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STRASBOURG, France -- Transvaginal cholecystectomy heralds the next stage in surgical evolution, offering the potential for pain-free surgery and "invisible mending," surgeons here proclaimed after doing their first procedure.

BANGKOK, Thailand -- Cooling the skin to protect it from hyperpigmentation after laser treatment actually increased discoloration in dark-skinned patients, researchers reported.

Pleural Effusion

Congestive heart failure and cirrhosis are the most common causes of transudative pleural effusions, while pneumonia and malignancy are responsible for the majority of exudative effusions. Plain chest films are valuable in confirming the presence of an effusion, providing clues to the cause, and directing the method of pleural fluid sampling. Thoracentesis is safe and simple, and it is diagnostic in about 75% of cases. Pleural biopsy is indicated for unexplained exudative effusions, most of which are found to result from malignancy or tuberculosis. Medical thoracoscopy, if available, is the procedure of choice for patients with these effusions. Thoracoscopy permits visually directed pleural biopsies and allows for therapeutic intervention at the time of diagnosis, obviating the need for subsequent invasive procedures.

Methicillin-resistant Staphylococcus aureus (MRSA) infection may be significantly more widespread than previously thought. Investigators analyzed data from more than 1200 county, public, and private health care facilities across the country, including centers for acute care, cancer, cardiac care, pediatric care, rehabilitation, and long-term care.

Submacular Hemorrhage

One morning, an 83-year-old woman woke up to find a gray-colored spot in the central vision of her right eye. The spot was constant, and she could not see through it. She had a history of dry age-related macular degeneration and cataract surgery in both eyes.

Larsen Syndrome

An abnormality of both first proximal interphalangeal joints was noted in a 54-year-old woman who had recently undergone an elective total hip arthroplasty to treat post-traumatic osteoarthritis. She had had worsening hip pain following an intertrochanteric fracture and open reduction internal fixation several years earlier.

A recent article made me reconsider a medical tradition that I have taken for granted and, in certain instances, that I may have inappropriately continued. The annual ambulatory history and physical examination is a persistent vestige from a time long gone.

CLAYTON, Australia -- A small number of special cells that resemble mesenchymal stem cells, bearing the possible application for major anatomic repairs, have been found in human endometrium, investigators here have found.