Pure Testicular Choriocarcinoma with Dermatological, Brain, and Gastrointestinal Metastases.

Testicular choriocarcinoma is a non-seminomatous germ cell tumor (NSGCT) and is the rarest of all testicular cancers. Nearly all choriocarcinomas can be classified as either pure choriocarcinoma or as a component of a mixed germ cell tumor. Pure testicular choriocarcinoma is extremely aggressive and metastasizes early and extensively.

Regulation of apolipoprotein A-I gene expression by the histamine H1 receptor: Requirement for NF-κB.

Aims: Earlier it had been found by us that apolipoprotein A-I (apo A-I) is suppressed by histamine in HepG2 cells. Histamine has been shown to regulate NF-κB activity, though not in hepatocytes. Therefore we examined the role of the histamine receptors and NF-κB in histamine-mediated apo A-I gene expression in HepG2 liver cells.

Evaluation and management of traumatic diaphragmatic injuries: A Practice Management Guideline from the Eastern Association for the Surgery of Trauma.

Background: Traumatic diaphragm injuries (TDI) pose both diagnostic and therapeutic challenges in both the acute and chronic phases. There are no published practice management guidelines to date for TDI. We aim to formulate a practice management guideline for TDI using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology.

Percutaneous transhepatic vs. endoscopic retrograde biliary drainage for suspected malignant hilar obstruction: study protocol for a randomized controlled trial.

Background: The optimal approach to the drainage of malignant obstruction at the liver hilum remains uncertain. We aim to compare percutaneous transhepatic biliary drainage (PTBD) to endoscopic retrograde cholangiography (ERC) as the first intervention in patients with cholestasis due to suspected malignant hilar obstruction (MHO).

Methods: The INTERCPT trial is a multi-center, comparative effectiveness, randomized, superiority trial of PTBD vs.

Risk of histologic Barrett's esophagus between African Americans and non-Hispanic whites: A meta-analysis.

Background: Barrett's esophagus (BE) is rare in African Americans (AA). However, the risk difference magnitude in histologic BE prevalence between AA and non-Hispanic whites (nHw) has not been quantified to date.

Objective: The objective of this article is to determine the degree of histologic BE risk difference between AA and nHw.

Inhibition of hepatic apolipoprotein A-I gene expression by histamine.

In a recent high throughput analysis to identify drugs that alter hepatic apolipoprotein A-I (apo A-I) expression, histamine receptor one (H) antagonists emerged as potential apo A-1 inducing drugs. Thus the present study was undertaken to identify some of the underlying molecular mechanisms of the effect of antihistaminic drugs on apo AI production. Apo A-I levels were measured by enzyme immunoassay and Western blots.

HIV/AIDS Outreach: Curriculum Development and Skills Training to Health and Information Professionals.

With funding from the National Library of Medicine HIV/AIDS Community Information Outreach Program (ACIOP), librarians at the University of Florida Health Sciences Libraries partnered with university and community groups to facilitate collaboration, develop new information resources, develop information-seeking skills, and raise general awareness surrounding HIV/AIDS risks, prevention, and treatment. This article describes the skills development elements of the project, including development and implementation of an HIV/AIDS information resource curriculum for health care providers, social services professionals, and public librarians within the project's partner organizations.

False Lung Metastasis: Concurrent Ewing Sarcoma and Minimally Invasive Adenocarcinoma.

Pediatric lung cancer is a very rare occurrence, particularly as a primary lesion. A concurrent diagnosis is even more unusual and only reported a handful of times in Ewing sarcoma. Our patient is a 13-year-old boy who had concurrent diagnoses of Ewing sarcoma and minimally invasive adenocarcinoma of the lung, formerly bronchoalveolar carcinoma.

Perforated esophageal intervention focus (PERF) study: a multi-center examination of contemporary treatment.

The treatment of esophageal perforation (EP) remains a significant clinical challenge. While a number of investigators have previously documented efficient approaches, these were mostly single-center experiences reported prior to the introduction of newer technologies: specifically endoluminal stents. This study was designed to document contemporary practice in the diagnosis and management of EP at multiple institutions around the world and includes early clinical outcomes.

Musculoskeletal Ultrasound Instruction in Adult Rheumatology Fellowship Programs.

