Characterisation of children and adolescents with acute lymphoblastic leukaemia who presented without peripheral blood blasts at diagnosis.

Of 1003 children with acute lymphoblastic leukaemia (ALL), 147 (14.7%) presented without peripheral blood blasts (PBB). While absence of PBB was not independently associated with survival outcomes when compared to those with PBB, patients without PBB had distinct genetic and clinical characteristics.

Fusion-negative rhabdomyosarcoma with diffuse bony metastases and remarkable chemosensitivity.

In this report, we describe the case of an adolescent male with an unusual case of fusion-negative, paratesticular alveolar rhabdomyosarcoma who presented with spontaneous tumour lysis syndrome and diffuse bony metastases throughout the axial and appendicular skeleton with additional significant bone marrow involvement. Both spontaneous tumour lysis syndrome and diffuse bony metastases are extremely unusual for rhabdomyosarcoma. On the backbone of standard vincristine, dactinomycin and cyclophosphamide (VAC) chemotherapy, the only local control was orchiectomy at 15 weeks, with no radiation administered due to the initially diffuse nature of the disease and rapid response to chemotherapy.

The two-hit hypothesis in practice: Monozygotic twins with simultaneous hyperdiploid acute lymphoblastic leukemia.

Approximately 25% of B-cell acute lymphoblastic leukemia (B-ALL) cases are defined by hyperdiploidy, with RAS mutations occurring in 30% of hyperdiploid B-ALL patients. It is believed that hyperdiploidy is an in utero event with RAS mutations occurring postnatally, but clinical evidence of this is based on relatively few patients. We present a case of monozygotic, monochorionic twins who developed concordant hyperdiploid B-ALL with identical chromosomal gains but different RAS mutations, adding further evidence that hyperdiploidy is occurring prenatally, with RAS mutations developing postnatally.

A clinician's guide to HLA matching in allogeneic hematopoietic stem cell transplant.

Human leukocyte antigen (HLA) matching is an essential component of allogeneic hematopoietic stem cell transplant (HSCT). However, for some clinicians the biology underpinning HLA structure and function may be but a distant memory from lectures many years past, and, understanding the complexities of HLA matching can be challenging for clinicians new to the field, particularly as there have been several important advances in the field this past decade. In this review, we provide an up to date resource to educate and remind clinicians of: 1) Why HLA matching matters, including reviewing the role HLA molecules play in the adaptive immune system and the consequences of HLA mismatch.

Preventing cardiovascular disease: Participant perspectives of the FAITH! Program.

Striking cardiovascular health disparities exist among African-Americans in Minnesota compared to Whites; however, community-based interventions to address cardiovascular disease risk are lacking. This study explored participant perceptions of a culturally tailored, cardiovascular disease prevention program developed using a community-based participatory research process. Research participation perceptions, program benefits, and program satisfaction/acceptability were analyzed using a mixed-methods approach.

Intimate Partner Violence Prevention Programs in North Carolina.

One in 4 women will experience intimate partner violence in her lifetime. The goal of primary intimate partner violence prevention programs is to stop the violence before it begins. Secondary prevention programs identify violence that is occurring and intervene as soon as possible to prevent the problem from progressing.

A comparison of central lines in pediatric oncology patients: Early removal and patient centered outcomes.

Background: While there is increasing evidence supporting the choice of subcutaneous ports (SPs) over external venous catheters (EVCs) in pediatric oncology patients, prior conflicting studies exist and little data have been gathered as to which type of central line is preferred from the patient/family perspective.

Procedure: We performed a single institution, 10 years, retrospective analysis of central lines in pediatric oncology patients (n = 878) to evaluate unplanned early removal and cause of removal while simultaneously obtaining a cross sectional survey of 143 of the primary caretakers/parents of these patients to evaluate their overall satisfaction with the line.

Results: EVCs have significantly higher odds of unplanned early removal in comparison to SPs (6.

A review of narrative pedagogy strategies to transform traditional nursing education.

Traditional nursing pedagogies using teacher-centered learning approaches have produced efficient, knowledgeable nursing graduates for many years. However, 21st century learners will require and demand new educational approaches. The information age of computers has challenged all facets of education to keep pace.

Design and evaluation of a sterile compounding facility.

The design and evaluation of a sterile compounding center for a large community teaching hospital are described. The new sterile products area was redesigned to improve efficiency by minimizing staff travel and to incorporate recommendations of the ASHP Technical Assistance Bulletin on Quality Assurance for Pharmacy-prepared Sterile Products. The design approach combined strategic planning with master facilities planning.

Sea anemone neuromuscular responses in anaerobic conditions.

The sea anemone Bunodosoma cavernata survives anoxic conditions for as long as 6 weeks. Whether or not oxygen is present, its neuromuscular responses are the same and the pulses of its nerve net have the same threshold size and shape. Bunodosoma cavernata buried in the sand during a low tide are exposed to anoxic conditions.