Baylor University Medical Center Proceedings最新文献

{"title":"Imaging features of uterine submucosal pseudoaneurysm.","authors":"Mimi Phan Haghshenas, Ashok Theruvath, Pritish Bawa, Roshni Parikh","doi":"10.1080/08998280.2026.2736352","DOIUrl":"https://doi.org/10.1080/08998280.2026.2736352","url":null,"abstract":"<p><p>Submucosal pseudoaneurysms located within the uterine wall can be particularly challenging to diagnose due to their atypical location and nonspecific clinical presentation. We report the case of a 32-year-old woman presenting with heavy postoperative uterine bleeding following robotic myomectomy and endometriosis resection. Contrast-enhanced computed tomography angiography revealed an 8-mm left intracavitary pseudoaneurysm arising from the arcuate artery within the submucosal layer. Diagnosis was confirmed with catheter-directed angiography, and the patient was successfully treated with selective embolization of the left uterine artery. This case highlights the importance of advanced imaging in identifying uterine pseudoaneurysms and guiding timely intervention.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149036146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding factors influencing concussion treatment and rehabilitation: an exploratory qualitative study.","authors":"Madisyn Cox, Brittany Davis, Kayla Covert","doi":"10.1080/08998280.2026.2731850","DOIUrl":"https://doi.org/10.1080/08998280.2026.2731850","url":null,"abstract":"<p><strong>Background: </strong>Concussion is a common neurological injury, affecting millions of individuals across the lifespan. Despite advances in early initiation of care, up to 30% of patients experience prolonged recovery that disrupts school, work, and daily life. While prior research has clarified when and how concussion treatment should be initiated, less is known about the factors shaping recovery once treatment has begun.</p><p><strong>Methods: </strong>This study used a pragmatic, hybrid descriptive qualitative design to examine the factors, including barriers and facilitators, influencing concussion recovery after treatment initiation. Data were generated through a small focus group that included eight clinicians and individuals with lived concussion experience.</p><p><strong>Results: </strong>Through thematic analysis, six themes emerged from the guiding research questions. Although distinct, these themes converged around four overarching mechanisms shaping recovery: educational transfer, relational communication, self-awareness, and structural access to appropriate care.</p><p><strong>Conclusions: </strong>Findings suggest that concussion recovery depends on factors extending beyond the clinical encounter itself. Effective care requires attention to educational, relational, structural, and contextual factors that enable patients to engage with, sustain, and generalize treatment over time. These insights highlight the need for concussion care models that are longitudinal, systemic, and responsive to patients' real-world contexts.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preexisting depression and early outcomes in inflammatory bowel disease: a propensity score-matched cohort study.","authors":"EzzElDien A Ibrahim, Nourhan Saleh, Mahmoud Mansour, Akram Alnounou, Islam Mohamed, Abdallah Al Ghnaimat, Mostafa Adel T Mahmoud, David C Kaelber, Ashraf Almomani","doi":"10.1080/08998280.2026.2732411","DOIUrl":"https://doi.org/10.1080/08998280.2026.2732411","url":null,"abstract":"<p><strong>Background: </strong>Depression is common in inflammatory bowel disease (IBD) and associated with adverse outcomes, but most studies examine depression arising after IBD diagnosis. Whether depression predating IBD diagnosis is independently associated with early postdiagnosis outcomes remains unclear.</p><p><strong>Methods: </strong>Using aggregated, de-identified electronic health record data from the TriNetX US Collaborative Network, we conducted parallel propensity score-matched cohort studies in adults with newly diagnosed Crohn's disease (CD) and ulcerative colitis (UC). Exposure was depression recorded 1 to 24 months before the initial IBD diagnosis. Primary outcomes over 24 months were biologic therapy use, emergency department visits, inpatient admissions, and gastrointestinal surgery. Secondary outcomes included colonoscopy, imaging, corticosteroid use, elevated C-reactive protein, anemia, hypoalbuminemia, malnutrition, and all-cause mortality.