Medicine and Health Sciences Commons^™

Importance Of Defining Anatomy: Uncovering An Unexpected Finding With Ct Coronary Angiography After Abnormal Spect Results, Anushree Puttur, Laith Alhuneafat, Omar Obeidat, Andreas Kyvernitakis, Ahmad Jabri, Abdallah Naser, Ahmad Al-Abdouh, Farhan Katchi

2020-Current year OA Pubs

Coronary CT angiography extends beyond detecting obstructive coronary artery disease by providing vital anatomical insights into extra-coronary pathologies, including acute aortic syndromes. This non-invasive modality enables early identification of life-threatening conditions and informs multidisciplinary management strategies, underscoring its critical role in comprehensive diagnostic evaluation and patient-centered care.

Comparing Effectiveness And Safety Of Left Atrial Appendage Closure Devices: A Network Meta-Analysis Of Randomized Controlled Trials, John W Davis, Steven L Mai, Wissam Harmouch, Jenna Reisler, Micaela Mackay, Elizabeth Davis, Pavel Osmancik, Michael W Rich

2020-Current year OA Pubs

INTRODUCTION: Atrial fibrillation-related stroke is a leading cause of morbidity and mortality. The comparative effectiveness and safety of left atrial appendage closure (LAAC) devices, compared with one another and with anticoagulation, is unclear.

METHODS: We conducted a systematic review and network meta-analysis (NMA) of all clinical trials comparing the Watchman and Amplatzer Amulet LAAC devices with each other or with warfarin or direct oral anticoagulants (DOACs). The primary comparison was between LAAC devices with secondary comparisons to anticoagulation. The primary effectiveness outcomes were any stroke and all-cause death. Safety outcomes included any thromboembolism, device embolization, and pericardial effusion.

RESULTS: There …

Adolescent Coronal Shear Fractures Of The Distal Humerus: Surgical Approach And Outcomes, David Wright, Zachary Meyer, Charles A Goldfarb, Lindley B Wall

2020-Current year OA Pubs

PURPOSE: Isolated coronal shear fractures of the distal humerus in adolescents are rare injuries with unique surgical challenges. Respect for the posterior blood supply, open physes, and need for direct visualization to achieve anatomic reduction are critical considerations in surgical fixation. This study presents a case series and a surgical approach used in treating these patients.

METHODS: A retrospective review of patients aged 10-19 presenting to a single quaternary-care academic center from 2016 to 2023 with isolated capitellar and trochlear shear fractures was performed. Demographic data, injury mechanism, fracture classification, and surgical approach were recorded. Outcomes included elbow range of …

Hiv Pre-Exposure Prophylaxis Does Not Increase Gonorrhea And Chlamydia Incidence In Young Black And Hispanic Men Who Have Sex With Men: An Observational Cohort Study, Octavio C Mesner, Rishabh Jain, Aditi Ramakrishnan, Derrick D Matthews, Jeremy T Goldbach

2020-Current year OA Pubs

BACKGROUND: HIV pre-exposure prophylaxis (PrEP) use has been linked with increases in sexually transmitted infection (STI) incidence. Despite efforts to expand PrEP uptake among young Black and Hispanic men who have sex with men (YBHMSM), little research has been done to understand the impact of PrEP on STI incidence within these communities. We examine the effect of PrEP use on gonorrhea and chlamydia (NG/CT) incidence, condom use, and external STI testing (ie, outside of study visits).

METHODS: In a longitudinal cohort of HIV-negative YBHMSM (ages 16-24 years), we modeled the effect of PrEP use on study-external STI testing and number …

Context-Dependent Contribution Of Peptidyl Arginine Deiminase 4 (Pad4) To Neutrophil Extracellular Trap Formation And Liver Injury In Acute And Chronic Hepatotoxicant Challenge, Gina E Capece, Amish K Patel, Daniel Hu, Tayana Roychowdhury, Bianca Hazel, Jessica Kothapalli, Noah A Mac, Frederik Denorme, Robert A Campbell, Lauren G Poole

2020-Current year OA Pubs

Neutrophils play a complex role in the pathogenesis of chronic liver disease and have been linked to both liver damage and injury resolution. Recent reports propose that neutrophils drive liver injury and fibrosis through the formation of neutrophil extracellular traps (NETs). This study tests the hypothesis that the enzyme peptidyl arginine deiminase-4 (PAD4) drives NET formation and liver fibrosis in experimental chronic liver injury. Wild-type (PAD4+/+) and PAD4-deficient (PAD4-/-) mice were chronically challenged twice weekly with carbon tetrachloride (CCl4, 1 ml/kg, i.p) or vehicle (corn oil) for 6 weeks, and samples were collected 24 h after the final challenge. In …

