An integrated practice unit tool for the Military Health System.

Objectives: To develop a tool for measuring performance of a coordinated care center against the criteria of an integrated practice unit (IPU) and test it against an established care center in the Military Health System (MHS).

Study Design: Characteristics of 4 patient care coordination models were sorted using the 11 criteria of the IPU.

Methods: Subject matter experts evaluated characteristics and criteria for inclusion or exclusion based on the needs of specialty care in the MHS.

Splenogonadal fusion: aiding detection and avoiding radical orchidectomy.

Splenogonadal fusion is a rare benign congenital anomaly in which there is an abnormal connection between the gonad and the spleen. It was first described over 100 years ago with limited reports in the literature since then. Its similarity in presentation to testicular neoplasia poses a significant challenge in diagnosis and management, often resulting in radical orchidectomy.

Immunogenetics and human papillomavirus (HPV) in male genital lichen sclerosus (MGLSc).

The pathogenesis of male genital lichen sclerosus (MGLSc) is controversial. Incriminated factors include infection with human papillomavirus (HPV) and autoimmunity (e.g.

Penile lymphoedema: approach to investigation and management.

Background: Penile lymphoedema (with and without cellulitis) is a rare, often chronic, clinically heterogeneous entity with an uncertain pathogenesis and an important differential diagnosis. It creates significant physical and psychosexual morbidity, and presents considerable therapeutic challenges. The existing literature is limited.

Male genital lichen sclerosus in recipients of bone marrow transplants.

We describe two patients who received haematopoietic stem cell marrow transplantation, and developed male genital lichen sclerosus (MGLSc), one of whom also had squamous carcinoma in situ (Bowen disease). MGLSc has previously been associated with graft-versus-host disease. Various aetiological factors for LSc have been proposed, including a role for chronic occluded epithelial exposure to urine.

Parental Iraq/Afghanistan deployment and child psychiatric hospitalization in the U.S. military.

Objective: Members of the US armed forces have been heavily deployed in support of wars in Afghanistan and Iraq. This study examined the affect of a parent's deployment to war on the rate of psychiatric hospitalization among their children.

Methods: This was a retrospective cohort study.

The patient-centered medical home: a case study in transforming the military health system.

This case study describes the Military Health System's (MHS) patient-centered medical home (PCMH) initiative and how it is being delivered across the MHS by the Army, Navy, and Air Force. The MHS, an integrated delivery model that includes both military treatment facilities and civilian providers and health care institutions, is transforming its primary care platforms from the traditional acute, episodic system to the PCMH model of care to maximize patient experience, satisfaction, health care quality, and readiness and to control cost growth. Preliminary performance measures are analyzed to assess the impact of PCMH implementation on the core primary care processes of the MHS.

Gene expression profiling in male genital lichen sclerosus.

Male genital lichen sclerosus (MGLSc) has a bimodal distribution in boys and men. It is associated with squamous cell carcinoma (SCC). The pathogenesis of MGLSc is unknown.

Clinical parameters in male genital lichen sclerosus: a case series of 329 patients.

Background:   The dermatological aspects of male genital lichen sclerosus (MGLSc) have not received much prominence in the literature. Sexual morbidity appears under-appreciated, the role of histology is unclear, the relative places of topical medical treatment and circumcision are not established, the prognosis for sexual function, urinary function and penis cancer is uncertain and the pathogenesis has not been specifically studied although autoimmunity (as in women) and HPV infection have been mooted.

Objective:   To illuminate the above by analysing the clinical parameters of a large series of patients with MGLSc.

The genitourinary complications of HIV infection in men.

This article discusses infective and malignant complications of HIV affecting the genitourinary tract in men. Immunosuppression increases both the frequency of infections, and the range of organisms that may be involved. Cancers are common and presentations may be atypical.

Ureteric colic: new trends in diagnosis and treatment.

The diagnostic approach to ureteric colic has changed due to the introduction of new radiological imaging such as non-contrast CT. The role of intravenous urography, which is regarded as the gold standard for the diagnosis of ureteric colic, is being challenged by CT, which has become the first-line investigation in a number of centres. The management of ureteric colic has also changed.

Mumps orchitis.

Although the incidence of mumps orchitis has dramatically declined since the introduction of the childhood vaccination programme, a sharp increase in reported cases of both mumps and mumps orchitis has been seen recently in the UK. There are great concerns about mumps outbreaks and the associated risk of infertility; it remains an important clinical condition. Immunization is the best policy to avoid this viral disease.

Using blood urea nitrogen to predict nitrogen excretion and efficiency of nitrogen utilization in cattle, sheep, goats, horses, pigs, and rats.

The objectives of this study were to evaluate the potential for using blood urea N concentration to predict urinary N excretion rate, and to develop a mathematical model to estimate important variables of N utilization for several different species of farm animals and for rats. Treatment means (n = 251) from 41 research publications were used to develop mathematical relationships. There was a strong linear relationship between blood urea N concentration (mg/100 mL) and rate of N excretion (g x d(-1) x kg BW(-1)) for all animal species investigated.

Penile intraepithelial neoplasia: clinical spectrum and treatment of 35 cases.

Background: Penile intraepithelial neoplasia (PIN) is the term used to describe erythroplasia of Queyrat (EQ), Bowen's disease (BD) and bowenoid papulosis (BP). These conditions are distinct clinical entities and have different epidemiological and aetiological associations and prognostic implications.

Objectives: To describe the presentation and treatment of patients with PIN.