Beyond Medical Care: How Different National Models of Care Impact the Experience of Adolescent and Young Adult Cancer Patients.

Patient experience is positively associated with clinical effectiveness, quality care, and patient safety. This study examines the experience of care of adolescents and young adult (AYA) cancer patients from Australia and the United States, allowing a comparison of patient experiences in the context of different national models of cancer care delivery. Participants ( = 190) were aged 15-29 years and received cancer treatment from 2014 to 2019.

Care Experience, by Site of Care, for Adolescents and Young Adults With Cancer.

Purpose: Most of the 77,000 adolescents and young adults (AYAs) 15-39 years of age diagnosed with cancer annually in the United States are treated at community rather than academic centers. Little is known about their healthcare experience.

Methods: A cross-sectional, anonymous, online survey was conducted with a convenience sample of AYAs treated for cancer at US academic (n = 112) or community centers (n = 64).

Effectiveness of the "Mohs and Close Technique" in Increasing the Efficiency of a Mohs Micrographic Surgery.

Introduction: Mohs micrographic surgery (MMS) is successful and cost effective, but may be time consuming as patients are required to wait for final wound repair until margins are clear. We propose for selected cases the "Mohs and Close technique" (MCT), in which the defect is immediately repaired after tumor resection rather than waiting until margins are clear.

Methods: MCT was only performed on tumors that had clearly de ned borders, low risk histology, whose resulting defect after exci- sion required either a primary or partial closure, and whose repair wouldn't change to a different repair option if further stages of exci- sion were necessary.

Fms-like tyrosine kinase 3 (Flt3) ligand depletes erythroid island macrophages and blocks medullar erythropoiesis in the mouse.

The cytokines granulocyte colony-stimulating factor (G-CSF) and Flt3 ligand (Flt3-L) mobilize hematopoietic stem and progenitor cells into the peripheral blood of primates, humans, and mice. We recently reported that G-CSF administration causes a transient blockade of medullar erythropoiesis by suppressing erythroblastic island (EI) macrophages in the bone marrow. In the study described here, we investigated the effect of mobilizing doses of Flt3-L on erythropoiesis in mice in vivo.

Macrophages and regulation of erythropoiesis.

Purpose Of Review: The nature and function of macrophages at the center of erythroblastic islands is not fully understood. This review discusses novel findings on the phenotypic and molecular characterization of erythroblastic island macrophages, and their role in regulating normal and pathological erythropoiesis.

Recent Findings: The phenotype to prospectively isolate erythroblastic island macrophages from mouse bone marrow has been identified.

Mobilization with granulocyte colony-stimulating factor blocks medullar erythropoiesis by depleting F4/80(+)VCAM1(+)CD169(+)ER-HR3(+)Ly6G(+) erythroid island macrophages in the mouse.

Similarly to other tissues, the bone marrow contains subsets of resident tissue macrophages, which are essential to maintain bone formation, functional hematopoietic stem cell (HSC) niches, and erythropoiesis. Pharmacologic doses of granulocyte colony-stimulating factor (G-CSF) mobilize HSC in part by interfering with the HSC niche-supportive function of BM resident macrophages. Because bone marrow macrophages are key to both maintenance of HSC within their niche and erythropoiesis, we investigated the effect of mobilizing doses of G-CSF on erythropoiesis in mice.

Vascular niche E-selectin regulates hematopoietic stem cell dormancy, self renewal and chemoresistance.

The microenvironment, or niche, surrounding a stem cell largely governs its cellular fate. Two anatomical niches for hematopoietic stem cells (HSCs) have been reported in the bone marrow, but a distinct function for each of these niches remains unclear. Here we report a new role for the adhesion molecule E-selectin expressed exclusively by bone marrow endothelial cells in the vascular HSC niche.

Chronic epileptic encephalopathy in adult patients with bilaterally synchronous frequent and/or prolonged subclinical epileptiform discharges.

We followed four patients with infrequent convulsive seizures for four to 10 years, with periodic EEGs and neuropsychological tests. All four had bursts of frontally predominant, bilaterally synchronous 1.5-3-Hz spike or polyspike and slow-wave discharges (SWDs) that initially comprised 15% to 88% but were reduced to 5% or less of total EEG time with appropriate antiepileptic drugs.

Chronically Impaired Frontal Lobe Function from Subclinical Epileptiform Discharges.

Subclinical epileptiform discharges (SEDs) are a common occurrence on electroencephalograms (EEGs). Their potential for acutely disrupting cognitive functions has been well documented, but detailed studies of cognitive performance by patients with chronic exposure to disruptive SEDs have been lacking and scant data have been available to guide treatment decisions or to assist in predicting recovery. We identified a patient with frequent frontotemporally (FT) predominant SEDs and monitored cognitive performance over time with periodic neuropsychological testing and EEGs.