</p><p><strong>Results: </strong>Preexisting depression was significantly associated with all four primary outcomes in both cohorts. Biologic therapy use showed the strongest association (CD: hazard ratio [HR] 1.20, 95% confidence interval [CI] 1.14-1.28; UC: HR 1.42, 95% CI 1.33-1.52). Emergency department visits (CD: HR 1.11, 95% CI 1.07-1.15; UC: HR 1.20, 95% CI 1.17-1.24), inpatient admission (CD: HR 1.07, 95% CI 1.03-1.11; UC: HR 1.10, 95% CI 1.07-1.14), and surgery (CD: HR 1.14, 95% CI 1.09-1.19; UC: HR 1.10, 95% CI 1.06-1.14) were also elevated. Effect sizes were larger in UC than in CD for most outcomes. C-reactive protein elevation was observed in both cohorts, while anemia and hypoalbuminemia were significantly elevated only in UC. All-cause mortality did not differ significantly.</p><p><strong>Conclusions: </strong>Preexisting depression is associated with increased treatment escalation and acute care utilization following IBD diagnosis. C-reactive protein elevation in both cohorts may reflect inflammatory burden but could also reflect differential testing. These hypothesis-generating findings suggest that preexisting depression may identify patients warranting closer early monitoring, although further research is needed to determine causality.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HPV-related head and neck neoplasms in solid organ transplant recipients: a case report highlighting gaps in adult vaccination guidelines.","authors":"Weston Wimbish, Julie Hill-Mak, Parker Wilson, Whitney Whiteley, Parag Kale","doi":"10.1080/08998280.2026.2732437","DOIUrl":"https://doi.org/10.1080/08998280.2026.2732437","url":null,"abstract":"<p><p>Human papillomavirus (HPV)-associated head and neck disease occurs at markedly higher rates in solid organ transplant recipients due to chronic immunosuppression, yet adult vaccination guidance for patients over 45 remains limited. We describe two heart transplant recipients, one with HPV-positive oropharyngeal squamous cell carcinoma and one with recurrent laryngeal papillomatosis, both diagnosed well beyond current Advisory Committee on Immunization Practices vaccination age thresholds. These cases highlight a preventive care gap warranting formal study in this high-risk population.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rosacea and seborrheic dermatitis: association, temporality, and diagnostic overlap.","authors":"Chun-Ying Chen, Ho Wen-Tsao","doi":"10.1080/08998280.2026.2731847","DOIUrl":"https://doi.org/10.1080/08998280.2026.2731847","url":null,"abstract":"","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Thoracic endometriosis: imaging perspectives in diagnosis.","authors":"Mimi Phan Haghshenas, Ashok Theruvath, Pritish Bawa, Roshni Parikh","doi":"10.1080/08998280.2026.2732416","DOIUrl":"https://doi.org/10.1080/08998280.2026.2732416","url":null,"abstract":"<p><p>Thoracic endometriosis is an uncommon but likely underrecognized manifestation of extragenital endometriosis that can present with catamenial pneumothorax, chest pain, and respiratory symptoms. This case series reviews imaging findings from three patients (aged 27 to 38) with histologically confirmed thoracic endometriosis. Imaging modalities included chest radiographs and contrast-enhanced magnetic resonance imaging. Key findings included pleural nodules, recurrent right-sided pleural effusions, pneumothoraces, and diaphragmatic involvement, often correlating with menstrual cycles. Recognizing these imaging features is essential for accurate diagnosis, as thoracic endometriosis can mimic other pulmonary conditions. Radiologists and clinicians should maintain a high index of suspicion in reproductive-age women with cyclic thoracic symptoms.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149029555","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of chronic hypertension on burn fluid resuscitation and outcomes.","authors":"Vishal Bandaru, Melissa Porter, Karter Morris, Orson Robertson, Brandon Youssi, Douglas Bettarelli, Kelly Trinh, Adilene Chapina, Hassan Tariq, Gabriel Cacao, Rafael Cacao, Alan Pang","doi":"10.1080/08998280.2026.2735152","DOIUrl":"https://doi.org/10.1080/08998280.2026.2735152","url":null,"abstract":"<p><strong>Background: </strong>Chronic hypertension is highly prevalent and may alter vascular autoregulation and perfusion thresholds in critically ill patients. However, its impact on fluid resuscitation requirements in major burn injury remains poorly defined. This study aimed to evaluate the effects of preexisting chronic hypertension on resuscitation parameters and clinical outcomes in adult burn patients.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adult patients with ≥20% total body surface area burns admitted between July 2011 and July 2021. Patients with both a documented diagnosis of hypertension and home antihypertensive medication use were classified as hypertensive. Outcomes included crystalloid resuscitation volumes at 24 and 48 hours. Secondary outcomes included urine output, mean arterial pressure, length of stay, and mortality.