Transfeminine Gender Confirmation Surgery with Penile Inversion Vaginoplasty: An Initial Experience.

Unlabelled: To detail the early experience with and results of a transfeminine (TF) genital reconstruction at an established plastic surgery practice in Western New York.

Methods: Between June 2016 and June 2019, 30 patients underwent penile inversion vaginoplasty for TF gender reassignment. All patients fulfilled World Professional Association for Transgender Health and NY State criteria for reassignment surgery.

Population Pharmacodynamic Modeling of Epoetin Alfa in End-Stage Renal Disease Patients Receiving Maintenance Treatment Using Bayesian Approach.

The ability to control dosage regimens of erythropoiesis-stimulating agents (ESAs) to maintain a desired hemoglobin (HGB) target is still elusive. We utilized a Bayesian approach and informative priors to characterize HGB profiles, using simulated drug concentrations, in patients with end-stage renal disease receiving maintenance doses of epoetin alfa. We also demonstrated an adaptive Bayesian method, applied to individual patients, to improve the accuracy of HGB predictions over time.

Beyond Single Nucleotide Polymorphisms: Composite and Haplotype Associations to Tacrolimus Pharmacokinetics in Black and White Renal Transplant Recipients.

Interpatient variability in tacrolimus pharmacokinetics is attributed to metabolism by cytochrome P-450 3A5 (CYP3A5) isoenzymes and membrane transport by P-glycoprotein. Interpatient pharmacokinetic variability has been associated with genotypic variants for both or . Tacrolimus pharmacokinetics was investigated in 65 stable Black and Caucasian post-renal transplant patients by assessing the effects of multiple alleles in both and A metabolic composite based upon the polymorphisms: (rs776746), (10264272), ), each independently responsible for loss of protein expression was used to classify patients as extensive, intermediate and poor metabolizers.

Bariatric Surgery: Remission of Inflammation, Cardiometabolic Benefits, and Common Adverse Effects.

Obesity is associated with increased mortality as a result of several comorbidities which occur in tandem with the obese state. Chronic inflammation is well documented in obesity, and evidence from numerous studies support the notion that the increased inflammation in individuals with obesity accentuates the comorbidities seen in this condition. The remission of comorbidities such as metabolic, cardiovascular, and neurological complications occurs following bariatric procedures.

Educational Animations to Inform Transplant Candidates About Deceased Donor Kidney Options: An Efficacy Randomized Trial.

Background: Transplant candidates struggle making decisions about accepting kidneys with variable kidney donor profile index (KDPI) and increased risk donor (IRD) status.

Methods: This single site, pilot randomized controlled trial evaluated the efficacy of 2 animations to improve KDPI/IRD knowledge, decisional self-efficacy, and willingness. Kidney candidates were randomly assigned to animation viewing plus standard nurse discussion (intervention) or standard nurse discussion alone (control).

Safety profile of atorvastatin in the role of burn wound injury conversion.

Background: Atorvastatin could be beneficial in the treatment of burn patients to prevent burn wound progression from partial to full thickness. Our primary aim is to evaluate the safety of atorvastatin in burn patients.

Methods: Single center retrospective chart review of burn patients receiving atorvastatin during admission May 2016-May 2019 with historic controls was performed.

Opinions of African American adults about the use of apolipoprotein L1 (ApoL1) genetic testing in living kidney donation and transplantation.

Apolipoprotein L1 (ApoL1) predictive genetic testing for kidney disease, and its emerging role in transplantation, remains controversial as it may exacerbate underlying disparities among African Americans (AAs) at increased risk. We conducted an online simulation among AAs (N = 585) about interest in ApoL1 testing and its cofactors, under 2 scenarios: as a potential living donor (PLD), and as a patient awaiting transplantation. Most respondents (61%) expressed high interest in genetic testing as a PLD: age ≥35 years (adjusted odds ratio [aOR], 1.

Fabrication of a Toe Prosthesis with Paintable and Interchangeable Nail: A Clinical Report.

This report describes the treatment of a 44-year-old woman with history of left great toe amputation due to surgical complications from metatarsophalangeal joint fusion procedure. The fabrication of a prosthetic great toe with interchangeable nail that is paintable is described in detail. This prosthetic demonstrates that the clinical and laboratory techniques used in fabrication of traditional maxillofacial prosthetics can be adapted for the fabrication of somatic prosthetics to enhance quality of life.

Describing barriers and facilitators for medication adherence and self-management among kidney transplant recipients using the information-motivation-behavioral skills model.

Background: We aimed to develop an adapted information-motivation-behavioral skills (IMB) model to describe barriers and facilitators for adherence and self-management among kidney transplant recipients.

Methods: We conducted a review of literature about kidney transplant recipients' knowledge, perceptions, and experiences and organized our results using the IMB framework. We then conducted interviews with transplant recipients and transplant providers to supplement our literature search.

Pain expectancy, prevalence, severity, and patterns following donor nephrectomy: Findings from the KDOC Study.

Postoperative pain is an outcome of importance to potential living kidney donors (LKDs). We prospectively characterized the prevalence, severity, and patterns of acute or chronic postoperative pain in 193 LKDs at six transplant programs. Three pain measurements were obtained from donors on postoperative Day (POD) 1, 3, 7, 14, 21, 28, 35, 41, 49, and 56.

