Posterior Reversible Encephalopathy Syndrome and Subarachnoid Hemorrhage After Lumboperitoneal Shunt for Fulminant Idiopathic Intracranial Hypertension.

A 33-year-old woman presented with severe visual loss from fulminant idiopathic intracranial hypertension. Her lumbar puncture opening pressure was 97 cm H2O. Soon after lumboperitoneal shunt surgery, she had a generalized tonic-clonic seizure. Magnetic resonance imaging demonstrated frontal subarachnoid hemorrhage (SAH) and neuroimaging findings consistent with posterior reversible encephalopathy syndrome (PRES). We hypothesize that an abrupt drop in intracranial pressure after lumboperitoneal shunting led to maladjustment of cerebral vascular autoregulation, which caused SAH and PRES. (C) 2016 by North American Neuro-Ophthalmology Society

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The Impact of Phosphohistone-H3-Assisted Mitotic Count and Ki67 Score in the Determination of Tumor Grade and Prediction of Distant Metastasis in Well-Differentiated Pancreatic Neuroendocrine Tumors

Abstract

This study investigated the impact of phosphohistone-H3 (PHH3)-assisted mitotic count by comparing its performance with conventional mitotic count and Ki67 score as well as the status of distant metastasis. A total of 43 surgically resected pancreatic neuroendocrine tumors (panNET) with complete follow-up information has been subjected to a standardized assessment with respect to mitotic count (both conventional and PHH3-assisted) and Ki67 score. Five participants assessed mitotic count and the time spent was recorded in both methods. All tumors were assigned to a G1 category of mitotic rate on conventional mitotic count that failed to identify three tumors with a G2 category of mitotic rate on PHH3. Near-perfect and fair agreements were achieved among observers when using PHH3 and conventional method, respectively. The mean time spent to determine mitotic count on PHH3-stained slides was significantly shorter (p < 0.001). The performance of PHH3-assisted mitotic grade category was significant as the three cases with a G2 mitotic category were associated with distant metastasis (p = 0.01). Despite its performance, the PHH3-assisted mitotic count downgraded 17 cases that were classified as G2 based on Ki67 scores in this series. The Ki67 grade category was either the same or higher than the mitotic grade category. Ten patients developed distant metastasis. Eleven tumors exhibited vascular invasion characterized by intravascular tumor cells admixed with thrombus. Our results indicate that PHH3-assisted mitotic count facilitates an accurate mitotic count with a perfect agreement among observers. The small size of this cohort is an important limitation of the current study, a G2 mitotic grade category based on PHH3 immunohistochemistry was one of the correlates of panNETs with distant metastasis. While the prognostic impact of PHH3-assisted mitotic count needs to be clarified in larger cohorts, Ki67 scores designated higher grade category in all cases; thus, it was the best determinant of the tumor grade. More importantly, the presence of vascular invasion along with the Ki67 grade category was found to be independent predictors of distant metastasis.

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The expression of osteopontin and vascular endothelial growth factor in correlation with angiogenesis in monoclonal gammopathy of undetermined significance and multiple myeloma

Publication date: Available online 2 March 2016
Source:Pathology – Research and Practice
Author(s): Emina Babarović, Toni Valković, Ivana Budisavljević, Ivan Balen, Sanja Štifter, Antica Duletić-Načinović, Ksenija Lučin, Nives Jonjić
Several studies have shown a gradual increase in the extent of bone marrow angiogenesis in various stages of proliferative plasma cell disorders, from monoclonal gammopathy of undetermined significance (MGUS) to active multiple myeloma (MM). The main aim of this study was to evaluate tumor angiogenesis parameters in detail and to correlate them with the expression of osteopontin (OPN) and vascular endothelial growth factor (VEGF) in the bone marrow of patients with MGUS and MM. In addition, we wanted to determine their prognostic significance in active MM.Ninety-five patients were enrolled in the study: 14 diagnosed with MGUS, 13 with asymptomatic myeloma (AMM) and 68 with active MM. Computer assisted image analysis was used to determine the angiogenesis parameters, the quantity of microvessels per 1 mm2(MVD), the area occupied by microvessels per 1 mm2 and the percentage of microvessel area in total section area (TVA). Double immunohistochemical methods CD138+VEGF and CD138+OPN were used to evaluate expression of these proteins in plasma cells, and OPN was also analyzed for its interstitial expression (iOPN).A significant positive correlation was determined between VEGF and iOPN with angiogenic parameters in the MGUS stage of the disease. In advanced stages of the disease, a significant negative correlation was recorded between OPN and iOPN with parameters of angiogenesis. Overall survival was significantly shorter for patients with negative iOPN (p=0.002) and higher angiogenic parameters, MVD (p=0.009), TVA (p= 0.008) and area of microvessels per 1 mm2 (p=0.02). Positive VEGF expression in our model predicted a better three-year survival of patients with active MM (OR: 5.25, p=0.03; HR: 0.44, p=0.04).The results of our study suggested a possible key role of VEGF and OPN in the induction of angiogenesis in early-stage disease.