</p><p><strong>Results: </strong>A total of 190 burn patients were split into two groups, 30 patients with chronic hypertension and 160 control patients. Baseline characteristics were largely similar between groups, though hypertensive patients had significantly less full-thickness burn. In-hospital mortality was numerically higher in the hypertensive group, but did not reach statistical significance. Early resuscitation volumes were comparable between groups. Mean arterial pressure and urine output were similar between groups.</p><p><strong>Conclusion: </strong>Chronic hypertension was not associated with significantly different in-hospital mortality, early crystalloid requirements, urine output, or mean arterial pressure trends. These findings suggest that standard burn resuscitation targets may be applicable in patients with chronic hypertension.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-8"},"PeriodicalIF":0.0,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PTHrP-mediated hypercalcemia in metastatic adrenocortical carcinoma mimicking pheochromocytoma: a diagnostic challenge.","authors":"Kirshima Kumari, Nena Kumari, Sira Jaffri, Amarsimha Yerrajonna, Venkatash Sai Abhilash Meda, Lakshya Motwani","doi":"10.1080/08998280.2026.2719087","DOIUrl":"https://doi.org/10.1080/08998280.2026.2719087","url":null,"abstract":"<p><p>Humoral hypercalcemia of malignancy is a paraneoplastic syndrome mediated by parathyroid hormone-related peptide (PTHrP). Adrenal masses may present a diagnostic challenge when clinical, biochemical, and imaging findings overlap with endocrine tumors such as pheochromocytoma. We report an 80-year-old man presenting with severe hypercalcemia, normal phosphate levels, elevated PTHrP, and suppressed intact parathyroid hormone. Imaging revealed an 8.8 cm heterogeneous left adrenal mass with hepatic and osseous lesions along with enlarged preauricular lymph nodes, suggestive of metastatic disease. Discordant catecholamine testing raised concern for pheochromocytoma; however, biopsy confirmed adrenocortical carcinoma. This case highlights the importance of integrating biochemical, radiological, and histopathological data in evaluating adrenal masses with atypical presentations.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149023719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peritoneocele mimicking vaginal wall prolapse on magnetic resonance defecography.","authors":"Sonia Bhandari Randhawa, Eugenia Kakadiaris, Neha Yadu, Gaurav Khatri, Joseph I Schaffer","doi":"10.1080/08998280.2026.2732435","DOIUrl":"https://doi.org/10.1080/08998280.2026.2732435","url":null,"abstract":"<p><p>Posterior vaginal wall prolapse can represent a spectrum of underlying defects that are difficult to distinguish on physical examination alone. We present a case of a 47-year-old woman with symptomatic stage III posterior prolapse in whom magnetic resonance defecography revealed a rare cul-de-sac hernia containing a large peritoneal inclusion cyst. Preoperative identification of the hernia contents altered surgical planning, allowing for targeted vaginal drainage and repair. This case highlights the diagnostic value of magnetic resonance defecography in complex or atypical prolapse and its role in guiding management.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148988080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of the expiratory disproportion index in early detection of idiopathic subglottic stenosis masked by asthma.","authors":"Srividya Sridhara, Anirudh Burli","doi":"10.1080/08998280.2026.2730076","DOIUrl":"https://doi.org/10.1080/08998280.2026.2730076","url":null,"abstract":"<p><p>Idiopathic subglottic stenosis (iSGS) is a rare fibrotic condition causing fixed extrathoracic airway obstruction, predominantly affecting postmenopausal women. The expiratory disproportion index (EDI), calculated as forced expiratory volume in one second (FEV₁) (mL)/peak expiratory flow (PEF) (L/min), can help differentiate fixed extrathoracic obstruction from obstructive lung diseases. Here we present the case of a 62-year-old woman with mild intermittent asthma who presented with progressive dyspnea and dry cough following COVID-19 infection. Spirometry revealed expiratory flattening with preserved FEV₁/forced vital capacity, markedly reduced PEF, and inadequate inspiratory curves. Laryngotracheoscopy confirmed iSGS, and surgical excision with balloon dilation resolved the stenosis. Routine EDI calculation in pulmonary function testing may facilitate earlier iSGS detection and reduce diagnostic delay in patients with refractory asthma-like symptoms.</p>","PeriodicalId":8828,"journal":{"name":"Baylor University Medical Center Proceedings","volume":" ","pages":"1-5"},"PeriodicalIF":0.0,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148975705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}