Development of the living donation and kidney transplantation information made easy (KidneyTIME) educational animations.

Background: Current web-based educational approaches about living kidney donation (LKD) are complex, lengthy, and/or text-laden, which may impair accurate interpretation of information, thereby limiting kidney transplant access.

Purpose: This paper describes the process of developing animation-based LKD education designed to be suitable for and acceptable to kidney transplant candidates and their support networks.

Methods: Based on formative work, early animation prototypes were designed by a transplant surgeon and a health communication expert.

Development and preliminary evaluation of an animation (simplifyKDPI) to improve kidney transplant candidate understanding of the Kidney Donor Profile Index.

Background: Transplant candidates are reluctant to accept kidneys from high Kidney Donor Profile Index (KDPI) donors. Incomplete understanding can lead to transplant delays for older transplant candidates. Patients need access to understandable information to make more informed decisions about KDPI.

Pharmacy Students' Standardized Self-Assessment of Interprofessional Skills During an Objective Structured Clinical Examination.

To examine pharmacy students' self-assessment and evaluator assessment of the global performance of skills required for effective interprofessional collaborative practice during an objective structured clinical examination (OSCE). Third-year pharmacy students completed three cases designed to evaluate the skills they would need to engage in effective interprofessional collaborative practice as part of a capstone objective structured clinical examination (OSCE). Students then also completed a brief survey regarding the quality of the cases and the Interprofessional Collaborative Competency Attainment Survey (ICCAS).

Understanding and Managing Withdrawal Syndromes After Discontinuation of Antidepressant Drugs.

Withdrawal symptoms commonly occur during tapering and/or after discontinuation of antidepressant drugs, particularly selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors. Withdrawal symptomatology does not necessarily subside within a few weeks and may be associated with other manifestations of behavioral toxicity (loss of treatment efficacy, refractoriness, switch into mania/hypomania, or paradoxical reactions). The oppositional model of tolerance provides a pathophysiologic basis for understanding and managing withdrawal syndromes.

Transplant Outcomes of Donation After Circulatory Death Livers Recovered With Versus Without Premortem Heparin Administration.

Premortem heparin administration during donation after circulatory death (DCD) organ recovery is thought to optimize liver perfusion. However, premortem heparinization is not universally practiced in the United States and limited data exist regarding its utility. US registry data were accessed between January 1, 2003, and March 10, 2017, and 2 cohorts were ascertained: (1) DCD donor livers recovered for transplantation (n = 5495) and (2) liver-only adult transplant recipients of DCD livers (n = 3754).

Improving Pharmacy Students' Attitudes Toward Collaborative Practice Through a Large-scale Interprofessional Forum Targeting Opioid Dependence.

To evaluate the impact of a large-scale interprofessional forum on pharmacy students' attitudes toward interprofessional collaborative practice. Pharmacy students were asked to complete the Interprofessional Attitudes Scale (IPAS) prior to and after completing a three-hour interprofessional forum. Scores for the total IPAS and each of the subscales were computed using the mean of students' responses to the items for each.

Maintenance of long-term blood pressure control and vascular health by low-dose amiloride-based therapy in hyperaldosteronism.

Whether aldosterone itself contributes directly to macro- or microcirculatory disease in man or to adverse cardiovascular outcomes is not fully known. We report our long-term single-practice experience in an unusual group of five patients with chronic hyperaldosteronism (HA, including three with glucocorticoid-remediable aldosteronism, GRA) treated with low-dose amiloride (a specific epithelial sodium channel [ENaC] blocker) 5-10 (mean 7) mg daily for 14-28 (mean 20) years. Except for one GRA diagnosed in infancy, all had severe resistant hypertension.

Presurgical induction chemotherapy for squamous cell carcinoma of the tonsil.

Objectives/hypothesis: The indications for and efficacy of induction chemotherapy in the management of squamous cell carcinoma of the head and neck is controversial. With the advent of human papillomavirus (HPV)-related cancers, survival has improved significantly. Here we present a group of patients with tonsil cancer treated with induction chemotherapy followed by surgery.

Oral keratosis of unknown significance shares genomic overlap with oral dysplasia.

Objectives: To identify molecular characteristics of keratosis of unknown significance and to nominate pathways of molecular progression to oral cancer. Our work could provide a rationale for monitoring and treating these lesions definitively.

Methods: Patients with oral leukoplakia were eligible for our prospective observational study.

Patterns and predictors of fatigue following living donor nephrectomy: Findings from the KDOC Study.

This study sought to identify the prevalence, pattern, and predictors of clinical fatigue in 193 living kidney donors (LKDs) and 20 healthy controls (HCs) assessed at predonation and 1, 6, 12, and 24 months postdonation. Relative to HCs, LKDs had significantly higher fatigue severity (P = .01), interference (P = .

High-dose Therapy and Autologous Hematopoietic Cell Transplantation as Consolidation Treatment for Primary Effusion Lymphoma.

Background: Primary effusion lymphoma (PEL) is a rare type of non-Hodgkin lymphoma. The limited disease-free survival after chemotherapy has resulted in a poor prognosis. The outcomes data for high-dose therapy followed by autologous hematopoietic cell transplantation (auto-HCT) for PEL are limited owing to the rarity of the disease.