Patterns and outcomes of colorectal cancer in adolescents and young adults.

Background: The incidence of colorectal cancer (CRC) in the adolescent and young adult (AYA) population (aged 15-39 y) is rising.

Materials And Methods: We used the Surveillance, Epidemiology, and End Results Database to study CRC in the AYA population. We studied clinical and socioeconomic factors associated with survival.

Hepatoblastoma Associated with Trisomy 18.

Very few reports exist in the literature regarding a possible association between trisomy 18 patients and the incidence of hepatoblastoma. Fewer reports exist on patients with multifocal hepatoblastoma. We reviewed our institutional database for the past 10 years and found three cases with this possible association to the tumor.

Bridging the Radiology-Pediatrics Interaction Gap by Incorporating a PGY4 Radiology Resident into the General Pediatrics Team.

To bridge the gap between clinicians and radiologists, radiology residents rounded with inpatient pediatric medicine teams to present and interpret daily imaging studies, as well as assist with decisions and indications for radiologic exams. Surveys were sent to team members who rotated with radiology residents, and the consensus strongly favored having radiology residents on future rotations. Team members responded that they benefitted from a better understanding of radiology exams, their indications and limitations.

Presence of an arterial line improves response to simulated hypotension and pulseless electrical activity.

With pulseless electrical activity (PEA) emerging as one of the leading cardiac arrest arrhythmias, the rapid response and accurate diagnosis of PEA is essential to improve survival rates. Although the use of invasive blood pressure monitoring to more quickly detect changes in blood pressure is widespread, evidence for its use is largely anecdotal and placement is not without risk. This is a prospective, multi-center, randomized controlled trial involving 58 senior anesthesiology residents undergoing a simulation of intraoperative PEA using high-fidelity simulation.

Oncostatin M promotes excitotoxicity by inhibiting glutamate uptake in astrocytes: implications in HIV-associated neurotoxicity.

Background: Elevated levels of oncostatin M (OSM), an interleukin-6 cytokine family member, have been observed in HIV-1-associated neurocognitive disorders (HAND) and Alzheimer's disease. However, the function of OSM in these disease conditions is unclear. Since deficient glutamate uptake by astrocytes is instrumental in HAND-associated neurotoxicity, we hypothesized that OSM impairs glutamate uptake in astrocytes and thereby promotes neuronal excitotoxicity.

Pancreas Adenocarcinoma: Ascites, Clinical Manifestations, and Management Implications.

Background: Ascites develops in a subset of patients with pancreatic adenocarcinoma (PAC) at presentation or as the disease advances. Limited data exist on the prognostic importance of malignant ascites in PAC. Our hypothesis is that this information will provide an understanding of the natural history and facilitate management decisions.

Macrophages: A review of their role in wound healing and their therapeutic use.

Macrophages are mononuclear phagocytes established during embryogenesis and derived from the yolk sac or the fetal liver but also recruited from the blood and bone marrow under proliferative inflammatory conditions (such as tissue repair). Most importantly, they take on distinct phenotypes and functions crucial to healing upon localization in the wound. The objective of this review is to summarize recent findings in regard to the cellular mechanisms of macrophages and chronic wounds.

Exploring How Substance Use Impedes Engagement along the HIV Care Continuum: A Qualitative Study.

Drug use is associated with low uptake of HIV antiretroviral therapy (ART), an under-studied step in the HIV care continuum, and insufficient engagement in HIV primary care. However, the specific underlying mechanisms by which drug use impedes these HIV health outcomes are poorly understood. The present qualitative study addresses this gap in the literature, focusing on African-American/Black and Hispanic persons living with HIV (PLWH) who had delayed, declined, or discontinued ART and who also were generally poorly engaged in health care.

Effect of Recombinant Human Growth Hormone and Rosiglitazone for HIV-Associated Abdominal Fat Accumulation on Adiponectin and other Markers of Inflammation.

Background/objective: In a previous report of HIV-infected patients with fat redistribution, we found that recombinant human growth hormone (rhGH) therapy reduced visceral adipose tissue (VAT) but increased insulin resistance, and that the addition of rosiglitazone reversed the negative effects of rhGH on insulin sensitivity. In this study, we sought to determine the effects of rhGH and rosiglitazone therapy on an array of inflammatory and fibrinolytic markers.

Methods: 72 patients with HIV-associated abdominal obesity and insulin resistance were randomized to treatment with rhGH, rosiglitazone, the combination of rhGH and rosiglitazone, or placebo for 12 weeks.

Comparison of failure rates of crossing side branch with pressure vs. coronary guidewire: a meta-analysis.

Objectives: The aim of this study was to compare the failure rates of crossing side branch (SB) with pressure guidewire vs. coronary guidewire after main vessel (MV) stenting in coronary bifurcation lesions (CBL).

