The gemcitabine, docetaxel, and capecitabine (GTX) regimen for metastatic pancreatic cancer: a retrospective analysis.

Purpose: We developed a laboratory based regimen called GTX which induces synergistic apoptosis in human pancreatic cancer cells. This retrospective review summarizes our clinical experience with GTX in an initial group of 35 patients; 66% untreated and 34% failed prior therapies.

Methods: All patients treated with GTX for metastatic pancreatic cancer, prior to initiation of a prospective phase II trial of GTX were assessed and followed until death.

Androgen and c-Kit receptors in desmoplastic small round cell tumors resistant to chemotherapy: novel targets for therapy.

Purpose: Desmoplastic small round cell tumor (DSRCT) is a highly fatal, mainly peritoneal cell origin cancer which predominantly affects young adult males. This predilection in young males led us to examine the role of androgen receptors (AR), testosterone, and growth factors in the biology of DSRCT.

Methods: Slides were prepared from 27 multi-institutional patients all with end-stage DSRCT.

A U.S. population-based survey of Staphylococcus aureus colonization.

Background: The epidemiology of staphylococcal colonization and community-associated methicillin-resistant Staphylococcus aureus (MRSA) is changing, and little is known from the national perspective.

Objective: To describe the U.S.

A comparison of magnetic resonance imaging findings of the acromioclavicular joint in symptomatic versus asymptomatic patients.

The purpose of this study was to compare acromioclavicular (AC) joint magnetic resonance imaging (MRI) findings in asymptomatic patients with those in symptomatic patients. The MRI scans of 25 patients with symptomatic AC joints were compared with 50 asymptomatic control subjects by use of the same grading scale. In the symptomatic group, AC joint arthritis grading was normal in 0%, mild in 20%, moderate in 52%, and severe in 28%.

Three cases of adenocarcinoma following restorative proctocolectomy with hand-sewn anastomosis for ulcerative colitis: a review of reported cases in the literature.

Restorative proctocolectomy (RPC) has been accepted as optimal surgical therapy for most patients with ulcerative colitis. The occurrence of adenocarcinoma adjacent to the ileoanal anastomotic site for ulcerative colitis is a serious but rare outcome. There are 16 reported cases.

18FDG-PET applications for cartilage neoplasms.

Objective: To assess the value of [18F]fluoro-2-deoxy-D-glucose positron emission tomography (18FDG-PET) in defining aggressive cartilage neoplasms, particularly those with problematic or borderline histologic, imaging and clinical characteristics.

Design And Patients: From 2000 to 2003, 29 cartilage lesions were studied with whole-body 18FDG-PET scans (Siemens Ecat Exact, Knoxville, Tenn.).

The Use of Unilateral Pericranial Flaps for the Closure of Difficult Medial Orbital and Upper Lateral Nasal Defects.

We present 3 cases in which a unilateral pericranial flap was used to repair defects in the medial orbital and upper lateral nasal areas. All three patients had undergone previous excision of malignant tumors from the upper septum and ethmoid areas. Postoperatively, they all received radiation and then developed wound breakdown with fistula formation, particularly in the area of the incisional site.

Previous cesarean delivery: understanding and satisfaction with mode of delivery in a subsequent pregnancy in patients participating in a formal vaginal birth after cesarean counseling program.

The objective of this study was to determine patient satisfaction with delivery experience in a pregnancy subsequent to primary cesarean and to evaluate knowledge about a trial of labor after cesarean in patients enrolled in a formal vaginal birth after cesarean educational program. During a 12-month period, women with a history of cesarean delivery who were participating in a formal counseling program regarding the risks and benefits of vaginal birth after cesarean were surveyed in the antepartum and postpartum periods. Patient demographics, past birth experience, understanding of the risks and benefits of vaginal birth after cesarean, pregnancy outcomes, and ratings of satisfaction and recovery following the current delivery were collected.

Automated detection of macular drusen using geometric background leveling and threshold selection.

Background: Age-related macular degeneration (ARMD) is the most prevalent cause of visual loss in patients older than 60 years in the United States. Observation of drusen is the hallmark finding in the clinical evaluation of ARMD.

Objectives: To segment and quantify drusen found in patients with ARMD using image analysis and to compare the efficacy of image analysis segmentation with that of stereoscopic manual grading of drusen.

Dental erosion due to wine consumption.

Background: Dental erosions can result from numerous causes, but extrinsic dietary factors are the most common. Because of wine's acidity, it may have a deleterious effect on teeth. Its use must be considered during an evaluation of erosive dental changes.

beta-Cell function and insulin sensitivity in early adolescence: association with body fatness and family history of type 2 diabetes mellitus.

The prevalence of type 2 diabetes mellitus (T2DM) among adolescents has increased 5- to 10-fold over the past decade. T2DM results from pancreatic beta-cell dysfunction and insulin resistance. Using rapid iv glucose tolerance testing, we examined beta-cell function and insulin resistance in 72 predominantly Latino eighth grade students (41 males and 31 females; mean +/- sem age, 13.

COX-2 inhibition in upper aerodigestive tract tumors.

