Reactive benign follicular mucinosis: a report of 2 cases.

We report 2 cases of adolescents who developed follicular mucinosis following cutaneous infections. A 17-year-old adolescent boy was evaluated for a 2-week history of erythematous papules and plaques on his face and neck. One month prior to presentation a culture was taken that was positive for methicillin-sensitive Staphylococcus aureus-associated impetigo.

Time-dependent trends in lymph node yield and impact on adjuvant therapy decisions in colon cancer surgery: an international multi-institutional study.

Background: Lymph node yield (LNY) and accuracy of nodal assessment are critical to staging and treatment planning in colon cancer (CC). A nationally agreed upon 12-node minimum is a quality standard in CC. The impact of this quality measure on LNY and impact on therapeutic decisions are evaluated in two international, multi-center, prospective trials comprising a well-characterized cohort assembled over 8 years (2001-2009) with long-term follow-up.

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.

Metabolic analysis of male servicemembers with transtibial amputations carrying military loads.

For servicemembers who have sustained amputations and wish to return to Active Duty, performing common military tasks is essential. The purpose of this study was to examine the metabolic requirements of servicemembers with transtibial amputations wearing a loaded rucksack and walking at a steady speed. We tested 12 servicemembers with unilateral transtibial amputations and 12 uninjured controls on a treadmill at two walking speeds (1.

Pain ratings by patients and their providers of radionucleotide injection for breast cancer lymphatic mapping.

Background: Disparity between patient report and physician perception of pain from radiotracer injection for sentinel node biopsy is thought to center on the severity of the intervention, ethnic composition of population queried, and socioeconomic factors.

Objective: The objectives of this study were, first, to explore agreement between physicians' and their breast cancer patients' pain assessment during subareolar radionucleotide injection; and second, to evaluate potential ethnic differences in ratings.

Methods: A trial was conducted, from January 2006 to April 2009, where 140 breast cancer patients were randomly assigned to standard topical lidocaine-4% cream and 99mTc-sulfur colloid injection, or to one of three other groups: placebo cream and 99mTc-sulfur colloid injection containing NaHCO3, 1% lidocaine, or NaHCO3 + 1% lidocaine.

Assessment of acute concussion in the combat environment.

Despite the prevalence of concussion in soldiers deployed to Iraq and Afghanistan, neuropsychological tests used to assist in concussion management have not been validated on the battlefield. This study evaluated the validity of the Automated Neuropsychological Assessment Metrics (ANAM) in the combat environment. Cases meeting criteria for concussion, healthy controls, and injured controls were assessed.

Use of physical therapy to augment dilator treatment for vaginal agenesis.

Objective: : Dilator therapy has been used successfully for many years to treat vaginal agenesis. Our objective was to show how established physical therapy techniques can be used to augment dilator therapy.

Methods: : A 36-year-old woman desiring nonsurgical management of vaginal agenesis was instructed in the use of vaginal dilators by a pelvic-floor physical therapist.

A pilot study on vaginally assisted laparoscopic sacrocolpopexy for patients with uterovaginal prolapse.

Objectives: : The primary objective of this pilot study was to compare the short-term anatomic outcomes and complication rates of vaginally assisted laparoscopic sacrocolpopexy (VALS) with those of conventional laparoscopic sacrocolpopexy (LS) in patients undergoing concurrent hysterectomy. The secondary objective was to compare operative times of the 2 different techniques.

Methods: : This is a retrospective pilot study comparing VALS-a method using transvaginal mesh attachment to the vaginal apex-to conventional LS in patients undergoing concurrent hysterectomy.

Anatomical and histological examination of the porcine vagina and supportive structures: in search of an ideal model for pelvic floor disorder evaluation and management.

Objective: : The objective of the study was to examine the anatomy and histology of the swine vagina and adjacent supportive structures in comparison to human tissues to determine the potential utility of this model for pelvic floor disorder evaluation and management.

Methods: : This is a descriptive study of the gross anatomy and histology of the swine vagina, uterosacral ligament, cardinal ligament, and rectovaginal space. Tissue was collected from 6 different sites in each of the 6 animals, processed, and stained with hematoxylin-eosin, Masson trichrome, and van Gieson and evaluated by both gynecologic and veterinary pathologists.

The application of genomic and molecular data in the treatment of chronic cancer pain.

