Contrasting Effects of Fasting on Liver-Adipose Axis in Alcohol-Associated and Non-alcoholic Fatty Liver.

Fatty liver, a major health problem worldwide, is the earliest pathological change in the progression of alcohol-associated (AFL) and non-alcoholic fatty liver disease (NAFL). Though the causes of AFL and NAFL differ, both share similar histological and some common pathophysiological characteristics. In this study, we sought to examine mechanisms responsible for lipid dynamics in liver and adipose tissue in the setting of AFL and NAFL in response to 48 h of fasting.

Grape Cells (Multinucleated Keratinocytes) in Noninfectious Dermatoses: Case Series and Review of the Literature.

Multinucleated keratinocytes (also known as multinucleated epidermal giant cells) are a frequently overlooked histological finding in noninfectious inflammatory dermatoses. They are sometimes found in conditions characterized by chronic rubbing and pruritus, such as lichen simplex chronicus or prurigo nodularis, and may be a helpful clue in making the clinical diagnosis. This finding must be differentiated from other conditions characterized by multinucleated keratinocytes on histopathology, specifically herpes simplex, varicella zoster, or measles viral infections.

Graft-versus-host disease-associated angiomatosis: a clinicopathologically distinct entity.

Background: Chronic graft-versus-host disease (GVHD) may present with various cutaneous manifestations. Isolated case reports describe eruptive angiomas in this setting.

Objective: We sought to provide a clinical and pathologic description of vascular proliferations in patients with GVHD.

Metrics for assessing improvements in primary health care.

Metrics focus attention on what is important. Balanced metrics of primary health care inform purpose and aspiration as well as performance. Purpose in primary health care is about improving the health of people and populations in their community contexts.

A reemerging political space for linking person and community through primary health care.

Objectives: We sought to understand how national policy key informants perceive the value and changing role of primary care in the context of emerging political opportunities.

Methods: We conducted 13 semistructured interviews in May 2011 with leaders of federal agencies, think tanks, nonprofits, and quality standard-defining organizations with influence over health care reform policies and implementation. We recorded the interviews and used an editing and immersion-crystallization analysis approach to identify themes.

A re-emerging political space for linking person and community through primary health care.

Purpose: The goal of the study was to understand how national policy key informants perceive the value and changing role of primary care in the context of emerging political opportunities.

Methods: Thirteen semistructured interviews were conducted in May 2011 with leaders of federal agencies, think tanks, nonprofits, and quality standard-defining organizations with influence over healthcare reform policies and implementation. Interviews were recorded; an editing and immersion-crystallization analysis approach was used to identify themes.

Increasing graduate medical education (GME) in critical access hospitals (CAH) could enhance physician recruitment and retention in rural America.

Critical Access Hospitals (CAHs) are essential to a functinoning health care safety net and are a potential partner of rural Graduate Medical Education (GME) which is associated with greater likelihood of service in rural and underserved areas. Currently very little Medicare funding supports GME in the CAH setting, highlighting a missed opportunity to improve access to care in rural America.

Perforating granulomatous dermatitis reaction to exogenous tattoo pigment: a case report and review of the literature.

: The majority of cutaneous hypersensitivity reactions to exogenous tattoo pigments can be histologically classified as lichenoid or granulomatous. The etiology is still uncertain but is generally accepted to be a delayed-type hypersensitivity reaction to either the pigment itself or its carrier solution. In this report, we review the literature concerning adverse reactions to tattoos.

Familial median canaliform nail dystrophy.

Median canaliform nail dystrophy typically appears as a central nail groove, beginning at or distal to the proximal nail fold, from which small lateral fissures may be found. Although the onset of this nail dystrophy has occasionally been associated with either prior local trauma or the initiation of treatment with isotretinoin, the etiology of this condition remains elusive for most affected individuals. We describe a man with median canaliform nail dystrophy whose brother and mother had the same nail dystrophy, review the other reported cases, and discuss the differential diagnosis of this nail disorder.