Multifetal Pregnancy Reduction.

Multiple gestations of triplets or more have a significant increase in perinatal morbidity and mortality compared with twins. On average, triplet gestations deliver at approximately 33.5 weeks.

Preliminary clinical assessment of the relationship between tumor alphavbeta3 integrin and perfusion in patients studied with [(18)F]fluciclatide kinetics and [ (15)O]H 2O PET.

Background: [(18)F]fluciclatide, a peptide ligand with high affinity for αvβ3/αvβ5 integrins, is a proposed biomarker of tumor angiogenesis. The study rationale was to perform a preliminary evaluation of the relationship between tumor [(18)F]fluciclatide uptake and perfusion by [(15)O]H2O PET.

Methods: Patients with non-small cell lung cancer and melanoma underwent dynamic imaging with arterial sampling following injection of [(15)O]H2O and [(18)F]fluciclatide.

Population-Specific Covariation between Immune Function and Color of Nesting Male Threespine Stickleback.

Multiple biological processes can generate sexual selection on male visual signals such as color. For example, females may prefer colorful males because those males are more readily detected (perceptual bias), or because male color conveys information about male quality and associated direct or indirect benefits to females. For example, male threespine stickleback often exhibit red throat coloration, which females prefer both because red is more visible in certain environments, and red color is correlated with male immune function and parasite load.

Rapid balloon distension as a tool to study cortical processing of visceral sensations and pain.

Background: The processing of discomfort and pain in the central nervous system is normally studied with experimental methods, but it is mandatory that they are reliable over time to ensure that any interventions will result in valid results. We investigated reliability of rapid balloon distension in the rectum to elicit cortical evoked potentials (CEPs) to study the reliability of central processing of visceral sensation and discomfort/pain.

Methods: Eighteen healthy volunteers had two series of rectal balloon distensions performed on two separate days.

Massage therapy alone and in combination with meditation for breast cancer patients undergoing autologous tissue reconstruction: A randomized pilot study.

This study explored whether massage combined with meditation is more helpful than massage alone for women recovering from autologous tissue reconstruction after mastectomy for breast cancer. Forty patients were randomly assigned to either massage therapy or massage plus meditation on postoperative days 1 through 3. Outcome measures were 1) visual analog scale (VAS) scores for stress, anxiety, relaxation, insomnia, alertness, fatigue, tension, pain, mood, and energy, and 2) Perceived Stress Scale-14 scores.

Female stickleback prefer shallow males: Sexual selection on nest microhabitat.

Sexual selection is most often thought of as acting on organismal traits, such as size or color. However, individuals' habitat use may also affect mating success. Here, we show that, in threespine stickleback, nest depth can be a target of sexual selection.

Balint groups in family medicine residency programs: a follow-up study from 1990--2010.

Background And Objectives: Balint groups have been part of residency education for decades. This study updates our understanding of the organization, purpose, and leadership of Balint groups within US family medicine residency programs.

Methods: Accreditation Council for Graduate Medical Education (ACGME)-approved family medicine residency training programs (n=453) were contacted to complete a questionnaire, similar to ones performed in 1990 and 2000.

Abnormal neuronal response to rectal and anal stimuli in patients with idiopathic fecal incontinence.

Background: The pathophysiology behind idiopathic fecal incontinence (IFI) is poorly understood. We hypothesized abnormal sensory pathways along the brain-gut axis as a key player in this disease, reflected in cortical evoked potentials (CEP) from mechanical stimuli of the rectum and the anal canal.

Methods: CEPs were recorded during repeated rapid balloon distensions of the rectum and anal canal in 19 women with IFI (mean age: 60 ± 14, mean Wexner score: 14.

The p53 isoform Δ133p53β promotes cancer stem cell potential.

Cancer stem cells (CSC) are responsible for cancer chemoresistance and metastasis formation. Here we report that Δ133p53β, a TP53 splice variant, enhanced cancer cell stemness in MCF-7 breast cancer cells, while its depletion reduced it. Δ133p53β stimulated the expression of the key pluripotency factors SOX2, OCT3/4, and NANOG.

Effect of protein overfeeding on energy expenditure measured in a metabolic chamber.

Background: Energy expenditure (EE) increases with overfeeding, but it is unclear how rapidly this is related to changes in body composition, increased body weight, or diet.

Objective: The objective was to quantify the effects of excess energy from fat or protein on energy expenditure of men and women living in a metabolic chamber.

Design: We conducted a randomized controlled trial in 25 participants who ate ∼40% excess energy for 56 d from 5%, 15%, or 25% protein diets.

Laryngeal inflammation in the sudden infant death syndrome.

Objective: Sudden infant death syndrome (SIDS) is marked by 'the sudden death of an infant that is unexpected by history and remains unexplained after a thorough forensic autopsy and a detailed death scene investigation'. The cause is unknown. Excessive subglottic submucosal glandular tissue and excessive sulphated mucus glycoprotein in the larynges of SIDS babies have been previously reported from our institution.