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Imaging, physical examination find most recurrences of HPV-positive oropharyngeal cancer

Source: http://ift.tt/1ft4mtm Author: Kathy Boltz, PhD Posttreatment imaging at 3 months and physical examinations during the 6 months following treatment can detect most recurrences in patients treated with definitive radiation therapy for oropharyngeal cancer caused by human papillomavirus (HPV).1 This research was presented at the 2016 Multidisciplinary Head and Neck Cancer Symposium. A dramatic increase […]

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Procalcitonin in critically ill patients: time to change guidelines and antibiotic use in practice

Publication date: Available online 2 March 2016
Source:The Lancet Infectious Diseases
Author(s): Philipp Schuetz, Beat Müeller

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Cancer gene may aid researchers find how immune system can help treat cancer or predict outcomes

Source: immuno-oncologynews.com Author: Daniela Semedo, PhD University of Cincinnati scientists have recently discovered that DEK, a human gene known to cause cancer, can be detected in the plasma of patients with head and neck cancer. DEK may help clinicians understand how a person's immune system can be used to treat cancer or predict outcomes for […]

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IFC: Editorial Board

Publication date: January 2016
Source:Prostaglandins & Other Lipid Mediators, Volume 122

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Anxiety Sensitivity Class Membership Moderates the Effects of Pre-Quit Reduction in Anxiety Sensitivity on Quit-Day Tobacco Craving

Publication date: Available online 2 March 2016
Source:Journal of Anxiety Disorders
Author(s): Jafar Bakhshaie, Michael J. Zvolensky, Kirsten J. Langdon, Adam M. Leventhal, Jasper A.J. Smits, Nicholas Allan, Norman B. Schmidt

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Addressing Potential Cumulative Impacts of Development on Threatened Species: The Case of the Endangered Black-Throated Finch

by Eric Peter Vanderduys, April E. Reside, Anthony Grice, Juliana Rechetelo

Where threatened biodiversity is adversely affected by development, policies often state that "no net loss" should be the goal and biodiversity offsetting is one mechanism available to achieve this. However, developments are often approved on an ad hoc basis and cumulative impacts are not sufficiently examined. We demonstrate the potential for serious threat to an endangered subspecies when multiple developments are planned. We modelled the distribution of the black-throated finch (Poephila cincta cincta) using bioclimatic data and Queensland's Regional Ecosystem classification. We overlaid granted, extant extractive and exploratory mining tenures within the known and modelled ranges of black-throated finches to examine the level of incipient threat to this subspecies in central Queensland, Australia. Our models indicate that more than half of the remaining P. cincta cincta habitat is currently under extractive or exploratory tenure. Therefore, insufficient habitat exists to offset all potential development so "no net loss" is not possible. This has implications for future conservation of this and similarly distributed species and for resource development planning, especially the use of legislated offsets for biodiversity protection.

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Blue Jays welcome City of Toronto’s proposed ban on chewing tobacco

Source: http://ift.tt/rt7GGw Author: Robert Macleod and Jeff Gray For years, it was a right of passage at the Toronto Blue Jays' spring training camp here. Manager John Gibbons would earnestly proclaim that he was finally giving up smokeless tobacco, a personal ban that would usually only last a couple of weeks before he would be […]

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Organic chemistry: Reactions triggered electrically

Single-molecule experiments have revealed that chemical reactions can be controlled using electric fields — and that the reaction rate is sensitive to both the direction and the strength of the applied field. See Letter p.88

Nature 531 38 doi: 10.1038/531038a

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Human health risk assessment of cadmium via dietary intake by children in Jiangsu Province, China

Abstract

The goal of this study was to quantify the exposure to dietary cadmium (Cd) and analyze the major contributors to total Cd intake of children from Jiangsu Province, China. The Cd concentration data were collected by the National Food Contamination Monitoring Program between 2001 and 2009. Consumption data were derived from the Chinese National Nutrition and Health Survey in 2002. The beta-binomial-normal model which included age as a covariate was used to assess the long-term dietary Cd intake assuming lower bound and upper bound concentration scenarios. A tolerable weekly intake of 2.5 µg/kg body weight for Cd was applied in the risk assessment. Cd intake decreased as age increased with almost all mean values and P95 of the estimates exceeding the tolerable weekly intake. Children with high-end exposure may suffer non-carcinogenic effects over a lifetime of exposure. Rice and rice products, wheat flour and wheat flour products, crustaceans, pak-choi, pig meat, and beans and bean products were found to be the major contributors to the total Cd intake in children. These conservative estimates of Cd intake indicate possible public health concerns for children in Jiangsu Province.

