The ProblemA 32-year-old woman with a history of fibromyalgia and irritable bowel syndrome presents to you for evaluation of rectal pain of 3 weeks’ duration. She has had episodes of diarrhea alternating with constipation for years. Despite psyllium therapy, her stools have been hard and difficult to pass. During defecation 3 weeks ago, she developed excruciating pain that lasted for 60 minutes. Presently, she says it feels like she is passing “broken glass” with every bowel movement. She has...

SAN FRANCISCO (EGMN) – The decision to perform radical nephrectomy instead of partial nephrectomy for clinically early-stage renal cell carcinoma should not be based on concerns that the cancer will have a higher stage or grade on pathology, investigators concluded based on a cohort study. The study population comprised 213 patients who had T1-stage disease preoperatively but were up-staged to pathological T2- or T3-stage disease postoperatively. Neither cancer-specific survival nor overall...