Vascular flow alteration is a dominant pattern of liver pathology in patients with orthotopic lung transplants: a retrospective observational study.

Aims: The number of orthotopic lung transplants (OLT) has skyrocketed since the 1960s, generating an ever-increasing cohort of post-OLT patients. Many challenges exist in the post-OLT timeframe, including donor graft dysfunction, infection, malignancy, and immunosuppression-related conditions. A rather elusive topic in the posttransplant setting remains the impact of the underlying disease process and donor lungs on other organ systems and the complications arising from the complex physiologic interactions.

Stage III Melanoma: A Proposed Staging Model That Outperforms the American Joint Committee on Cancer Eighth Edition Staging System.

National Comprehensive Cancer Network guidelines state that clinical stage III melanoma patients may undergo ultrasound surveillance of the nodal basin in lieu of complete lymph node dissection (CLND). This has led to an inability to accurately classify patients according to the American Joint Committee on Cancer (AJCC) eighth edition staging system because it uses the total number of positive lymph nodes from the CLND to assign a pathologic N stage. We propose a new model for clinical stage III melanoma patients that does not rely on the total number of positive lymph nodes.

Growing Medical Educators from Medical Students by Supporting Self-directing Learning Opportunities Born Out of Cadaveric Dissection.

This study focuses on a subset of medical students who participated in an anatomy dissection program and undertook an additional self-directed learning (SDL) project investigating incidental findings of cadaveric pathology. The value of SDL activity is explored as a means of enhancing medical student education, particularly its student perceived value in preparing and developing them as future medical educators. It was assessed whether the project advanced student interest in medical education by analyzing their motivations for participation.

Fecal microbiota transplant on Escherichia-Shigella gut composition and its potential role in the treatment of generalized anxiety disorder: A systematic review.

Background: The gut-brain-axis has a role in mental health disorders. In people with generalized anxiety disorder, GAD, normal flora Escherichia-Shigella, are significantly elevated. Fecal microbiota transplant, FMT, has been used to alter the gut composition in unhealthy individuals.

Application of immunohistochemical studies in diagnosing emerging superficial mesenchymal neoplasms.

Molecular diagnostics, with the subsequent development of novel immunohistochemical markers, continues to advance and expand the field of soft tissue pathology. As such, the ever-evolving molecular diagnostic landscape will continue to shape and refine our understanding and classification of neoplasms. This article reviews the current literature on various tumors of mesenchymal origin, including fibroblastic/fibrohistiocytic, adipocytic, vascular, and tumors of uncertain origin.

Game-Day Pitch and Throw Count Feasibility Using a Single Sensor to Quantify Workload in Youth Baseball Players.

Background: Pitch count recommendations are used to reduce injury risk in youth baseball pitchers and are based chiefly on expert opinion, with limited scientific support. Furthermore, they only account for pitches thrown against a hitter and do not include the total number of throws on the day a player pitched. Currently, counts are recorded manually.

Cutaneous inflammatory myofibroblastic tumor with CARS-ALK fusion: Case report and literature review.

Cutaneous inflammatory myofibroblastic tumors (IMT) constitute a rare entity, generating a diagnostic pitfall when diagnosing spindle cell proliferation within the dermis. Raising awareness of this tumor among dermatopathologists remains vital in differentiating it from common cutaneous tumors such as fibrous histiocytoma, atypical fibroxanthoma, melanoma, poorly differentiated carcinoma, and other more aggressive tumors. Accurate diagnosis of IMT aids in ensuring appropriate management and follow-up for patients while preventing unnecessary harm and overtreatment.

Hidden realities of electrical injuries.

The clinical spectrum of electrical injury ranges from the absence of any external physical signs to severe and life-threatening trauma. This article discusses the fundamental concepts and misunderstandings surrounding electrical injuries and the best practices for evaluation and treatment.

Cutaneous Vascular Neoplasms of Uncertain Biological Behavior.

Neoplasms of uncertain biological behavior present physicians with a genuine conundrum in practice. Cutaneous vascular neoplasms within this category are exceedingly rare, possessing significant gaps and uncertainty in many facets of clinical practice. Firstly, lesions were selected for review based on their categorization as indeterminate behavior, indicating the potential for local recurrence and rarely metastasize.

Five New Cases of Megacystis-Microcolon-Intestinal Hypoperistalsis Syndrome (MMIHS), with One Case Showing a Novel Mutation.

Background: Megacystis-microcolon-intestinal hypoperistalsis syndrome (MMIHS) is a lethal congenital disorder characterized by a large, non-obstructed bladder, microcolon, and lack of proper peristalsis.

Materials And Methods: Five cases of MMIHS were identified, confirmed histologically and were predominantly female (F:M, 4:1). DNA sequencing was also performed.

Reported Technical Aspects of Type II SLAP Lesion Repairs in Athletes.

Purpose: To systematically review the available literature to further describe and report the available data on SLAP repair techniques and the association with outcomes.

Methods: A systematic review of literature was performed on manuscripts describing type II SLAP repairs in athletes. Selection criteria included studies reporting exclusively type II SLAP tears without concomitant pathology, minimum 2-year postoperative follow-up, use of anchor fixation, and return to previous level of play data available.

Quantifying Throw Counts and Intensities Throughout a Season in Youth Baseball Players: A Pilot Study.

Overuse injuries in youth baseball players due to throwing are at an all-time high. Traditional methods of tracking player throwing load only count in-game pitches and therefore leave many throws unaccounted for. Miniature wearable inertial sensors can be used to capture motion data outside of the lab in a field setting.

Multimodal anesthesia with the addition of methadone is superior to epidural analgesia: A retrospective comparison of intraoperative anesthetic techniques and pain management for 124 pediatric patients undergoing the Nuss procedure.

