IP32-30 LOWER URINARY TRACT SYMPTOMS AND STOOL BURDEN EVALUATED BY OBJECTIVE ABDOMINAL X-RAY CRITERIA

The Journal of Urology · 2026-04-27

Unique North American isolates of severe metastatic hypervirulent Klebsiella pneumoniae strain infections with hepatic abscesses seen in young patients within Texas

PLoS ONE · 2025-02-03 · 1 citations

RATIONALE: Hypervirulent Klebsiella pneumoniae (hvKp) infections have principally been identified in Asia. Within a two-month period, two patients between the ages of 30 to 50 years old presented to a tertiary referral hospital in Texas with septic shock, hepatic abscess, and septic thrombophlebitis. Blood cultures were positive for Klebsiella pneumoniae (isolates 2020CK-00441 and 2021CK-00720 respectively). The first patient survived after a prolonged hospital course while the second patient expired. OBJECTIVES: Describe the clinical presentation of these two patients. Perform whole genome sequencing and bioinformatic analysis to evaluate potential outbreak of specific hvKp bacteria isolates. METHODS: Whole genome sequencing was performed using both paired-end Illumina MiSeq and nanopore sequencing to obtain a Completed genome for both isolates. MAIN RESULTS: 2020CK-00441 belonged to ST23 type while 2021CK-00720 was a ST65 type isolate. Kleborate analyses predicted with high confidence both isolates were hvKp. Phylogenetic analyses showed the two strains are not closely related to each other nor to any known hvKp isolates reported. Both isolates had yersiniabactin, colibactin, aerobactin and salmochelin producing loci which likely confer these isolates hvKp phenotype. 2020CK-00441 and 2021CK-00720 had a unique pK2044 like plasmid. CONCLUSIONS: HvKp strains capable of causing devastating metastatic septic infections have emerged in Texas. These isolates are unique compared to other hvKp strains globally. Country-wide surveillance and whole genome sequencing of these strains is essential to prevent a major public health emergency in the USA.

Contemporary Analysis of 30-Day UTI Rates Post-ureteral Reimplantation in VUR Patients: Evaluating the Role of Discharge Antibiotics

Urology · 2025-12-08

IP20-40 CONTEMPORARY ANALYSIS OF 30-DAY UTI RATES POST-URETERAL REIMPLANTATION IN VUR PATIENTS: EVALUATING THE ROLE OF DISCHARGE ANTIBIOTICS

The Journal of Urology · 2025-04-08

SEVERE MITRAL BIOPROTHESIS STENOSIS, A CLINICAL DILEMMA SOLVED BY THE SAPIEN 3 VALVE

Journal of the American College of Cardiology · 2025-03-30

Converting USMLE Step 1 to Pass or Fail: The Potential Impact on Applicants Who Are Female or From Underrepresented Groups

HCA Healthcare Journal of Medicine · 2025-08-29 · 1 citations

Background: In January 2022, the United States Medical Licensing Examination (USMLE) Step 1 exam became pass/fail and the transition to using USMLE Step 2 scores for residency interview screening appeared imminent. While this change was intended to result in holistic reviews of residency applicants, the impact remains unclear. In this study, we aimed to determine how USMLE scoring changes might affect female candidates and applicants from underrepresented groups (URM). Methods: We performed a retrospective cross-sectional study of all applicants to a single institution. Data for applicants were extracted from their 2021-2022 residency applications and included age, race, sex, medical school, region, USMLE Step 1 score, and USMLE Step 2 scores. All applicants who graduated from a US medical school with both USMLE Step 1 and Step 2 scores were eligible for inclusion. Our primary outcome was the difference between USMLE Step 1 versus Step 2 scores. Two comparisons were made; female candidates were compared to male candidates and URM compared to non-URM. Results: < .005) demonstrated smaller differences between USMLE scores compared to the reference group (non-URM). Conclusion: Making USMLE Step 1 pass/fail may benefit female candidates during the interview process, while adversely impacting URM. As the application process evolves, the impacts on female and URM need to be carefully evaluated to achieve equitable representation in residency programs.

