Features of basal cell carcinomas in basal cell nevus syndrome.

Basal cell nevus syndrome (BCNS) is an autosomal dominant genodermatosis that is characterized by early onset basal cell carcinomas (BCCs) that define the disease and often lead to diagnosis of the underlying syndrome. The objective of this study was to investigate the anatomic location, subtypes, and impact of BCCs on a group of 61 individuals affected with BCNS attending a research colloquium. Fifty individuals had at least one prior BCC with 22 participants having over 100 lesions.

18F-FDG PET/CT of patients with cancer: comparison of whole-body and limited whole-body technique.

Objective: Use of the routine field of view for whole-body (18)F-FDG PET/CT can lead to underestimation of the true extent of the disease because metastasis outside the typical base of skull to upper thigh field of view can be missed. The purpose of this study was to evaluate the incremental added value of true whole-body as opposed to this limited whole-body PET/CT of cancer patients.

Materials And Methods: True whole-body FDG PET/CT, from the top of the skull to the bottom of the feet, was performed on 500 consecutively registered patients.

F-18 FDG PET/CT characterization of talc pleurodesis-induced pleural changes over time: a retrospective study.

Purpose: The current study characterized pleural changes induced by talc pleurodesis (TP), based on serial positron emission tomography/computer-tomography (PET/CT) with F-18 fluorodeoxyglucose (FDG).

Materials And Methods: A total of 8 cancer patients who had both TP and PET/CT and no evidence of active pleural involvement after TP were retrospectively evaluated. Maximum standard uptake values, maximum Hounsfield units (HU), and thickness were followed over time.

Liver donor's age and recipient's serum creatinine predict blood component use during liver transplantation.

Background: Excessive use of blood components during liver transplantation should be avoided because it has been associated with poor outcomes and it may stress blood bank resources.

Study Design And Methods: To determine preoperative predictors of excessive transfusion requirements in patients undergoing liver transplantation, the clinical records of 126 consecutive adult patients undergoing primary liver transplantation were retrospectively reviewed. Outcome variables included number of red blood cells (RBCs), plasma, and plateletpheresis components intraoperatively transfused.

Comparative reliability of 3 thoracolumbar fracture classification systems.

Study Design: Prospective study of 3 spine surgeons, 3 spine fellows, 3 nonspine orthopedists, and 12 orthopedic residents classifying 97 thoracolumbar fractures using the Denis, Association for Osteosynthesis (AO), and Thoracolumbar Injury Severity Score (TLISS) systems and reclassifying them 3 months later.

Objective: To compare the reliability of the Denis, AO, and TLISS classification systems and evaluate the skills necessary for their use.

Summary Of Background Data: The Denis and AO systems are the traditional methods of classification of thoracolumbar fractures.

Increased 18F-FDG uptake in the posterior ocular bulb is associated with brain metastasis: a retrospective study.

Objective: An observation of increased (18)F-FDG uptake in the posterior ocular bulb led us to the hypothesis that increased posterior ocular bulb uptake is likely abnormal and may indicate intracranial lesions.

Materials And Methods: Fifteen healthy volunteers and 35 patients with lung carcinoma-14 without brain metastasis and 21 with brain metastases-were retrospectively studied. The individuals underwent whole-body PET/CT including the brain with low-dose and unenhanced CT.

A retrospective review of the outcome of plasma exchange and aggressive medical therapy in antibody mediated rejection of renal allografts: a single center experience.

Unlabelled: Antibody-mediated rejection (AMR) has been recognized as a major cause of renal allograft loss. Protocols using plasma exchange (PE) to reverse rejection have mixed results.

Methods: A retrospective chart review was performed to determine the clinical response to PE inpatients with AMR of renal allograft.

Gastric residual volume and aspiration in critically ill patients receiving gastric feedings.

Background: The helpfulness of bedside assessment of gastric residual volume in the prediction of aspiration has been questioned, as has the volume that signals increased risk of aspiration.

Objective: To describe the association between gastric residual volumes and aspiration of gastric contents.

Methods: In a prospective study of 206 critically ill patients receiving gastric tube feedings for 3 consecutive days, gastric residual volumes were measured with 60-mL syringes every 4 hours.

Age and racial variation in central corneal thickness of preschool and school-aged children.

Purpose: The purpose of this study was to determine variations in central corneal thickness (CCT) of preschool and school-aged African American and white children. Secondary aims were to assess possible correlations between CCT measurements and gender, axial length, intraocular pressure (IOP), family history of glaucoma, or history of prematurity.

Methods: Contact ultrasound was used to measure CCT and axial length in 76 white and 60 African American children between the ages of 7 months and 18 years.

Reading a research article part III: the data collection instrument.

Parts I through III of this series of articles gave an introduction to some of the issues requiring attention when performing clinical studies and summarizing the results statistically as well as clinically. Statistical methods have been described for the identification of statistically significant differences and associations between an experimental group and a control group or over the course of time after an intervention. The next article will address the methods used for the determination of the strength or magnitude of these identified statistically significant differences.

Tracheobronchial aspiration of gastric contents in critically ill tube-fed patients: frequency, outcomes, and risk factors.

