Postmenopausal Vaginal and Cervical Cancer Risk Related to In Utero Diethylstilbestrol Exposure.

Objectives: Women exposed to diethylstilbestrol (DES) in utero have an increased risk of clear cell adenocarcinoma of the lower genital tract, requiring lifelong cervical and vaginal cancer screening. We examined the incidence of DES-related cancers in postmenopausal women 50 years and older.

Materials And Methods: We conducted a retrospective chart review of patients 50 years and older exposed to DES in utero who received care at our institution.

Magnetic droplet nucleation boundary in orthogonal spin-torque nano-oscillators.

Static and dynamic magnetic solitons play a critical role in applied nanomagnetism. Magnetic droplets, a type of non-topological dissipative soliton, can be nucleated and sustained in nanocontact spin-torque oscillators with perpendicular magnetic anisotropy free layers. Here, we perform a detailed experimental determination of the full droplet nucleation boundary in the current-field plane for a wide range of nanocontact sizes and demonstrate its excellent agreement with an analytical expression originating from a stability analysis.

Confined dissipative droplet solitons in spin-valve nanowires with perpendicular magnetic anisotropy.

Magnetic dissipative droplets are localized, strongly nonlinear dynamical modes excited in nanocontact spin valves with perpendicular magnetic anisotropy. These modes find potential application in nanoscale structures for magnetic storage and computation, but dissipative droplet studies have so far been limited to extended thin films. Here, numerical and asymptotic analyses are used to demonstrate the existence and properties of novel solitons in confined structures.

Advancing obstetric and neonatal care in a regional hospital in Ghana via continuous quality improvement.

Objective: To reduce maternal and neonatal death at a large regional hospital through the use of quality improvement methodologies.

Methods: In 2007, Kybele and the Ghana Health Service formed a partnership to analyze systems and patient care processes at a regional hospital in Accra, Ghana. A model encompassing continuous assessment, implementation, advocacy, outputs, and outcomes was designed.

Neonates with tongue-based airway obstruction: a systematic review.

Objective: In this systematic review, the authors summarize the current evidence in the literature regarding diagnosis, treatment, and long-term outcomes in neonates with tongue-based airway obstruction (TBAO) and assess the level of evidence of included studies.

Data Sources: The terms Pierre Robin syndrome/sequence, micrognathia, retrognathia, and cleft palate were combined with airway obstruction, treatment, tongue-lip plication, and osteogenesis distraction to perform an Ovid literature search, yielding 341 references. The authors excluded references containing patients with isolated choanal/nasal obstruction, patients older than 12 months, and expert opinion papers, yielding 126 articles.

Using quality-improvement methods to reduce variation in surfactant administration.

Background: Respiratory distress syndrome and chronic lung disease are prevalent disorders in extremely low-birth-weight infants. Evidence demonstrates that timely surfactant administration improves respiratory outcomes.

Objective: To assess whether basic quality-improvement methods can reduce the time to initial surfactant dose for premature infants.

Evaluation of ability of biochemical markers of bone turnover to predict a response to increased doses of HRT.

Antiresorptive therapy is usually given in a fixed dose, and we hypothesized that some patients receiving standard doses of hormone replacement therapy (HRT) might benefit from a higher dose, particularly if their bone turnover decreases after increasing the dose of HRT. Eighty-eight women who had been receiving standard-dose (0.625 mg/day) conjugated equine estrogens (CEE) for at least one year were randomized to take either standard-dose (0.

Mild fetal cerebral ventriculomegaly: diagnosis, clinical associations, and outcomes.

The normal fetal lateral ventricular diameter remains stable at 10 mm over gestation. Mild ventriculomegaly, defined as a lateral ventricular diameter of >or=10 mm but or=3 mm but View Article and Find Full Text PDF

Defect repair in the rat mandible with bone morphogenic proteins and marrow cells.

Objective: To investigate the ability of a bone growth factor mixture and bone marrow cells to repair a critical size defect of the rat mandibular body.

Design: Prospective, randomized controlled trial.

Subjects: Thirty-seven male Fischer rats.

Muscle fiber and satellite cell apoptosis in the aging human thyroarytenoid muscle: a stereological study with confocal laser scanning microscopy.

Objective: This study determines the role of changes in numerical densities of apoptotic myonuclei and satellite cells in age-related remodeling of the thyroarytenoid muscle (TA).

Design: Changes in numerical densities of apoptotic myonuclei and satellite cells were estimated for the entire TA by using stereological techniques.

Results: There was an increase in N(V apoptotic myonucleus, fiber type) (P < 0.

Numerical densities of myonuclei and satellite cells in muscle fiber types in the aging human thyroarytenoid muscle: an immunohistochemical and stereological study using confocal laser scanning microscopy.

Objective: This study determines the role of changes in numerical densities of myonuclei and satellite cells in age-related remodeling of the thyroarytenoid muscle (TA).

Design: Changes in numerical densities (N(V)) and ratios (N(N)) of myonuclei and satellite cells were estimated for the entire TA by use of stereological techniques.

Results: There was no age-related change or difference between fiber types for N(V myonucleus, fiber), but N(V myonucleus, fiber) increased with decreasing fiber diameter.

Age-related changes in muscle fiber types in the human thyroarytenoid muscle: an immunohistochemical and stereological study using confocal laser scanning microscopy.

A decline in motor performance contributes to laryngeal dysfunction in the elderly, but the pathogenetic mechanisms are unknown. Quantitative 3-dimensional, age-related changes in the muscle fiber content of the human thyroarytenoid muscle were estimated from geometric probability (stereology) by use of a technique that provided a statistically unbiased sample of all possible section orientations and locations in the entire muscle volume. There was a preferential 27% age-related loss in the length density (L(V type, muscle)) of type 1 (slow) fibers in contrast to the selective type 2 (fast) fiber loss typical of aging limb muscles.

A.T.L.S. on the ski slopes--a steamboat experience.

The Steamboat Mountain Ski Patrol incorporates local emergency physicians and a visiting trauma surgeon as a second-tier response to life-threatening mountain events. The case of a 48-year-old man surviving a potentially lethal postinjury tension pneumothorax and a review of the 1989-1990 major trauma experience on this ski mountain underscores the value of this concept.

Pseudoexfoliative fibrillopathy in the conjunctiva. A relation to elastic fibers and elastosis.

Pseudoexfoliative (PSX) material in the conjunctiva was found to have a close association with elements of the elastic system in 13 eyes of patients with PSX disease studied ultrastructurally. Pseudoexfoliation aggregates were rare within vascular walls but frequent in proximity to the plasmalemma of stromal fibroblasts. No amyloid was found.

Bile duct dyskinesia. Clinical and manometric study.

Unexplained right upper quadrant symptoms have often been attributed to bile duct dyskinesia. In this study we evaluated the pressure profile of the sphincter of Oddi in 10 patients with recurrent episodes of right upper quadrant pain, intermittent mild transaminasemia, and a normal pancreatobiliary tract. Nine healthy volunteers served as control.

The portable Doppler: practical applications in EMS care.

The practical application of a new, commercially available, portable Doppler ultrasound device to the operation of a busy city-county emergency department and ambulance service was investigated. An initial evaluation using healthy volunteers confirmed accuracy and reproducibility of the Doppler blood pressure readings comparable to that of auscultatory and palpatory measurement. In selected patients, the Doppler readings correlated well with readings from patients who had intra-arterial lines.