"Irritable Hip": Diagnosis in the Emergency Department. A Descriptive Study Over One Year.

Background A 'limping child' commonly presents to the emergency department (ED), often without a history of trauma. It is important that serious underlying pathology is ruled out before a diagnosis of benign irritable hip (IH). The aetiology of IH is not well understood and there may be geographical and seasonal variation.

A seasonal switch in histone deacetylase gene expression in the hypothalamus and their capacity to modulate nuclear signaling pathways.

Seasonal animals undergo changes in physiology and behavior between summer and winter conditions. These changes are in part driven by a switch in a series of hypothalamic genes under transcriptional control by hormones and, of recent interest, inflammatory factors. Crucial to the control of transcription are histone deacetylases (HDACs), generally acting to repress transcription by local histone modification.

Levonorgestrel release rates over 5 years with the Liletta® 52-mg intrauterine system.

Objective: To understand the potential duration of action for Liletta®, we conducted this study to estimate levonorgestrel (LNG) release rates over approximately 5½years of product use.

Methods: Clinical sites in the U.S.

Angiogenic imbalances: the obstetric perspective.

Clinical and experimental evidence indicates that angiogenic imbalances may participate in the mechanisms of disease of several pregnancy complications, some of which may be life threatening. This article reviews current evidence in support of this view and the possibility that the fetus may play a central role in these imbalances; it also reviews recent experimental observations that modulation of angiogenic imbalances during pregnancy may have prophylactic and/or therapeutic value.

Insights into angiogenic imbalances during pregnancy.

Background: An excess of either angiogenic or antiangiogenic factors may participate in the pathophysiology of life-threatening pregnancy complications.

Cases: We describe two patients with severe early onset preeclampsia associated with partial mole or sacrococcygeal teratoma who had an excess of circulating concentrations of the antiangiogenic factors soluble vascular endothelial growth factor receptor-1 and soluble endoglin. In contrast, a patient with severe ovarian hyperstimulation syndrome at 5 weeks of gestation had an excess of circulating free vascular endothelial growth factor, a key angiogenic factor.

Implementing a surgical skills training program.

Significant change is underway in surgical training programs. Many educators believe that an outcomes-based approach to surgical education best addresses the need for greater public accountability and patient safety in surgical education. To achieve this end, surgical educators need to understand the basic principles of curriculum design and demonstrate a willingness to apply these educational methods within their training programs.