Myeloablative vs nonmyeloablative consolidation for primary central nervous system lymphoma: results of Alliance 51101.

Although it is evident that standard-dose whole-brain radiotherapy as consolidation is associated with significant neurotoxicity, the optimal consolidative strategy for primary central nervous system lymphoma (PCNSL) is not defined. We performed a randomized phase 2 clinical trial via the US Alliance cancer cooperative group to compare myeloablative consolidation supported by autologous stem cell transplantation with nonmyeloablative consolidation after induction therapy for PCNSL. To our knowledge, this is the first randomized trial to be initiated that eliminates whole-brain radiotherapy as a consolidative approach in newly diagnosed PCNSL.

Consultation on UTUC II Stockholm 2022: diagnostic and prognostic methods-what's around the corner?

Purpose: To map current literature and provide an overview of upcoming future diagnostic and prognostic methods for upper tract urothelial carcinoma (UTUC), including translational medical science.

Methods: A scoping review approach was applied to search the literature. Based on the published literature, and the experts own experience and opinions consensus was reached through discussions at the meeting Consultation on UTUC II in Stockholm, September 2022.

Gastro-oesophageal reflux is not a major cause of brief resolved unexplained events in infants.

http://bit.ly/2FjknUy.

VGF in the Medial Preoptic Nucleus Increases Sexual Activity Following Sexual Arousal Induction in Male Rats.

The central part of the medial preoptic nucleus (MPNc) is associated with sexual arousal induction in male rats. However, it is largely unclear how males are sexually aroused and achieve their first copulation. We previously reported that more MPNc neurons activate during the first copulation than the second copulation.

Pubertal activation of estrogen receptor α in the medial amygdala is essential for the full expression of male social behavior in mice.

Testosterone plays a central role in the facilitation of male-type social behaviors, such as sexual and aggressive behaviors, and the development of their neural bases in male mice. The action of testosterone via estrogen receptor (ER) α, after being aromatized to estradiol, has been suggested to be crucial for the full expression of these behaviors. We previously reported that silencing of ERα in adult male mice with the use of a virally mediated RNAi method in the medial preoptic area (MPOA) greatly reduced sexual behaviors without affecting aggressive behaviors whereas that in the medial amygdala (MeA) had no effect on either behavior.

Effects of Prepubertal or Adult Site-Specific Knockdown of Estrogen Receptor β in the Medial Preoptic Area and Medial Amygdala on Social Behaviors in Male Mice.

Testosterone, after being converted to estradiol in the brain, acts on estrogen receptors (ERα and ERβ) and controls the expression of male-type social behavior. Previous studies in male mice have revealed that ERα expressed in the medial preoptic area (MPOA) and medial amygdala (MeA) are differently involved in the regulation of sexual and aggressive behaviors by testosterone action at the time of testing in adult and/or on brain masculinization process during pubertal period. However, a role played by ERβ in these brain regions still remains unclear.

Cystathionine β-synthase-derived hydrogen sulfide is involved in human malignant hyperthermia.

Hydrogen sulfide is an endogenous gasotransmitter and its mechanism of action involves activation of ATP-sensitive K(+) channels and phosphodiesterase inhibition. As both mechanisms are potentially involved in malignant hyperthermia (MH), in the present study we addressed the involvement of the L-cysteine/hydrogen sulfide pathway in MH. Skeletal muscle biopsies obtained from 25 MH-susceptible (MHS) and 56 MH-negative (MHN) individuals have been used to perform the in vitro contracture test (IVCT).

The relationship among health literacy, health knowledge, and adherence to treatment in patients with rheumatoid arthritis.

Background: Patients with poor health literacy often lack the knowledge needed to manage their treatment.

Objective: The aim of this cross-sectional study is to determine whether health literacy is a predictor of health knowledge and/or adherence to medication treatment in patients with rheumatoid arthritis.

Method: The study was completed in an urban, outpatient rheumatology setting.

5 points on hip resurfacing.

Hip resurfacing has enjoyed a resurgence in popularity as an alternative to total hip replacement (THR) for the treatment of end-stage arthritis in younger, active patients. However, technical difficulties in implant positioning have been realized, as the procedure has been introduced amongst surgeons new to the concept. Furthermore, as the follow-up interval increases beyond the short-term, it is evident that certain issues with the metal-on-metal bearing surface may lead to complications.

An integrated approach to lower blepharoplasty.