Comparison Of Rule- And Large Language Model-Based Phenotype Extraction From Clinical Notes For Neurofibromatosis Type 1, Levi Kaster, Ethan Hillis, Inez Y Oh, Elizabeth C Cordell, Randi E Foraker, Albert M Lai, Stephanie M Morris, David H Gutmann, Philip R O Payne, Aditi Gupta

2020-Current year OA Pubs

INTRODUCTION: Neurofibromatosis type 1 (NF1) is a rare genetic disorder affecting multiple organ systems with significant clinical heterogeneity. Managing individuals with NF1 is challenging due to variability in disease progression and outcomes and limited early risk assessment tools.

OBJECTIVE: This study aims to develop an effective, generalizable, user-friendly clinical entity extraction pipeline for identifying NF1-related phenotypes from unstructured clinical notes to enhance research and risk-modeling efforts. We compare the benefits of rule-based natural language processing (NLP) vs large language models (LLMs) for this purpose.

MATERIALS AND METHODS: Four phenotype extraction pipelines (3 LLM-based vs 1 rule-based) were developed to automatically …

Characterization Of Educational And Executive Leadership In University-Based General Surgery Programs: Demographics, Training Backgrounds, And Institutional Ties, Nicole M Santucci, Daniel Alligood, Sabrina Madrigal, Ariana Naaseh, Jonathan Davies, Hannah M Phelps, Paul E Wise, Jennifer Yu, Jesse D Vrecenak, Colin A Martin

2020-Current year OA Pubs

INTRODUCTION: Despite longstanding homogeneity in surgical leadership at academic institutions, promoting diversity in leadership positions is increasingly recognized as critical to fostering inclusion, mentorship, and improved patient outcomes. This study aims to further characterize and compare educational and executive leaders within academic general surgery (GS) programs.

METHODS: A cross-sectional study was conducted using publicly accessible online resources to collect program characteristics and leadership demographics for Accreditation Council for Graduate Medical Education-accredited, university-based GS residency programs for the 2024-25 academic year. Leadership roles included Program Directors (PDs), Associate Program Directors (APDs), Clerkship Directors (CDs), Vice Chairs of Education (VCE), and Department …

Association Of Hospital Surgical Volume With Outcomes In Resected Stage I Non-Small Cell Lung Cancer, Steven Tohmasi, Daniel B Eaton Jr, Brendan T Heiden, Nikki E Rossetti, Theodore S Thomas, Martin W Schoen, Su-Hsin Chang, Ana A Baumann, Yan Yan, Mayank R Patel, Whitney S Brandt, Bryan F Meyers, Varun Puri

2020-Current year OA Pubs

INTRODUCTION: Prior research examining the volume-outcome relationship for lung cancer resection has focused primarily on non-Veteran populations treated across diverse healthcare systems. This study aimed to evaluate the relationship between hospital surgical volume and postoperative outcomes for early-stage non-small cell lung cancer (NSCLC) in Veteran and non-Veteran populations in the United States.

METHODS: We conducted a retrospective cohort study of patients diagnosed with stage I NSCLC who underwent surgical resection in the Veterans Health Administration (VHA) from 2007-2019 and National Cancer Database (NCDB) from 2010-2019. Hospitals were categorized based on their annual volume of lung cancer resections. Multivariable regression models …

A Glial Circadian Gene Expression Atlas Reveals Cell-Type And Disease-Specific Reprogramming In Response To Amyloid Pathology Or Aging, Patrick W. Sheehan, Stuart B Fass, Darshan Sapkota, Sylvia Kang, Henry C Hollis, Jennifer H Lawrence, Sohui Park, Ashish Sharma, Dorothy P Schafer, Ron C Anafi, Joseph D Dougherty, John D Fryer, Erik S Musiek

2020-Current year OA Pubs

While circadian rhythm disruption may promote neurodegenerative disease, the impact of aging and neurodegenerative pathology on circadian gene expression patterns in different brain cell types remains unknown. Here we used a translating ribosome affinity purification to identify the circadian translatomes of astrocytes, microglia and bulk tissue in healthy mouse cortex and in the settings of amyloid-β plaque pathology or aging. We show that glial circadian translatomes are highly cell-type-specific and exhibit profound, context-dependent reprogramming in response to amyloid pathology or aging. Transcripts involved in glial reactivity, immunometabolism and proteostasis, as well as nearly half of all Alzheimer's disease risk genes, …

