Reirradiation in head and neck squamous cell carcinoma; prognostic indicators, oncologic and functional outcomes.

Objectives: Patients with recurrent squamous cell carcinoma of the head and neck (HNSCC) have a poor prognosis and limited therapeutic alternatives. While reirradiation is feasible, it is usually associated with high treatment toxicity and is not yet considered the standard of care. Based on current NCCN guidelines, in the context of very advanced head and neck cancer (recurrent and/or persistent disease), surgical intervention is explored initially with/without adjuvants while unresectable disease is approached with radiation and/or systemic therapies.

A differential comes up short in a patient with shortness of breath.

Chronic obstructive pulmonary disease (COPD) exacerbation and allergic bronchopulmonary aspergillosis (ABPA), in spite of sharing common features such as airway inflammation, airflow obstruction, and mucus hypersecretion, differ significantly from each other. We report a case of ABPA that was unsuccessfully treated as a COPD exacerbation. The history of non-exertional progressive dyspnea, absence of a symptom-free interval, and hemoptysis combined with a minimal, distant smoking history and prior employment at a fertilizer plant favor a diagnosis other than COPD exacerbation.

Evaluation of iron intake in preschool children in a setting with high anemia burden.

Background: Iron deficiency anemia affects millions of children worldwide. Iron intake assessments can inform targeted interventions.

Methods: This cross-sectional study describes diet and hemoglobin levels of children 1-5 y of age in a resource-limited setting in the Dominican Republic.

Evaluation of Iron Deficiency Anemia in a Pediatric Clinic in the Dominican Republic.

Background: Iron deficiency and iron deficiency anemia affect billions of people worldwide. Infants and young children are the most vulnerable. The Niños Primeros en Salud pediatric clinic aims to follow the American Academy of Pediatrics (AAP) recommendation to screen all children at 12 months of age, a vital period for development and the time of greatest risk.

Effectiveness of Computer Automation for the Diagnosis and Management of Childhood Type 2 Diabetes: A Randomized Clinical Trial.

Importance: Type 2 diabetes (T2D) is increasingly common in young individuals. Primary prevention and screening among children and adolescents who are at substantial risk for T2D are recommended, but implementation of T2D screening practices in the pediatric primary care setting is uncommon.

Objective: To determine the feasibility and effectiveness of a computerized clinical decision support system to identify pediatric patients at high risk for T2D and to coordinate screening for and diagnosis of prediabetes and T2D.

Implementation of a Novel, Resident-Led, Nocturnal Curriculum.

Background: Duty hour restrictions for resident physicians have led to radical changes in graduate medical education, including a shift to more night float rotations. These rotations have been viewed by residents as predominantly service focused with little opportunity for formalized education.

Objective: To develop and deliver a resident-driven, nocturnal curriculum to enhance the educational content and value of night float rotations.

Halide Effects in the Synthesis of Mixed Uranium(IV) Aryloxide-Halide Compounds.

Several uranium(IV) aryloxide and mixed aryloxide-halide compounds of the formula UX(4)(-)(z)()(OAr)(z)() (X = Cl, Br, I; OAr = 2,6-di-tert-butylphenoxide; z = 2, 3, 4) have been prepared by the reaction of KOAr with the appropriate uranium tetrahalide in tetrahydrofuran (THF). The complex UI(4)(CH(3)CN)(4) reacts with 2 equiv of KOAr in THF to yield the compound I(2)U(OAr)(2) (1). The utility of this reaction is limited by the instability of UI(4)(CH(3)CN)(4) in THF, however, and isolated yields of the THF adduct of 1 do not exceed 50%.