Immediate Skin Replacement Allows for Nipple-sparing, Direct-to-implant Reconstruction in Patients with Advanced Breast Cancers.

Mastectomy has evolved from approaches that involved extensive skin resection to nipple-sparing mastectomy (NSM). However, patients with advanced breast cancers who require extensive skin resection usually also have their nipple areola complexes (NACs) removed, even if they are distant from the cancer. Implant reconstruction in these patients is challenging as they require tissue expansion and, typically, radiotherapy with additional surgeries to complete their reconstruction.

Optimizing Symmetry after Unilateral Mastectomy and Reconstruction with a Less Form-stable Prepectoral Implant.

Implant-based breast reconstruction after bilateral mastectomy allows for excellent symmetry between the reconstructed breasts. After unilateral mastectomy, it is difficult to achieve symmetry between the reconstructed and native breast. In the past, anatomical implants provided a reconstruction that more closely resembled the shape of a native breast compared with the cohesive, round subpectoral implants commonly placed today.

Students' response to a Massage & Meditation medical school course elective.

This article was migrated. The article was marked as recommended. Due to high incidence of medical student and physician burnout, medical education needs to include skills for life-work balance.

Voriconazole Exposure and Risk of Cutaneous Squamous Cell Carcinoma, Aspergillus Colonization, Invasive Aspergillosis and Death in Lung Transplant Recipients.

Voriconazole is a triazole antifungal used to prevent and treat invasive fungal infections after lung transplantation, but it has been associated with an increased risk of developing cutaneous squamous cell carcinoma (SCC). Despite widespread use, there are no clear guidelines for optimal prophylactic regimens that balance the competing risks and benefits. We conducted a retrospective cohort study of all lung transplant recipients at the University of California, San Francisco, who were transplanted between October 1991 and December 2012 (n = 455) to investigate whether voriconazole exposure affected development of SCC, Aspergillus colonization, invasive aspergillosis and all-cause mortality.

Single-nucleotide polymorphisms in pigment genes and nonmelanoma skin cancer predisposition: a systematic review.

Nonmelanoma skin cancer (NMSC) is the most common cancer in the U.S.A.

Fitzpatrick skin phototype is an independent predictor of squamous cell carcinoma risk after solid organ transplantation.

Background: Solid organ transplant recipients (OTR) are at an increased risk of developing squamous cell carcinoma (SCC) of the skin after transplantation. In predominantly white cohorts, Fitzpatrick skin type (FST) has been reported to be a risk factor for developing posttransplantation skin cancers.

Objective: Our goal was to determine if FST is a statistically significant risk factor for the development of SCC after solid organ transplantation in a diverse US population of OTR.

High cumulative dose exposure to voriconazole is associated with cutaneous squamous cell carcinoma in lung transplant recipients.

Background: Lung transplant recipients (LTR) have an increased risk of cutaneous squamous cell carcinoma (SCC) due to immunosuppressive therapy. Voriconazole, which is associated with phototoxic side effects in some patients, may be an additional risk factor for SCC in this population.

Methods: To test whether voriconazole is a risk factor for developing SCC in LTR, we evaluated cumulative exposure to voriconazole in 327 adults who underwent lung transplantation at one center between 1991 and 2010.

Cervical and vaginal cytologic smears suggestive of adenocarcinoma.

Objective: To determine the appropriate evaluation of women with cervical cytologic smears suggestive of adenocareinoma.

Study Design: Of 1,192,972 smears obtained between July 1989 and March 1992, 57 (0.005%) were interpreted as adenocarcinoma, adenocarcinoma in situ or "rule out" adenocarcinoma.

Alternative prenatal care. Impact of reduced visit frequency, focused visits and continuity of care.

Objective: To investigate the impact of an alternative prenatal care program for low-risk patients.

Study Design: Five hundred forty-nine low-risk pregnant women were allocated to the study and control groups. The study group received, on average, eight visits, all of them with one of nine study providers.

Combined vesicovaginal-ureterovaginal fistulas associated with a vaginal foreign body.

A case is presented of vesicovaginal-ureterovaginal fistulas associated with a neglected vaginal foreign body. The patient complained of a foul-smelling vaginal discharge and was found to have a 4-cm hard vaginal mass on examination. Urinary incontinence developed subsequently.

A comparison of compliance techniques on the control of high blood pressure.

Four compliance strategies were compared with education alone to investigate their impact on the control of high blood pressure. One hundred twelve subjects with documented high blood pressure were randomly assigned to receive education alone, home blood pressure monitoring, contracts, pill packs, or a combination of techniques. Groups were similar in terms of age, sex, race, initial blood pressure, and medications.

The clinical implications of retroperitoneal endometriosis.

Over the past 10 years five patients with endometriosis involving only retroperitoneal structures in the pelvis without intraperitoneal involvement have been managed at the University of California-Los Angeles Hospital. These patients have presented difficult diagnostic and therapeutic problems. Moreover, this interesting but uncommon distribution of the disease has led to speculation concerning its pathogenesis.

Adenocarcinoma in a choledochal cyst during pregnancy: a case report and guidelines for management.

Choledochal cysts, although more common in females than males, have only rarely been encountered in association with pregnancy. We report a patient with a large choledochal cyst that was excised at the time of cesarean section. Pathologically, the cyst wall was found to contain a focus of adenocarcinoma.

Coffee and pancreatic cancer: an analysis of international mortality data.

This study assessed the relationship of per capita coffee imports and consumption, total dietary fat, saturated fat, cholesterol, tobacco, cigarettes, and national income for 1957-1965 to age-adjusted pancreatic cancer death rates of men and women from 22 countries in 1971-1974. With simple correlation analysis, coffee, total dietary fat, saturated fat, and national income were each significantly correlated with both male and female pancreatic cancer mortality. Bivariate partial correlation coefficients of coffee with pancreatic cancer mortality were significant (one-tailed) in 11 of 12 analyses and borderline significant in two-way analyses of variance (ANOVA) (two-tailed) controlling for each of the other variables.

Pseudotumor cerebri in an obese woman with Turner syndrome.

Extraovarian estrogen production was studied in an obese young woman with pathologically confirmed mosaic Turner syndrome and pseudotumor cerebri. Diet plus enough dexamethasone to suppress adrenal steroidogenesis promptly lowered cerebrospinal fluid testosterone. Estrone was detected in cerebrospinal fluid before and after but not during dexamethasone treatment.

Effect of calcitonin and glutocorticoids in combination on the hypercalcemia of malignancy.

The effects of the combination of glucocorticoids and calcitonin on serum calcium levels were compared with the responses to calcitonin alone in 14 patients with malignant disease and hypercalcemia. The serum calcium concentrations of those patients treated with calcitonin alone returned to pretreatment concentrations within 48 hours, whereas those treated with the combination of calcitonin and glucocorticoids maintained the lower serum calcium concentrations for more than 4 days. These results suggest that the combination of calcitonin and glucocorticoids is a rapidly effective form of medical treatment for hypercalcemia and that glucocorticoids help to maintain the acute response to calcitonin in patients with hypercalcemia.