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Current literature shows that the GNAS mutation is an oncogenic driver in many tumor types such as pancreatic adenocarcinoma, adrenocortical carcinoma, and thyroid carcinoma; however, current data are limited on the role of GNAS mutations in SCC of the lung. In addition, it is important to investigate malignant causes of hypercalcemia in patients with MAS. The clinical features and treatments of MAS can lead to hypercalcemia and hypophosphatemia and thus mask a malignancy. Clinicians must be wary of a masked malignancy, as it could delay treatment and negatively impact overall outcomes for patients with MAS.Objective Latina and African American breast cancer survivors (BCS) are affected by health disparities that have negatively impacted their health outcomes and quality of life more than other BCS. Examining the relationships among social support, culture, and well-being in underserved groups may help clarify critical factors that influence health disparities in cancer survivors. Methodology Ethnic salience (impact of ethnicity on identity), religious support, social support, and well-being were examined in African American and Latina breast cancer survivors using archival data. Participants included 320 breast cancer survivors (28% African American and 72% Latina) ranging from 26-89 years old and one to five years post breast cancer diagnosis. Results Ethnic salience was positively associated with well-being (p less then .001). African American breast cancer survivors endorsed greater well-being, social support, religious support, and ethnic salience than Latinas (ps less then .05). Religious support was associated with well-being even after controlling for the effects of general social support [ΔR 2 = .02, p = .005; F(5, 298) = 23.67]. Conclusion Ethnic salience and religious support are important factors in understanding health disparities and should inform survivorship care plans for underserved populations.Epithelioid sarcoma is a rare, slow-growing, malignant tumor with multivariate presentation and a high rate of recurrence following surgery. Diagnosis is often missed or delayed due to its infrequent nature and confusing clinical and pathological presentation. This is compounded by the fact that this tumor is aggressive with a propensity for metastases without being detected. The treatment of this deadly tumor is controversial with no clear-cut consensus. The author presents a case of epithelioid sarcoma in the finger of a young patient with subsequent recurrence after surgery and a review of current literature pertaining to this aggressive tumor. This report would like to stress the importance of a multimodal approach in combatting this tumor as prompt diagnosis and aggressive therapy can significantly reduce the poor outcomes associated with this disease.

Despite relatively low incidence, dislocation remains one of the main reasons for total hip arthroplasty (THA) revision. It is a devastating complication for a patient and a surgeon, and has high burden on the healthcare system. The aim of the present study was to assess and compare the risk factors for revision after early and delayed THA dislocations.

Some 3403 THA through posterior approach for primary osteoarthritis were retrospectively studied in the Lithuanian Arthroplasty Register from 2011 to 2018. Three months after THA was the splitting time between the first event of early and delayed dislocations. Revision was set as outcome measure. Gender, affected side, number of dislocations, femoral head and neck size, and prosthesis fixation type were tested as risk factors for revision after early and delayed THA dislocations.

Dislocation occurred in 108 patients (3.2%), and 26 cases (0.8%) required revision. Men had statistically significant higher risk for revision due to early dislocation [hazard r dislocation. In early stage, additional precautions should be considered when 28 mm short metal heads are used.Introduction Craniopharyngiomas (CPs) are benign neoplasms and most common suprasellar tumors. They are more frequent in children, contributing to a significant number of intracranial tumors in the pediatric population and are thought to be arising either from the epithelial remnant cells of the craniopharyngeal duct or from the adenohypophysis epithelium. Two subtypes of CPs exist, namely, adamantinomatous craniopharyngioma (ACP) and papillary craniopharyngioma (PCP). ACP is more common in children with a relatively aggressive clinical course and more frequent relapses than PCP. The study objective was to evaluate the clinicopathological features of CP in our population. Methods We conducted a retrospective observational study in the Department of Histopathology at Aga Khan Hospital, Karachi, Pakistan, over a period of 15 years, from January 2001 to December 2015. All CP cases were included in the study. A total of 207 cases were diagnosed during this period by histopathologists based on histologic features. All slides were retrieved, and diagnosis was confirmed after a reexamination of slides. Results We found that the mean age of diagnosis was 25.59±14.71 years, and the median follow-up time was 7 (3-19) years. The number of male patients was 136 (65.7%) and the number of female patients was 71 (34.3%). The most common tumor site was suprasellar (71.5%) followed by the sellar and temporal lobe (12.1% and 6.8%, respectively). The most common complaints were headache (21.7%), followed by loss of vision/decreased vision (16.4%) and vomiting (5.3%). selleck products The overall survival rate was 95.2% with a recurrence rate of 5.8%. A significant association of survival was noted with tumor recurrence. Conclusion CP is a rare brain tumor with good overall survival. We found a low recurrence rate of CP in our study. However, recurrence was found to be the most important factor determining survival in patients with CP.

