Targeted Tissue and Cell-Free Tumor DNA Sequencing of Advanced Lung Squamous-Cell Carcinoma Reveals Clinically Significant Prevalence of Actionable Alterations

Background

Major guidelines do not recommend routine molecular profiling of lung squamous-cell carcinoma (LUSC) because the prevalence of actionable alterations is thought to be low. Increased utilization of next-generation sequencing (NGS), particularly with cell-free circulating tumor DNA, facilitates reevaluation of this premise.

Lupus‐like cutaneous reaction following pembrolizumab: An immune‐related adverse event associated with anti‐PD‐1 therapy

PD‐1 (programmed cell death‐1) inhibitors, used to treat metastatic melanoma and other malignancies, are associated with development of immune‐related adverse events in the skin. Such reactions include morbilliform eruptions, vitiligo, alopecia areata and bullous pemphigoid. In this report, we describe a patient who developed a lupus‐like cutaneous reaction in the setting of pembrolizumab therapy for metastatic melanoma, adding to the spectrum of reactions which may be observed in association with PD‐1 inhibitor therapy.     

Concurrent mycosis fungoides and intravascular large B-cell lymphoma in a single patient

Mycosis fungoides (MF) is an indolent, uncommon, non-Hodgkin T-cell lymphoma of the skin. It classically presents with patches, plaques, and tumors and may rarely show spread to internal organs or bone marrow. Up to 7.5% of MF patients may be diagnosed with a second malignancy. Intravascular large B-cell lymphoma (IVLBCL) is an exceedingly rare non-Hodgkin B-cell lymphoma characterized by predominant growth of large neoplastic cells in the lumina of blood vessels. This case presents with an unusual confluence of two rare diagnoses, MF and IVLBCL, made more remarkable by the presence of both diagnoses on a single skin biopsy sample.     

Charcot arthropathy of the shoulder associated with typical and atypical findings

We present a patient with a relatively rare condition: Charcot joint of the shoulder, with a rare complication, the first known example of combined neurovascular compression in this location. A 49‐year‐old man presented with neuropathic arthropathy of the shoulder caused by syringomyelia from a Chiari I malformation, leading to compression of both the brachial plexus and the axillary vein by mass effect from the synovitis. The brachial plexopathy resolved with surgical decompression and synovectomy, and the syringomyelia stabilized after Chiari decompression. A large acromioclavicular joint synovial cyst developed as a late complication, which was treated nonoperatively. Understanding neuropathic arthropathy can explain the spectrum of interrelated typical and atypical features in this case over long‐term follow‐up. Clin. Anat. 26:1017–1023, 2013. © 2012 Wiley Periodicals, Inc.     

Development and Preliminary Evaluation of a Training Workshop for the Collection of Patient-Reported Outcome (PRO) Interview Data by Research Support Staff

This paper describes the development and initial evaluation of a didactic curriculum to prepare research support staff with the core knowledge and skills required to collect patient-reported outcomes (PROs) via interviews. Research support staff members (N?=?77) were recruited for eight separate workshops, each consisting of a didactic presentation followed by role-play scenarios with trained actors depicting common scenarios they may encounter as part of patient interaction. Trainees were observed and received feedback on their performance from trained facilitators and peers. In comparison to their pre-training assessment, trainees showed significant improvement in their confidence to conduct a research interview, handle a distressed participant, manage a wandering interview, ask participants sensitive questions, and handle irritated patients. Training research support staff in the effective collection of PROs via patient interviews can improve the confidence of these individuals in interacting with patients, which can ultimately lead to increased accuracy of data collection.     

Previous Mental Illness Diagnoses Predict Perceptions of Current Mental Illness: A Cultural and Gender Differences Analysis of the United States and India

The disparities in mental health care around the world have led to differences in the way mental illness is treated, diagnosed, and stigmatized. The studies conducted revealed in this article investigated differences between the United States and India in terms of their willingness to agree with a possible mental illness diagnosis. Each study was conducted online using FluidSurveys®. Participants were recruited via Amazon’s® Mechanical Turk® (MTurk), which is a website that provides access to an online, highly diverse participant pool. For Study 1, we hypothesized that there would be significant differences in agreement rates between the two countries and that there would be a positive relationship between agreement rates and the number of previous diagnoses. The three main hypotheses for Study 2 were that there would be a significant difference in agreement rates for the United States and India, the gender of the target individual would have a main effect, and the gender of the participant would have a main effect. The first study was focused on how the number of previous diagnoses would affect agreement rates and how that effect differed between the two countries. The second study looked specifically at how the gender of the participant as well as the gender of the target individual would affect agreement rates. Study 1 yielded significant differences between the United States and India for agreement rates when no previous diagnosis was presented. There was also evidence that as the number of previous diagnoses went from zero, to three, to five, agreement rates also increased. Study 2 also yielded significant differences between the two countries. There was a main effect of participant gender on agreement rates, but no main effect found for target gender.