Objectives: To describe the frequency of pepsin-positive tracheal secretions (a proxy for the aspiration of gastric contents), outcomes associated with aspiration (including a positive Clinical Pulmonary Infection Score [a proxy for pneumonia] and use of hospital resources), and risk factors associated with aspiration and pneumonia in a population of critically ill tube-fed patients.

Design: Prospective descriptive study conducted over a 2-yr period.

Setting: Five intensive care units in a university-affiliated medical center with level I trauma status.

Indicators of tubesite during feedings.

Nurses are forced to make decisions about feeding tube position at regular intervals during the delivery of tube feedings; failure to detect an improperly positioned feeding tube can have serious consequences. This study was designed to determine the extent to which specific indicators could singularly and collectively differentiate between gastric and small-bowel placement in patients with nasally or orally inserted small-bore feeding tubes. Indicators were the length of tubing extending from the tube's insertion site as well characteristics of aspirates withdrawn from the feeding tube (volume, appearance, and pH).

Surgical margin determination in head and neck oncology: current clinical practice. The results of an International American Head and Neck Society Member Survey.

Background: Our aim was to investigate the ways in which surgeons who perform head and neck ablative procedures on a regular basis define margins, how they use frozen sections to evaluate margins, and the effect of chemoradiation on determining tumor margins.

Methods: A custom-designed questionnaire was mailed to members of the American Head and Neck Society asking members how they evaluate and define tumor margins.

Results: Of 1500 surveys mailed, 476 completed surveys were received.

Effect of significant histologic steatosis or steatohepatitis on response to antiviral therapy in patients with chronic hepatitis C.

Background & Aims: Treatment of chronic hepatitis C (CHC) results in an average sustained viral response (SVR) rate of 54%-63%. Most previous studies have not separately reported SVR rates for patients who have CHC and concomitant significant hepatic steatosis (>33%) or histologic evidence of steatohepatitis (SH). The aim of this study was to evaluate SVR in patients with CHC plus steatosis or SH on biopsy examination, compared with a group of controls with CHC and no significant steatosis or SH.

Effect of testosterone on functional recovery in a castrate male rat stroke model.

Both increased and decreased testosterone levels have been reported to correlate with poor outcome after acute ischemic stroke. The present study focused on the role of testosterone during recovery from neurological deficits in a rat focal ischemia model. Castrate male rats were subjected to behavioral tests after 90 min of middle cerebral artery occlusion (MCAO).

Reading a research article part II: parametric and nonparametric statistics.

Researchers often try to use a randomization technique in an attempt to reduce bias and ensure that treatment and control groups are as similar as possible. This article has provided an overview of how researchers might use parametric and nonparametric statistics when analyzing data and looking for differences between groups. Researchers must consider the types of data and choose the tests that are appropriate for the variable types to draw appropriate conclusions.

Effect of feeding-tube properties on residual volume measurements in tube-fed patients.

Background: The effect of feeding tube size and port configuration on the ability to measure gastric residual volume (GRV) is poorly understood. In addition, there is confusion about the need to measure GRVs during feedings into the small bowel. This study sought to (1) compare the volume of gastric contents obtained from small-diameter feeding tubes and large-diameter sump tubes concurrently positioned in the stomach and (2) describe the distribution of GRVs during small-bowel feedings.

Vitamin D insufficiency and deficiency in chronic kidney disease. A single center observational study.

Background: Kidney disease has been identified as a risk factor for vitamin D deficiency in hospitalized patients, and low levels of 25-hydroxyvitamin D have been suggested to be a risk factor for hyperparathyroidism in patients with chronic kidney disease (CKD). However, little is known about the magnitude of vitamin D deficiency in patients with CKD living in the United States.

Methods: In this regard, we examined the levels of 25(OH)D in 43 patients with CKD and serum creatinine between 1 and 5 mg/dl (calculated glomerular filtration rate 111-11 ml/min per 1.

Nonalcoholic steatohepatitis: histologic features and clinical correlations with 30 blinded biopsy specimens.

Thirty overweight patients with clinically characterized and biopsy proven nonalcoholic steatohepatitis (NASH) were enrolled in a 48-week treatment trial with rosiglitazone, a peroxisome proliferator-activator receptor (PPAR)-gamma agonist that enhances insulin sensitivity. Improvement in laboratory liver tests, insulin resistance and liver fat content were documented; blinded biopsy review demonstrated decreases in necroinflammatory activity or grade and in individual components of grade, and changes in the relationship of lobular and portal inflammation as well as in the nature of perisinusoidal fibrosis. The current study identified correlations of histological features of the protocol entry biopsy specimens with contemporaneous laboratory and imaging tests.

Improved nonalcoholic steatohepatitis after 48 weeks of treatment with the PPAR-gamma ligand rosiglitazone.

Insulin resistance (IR) commonly is associated with nonalcoholic steatohepatitis (NASH). To establish whether IR causes NASH, this study was undertaken to determine if improving IR would improve the histologic features that define NASH. Thirty adults with prior biopsy evidence of NASH were enrolled to receive rosiglitazone, 4 mg twice daily for 48 weeks.