Variability of forearm collateral circulation: An observational study of serial hand plethysmography testing.

Objectives: Evaluation of plethysmography as a reliable triage tool to access collateral circulation in the hand prior to transradial access.

Background: Hand plethysmographic testing has been used for access site triage prior to cardiac catheterization despite a lack of data supporting its result's stability.

Methods: Cohort of consecutive outpatients presenting for evaluation prior to cardiac catheterization underwent hand plethysmographic testing at the beginning of the office visit and before discharge.

The role of HFE genotype in macrophage phenotype.

Background: Iron regulation is essential for cellular energy production. Loss of cellular iron homeostasis has critical implications for both normal function and disease progression. The H63D variant of the HFE gene is the most common gene variant in Caucasians.

HFE Genotype Restricts the Response to Paraquat in a Mouse Model of Neurotoxicity.

Parkinson's disease is marked clinically by motor dysfunction and pathologically by dopaminergic cell loss in the substantia nigra and iron accumulation in the substantia nigra. The driver underlying iron accumulation remains unknown and could be genetic or environmental. The HFE protein is critical for the regulation of cellular iron uptake.

Emerging technologies in autoantibody testing for rheumatic diseases.

Testing for the presence of antinuclear antibodies (ANAs) is a key step in the diagnosis of systemic lupus erythematosus (SLE) and other systemic autoimmune rheumatic diseases (SARD). The standard slide-based indirect immunofluorescence (IIF) test is widely used, but is limited by a relative lack of specificity for SLE and not all SARD-ANAs are detected. Alternative immunoassays that might offer enhanced diagnostic and prognostic information have evolved, and some of these have entered clinical practice.

Controversies in complex percutaneous coronary intervention: radial versus femoral.

Evolution in the technology used in the cardiac catheterization laboratory has permitted a migration from the femoral to radial artery access for many interventional procedures while concurrently improving outcomes. As a disruptive technology, transradial access has been associated with several controversies including a dichotomous relationship with femoral access. Areas covered: Several different patient subsets along with perceived technical challenges in interventional cardiology are reviewed with regard to the issue of access site.

Expression of long non-coding RNAs in autoimmunity and linkage to enhancer function and autoimmune disease risk genetic variants.

Genome-wide association studies have identified numerous genetic variants conferring autoimmune disease risk. Most of these genetic variants lie outside protein-coding genes hampering mechanistic explorations. Numerous mRNAs are also differentially expressed in autoimmune disease but their regulation is also unclear.

Cognitive changes across the menopause transition: A longitudinal evaluation of the impact of age and ovarian status on spatial memory.

Cognitive changes that occur during mid-life and beyond are linked to both aging and the menopause transition. Studies in women suggest that the age at menopause onset can impact cognitive status later in life; yet, little is known about memory changes that occur during the transitional period to the postmenopausal state. The 4-vinylcyclohexene diepoxide (VCD) model simulates transitional menopause in rodents by depleting the immature ovarian follicle reserve and allowing animals to retain their follicle-deplete ovarian tissue, resulting in a profile similar to the majority of perimenopausal women.

Assessment of cytotechnologist-cytopathologist interpretative agreement using the Bethesda system for reporting thyroid cytopathology.

Background: The Bethesda system for reporting thyroid cytopathology was proposed to provide a clinically relevant framework for interpretations to improve interobserver agreement. Limited data is available regarding the level of interobserver agreement between groups of cytotechnologists (CTs) and cytopathologists (CPs) examining the same thyroid fine needle aspirate (FNA) samples.

Methods: Retrospective review of 1,229 thyroid FNAs from 976 patients between 03/2010 and 08/2012 was performed.

Construct damage and loosening around glenoid implants: A longitudinal micro-CT study of five cadaver specimens.

The evolution of failure of bone and cement leading to loosening of glenoid components following shoulder arthroplasty is not well understood. The purpose of this study was to identify and visualize potential mechanisms of mechanical failure within cadavers, cemented with two types of components, and subject to cyclic loading. Five glenoid cadaver bones were implanted with either a three-pegged polyethylene component, or prototype posteriorly augmented component which addresses posterior bone loss.

Skin conductance at baseline and postheel lance reflects sympathetic activation in neonatal opiate withdrawal.