Identifying Performance Differences Between Two Pulse Oximetry Systems In Simulated Critical Neonatal Conditions, Brian King, Jake Dove, Scott J Mcgonigle, Warwick A Ames, Zachary A Vesoulis

2020-Current year OA Pubs

OBJECTIVE: Pulse oximetry is used to guide critical clinical decisions in neonatology. We used a vital signs simulator to compare performance of two pulse oximetry systems in conditions not tested in standardized clinical verification studies.

STUDY DESIGN: We devised a set of simulated tissue translucency, perfusion, peripheral oxygen saturation (SpO

RESULTS: The mean SpO

CONCLUSION: Significant performance differences can be observed when comparing pulse oximeters at low translucency and perfusion conditions. Patient simulators cannot replace clinical testing but provide a safe and cost-effective method for additional performance profiling.

Management Of The Patent Ductus Arteriosus Among Infants Born At 23 To 32 Weeks' Gestation Between 2011 To 2022: A Report From In The Children's Hospitals Neonatal Consortium, Mark F Weems, Molly K Ball, Isabella Zaniletti, Sharifa Habib, Shannon Hamrick, Theresa R Grover, Sarah Keene, Karna Murthy, Michael Padula, Ranjit Philip, Rakesh Rao, Shawn Sen, Philip T Levy, Sharada H Gowda, Chnc Cardiac Focus Group

2020-Current year OA Pubs

OBJECTIVE: This study reports on patent ductus arteriosus (PDA) therapy trends across the Children's Hospital Neonatal Consortium.

STUDY DESIGN: We performed a 12-year (2011-2022) retrospective study of premature infants (<  33 weeks) with a PDA. We utilized descriptive statistics to compare demographic, inpatient, and discharge characteristics in 3-year epochs.

RESULT: From 54,813 infants, 19,843 (36%) had a diagnosis of PDA. Use of pharmacotherapy increased 44% (relative) over time, mostly with increased acetaminophen use. There was a 12.7-fold increase in exposure to multiple PDA medications over the study period. While the rate of definitive closure did not change, use of transcatheter PDA closure increased from 0 to 20.3% and surgical ligation decreased from 25.1% to 3.6%.

CONCLUSION: There has been …

Cultural Humility In Patient Education: Development Of A Nutrition-Related Simulation For Nursing Students, Theresa G. Schnable, Sylvia Peña, Juanita T. Garcia, Marilyn Frenn

College of Nursing Faculty Research and Publications

Introduction:

The Latinx community is disproportionately impacted by social and structural inequities such as food insecurity and culturally and linguistically appropriate resources. To address a gap in culturally appropriate nutrition education with Latinx individuals among baccalaureate nursing students, a simulation learning experience (SLE) was developed.

Methodology:

The SLE was designed using best practice standards by faculty experts and reviewed by consultants. After the SLE, students and faculty provided feedback regarding simulation design and implementation.

Results:

Participants reported improved knowledge and confidence when providing culturally appropriate nutrition education and valued working with an interpreter.

Discussion:

This innovative strategy using simulation offers …

Comparison Of Metal Nanoparticles As Antifungal Agents: Efficacy, Mechanisms, And Toxicity Against Candida, Aspergillus, And Cryptococcus, Ahmed Falah Imran, Hayder Hameed Saeed, Khaldoon Jasim Mohammed

AUIQ Complementary Biological System

Candida albicans, Aspergillus fumigatus, and Cryptococcus neoformans are the invasive fungi whose diseases are becoming a growing health issue in the global community, particularly in immunocompromised people. The increasing resistance of the conventional antifungals and the shortage of the existing treatment methods require alternative methods. The present review is an evaluation of the antifungal activity of metal-based nanoparticles, including silver (Ag), copper (Cu), zinc oxide (ZnO), titanium dioxide (TiO₂), and selenium (Se) in relation to the three predominant pathogenic fungi. It also talks about their mode of action, relative efficacy, toxicity and their possible future clinical …

Telepsychiatry For Substance Use Disorders: Evolution From Rapid Covid-19 Pandemic Adoption To Sustainable Integration, Jack Wang

