Merkel cell carcinoma (MCC) is a rare, highly aggressive skin cancer of neuroendocrine origin that is typically associated with either the presence of Merkel cell polyomavirus or chronic exposure to ultraviolet (UV) light. We report a case of relapsed MCC that presented with new symptoms of fatigue, back pain, and myeloid left shift identified during scheduled follow-up. The patient was found to have circulating neoplastic cells in the peripheral blood and bone marrow metastasis.
View Article and Find Full Text PDFIntroduction: Longitudinal changes in residual kidney function have not been well-examined in patients starting chronic hemodialysis (HD).
Methods: We analyzed urine volume and kidney solute clearances from timed urine collections and corresponding plasma samples from 42 patients randomized to incremental HD ( = 21) and conventional HD ( = 21) in the TwoPlus pilot study. Samples were collected before HD initiation (baseline); and at 6, 12, 24, and 48 weeks.
Background: Physical and emotional symptoms are prevalent in patients with kidney-dysfunction requiring dialysis (KDRD) and the rigors of thrice-weekly hemodialysis (HD) may contribute to deteriorated health-related quality of life. Less intensive HD schedules might be associated with lower symptom and/or emotional burden.
Methods: The TWOPLUS Pilot study was an individually-randomized trial conducted at 14 dialysis units, with the primary goal to assess feasibility and safety.
Rationale & Objective: Thrice-weekly hemodialysis (HD) is the most common treatment modality for kidney failure in the United States. We conducted a pilot study to assess the feasibility and safety of incremental-start HD in patients beginning maintenance HD.
Study Design: Pilot study.
Previous research finds an association between spirituality and subjective well-being. However, the widespread use of poorly defined concepts of spirituality, tautological spirituality scales, and heavy reliance on cross-sectional samples cast doubts on prior findings. Here, we leverage ten waves of panel data from a nationally diverse longitudinal study to systematically test whether having spiritual beliefs leads to growth in personal well-being and life satisfaction ( = 3257, New Zealand, 2010-2020).
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