Seroprevalence of human papillomavirus type 16 in children

We evaluated the prevalence of antibodies to human papillomavirus (HPV) type 16 in a representative sample of children 6-11 years of age in the United States. Serum samples and questionnaire data were collected between 1991 and 1994, for the National Health and Nutrition Examination Survey III. HPV-16-specific immunoglobulin G antibodies were detected by an HPV-16 L1 virus-like particle-based enzyme-linked immunosorbant assay. Overall, 2.4% of 1316 children 6-11 years of age were seropositive. Seroprevalence was higher in boys than in girls (3.5% vs. 1.2%; P=.08) and in children >7 years of age than in children < or =7 years of age (3.3% vs. 0.4%; P<.05). None of the variables tested for, including race/ethnicity, socioeconomic status, and urban or rural residence, were significantly associated with HPV-16 seropositivity. To explain HPV-16 seropositivity in this population, further study is required.     

Thirty-day readmission after ventral hernia repair: predictable or preventable?

Introduction  

Thirty-day readmission has become an increasingly scrutinized event in the field of surgery, especially in light of projected cuts in reimbursement. Although studies have evaluated large populations, little work has been done on procedure-specific populations. Our objective is to determine if any factors are predictive of 30-day readmission in patients undergoing ventral hernia repair.     

Open versus endoscopic component separation: a cost comparison

Background  

The components separation technique (CST) is performed through an open or endoscopic approach. It is unclear whether the costs associated with the endoscopic instruments outweigh any clinical benefit derived from their use and the avoidance of lipocutaneous flaps. This study aimed to compare the direct costs associated with each approach.     

Effects of tomatoes on the lipid profile

PURPOSE: The Mediterranean diet has been reported to reduce cardiovascular mortality and morbidity considerably. Tomatoes and lycopene are considered potent antioxidants. Our purpose was to study the effects of a tomatoe-rich diet on the lipid profile following 300g daily of tomatoes for one month. METHODS: Plasma concentrations of triglyceride, total cholesterol, HDL-cholesterol, LDL-cholesterol and VLDL-cholesterol were determined in 98 apparently healthy volunteers (mean age 45.5+/-14.1 yr) before and after one month of follow-up. Fifty volunteers (34 women and 16 men) ate tomatoes 300g daily and 48 volunteers (32 women and 16 men) continued their regular diet without eating tomatoes for a month. RESULTS: In the regular diet group, there were no changes in the lipid profile: triglyceride level (169.6+/-156.8 vs. 147.6+/-93.4mg/dl; P=0.33), total cholesterol level (198.3+/-41.2mg/dl vs. 204.2+/-70.9mg/dl; P=0.23), HDL-cholesterol level (50.6+/-12.2mg/dl vs. 47.6+/-10.8mg/dl; P=0.79), and LDL-cholesterol level (122.7+/-39.4mg/dl vs. 120.2+/-32.2mg/dl; P=0.24) before and after the 1 month offollow-up. In the tomato-rich diet group: triglyceride level 170.8+/-85.4mg/dl to 167.4+/-99.4mg/ dl (P=0.98), total cholesterol level 207.5+/-44.3mg/ dl to 204.1+/-45.1mg/dl (P=0.68), HDL-cholesterol level 46.1+/-10.6mg/dl to 53.4+/-13.3mg/dl (P=0.03), and LDL-cholesterol level 127.7+/-41.8mg/dl to 119.1+/-41.7mg/dl (P=0.57). CONCLUSION: We found that tomatoes'-rich diet (300g daily for one month) increased HDL-cholesterol level significantly by 15.2%.     

Optimum repair for massive ventral hernias in the morbidly obese patient--is panniculectomy helpful?

Background

The appropriate surgical management of morbidly obese patients with symptomatic hernias is not well defined. The authors evaluated the role of simultaneous panniculectomy in complex abdominal wall reconstruction.

Methods

A retrospective study (2007–2010) was conducted of morbidly obese (body mass index > 40 kg/m²) patients undergoing open complex abdominal wall reconstruction.

Results

Thirty patients were identified. Twenty underwent simultaneous panniculectomy. The median pannus weight was 5.2 kg. Greater all-cause postoperative complications and wound-related morbidity occurred in the panniculectomy group (P < .05). Performing a panniculectomy increased the risk for a wound complication by 5-fold (P = .04). Following 7-month to 9-month follow-up, both groups had a recurrence rate of 10%.

Conclusion

Simultaneous panniculectomy in the setting of complex abdominal wall reconstruction is feasible but associated with significant postoperative morbidity. Its potential for benefit in reducing long-term hernia recurrence remains unclear.     

Unusual mixed gonadal dysgenesis associated with Müllerian duct persistence, polygonadia, and a 45,X/46,X,idic(Y)(p) karyotype

Mixed gonadal dysgenesis (MGD) is a developmental anomaly in which most of the patients have a dysgenetic testis, a contralateral streak and a 45,X/46,XY karyotype. This entity involves an heterogeneous group of gonadal and phenotypic abnormalities with a wide clinical spectrum. The phenotype depends on the ratio of testicular tissue which induces virilization. Although the karyotype in these patients is 45,X/46,XY, no genotype-phenotype correlation has been found to date. Müllerian ducts persistence (MDP) in MGD is rare; however, four patients with both entities and different karyotypes have been described. Here we present the data on a newborn patient with an atypical MGD associated with MDP, two left testes, a gonadal streak on the right, and absence of Wolffian derivatives. PCR analysis identified all the Y-derived sequence tested in the father, while the patient had them all except the AZF b,c regions which were lost. FISH analysis of the paternal Y chromosome documented Yq paracentric inversion while the patient's karyotype was 45,X/46,X,idic(Yp). No mutations were observed in MIS/MISRII genes.