Spontaneous echo contrast mimicking aortic root thrombus in a patient supported with extracorporeal membrane oxygenation

Aortic root spontaneous echo contrast is a rare but significant finding. We report a 31‐year‐old female who was placed on venoarterial extracorporeal membrane oxygenation emergently for acute mitral regurgitation secondary to papillary muscle rupture. Following stabilization, subsequent transesophageal echocardiography suggested aortic root thrombus and prompted emergent surgery. However, further inspection with intraoperative transesophageal echocardiography revealed a spontaneous echo contrast which aided us in the intraoperative decision making.     

Assessing the CT findings and clinical course of ED patients with first-time versus recurrent acute pancreatitis

Study objectives

The primary objective of this study was to compare Emergency Department patients with first-time versus recurrent acute pancreatitis.

Mandibular implant-retained overdenture with magnets: a case report

Implant-retained overdentures can be a simple treatment option to restore the edentulous mandible. Retention can be achieved via studs, linked bar system or magnets. Success rates using the different retention mechanisms have been reported to be high. However, long-term prospective studies on implant-retained overdentures are limited. This paper reports on a patient who has successfully worn a mandibular implant-retained overdenture with magnets for 12 years.     

Determination of in vitro susceptibility of ocular Fusarium spp. isolates from keratitis cases and comparison of Clinical and Laboratory Standards Institute M38-A2 and E test methods

We evaluated the susceptibility of 85 Fusarium spp. isolates from cases of fungal keratitis with 8 antifungal drugs using the standard Clinical and Laboratory Standards Institute broth microdilution and E test methods. Members of the Fusarium solani species complex showed consistently higher MICs to the triazole drugs itraconazole, voriconazole, and posaconazole than did members of other species complexes (Fusarium oxysporum and other minor species). High MICs to amphotericin B, natamycin, and echinocandins were consistently obtained with no discrimination based on species or method. Further work is required to determine any potential correlation between MIC and clinical outcome in keratitis.     

Unsuspected colorectal carcinoma on routine abdominopelvic computed tomography

Colorectal carcinoma is a common lethal disease with signs and symptoms that may be nonspecific. Computed tomography (CT) of the abdomen and pelvis with or without contrast is frequently performed for various general abdominal complaints, but unlike CT colonography, the large bowel may not be optimally prepared for evaluation. As such, careful and diligent assessment of the non-prepared colon in all CT images of the abdomen and pelvis is important, as it ensures that incidental colorectal malignancy is not missed, especially in older patients. This article gives an overview of multidetector CT imaging signs and subtle clues to aid in the diagnosis of colorectal carcinoma, as well as their pitfalls.     

Expression of tumor suppressive microRNA‐34a is associated with a reduced risk of bladder cancer recurrence

Bladder cancer is the fourth most common cancer among men in the United States and more than half of patients experience recurrences within 5 years after initial diagnosis. Additional clinically informative and actionable biomarkers of the recurrent bladder cancer phenotypes are needed to improve screening and molecular therapeutic approaches for recurrence prevention. MicroRNA‐34a (miR‐34a) is a short noncoding regulatory RNA with tumor suppressive attributes. We leveraged our unique, large, population‐based prognostic study of bladder cancer in New Hampshire, United States to evaluate miR‐34a expression levels in individual tumor cells to assess prognostic value. We collected detailed exposure and medical history data, as well as tumor tissue specimens from bladder patients and followed them long‐term for recurrence, progression and survival. Fluorescence‐based in situ hybridization assays were performed on urothelial carcinoma tissue specimens (n = 229). A larger proportion of the nonmuscle invasive tumors had high levels of miR‐34a within the carcinoma cells compared to those tumors that were muscle invasive. Patients with high miR‐34a levels in their baseline nonmuscle invasive tumors experienced lower risks of recurrence (adjusted hazard ratio 0.57, 95% confidence interval 0.34–0.93). Consistent with these observations, we demonstrated a functional tumor suppressive role for miR‐34a in cultured urothelial cells, including reduced matrigel invasion and growth in soft agar. Our results highlight the need for further clinical studies of miR‐34a as a guide for recurrence screening and as a possible candidate therapeutic target in the bladder.     

Essential learning tools for continuing medical education for physicians,geneticists, nurses,allied health professionals,mental health professionals,business administration professionals,and reproductive endocrinology and infertility (REI) fellows: the Midwest Reproductive Symposium International

Essential learning tools for continuing medical education are a challenge in today’s rapidly evolving field of reproductive medicine. The Midwest Reproductive Symposium International (MRSi) is a yearly conference held in Chicago, IL. The conference is targeted toward physicians, geneticists, nurses, allied health professionals, mental health professionals, business administration professionals, and reproductive endocrinology and infertility (REI) fellows engaged in the practice of reproductive medicine. In addition to the scientific conference agenda, there are specific sessions for nurses, mental health professionals, and REI fellows. Unique to the MRSi conference, there is also a separate “Business Minds” session to provide education on business acumen as it is an important element to running a department, division, or private clinic.