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Electrostatic catalysis of a Diels–Alder reaction

It is often thought that the ability to control reaction rates with an applied electrical potential gradient is unique to redox systems. However, recent theoretical studies suggest that oriented electric fields could affect the outcomes of a range of chemical reactions, regardless of whether a redox system is involved. This possibility arises because many formally covalent species can be stabilized via minor charge-separated resonance contributors. When an applied electric field is aligned in such a way as to electrostatically stabilize one of these minor forms, the degree of resonance increases, resulting in the overall stabilization of the molecule or transition state. This means that it should be possible to manipulate the kinetics and thermodynamics of non-redox processes using an external electric field, as long as the orientation of the approaching reactants with respect to the field stimulus can be controlled. Here, we provide experimental evidence that the formation of carbon–carbon bonds is accelerated by an electric field. We have designed a surface model system to probe the Diels–Alder reaction, and coupled it with a scanning tunnelling microscopy break-junction approach. This technique, performed at the single-molecule level, is perfectly suited to deliver an electric-field stimulus across approaching reactants. We find a fivefold increase in the frequency of formation of single-molecule junctions, resulting from the reaction that occurs when the electric field is present and aligned so as to favour electron flow from the dienophile to the diene. Our results are qualitatively consistent with those predicted by quantum-chemical calculations in a theoretical model of this system, and herald a new approach to chemical catalysis.

Nature 531 88 doi: 10.1038/nature16989

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Identification of a predictive factor for distant metastasis in esophageal squamous cell carcinoma after definitive chemoradiotherapy

Abstract

Background and purpose

Distant metastasis (DM) after definitive chemoradiotherapy has not been a focus of research in esophageal carcinoma. At present, local–regional control is improving following advances in salvage treatments after definitive chemoradiotherapy. There is a need to focus on suppressing the development of DM. The aim of this study was to identify pre-treatment factors associated with DM after definitive chemoradiotherapy.

Materials and methods

This study included 144 patients with thoracic esophageal squamous cell carcinoma (Stage I/II/III/IV; 35/17/69/23) (TNM 7th) who underwent definitive chemoradiotherapy; >50 Gy was prescribed to all gross tumors with concurrent administration of 5-fluorouracil ± platinum. Pre-treatment factors included age, gender, performance status, tumor location, T/N/M status, tumor length, size of metastatic lymph nodes (LN size), and the presence of intramural metastasis or multiple primary tumors. The effects of pre-treatment factors on overall survival (OS) and DM were evaluated.

Results

The median follow-up period was 48 months. DM occurred as an initial progression in 21 % of patients, and LN size correlated with DM development (hazard ratio [HR] = 5.12; p = 0.0013) and poor OS (HR = 2.20; p = 0.0076) in univariate and multivariate analyses.

Conclusions

LN size is a quantitative pre-treatment prognostic factor that should be assessed prior to definitive chemoradiotherapy. Patients with large metastatic lymph nodes are at high risk of DM and should be monitored.

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Fat mice provide clue to obesity-colon cancer puzzle

Study suggests stem-cell stimulation is behind obesity's contribution to cancer risk.

Nature News doi: 10.1038/nature.2016.19484

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IFC: Editorial Board

Publication date: January 2016
Source:Prostaglandins & Other Lipid Mediators, Volume 122

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Fresh confusion over origins of enigmatic radio-wave blasts

One paper suggests that fast radio bursts can repeat, but a finding on the origin of another burst is in doubt.

Nature News doi: 10.1038/nature.2016.19494

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Efficient Targeted Next Generation Sequencing-Based Workflow for Differential Diagnosis of Alport-Related Disorders

by Gábor Kovács, Tibor Kalmár, Emőke Endreffy, Zoltán Ondrik, Béla Iványi, Csaba Rikker, Ibolya Haszon, Sándor Túri, Mária Sinkó, Csaba Bereczki, Zoltán Maróti

Alport syndrome (AS) is an inherited type IV collagen nephropathies characterized by microscopic hematuria during early childhood, the development of proteinuria and progression to end-stage renal disease. Since choosing the right therapy, even before the onset of proteinuria, can delay the onset of end-stage renal failure and improve life expectancy, the earliest possible differential diagnosis is desired. Practically, this means the identification of mutation(s) in COL4A3-A4-A5 genes. We used an efficient, next generation sequencing based workflow for simultaneous analysis of all three COL4A genes in three individuals and fourteen families involved by AS or showing different level of Alport-related symptoms. We successfully identified mutations in all investigated cases, including 14 unpublished mutations in our Hungarian cohort. We present an easy to use unified clinical/diagnostic terminology and workflow not only for X-linked but for autosomal AS, but also for Alport-related diseases. In families where a diagnosis has been established by molecular genetic analysis, the renal biopsy may be rendered unnecessary.