Sensitivity of quantitative sensory models to morphine analgesia in humans.

Introduction: Opioid analgesia can be explored with quantitative sensory testing, but most investigations have used models of phasic pain, and such brief stimuli may be limited in the ability to faithfully simulate natural and clinical painful experiences. Therefore, identification of appropriate experimental pain models is critical for our understanding of opioid effects with the potential to improve treatment.

Objectives: The aim was to explore and compare various pain models to morphine analgesia in healthy volunteers.

HIRA orchestrates a dynamic chromatin landscape in senescence and is required for suppression of neoplasia.

Cellular senescence is a stable proliferation arrest that suppresses tumorigenesis. Cellular senescence and associated tumor suppression depend on control of chromatin. Histone chaperone HIRA deposits variant histone H3.

Balint seminars: the transatlantic experience through videoconference.

Introduction: The Balint seminar is used in many family medicine residencies to improve and strengthen the patient-doctor relationship: to make better doctors. Given the lack of Balint leaders in developing countries, the family medicine department at the American University of Beirut (AUB) decided to collaborate with the Medical University of South Carolina (MUSC)-with more than 30 years of experience-to start Balint seminars through videoconferencing.

Objective: Evaluate the feasibility and effectiveness of Balint seminars conducted through videoconference.

Clinical potential of naloxegol in the management of opioid-induced bowel dysfunction.

Opioid-induced bowel dysfunction (OIBD) is a burdensome condition which limits the therapeutic benefit of analgesia. It affects the entire gastrointestinal tract, predominantly by activating opioid receptors in the enteric nervous system, resulting in a wide range of symptoms, such as reflux, bloating, abdominal cramping, hard, dry stools, and incomplete evacuation. The majority of studies evaluating OIBD focus on constipation experienced in approximately 60% of patients.

Benign and precursor lesions in the esophagus.

The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the role of salivary stimulation and esophageal secretion of protective factors in prevention of adenocarcinoma sequelae in gastroesophageal reflux disease; the pediatric conditions associated with esophageal cancer; the relationship of achalasia and pseudoachalasia with esophageal cancer; the potential for malignant transformation in eosinophilic esophagitis and overlap syndromes; the role of lymphocytic esophagitis as an overlapping phenotype; the role of Barrett's esophagus as a premalignant condition; the indications and type of treatment of premalignant conditions of the esophagus; and the decision for use of endoscopical procedures in premalignant conditions of the esophagus.

Neurophysiology of the esophagus.

The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the methods and characteristics of esophageal afferents in humans; the pitfalls in characterization of mechanosensitive afferents; the sensitization of esophageal afferents in human studies; the brain source modeling in the understanding of the esophagus-brain axis; the use of evoked brain potentials in the esophagus; and measuring descending inhibition in animal and human studies.

Pharmacologic treatments for esophageal disorders.

The following, from the 12th OESO World Conference: Cancers of the Esophagus, includes commentaries on the role for ketamine and other alternative treatments in esophageal disorders; the use of linaclotide in the treatment of esophageal pain; the alginate test as a diagnostic criterion in gastroesophageal reflux disease (GERD); the use of baclofen in treatment of GERD; the effects of opioids on the esophagus; the use of antagonists on the receptor level in GERD; the effect of local formulation of drugs on the esophageal mucosa; and the use of electroencephalographic fingerprints to predict the effect of pharmacological treatment.

Sacral nerve stimulation changes rectal sensitivity and biomechanical properties in patients with irritable bowel syndrome.

Background: Sacral nerve stimulation (SNS) has been demonstrated to alleviate symptoms and improve quality of life in selected patients with irritable bowel syndrome (IBS). The mechanisms of action, however, remain unknown. The aim of the study was to evaluate the effects of SNS on rectal sensitivity and biomechanical properties in patients with IBS.

Rectal sensitivity in diabetes patients with symptoms of gastroparesis.

In a clinical setting, diabetic autonomic complications (cardiac, gastrointestinal, urogenital, etc.) are often handled as separate entities. We investigated rectal sensitivity to heat, mechanical distension, and electrical stimulations in 20 patients with diabetes and symptoms of gastroparesis, to evaluate the extent of visceral neuronal damage.

The legacy of Michael Balint.

Michael Balint's lead article, "Repeat Prescription Patients: Are They An Identifiable Group?" inaugurated the first issue of Psychiatry in Medicine, Vol. 1, No. 1, 1970.

Pathophysiology of late anorectal dysfunction following external beam radiotherapy for prostate cancer.

Background: Patients treated with external beam radiotherapy (EBRT) may suffer from long-term anorectal adverse effects. The purpose of the present study was to assess long-term functional and structural anorectal changes in patients previously treated with EBRT for prostate cancer and to suggest the mechanism behind the development of the adverse effects.

Material And Methods: Our previously proposed RT-induced anorectal dysfunction (RT-ARD) score, developed with the intention to survey anorectal dysfunction was used to identify patients with and without anorectal symptoms.