Background: Percutaneous coronary intervention of CBL is technically difficult.

An Unusual Case of Systemic Lupus Erythematosus and Hemophagocytic Syndrome.

Hemophagocytic syndrome (HS) or hemophagocytic lymphohistiocytosis (HLH) is an immune mediated phenomenon that can occur in the setting of an autoimmune disease, chronic immunosuppression, malignancy, or infection. It has been more commonly described in the pediatric population and less commonly in adults. We describe a case of a 52-year-old male who presented with a rash.

Negative Pressure Wound Therapy With Instillation: Review of Evidence and Recommendations.

Negative pressure wound therapy with instillation (NPWTi) and dwell time is an adjunctive treatment modality for selected complex wounds. Because of the greater amount of research now available, a multidisciplinary expert panel comprising the fields of podiatry, plastic and general surgery, burn treatment, infectious diseases, and orthopedics was convened on July 11, 2015, to produce a summary of the data and recommendations on the use of NPWTi. The panel members each reviewed available published literature on NPWTi in the PubMed, Cochrane, and Google Scholar databases from 1 January 2012 up until 20 July 2015 using the string search term negative pressure wound therapy instillation provided by the panel moderator; there were no restrictions on the language or type of publication.

Granulomatous Interstitial Nephritis Presenting as Hypercalcemia and Nephrolithiasis.

We report a case of acute kidney injury as the initial manifestation of sarcoidosis. A 55-year-old male was sent from his primary care physician's office with incidental lab findings significant for hypercalcemia and acute kidney injury with past medical history significant for nephrolithiasis. Initial treatment with intravenous hydration did not improve his condition.

Genomic instability in pancreatic adenocarcinoma: a new step towards precision medicine and novel therapeutic approaches.

Pancreatic cancer is one of the most challenging cancers. Whole genome sequencing studies have been conducted to elucidate the underlying fundamentals underscoring disease behavior. Studies have identified a subgroup of pancreatic cancer patients with distinct molecular and clinical features.

Role of Vorapaxar After Coronary Revascularization.

We aim to evaluate the potential benefit and risk of addition of vorapaxar to standard medical therapy in patients who underwent coronary revascularization with either percutaneous coronary revascularization or coronary artery bypass graft surgery. We searched PubMed, EMBASE, the Cochrane Central Register of Controlled trials, and the clinical trial registry maintained at clinicaltrials.gov for randomized control trials evaluating the safety and efficacy of vorapaxar in patients who underwent coronary revascularization procedures with either percutaneous coronary revascularization or coronary artery bypass graft surgery.

Phase angle and its determinants in healthy subjects: influence of body composition.

Background: The phase angle (PA) has been used as a prognostic marker in several clinical situations. Nevertheless, its biological meaning is not completely understood.

Objective: We verified how body-composition components could explain the PA.

Merkel Cell Carcinoma With Gastric Metastasis and Review of Literature.

Background: Merkel cell carcinoma (MCC) is a rare, highly aggressive cutaneous neoplasm, with a propensity for recurrence and metastasis. Very few cases of metastases to the gastrointestinal tract have been reported in the medical literature.

Objectives: The aim of this study was to report a case of MCC metastasizing to the stomach, its clinical presentation, and its management.

Cytokine preconditioning of engineered cartilage provides protection against interleukin-1 insult.

Background: During osteoarthritis and following surgical procedures, the environment of the knee is rich in proinflammatory cytokines such as IL-1. Introduction of tissue-engineered cartilage constructs to a chemically harsh milieu may limit the functionality of the implanted tissue over long periods. A chemical preconditioning scheme (application of low doses of IL-1) was tested as a method to prepare developing engineered tissue to withstand exposure to a higher concentration of the cytokine, known to elicit proteolysis as well as rapid degeneration of cartilage.

Computed tomography findings of internal hernia after gastric bypass that may precede small bowel obstruction.

Purpose: This study evaluates computed tomography signs of internal hernia in gastric bypass patients, including several previously unreported signs suggestive of internal hernia.

Methods: Eighteen patients with surgically proven internal hernia were included in the study cohort. The signs analyzed included the mesenteric swirl, hurricane eye, mushroom sign, and dilated small bowel loops, as well as previously non-investigated signs such as bowel wall edema, engorged mesenteric vessels, engorged mesenteric lymph nodes, and hazy mesenteric fat.

Ultrasound in the evaluation of penetrating thoraco-abdominal trauma: a review of the literature.

The use of ultrasound in the evaluation of blunt thoraco-abdominal trauma is well described. Evidence for the use of ultrasound in the evaluation of penetrating cardio-thoracic and abdominal trauma, however, is more limited and varied. Current literature demonstrates that ultrasound is an excellent screening tool for penetrating thoracic and cardiac injuries with a high sensitivity for detecting injury requiring acute intervention.