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Having a partner increases cancer survival rates: Australian study

Source: http://ift.tt/H4Fm6m Author: Sean Parnell People diagnosed with cancer are more likely to die if they do not have a partner, according to a new Australian study. Researchers from Cancer Council Queensland and Queensland University of Technology examined 176,050 cases of the 10 most common cancers in Queensland, diagnosed between 1996 and 2012. They found […]

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Imaging, physical examination find most recurrences of HPV-positive oropharyngeal cancer

Source: http://ift.tt/1ft4mtm Author: Kathy Boltz, PhD Posttreatment imaging at 3 months and physical examinations during the 6 months following treatment can detect most recurrences in patients treated with definitive radiation therapy for oropharyngeal cancer caused by human papillomavirus (HPV).1 This research was presented at the 2016 Multidisciplinary Head and Neck Cancer Symposium. A dramatic increase […]

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A. Baaj, P.V. Mummaneni, J.S. Uribe, A.R. Vaccaro, M.S. Greenberg (eds): Handbook of spine surgery

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Learning to Manage Chronic Pain: The Patients’ Perspective

Abstract

Introduction

The objective of the present study was to gain insight into patients' experiences in a 4-week interdisciplinary chronic pain management program by determining major themes from patients' written comments on exit questionnaires.

Methods

Upon completion of the program at the Chronic Pain Management Unit (CPMU), patients fill out program satisfaction (Pain Program Satisfaction Questionnaire) and evaluation of goal accomplishment (Self-Evaluation Scale) forms, sections of which are open-ended. Questionnaire data from 50 patients, admitted into the CPMU between May 2013 and December 2014, were randomly selected for this study. Written responses to open-ended sections were obtained. Comments were stratified by gender and coded using an inductive approach. Codes were grouped into categories which were further combined into several major themes.

Results

Six main themes extracted from comments were (1) impact of a strong interdisciplinary team, (2) learning to adapt in order to manage, (3) the Program as a stepping stone, (4) positive effects of a group effort, (5) improved mental health, and (6) benefits of the program.

Conclusion

The results of this analysis reinforce the effectiveness of the interdisciplinary CPMU program at improving patients' quality of life. Findings may assist in the promotion of the program to stakeholders such as referral sources. The outcomes may also assist in the development of future programs that have similar goals. Concerns that arise within patients' comments may assist clinicians in this program to make adjustments such that all unique needs are met.

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Elderly Patients With Head and Neck Cancer Benefit From Chemoradiation – Oncology Nurse Advisor

Elderly Patients With Head and Neck Cancer Benefit From Chemoradiation Oncology Nurse Advisor Adding chemotherapy to radiation therapy improves survival among elderly patients with head and neck cancers who are age 71 to 79 years, have low comorbidity scores, and have advanced-stage disease. These findings were presented at the 2016 …

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Das autologe Haut-Knorpel-Transplantat aus dem Cavum conchae zur Rekonstruktion mehrschichtiger nasaler Defekte

Zusammenfassung

Hintergrund

Autologe Haut-Knorpel-Transplantate, sog. Composite grafts (CG), sind ein wichtiger Bestandteil der Rekonstruktion mehrschichtiger Defekte der Nase. Ein CG aus dem Cavum conchae muss sowohl funktionelle als auch ästhetische Ansprüche erfüllen.

Ziel der Arbeit

Dieser Artikel beschreibt die Indikationen für CG und untersucht das Einheilungsverhalten sowie die funktionell-ästhetischen Ergebnisse. Es handelt sich um eine Übersichtsarbeit; die ausführlichen Daten wurden im Rahmen der Ernennung des APKO-Preisträgers 2014 unter dem Titel „The auricle's cavum conchae composite graft in nasal reconstruction" veröffentlicht.

Material und Methoden

An der HNO-Universitätsklinik Ulm werden mehrschichtige Defekte verschiedener ästhetischer Untereinheiten der Nase mit CG versorgt. Auf der Basis dieser Erfahrungen berichten die Autoren über eigene Langzeitergebnisse hinsichtlich Funktion und Ästhetik im Bereich des Spender- und Empfängerareals.

Schlussfolgerung

Aurikuläre CG sind vielseitige und verlässliche autologe Transplantate, die aufgrund einfacher Gewinnung, geringer Spenderarealmorbidität und der konvexen stabilen Form ideal zur Rekonstruktion mehrschichtiger nasaler Defekte geeignet sind. Septumfolien und individuell gefertigte Stents unterstützen die Wundheilung und beugen narbigen Stenosierungen vor.

