Granular parakeratosis: pathologic and clinical correlation of 18 cases of granular parakeratosis.

Background: Granular parakeratosis (originally termed axillary granular parakeratosis) is an idiopathic, benign, nondisabling cutaneous disease that manifests with intertriginous erythematous, brown or red, scaly or keratotic papules and plaques. It presents in all age groups and has no established clinical associations.

Objectives: We wanted to assess the following: (1) the incidence of granular parakeratosis in biopsy specimens; (2) the differential diagnosis submitted with specimens requisition of granular parakeratosis; and (3) variations in its histopathology.

Hypoxia and anemia: factors in decreased sensitivity to radiation therapy and chemotherapy?

Hypoxia is a common feature of solid tumors that occurs across a wide variety of malignancies. Hypoxia and anemia (which contributes to tumor hypoxia) can lead to ionizing radiation and chemotherapy resistance by depriving tumor cells of the oxygen essential for the cytotoxic activities of these agents. Hypoxia may also reduce tumor sensitivity to radiation therapy and chemotherapy through one or more indirect mechanisms that include proteomic and genomic changes.

Photosensitivity in lupus erythematosus.

Background: Lupus erythematosus is a systemic disease process that may manifest with a variety of internal and cutaneous findings. Photosensitivity is one the most common manifestations of lupus erythematosus. In patients with lupus erythematosus, there is a relationship between exposure to ultraviolet light, autoantibodies, genetics and other factors in the development of photosensitivity.

Controlling scabies in institutional settings: a review of medications, treatment models, and implementation.

Scabies is a global problem and a significant source of morbidity in nursing home residents and workers because of its highly contagious nature. It is also a problem in hospitals that care for the elderly, the debilitated, and the immunocompromised. New outbreaks continue to occur, despite controlling the recurrent epidemics.

Identification of a recurrent mutation in the CYLD gene in Brooke-Spiegler syndrome.

Brooke-Spiegler syndrome is an autosomal dominantly inherited disease with predisposition to neoplasms of the skin appendages. The disease has been mapped to 16q, and mutations in the CYLD gene have been identified in families with this disorder. We describe an individual with BSS exhibiting clinical heterogeneity in which a heterozygous frameshift mutation in CYLD, 2172delA, has been identified.

Adalimumab (HUMIRA): a review.

Adalimumab (HUMIRA, Abbott Laboratories) is a new fully human TNF-alpha monoclonal antibody recently approved for the treatment of rheumatoid arthritis and undergoing trials for use in treating other conditions, including psoriasis and psoriatic arthritis. This article reviews its mechanisms of action, clinical trial results, and related discussion.

A case of dissecting cellulitis and a review of the literature.

Dissecting cellulitis (also called perifolliculitis capitis abscedens et suffodiens) manifests with perifollicular pustules, nodules, abscesses and sinuses that evolve into scarring alopecia. It predominantly occurs in African American men between 20-40 years of age, but can occasionally affect other races and women too. Associated musculoskeletal findings are sometimes reported.

Cardiogenic shock: a summary of the randomized SHOCK trial.

Cardiogenic shock is the most common cause of death for patients hospitalized with acute myocardial infarction. The Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock (SHOCK) trial randomly assigned 302 patients with predominant left ventricular failure following an acute myocardial infarction to a strategy of emergency revascularization or initial medical stabilization. Emergency revascularization by either coronary artery bypass grafting or angioplasty was required within 6 hours of randomization.

Body composition in aging: a biological perspective.

Purpose Of Review: Changes in body composition accompany and predict medical and surgical risk; interventions may be considered. Aging affects body composition, particularly in reduction of the body cell mass.

Recent Findings: The molecular biology of aging has become an active frontier of research in the past 30 years, with acceleration in the past decade.

Compartment reconstruction for De Quervain's disease.

A new surgical treatment for De Quervain's disease is presented, in which the anatomy and function of the first dorsal compartment is preserved. Our findings in 11 wrists in ten patients revealed complete relief of the pre-operative symptoms in all instances. The advantages of this technique are its ease, its restoration of normal anatomy, and the prevention of tendon prolapse.

