Detection of micrometastases by flow cytometry in sentinel lymph nodes from patients with renal tumours.

Background: Stage is an important prognostic factor in renal tumours and dissemination to regional lymph nodes is associated with poor outcomes. Lymph nodes are routinely assessed by immunohistochemistry and microscopic evaluation, a time-consuming process where micrometastases might go undiagnosed. We evaluate an alternative method for detecting metastatic cells in sentinel nodes (SNs) by flow cytometry.

Utility of the T2 Mood Tracker mobile application among army warrior transition unit service members.

Many military personnel returning from deployment experience increases in psychological symptoms, including post-traumatic stress disorder (PTSD), depression, and mood changes. Patient health diaries are commonly used for self-reporting over time away from the clinic. "T2 Mood Tracker" is an application ("app") for smartphones and other mobile devices that enables users to rate their moods, to self-monitor across time, and to report their emotional experiences to health providers.

Incentives to create and sustain healthy behaviors: technology solutions and research needs.

Health-related technology, its relevance, and its availability are rapidly evolving. Technology offers great potential to minimize and/or mitigate barriers associated with achieving optimal health, performance, and readiness. In support of the U.

Leveraging technology: creating and sustaining changes for health.

Objective: The rapid growth and evolution of health-related technology capabilities are driving an established presence in the marketplace and are opening up tremendous potential to minimize and/or mitigate barriers associated with achieving optimal health, performance, and readiness. This article summarizes technology-based strategies that promote healthy habits related to physical activity, nutrition, and sleep.

Materials And Methods: The Telemedicine and Advanced Technology Research Center convened a workshop titled "Leveraging Technology: Creating & Sustaining Changes for Health" (May 29-30, 2013, Fort Detrick, MD).

Soldiers' preferences for follow-up communications with behavioral health providers.

Background: Recent research has shown value in utilizing follow-up communication with patients to improve long-term outcomes of behavioral health, particularly among the most high-risk patients.

Materials And Methods: We surveyed 38 active-duty Army personnel who were attached as behavioral health patients to a Warrior Transition Unit at a large military installation to ask their preferences for follow-up communication to behavioral healthcare.

Results: Strongest preferences for contact were (1) personal cellphone, (2) text message, and (3) e-mail to non-work account.

Key enablers to facilitate healthy behavior change: workshop summary.

The increases in preventable chronic diseases and the rising costs of health care are unsustainable. The US Army Surgeon General's vision to transition from a health care system to a system of health requires the identification of key health enablers to facilitate the adoption of healthy behaviors. In support of this vision, the US Army Telemedicine and Advanced Technology Research Center hosted a workshop in April 2013 titled "Incentives to Create and Sustain Change for Health.

Conservative management of placenta accreta: hysteroscopic resection of retained tissues.

Study Objective: To evaluate the feasibility and the results of hysteroscopic removal of tissue after conservative management of retained placenta accreta.

Design: Retrospective study (Canadian Task Force classification II-3).

Setting: Tertiary care university hospital.

The effects of chemotherapeutic drugs on human monocyte-derived dendritic cell differentiation and antigen presentation.

Recent studies indicate that chemotherapeutic agents may increase the anti-tumoral immune response. Based on the pivotal role of dendritic cells (DCs) in host tumour-specific immune responses, we investigated the effect of commonly used chemotherapeutic drugs dexamethasone, doxorubicin, cisplatin and irinotecan and glucocorticoids on monocyte-derived DCs (moDCs). Dexamethasone displayed the strongest inhibitory effect on DC differentiation.

Evaluation of the two intraoperative examination methods for sentinel lymph node assessment: a multicentric and retrospective study on more than 2,000 nodes.

Background: Intraoperative frozen section (FS) and imprint cytology (IC) are currently used to detect sentinel lymph node (SLN) metastasis, allowing for complete dissection when necessary.

Materials And Methods: A 2-year retrospective chart review was performed for patients who underwent SLN procedure in five French hospitals. The FS and IC results were compared to the definitive histology in order to calculate the sensitivity, specificity and false-negative rate.

Long lasting local and systemic inflammation after cerebral hypoxic ischemia in newborn mice.