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The Gendered Culture of Scientific Competence: A Study of Scientist Characters in Doctor Who 1963–2013

Abstract

The present study examines the relationship between gender and scientific competence in fictional representations of scientists in the British science fiction television program Doctor Who. Previous studies of fictional scientists have argued that women are often depicted as less scientifically capable than men, but these have largely taken a simple demographic approach or focused exclusively on female scientist characters. By examining both male and female scientists (n = 222) depicted over the first 50 years of Doctor Who, our study shows that, although male scientists significantly outnumbered female scientists in all but the most recent decade, both genders have consistently been depicted as equally competent in scientific matters. However, an in-depth analysis of several characters depicted as extremely scientifically non-credible found that their behavior, appearance, and relations were universally marked by more subtle violations of gender expectations. Incompetent male scientists were largely depicted as effeminate and lacking in masculinity. In addition, many incompetent male and all incompetent female scientists served regimes that were problematically effeminate, collectivist and pacifist, or male-rejecting and ruled by women. Although Doctor Who avoids overtly treating women and men unequally, strong codes of masculine capability and prowess nevertheless continue to influence representations of scientific competence, pointing to the continued pervasiveness of such associations within wider Western culture. Professionals working to encourage gender-inclusive practices in science should look to subtle discourses about the masculine culture of science in addition to institutional and structural impediments to participation for women and gender minorities.

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The truth about the cuts: the teaching assistant

"I work as a special educational needs (SEN) classroom assistant, helping a year five boy who is autistic. "There are several other children in the class who don't have SEN assistants, but who need a lot of support. Some of them can't even read or write. I'm not supposed to spend time with other children in class. But if they don't get proper attention now, it's just going to lead to further problems later on. "We need more classroom assistants, but the school can't afford to pay them. "I went to this school myself. In those days it was fantastic, but now it's changed. It didn't pass the inspection, and there just isn't enough money for what's needed, not even a glue stick or other materials like that. There's no PE equipment – none at all, no football nets …

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A New Species of Frog (Anura: Dicroglossidae) Discovered from the Mega City of Dhaka

by Mohammad Sajid Ali Howlader, Abhilash Nair, Juha Merilä

We describe a new species of frog of the genus Zakerana discovered from the urban core of Dhaka, Bangladesh, one of the most densely populated cities in the world. Although the new species is morphologically similar to the geographically proximate congeners in the Bangladeshi cricket frog group, we show that it can be distinguished from all congeners on the basis of morphological characters, advertisement calls and variation in two mitochondrial DNA genes (12S rRNA and 16S rRNA). Apart from several diagnostic differences in body proportions, the new species differs from other Zakerana species in having a flattened snout (from ventral view) projecting over the lower jaw, and diagnostic trapezoid-shaped red markings on the vocal sac in males. Molecular genetic analyses show that the new species is highly divergent (3.1–20.1% sequence divergence) from all congeneric species, and forms a well-supported clade with its sister species, Zakerana asmati. The discovery of a new amphibian species from the urban core of Dhaka together with several recent descriptions of new amphibian species from Bangladesh may indicate that more amphibian species remain to be discovered from this country.

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The crunch effect: Food sound salience as a consumption monitoring cue

Publication date: July 2016 Source:Food Quality and Preference, Volume 51 Author(s): Ryan S. Elder, Gina S. Mohr While a growing body of research explores the impact of normative and environmental extrinsic factors on food consumption quantity, less attention is given to the intrinsic cues, or sensory properties, of the food being consumed. Our research contributes to this growing literature by examining the effect of food sound salience (i.e., the sound that a food makes during mastication) on consumption quantity. Specifically, we show that increased attention to the sound the food makes, or food sound salience, may serve as a consumption monitoring cue leading to reduced consumption. Across three studies, we show a consistent negative relationship between the salience of a food's …

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Episode 29 (Part 1): Noise-Induced Hearing Loss in Children—A Preventable Problem

ASHA-certified audiologist Dr. Jessica Rossi-Katz discusses the prevalence of noise-induced hearing loss in children, how to prevent it from occurring, and available treatment options. Read the Episode 29 (Part 1) transcript Continue listening to Part 2 of this podcast series: Dr. Rossi-Katz discusses signs of hearing loss in children, sources of noise in everyday life, and how audiologists treat such hearing loss. (Source: ASHA Podcast)

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Foreword.

Related Articles

Foreword.

Recent Results Cancer Res. 2015;204:v-vi

Authors: Wells S

PMID: 26714327 [PubMed - indexed for MEDLINE]

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Interventions to increase the reporting of occupational diseases by physicians: a Cochrane systematic review

Introduction

Under-reporting of occupational diseases is an important issue in many countries. Timely and complete reporting is fundamental to a successful physician-based public health surveillance system and to plan intervention programmes and allocation of resources.

For physicians, the main reasons for under-reporting consist of lack of awareness regarding reporting requirements, time and effort involved in reporting and lack of benefit from reporting.

