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This article discusses the trend towards outpatient pediatric endoscopic retrograde cholangiopancreatography (ERCP), a procedure used to diagnose and treat certain digestive disorders. The study analyzes patient characteristics, indications, and adverse events associated with outpatient versus inpatient pediatric ERCP. The findings suggest that outpatient ERCP is safe and viable for selected children and adolescents. The study's implications include the potential to boost patient satisfaction, reduce healthcare costs, and improve outcomes. However, the study has limitations, such as its single-center design and the need for a larger trial to generalize the findings. Overall, this study represents an important step towards transitioning to outpatient ERCP for selected pediatric patients. [Extracted from the article]

An enormous amount of efforts have been poured to find an effective therapeutic agent for the treatment of neurodegenerative diseases including Alzheimer’s disease (AD). Among those, neurotrophic peptides that regenerate neuronal structures and increase neuron survival show a promise in slowing neurodegeneration. However, the short plasma half-life and poor blood-brain-barrier (BBB)-permeability of neurotrophic peptides limit their in vivo efficacy. Thus, an alternative neurotrophic agent that has longer plasma half-life and better BBB-permeability has been sought for. Based on the recent findings of neuroprotective polysaccharides, we searched for a BBB-permeable neuroprotective polysaccharide among natural polysaccharides that are approved for human use. Then, we discovered midi-GAGR, a BBB-permeable, long plasma half-life, strong neuroprotective and neurotrophic polysaccharide. Midi-GAGR is a 4.7kD cleavage product of low acyl gellan gum that is approved by FDA for human use. Midi-GAGR protected rodent cortical neurons not only from the pathological concentrations of co-/post-treated free reactive radicals and Aβ42 peptide but also from activated microglial cells. Moreover, midi-GAGR showed a good neurotrophic effect; it enhanced neurite outgrowth and increased phosphorylated cAMP-responsive element binding protein (pCREB) in the nuclei of primary cortical neurons. Furthermore, intra-nasally administered midi-GAGR penetrated the BBB and exerted its neurotrophic effect inside the brain for 24 h after one-time administration. Midi-GAGR appears to activate fibroblast growth factor receptor 1 (FGFR1) and its downstream neurotrophic signaling pathway for neuroprotection and CREB activation. Additionally, 14-day intranasal administration of midi-GAGR not only increased neuronal activity markers but also decreased hyperphosphorylated tau, a precursor of neurofibrillary tangle, in the brains of the AD mouse model, 3xTg-AD. Taken together, midi-GAGR with good BBB-permeability, long plasma half-life, and strong neuroprotective and neurotrophic effects has a great therapeutic potential for the treatment of neurodegenerative diseases, especially AD. [ABSTRACT FROM AUTHOR]

Hepatic myelolipoma is a benign tumor composed of mature adipocytes and bone marrow elements. Most commonly it is found in the adrenal glands; though, in very rare instances extra-adrenal manifestations have been reported. We are reporting a 67-year-old man with history of multiple chronic illnesses such as DM, HTN, and sleep apnea. His chief complaint of right upper quadrant abdominal pain led to the physical findings of hepatomegaly. The MRI of the abdomen with contrast revealed an 8.4 x 6 cm fatty mass demonstrating minimal internal enhancement on post-contrast imaging. Also, the MRI revealed hepatic tissue with severe steatosis. The adrenal glands were unremarkable. The CT-guided biopsy provided two soft red cores both measuring 2.5 x 0.1 cm in diameter. Microscopic findings of mature adipocytes, trilineage hematopoietic cells, and liver tissue with macrovesicular steatosis were consistent with a diagnosis of myelolipoma of the liver. Following review of the literature, very few cases of hepatic myelolipoma had been reported. [ABSTRACT FROM AUTHOR]