Stool Testing for Colorectal Cancer Screening.

Colorectal cancer (CRC) screening has been shown to reduce CRC incidence and mortality and is widely recommended. However, despite the demonstrated benefits of screening and ongoing efforts to improve screening rates, a large percentage of the population remains unscreened. Noninvasive stool based tests offer great opportunity to enhance screening uptake.

Simple formulas to determine optimal subclavian central venous catheter tip placement in infants and children.

Background/purpose: Optimal central venous catheter (CVC) tip location is necessary to decrease the incidence of complications related to their use. We sought to create a practical method to reliably predict the length of catheter to insert into the subclavian vein during CVC placement in children.

Methods: We performed a retrospective review of 727 chest radiographs of children who underwent either left or right subclavian CVC placement.

Colorectal cancers soon after colonoscopy: a pooled multicohort analysis.

Objective: Some individuals are diagnosed with colorectal cancer (CRC) despite recent colonoscopy. We examined individuals under colonoscopic surveillance for colonic adenomas to assess possible reasons for diagnosing cancer after a recent colonoscopy with complete removal of any identified polyps.

Design: Primary data were pooled from eight large (>800 patients) North American studies in which participants with adenoma(s) had a baseline colonoscopy (with intent to remove all visualised lesions) and were followed with subsequent colonoscopy.

Rowing: sport-specific concerns for the team physician.

Rowing injuries occur mostly from overuse and are seen primarily in the back, rib, knee, and forearm. Many of these have a specific cause owing to the mechanics of the rowing stroke, which are discussed, as are sport-specific treatment strategies. Also discussed are specific injuries sustained on the rowing machine, emergency issues, and special population concerns.

Invasive mucinous cystic neoplasms of the pancreas.

Mucinous cystic neoplasms (MCN) and intraductal papillary mucinous neoplasms (IPMN) of the pancreas both appear to have been included and intermixed in some early reports of pancreatic cystic neoplasms. Recognition of their distinguishing features evolved during the last decade of the twentieth century. One legacy of the early period is the statement that mucinous cystic neoplasms sometimes progress to invasive colloid carcinoma.

Rituximab mediates loss of CD19 on B cells in the absence of cell death.

Objective: To evaluate loss of the B cell-specific marker CD19 after the addition of rituximab (RTX) to healthy donor blood and to determine the role of complement-mediated cytotoxicity in these cells.

Methods: Whole blood and peripheral blood mononuclear cells (PBMCs) from healthy donors were evaluated for the loss of CD19 in the presence of RTX using flow cytometry. The effect of complement on CD19 loss was examined using serum-free media, C3- and C5-deficient sera, and a C5-blocking antibody.

The prognostic value of using the duration of acute kidney injury in cardiac surgery: an example using two antifibrinolytics.

Previously, we reported that the addition of duration to the Acute Kidney Injury Network (AKIN) definition of acute kidney injury (AKI) is a marker for more severe kidney injury and predicts long-term mortality. We aimed to evaluate an example of the utility of adding AKI duration to the AKIN definition by comparing the historical use of aprotinin with Amicar. In a single-center observational study, we followed 4987 consecutive patients undergoing cardiac surgery between 2002 and 2007 for postsurgery AKI.

Lessons learned in developing community mental health care in North America.

This paper summarizes the findings for North America of the WPA Task Force on Steps, Obstacles and Mistakes to Avoid in the Implementation of Community Mental Health Care. Community mental health has evolved over five decades in the United States and Canada. The United States has led the world in innovation and spending, but provide variable quality of care; Canada has steadily developed a more uniform public health system for less cost.

Determinants of acute kidney injury duration after cardiac surgery: an externally validated tool.

Background: Acute kidney injury (AKI) duration after cardiac surgery is associated with poor survival in a dose-dependent manner. However, it is not known what perioperative risk factors contribute to prolonged AKI and delayed recovery. We sought to identify perioperative risk factors that predict duration of AKI, a complication that effects short and long-term survival.