There are no systematic reviews of the effects of interventions for increasing the reporting (or reducing the under-reporting) of occupational diseases. Therefore, we conducted a Cochrane systematic review to evaluate the effectiveness of interventions aimed at increasing the reporting of occupational diseases by physicians.1

Methods

We searched the Cochrane Occupational Safety and Health Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (PubMed), EMBASE, OSH UPDATE, Database of Abstracts of Reviews of Effects (DARE), Open-SIGLE and Health Evidence, up to January 2015.

We intended to include randomised…

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Episode 29 (Part 1): Noise-Induced Hearing Loss in Children—A Preventable Problem

ASHA-certified audiologist Dr. Jessica Rossi-Katz discusses the prevalence of noise-induced hearing loss in children, how to prevent it from occurring, and available treatment options. Read the Episode 29 (Part 1) transcript Continue listening to Part 2 of this podcast series: Dr. Rossi-Katz discusses signs of hearing loss in children, sources of noise in everyday life, and how audiologists treat such hearing loss. (Source: ASHA Podcast)

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Foreword.

Related Articles

Foreword.

Recent Results Cancer Res. 2015;204:v-vi

Authors: Wells S

PMID: 26714327 [PubMed - indexed for MEDLINE]

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Renal Cell Carcinoma Metastases to Thyroid and Pancreas: A Rare Occurrence.

Related Articles

Renal Cell Carcinoma Metastases to Thyroid and Pancreas: A Rare Occurrence.

S D Med. 2015 Nov;68(11):483-5

Authors: Potu KC, Pownell B, Ananthaneni HD, Bhatia V

Abstract
OBJECTIVE: To report on a case of late metastases of clear cell renal carcinoma to the thyroid and pancreas.
METHODS: A 51-year-old female with a history of nephrectomy 15 years prior for renal cell carcinoma presented with new metastases in the thyroid and pancreas, which were surgically excised.
RESULTS: Pathology noted that both lesions were clear cell carcinomas, and the immunohistochemistry was consistent with metastases from clear cell renal carcinoma.
CONCLUSION: 1) Renal cell carcinoma can present late metastases to unusual organs like the thyroid and pancreas. 2) A prior history of renal cell carcinoma should raise suspicions of metastases when evaluating a thyroid or pancreatic mass. 3) An ultrasound-guided fine needle aspiration biopsy of the thyroid may not be diagnostic. 4) The treatment of choice is surgical resection.

PMID: 26689030 [PubMed - indexed for MEDLINE]

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Episode 31: Building Language & Literacy Skills During the Lazy Days of Summer

Summers mean a break from academics for most kids, but that doesn't mean learning should stop, particularly for elementary school children who are building so much foundational knowledge. In this podcast, certified speech-language pathologist Lyndsey Zurawski offers tips and advice for parents about how to stimulate children's language skills during everyday activities over the break—helping them build literacy skills and setting the stage for long-term academic success. Read the Episode 31 transcript (Source: ASHA Podcast)

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The week in science: 26 February–3 March 2016

Italian researchers protest over government support; Illumina launches lawsuit over nanopores; and report published on women in academia.

Nature 531 12 doi: 10.1038/531012a

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Use of Tyrosine Kinase Inhibitors for Treatment of Medullary Thyroid Carcinoma.

Related Articles

Use of Tyrosine Kinase Inhibitors for Treatment of Medullary Thyroid Carcinoma.

Recent Results Cancer Res. 2015;204:227-49

Authors: Dadu R, Hu MN, Grubbs EG, Gagel RF

Abstract
Two independent events--the identification of activating mutations of the RET proto-oncogene, a receptor tyrosine kinase, in medullary thyroid carcinoma, and the recognition that small organic molecules could bind to and inhibit phosphorylation of signaling molecules, thereby inactivating the pathway-led to the recognition that kinase inhibitors could be used to treat medullary thyroid carcinoma (MTC). The introduction of these compounds into clinical practice has transformed the treatment of metastatic MTC and provided insight into the mechanisms by which RET causes C-cell transformation. This chapter will review the progress in this field over the past 7 years.

PMID: 26494392 [PubMed - indexed for MEDLINE]

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Episode 30 (Part 2): Autism Diagnosis & Treatment of Today & Tomorrow

Autism is a topic of significant interest to almost all parents given the spike in children diagnosed with the condition over the past decade. ASHA-certified speech-language pathologist Dr. Patricia Prelock offers an in-depth look at treatment options, and explains the new criteria for diagnosing autism. Read the Episode 30 (Part 2) transcript Listen to Part 1 of this podcast series: Dr. Patricia Prelock discusses some of the reasons behind the increase, as well as the early signs parents should look for, and when and where parents should go for a diagnosis if they suspect autism. (Source: ASHA Podcast)

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Episode 30 (Part 1): Autism Diagnosis & Treatment of Today & Tomorrow

