Perceived Racial Discrimination and Self-Esteem in African American Youth: Racial Socialization as a Protective Factor.

Racial socialization was examined as a protective factor that might buffer African American youth from the negative effects of perceived racial discrimination. Two types of racial socialization were examined: messages about race pride and preparation for bias. One hundred twenty-eight eighth-grade African American students participated in the study.

Peripheral blood grafts from unrelated donors are associated with increased acute and chronic graft-versus-host disease without improved survival.

Few studies have tested the benefits of using peripheral blood stem cell (PBSC) grafts versus bone marrow (BM) grafts for unrelated donor transplantation. Yet there has been a substantial change in clinical practice, with increasing numbers of adults receiving unrelated donor PBSC grafts. We compared outcomes after 331 PBSC and 586 BM transplants in adults with leukemia and myelodysplastic syndrome (MDS) who were followed for a median of 3 years after transplantation.

Impact of obesity on outcomes in the management of localized adenocarcinoma of the esophagus and esophagogastric junction.

Objective: Obesity trends in the Western world parallel the increased incidence of adenocarcinoma of the esophagus and esophagogastric junction. The implications of obesity on standard outcomes in the management of localized adenocarcinoma, particularly operative risks, have not been systematically addressed.

Methods: This retrospective analysis of prospectively collected data included 150 consecutive patients (36 [24%] obese [body mass index > 30] and 114 nonobese), of whom 43 were normal weight (body mass index 20-25) and 71 were overweight (body mass index 25-30).

Short-term nutritional implications of total gastrectomy for malignancy, and the impact of parenteral nutritional support.

Aims: To report on peri-operative nutritional status in gastric cancer patients undergoing total gastrectomy, and to examine the role of post-operative parenteral nutrition.

Methods: Retrospective study of prospectively collected data on 90 consecutive patients who underwent total gastrectomy for malignancy.

Results: At diagnosis 46% of patients reported clinically severe weight loss, and dietary intake was inadequate in 72% of patients.

Effect of pacifier use on mandibular position in preterm infants.

Aim: It has been hypothesized that the association of pacifier use with reduced risk of sudden infant death is mediated by forward movement of the mandible and tongue that helps open the upper airway. Our aim was to examine whether the mandible is moved forward when an infant is sucking on a pacifier, and if so, whether the mandible remains advanced after the pacifier is removed.

Methods: In sixty clinically stable premature infants (corrected gestation age 36.

Association of hypoalbuminemia on the first postoperative day and complications following esophagectomy.

Objective: Changes in serum albumin may reflect systemic immunoinflammation and hypermetabolism in response to insults such as trauma and sepsis. Esophagectomy is associated with a major metabolic stress, and the aim of this study was to determine if the absolute albumin level on the first postoperative day was of value in predicting in-hospital complications.

Methods: A retrospective study of 200 patients undergoing esophagectomy for malignant disease at St.

Management of gastrointestinal stromal tumours: a single-centre experience.

Background: Gastrointestinal stromal tumours (GISTs), although rare, are increasingly recognized, characterized immuno-phenotypically in most cases by a mutation in C-Kit. The advent of imatinib, a tyrosine kinase inhibitor, has presented a novel and effective therapy in advanced disease. The aim of this study was to present the experience and outcomes of a single centre.

Late intraocular pressure rise following intravitreal triamcinolone injection.

Most ophthalmologists are aware of the risk of elevated intraocular pressure developing 1 or 2 months after an intravitreal injection of triamcinolone. However, the two cases reported here demonstrate that such a rise can occur significantly later than this. All patients who have had intravitreal steroid injection should therefore have prolonged intraocular pressure monitoring.

Comparison of two fractionation regimens in the multimodal therapy of cancer of the esophagus.

Multimodal therapy is increasingly utilized in the management of esophageal cancer. The optimum dose and fraction is unclear, and this retrospective analysis compared two radiation regimens in multimodality regimens where the chemotherapy arm and the type and magnitude of surgery was constant. Ninety-three consecutive patients with squamous cell carcinoma or adenocarcinoma of the esophagus were reviewed.

Long-term outcomes following neoadjuvant chemoradiotherapy for esophageal cancer.

Objective: We present and analyze long-term outcomes following multimodal therapy for esophageal cancer, in particular the relative impact of histomorphologic tumor regression and nodal status.

Patients And Methods: A total of 243 patients [(adenocarcinoma (n = 170) and squamous cell carcinoma (n = 73)] treated with neoadjuvant chemoradiotherapy in the period 1990 to 2004 were followed prospectively with a median follow-up of 60 months. Pathologic stage and tumor regression grade (TRG) were documented, the site of first failure was recorded, and Kaplan-Meier survival curves were plotted.

Impact of solitary involved lymph node on outcome in localized cancer of the esophagus and esophagogastric junction.

Node-positive esophageal cancer is associated with a dismal prognosis. The impact of a solitary involved node, however, is unclear, and this study examined the implications of a solitary node compared with greater nodal involvement and node-negative disease. The clinical and pathologic details of 604 patients were entered prospectively into a database from1993 and 2005.

A randomized, placebo-controlled trial of oral beclomethasone dipropionate as a prednisone-sparing therapy for gastrointestinal graft-versus-host disease.

We tested the hypothesis that oral beclomethasone dipropionate (BDP) would control gastrointestinal graft-versus-host disease (GVHD) in patients with anorexia, vomiting, and diarrhea. Patients were randomized to prednisone for 10 days and either oral BDP 8 mg/d (n = 62) or placebo (n = 67) tablets for 50 days. At study day 10, prednisone was rapidly tapered while continuing study drug.

