Does conventional posterior vault remodeling alter endocranial morphology in patients with true lambdoid synostosis?

Background: True lambdoid synostosis (TLS) produces a consistent morphology that includes occipital flattening, an ipsilateral occipitomastoid prominence, and a mild contralateral hemifacial deficiency that minimally improves with surgery. Prior studies have demonstrated that dysmorphic middle and posterior cranial fossae contribute to the craniofacial scoliosis characteristic of TLS. We hypothesize that these endocranial features remain after surgery, causing the persistent hemifacial deficiency seen in these patients.

Reversal of associations between Spanish language use and mammography and pap smear testing.

Latina women are less likely to utilize cancer screening services than are non-Latina White women. The purpose of this study is to examine the relationship between preferred language (English vs. Spanish) and receipt of mammography and Pap-smear testing among US Latinas and non-Latinas.

Extended-release niacin acutely suppresses postprandial triglyceridemia.

Objective: Postprandial triglyceridemia predicts cardiovascular events. Niacin might lower postprandial triglycerides by restricting free fatty acids. Immediate-release niacin reduced postprandial triglycerides, but extended-release niacin failed to do so when dosed the night before a fat challenge.

Robotics and telesurgery in otolaryngology.

This article reviews the use of robotic technology for otolaryngologic surgery. The authors discuss the development of the technology and its current uses in the operating room. They address procedures such as oropharyngeal transoral robotic surgery (TORS), laryngeal TORS, and thyroidectomy, and also note the role of robotics in teaching.

Efficacy and complications of surgery for Crohn's disease.

Patients with Crohn's disease commonly undergo surgery during their lifetime. Indications for surgical intervention include obstruction, intra-abdominal or perianal abscess, enterocutaneous fistulas, and complex perianal disease. As medical therapies continue to improve, it is important that surgical therapies are chosen carefully.

Analysis of differences in the cranial base and facial skeleton of patients with lambdoid synostosis and deformational plagiocephaly.

Background: Earlier investigations suggest that the morphologic features of patients with lambdoid synostosis include ipsilateral occipital flattening, an ipsilateral mastoid prominence, downward cant of the posterior skull base to the affected side, and contralateral hemifacial deficiency. These features are absent in patients with deformational plagiocephaly. The authors hypothesize that significant differences in craniofacial morphology exist between patients with lambdoid synostosis and those with deformational plagiocephaly.

Fatal fat embolism in isolated vertebral compression fracture.

Fat embolism after long bone and pelvic fractures as well as orthopedic interventions is a well-documented phenomenon, but it is highly unusual after isolated vertebral fractures. We report a case of fatal fat embolism in a 78-year-old man after an isolated vertebral compression fracture with no related orthopedic intervention. A high index of suspicion is necessary for early diagnosis and successfully treating this unusual complication.

MRI features of cellular angiomyofibroma with pathologic correlation.

Within the spectrum of extratesticular mesenchymal tumors in the scrotum and perineum lies cellular angiofibroma, also known as angiomyofibroblastoma-like tumor, a rare lesion originally described to almost exclusively occur in the vulva, perineum, and pelvis of women. We report a case of this tumor, with an adjacent scrotal lipoma, occurring in a 60-year-old male who presented to our department with a firm palpable scrotal mass. To our knowledge, the MRI findings of this entity have yet to be described in the radiological literature.

Immunohistochemical expression of estrogen receptors in chondrosarcomas and enchondromas.

Immunohistochemical expression of estrogen receptors alpha and beta was studied in chondrosarcomas and enchondromas and was correlated with chondrosarcoma grade, type, and dedifferentiation. Estrogen receptor alpha was studied in 37 chondrosarcomas, 10 enchondromas, and 2 extraskeletal myxoid chondrosarcomas. Estrogen receptor beta was studied in 23 chondrosarcomas, 6 enchondromas, and 2 extraskeletal myxoid chondrosarcomas.

Bronchiectasis, part 2: Management.

Systemic antibiotics are the mainstay of the management of acute exacerbations of bronchiectasis. Antibiotic selection should include coverage for Streptococcus pneumoniae and Haemophilus influenzae; particular attention also should be paid to the presence of Staphylococcus aureus and Pseudomonas species. The duration of antibiotic therapy is not well-established, but most clinicians recommend a prolonged course, often longer than 3 weeks.

Phospho-S6 ribosomal protein: a potential new predictive sarcoma marker for targeted mTOR therapy.

Metastatic sarcomas are commonly resistant to chemotherapy. The serine/threonine kinase, mammalian target of rapamycin (mTOR), is a protein kinase of the phosphatidylinositol 3-kinase (PI3K)/AKT signaling pathway thought to have a key role in controlling cancer growth and thus is an important target for cancer therapy. Several inhibitors of mTOR are in clinical trials, including AP23573, which is being tested on metastatic sarcomas and other tumors.

Developing a multidisciplinary geriatric oncology program in a community cancer center.

Cancer is a disease of older adults, and with unprecedented growth in the number of people entering late adulthood, an increasing need exists for specialized services and programs to address the needs of older adults with cancer. Few examples in the literature detail development of a geriatric oncology program. This article describes a pilot project undertaken by a community cancer center to develop a specialized program for older adults with cancer by identifying local demographics and population needs.

Association between indices of prosthesis internal orifice size and operative mortality after isolated aortic valve replacement.

Objectives: The appropriate index of prosthesis internal orifice size and its effect on operative mortality after aortic valve replacement are controversial. We examined the association between several relevant indices and patient size on operative mortality. Indices examined included projected in vivo effective orifice area and geometric orifice area, with patient size defined as body surface area.

Advanced maternal age is an independent risk factor for intrauterine growth restriction.

Reports on the association between advanced maternal age (AMA) and intrauterine growth restriction (IUGR) are conflicting. Our objective was to determine if AMA is an independent risk factor for IUGR. Our case-control study compared cases with IUGR (birthweight<10th percentile for gestational age) and a control group without IUGR.

Guidelines for the clinical use of transmyocardial laser revascularization.

Patients with chronic, severe angina refractory to medical therapy who cannot be completely revascularized with either percutaneous catheter intervention or coronary artery bypass graft surgery (CABG) are clinically challenging. Transmyocardial laser revascularization (TMR), as sole therapy or as an adjunct to CABG, may be appropriate therapy for these patients. The recommendations are based on a review of the available evidence including expert consensus opinions.