anterograde and retrograde amnesia. TGA following angiography is rare and its possible etiologies have not been determined definitively. Herein, I report a case of TGA after carotid artery stenting with DWI findings, which, to date, has not been reported. The patient was a 71-year-old man who developed TGA following carotid artery stenting. Diffusion-weighted imaging demonstrated a focal restricted diffusion lesion in the left medial temporal lobe. Left carotid artery stenting was performed via the common femoral artery, and the procedural course was uneventful. However, the patient suffered an amnestic event 1 hour after the procedure. DWI performed 1 hour after amnesia onset revealed a small punctate restricted diffusion lesion in the left hippocampus. One day later, his amnesia spontaneously resolved. Although TGA after endovascular procedure is rare and usually has a favorable prognosis, clinicians and interventionists should be aware of this rare complication.Intramural gastric air is a rare but potentially life-threatening imaging finding. We present the case of a 56-year-old female patient with a history of schizophrenia, who presented with multiple episodes of vomiting and altered mental status. CT scan revealed intramural gastric air and portal venous gas. The patient was treated conservatively with a favorable outcome. Gastric emphysema and emphysematous gastritis should be considered in the differential diagnosis of air in the gastric wall. It is critical to distinguish between these 2 entities as their clinical course and management differ significantly, although radiographic findings may mimic each other.Persistent eating of non-nutritive, nonfood substances (Pica) is seen in children and adult patients with psychiatric problems. Ingestion of multiple metallic FBs with resultant bezoar formation is rare. selleck products While many FBs are passed without complication, mucosal injury, bleeding, obstruction or perforation can occur in some cases. Endoscopic FB removal is performed in 20% of patients following FB ingestion. Generally, these are safe procedures, and very effective in extracting ingested FBs. We report, a 25-year-old male patient with a metal ingestion predominant Pica, requiring multiple prior extraction procedures (including open gastrostomy). He developed a splenic artery pseudoaneurysm following his latest endoscopic FB removal, that was successfully treated with transarterial coil embolization. The unique circumstances leading to this rare complication and its successful endovascular management make this case worthy of report.Cystic partially differentiated nephroblastoma is a rare renal tumor of childhood. It is part of a spectrum of multicystic renal tumors that also includes cystic nephroma and cystic Wilms' tumor. We present a case of cystic partially differentiated nephroblastoma, highlighting the clinical and imaging diagnostic challenge. Although the histological diagnostic criteria for all these 3 entities are well established, they are clinically and radiologically indistinguishable. Cystic partially differentiated nephroblastoma is often observed in male children under 2 years old. Typical clinical presentations include abdominal masses, abdominal pain and/or hematuria. Patients should be treated according to tumor histology and stage.Background Needle-exchange programs (NEPs) reduce infections in people who inject drugs. This study assesses the impact community pharmacies have had in the Needle-Exchange Program in Portugal since 2015. Methods Health gains were measured by the number of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections averted, which were estimated, in each scenario, based on a standard model in the literature, calibrated to national data. The costs per infection were taken from national literature; costs of manufacturing, logistics and incineration of injection materials were also considered. The results were presented as net costs (i.e., incremental costs of the program with community pharmacies less the costs of additional infections avoided). Results Considering a 5-year horizon, the Needle Exchange Program with community pharmacies would account for a 6.8% (n = 25) and a 6.5% reduction (n = 22) of HCV and HIV infections, respectively. The present value of net savings generated by the participation of community pharmacies in the program was estimated at €2,073,347. The average discounted net benefit per syringe exchanged is €3.01, already taking into account a payment to community pharmacies per needle exchanged. Interpretation We estimate that the participation of community pharmacies in the Needle Exchange Program will lead to a reduction of HIV and HCV infections and will generate over €2 million in savings for the health system. Conclusions The intervention is estimated to generate better health outcomes at lower costs, contributing to improving the efficiency of the public health system in Portugal.Introduction Our previous study in British Columbia (BC) indicated that pharmacists have a poor perception of their working conditions. The objective of this study is to assess pharmacists' perceptions of their working conditions in 4 other Canadian provinces. Methods This was a cross-sectional study across Alberta, New Brunswick, Prince Edward Island and Newfoundland and Labrador, using a survey adapted from the Oregon Board of Pharmacy. Data collected previously from BC were also included in the analyses. The survey was emailed to all pharmacist registrants. Respondents were provided with 6 statements and asked to rate their agreement with them, using a 5-point Likert scale. Statements were framed such that agreement with them indicated good perception of working conditions. Logistic regression analyses were used to study the relationship between workplace factors on perception of working conditions. Results Pharmacists perceived their working conditions to be poor. Pharmacists indicated that they do not have time for break/lunch (48.