Development of an international standard set of outcome measures for patients with venous thromboembolism: an International Consortium for Health Outcomes Measurement consensus recommendation.

The International Consortium for Health Outcomes Measurement assembled an international working group of venous thromboembolism experts and patient representatives to develop a standardised minimum set of outcomes and outcome measurements for integration into clinical practice and potentially research to support clinical decision making and benchmarking of quality of care. 15 core outcomes important to patients and health-care professionals were selected and categorised into four domains: patient-reported outcomes, long term consequences of the disease, disease-specific complications, and treatment-related complications. The outcomes and outcome measures were designed to apply to all patients with venous thromboembolism aged 16 years or older.

The Challenges of HLA Class I Loss in Cancer Immunotherapy: Facts and Hopes.

HLA class I molecules are key in tumor recognition and T cell-mediated elimination. Loss of tumor HLA class I expression with different underlying molecular defects results in reduced antigen presentation and facilitates cancer immune evasion. It is also linked to significant changes in tumor microenvironment and tissue architecture.

Adenocarcinoma of the Lung Metastatic to the Ovary With a Signet Ring Cell Component.

A nonsmoker 45-year-old woman, presented with a solid right ovarian mass. Microscopic examination revealed heterogeneous histology with tubular formations and extensive signet ring cell component that resembled the usual appearance of metastatic gastric carcinoma to the ovary. Moreover, the histology also showed solid nests of cells with a microvacuolated basophilic cytoplasm similar to those found in adenosquamous cervical carcinoma of glassy cell type.

Characterization of daptomycin non-susceptible Enterococcus faecium producing urinary tract infection in a renal transplant recipient.

Objectives: Characterization of a urine isolate of daptomycin non-susceptible Enterococcus faecium recovered from a patient with kidney transplantation and no history of daptomycin exposure.

Methods: After isolation in a urine sample, identification of E. faecium was confirmed by amplification of the E.

Adenovirus expressing β2-microglobulin recovers HLA class I expression and antitumor immunity by increasing T-cell recognition.

Optimal tumor cell surface expression of human leukocyte antigen (HLA) class I molecules is essential for the presentation of tumor-associated peptides to T-lymphocytes. However, a hallmark of many types of tumor is the loss or downregulation of HLA class I expression associated with ineffective tumor antigen presentation to T cells. Frequently, HLA loss can be caused by structural alterations in genes coding for HLA class I complex, including the light chain of the complex, β2-microglobulin (β2m).

Treatment of ovarian anaplastic ependymoma by an aromatase inhibitor.

Background: Histopathologic diagnosis and treatment of ovarian anaplastic ependymoma are challenging.

Case: A 61-year-old-woman presented with a 10-cm right adnexal tumor associated with peritoneal carcinomatosis extending to the right diaphragm and liver surface. After initial diagnosis of a papillary serous carcinoma, we performed extensive but nonoptimal cytoreductive surgery including hysterectomy with bilateral oophorectomy.

Immune escape of cancer cells with beta2-microglobulin loss over the course of metastatic melanoma.

Cancer cells escape T-cell-mediated destruction by losing human leukocyte antigen (HLA) class I expression via various mechanisms, including loss of beta2-microglobulin (β2m). Our study illustrates the immune escape of HLA class I-negative tumor cells and chronological sequence of appearance of tumor β2m gene mutation in successive lesions obtained from a patient with metastatic melanoma. We observed a gradual decrease in HLA expression in consecutive lesions with few HLA-negative nodules in the primary tumor and the emergence of a totally negative lesion at later stages of the disease.

Prevention of VTE in nonorthopedic surgical patients: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines.

Background: VTE is a common cause of preventable death in surgical patients.

Methods: We developed recommendations for thromboprophylaxis in nonorthopedic surgical patients by using systematic methods as described in Methodology for the Development of Antithrombotic Therapy and Prevention of Thrombosis Guidelines. Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines in this supplement.

Yolk sac tumours revisited. A review of their many faces and names.

We review the current knowledge on human yolk sac tumours (YSTs) 50 years after their initial description. Their complex nomenclature and histogenesis stress the fact that they are not a discrete entity, but represent a multifaceted group of neoplasms, for which the term primitive endodermal tumours would be more appropriate, accounting for their capacity to differentiate into various extraembryonal and somatic cell types. Different histological patterns of human YSTs correlate with the developmental potential of primitive endoderm and mesenchyme, but they are also similar to some murine experimental tumours.

Current status of venous thromboembolism prophylaxis.

Postoperative venous thromboembolism (VTE) represents a serious and potentially fatal complication that affects 40% to 60% of patients undergoing major orthopedic surgery and not receiving antithrombotic prophylaxis. Several prophylactic modalities, including pharmacological agents such as oral vitamin K antagonists (VKA) and low molecular weight heparins (LMWH), have been shown to be effective and safe for most patients at high risk for VTE. However, some patients undergoing cancer or major orthopedic surgery remain at some residual VTE risk despite the use of these methods.

Low level of exposure to pesticides leads to lung dysfunction in occupationally exposed subjects.

Pesticides may contribute to adverse respiratory health effects among farmers and have been considered one causal factor for the rise in asthma prevalence. This cross-sectional study was conducted to evaluate potential respiratory function abnormalities following long-term pesticide exposure by means of a complete pulmonary function testing, including spirometry, lung volumes, and diffusing capacity for carbon monoxide. The study population was comprised by workers from a prominent intensive agriculture area of southern Spain that relied on pesticides for the control of plagues.