Background: The Nuss procedure corrects pectus excavatum by forceful displacement of the sternum with metal bars. Optimal pain management remains a challenge. Mutimodal anesthesia alleviates pain through blockade of multiple nociceptive and inflammatory pain receptors.

Evaluation of a breast and colon cancer survivorship program.

This article describes a cancer survivorship program that addressed quality of life (QOL) changes related to chemotherapy. The program focused on adult breast and colon cancer survivors at a community oncology practice in the southeastern United States, and consisted of an educational visit designed to identify and address QOL changes that occurred as a result of chemotherapy. The QOL of Cancer Survivors (QOL-CS) survey administered before and after the visit analyzed QOL metrics, which were combined with program evaluation data to assess physical, psychosocial, social, and spiritual well-being changes that may have occurred as a result of program participation.

Racial/Ethnic Differences in Breastfeeding Initiation and Duration Among Low-income, Inner-city Mothers.

OBJECTIVES: Despite the promotion of breastfeeding as the "ideal" infant feeding method by health experts, breastfeeding continues to be less common among low-income and minority mothers than among other women. This paper investigates how maternal socio-demographic and infant characteristics, household environment, and health behaviors are related to breastfeeding initiation and duration among low-income, inner-city mothers, with a specific focus on differences in breastfeeding behavior by race/ethnicity and nativity status. METHODS: Using data from a community-based, longitudinal study of women in Philadelphia, PA (N=1,140), we estimate logistic regression and Cox proportional hazard models to predict breastfeeding initiation and duration.

Evaluation of semen detection in vaginal secretions: comparison of four methods.

Problem: To determine the best method to detect semen in human vaginal secretions.

Method Of Study: Vaginal secretions from 302 pregnant women at mean 11.8 weeks' gestation were analyzed.

Continuous source of care among young underserved children: associated characteristics and use of recommended parenting practices.

Objectives: The aim of this study was to 1) assess sociodemographic and health characteristics associated with having a continuous source of care (CSOC) among young children and 2) determine the relationship between having a CSOC and use of parenting practices.

Methods: We conducted a prospective, community-based survey of women receiving prenatal care at Philadelphia community health centers. We conducted surveys at the first prenatal visit and at a mean age +/- standard deviation of 3 +/-1, 11 +/- 1, and 24 +/- 2 months postpartum, obtaining information on sociodemographic and health characteristics, child's health care provider, and 6 parenting practices.

Relative performance of three methods for diagnosing bacterial vaginosis during pregnancy.

Objective: This study measures the relative performance of three methods for diagnosing bacterial vaginosis (BV) during pregnancy and assesses the implications of measurement for clinical practice and surveillance.

Methods: A sample (n = 1,780) of English or Spanish speaking women, with a singleton intrauterine pregnancy and receiving prenatal care at a consortium of public health centers in Philadelphia were consecutively enrolled. Gram stain, clinician's diagnosis, and a commercial test were the three diagnostic methods used to assess BV.

Literacy and depressive symptomatology among pregnant Latinas with limited English proficiency.

Latina immigrants with limited English proficiency face significant obstacles to using maternal health services. Using a measure of reading skill and problem solving in the health context (the Spanish version of the Test of Functional Health Literacy in Adults), the authors assessed the association between literacy in Spanish and depressive symptomatology among 99 Latinas receiving prenatal care who had limited English proficiency. After adjusting for potential confounds, women with inadequate literacy were found to be more than twice as likely to have Center for Epidemiological Studies-Depression Scale scores greater than 16 (the standard clinical threshold) than women with adequate literacy.

The power of professional nursing practice--an essential element of patient and family centered care.

Understanding power and learning how to use it is critical if nurses' efforts to shape their practice and work environments are to be successful. As part of our efforts to develop a Fast-Track BSN-to-PhD nursing program, we met with nurse leaders from six organizations to explore what power means, how nurses acquire it, and how they demonstrate it in their practice. Through these discussions, we identified eight characteristics of powerful nursing practice that, together, form a framework that can guide nurses' efforts to develop a powerful practice and shape the health care delivery settings and academic institutions in which they work.

Variation in vaginal immune parameters and microbial hydrolytic enzymes in bacterial vaginosis positive pregnant women with and without Mobiluncus species.

Objective: This study was undertaken to assess if levels of interleukin-1beta (IL-1beta), IL-8, sialidase, prolidase and immunoglobulin A against Gardenerella vaginalis hemolysin (anti-Gvh IgA) in vaginal secretions differ between BV+ women with (M+) and without (M-) Mobiluncus spp.

Study Design: Vaginal secretions were obtained from 265 women at their first prenatal care visit and assessed for all study parameters. Gram stain evaluation using Nugent criteria was performed and coinfection with sexually transmitted infections determined.

Unintended rapid repeat pregnancy and low education status: any role for depression and contraceptive use?

Objective: The purpose of this study was to assess the contribution of depressive symptoms and poor contraceptive use early in the first postpartum year to the risk of unintended repeat pregnancy at the end of that year among adults with low educational status (< 12th grade or equivalence).

Study Design: This was a prospective observational cohort study of 643 sexually active, low-income, inner-city adult women (age > or = 19) who enrolled prenatally (14.7 +/- 6.

Does prenatal care at community-based health centers result in infant primary care at these sites?

Objectives: To describe where women receiving prenatal care (PNC) at community-based health centers (CBHCs) go for infant primary care, and to assess reasons for and factors associated with leaving CBHCs and using other practices for infant care.

Methods: A prospective survey of women receiving PNC at CBHCs from February 2000 to February 2002 was conducted. In-person, prepartum, and postpartum surveys included questions about sociodemographic and health characteristics, and health services use.