Diagnosis of Adrenocortical Carcinoma with Hypercortisolism in a Patient Presenting with Hypokalemic Metabolic Alkalosis.

Adrenocortical carcinoma (ACC) is a rare malignancy with an estimated annual incidence of 0.7-2 cases per million. Most patients present with steroid hormone excess or abdominal mass effects, but 15% of patients with ACC are diagnosed incidentally.

Epigenetic chromatin conformation changes in peripheral blood can detect thyroid cancer.

Background: Fine needle aspiration has been the traditional method for diagnosing thyroid cancer. Epigenetic chromatin conformation changes offer an alternative method of diagnosing cancer. The purpose of this study is to evaluate an EpiSwitch assay of epigenetic markers that can be used to diagnose thyroid cancer in blood samples.

Long-term Outcomes After Pediatric Free Flap Reconstruction.

Introduction: Whereas free tissue transfer has evolved to minimize morbidity in adults, less is known about outcomes after free flaps in children. This study sought to assess short- and long-term outcomes after microvascular reconstruction in the pediatric population.

Methods: Short- and long-term outcomes of free tissue transfer were assessed using chart-review and quality-of-life surveys.

A Case of Factitious Hyperglycemia in a Patient on Intravenous Ascorbic Acid.

Finger stick blood glucose meters are widely used in outpatient and inpatient settings. However, various factors can affect accuracy of readings from these meters. Here we present a patient who had spurious glucose elevation on these meters while being on intravenous ascorbic acid.

Antineutrophilic Cytoplasmic Antibody Positive Vasculitis Associated with Methimazole Use.

ANCA-associated vasculitis (AAV) is a rare and potentially life threatening complication associated with antithyroid drug use. It is more commonly reported with propylthiouracil, with fewer cases reported with methimazole use. We present the case of a 55-year-old man with toxic multinodular goiter which was treated with methimazole for 6 months.

R-Ras is required for murine dendritic cell maturation and CD4+ T-cell priming.

R-Ras is a member of the RAS superfamily of small GTP-binding proteins. The physiologic function of R-Ras has not been fully elucidated. We found that R-Ras is expressed by lymphoid and nonlymphoid tissues and drastically up-regulated when bone marrow progenitors are induced to differentiate into dendritic cells (DCs).

The neurosurvival factor Humanin inhibits beta-cell apoptosis via signal transducer and activator of transcription 3 activation and delays and ameliorates diabetes in nonobese diabetic mice.

Pancreatic beta-cell apoptosis is important in the pathogenesis and potential treatment of type 1 diabetes mellitus. We investigated whether Humanin, a recently described survival factor for neurons, could improve the survival of beta-cells and delay or treat diabetes in the nonobese diabetic (NOD) model. Humanin reduced apoptosis induced by serum starvation in NIT-1 cells and decreased apoptosis induced by cytokine treatment.

Atypical pituitary adenoma with malignant features.

Pituitary carcinoma is characterized by the presence of systemic or central nervous system metastases rather than malignant histological features, making it an anomaly amongst carcinomas. In contrast, aggressive or atypical pituitary adenomas often have a relatively bland histological appearance despite their malignant growth patterns. We now report a case of a 67-years-old male with a giant pituitary tumor with overt pathologic and phenotypic features of malignancy, but the absence of metastases, that evolved from a benign non-functioning gonadotroph macroadenoma treated 10 years earlier.

National emergency response programs for dental health care professionals.

Background: Members of the established public health systems and medical community must understand that, in medical surge events, members of the dental profession and other non-traditional disaster health care personnel are an additional source of assistance in response activities.

Methods: The authors relied on hands-on experience, expert consultations, literature reviews and Web searches to identify disaster response training programs appropriate for members of the dental profession and other health care personnel.

Results: The authors identified multiple governmental and professional disaster training programs.

Proposed educational objectives for hospital-based dentists during catastrophic events and disaster response.

The purpose of this project was to define education and training requirements for hospital-based dentists to efficiently and meaningfully participate in a hospital disaster response. Eight dental faculty with hospital-based training and/or military command and CBRNE (chemical, biological, radiological, nuclear, and explosive) expertise were recruited as an expert panel. A consensus set of recommended educational objectives for hospital-based dentists was established using the following process: 1) identify assumptions supported by all expert panelists, 2) determine current advanced dental educational training requirements, and 3) conduct additional training and literature review by various panelists and discussions with other content and systems experts.

Insulin-like growth factor I (IGF-I) measurements in growth hormone (GH) therapy of idiopathic short stature (ISS).

Growth hormone (GH) therapy has evolved rapidly over the past decade. Ongoing research has demonstrated a clear role for therapeutic GH in a wide spectrum of pediatric disorders involving both poor growth and abnormal body composition. Although guidelines for GH dosing are not fully established, a series of key studies has delineated the range of dosages that are useful in the treatment of children with growth disorders.

The role of insulin-like growth factor I monitoring in growth hormone-treated children.

Growth hormone (GH) therapy has evolved rapidly over the past decade, and continuing research has established a clear role for therapeutic GH in a wide spectrum of disorders, including idiopathic GH deficiency (childhood- and adult-onset), Turner syndrome, Prader-Willi syndrome, small-for-gestational age children with failure of catch-up growth, AIDS-related catabolism, children with chronic renal failure, and idiopathic short stature. Although GH is used therapeutically in a wide variety of conditions, actual guidelines regarding the logistics of GH dosing continue to evolve, with data emerging regarding efficacy and safety. This review proposes a role for insulin-like growth factor I measurement in optimizing GH dosing.