Cardiology-Rheumatology Intersections in Aortitis and Aortic Aneurysms: Focus on Early Recognition and Management.

Aortitis is an uncommon cause of aortic aneurysms. Arterial inflammation can lead to irreversible vascular damage. Early recognition is necessary for treatment to prevent permanent consequences of vessel inflammation.

Impact of Tafamidis on Survival in a Real-World Community-Based Cohort.

Tafamidis is the only therapy shown to improve survival in transthyretin cardiac amyloidosis (ATTR) based on randomized controlled trial data. We sought to evaluate the impact of tafamidis on survival in a real-world community-based cohort. This was a prospective observational cohort study that included consecutive patients with confirmed ATTR based on biopsy or TcPYP imaging.

Academic disparities and health: How gender-based disparities in schools relate to boys' and girls' health.

Rationale: Recent research reveals that, although girls encounter some barriers in school (e.g., in science and math), on balance, boys perform worse academically.

The future of population medicine: Investigating the role of advanced practice providers and simulation education in special patient populations.

Advanced practice providers (APPs) have come to play an increasingly significant role in the United States healthcare system in the past five decades, particularly in primary care. The first portion of this paper will explore the utilization of APPs in specific patient populations: pediatrics, obstetrics, geriatrics, and psychiatry. After a brief discussion of the demand for these specialties, the authors will outline the educational preparation and competencies that nurse practitioners and physician assistants must achieve before working with these special populations.

Clinical and molecular features of innate and acquired resistance to anti-PD-1/PD-L1 therapy in lung cancer.

Hypothesis: The majority of non-small cell lung cancer (NSCLC) patients treated with anti-PD-1/PD-L1 therapy develop either innate or acquired resistance. Across tumor types, the "T cell-inflamed" tumor microenvironment correlates with clinical response to immunotherapy. We hypothesize that clinical characteristics may be predictive of resistance and that "T cell-inflamed" NSCLC tumors can be identified by gene expression profiling.

Quality of life after laparoscopic totally extraperitoneal repair of an asymptomatic inguinal hernia.

Background: When considering an asymptomatic inguinal hernia, surgeons must weigh the risks of watchful waiting against the risk of operative complications. Laparoscopy offers the benefit of reduced postoperative pain, which, for appropriate surgical candidates, may strengthen the case for repair. This study compares general and disease-specific quality of life following totally extraperitoneal (TEP) laparoscopic inguinal hernia repair (LIHR) of asymptomatic and symptomatic hernias.

Adjuvant Therapy Improves Survival for T2N0 Gastric Cancer Patients with Sub-optimal Lymphadenectomy.

Background: The benefit of adjuvant therapy following resection of early stage, node-negative gastric adenocarcinoma following a margin negative (R0) resection is unclear.

Methods: The National Cancer Data Base was used to identify patients with a T2N0 gastric adenocarcinoma (tumor invasion into the muscularis propria) who underwent R0 resection. Patients treated with neoadjuvant therapy and those for whom lymph node count was unavailable were excluded from the analysis.

Newborn hearing screening may predict Eustachian tube dysfunction.

Introduction: There is evidence for temporary hearing loss in neonates immediately after birth because of residual liquid derived from amniotic fluid in the ME cavity. This study examines whether a referred newborn hearing screen (NBHS) with subsequent testing confirming normal hearing can be attributed to persistence of middle ear effusion and predict poor Eustachian tube function manifested as recurrent otitis media or otitis media with effusion in the first year of life. The aims of the present study are to investigate the following: (1) whether infants who fail a neonatal hearing screen and subsequently pass are more likely to experience recurrent otitis media or otitis media with effusion, (2) whether these infants are more likely to obtain tympanostomy tubes.

Definitive Characterization of CA 19-9 in Resectable Pancreatic Cancer Using a Reference Set of Serum and Plasma Specimens.

The validation of candidate biomarkers often is hampered by the lack of a reliable means of assessing and comparing performance. We present here a reference set of serum and plasma samples to facilitate the validation of biomarkers for resectable pancreatic cancer. The reference set includes a large cohort of stage I-II pancreatic cancer patients, recruited from 5 different institutions, and relevant control groups.

Rectal Optical Markers for In Vivo Risk Stratification of Premalignant Colorectal Lesions.

Purpose: Colorectal cancer remains the second leading cause of cancer deaths in the United States despite being eminently preventable by colonoscopy via removal of premalignant adenomas. In order to more effectively reduce colorectal cancer mortality, improved screening paradigms are needed. Our group pioneered the use of low-coherence enhanced backscattering (LEBS) spectroscopy to detect the presence of adenomas throughout the colon via optical interrogation of the rectal mucosa.

In vivo risk analysis of pancreatic cancer through optical characterization of duodenal mucosa.