Objective: Musculoskeletal ultrasound (MSUS) in rheumatology in the US has advanced by way of promotion of certifications and standards of use and inclusion of core fellowship curriculum. In order to inform endeavors for curricular integration, the objectives of the present study were to assess current program needs for curricular incorporation and the teaching methods that are being employed.

Methods: A needs-assessment survey (S1) was sent to 113 rheumatology fellowship program directors.

Immediate Reconstruction and Dental Rehabilitation of Segmental Mandibular Defects: Description of a Novel Technique.

The aim of this report is to present a new technique using current technologic advances for immediate reconstruction and dental rehabilitation of segmental mandibular defects with a screw-retained prosthesis. One case is reviewed and a detailed review of surgical and prosthetic techniques used is presented.

A Framework Illustrating Care-Seeking Among Older Adults in a Hospital Emergency Department.

Background And Objectives: Older adults seeking emergency department (ED) care often have multiple, complex chronic conditions. We sought to understand factors that influence ED care-seeking by older adults and present a theoretical framework illustrating this process.

Research Design And Methods: In this grounded theory study, we interviewed 40 older adults with chronic illness within 90 days of an ED visit to explore their decision-making about seeking ED care.

Enhancing Feedback on Professionalism and Communication Skills in Anesthesia Residency Programs.

Background: Despite its importance, training faculty to provide feedback to residents remains challenging. We hypothesized that, overall, at 4 institutions, a faculty development program on providing feedback on professionalism and communication skills would lead to (1) an improvement in the quantity, quality, and utility of feedback and (2) an increase in feedback containing negative/constructive feedback and pertaining to professionalism/communication. As secondary analyses, we explored these outcomes at the individual institutions.

Anatomic Knowledge and Perceptions of the Adequacy of Anatomic Education Among Applicants to Orthopaedic Residency.

Background: The time dedicated to the study of human anatomy within medical school curriculums has been substantially reduced. The effect of this on the knowledge of incoming orthopaedic trainees is unknown. The current study aimed to evaluate both the subjective perceptions and objective anatomic knowledge of fourth-year medical students applying for orthopaedic residency.

Survival of women with microinvasive adenocarcinoma of the cervix is not improved by radical surgery.

Background: Treatment for early-invasive adenocarcinoma of the cervix remains controversial. Although data have shown similar survival rates to those seen with squamous cell carcinoma, conservative options for patients with microinvasive adenocarcinoma have not been as widely accepted. Despite comparable survival outcomes, patients with early-invasive adenocarcinoma are still routinely subjected to more radical surgical techniques than their equivalently staged squamous cell counterparts.

Behavioral and Pharmacological Adherence in Pediatric Sickle Cell Disease: Parent-Child Agreement and Family Factors Associated With Adherence.

Objective: This study aimed to evaluate agreement between children and parents on a measure of behavioral and pharmacological adherence in children with sickle cell disease (SCD), and the associations among family factors (i.e., problem-solving skills, routines, communication) and adherence behaviors.

The frequency of histologically confirmed Barrett's esophagus varies by the combination of ethnicity and gender.

Background: Barrett's esophagus (BE) is the primary risk factor for esophageal adenocarcinoma (EAC). Limited data exists regarding the frequency of histologically confirmed BE by both gender and ethnicity in the United States. The study aim was to determine whether the frequency of histologically confirmed BE varies by ethnicity and gender.

How implantable cardioverter-defibrillators work and simple programming.

Following the sudden death of a friend in 1966, Dr Michel Mirowski began pioneering work on the first implantable cardioverter-defibrillator. By 1969 he had developed an experimental model and performed the first transvenous defibrillation. In 1970 he reported on the use of a "standby automatic defibrillator" that was tested successfully in dogs.

Randomized, placebo-controlled trial evaluating the safety of one-year administration of green tea catechins.

Purpose: Although preclinical, epidemiological and prior clinical trial data suggest that green tea catechins (GTCs) may reduce prostate cancer (PCa) risk, several preclinical studies and case reports have reported liver toxicities and acute gastrointestinal bleeding. Based on these observations, regulatory bodies have required stringent inclusion criteria with frequent, excessive toxicity monitoring and early stopping rules in clinical trials. These requirements have impeded recruitment and retention of subjects in chemoprevention trials and subsequent progress in agent development efforts.