Autism is a topic of significant interest to almost all parents given the spike in children diagnosed with the condition over the past decade. ASHA-certified speech-language pathologist Dr. Patricia Prelock discusses some of the reasons behind the increase, as well as the early signs parents should look for, and when and where parents should go for a diagnosis if they suspect autism. Read the Episode 30 (Part 1) transcript Listen to Part 2 of this podcast series: Dr. Patricia Prelock offers an in-depth look at treatment options, and explains the new criteria for diagnosing autism. (Source: ASHA Podcast)

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No economic benefit of early knee reconstruction over optional delayed reconstruction for ACL tears: registry enriched randomised controlled trial data

Background

To analyse 5-year cost-effectiveness of early versus optional delayed acute anterior cruciate ligament (ACL) reconstruction.

Methods

121 young, active adults with acute ACL injury to a previously uninjured knee were randomised to early ACL reconstruction (n=62, within 10 weeks of injury) or optional delayed ACL reconstruction (n=59; 30 with ACL reconstruction within 6–55 months); all patients received similar structured rehabilitation. Real life data on health care utilisation and sick leave were obtained from regional and national registers. Costs and quality-adjusted life years (QALYs) were discounted at 3%. Full-analysis set (based on study randomisation) and as-treated analysis (according to actual treatment over 5 years) principles were applied.

Results

Mean cost of early ACL reconstruction was 4695 higher than optional delayed ACL reconstruction (p=0.19) and provided an additional 0.13 QALYs (p=0.11). Full-analysis set showed incremental net benefit of early versus optional delayed ACL reconstruction was not statistically significantly different from zero at any level. As-treated analysis showed that costs for rehabilitation alone were 13 650 less than early ACL reconstruction (p<0.001). Results were robust to sensitivity analyses.

Conclusions

In young active adults with acute ACL injury, a strategy of early ACL reconstruction did not provide extra economic value over a strategy of optional delayed ACL reconstruction over a 5-year period. Results from this and previous reports of the KANON-trial imply that early identification of individuals who would benefit from either early ACL reconstruction or rehabilitation alone might reduce resource consumption and decrease risk of unnecessary overtreatment.

Trial registration

ISRCTN84752559.

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The price of our illusions and myths about the dead donor rule

The recent consensus statement from the American Thoracic Society perfectly captured the central ethical dilemma in organ procurement: 'the tension between the need for both "live organs" and a "dead donor" has required the development of very explicit criteria for declaring the "moment" of death, despite the absence of a biological basis for this degree of precision'.1

As such, what is most notable about the paper by Dalle Ave et al2 is their description of how the transplantation community has twisted themselves into pretzels creating ethical justifications for increasingly contrived ways to extract functioning organs from people deemed to be dead. In so doing, they are sustaining ethical myths and illusions that have ceased to have any face validity in terms of common sense clinical practice. Let me explain.

The driving force behind these contortionist efforts is the so-called dead donor rule (DDR), which seeks to establish a…

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Muscimol Microinjected in the Arcuate Nucleus Affects Metabolism, Body Temperature & Ventilation

Publication date: Available online 2 March 2016
Source:Respiratory Physiology & Neurobiology
Author(s): Evelyn H. Schlenker
Effects of microinjection of 2 doses of γ-aminobutyric acid (GABA) A receptor agonist, muscimol (M), into the hypothalamic arcuate nucleus on oxygen consumption and control of ventilation over time and body temperature (BT) at the end of the experiment were compared in adult male and female rats. Relative to cerebrospinal fluid (CSF, 0 nmol), BT was decreased only in male rats with both doses of M, while in female rats, the 5 nmol dose depressed oxygen consumption. Ventilation was depressed by 5 nmol M in male and 10 nmol M in female rats by decreasing tidal volume. M did not affect the ventilatory response of male or female rats to hypoxia, whereas in females 5 and 10 nmol M and in males 10 nmol M depressed the ventilatory response to hypercapnia. Thus, in rats GABAA receptors in the arcuate nucleus modulate BT, oxygen consumption, and ventilation in air and in response to hypercapnia in a sexually dimorphic manner.

