The 2015 International Society for the Study of Vulvovaginal Disease (ISSVD) Terminology of Vulvar Squamous Intraepithelial Lesions.

Objectives: The impact of terminology for vulvar intraepithelial lesions has been significant over the years, because it has affected diagnosis, treatment, and research. The introduction of the Lower Anogenital Squamous Terminology (LAST) in 2012 raised 2 concerns in relation to vulvar lesions: firstly, the absence of reference to "differentiated vulvar intraepithelial neoplasia" (differentiated VIN) could lead to its being overlooked by health care providers, despite its malignant potential. Secondly, including the term "low-grade squamous intraepithelial lesion" (LSIL) in LAST recreated the potential for overdiagnosis and overtreatment for benign, self-limiting lesions.

Human Papillomavirus Vaccination in the United States: Uneven Uptake by Gender, Race/Ethnicity, and Sexual Orientation.

Objectives: To assess national differences in human papillomavirus (HPV) vaccine uptake among young adults in the United States by gender, race/ethnicity, and sexual orientation.

Methods: We tested group differences in initiation and completion of the HPV vaccine series (i.e.

Genetic variants associated with response to lithium treatment in bipolar disorder: a genome-wide association study.

Background: Lithium is a first-line treatment in bipolar disorder, but individual response is variable. Previous studies have suggested that lithium response is a heritable trait. However, no genetic markers of treatment response have been reproducibly identified.

Predictive factors and practice trends in red blood cell transfusions for very-low-birth-weight infants.

Background: Red blood cell (RBC) transfusions in very-low-birth-weight (VLBW) infants, while common, carry risk. Our objective was to determine clinical predictors of and trends in RBC transfusions among VLBW infants.

Methods: RBC transfusion practice and its clinical predictors in 1,750 VLBW (≤1,500 g) infants were analyzed in a single-center cohort across sequential epochs: 2000-2004 (Epoch 1), 2005-2009 (Epoch 2), and 2010-2013 (Epoch 3).

Aspiration Thrombectomy in Patients Undergoing Primary Angioplasty for ST Elevation Myocardial Infarction: An Updated Meta-Analysis.

Background: The Trial of Routine Aspiration Thrombectomy with PCI versus PCI alone in patients with STEMI (TOTAL trial) refuted the salutary effect of routine aspiration thrombectomy (AT) in PPCI for patients with ST-elevation myocardial infarction (STEMI).

Objectives: We performed an updated meta-analysis to assess clinical outcomes with AT prior to PPCI compared with conventional PPCI alone including the additional trial data.

Methods And Results: Clinical trials (n = 20) that randomized patients (n = 21,281) with STEMI between Routine AT (n = 10,619) and PPCI (n = 10,662) were pooled.

Metabolic fibroblast growth factors (FGFs): Mediators of energy homeostasis.

The metabolic fibroblast growth factors (FGFs), FGF1, FGF15/19, and FGF21 differ from classic FGFs in that they modulate energy homeostasis in response to fluctuating nutrient availability. These unique mediators of metabolism regulate a number of physiological processes which contribute to their potent pharmacological properties. Administration of pharmacological doses of these FGFs causes weight loss, increases energy expenditure, and improves carbohydrate and lipid metabolism in obese animal models.

Pregame Sore Throat, Postgame Intensive Care Unit.

A collegiate football athlete presented, on game day, with an acute onset of sore throat. He was afebrile, speaking in full sentences, without signs of respiratory distress. His examination was negative for lymphadenopathy or tonsillar enlargement or exudate.

Liquid gastric emptying as an adjunct to hepatobiliary scintigraphy when oral corn oil is used as a cholecystagogue for determining gallbladder emptying.

Unlabelled: During times of sincalide shortage, a fatty meal can be used to stimulate gallbladder contraction during hepatobiliary scintigraphy. However, if a patient has an abnormal gallbladder ejection fraction (GBEF), is the cause chronic cholecystitis or is it inadequate cholecystokinin stimulation due to poor gastric emptying? Hence, during the 2014 sincalide shortage, simultaneous liquid gastric emptying using (99m)Tc-sulfur colloid along with corn oil emulsion was initiated as routine practice in patients evaluated for GBEF. The objective of this study was to retrospectively assess the time course of gastric emptying in these patients, especially with regard to whether delayed gastric emptying may be a factor in some patients with a poor GBEF.

Employee resistance and injury during commercial robberies.

Objectives: To examine the association between employee resistance and injury and examine whether type or location of property stolen was associated with employee resistance during commercial robberies in a large metropolitan city.

Methods: Robbery data were abstracted from police crime reports between 2008 and 2012. Log binomial regression models were used to identify predictors of employee resistance and to evaluate the association between employee resistance and injury.

Hormone replacement therapy and adverse outcomes in women with atrial fibrillation: an analysis from the atrial fibrillation follow-up investigation of rhythm management trial.

Background And Purpose: Hormone replacement therapy (HRT) use has been related to thromboembolism, but whether HRT increases adverse outcomes in females with atrial fibrillation is uncertain.

Methods: We used the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) trial data set that included 1594 women (39.3% of the population, mean age 71±8), of whom 376 (23.

Anti-asialo-GM1 and GD1a variant of Miller Fisher variant of Guillain-Barré Syndrome.

We present a woman with acute onset of bilateral ophthalmoparesis and ataxia occurring 4 weeks after gastroenteritis. Serum antibody titers against asialo-GM1 and GD1a, typically associated with inflammatory axonal neuropathies, were elevated but titers against anti-GQ1b, the most commonly found antibody found in the Miller Fisher variant of Guillain-Barre syndrome were not. No other etiology for ophthalmoparesis was found despite extensive patient evaluation.