Many cancer patients will develop complex pain syndromes requiring aggressive, innovative, and comprehensive multimodal pain management strategies. Recently, data from both animal studies and clinical trials have allowed clinical research to focus on creating applicable clinical treatment strategies. This article is a review of genomic and molecular data, which has contributed to creating novel modalities for use in clinical pain management of patients with cancer-induced pain.

Longitudinal assessment of cardiac diastolic function in HIV-infected patients.

Asymptomatic isolated diastolic dysfunction (DD), with normal left ventricular systolic function, may be the first indication of underlying cardiac disease in HIV-negative populations. We previously reported a high prevalence (37%) of DD among asymptomatic HIV-infected patients at low risk for AIDS and cardiovascular disease (CVD). We performed a longitudinal assessment of interval echocardiographic changes in this cohort over a four-year period.

Impact of patient selection in various study designs: identifying potential bias in clinical results.

Many different study designs are used to address different types of clinical questions. The two broad categories are the experimental study, which is the randomized controlled trial, and observational studies, which includes all of the other basic study designs (cohort [prospective and retrospective] studies, case-control [etiologic] studies, cross-sectional [prevalence] studies, case series, and case reports). These study designs address basic categories of clinical questions: treatment, diagnosis, prognosis, and harm.

Ultrasound-guided peripheral nerve stimulator placement in two soldiers with acute battlefield neuropathic pain.

Acute peripheral neuropathic pain after combat-related polytrauma is a common occurrence in the United States military that is often refractory to current drugs and regional anesthesia. Both spinal cord and peripheral nerve stimulation are successfully used for chronic neuropathic pain states, but are not reported for acute neuropathic pain. We present 2 cases of percutaneous ultrasound-guided sciatic peripheral nerve stimulation placement in soldiers who had conditions precluding them from spinal cord stimulation placement.

Whooping cough in adults: an update on a reemerging infection.

Pertussis, or whooping cough, which is commonly thought of as a pediatric illness, is an underappreciated adult pathogen. Recent outbreaks highlight the significance of pertussis in adults and the risk of transmission to at-risk infants who are most susceptible to complications, including death. This article describes the recent epidemiologic shifts and reviews the clinical presentation, diagnosis, and treatment of pertussis.

Incidence of laryngospasm and bronchospasm in pediatric adenotonsillectomy.

Objectives/hypothesis: To evaluate and describe airway complications in pediatric adenotonsillectomy.

Study Design: Retrospective case-control study.

Methods: A chart review of patients that underwent adenotonsillectomy between 2006 and 2010 was performed.

T-cell activation is enhanced by targeting IL-10 cytokine production in toll-like receptor-stimulated macrophages.

Toll-like receptor (TLR) agonists represent potentially useful cancer vaccine adjuvants in their ability to stimulate antigen-presenting cells (APCs) and subsequently amplify the cytotoxic T-cell response. The purpose of this study was to characterize APC responses to TLR activation and to determine the subsequent effect on lymphocyte activation. We exposed murine primary bone marrow-derived macrophages to increasing concentrations of agonists to TLRs 2, 3, 4, and 9.

Alterations in recovery from spinal cord injury in rats treated with recombinant human bone morphogenetic protein-2 for posterolateral arthrodesis.

Background: Treatment of trauma-related spinal instability with use of recombinant human bone morphogenetic protein-2 (rhBMP-2) may appear as a viable option, but little is known of the direct effects of rhBMP-2 on the injured spinal cord. In the current study, we investigated the acute and long-term effects of using rhBMP-2 in the posterolateral spine at the level of a spinal cord injury in rats.

Methods: Fifty-two rats underwent a T10 dorsal hemisection and were assigned to one of two groups: the vehicle control group (twenty-four rats) or the rhBMP-2 group (twenty-four rats).

Effects of thrombolytic agents on tympanostomy tubes occluded by blood clots.

Objective: To investigate the efficacy of various topical applications in opening a clotted tympanostomy tube (TT) using an in vitro model.

Design: In vitro clinical trial.

Interventions: Fresh human blood was allowed to clot in the lumen of TTs.

Situs inversus totalis.

We present a case of situs inversus totalis. A 22-month-old infant presented with cyanosis, double-inlet left ventricle, severe pulmonary stenosis, and concern for underlying visceroatrial abnormalities. Chest (Fig.

Trends in testicular germ cell tumors among U.S. military servicemen, 1990-2003.

Objective: To determine the incidence of testicular germ cell tumors among active duty males and compare it with the incidence in the general U.S. population.