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Episode 29 (Part 2): Noise-Induced Hearing Loss in Children—A Preventable Problem

ASHA-certified audiologist Dr. Jessica Rossi-Katz discusses the prevalence of noise-induced hearing loss in children, how to prevent it from occurring, and available treatment options. Read the Episode 29 (Part 2) transcript Listen to Part 1 of this podcast series: Dr. Rossi-Katz discusses the background of noise-induced hearing loss in children and prevention strategies for parents. (Source: ASHA Podcast)

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Aufklärung über die Risiken der Transfusion von Blut

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Episode 27: Early Speech and Language Development of Children

How can you tell the difference between a child who may have a speech or language disorder and a "late bloomer?" What are the benefits of early intervention? Speech-language pathologist and ASHA fellow Elizabeth Crais answers these and other key questions as part of ASHA's "Identify the Signs" campaign. Read the Episode 27 transcript (Source: ASHA Podcast)

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Complicity and torture

One of the great merits of On Complicity and Compromise is that it wades into specific swamps where ordinary theorists fear to slog. It is persuasive that in general it can be right sometimes to be complicit in wrongdoing by others through causally contributing to the wrongdoing, but not sharing its purpose, if by being involved one can reasonably expect to lessen the extent of the wrong that would otherwise be suffered by the victims. I focus on whether the book's general thesis is applicable to torture, which depends on what torture and the torture situation are in fact like. I focus on the case to which the chapter several times refers: the innovative CIA paradigm of torture. First, to the extent that the paradigm, which is predominantly mental, or psychological, torture succeeds in its goal of producing regression to a compliant state, the physician would be unable to rely on the torture victim's expressions of preferences or interests as authentically his own. Second, since disorientation plays such a large role in the CIA's style of torture (adopted at Guantanamo by the military), the authorities would refuse to allow a stable relationship to be built up with any one doctor by any victim, making comprehension of the victim's preferences difficult. Third, even if the doctor could somehow judge what the victim's genuine interests were, the control of the situation is much too totalistic to allow the physician any action independent of what the torture regime requires.

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Episode 28: Newborn Hearing Screening—In the Hospital and Beyond

ASHA-certified audiologist Dr. Patti Martin talks about what to expect from a newborn hearing screening, why it is important, and how to identify the signs of hearing loss within the first year of a child's life. Read the Episode 28 transcript (Source: ASHA Podcast)

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Episode 24: Living With Hearing Loss

Pam Mason, Director of Audiology Professional Practices at the American Speech-Language-Hearing Association (ASHA), shares valuable information about living with hearing loss. (Source: ASHA Podcast)

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Episode 26: Untreated Hearing Loss in Older Americans

With roughly 50 percent of Americans over 60 suffering from some form of hearing loss, Sandra Gordon-Salant, audiologist and ASHA fellow, discusses signs of hearing loss and available treatment options as part of ASHA's new "Identify the Signs" campaign. Read the Episode 26 transcript (Source: ASHA Podcast)

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Darstellbarkeit der Vena cava superior im rechten supraklavikulären Schallfenster

Zusammenfassung

Hintergrund

Die Ultraschall-gesteuerte Anlage eines Zentralvenösen Katheters (ZVK) über die Vena jugularis interna dextra mit einem Linearschallkopf ist ein etabliertes Verfahren. Bislang sind für die ZVK-Lagekontrolle Methoden wie intrakardiales EKG oder Röntgenthoraxaufnahme bekannt. Wir konnten mit einem Mikrokonvexschallkopf die Fossa supraclavicularis dextra als Schallfenster für die Darstellung der Vena cava superior (VCS) für die ultraschall-gesteuerte ZVK-Lagekontrolle etablieren. Limitierend ist jedoch die geringe Verbreitung des Mikrokonvexschallkopfs. Daher haben wir in der vorliegenden Probandenstudie systematisch die Darstellbarkeit der intrathorakalen Gefäße über das rechte supraklavikuläre Fenster mit einem Linearschallkopf und einem Mikrokonvexschallkopf verglichen.

Methode

Wir evaluierten bei 30 Probanden die Darstellbarkeit der VCS, der Venae brachiocephalicae, des Zusammenflusses der Venae brachiocephalicae (Confl.), der rechten Pulmonalarterie, der Aorta ascendens und der Vena jugularis interna mit dem Mikrokonvex- und Linearschallkopf in der Anlotung über die Fossa supraclavicularis dextra. Die VCS wurde auch mittels Doppler verifiziert.

Ergebnisse

Mit dem Mikrokonvexschallkopf ließ sich bei allen Probanden die VCS darstellen, mit dem Linearschallkopf hingegen nur bei 53 %. Die kombinierte Sichtbarkeit von VCS und Arteria pulmonalis dextra war mit dem Mikrokonvexschallkopf in allen Fällen gegeben, mit dem Linearschallkopf nur in 38 %. Confl. beziehungsweise Aorta war bei 57 %/87 % mit dem Mikrokonvexschallkopf sichtbar, in 35 %/30 % mit dem Linearschallkopf. Die Vena jugularis interna war bei allen Probanden mit beiden Sonden sichtbar.

Schlussfolgerung

Der Mikrokonvexschallkopf ist für die Darstellbarkeit der VCS dem Linearschallkopf klar überlegen. Wahrscheinliche Gründe hierfür liegen in der kleineren Auflagefläche, der größeren Angulationsfreiheit und der höheren Eindringtiefe der Mikrokonvexsonde.

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