Background: Hypoxic ischemia (HI) is an important cause of neonatal brain injury and subsequent inflammation affects neurological outcome. In this study we performed investigations of systemic and local activation states of inflammatory cells from innate and adaptive immunity at different time points after neonatal HI brain injury in mice.

Methodology/principal Findings: We developed a multiplex flow cytometry based method combined with immunohistochemistry to investigate cellular immune responses in the brain 24 h to 7 months after HI brain injury.

Effectiveness of the electronic medical record in improving the management of hypertension.

Clinical studies suggest that hypertension is often undiagnosed, undertreated, and poorly controlled. In 1997, the authors developed a comprehensive electronic medical record that interfaces with physicians during each outpatient visit and provides real-time feedback about patient care management, including the management of hypertension. The purpose of this study was to determine whether this interactive electronic medical record results in better detection and control of hypertension.

Cardiovascular risk management in clinical practice: the Midwest Heart Specialists experience.

Evaluating cardiovascular risk and managing hypercholesterolemia are essential components in the identification and treatment of coronary artery disease. A collaborative care-based lipid clinic is a beneficial part of an integrated prevention program and can result in improved lipid management. Advances in technology now enable use of the electronic medical record in combination with a virtual lipid clinic to promote superior cholesterol management.

Effectiveness of the electronic medical record in cholesterol management in patients with coronary artery disease (Virtual Lipid Clinic).

This study demonstrates that the Virtual Lipid Clinic, an electronic medical record with computer-assisted cholesterol management, is associated with improved lipid management in patients with coronary artery disease. In comparison to traditional documentation methods with "pen and paper" charts, outpatient visits utilizing the electronic medical record were associated with a twofold increase in low-density lipoprotein (LDL) documentation, a threefold increase in achieving LDL goal, and a 30% increase in the use of lipid-lowering drugs.

Recruiting and retention tips and techniques.

By incorporating today's technology and common sense into their recruiting and retention efforts, businesses will update age-old practices and reduce unnecessary costs.

Effect of platelet activation on coronary collateral blood flow.

Background: The platelet products thromboxane A2 and serotonin have been shown to cause constriction of well-developed coronary collateral vessels. This study was performed to determine whether intravascular platelet activation produced with platelet activating factor (PAF) can cause a decrease in coronary collateral blood flow.

Methods And Results: Collateral vessel growth was induced by embolization of a hollow stainless steel plug into the left anterior descending coronary artery (LAD) of adult dogs.

Nitric oxide inhibition impairs blood flow during exercise in hearts with a collateral-dependent myocardial region.

Objectives: We sought to determine the importance of nitric oxide (NO) production in maintaining coronary blood flow during exercise in hearts with collateral-dependent myocardium.

Background: Coronary collateral vessels demonstrate endothelium-mediated NO-dependent vasodilation in response to agonists such as acetylcholine. However, the contribution of endogenous NO production to maintaining vasodilation of coronary collateral vessels during exercise has not been previously studied.

Primary angioplasty reduces risk of myocardial rupture compared to thrombolysis for acute myocardial infarction.

Although the mechanical complications of acute ventricular septal defect and acute mitral regurgitation are uncommon after acute myocardial infarction, these complications are associated with an extremely high morbidity and mortality. We hypothesized that the administration of thrombolytic drugs may result in hemorrhagic infarction as well as the potential for incomplete revascularization and thus may lead to an increased incidence of mechanical complications compared to primary angioplasty. Accordingly, we reviewed the data of the most contemporary thrombolytic and primary angioplasty trials and compared the incidence of mechanical complications among 36,303 patients treated with thrombolytics reported in the GUSTO trial to the incidence of mechanical complications among 1,295 patients treated with primary angioplasty obtained from the PAMI-1 and PAMI-2 trials.

Treatment of no-reflow in degenerated saphenous vein graft interventions: comparison of intracoronary verapamil and nitroglycerin.

No-flow has been reported after 10-15% of percutaneous interventions on degenerated saphenous vein grafts. In this prospective study of 36 degenerated saphenous vein graft lesions (32 patients), no-flow (TIMI flow < 3 in the absence of a significant lesion or dissection) occurred in 15/36 (42%) lesions. A total of 32 episodes of no-flow occurred after angioscopy (n = 14), extraction atherectomy (n = 10), balloon angioplasty (n = 2) or stent implantation (n = 6).