Aim: Skin conductance (SC) provides an objective measure of autonomic system regulation through sympathetic-mediated filling of sweat glands. This study aimed to test the utility of SC to detect sympathetic activation in neonatal abstinence syndrome (NAS).

Methods: Fourteen term (mean, SE: 38.

Testing of a novel pin array guide for accurate three-dimensional glenoid component positioning.

Background: A substantial challenge in total shoulder replacement is accurate positioning and alignment of the glenoid component. This challenge arises from limited intraoperative exposure and complex arthritic-driven deformity. We describe a novel pin array guide and method for patient-specific guiding of the glenoid central drill hole.

Tangential Bicortical Locked Fixation Improves Stability in Vancouver B1 Periprosthetic Femur Fractures: A Biomechanical Study.

Objectives: The biomechanical difficulty in fixation of a Vancouver B1 periprosthetic fracture is purchase of the proximal femoral segment in the presence of the hip stem. Several newer technologies provide the ability to place bicortical locking screws tangential to the hip stem with much longer lengths of screw purchase compared with unicortical screws. This biomechanical study compares the stability of 2 of these newer constructs to previous methods.

Comparative evaluation of nephrotoxicity and management by macrophages of intravenous pharmaceutical iron formulations.

Background: There is a significant clinical need for effective treatment of iron deficiency. A number of compounds that can be administered intravenously have been developed. This study examines how the compounds are handled by macrophages and their relative potential to provoke oxidative stress.

Diagnosis and treatment of polycystic ovary syndrome (PCOS): an interview with Richard Legro.

In this podcast, we talk to Professor Richard Legro about the recommendations for the diagnosis and treatment of polycystic ovary syndrome (PCOS) based on clinical practice guidelines and discuss the challenges of diagnosis PCOS at specific age groups. The controversies associated with treatment of PCOS, including therapies for infertility as this is a problem commonly observed in PCOS subjects, are highlighted together with future directions on the topic. The podcast for this interview is available at.

Adaptive endoplasmic reticulum stress alters cellular responses to the extracellular milieu.

The ability to respond to perturbations in endoplasmic reticulum (ER) function is a critical property for all cells. In the presence of chronic ER stress, the cell must adapt so that cell survival is favored or the stress may promote apoptosis. In some pathological processes, such as neurodengeneration, persistent ER stress can be tolerated for an extended period, but eventually cell death occurs.

Contouring variations and the role of atlas in non-small cell lung cancer radiation therapy: Analysis of a multi-institutional preclinical trial planning study.

Purpose: To quantify variations in target and normal structure contouring and evaluate dosimetric impact of these variations in non-small cell lung cancer (NSCLC) cases. To study whether providing an atlas can reduce potential variation.

Methods And Materials: Three NSCLC cases were distributed sequentially to multiple institutions for contouring and radiation therapy planning.

Magnitude of daily energy deficit predicts frequency but not severity of menstrual disturbances associated with exercise and caloric restriction.

We assessed the impact of energy deficiency on menstrual function using controlled feeding and supervised exercise over four menstrual cycles (1 baseline and 3 intervention cycles) in untrained, eumenorrheic women aged 18-30 yr. Subjects were randomized to either an exercising control (EXCON) or one of three exercising energy deficit (ED) groups, i.e.

Evaluation of an after-hours call center: are pediatric patients appropriately referred to the emergency department?

Background: There is concern that after-hours nurse telephone triage systems are overwhelming the emergency department (ED) with nonemergent pediatric referrals.

Objectives: This study aimed to critically review a nonpediatric hospital-based call center with the aim of identifying the algorithms responsible for the majority of nonessential referrals.

Methods: This is a retrospective observational study performed at a tertiary medical care facility over 1 year.

H63D HFE genotype accelerates disease progression in animal models of amyotrophic lateral sclerosis.

H63D HFE is associated with iron dyshomeostasis and oxidative stress; each of which plays an important role in amyotrophic lateral sclerosis (ALS) pathogenesis. To examine the role of H63D HFE in ALS, we generated a double transgenic mouse line (SOD1/H67D) carrying the H67D HFE (homologue of human H63D) and SOD1(G93A) mutations. We found double transgenic mice have shorter survival and accelerated disease progression.