Pancreatectomy predicts improved survival for pancreatic adenocarcinoma: results of an instrumental variable analysis.

Background And Objective: Pancreatic resection is the standard treatment option for patients with stage I/II pancreatic ductal adenocarcinoma (PDA), yet many studies demonstrate low rates of resection. The objective of this study was to evaluate whether increasing resection rates would result in an increase in average survival in patients with stage I/II PDA.

Methods: SEER (Surveillance, Epidemiology, and End Results) data were analyzed for patients with stage I/II pancreatic head cancers treated from 2004 to 2009.

Giant adrenal myelolipoma masquerading as heart failure.

Adrenal myelolipomas are rare benign tumors of the adrenal cortex composed of adipose and hematopoietic cells. They have been postulated to arise from repeated stimulation by stress, inflammation and ACTH oversecretion. Myelolipomas are usually detected incidentally on imaging and do not require any active intervention besides regular follow-up by imaging.

The correction index: setting the standard for recommending operative repair of pectus excavatum.

Background: The Haller index, derived from a chest computed tomography scan, remains the standard for determining candidacy for pectus excavatum repair (Haller index≥3.25). However, it has been suggested that this index may not accurately reflect pectus severity in patients with abnormal chest wall morphologies.

Defining the role of chest radiography in determining candidacy for pectus excavatum repair.

Objective: The Haller index (HI), derived from computed tomography (CT) of the chest, remains the standard for determining pectus excavatum (PE) severity. The ability to accurately determine PE severity from chest radiography (CXR) may provide substantial benefits. This study proposes to establish data-driven criteria for the use of CXR as a diagnostic modality in the preoperative evaluation of patients with PE.

Value of social media in reaching and engaging employers in Total Worker Health.

Objective: To describe the initial use of social media by the National Institute for Occupational Safety and Health (NIOSH) Total Worker Health™ (TWH) Program and the University of Iowa Healthier Workforce Center for Excellence (HWCE) Outreach Program.

Methods: Social media analytics tools and process evaluation methods were used to derive initial insights on the social media strategies used by the NIOSH and the HWCE.

Results: The on-line community size for the NIOSH TWH Program indicated 100% growth in 6 months; however, social media platforms have been slow to gain participation among employers.

Forceps delivery volumes in teaching and nonteaching hospitals: are volumes sufficient for physicians to acquire and maintain competence?

Purpose: The decline in the use of forceps in operative deliveries over the last two decades raises questions about teaching hospitals' ability to provide trainees with adequate experience in the use of forceps. The authors examined (1) the number of operative deliveries performed in teaching and nonteaching hospitals, and (2) whether teaching hospitals performed a sufficient number of forceps deliveries for physicians to acquire and maintain competence.

Method: The authors used State Inpatient Data from nine states to identify all women hospitalized for childbirth in 2008.

Impact of cardiovascular comorbidity on ovarian cancer mortality.

Background: A retrospective cohort study utilizing prospectively collected data was conducted from August 2003 until March 2008 at M.D. Anderson Cancer Center.

Survey of high school athletic programs in Iowa regarding infections and infection prevention policies and practices.

Objective: To assess high school athletic programs' infection prevention policies and procedures and to estimate the frequency of skin and soft tissue infections (SSTIs) among Iowa's high school athletes.

Methods: An on-line survey of high school athletic programs.

Results: Nearly 60% of programs responded.

Characterization of a peptide domain within the GB virus C envelope glycoprotein (E2) that inhibits HIV replication.

GB virus C (GBV-C) infection is associated with prolonged survival in HIV-infected cohorts, and GBV-C E2 protein inhibits HIV entry when added to CD4+ T cells. To further characterize E2 effects on HIV replication, stably transfected Jurkat cell lines expressing GBV-C E2 or control sequences were infected with HIV and replication was measured. HIV replication (all 6 isolates studied) was inhibited in all cell lines expressing a region of 17 amino acids of GBV-C E2, but not in cell lines expressing E2 without this region.

Evidence against GB virus C infection in dromedary camels.

A recent publication described finding GB virus C (GBV-C) RNA in 4 of 22 dromedary camel sera, and sequence analysis found that these viruses were phylogenetically clustered within human GBV-C isolates. Since all other GB viruses to date form monophyletic groups according to their host species, the close relationship between the sequences generated from camel sera and human GBV-C isolates seemed implausible, leading us to conduct an independent analysis of the sequences. Our investigation found three lines of evidence arguing against GBV-C infection in dromedary camels.

Successful use of maternal blood in the management of severe hemolytic disease of the fetus and newborn due to anti-Kp(b).

Background: The incidence of hemolytic disease of the fetus and newborn (HDFN) has decreased since the introduction of Rh immunoglobulin prophylaxis in Rh(D)-negative pregnant women. Thus, the relative incidence of rare alloantibody-related HDFN has increased. The lack of available maternally matched red blood cells for transfusion in these cases may create management difficulties.

Activation of endothelin A receptors contributes to impaired responsiveness of renal mechanosensory nerves in congestive heart failure.

Increasing renal pelvic pressure results in PGE2-mediated release of substance P, leading to increases in afferent renal nerve activity (ARNA) and natriuresis, that is, a renorenal reflex response. The renorenal reflexes are impaired in congestive heart failure (CHF). Impairment of the renorenal reflexes may contribute to the increased renal sympathetic nerve activity and sodium retention in CHF.

Illuminating rationale and uses for light therapy.

Light therapy is increasingly applied in a variety of sleep medicine and psychiatric conditions including circadian rhythm sleep disorders, seasonal affective disorder, and dementia. This article reviews the neural underpinnings of circadian neurobiology crucial for understanding the influence of light therapy on brain function, common mood and sleep disorders in which light therapy may be effectively used, and applications of light therapy in clinical practice.