Objectives: To reduce pancreatic cancer mortality, a paradigm shift in cancer screening is needed. Our group pioneered the use of low-coherence enhanced backscattering (LEBS) spectroscopy to predict the presence of pancreatic cancer by interrogating the duodenal mucosa. A previous ex vivo study (n = 203) demonstrated excellent diagnostic potential: sensitivity, 95%; specificity, 71%; and accuracy, 85%.

The laparoscopic approach to distal pancreatectomy for ductal adenocarcinoma results in shorter lengths of stay without compromising oncologic outcomes.

Background: The oncologic equivalence of laparoscopic distal pancreatectomy (LDP) to open pancreatectomy (ODP) for ductal adenocarcinoma (DAC) is not established.

Methods: The National Cancer Data Base was used to compare perioperative outcomes following LDP and ODP for DAC between 2010 and 2011.

Results: One hundred forty-five patients underwent LDP; 625 underwent ODP.

Baked milk- and egg-containing diet in the management of milk and egg allergy.

Cow's milk (CM) and hen's egg allergies are among the most common food allergies in children. With evidence of increasing food allergy prevalence and more persistent disease, it has become vital to improve the management of CM and egg allergies. The ability to tolerate baked milk or egg, such as in a cake or muffin, has been associated with an increased chance of tolerance development.

Towards non-invasive diagnostic imaging of early-stage Alzheimer's disease.

One way to image the molecular pathology in Alzheimer's disease is by positron emission tomography using probes that target amyloid fibrils. However, these fibrils are not closely linked to the development of the disease. It is now thought that early-stage biomarkers that instigate memory loss are composed of Aβ oligomers.

Irritants and corrosives.

This article reviews toxic chemicals that cause irritation and damage to single and multiple organ systems (corrosion) in an acute fashion. An irritant toxic chemical causes reversible damage to skin or other organ system, whereas a corrosive agent produces irreversible damage, namely, visible necrosis into integumentary layers, following application of a substance for up to 4 hours. Corrosive reactions can cause coagulation or liquefaction necrosis.

Buccal spectral markers for lung cancer risk stratification.

Lung cancer remains the leading cause of cancer deaths in the US with >150,000 deaths per year. In order to more effectively reduce lung cancer mortality, more sophisticated screening paradigms are needed. Previously, our group demonstrated the use of low-coherence enhanced backscattering (LEBS) spectroscopy to detect and quantify the micro/nano-architectural correlates of colorectal and pancreatic field carcinogenesis.

Predicting aggressive behavior in nonfunctioning pancreatic neuroendocrine tumors.

Purpose: The biologic potential of nonfunctioning pancreatic neuroendocrine tumors (PNETs) is highly variable and difficult to predict before resection. This study was conducted to identify clinical and pathologic factors associated with malignant behavior and death in patients diagnosed with PNETs.

Methods: We used International Classification of Diseases 9th edition codes to identify patients who underwent pancreatectomy for PNETs from 1998 to 2011 in the databases of 4 institutions.

Perforin rapidly induces plasma membrane phospholipid flip-flop.

The cytotoxic cell granule secretory pathway is essential for host defense. This pathway is fundamentally a form of intracellular protein delivery where granule proteases (granzymes) from cytotoxic lymphocytes are thought to diffuse through barrel stave pores generated in the plasma membrane of the target cell by the pore forming protein perforin (PFN) and mediate apoptotic as well as additional biological effects. While recent electron microscopy and structural analyses indicate that recombinant PFN oligomerizes to form pores containing 20 monomers (20 nm) when applied to liposomal membranes, these pores are not observed by propidium iodide uptake in target cells.

Intracellular trafficking of perforin: to thwart a killer.

How do killer cells restrain perforin, the most potent toxin known to biologists, at its point of synthesis in the endoplasmic reticulum, where conditions are ideal for its activation? In this issue of Immunity, Brennan et al. (2011) study its trafficking, offering insights into protective mechanisms.

Longer-term outcomes of paclitaxel stent implantation as an initial treatment strategy for sirolimus-eluting stent restenosis.

Objective: The goal of this study was to determine the long-term clinical outcomes after an initial strategy of paclitaxeleluting stent (PES) implantation for de novo sirolimus-eluting stent (SES) restenosis.

Background: The optimal treatment of drug-eluting stent (DES) restenosis is unknown.

Methods: Consecutive patients undergoing PES implantation for SES restenosis were identified.

Volumetric analysis of thoracic and lumbar vertebral bodies.

Background Context: During the last decade, vertebral augmentation techniques with cement (kyphoplasty and vertebroplasty) have revealed that 75% to 100% of individuals with osteoporotic vertebral compression fractures have good to moderate pain relief postoperatively, as well as adequate restoration of the vertebral body height. The volume of cement injected into a vertebra varied in different reports. To our knowledge, there are no studies that report on the physiological distribution of thoracic and lumbar vertebrae body volumes.