A fatal case following exposure to zinc chloride and hexachloroethane from a smoke bomb in a fire simulation at a school.

Introduction: The common mixture for smoke bombs contains zinc oxide and a chlorine donor, which allows for the formation of fine particles of zinc chloride. We report a fatal case of exposure to a smoke bomb used for a fire training exercise at a school.

Case Report: A 21-year-old student inhaled zinc oxide/hexachloroethane from a smoke bomb during a fire simulation at a school.

Subjective effects and the main reason for smoking in outpatients with schizophrenia: a case-control study.

This study examines in daily smokers (1) subjective effects and main reason for smoking after controlling for nicotine dependence level in 100 controls and 173 patients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, schizophrenia and (2) the association of specific subjective effects and schizophrenia symptoms. The subjective effects and the main reason for smoking were studied using a questionnaire and the schizophrenia symptoms with the Positive and Negative Syndrome Scale. Proportions were compared by odds ratios controlling for the effects of sex, age, education, and level of nicotine dependence by logistic regression.

Venous thromboembolism following major orthopedic surgery: what is the risk after discharge?

Guidelines recommend thromboprophylaxis for at least 10 days to prevent venous thromboembolism in patients undergoing high-risk orthopedic surgery, such as total hip arthroplasty (THA) or total knee arthroplasty (TKA). Furthermore, the recently updated ACCP guidelines also recommend extending the duration of thromboprophylaxis for 28 to 35 days following THA or hip fracture surgery as the risk for venous thromboembolism persists for up to 3 months after surgery. Extended-duration thromboprophylaxis (up to 6 weeks) with low-molecular-weight heparin is significantly more effective in preventing venous thromboembolism in orthopedic surgery patients than the recommended practice of at least 10 days.

Fewer but heavier caffeine consumers in schizophrenia: a case-control study.

According to the literature, there is an association between schizophrenia and caffeine consumption, but it is not clear whether schizophrenia is associated with either higher prevalence of daily caffeine intake or the amount consumed. In this study we compared our previously published schizophrenia patients (n=250) with a control sample (n=290) after controlling for demographic variables and tobacco and alcohol consumption. Current caffeine intake was less frequent in schizophrenia patients (59%, 147/250) than in controls (70%, 204/290).

Emotional distress and occupational burnout in health care professionals serving HIV-infected patients: A comparison with oncology and internal medicine services.

Background: The present paper examines the levels of emotional distress and professional burnout among health care professionals working with HIV patients in two different settings, Infectious Disease (ID) Units and a Haemophilia (H) Unit, and compares them with those of professionals working in Oncology (O) or General Internal Medicine (IM) Units, all at public hospitals.

Methods: Cross-sectional anonymous survey assessing their psychological condition, occupational stress, work and social adjustment, and providing information about stressors, supports and coping methods, using the General Health Questionnaire, the Maslach Burnout Inventory, the Modified Social Adjustment Scale, and other self-administered instruments.

Results: Perceived stress was higher in both O and IM, and the number of stressful circumstances was especially higher in O.

Subendometrial contractility in menstrual phase visualized by transvaginal sonography in patients with endometriosis.

Objective: To describe the propagation direction of the subendometrial myometrial contractile wave in menstrual phase sonographically assessed in patients with and without endometriosis.

Design: Prospective study.

Setting: Patients and normal volunteers in a university hospital.

Prenatal sonographic appearance of foramina parietalia permagna.

Foramina parietalia permagna (FPP) is an extremely uncommon congenital defect, inherited as an autosomal dominant condition. Its characteristics are two symmetrical orifices in the parietal bones (not of fixed size) on both sides of the midline. This defect does not affect either the psychic or the physical development of the affected person.

Alobar holoprosencephalic embryo detected via transvaginal sonography.

The incorporation of high-frequency transvaginal probes in commercial ultrasonic equipment allows now for the earlier detection of fetal malformations and the possibility of interrupting pregnancy when such an anomaly is incompatible with postnatal life. We describe here a case of alobar holoprosencephaly associated with serious facial anomalies, diagnosed via transvaginal sonography during the 10th week of amenorrhea. A cytogenetic study was carried out by transabdominal chorial biopsy and diagnostic confirmation by necropsy was made after termination.

Prenatal ultrasound semiography of anencephaly: sonographic-pathological correlations.

A better understanding of the ultrasound findings in each of the different types of fetal anencephaly can help to reduce the number of false-negative diagnoses of this condition during the prenatal period. Errors in the estimation of the remaining cerebral tissue (angiomatous stroma, area cerebrovasculosa) can cause false-negative diagnoses or diagnostic confusion with cases of microcephaly or incomplete ossification of the cranial vault. In a retrospective study, 30 fetuses with anencephaly (diagnosed at 13-38 weeks of gestation) were grouped, in terms of their ultrasound results, according to the Nanagas classification.

Regression of peritoneal leiomyomatosis after treatment with gonadotropin releasing hormone analogue.

A case of a 42-year-old woman with peritoneal leiomyomatosis (PL) unrelated to pregnancy or any other obvious hormonal source is presented. After treatment with leuprolide acetate for six months, a second-look operation revealed that the majority of the nodules totally regressed. The few remaining ones were substantially reduced in size and exhibited histopathologic evidence of fibrotic change.