Neoadjuvant chemoradiation may increase the risk of respiratory complications and sepsis after transthoracic esophagectomy.

Background: The role of neoadjuvant chemotherapy and radiation therapy before resection in esophageal cancer remains controversial. Operative risks may be increased, but this has not been systematically addressed in published trials or reports.

Methods: This was a prospective, nonrandomized, restricted cohort design of patients (n = 200) from 1997 to 2003 with resectable cancer of the esophagus or esophagogastric junction.

Clinicopathologic factors predicting complete pathological response to neoadjuvant chemoradiotherapy in esophageal cancer.

Multimodal therapy comprising neoadjuvant chemotherapy and radiation therapy prior to radical resection is increasingly utilized in gastroesophageal cancer. The achievement of a complete pathological response (pCR) or a major response is associated with an improved survival. However, up to 70% of patients show an incomplete or no response to the neoadjuvant regimen, and the identification of factors which predict a response would be of considerable clinical benefit.

Prospective evaluation of quality of life in patients with localized oesophageal cancer treated by multimodality therapy or surgery alone.

Background: Health-related quality of life (HRQL) outcomes are important in assessing new approaches to the treatment of cancer. Neoadjuvant therapy is being used increasingly before surgery in patients with localized oesophageal cancer. This prospective non-randomized study evaluated HRQL in patients treated by preoperative chemotherapy and radiation therapy followed by surgery (multimodal therapy) or by surgery alone.

Post-oesophagectomy early enteral nutrition via a needle catheter jejunostomy: 8-year experience at a specialist unit.

Background And Aims: The purpose of this study was to prospectively evaluate post-operative jejunostomy feeding in terms of nutritional, biochemical, gastrointestinal and mechanical complications in patients undergoing upper gastrointestinal surgery for oesophageal malignancy.

Methods: The study included 205 consecutive patients who underwent oesophagectomy for malignancy. All patients had a needle catheter jejunostomy (NCJ) inserted at the conclusion of laparotomy.

The journey of a teaching hospital to become a learning organisation.

This paper describes how an acute tertiary referral hospital moved away from a "culture of blame", using change management principles aligned with the concept of the learning organisation. I outline the process of change, and describe its outcomes. The result is summarised as an improvement in desired attributes of the organisation's culture, as evidenced by consistent improvement in the results of a proprietary staff survey.

Adenocarcinoma of the oesophagus and gastric cardia: male preponderance in association with obesity.

Recent evidence links obesity with the rising incidence of oesophageal adenocarcinoma. In Ireland between 1995 and 2004 the incidence of oesophageal adenocarcinoma increased by 38%, and this coincided with a 67% increase in the prevalence of obesity. In this study, a prospective case-control study was undertaken in 760 patients presenting to a tertiary centre between 1994 and 2004 diagnosed with cancer of the oesophagus, gastric cardia or stomach.

Utilization of a hospital for treatment of pediatric dental emergencies.

Purpose: The purpose of this study was to investigate dental emergencies treated at a hospital clinic and emergency department (ED) to: (1) analyze emergency types; (2) determine reasons for seeking hospital care; and (3) examine trends compared to previous studies from this institution.

Methods: Records of 2,683 emergencies from 1995 to 2003 were reviewed. Demographics, reason for seeking care, and treatment details were analyzed overall by emergency type and for subgroups of patients with severe early childhood caries (S-ECC) and patients referred from other EDs.

Treatment of extensive chronic graft-versus-host disease with extracorporeal photochemotherapy.

Extracorporeal photochemotherapy (ECP; photopheresis), an immunomodulatory therapy developed for cutaneous T-cell lymphoma, has shown promise in treating chronic graft-versus-host disease (cGvHD) in uncontrolled studies. The purpose of this study was to further examine the effects of ECP on cGvHD. ECP (administered initially 3 times weekly on alternating days) was retrospectively evaluated in 14 patients with extensive cGvHD following allogeneic hematopoietic stem cell transplantation.

Acid normalization and improved esophageal motility after Nissen fundoplication: equivalent outcomes in patients with normal and ineffective esophageal motility.

Background: Severe gastroesophageal reflux disease may result in acquired esophageal dysmotility. The correct surgical approach to associated gastroesophageal reflux disease and dysmotility is controversial, in particular whether the "gold-standard" total fundoplication of Nissen is appropriate compared with partial fundoplication. Our unit has performed total fundoplication for all patients, irrespective of esophageal motility, and this article describes that experience.

The use of AMD3100 plus G-CSF for autologous hematopoietic progenitor cell mobilization is superior to G-CSF alone.

Hematopoietic progenitor cells (HPCs) traffic to and are retained in the marrow through the trophic effects of the chemokine stromal cell-derived factor-1alpha (SDF-1alpha) binding to its receptor, CXC chemokine receptor 4 (CXCR4). AMD3100 reversibly inhibits SDF-1alpha/CXCR4 binding, and AMD3100 administration mobilizes CD34(+) cells into the circulation. We therefore tested the hypotheses that the combination of AMD3100 plus granulocyte colony-stimulating factor (G-CSF) (hereafter A + G) would be superior to G-CSF alone (hereafter G) in mobilizing hematopoietic progenitor cells (HPCs) and that A + G-mobilized cells would engraft as well as G-mobilized cells.

Analyzing protein lists with large networks: edge-count probabilities in random graphs with given expected degrees.

We present an analytical framework to analyze lists of proteins with large undirected graphs representing their known functional relationships. We consider edge-count variables such as the number of interactions between a protein and a list, the size of a subgraph induced by a list, and the number of interactions bridging two lists. We derive approximate analytical expressions for the probability distributions of these variables in a model of a random graph with given expected degrees.