Allergic disease is associated with epilepsy in childhood: a US population-based study.

Background: Previous studies using animal models suggest an association between allergic disease and epilepsy. We sought to determine whether allergic disease is associated with epilepsy in children.

Methods: We used the 2007-2008 National Survey of Children's Health, a US population-based study of 91 642 children aged 0-17 years to determine the association between the prevalence of epilepsy and allergic disease, including asthma, atopic dermatitis (AD)/eczema, hay fever, and food allergies.

CD99 expression in dermatofibrosarcoma protuberans and dermatofibroma.

Background: Differentiating between dermatofibrosarcoma protuberans (DFSP) and hypercellular dermatofibroma (DF) can sometimes be challenging, and a panel of immunostains is often employed. Expression of conventional markers oftentimes overlaps. We evaluated CD99 expression in DFSP and DF and its utility in distinction between these 2 entities.

Treatment of cancer-associated retinopathy with rituximab.

Cancer-associated retinopathy (CAR) is a rare autoimmune condition associated with various cancers, causing significant visual impairment. Visual symptoms in CAR may or may not correlate with the extent of systemic disease or its response to chemotherapy, and must be addressed separately from the management of systemic malignancy. Steroids have been the mainstay of CAR therapy.

How Patient Interactions With a Computer-Based Video Intervention Affect Decisions to Test for HIV.

The current study examines predictors of HIV test acceptance among emergency department patients who received an educational video intervention designed to increase HIV testing. A total of 202 patients in the main treatment areas of a high-volume, urban hospital emergency department used inexpensive netbook computers to watch brief educational videos about HIV testing and respond to pre-postintervention data collection instruments. After the intervention, computers asked participants if they would like an HIV test: Approximately 43% (n = 86) accepted.

Nodular fasciitis: a possible side effect of etanercept?

Etanercept is a biologic agent prescribed by dermatologists for the treatment of moderate to severe plaque psoriasis and psoriatic arthritis. Although the safety profile of etanercept is well established, it is always important to be vigilant in noting the development of novel side effects associated with biologic agents. We report a case of biopsy-proven nodular fasciitis (NF) that developed in an otherwise healthy man with plaque psoriasis who was undergoing treatment with etanercept.

From the Medical Board of the National Psoriasis Foundation: The risk of cardiovascular disease in individuals with psoriasis and the potential impact of current therapies.

Background: Many studies have identified cardiovascular risk factors in patients with psoriasis. Some psoriasis therapies may increase cardiovascular disease (CVD) and others may decrease CVD.

Objective: We reviewed the literature to define the impact of common psoriasis therapies on cardiovascular measures and outcomes.

Endoscopic tattooing to mark distal margin for low anterior rectal and select sigmoid resections.

Obtaining a reliable distal margin during anterior colorectal resection can be difficult. In this study, endoscopic transmural tattoos were placed to mark the distal transection point in patients with distal colorectal neoplasms who undergo bowel resection. In the operating room, before surgery, sigmoidoscopy is performed with a 2-channel scope using CO₂ insufflation.

A phase II study of bevacizumab and high-dose interleukin-2 in patients with metastatic renal cell carcinoma: a Cytokine Working Group (CWG) study.

Overexpression of vascular endothelial growth factor in renal cell carcinoma (RCC) leads to angiogenesis, tumor progression, and inhibition of immune function. We conducted the first phase II study to estimate the efficacy and safety of bevacizumab with high-dose interleukin-2 (IL-2) therapy in patients with metastatic RCC. Eligible patients had predominantly clear cell metastatic RCC, measurable disease, a Karnofsky Performance Status of ≥80%, and adequate end-organ function.

Jolt accentuation of headache and other clinical signs: poor predictors of meningitis in adults.

Jolt accentuation or exacerbation of a baseline headache with horizontal rotation of the neck is a physical finding believed to assess for meningeal irritation. We conducted a prospective observational study of neurologically intact emergency department (ED) patients undergoing lumbar puncture in 2 inner city academic EDs to validate the sensitivity and specificity of jolt accentuation and to assess the sensitivity and specificity of Kernig sign, Brudzinski sign, and nuchal rigidity, in predicting cerebrospinal fluid (CSF) pleocytosis in individuals being assessed for meningitis. Adult patients 18 years and older undergoing lumbar puncture between 2006 and 2009 were approached for consent.

Aplasia cutis congenita in a setting of fetus papyraceus associated with small fetal abdominal circumference and high alpha-fetoprotein and amniotic acetylcholinesterase.

Fetus papyraceus is the fetal death of one or more fetuses in a multiparous pregnancy. The surviving infants can experience extensive aplasia cutis in an H-shaped distribution over the flanks and abdomen as a consequence of the loss of their fetal sibling. We report the case of a monochorionic, diamniotic pregnancy complicated by a single fetal death at 13 weeks of gestational age.

Cigarette smoke activates the proto-oncogene c-src to promote airway inflammation and lung tissue destruction.

The diagnosis of chronic obstructive pulmonary disease (COPD) confers a 2-fold increased lung cancer risk even after adjusting for cigarette smoking, suggesting that common pathways are operative in both diseases. Although the role of the tyrosine kinase c-Src is established in lung cancer, less is known about its impact in other lung diseases, such as COPD. This study examined whether c-Src activation by cigarette smoke contributes to the pathogenesis of COPD.