Adjuvant and neoadjuvant therapy for primary GIST.

Adjuvant therapy for primary GIST has proven benefit in extending disease free survival. Defined risk factors for recurrent disease are based on GIST size, location, and mitotic rate and provide useful guidelines for selecting patients for adjuvant therapy considerations. Neoadjuvant therapy with tyrosine kinase inhibition has potential usefulness in primary GIST, although not yet as standard of care.

Surveying the traumatic stress literature: the effective use of bibliographic databases in preparing reviews and meta-analyses.

The value of a systematic review or meta-analysis depends upon the care with which it is designed and conducted. A major factor in this is the literature search that identifies the articles to be reviewed. Careful selection of bibliographic databases and the use of well-designed search strategies based on the controlled vocabularies contained in published thesauri are essential to ensure retrieval of all relevant articles.

Duration of acute kidney injury impacts long-term survival after cardiac surgery.

Background: Acute kidney injury (AKI) after cardiac surgery is associated with worse outcomes. However, it is not known how adverse long-term consequences vary according to the duration of AKI. We sought to determine the association between duration of AKI and survival.

A business case for shared medical appointments in dermatology: improving access and the bottom line.

Objectives: To evaluate the economic viability of shared medical appointments (SMAs) in dermatology. Secondary objectives include a comparison of the hourly adjusted census levels generated by SMAs compared with regular clinic appointments (RCAs), as well as a comparison between the economic viability of dermatology SMAs and SMAs in other fields of medicine.

Design: Cost-benefit analysis.

Required reduction in dose of chemotherapy for retinoblastoma due to down syndrome-associated chemosensitivity.

Purpose: To report a case of a boy with bilateral germinal retinoblastoma and Down syndrome who was successfully treated despite a predilection toward chemotoxicity associated with Down syndrome.

Methods: A 3-month-old boy presenting with germinal retinoblastoma and Down syndrome was treated with diode laser and systemic carboplatin and low-dose vincristine, with gradual dose escalation. Etoposide and cyclosporine were later added for a greater tumor response.

Intratumoral delivery of shRNA targeting cyclin D1 attenuates pancreatic cancer growth.

The aim of this study was to assess the biological consequences of cyclin D1 silencing in pancreatic cancer cells. A replication-defective lentivirus based small hairpin RNA (shRNA) system targeting cyclin D1 caused a marked reduction in cyclin D1 protein levels in ASPC-1 and BxPC3 pancreatic cancer cell lines in conjunction with decreased cell growth and invasiveness in vitro. Moreover, a single intratumoral injection of the recombinant lentivirus targeting cyclin D1 attenuated the growth of pre-existing tumors arising from two distinct cell lines.

Sex, immorality, and mental disorders.

Although the definition of a mental disorder has remained essentially the same from Diagnostic and Statistical Manual of Mental Disorder, Third Edition, Revised (DSM-III-R) through DSM-IV to DSM-IV-TR, the account of the paraphilias has changed continually. Although the definition in all the DSMs explicitly rules out deviant sexual behavior as sufficient for labeling someone as having a mental disorder, deviant sexual behavior counts as sufficient for all the paraphilias in DSM-III-R. In DSM-IV, the account of all the paraphilias is made consistent with the definition.

Anti-inflammatory effect of aprotinin: a meta-analysis.

It is important to define the extent, and any limitations, of potential anti-inflammatory regimens used in cardiac surgery to guide the rational combination of drugs to suppress the systemic inflammatory response. Aprotinin (Trasylol) is an anti-fibrinolytic agent with reported anti-inflammatory properties. In this study, we investigated the published data on aprotinin's effect on acute phase protein and cytokine levels in cardiac surgery patients.

Improvement in the family-centered medical home enhances outcomes for children and youth with special healthcare needs.

Family-centered, coordinated, comprehensive, and culturally competent care for children and youth with special healthcare needs is a national priority. Access to a primary care medical home is a US Maternal and Child Health Bureau performance measure. Most primary care practices lack methods by which to partner with families and improve care.