Sister Mary Joseph's Nodule as a Cutaneous Expression of Metastatic Pancreatic Adenocarcinoma.

A Sister Mary Joseph's nodule (SMJN) is characterized by a palpable umbilical nodule and is often a clinical indicator of the metastasis of an advanced abdominal or pelvic malignancy. Observing the cutaneous manifestation of an abdomino-pelvic malignancy is a relatively rare phenomenon due to the appearance of visible changes in the later stages of the disease. With the pancreas being a less common primary tumor site for SMJN, this case report describes a 57-year-old male diagnosed with metastatic pancreatic adenocarcinoma with a SMJN.

Pyoderma Gangrenosum in a 75-Year-Old Male With Follicular Diffuse Large B-cell Lymphoma.

Pyoderma gangrenosum (PG) is a rare neutrophilic dermatosis that characteristically presents with progressive ulcerative lesions. The association of PG with hematological malignancies remains unclear due to its varied clinical presentation. Herein, we report the unusual case of PG in a 75-year-old male with stage III follicular diffuse large B-cell lymphoma.

An Unusual Presentation of Propylthiouracil-Induced Immunoglobulin A Vasculitis With Positive Anti-proteinase-3 and Anti-myeloperoxidase Antibodies.

Propylthiouracil (PTU) has been identified as a known cause of anti-neutrophil cytoplasmic antibodies-associated vasculitis. However, the association between PTU and immunoglobulin A (IgA) vasculitis remains uncertain due to its rarity and diverse clinical presentation. Here, we report the case of a 57-year-old female with a past medical history of chronic leukopenia and Graves' disease treated with PTU that presented with pancytopenia and widespread non-blanching ecchymoses on the bilateral legs.

Generation of Rhesus Macaque Embryos with Expanded CAG Trinucleotide Repeats in the Gene.

Huntington's disease (HD) arises from expanded CAG repeats in exon 1 of the () gene. The resultant misfolded HTT protein accumulates within neuronal cells, negatively impacting their function and survival. Ultimately, HTT accumulation results in cell death, causing the development of HD.

"Navigating chaos": Urban, Rural, and Remote Patient Experiences in Accessing Healthcare with Indigenous and Non-Indigenous Perspectives of Living with Chronic Low Back Pain.

Background: Healthcare access for chronic low back pain is complex and should consider not only the health system, but patient care seeking experiences as well. People who live in rural and remote communities and/or identify as being Indigenous may often encounter additional barriers to accessing care for chronic low back pain; thus, these contexts must be considered to fully understand barriers and facilitators.

Aims: The aim of this study was to understand care-seeking experiences of people living with chronic back pain in Saskatchewan and determine unique experiences facing urban, rural, remote, and/or Indigenous peoples.

Healthcare Access Challenges and Facilitators for Back Pain Across the Rural-Urban Continuum in Saskatchewan, Canada: Cross-Sectional Results From a Provincial-Wide Telephone Survey.

Background: Chronic back pain is a common musculoskeletal disorder, disproportionately affecting rural and Indigenous people. Saskatchewan has a relatively high proportion of rural and Indigenous residents; therefore, understanding barriers and facilitators to accessing healthcare are needed to improve healthcare service delivery.

Methods: A provincial-wide telephone survey explored experiences and perceived healthcare access barriers and facilitators among 384 Saskatchewan residents who experienced chronic low back pain.

Experiences of Health Care Access Challenges for Back Pain Care Across the Rural-Urban Continuum in Canada: Protocol for Cross-sectional Research.

Background: Back pain is common and costly, with negative impacts on both individuals and the health care system. Rural, remote, and Indigenous populations are at greater risk of experiencing back pain compared to urban and non-Indigenous populations. Potential barriers to health care access among Canadians with chronic back pain (CBP) have been identified; however, no study has used lived experiences of people with CBP to drive the selection, analysis, and interpretation of variables most meaningful to patients.

The hand therapist's role in the prevention and management of upper extemity injuries in the modern mass production industrial setting.

Background: This case study presents the role of an onsite hand therapist (Certified Hand Therapist, Occupational Therapist, Physical Therapist) in an industrial setting and the services that can be provided in this comprehensive care model. Onsite hand therapists can impact on Occupational Safety and Health Administration (OSHA) first aid programs and can provide state of the art treatment for the injured worker in both a direct and indirect capacity.

Purpose: The purpose of this case study article is to review the many potential services the hand therapist can offer to facilitate the return-to-work of injured employees and provide employers with a proactive case management and state-of-the-art ergonomic prevention, improving profit margins and facilitating safe work environments.

Orthopaedic Nurses' Perceptions of Preoperative Education for Total Knee Replacement.

Background: Limited descriptions of preoperative education programs for total knee replacement (TKR) surgery are provided in the literature, and the most effective program design is currently unknown.

Purpose: The purpose of this qualitative study is to describe orthopaedic nurses' perceptions of preoperative education prior to TKR surgery.

Methods: Ten participants completed phone interviews and transcripts were analyzed qualitatively for themes among participants.

Preoperative Education for Total Knee Replacement: A National Survey of Orthopaedic Nurses.

Background: Preoperative education aids in reducing the incidence of poor outcomes after total knee replacement (TKR) and increasing patient readiness for discharge home but is not well described in the literature.

Purpose: The purpose of the study is to describe the current design of preoperative education for TKR across the United States.

Methods: A large, national sample of orthopaedic nurses completed an online survey to describe preoperative education at their facilities.

Identifying Homogeneous Outcome Groups in Adult Rehabilitation Using Cluster Analysis.