Marshall Journal of Medicine

ABSTRACT

Introduction: Prior to the COVID-19 pandemic, telepsychiatry for substance use disorder (SUD) management was generally an underutilized modality, mainly due to regulatory constraints. Through the pandemic, governmental deregulations rapidly and massively expanded their adoption, bringing out their significant potential to expand access, overcome barriers, and mitigate stigma for individuals seeking addiction care, particularly for rural and underserved populations. This narrative review consolidates the recent research on the growing adoption of telepsychiatry in the management of SUDs. It aims to explore the evidence-based benefits, identify common challenges, and underscore key considerations for its effective and equitable integration into SUD treatment …

Lyme Disease Presenting As A Dermal Hypersensitivity Reaction, William T. Snider, Ian Depew, Rebecca Hicks, Shane Cook

Marshall Journal of Medicine

Background:

Lyme disease is a well-recognized illness commonly associated with skin manifestations such as erythema migrans. However, atypical presentations can complicate diagnosis, particularly when they deviate from classic clinical and histological findings.

Methods:

We report a potential case of Lyme disease presenting as a dermal hypersensitivity reaction (DHR), with clinical findings resembling urticaria rather than urticarial vasculitis. Skin biopsy findings were reviewed, and Lyme serology testing was performed.

Results:

The biopsy did not demonstrate the characteristic superficial perivascular lymphocytic infiltrate typically seen with erythema migrans. The patient's history included prior tick exposures, but while Lyme IgM was positive, the Lyme …

Diagnosis And Surgical Management Of Lymphoproliferative Unicentric Castleman Disease, Kristen E. Bowman, Jonathan Evans, Yancy Short, David Webb

Marshall Journal of Medicine

Castleman Disease (CD) describes a group of complex lymphoproliferative disorders that share common histopathological features. Classification largely centers around the number of affected lymph nodes and the presence or absence of Human Herpesvirus 8 (HHV-8). Unicentric CD (UCD) is estimated to make up 40% of all CD cases with the remaining 60% being multicentric CD (MCD), involving several regions of the body and increasing concern for HHV-8 involvement. While UCD is often discovered through incidental imaging or routine examination, swift confirmation via pathological diagnostics can often lead to a cure through simple resection. Presented here is the case of a …

A Severe And Unusual Case Of Propriospinal Myoclonus, Mouhannad Azzouz, Robert Young, Ammar Md Bata, Thaiddeus Dillie, Anam Sabzwari

Marshall Journal of Medicine

Propriospinal myoclonus (PSM) is a rare disorder characterized by axial muscle jerks originating in the thoracoabdominal region; medical management of this disease is extremely challenging given the paucity of trials and few reported cases only. Chronic cough has not been described in the literature in association with PSM. We describe a 51 year old female presenting with chronic unexplained cough along with myoclonic jerking, ultimately diagnosed with severe PSM. Fortunately our case after different medication trials showed great response to lacasomide which has been rarely reported in PSM management.

Mirm In An Adolescent Male: A Diagnostic Challenge And Review Of The Literature, Emily Saurborn, Savannah Carty, Shane Cook, Lauren Tufts

Marshall Journal of Medicine

Mycoplasma-Induced Rash and Mucositis (MIRM) is a subset of Reactive Infectious Mucocutaneous Eruption (RIME), most commonly associated with Mycoplasma pneumoniae. MIRM commonly presents with significant mucositis and mild or absent cutaneous involvement. MIRM exists on a spectrum with Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). Due to the significant clinical overlap, early diagnosis of MIRM can be challenging. We report a case of a 19-year-old male who presented with a two-day history of worsening throat pain and decreased oral intake after initiating Augmentin for treatment of community acquired pneumonia. During hospitalization, he developed progressive ocular, oral and genital …

Diagnosis Of Kasabach-Merritt Phenomenon In A Newborn, Kiersten Ricci, Sara Basala, Edward Raykhelson, Aaron Mcguffin

Marshall Journal of Medicine

Kasabach-Merritt Phenomenon (KMP) is a rare and potentially life-threatening coagulopathy that has high bleeding risk and is characterized by severe thrombocytopenia and hypofibrinogenemia. Timely diagnosis and intervention are essential, as untreated kaposiform hemangioendothelioma (KHE) or tufted angioma (TA) associated with Kasabach-Merritt phenomenon (KMP) can result in significant morbidity and mortality..

