Analysis of PSPHL as a Candidate Gene Influencing the Racial Disparity in Endometrial Cancer.

Endometrial cancer is the most commonly diagnosed gynecologic malignancy in the United States. A well recognized disparity by race in both incidence and survival outcome exists for this cancer. Specifically Caucasians are about two times more likely to develop endometrial cancer than are African-Americans.

Obstructive sleep apnea presenting as pseudopheochromocytoma.

A 39-year-old man with a history of poorly controlled hypertension presented with a 2-year history of fatigue, daytime somnolence, and intermittent episodes of diaphoresis and palpitations. Episodes were self-limiting, lasting approximately 5-10 minutes and occurred several times per month, most notably at night. Laboratory evaluation was significant for elevated 24-h urinary catecholamine levels, suggestive of pheochromocytoma.

Biology and management of rare primary extranodal T-cell lymphomas.

Peripheral T-cell lymphomas (PTCLs) are uncommonly encountered malignancies in the United States, and hepatosplenic T-cell lymphoma (HSTCL), subcutaneous panniculitis-like T-cell lymphoma (SPTCL), and enteropathy-type T-cell lymphoma (ETTCL) are rare subtypes of PTCLs that often present with primarily extranodal disease. Despite the fact that these tumors have distinct clinical and pathologic features, they are often diagnosed after significant delay. The combination of delay in diagnosis with ineffective therapies has resulted in a poor prognosis in most cases.

Assessment of Orofacial Strength in Patients with Dysarthria.

Assessment of orofacial weakness is common during the evaluation of patients with suspected dysarthria. This study addressed the validity of clinical assessments of orofacial weakness by comparing clinical (subjective) ratings to instrumental (objective) measures. Forty-four adults referred to a speech pathology clinic for dysarthria evaluation were tested for strength of the tongue during elevation, lateralization, and protrusion, and for the strength of the muscles of the lower face during buccodental and interlabial compression.

How should we measure medication adherence in clinical trials and practice?

Objective: To determine if simple adherence measures, such as twenty-four hour recall and refill history, are accurate for routine use, compared to more time-consuming measures such as pill counts.

Design: Randomized, double-blind, placebo-controlled trial.

Setting: Walter Reed Army Medical Center, a tertiary medical center in Washington.

Population screening for prostate cancer and emerging concepts for young men.

Prostate cancer is the most common malignancy in American men, accounting for > 29% of all diagnosed cancers and approximately 13% of all cancer deaths. Nearly 1 of every 6 men will be diagnosed with the disease at some time in their lives. In 2003 alone, an estimated 221000 men in the United States will be diagnosed with prostate cancer and > 28000 will die of the disease.

Acute respiratory distress syndrome after kidney transplantation: epidemiology, risk factors, and outcomes.

Objective: To determine the rate of the acute respiratory distress syndrome (ARDS) after kidney transplantation and to identify risk factors associated with the development of ARDS after kidney transplantation and outcomes for patients diagnosed with ARDS in this setting.

Design: Retrospective analysis of the national registry for end-stage renal disease in the United States.

Patients: We studied all patients who underwent kidney transplantation between July 1, 1994 and June 30, 1998 and identified patients diagnosed with ARDS.

Thyroid cancer yield in patients with Graves' disease selected for surgery on the basis of cold scintiscan defects.

Previous studies have suggested that thyroid nodules found in patients with Graves' disease (GD) have a higher likelihood of being malignant, and that thyroid cancer behaves more aggressively when associated with GD, although both of these assertions remain controversial. The purpose of this study was to assess the frequency of cold scintiscan (SC) defects in patients with GD, and to determine the prevalence of thyroid cancer in such patients. Our secondary objective was to determine if there are any risk factors for developing cold defects by comparing clinical characteristics of both GD patients with cold SC defects and age and gender-matched GD patients without cold defects.

Local anti-angiogenic brain tumor therapies.

The critical role of angiogenesis in the growth of solid tumors, including neoplasms of the central nervous system, has provided the impetus for research leading to the discovery of inhibitors of tumor neovascularization. The therapeutic potential of systemically administered antiangiogenic drugs for brain tumors, however, is limited by a variety of anatomic and physiologic barriers to drug delivery. Implantable controlled-release polymers for local drug administration directly into the tumor parenchyma have therefore been developed to achieve therapeutic concentrations of these drugs within the brain while minimizing systemic toxicity.

Treatment of fibromyalgia with antidepressants: a meta-analysis.

Background: Fibromyalgia is a common, poorly understood musculoskeletal pain syndrome with limited therapeutic options.

Objective: To systematically review the efficacy of antidepressants in the treatment of fibromyalgia and examine whether this effect was independent of depression.

Design: Meta-analysis of English-language, randomized, placebo-controlled trials.

Endoscopic management of a pineal and suprasellar germinoma with associated hydrocephalus: technical case report.

A patient with a synchronous pineal and suprasellar germinoma and symptomatic hydrocephalus underwent a minimally invasive endoscopic biopsy and third ventriculostomy. We performed multiple biopsies of both tumors and fenestration of the floor of the third ventricle with a flexible fiberoptic endoscope through a single burr hole. Postoperative quantitative cine-mode magnetic resonance imaging (MRI) confirmed the patency of the fenestration.

Microcytic anemia with iron malabsorption: an inherited disorder of iron metabolism.

Two siblings were identified with severe hypoproliferative microcytic anemia and iron malabsorption, in the absence of any gastrointestinal disorder or blood loss. These children had severe microcytosis (MCV 48 fl, hemoglobin 7.5 g/dl) with decreased serum iron, elevated serum TIBC, and decreased serum ferritin, despite prolonged treatment with oral iron.

Cutaneous myiasis caused by the African tumbu fly (Cordylobia anthropophaga).

We describe a patient with cutaneous myiasis caused by the African tumbu fly (Cordylobia anthropophaga). This case demonstrates the need for a detailed travel history and an understanding of the fly life cycle to prevent erroneous diagnosis and to expedite prompt treatment. The nature of the lesions, larval morphological features, histological characteristics, and immune response directed toward fly maggots are described.