Evidence continues to accumulate that cyclooxygenase-2 (COX-2), an inducible COX isoform, represents a potential pharmacological target for the prevention and treatment of cancer, including tumors affecting the entire upper aerodigestive tract. Studies in experimental models of these malignancies show that selective COX-1 inhibitors reduce tumor formation and growth. Clinical studies have been initiated to determine the chemoprotective effects of selective COX-2 inhibitors in patients with oral leukoplakia and Barrett's esophagus, and other studies are assessing the feasibility of incorporating these agents into existing treatment modalities for patients with locally advanced or metastatic cancer.

Effect of bracing on the quality of life of adolescents with idiopathic scoliosis.

Background Context: There is considerable controversy regarding the effectiveness of bracing for patients with adolescent idiopathic scoliosis (AIS). Furthermore, little work has focused on the effect of formal bracing on the health-related quality of life (QOL) of affected adolescents.

Purpose: This study is an attempt to assess the QOL of adolescents with AIS who were treated with a brace in comparison to those who were not.

Management of single fetal demise in a multiple gestation.

Intrauterine fetal demise of 1 twin in a multiple gestation is a complex clinical situation. Chorionicity, gestational age at diagnosis, problems specific to the pregnancy, and the emotional needs of the patient can impact management. Strategies to optimize outcomes may include a multidisciplinary team approach and fetal surveillance.

Pitfalls in management of shoulder dystocia with occiput-posterior position.

Background: The protocol for shoulder dystocia assumes an anterior shoulder entrapped above the pubic symphysis. If the shoulders lie in a different position, a different strategy is required. Such a situation can occur in shoulder dystocia with an occipito-posterior position.

Horizontal violence among nurses in the operating room.

MANY NURSES report that sabotage is a common event in the OR, and the level of sabotage present in the OR may have an effect on overall job satisfaction among perioperative nurses. THIS STUDY looked at the relationship between the presence of sabotage in the OR and job satisfaction levels reported by a group of perioperative nurses in New Jersey. STUDY RESULTS found that although sabotage is reported as common in the OR, the presence of sabotage is not significantly associated with reported job satisfaction.

Obstetric outcomes of human immunodeficiency virus-1-serodiscordant couples following in vitro fertilization with intracytoplasmic sperm injection.

The objective of this article is to report obstetric outcomes of human immunodeficiency virus-1 (HIV-1)-serodiscordant couples who underwent in vitro fertilization and embryo transfer (IVF-ET) with intracytoplasmic sperm injection (ICSI) at a tertiary care center. We reviewed the outcomes of seronegative women after IVF-ET with ICSI from January 1, 1997 to June 1, 2002. Serodiscordant couples (n = 25) successfully conceived 27 pregnancies delivering 40 neonates (16 singletons, 9 twins, and 2 triplets).

The "Demon Plague" and access to care among Asian undocumented immigrants living with HIV disease in New York City.

Access to and utilization of care for HIV-positive Asians (A) and Pacific Islanders (PI) have been largely unaddressed despite the rising influx of immigrants from Asia and the Pacific to the United States and the growing HIV prevalence in these regions. This paper describes the cultural attitudes, behaviors, and perceptions that affect access to and utilization of care among Asian undocumented noncitizens living with HIV/AIDS (UNWHA) in New York City. Sixteen semistructured interviews with HIV-positive UNWHAs revealed that their access to care was influenced by community misperceptions of HIV transmission, discriminatory attitudes towards persons living with HIV, competing immigration related stressors, and difficulty navigating service systems.

Extended spectrum beta lactamase-producing Klebsiella pneumoniae infections: a review of the literature.

Infections caused by extended-spectrum beta-lactamase (ESBL)-producing pathogens, particularly Klebsiella pneumoniae, are increasing. The epidemiology of ESBL-producing K. pneumoniae, the mechanisms of resistance, and treatment strategies for infections caused by these organisms are reviewed.

The role of factor V Leiden mutation in recurrent pregnancy loss.

Although recurrent pregnancy loss is rare, it is a major health problem. Fewer than 50% of cases have definitive causes. Thrombophilias such as factor V Leiden mutation may be responsible for a portion of the unexplained cases.

The expanding domain of implantable hearing devices: an update on current status in the United States.

Several implantable devices are now approved in the United States for rehabilitation of conductive, mixed, and sensorineural hearing loss. This paper will review current rehabilitative options including middle ear implants, used for mild to severe sloping sensorineural loss, and bone-anchored hearing aids, for conductive or mixed hearing loss. The indications for these devices differ, as do the bases for exclusion.

New antiepileptic drugs.

Background: Eight novel anticonvulsant drugs have been introduced in the United States in the past 10 years, as well as two new intravenous preparations of anticonvulsant drugs. The role of each in the treatment of patients with epilepsy is being refined as experience and research data accumulate.

Review Summary: Gabapentin, tiagabine, and oxcarbazepine are effective for partial seizures, whereas felbamate, lamotrigine, topiramate, levetiracetam, and zonisamide treat both partial and generalized seizure types.

An outbreak of methicillin-resistant Staphylococcus aureus in a neonatal intensive care unit.

Objective: To describe the epidemiologic and molecular investigations that successfully contained an outbreak of methicillin-resistant Staphylococcus aureus (MRSA) in a neonatal intensive care unit (NICU).

Design: Isolates of MRSA were typed by pulsed-field gel electrophoresis (PFGE) and S. aureus protein A (spa).