Getting out of Procrustes' bed: The needs and benefits of qualitative research in stuttering

Qualitative research has a vast potential for understanding complex issues such as stuttering, and is becoming more common in that research field. The purpose of this article is to highlight the potential benefits of qualitative research in stuttering through exploration of four different research paradigms and their knowledge claims. Through this explanation, a case is built for the benefits of applying qualitative methods to stuttering research. Questions such as “how” a certain behavior or process take places, rather than just “if” a certain behavior or process takes place, are possible within the qualitative paradigm. It is concluded that future knowledge about stuttering and its treatment will be well served by applying the most appropriate investigative methods to it rather than by attempting to establish information with a restricted set of quantitative approaches.     

The opacified maxillary sinus: CT findings in chronic sinusitis and malignant tumors

To distinguish opacification owing to inflammatory conditions (sinusitis) from that caused by nasomaxillary malignancy, computed tomography scans in 24 proved cases of sinusitis or tumor were reviewed for features related to sinus size, wall thickness, and character of bone erosion. An anatomic system was defined for classifying lesions according to the surface and type of bony involvement. In 12 cases of chronic maxillary sinusitis, the involved sinus was usually small and thick walled. The nasal surface of the involved sinus usually was eroded; often the orbital surface was eroded. The erosion was, however, short, irregular, and in the region of a normal dehiscence (semilunar hiatus or infraorbital canal) in all cases. The infratemporal surface was never eroded. In 12 cases of nasomaxillary neoplasia, the sinus was enlarged, one or more walls of the involved sinus being thinned and expanded. Bone erosion was present in all cases; erosion of the infratemporal surface was specific for neoplasia and significant as the usual site of recurrence.     

Panton–Valentine leukocidin Staphylococcus aureus osteomyelitis of the adult tibia – a case report

Panton–Valentine leukocidin toxin producing Staphylococcus aureus (PVLSA) is known to be responsible for recurrent soft tissue infections and more serious invasive infections including necrotising pneumonia, pyomyositis, and osteomyelitis. Most reported cases involving musculoskeletal infection in adults are associated with methicillin-resistant S. aureus (MRSA) PVL-producing strains. We present the case of an adult male with PVL toxin–producing methicillin-sensitive S. aureus (MSSA) osteomyelitis of the tibia which has not previously been described in adults and highlight issues of recognition, treatment, and surgical management of PVLSA osteomyelitis.     

The relevance of long head biceps degeneration in the presence of rotator cuff tears

Background  

Long head biceps (LHB) degeneration in combination with rotator cuff tears can be a source of chronic shoulder pain. LHB tenotomy is an approved surgical procedure for pain reduction and improvement of joint function, however, the pathophysiology of LHB degeneration is not fully understood. In the literature, neoangiogenesis in tendon tissue has previously been shown to be associated with tendon degeneration. Vascular Endothelial Growth Factor (VEGF) is an important inducer of neoangiogenesis. The hypotheses are first that an elevated VEGF expression and vessel density can be found in degenerated LHB tissue and second that there is a relation between VEGF expression, vessel density and the different types of rotator cuff tears.     

Osteochondritis dissecans of the capitellum in adolescents

Osteochondritis dissecans(OCD)is a disorder of articular cartilage and subchondral bone.In the elbow,an OCD is localized most commonly at the humeral capitellum.Teenagers engaged in sports that involve repetitive stress on the elbow are at risk.A high index of suspicion is warranted to prevent delay in the diagnosis.Plain radiographs may disclose the lesion but computed tomography and magnetic resonance imaging are more accurate in the detection of OCD.To determine the best treatment option it is important to differentiate between stable and unstable OCD lesions.Stable lesions can be initially treated nonoperatively with elbow rest or activity modification and physical therapy.Unstable lesions and stable lesions not responding to conservative therapy require a surgical approach.Arthroscopic debridement and microfracturing has become the standard initial procedure for treatment of capitellar OCD.Numerous other surgical options have been reported,including internal fixation of large fragments and osteochondral autograft transfer.The aim of this article is to provide a current concepts review of the etiology,clinical presentation,diagnosis,treatment,and outcomes of elbow OCD.     

MicroRNAs differentially expressed in ACTH-secreting pituitary tumors

CONTEXT: MicroRNAs (miRNAs) are small noncoding RNAs, functioning as antisense regulators of gene expression by targeting mRNA and contributing to cancer development and progression. More than 50% of miRNA genes are located in cancer-associated genomic regions or in fragile sites of the genome. Objective: The aim of the study was to analyze the differential expression of let-7a, miR-15a, miR-16, miR-21, miR-141, miR-143, miR-145, and miR-150 in corticotropinomas and normal pituitary tissue and verify whether their profile of expression correlates with tumor size or remission after treatment. MATERIAL AND METHODS: ACTH-secreting pituitary tumor samples were obtained during transphenoidal surgery from patients with Cushing disease and normal pituitary tissues from autopsies. The relative expression of miRNAs was measured by real-time PCR using RNU44 and RNU49 as endogenous controls. Relative quantification of miRNA expression was calculated using the 2(-DeltaDeltaCt) method. RESULTS: We found underexpression of miR-145 (2.0-fold; P = 0.04), miR-21 (2.4-fold; P = 0.004), miR-141 (2.6-fold; P = 0.02), let-7a (3.3-fold; P = 0.003), miR-150 (3.8-fold; P = 0.04), miR-15a (4.5-fold; P = 0.03), miR-16 (5.0-fold; P = 0.004), and miR-143 (6.4-fold; P = 0.004) in ACTH-secreting pituitary tumors when compared to normal pituitary tissues. There were no differences between miRNA expression and tumor size as well as miRNA expression and ratio of remission after surgery, except in patients presenting lower miR-141 expression who showed a better chance of remission. CONCLUSION: Our results support the possibility that altered miRNA expression profile might be involved in corticotrophic tumorigenesis. However, the lack of knowledge about miRNA target genes postpones full understanding of the biological functions of down-regulated or up-regulated miRNAs in corticotropinomas.     

The role of neutropenia on outcomes of cancer patients with community-acquired pneumonia

Although the presence of neutropenia may predispose cancer patients to develop community-acquired pneumonia, the role of neutropenia on their outcomes has not been investigated. The purpose of the present study was to compare clinical outcomes of cancer community-acquired pneumonia patients with and without neutropenia. Patients with cancer, identified in the Community-Acquired Pneumonia Organization database, were divided into two groups according to the type of cancer and the presence of neutropenia: patients with solid cancer without neutropenia versus those with functional or absolute neutropenia. Among the 3,106 community-acquired pneumonia patients enrolled, 135 had cancer without neutropenia and 75 had cancer with neutropenia. No significant difference was found between patients with and without neutropenia regarding mean time to clinical stability (5.4+/-2.7 versus 4.9+/-2.7 days, respectively), mean length of hospital stay (9.2+/-7.7 versus 9.9+/-9.6 days) and in-hospital mortality (18 versus 15%, respectively). Using a multiple logistic regression model, neutropenia was not associated with mortality in cancer patients when adjusting for significant covariates (odds ratio 1.30). Lack of neutropenia, during the initial evaluation of a cancer community-acquired pneumonia patient, should not be considered an indicator of better clinical outcome.