We report a case of a full-term female neonate who was noted to have a large vascular scalp mass at birth. The tumor was initially misidentified as an infantile and a congenital hemangioma. Upon specialty evaluation at a vascular anomaly center and additional diagnostics, the child was diagnosed with KHE …

A Rare Case Of Porokeratosis Arising In Association With A Verruca, Kiran Patel, Robert Levi Snedegar, Walaa Hammad

Marshall Journal of Medicine

Porokeratosis is a rare keratinizing disorder of the epidermis that carries an increased risk of malignant transformation. Among its less common variants is verrucous porokeratosis, which can mimic benign skin conditions such as verruca vulgaris. We present the case of a 57-year-old male who developed a lesion on the posterior heel, initially treated as a verruca, which recurred and was later diagnosed via shave biopsy as porokeratosis arising in association with a verruca. A literature search of PubMed and Google Scholar did not identify any prior reports of porokeratosis arising in association with a verruca on the posterior heel. The …

Unaccompanied Migrant Minors: A Psychiatric Case Series Review, Cecilia De Vargas, Eden Hernandez Robles, Fernando Doval Perez, Leslie Salazar-Hinojosa, Danielle Parker, Javier Segovia, Aleli Campbell, Deborah J. Clegg

International Journal on Responsibility

Unaccompanied children and adolescents who migrate from Central America and Mexico into the United States (U.S.) are exposed to and experience trauma throughout the process of migration. These traumatic experiences result in an increasing prevalence of psychiatric illnesses and challenges to treatment. This study presents a psychiatric patient record review of minors and their complex trauma. Unaccompanied migrant minors (UMM) ages 12-17 (28 males and 22 females; n = 50) received comprehensive psychiatric assessments at the El Paso Texas Tech Child and Adolescent Psychiatry outpatient clinic. Their charts were reviewed for psychiatric diagnosis, treatment progress, and trauma experiences before, during, …

Is It Retaliation Or Remediation? Educating Our Learners On The Difference, France M. Leandre, Almari Ginory

HCA Healthcare Journal of Medicine

The goal of this article is to discuss 1 of the questions in the Accreditation Council for Graduate Medical Education Resident/Fellow Survey, which assesses the fear of retaliation in a program. To better understand the needs of residents and facilitate the reporting of concerns, programs must evaluate and educate residents on the difference between remediation and retaliation.

The Mahec Research Certificate Program: A Brief And Introductory Exposure To Key Research Topics For Diverse Learners, Grace E. Flinchum, Emily S. Mazure, Chelsea C. Atkins, Wendy Nuzzo, C Micha Belden, Edward C. Jauch, Jacqueline R. Halladay

HCA Healthcare Journal of Medicine

Background

Research is a core component of health profession training programs, but few efficient training resources exist that provide introductory research training that is brief, freely accessible, and supportive of learners with varying levels of research experience.

Methods

We set out to create the Mountain Area Health Education Center (MAHEC) Research Certificate program to support Graduate Medical Education (GME) residents and other learners. We initially explored existing curricula used to instruct medical and doctor of pharmacy students in order to identify foundational research topics to include in our introductory research program. We were guided by stakeholders to create a curriculum …

Nonglomerular Hypocomplementemic Interstitial Nephritis, Tyler Hemphill, Yogesh Sanghvi

HCA Healthcare Journal of Medicine

Background

Acute interstitial nephritis (AIN) is the most common cause of acute kidney injury (AKI) with subsequent renal impairment and is often underdiagnosed. Acute interstitial nephritis presents with a decline in kidney function and is characterized by an inflammatory infiltrate in the kidney interstitium. It is most often induced by drug therapy and is sometimes followed by infections with unknown causes. In a typical presentation of AIN, there is no evidence of hypocomplementemia; low complement is associated most commonly with autoimmune etiologies. Renal biopsy serves as the most definitive test for both the diagnosis and prognosis of AIN.

Case Presentation …

Spontaneous Pneumomediastinum Following Ingestion Of Bleach, Dish Soap, And Laundry Detergent And Inhalation Of Methamphetamines, Marshall Johnson, Matthew Boss, Alayna S. Buzzetta, Barbara L. Gracious

HCA Healthcare Journal of Medicine

Introduction

Spontaneous pneumomediastinum (SPM) is a rare condition defined by the presence of air in the mediastinum in patients without an observable traumatic cause. Pneumomediastinum is a somewhat rare condition that occurs 1 in every 25 000 individuals, aged 5 to 34 years old, with 76% occurring in men. Pneumomediastinum can further be divided into 2 categories: SPM and traumatic pneumomediastinum. Traumatic pneumomediastinum is most commonly seen with blunt force trauma or any iatrogenic procedures to the chest wall. Spontaneous pneumomediastinum frequently occurs due to air leaking through small alveolar sacs, which rupture within the surrounding bronchovascular sheath. Spontaneous pneumomediastinum …

