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More prospective studies are needed to further delineate the risks, benefits, and overall outcomes of testosterone replacement therapy in patients with cancer and cancer survivors.

More prospective studies are needed to further delineate the risks, benefits, and overall outcomes of testosterone replacement therapy in patients with cancer and cancer survivors.

In this review, we outline the most recent advances in the development of Leydig stem cells (LSCs) and summarize the current and upcoming treatments for hypogonadism.

In-vitro and in-vivo studies show that inducing stem cells to differentiate into testosterone-producing adult Leydig cells is possible. In addition, LSCs can be grafted with Sertoli cells to increase testosterone levels in vivo. This therapy causes minimal effects on luteinizing hormone and follicle stimulating hormone levels. Novel therapies for hypogonadism include varying methods of testosterone delivery such as intranasal and oral agents, as well as novel selective estrogen and androgen receptor modulators.

LSC therapies provide an effective way of increasing testosterone levels without detrimentally affecting gonadotropin levels. Next steps in developing viable Leydig cell grafting options for the treatment of hypogonadism should include the assessment of efficacy and potency of current animal models in human trials. selleck inhibitor Recently, both intranasal and oral testosterone have been made available and shown promising results in treating hypogonadism while maintaining fertility. Enclomiphene citrate and selective androgen receptor modulators have been suggested as future therapies for hypogonadism; however, further studies assessing efficacy and adverse effects are needed.

LSC therapies provide an effective way of increasing testosterone levels without detrimentally affecting gonadotropin levels. Next steps in developing viable Leydig cell grafting options for the treatment of hypogonadism should include the assessment of efficacy and potency of current animal models in human trials. Recently, both intranasal and oral testosterone have been made available and shown promising results in treating hypogonadism while maintaining fertility. Enclomiphene citrate and selective androgen receptor modulators have been suggested as future therapies for hypogonadism; however, further studies assessing efficacy and adverse effects are needed.

Osteochondromas occur most commonly in the distal femur, proximal tibia, and humerus. There are no large studies reviewing the outcome of treatment for patients with an osteochondroma involving the proximal fibula. The purpose of this study is to specifically understand the manifestations of a proximal fibular osteochondroma (PFO) on the preoperative peroneal nerve function, and how surgical management of the osteochondroma affects function immediately postoperatively and at long-term follow-up.

This is an institutional review board-approved retrospective review of a consecutive series of patients with a PFO treated operatively at a single institution. The medical record was carefully reviewed to identify demographic data, clinical data especially the status of the peroneal function at various time points.

There were 25 patients with 31 affected extremities who underwent surgical excision of the PFO at an average age of 12.4 years (range, 3.0 to 17.9 y). There were 16 males and 9 females. The underlyingollowing excision of the osteochondroma.

Level IV.

Level IV.The new nurse manager survival guide, part III.The following articles represent the first place and runner-up winners from the Nursing Management Congress2019 poster contest. Both posters were presented and recognized at last year's Congress in New Orleans. Congratulations to our winners!Pathway to Excellence standards promote virtual reality innovation at the Charles George VA Medical Center.The purpose of this study is to evaluate whether additive manufactory technology through the use of 3D mandible and skull cast models can provide additional support to the virtual surgical planning for patients affected by unilateral condylar hyperplasia (UCH). This study describes 2 patients affected by active UCH. Cone beam computed tomography (CBCT) scans were converted in STL files and then sent to a 3D printer that provided 3D cast models of patient's mandible and skull. Surgical planning was conducted performing linear measurement both on 3D virtual images and on 3D cast models. Proportional condylectomy was then simulated with the virtual software and on the 3D cast models as well. After 18 months, new CBCT scans of the patients were acquired and new 3D cast models were printed. Measurements performed on the 3D cast models were close and reliable if compared to measurements obtained on 3D virtual images. None of the patients underwent further surgeries obtaining stable results in terms of symmetry. 3D printing technologies have a relevant support for a more accurate planning and surgical treatment in UCH.Spring-assisted surgery for the correction of scaphocephaly has gained popularity over the past 2 decades. Our unit utilizes standardized torsional springs with a central helix for spring-assisted surgery. This design allows a high degree of accuracy and reproducibility of the force vectors and force distance curves. In this manuscript, we expand on the biomechanical testing and properties of these springs. Standardization of design has enabled us to study the springs on bench and in vivo and a comprehensive repository of calvarial remodeling and spring dynamics has been acquired and analyzed.Finite element modeling is a technique utilized to predict the outcomes of spring-assisted surgery. We have found this to be a useful tool, in planning our surgical strategy and improving outcomes. This technique has also contributed significantly to the process of informed consent preoperatively. In this article, we expand on our spring design and dynamics as well as the finite element modeling used to predict and improve outcomes.In our unit, this practice has led to a significant improvement in patient outcomes and parental satisfaction and we hope to make our techniques available to a wider audience.