High-dose-rate intraoperative irradiation: current status and future directions.

Intraoperative irradiation (IORT) refers to the delivery of a single high dose of radiation therapy at the time of surgery when the tumor bed can be precisely defined and adjacent normal tissue maximally protected. It can be effectively delivered using either electrons (IOERT) or photons produced from a high-dose-rate gamma emitting radioisotope (HDR-IORT) and has been explored primarily for locally advanced or recurrent tumors at high risk for local failure despite extensive resection and full dose external beam radiation. With coordinated multidisciplinary interaction, IORT can be integrated in a combined-modality setting without undue additional toxicity.

Migraine MLT-down: an unusual presentation of migraine in patients with aspartame-triggered headaches.

Aspartame, an artificial sweetener added to many foods and beverages, may trigger headaches in susceptible individuals. We report two patients with aspartame-triggered attacks in whom the use of an aspartame-containing acute medication (Maxalt-MLT) worsened an ongoing attack of migraine.

Endoscopic retrograde cholangiopancreatography and the pancreas: when and why?

Historically, endoscopic retrograde cholangeopancreatography (ERCP) has played a unique role as a diagnostic and therapeutic modality for diseases of the pancreas. Despite the advent of new imaging techniques, ERCP continues to play a central role in the evaluation and treatment of pancreatitis of various causes. Endoscopic cholangiography and stenting remain mainstays in the palliation of inoperable obstructive jaundice in patients with cancer of the pancreas.

Menstrual migraine: diagnosis and treatment.

Of the nearly 20 million American women suffering with migraine, approximately 12 million experience a worsening of their migraines in association with their menstrual cycle. Prior to puberty the prevalence of migraine is slightly higher in boys; however, after puberty there is an emerging female predominance. Estrogen likely plays an important role in explaining this gender difference; however, hormones unlikely explain the entire epidemiologic variation.

Correlations between skeletal muscle mass and bone mass in children 6-18 years: influences of sex, ethnicity, and pubertal status.

A constant sex-specific relationship between skeletal muscle mass and bone mass was observed in healthy adults based on TBK/TBCa, using TBK (total body potassium) by 40K counting and TBCa (total body calcium) by in-vivo neutron activation analysis (Ellis and Cohn, 1975). We revisited this topic in children by studying correlations between TBK and TBCa, and by comparing TBK/TBCa between sexes, pubertal groups (prepubertal and pubertal) and ethnic groups in 141 white, 101 black, and 62 Asian healthy children, aged 6 - 18 years, living in New York City. TBK was measured by 40K counting, and TBCa by dual energy x-ray absorptiometry.

Pregnancy rates following hysteroscopic polypectomy, myomectomy, and a normal cavity in infertile patients.

Objective: To assess the reproductive benefits of hysteroscopic myomectomy and polypectomy for infertility when compared to infertile couples with a normal cavity at hysteroscopy.Material and Methods: All patients with a diagnosis of infertility who underwent hysteroscopic evaluation by a single surgeon between 1975 and 1996 were sent a questionnaire as routine follow-up regarding their reproductive history. All 100 subjects who were located responded to the questionnaire, and 78 subjects met the inclusion criteria; age <45 years, 12 months of infertility, and 18 months of follow-up with attempts to conceive including in vitro fertilization in patients with bilateral tubal occlusion.

Total temporomandibular joint replacement. Who? What? When? Where?

The temporomandibular joint, like other joints such as the hip and knee, can be affected by a number of conditions that may lead to joint failure, necessitating total joint replacement. The TMJ Implants, Inc., or Christensen alloplastic reconstruction prostheses, play an important role in the treatment of these conditions.

Studies of calcium in food supplements in humans.

Colon cancer is one of the commonest cancers in the Western world. Environmental factors appear to predominate as exemplified by a change in incidence in colon cancer within 20 years when people emigrate from a low- to a high-incidence country. It had been suggested that a diet high in energy, fat, and meat content and low in fiber content is most likely responsible.