SUBMASSIVE PULMONARY EMBOLISM WITH CONCOMITANT UPPER LIMB ISCHEMIA: A UNIQUE PARADOXICAL PHENOMENON

Journal of the American College of Cardiology · 2024-04-01

Massive sigmoid megacolon due to giant fecaloma: A case report of anal stricture

Surgery Case Reports · 2024-08-15

A fecaloma is a mass of hardened feces in the colon or rectum, more solid than typical impacted feces, leading to severe intestinal distension. It predominantly affects elderly, frail individuals, children with anorectal deformities, and patients with conditions such as Chagas disease, Hirschsprung's disease, and spinal injuries. We report the case of a 34-year-old man with a history of anal imperforation and subsequent anal stricture, who presented with a massive megacolon due to a giant fecaloma. The patient experienced progressive abdominal distension, colicky pain, and an inability to pass stool for 15 days. Physical examination revealed a tender, distended abdomen and impacted feces in the rectum. Laboratory tests and imaging studies confirmed the diagnosis. An emergency laparotomy revealed a 30 × 30 cm dilated sigmoid colon filled with 15–25 kg of fecal material. The fecaloma was removed via enterectomy, and a Hartmann's procedure with colostomy was performed. Histopathological examination showed no evidence of malignancy. Post-operatively, the patient recovered well and was discharged in good condition. This case highlights the presentation and surgical management of a giant fecaloma causing megacolon. Prompt surgical intervention is critical in managing severe fecaloma to prevent life-threatening complications. • Giant fecaloma most commonly affects elderly, frail individuals, children with anorectal deformities, and may also be associated with various conditions such as Chagas disease, Hirschsprung's disease, inflammatory disorders, psychiatric and neoplastic disorders. • Serious consequences including stercoral perforations of the colon and rectum may also arise from untreated fecaloma. • Conservative management of fecaloma includes laxatives, enemas, or digital evacuation, but these methods require access to the rectum, often restricted by anal strictures. Surgical intervention becomes necessary when conservative measures are impeded, ensuring effective management in cases of significant anal strictures. • Patients that are bed-bound, with psychiatric illness, Hirschsprung's or Chagas disease and with previous history of anal surgery should always be considered for risk of developing chronic constipation and fecaloma.

An Efficient System to Analyze Criminal Activities

2024-09-25

Developing countries in the world have been fighting street crime for a long time. This problem has become so serious that many times people's lives are lost in this robbery besides the loss of property. The biggest tragedy is that there is no restriction on the free sale of such snatched or stolen items within the market and there is no record of such items anywhere to show that these devices are from someone snatched or stolen and no one should buy them in the market. To address this problem, a user-friendly web application has been proposed that enables users to report stolen devices by providing their IMEI and other relevant identifiers along with location and time of events. Additionally, potential buyers can verify the legitimacy of a product before purchase. This platform aims to create a centralized database to curb the resale of stolen items, enhancing the chances of recovery. The proposed system is based on two algorithms to process the date and to produce results in the form of reports. First algorithm has been presented to provide area wise stolen items with location and time. Second algorithm provides total no. of stolen items with their classification. The results shows that the algorithms have put a significant impact in reducing no of crimes in the city. This solution has the potential to significantly reduce the circulation of stolen devices in the market, benefiting both original owners and potential buyers. Further the application is enable to report the events to law enforcement agencies to control these kind of events.

Enhancing Smart Mobility Through Machine Learning and Neural Networks

2024-09-25

This study investigates the prediction of taxi trip durations in New York City using machine learning (ML) models and neural networks (NN). Three models Linear Regression, Random Forest Regressor, and a Neural Network were developed and evaluated on a dataset containing various trip details. The analysis highlighted the importance of geographic and temporal features in predicting trip durations. The Neural Network model outperformed others, achieving a mean squared error (MSE) of 12,577,211 and a root mean squared error (RMSE) of 3,546, significantly better than the comparative models. These results underscore its capacity to capture complex urban mobility patterns effectively. The superior performance of the Neural Network supports its potential to optimize traffic flow and reduce congestion in dense urban environments, offering substantial improvements to urban transportation systems.