Background: Limitations associated with traditional skin-muscle flaps and later with transconjunctival fat resection combined with carbon dioxide laser resurfacing have led to newer concepts in lower blepharoplasty that emphasize fat preservation, blending of the lid-cheek junction, simplified skin excision, and less morbid resurfacing techniques. Avoiding incision through the orbicularis muscle to preserve its innervation and reduce translamellar scarring is favored, as is a more liberal use of lateral canthal tightening procedures. This study investigates the use of a transconjunctival approach to resect and transpose fat combined with a skin flap technique that permits skin excision and simultaneous resurfacing with 30% trichloroacetic acid.

Esophageal cancer chemotherapy: recent advances.

Esophageal cancer, though relatively uncommon in the United States, is a major global health threat. Squamous cell carcinoma remains the most common histology worldwide, whereas adenocarcinoma of the esophagus is increasing at epidemic proportions in the United States and other Western countries. Both histologies carry a poor prognosis: 5-year mortality for esophageal cancer exceeds 85% to 90%.

The effect of controlled therapy interruption in chronic HCV infection: enhanced host immune response? A hypothesis.

Background: We have hypothesized that prolonged viral suppression partially reverses immune tolerance in chronic hepatitis C virus infection. Brief periods of treatment interruption can then simulate 'auto-vaccination' and evoke powerful secondary host immune responses.

Objective: To determine the effect of controlled therapy interruption CTI on viral load in previous relapsers to interferon and ribavirin treatment.

Immune suppression leading to hepatitis C virus re-emergence after sustained virological response.

Sustained virological response SVR is defined as undetectable HCV RNA in plasma 6 months after therapy has been discontinued. Relapse or re-emergence of viremia after SVR is rare. We report two patients that relapsed when immune suppressive therapy was given within a few weeks of achieving SVR.

Y-scar vertical mammaplasty.

Background: Vertical mammaplasty is an effective alternative to inverted-T methods. Among other benefits, it results in a significantly reduced scar pattern. There exists a subset of patients with mild macromastia and minimal ptosis who are candidates for a scar pattern that is further reduced.

Esophageal cancer: adjuvant therapy.

In the United States, esophageal cancer is an uncommon but aggressive malignancy. Prior research has focused on the incorporation of chemotherapy and radiotherapy in both the pre- and postoperative setting. Both squamous cell and adenocarcinoma histologies have been treated in trials, with adenocarcinoma now the predominant histology seen in the United States.

Cancer of the gastroesophageal junction: combined modality therapy.

Esophageal cancer, an uncommon, but highly virulent malignancy in the United States, will be responsible for nearly 14,000 deaths in the year 2005. The prognosis for patients who have adenocarcinoma of the distal esophagus and gastroesophageal junction and who are treated with the standard approaches of surgery or combined chemoradiation therapy is poor. Recent clinical trials have evaluated the use of preoperative chemotherapy followed by surgery, combined concurrent preoperative chemoradiotherapy followed by surgery, or definitive chemoradiotherapy alone without surgery.

Cancer of the gastroesophageal junction: Current therapy options.

Active chemotherapy agents in metastatic adenocarcinoma of the esophagus include taxanes (docetaxel or paclitaxel), 5-fluorouracil, irinotecan, platinum drugs (including cisplatin, oxaliplatin, and carboplatin), and anthracyclines. Conventional chemotherapy combines infusional 5-fluorouracil with cisplatin. The addition of a third drug to this backbone results in greater toxicity and only marginal improvements in outcome.

Vertical mammaplasty.

Current criticisms regarding vertical mammaplasty include problems with poor immediate postoperative appearance, nipple-areola complex malposition, and excessive lower pole length. These problems can be avoided by proper patient selection, by utilizing correct concepts of skin design, and by observing correct glandular resection and closure concepts. Vertical mammaplasty also can result in other problems, such as hypertrophic circumareolar scars and lower pole deformities, including notching, boxy shape, infra-areolar depression, and flatness.

Gastric pacing is not enough: additional measures for an effective obesity treatment program.

Obesity has long been considered a behavioral disorder. Recent breakthroughs in our understanding of body weight regulation, however, have shown that once adipose tissue accumulates, a system of overlapping neuroendocrine systems actively resists weight loss. This counter-regulatory mechanism, which has evolved as protection against starvation, causes changes in appetite and metabolism that limit the amount of weight lost with every obesity intervention, including surgery.

Nocturnal polyuria versus overactive bladder in nocturia.

The purpose of this article is to review the current state of knowledge on contributions of nocturnal urine overproduction and overactive bladder to the syndrome of nocturia. We review the recent literature and current state of the art in differential diagnosis, pathophysiology, and classification of nocturia. We found that multiple pathologic factors may result in nocturia, including cardiovascular disease, diabetes mellitus or insipidus, third spacing of fluid, sleep apnea, lower urinary tract obstruction, primary sleep disorders, and behavioral and environmental factors.