Polydioxanone (PDS) has been widely used in the medical field over the past 30 years. In the 2000s, PDS plate began to be used for rhinoplasty and septoplasty. However, in Asia PDS plates are not widely used due to lack of awareness and high prices. The authors devised a method of producing a modified PDS (m-PDS; Rhinoblock Material & Design Co., Gyeonggi-do, Sothh Korea) at low cost, and compared the biocompatibilities and degradabilities of plates produced with m-PDS and commercial PDS plates (Ethicon, Somerville, NJ) in vivo and in vitro.

The melting point and decomposition rate of m-PDS were determined by differential scanning calorimetry and thermogravimetric analysis and its tensile strength was also measured. Implants (1 cm × 1 cm × 0.15 mm sized) were inserted subcutaneously into mice and harvested en bloc 2, 5, 10, 15, or 25 weeks later. Tissues were stained with hematoxylin and eosin or Masson's trichrome to evaluate inflammation, extracellular matrix deposition, and vascularization, and plathat the modified PDS can be used to produce versatile, low cost, absorbable graft materials for rhinoplasty and septoplasty.The current study was undertaken with the aim of assessing the psychopathological symptoms, personality profile, and hostility in detained adolescents with delinquent behavior. A cross-sectional analytical study was carried out on 50 admitted adolescent delinquents in correctional institutes in the Greater Cairo region of Egypt. Results for delinquent adolescents were compared with age-equivalent adolescents with no history of delinquency. Both groups were subjected to the Adolescent and Adult Psychological State Inventory, Eysenck Personality Questionnaire, Locus of Control scale, and the Hostility and Direction of Hostility Questionnaire (HDHQ). Results concluded that adolescents with delinquent behavior displayed increased rates of psychiatric disorders over the comparative group. Significantly higher scores on the psychoticism, neuroticism, extraversion, and psychopathic deviation subscales and the Locus of Control scale were evident among the adolescent delinquent group compared with their nondelinquent peers. The delinquent group obtained, in general, higher overall scores on the HDHQ questionnaire when compared with the nondelinquent adolescents, while also obtaining higher scores on the paranoid hostility subscale of HDHQ. Acting out hostility scores correlated positively with neuroticism and psychoticism in delinquents. Psychiatric morbidity, extraversion, neuroticism, psychoticism, and increased hostility were found to contribute as major psychosocial factors underlying the psychopathology in detained juvenile delinquents.The novel coronavirus pandemic and the resulting expanded use of telemedicine have temporarily transformed community-based care for individuals with serious mental illness (SMI), challenging traditional treatment paradigms. We review the rapid regulatory and practice shifts that facilitated broad use of telemedicine, the literature on the use of telehealth and telemedicine for individuals with SMI supporting the feasibility/acceptability of mobile interventions, and the more limited evidence-based telemedicine practices for this population. We provide anecdotal reflections on the opportunities and challenges for telemedicine drawn from our daily experiences providing services and overseeing systems for this population during the pandemic. We conclude by proposing that a continued, more prominent role for telemedicine in the care of individuals with SMI be sustained in the post-coronavirus landscape, offering future directions for policy, technical assistance, training, and research to bring about this change.

The Functional Comorbidity Index (FCI) was developed for community-based adult populations, with function as the outcome. The original FCI was a survey tool, but several International Classification of Diseases (ICD) code lists-for calculating the FCI using administrative data-have been published. However, compatible International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) and ICD-10-CM versions have not been available.

We developed ICD-9-CM and ICD-10-CM diagnosis code lists to optimize FCI concordance across ICD lexicons.

We assessed concordance and frequency distributions across ICD lexicons for the FCI and individual comorbidities. We used length of stay and discharge disposition to assess continuity of FCI criterion validity across lexicons.

State Inpatient Databases from Arizona, Colorado, Michigan, New Jersey, New York, Utah, and Washington State (calendar year 2015) were obtained from the Healthcare Cost and Utilization Project. State Inpatient Databases contained ICD-9-CM diagnoses for the first 3 calendar quarters of 2015 and ICD-10-CM diagnoses for the fourth quarter of 2015. Inpatients under 18 years old were excluded.

Length of stay and discharge disposition outcomes were assessed in separate regression models. Covariates included age, sex, state, ICD lexicon, and FCI/lexicon interaction.

The FCI demonstrated stability across lexicons, despite small discrepancies in prevalence for individual comorbidities. Under ICD-9-CM, each additional comorbidity was associated with an 8.9% increase in mean length of stay and an 18.5% decrease in the odds of a routine discharge, compared with an 8.4% increase and 17.4% decrease, respectively, under ICD-10-CM.

This study provides compatible ICD-9-CM and ICD-10-CM diagnosis code lists for the FCI.

This study provides compatible ICD-9-CM and ICD-10-CM diagnosis code lists for the FCI.