Importance: Adults receiving occupational therapy in inpatient rehabilitation are a heterogeneous population with differing needs, outcomes, and rehabilitation processes. Outcome studies based on what works for all clients may obscure the needs of population subgroups who benefit unequally from rehabilitation services.

Objective: To identify subgroups on the basis of client satisfaction and progress in functional self-care among a diverse rehabilitation population and to understand subgroup differences in occupational therapy and rehabilitation processes and client discharge status.

Post-traumatic stress disorder and hypertensive disorders of pregnancy among military women.

Background: Women are more likely to develop post-traumatic stress disorder (PTSD) than men. Limited research exists evaluating the risk of hypertensive disorders of pregnancy (HDP) among military women with PTSD.

Methods: We conducted a retrospective cohort study using US Department of Defense (DoD) data comprised of all active-duty women giving birth to their first, liveborn singleton infant using DoD-sponsored health insurance from 1 January 2004 to 31 December 2008 (n = 34 176).

Factors Influencing Discharge Readiness After Total Knee Replacement.

Total knee replacement (TKR) surgery has been found to achieve positive outcomes for many patients such as reduced pain and increased function. However, some patients experience suboptimal outcomes including falls, readmission to hospital, and reduced functional performance. Preparation for discharge after TKR surgery is often defined related to pain control, walking, knee function, and ability to climb stairs.

Deployment Among Active-Duty Military Women and Pregnancy-Related Hypertensive Disorders.

Introduction: Today women comprise 15% of the U.S. active-duty military, but are often overlooked in research of the Armed Forces.

Progesterone Receptor-Mediated Actions Regulate Remodeling of the Cervix in Preparation for Preterm Parturition.

This study determined whether a progesterone (P) receptor (PR)-mediated mechanism regulates morphological characteristics associated with prepartum cervix remodeling at term and with preterm birth. With focus on the transition from a soft to ripe cervix, the cervix stroma of untreated controls had reduced cell nuclei density/area and less organized extracellular collagen, while the density of macrophages/area, but not neutrophils, increased just 2 days before birth (day 17 vs day 15 or 16.5 postbreeding).

Assessing the Validity of a Continuum-of-care Survey: A Rasch Measurement Approach.

Satisfied patients are more likely to be compliant, have better outcomes, and are more likely to return to the same provider or institution for future care. The Satisfaction with a Continuum of Care survey (SCC) was designed to improve patient care using measures of patient satisfaction and facilitate a cultural shift from a "silos-of-care" to a "continuum-of-care" mentality by fostering inter-departmental communication as patients moved between environments of care at a Midwestern rehabilitation hospital. This study provides a Rasch measurement framework for investigating issues related to survey reliability and validity.

The Nature and Meaning of Body Concepts in Everyday Language and Theoretical Discourse.

Within phenomenological philosophy four topics, (1) Body, (2) Time, (3) Others and the Social Order and (4) World serve as the major contexts in which human perception, action and reflection take place. At present only three of these domains have been studied from an empirical perspective, leaving Body as the one domain requiring further analysis. Given this state of affairs, the purpose of the present study is to determine the everyday and theoretical meanings of body.

Combined alphavirus replicon particle vaccine induces durable and cross-protective immune responses against equine encephalitis viruses.

Alphavirus replicons were evaluated as potential vaccine candidates for Venezuelan equine encephalitis virus (VEEV), western equine encephalitis virus (WEEV), or eastern equine encephalitis virus (EEEV) when given individually or in combination (V/W/E) to mice or cynomolgus macaques. Individual replicon vaccines or the combination V/W/E replicon vaccine elicited strong neutralizing antibodies in mice to their respective alphavirus. Protection from either subcutaneous or aerosol challenge with VEEV, WEEV, or EEEV was demonstrated out to 12 months after vaccination in mice.

Successful implementation of a unit-based quality nurse to reduce central line-associated bloodstream infections.

Background: Central line (CL)-associated bloodstream infections (CLABSI) are an important cause of patient morbidity and mortality. Novel strategies to prevent CLABSI are needed.

Methods: We described a quasiexperimental study to examine the effect of the presence of a unit-based quality nurse (UQN) dedicated to perform patient safety and infection control activities with a focus on CLABSI prevention in a surgical intensive care unit (SICU).

Client-chosen goals in occupational therapy: strategy and instrument pilot.

ABSTRACT Client-centered practice and outcomes research are missions of occupational therapy. Although strategies for client goal-setting have advanced the field, the process has limitations. This study tested a self-report strategy using brief, easy to score measures.

Venezuelan equine encephalitis replicon particles can induce rapid protection against foot-and-mouth disease virus.

We have previously shown that delivery of the porcine type I interferon gene (poIFN-α/β) with a replication-defective human adenovirus vector (adenovirus 5 [Ad5]) can sterilely protect swine challenged with foot-and-mouth disease virus (FMDV) 1 day later. However, the need of relatively high doses of Ad5 limits the applicability of such a control strategy in the livestock industry. Venezuelan equine encephalitis virus (VEE) empty replicon particles (VRPs) can induce rapid protection of mice against either homologous or, in some cases, heterologous virus challenge.

Venezuelan equine encephalitis virus replicon particle vaccine protects nonhuman primates from intramuscular and aerosol challenge with ebolavirus.

There are no vaccines or therapeutics currently approved for the prevention or treatment of ebolavirus infection. Previously, a replicon vaccine based on Venezuelan equine encephalitis virus (VEEV) demonstrated protective efficacy against Marburg virus in nonhuman primates. Here, we report the protective efficacy of Sudan virus (SUDV)- and Ebola virus (EBOV)-specific VEEV replicon particle (VRP) vaccines in nonhuman primates.