Use Of Topical Hemostatic Agents In A Gynecologic Patient With Coagulopathy, Alexis O'Connell, Syeda Zainab Shah

HCA Healthcare Journal of Medicine

Introduction

The use of topical hemostatic agents has become common during surgical interventions. There is a wide variety of substances available to augment clotting, ranging from physical agents to topical thrombin combinations. Application of these agents in gynecologic surgery in patients with existing coagulopathies has not been studied.

Case Presentation

A 62-year-old woman with an inferior vena cava filter and a history of multiple deep vein thromboses presented to the clinic with pelvic pain, stress urinary incontinence, and uterovaginal prolapse. She underwent a total vaginal hysterectomy, sacral colpopexy, tension-free vaginal tape sling, and cystourethroscopy. Warfarin was cross titrated to enoxaparin …

Utilizing Femoral Metaphyseal Sleeves In Primary Total Knee Arthroplasty For Post-Traumatic Osteoarthritis: A Case Report, Zachary Sukin, Adam Dentinger, Jeremiah Earl

HCA Healthcare Journal of Medicine

Background

Total knee arthroplasty in younger patients presents a heightened risk of postoperative complications and implant failures compared to older populations, particularly in those with posttraumatic arthritis. These challenges necessitate careful consideration and specialized approaches to optimize the outcomes in this patient demographic.

Case Presentation

A 43-year-old man presented with left knee pain resulting from a traumatic lawn mower injury, causing an intraarticular distal femur, at the age of 6. The injury led to a limb-length discrepancy for which he underwent 2 limb-lengthening procedures in his early 20s. Radiographs demonstrated advanced posttraumatic osteoarthritis, and the patient elected to proceed with …

Upper Respiratory Tract Infection Leading To A New Diagnosis Of Sweet Syndrome And Monoclonal Gammopathy Of Unknown Significance, Nidhi Rawat, Meron Gebrehiwot, Jason Raw, Jeyaprakash Ramachandran

HCA Healthcare Journal of Medicine

Background

We present a rare case of Sweet syndrome with underlying monoclonal gammopathy of unknown significance (MGUS) which initially presented as upper respiratory tract infection.

Case Presentation

A 52-year-old woman presented with a complaint of sore throat for 6 days, productive cough and fever for 5 days, and red, pruritic, circular, tender rashes on face, arms and trunk for 2 days. There was a past history of similar self-limiting rashes presenting intermittently for 1.5 years. She also reported to be taking tablet ibuprofen, as required for the past 1-2 years, for cervical spondylosis. On integumentary examination, widespread, red, tender, annular …

Capacity Over Cognition: A Case Of High-Risk Disease And Homelessness, Mikalah E. Maury, Avery M. Duncan, Rebecca A. Taylor, Mary Ann Beil, Maulikkumar A. Patel

HCA Healthcare Journal of Medicine

Background

Medical decision-making in indigent patients with baseline cognitive deficits and lack of supportive resources is a difficult problem that reveals many ethical issues. Performing high-level medical procedures (eg, invasive surgery, chemotherapy, radiation therapy) on these patients without supportive resources brings into question the efficacy and necessity of treatment if it places the patient at higher risk of additional complications and mortality.

Case Presentation

In this article, we present a case of a 62-year-old indigent man with a long history of encephalopathy secondary to alcohol abuse, presenting with an aggressive head and neck cancer impacting his quality of life.

Conclusion …

Rapid Percutaneous Nephrostomy Stent Encrustation In Pregnancy: Navigating Your Stone Challenge, Victor M. Feldbaum, Roberto Morales, Shawn R. Ramsey, Michael L. Douso

HCA Healthcare Journal of Medicine

Background

Surgical management of kidney stones in pregnancy can be a serious problem for both mother and fetus.

Case Presentation

A 20-year-old woman with a second trimester pregnancy presented to the emergency room with renal calculi. She required surgical intervention and a left nephrostomy tube after consultation with urology. Five weeks later, her tube was solidified in place unbeknownst to her care team. She required several surgeries, dealt with encrustation remnants, infections, radiation exposure, persistent infection requiring antibiotic management, and, ultimately, an early delivery at 37 weeks.

Conclusion

At the time of writing, this was the first case to describe …