An interprofessional consultation (eConsult) is an asynchronous form of telehealth whereby a primary care provider requests electronic consultation with a specialist in place of an in-person consultation. While eConsults have been successfully implemented in many medical specialties, their use in the practice of urology is relatively unknown.
 
  We included data from four academic institutions University of Michigan, University of California -San Francisco, University of Washington, and Montefiore Medical Center. We included every urological eConsult performed at each institution from the launch of their respective programs through August 2019. We considered an eConsult "converted" when the participating urologist recommended a full in-person evaluation. We report eConsult conversion rate, response time, completion time, and diagnosis categories.
 
  A total of 462 urological eConsults were requested. Of these, 36% were converted to a traditional in-person visit. Among resolved eConsults, with data on provideraccess to urological care are necessary.The insensitivity of multiphoton microscopy to optical scattering enables high-resolution, high-contrast imaging deep into tissue, including in live animals. Scattering does, however, severely limit the use of spectral dispersion techniques to improve spectral resolution.  https://www.selleckchem.com/products/l-arginine-l-glutamate.html  In practice, this limited spectral resolution together with the need for multiple excitation wavelengths to excite different fluorophores limits multiphoton microscopy to imaging a few, spectrally-distinct fluorescent labels at a time, restricting the complexity of biological processes that can be studied. Here, we demonstrate a hyperspectral multiphoton microscope that utilizes three different wavelength excitation sources together with multiplexed fluorescence emission detection using angle-tuned bandpass filters. This microscope maintains scattering insensitivity, while providing high enough spectral resolution on the emitted fluorescence and capitalizing on the wavelength-dependent nonlinear excitation of fluorescent dyes to enable clean separation of multiple, spectrally overlapping labels, in vivo. We demonstrated the utility of this instrument for spectral separation of closely-overlapped fluorophores in samples containing ten different colors of fluorescent beads, live cells expressing up to seven different fluorescent protein fusion constructs, and in multiple in vivo preparations in mouse cortex and inflamed skin with up to eight different cell types or tissue structures distinguished.Purpose The objective of this study is to quantitatively evaluate terahertz (THz) imaging for differentiating cancerous from non-cancerous tissues in mammary tumors developed in response to injection of N-ethyl-N-nitrosourea (ENU) in Sprague Dawley rats. Approach While previous studies have investigated the biology of mammary tumors of this model, the current work is the first study to employ an imaging modality to visualize these tumors. A pulsed THz imaging system is utilized to experimentally collect the time-domain reflection signals from each pixel of the rat's excised tumor. A statistical segmentation algorithm based on the expectation-maximization (EM) classification method is implemented to quantitatively assess the obtained THz images. The model classification of cancer is reported in terms of the receiver operating characteristic (ROC) curves and the areas under the curves. Results The obtained low-power microscopic images of 17 ENU-rat tumor sections exhibited the presence of healthy connective tissue adjacent to cancerous tissue. The results also demonstrated that high reflection THz signals were received from cancerous compared with non-cancerous tissues. Decent tumor classification was achieved using the EM method with values ranging from 83% to 96% in fresh tissues and 89% to 96% in formalin-fixed paraffin-embedded tissues. Conclusions The proposed ENU breast tumor model of Sprague Dawley rats showed a potential to obtain cancerous tissues, such as human breast tumors, adjacent to healthy tissues. The implemented EM classification algorithm quantitatively demonstrated the ability of THz imaging in differentiating cancerous from non-cancerous tissues.Ileal pouch-anal anastomosis is the surgical procedure of choice for patients who require colectomy for complicated ulcerative colitis with or without associated dysplasia and familial adenomatous polyposis. Leaks from the suture lines or anastomosis can lead to pouch failure. Treatment options have been radiographic drainage and surgical intervention. Endoscopic therapy has emerged a viable nonsurgical treatment option for some of the complications associated with J-pouch surgery. Here, we present a case of endoscopic management of a leak from the tip of the J-pouch with sequential application of 2 over-the-scope clips.Colonoscope entrapment in an inguinal hernia is rare and few cases have been described in the literature. We present a 54-year-old patient who underwent a diagnostic colonoscopy which was complicated by incarceration of the colonoscope in a left inguinal hernia. This rare complication occurs more frequently during withdrawal, and our case was unique, given the incarceration of the colonoscope occurred during the insertion phase. Recognizing this scenario is very important to immediately proceed with general anesthesia and surgical consultation for successful nonoperative hernia reduction and colonoscope removal. We recommend reattempting colonoscopy after surgical hernia repair or proceed with computed tomography colonography if appropriate for the indication.Solitary rectal ulcer syndrome (SRUS) is an uncommon disorder often challenging to treat. Surgical treatment is associated with suboptimal outcomes and postoperative complications. Argon plasma coagulation helps control rectal bleeding and healing of ulcers, but more extended follow-up data are not available. The macroscopic appearance of SRUS can be polypoid in 17%-25% of cases. Here, we describe a novel endoscopic technique for treating symptomatic patients with polypoidal variant of SRUS after failed medical and endoscopic argon plasma coagulation treatments.