The second best arterial graft: a propensity analysis of the radial artery versus the free right internal thoracic artery to bypass the circumflex coronary artery.

Objective: We sought to determine if the radial artery (RA) or the free right internal thoracic artery (RITA) is the better conduit to bypass the circumflex coronary artery during coronary artery bypass grafting (CABG) using the left internal thoracic artery (LITA).

Methods: Propensity matching was performed on 2488 CABG-LITA patients from 2 affiliated centers, resulting in 528 pairs who received either a RA at one center or a free RITA at the other center to bypass the circumflex coronary artery from 1995 to 2009.

Results: Kaplan Meier estimated 1-, 5-, 10-, and 15-year survival rates were 99%, 95%, 85%, and 76% for RA patients, respectively, and 97%, 92%, 80%, and 71% for RITA patients, respectively (P = .

Acitretin.

Acitretin, a synthetic retinoid, is the pharmacologically active metabolite of etretinate. It is currently approved by the US Food and Drug Administration for the treatment of severe psoriasis in adults and has been established as a second-line therapy for the treatment of psoriasis resistant to the use of topical therapy. It is also an option for generalized pustular psoriasis, palmoplantar pustulosis, exfoliative erythrodermic psoriasis, and severe psoriasis in the setting of acitretin.

Childhood atopic dermatitis and warts are associated with increased risk of infection: a US population-based study.

Background: Previous studies suggested that atopic dermatitis (AD) is associated with aberrant immune responses, which might predispose toward both cutaneous and extracutaneous infections. The goal of this study was to determine whether childhood AD is associated with increased risk of warts, extracutaneous infections, and other atopic diseases and how these disorders cosegregate.

Methods: The 2007 National Health Interview Survey from a nationally representative sample of 9417 children age 0 to 17 years was used.

Characteristics of an outpatient treatment sample by primary substance of abuse.

Objective: This study examines sociodemographic and clinical characteristics, as a function of primary substance of abuse, among clients approached, screened, and assessed for eligibility in a 10-site effectiveness trial of a Web-based psychosocial intervention for substance use disorders. Consistent with the design of effectiveness trials, eligibility criteria were broad and exclusion criteria minimal; thus, the recruited sample may be viewed as relatively representative of patients seeking treatment throughout the United States.

Methods: χ tests for categorical variables and F tests for continuous variables were used to analyze demographic, substance use, physical and mental health, and sexual risk data collected at screening and baseline; pairwise comparisons between primary substance subgroups for baseline data were conducted if the test statistic P value was 0.

Laparoendoscopic single-site surgery for the placement of an adjustable gastric band: a large cohort comparison.

Background: Laparoendoscopic single-site (LESS) surgery has been shown to be a well-tolerated alternative for the placement of an adjustable gastric band. To date, only small series have suggested that this approach may provide potential clinical benefits over standard multiport laparoscopy. The objective of this study was to compare the outcomes of patients undergoing LESS adjustable gastric banding (LESS-AGB) and a cohort of patients undergoing standard multiport laparoscopic adjustable gastric banding (LAGB).

Use of prognostic tools in the hospital, assessment of factors behind their use or lack thereof through a physician-oriented survey.

Physician's use of prognostic tools may help to decide on the intensity of therapies provided and communicate with patients and their caregivers in a timely fashion. However, literature that describes knowledge, perceived limitations and overall use of these tools by doctors is lacking. By way of a physician survey, we attempted to look at the use of prognostic tools in our community of doctors in our department of internal medicine.

Comparison of fluid volume estimates in chronic hemodialysis patients by bioimpedance, direct isotopic, and dilution methods.

Bioimpedance analysis (BIA) is accepted for the assessment of total-body water (TBW), intracellular fluid (ICF) and extracellular fluid (ECF). We aimed to compare precision and accuracy of single and multi-frequency-BIA to direct estimation methods (DEMs) of TBW, ECF, and ICF in hemodialysis patients. Linear regression analysis of volume estimates in 49 patients by single- and multi-frequency-BIA correlated significantly with DEMs.

PTPN22 profile indicates a novel risk group in Alopecia areata.

Alopecia areata (AA) is a genetically determined autoimmune hair loss disorder. A polymorphism in protein tyrosine phosphatase N22 (PTPN22), which normally suppresses T-cell proliferation, has been associated with human autoimmune disease, including AA in European populations. PTPN22 genotype frequency in known to vary geographically.

Fatal acute necrotizing eosinophilic myocarditis temporally related to use of adalimumab in a patient with relapsing polychondritis.

Tumor necrosis factor α (TNF-α) antagonists are being increasingly used as maintenance therapies for rheumatic diseases, and therefore knowledge of their adverse effects is important. We report a case of fatal acute necrotizing eosinophilic myocarditis temporally related to use of a second course of the TNF-α antagonist, adalimumab. A 51-year-old woman with relapsing polychondritis took adalimumab 2 weeks before presenting with acute myocarditis.

Impact of cardiovascular comorbidity on ovarian cancer mortality.

Background: A retrospective cohort study utilizing prospectively collected data was conducted from August 2003 until March 2008 at M.D. Anderson Cancer Center.