In this study, we aimed to investigate the degree of nasal tip rotation three months after rhinoplasty using columellar strut graft.

Using photographs of 25 patients who underwent rhinoplasty, we prospectively analyzed nasal tip rotation before, during, and after three months of the surgery. Columellar strut graft was used for all patients for tip support. Standardized left profile images were taken. For evaluation of tip rotation, the nasolabial angle was measured. The results were statistically compared, and ap value less than 0.05 was considered statistically significant.

The mean preoperative nasolabial angle (NLA) for the entire group was 91.44°, and the directly postoperative angle measured 108.84°. The mean of postoperative nasolabial angles measured at three-month follow-up was 97.2°. The preoperative, directly postoperative, and three-month postoperative nasolabial angles were all recorded.

Considering the results of this study, a postoperative nasolabial angle is increased compared to preoperative angle. However, an occasional dropping of the angle might be seen in following months, which can be linked to several factors.

Considering the results of this study, a postoperative nasolabial angle is increased compared to preoperative angle. However, an occasional dropping of the angle might be seen in following months, which can be linked to several factors.

Research on polymer materials for additive manufacturing technology in biomedical applications is as promising as it is numerous, but biocompatibility of printable materials still remains a big challenge. Changes occurring during the 3D-printing processes itself may have adverse effects on the compatibility of the completed print. This prospective will put emphasis on the different additives and processes that can have a direct impact on biocompatibility during and after 3D printing of polymer materials.

The Micra™ transcatheter pacing system (TPS) (Medtronic, Minneapolis, MN, USA) is the only leadless pacemaker currently approved by the United States Food and Drug Administration. A limitation to the use of this device in the pediatric population is the large size of the delivery sheath. We present a 28-kg, nine-year-old male with symptomatic asystolic pauses who underwent successful placement of a Micra™ TPS via right internal jugular vein surgical cutdown as a first-line option. Current reports in the literature using the right internal jugular vein due to small patient size are limited to those involving patients with concurrent medical conditions that render the use of traditional systems unfavorable or contraindicated. Given the potential benefits of a leadless pacemaker system, its use in the pediatric population will likely continue to increase with time. This case describes technical strategies and procedural caveats that could aid in continued successful implantations of the Micra™ TPS in smaller patients as first-line therapy. In this report, room setup, the use of preprocedure vascular duplex studies, sheath manipulation, and a multidisciplinary approach are reviewed.Cardioneuroablation (CNA) is an emerging technique used to treat patients with vasovagal syncope (VVS). We herein describe a case of CNA targeting the atrial ganglionated plexi (GPs) based upon anatomical landmarks and fractionated electrogram (EGM) localization in a 20-year-old healthy female who presented to our center with malignant VVS and symptomatic sinus pauses, the longest of which measured 10 seconds. She underwent acutely successful CNA with a demonstration of vagal response noted following ablation of the left-sided GPs, and tachycardia was noted with right-sided GP ablation. All GP sites were defined by anatomical landmarks and EGM analysis. By using the fractionation mapping software of the EnSite Precision™ cardiac mapping system (Abbott, Chicago, IL, USA) with high-density mapping, fragmented EGMs were successfully detected in each GP site. One month after vagal denervation, no recurrent syncopal episodes or sinus pauses had been recorded. Longer-term follow-up with an implantable loop recorder is planned. Broadly, we performed CNA in a patient with VVS by combining high-density mapping and fractionation mapping software in a novel approach, which allowed us to detect fractionation in all GP sites and demonstrate an acute vagal response. This workflow may facilitate the introduction of a standardized technique suitable for widespread use.In ischemic cardiomyopathy, endocardial reentry has traditionally been the mechanistic paradigm for understanding ventricular tachycardia (VT). However, recognition is growing that epicardial myocardium is a critical component for VT substrate, even in patients with ischemic cardiomyopathy. In this report, we present a novel case of a three-dimensional VT reentry involving epicardial components and an endocardial exit.Superior vena cava (SVC) syndrome is a rare complication associated with transvenous cardiac implantable electronic devices that may present with a variety of manifestations. Various strategies such as transvenous lead extraction, anticoagulation, venoplasty, and stenting have been used to treat this condition, but the optimal management protocols have yet to be defined. Subcutaneous implantable cardioverter-defibrillator (ICD) (S-ICD) therapy can be an alternative option to a transvenous system for those who require future ICD surveillance. We present a case of lead-associated SVC syndrome where thoracic venous congestion due to SVC obstruction influenced preimplant S-ICD QRS vector screening. Following treatment of venous obstruction, QRS amplitude may change and patients who were not initially S-ICD candidates may later become eligible.

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