Repair of a Mycotic Aneurysm of the Infrarenal Aorta in a Patient with HIV,Using a Palmaz Stent and Autologous Femoral Vein Graft

With the widespread use of endovascular surgery, aneurysms can be managed selectively with the use of stent grafts. Standard treatment of mycotic aneurysms usually requires resection and extraanatomic bypass. Although stent graft repair of a mycotic femoral aneurysm with autologous graft has been reported, we present a case of an infrarenal mycotic aneurysm in a patient with the human immundeficiency virus (HIV) that was successfully treated with a novel endovascular approach.     

Physical Activity Among Native Hawaiians and Pacific Islanders: A Systematic Review and Meta-Analysis

Objective

To examine the proportion of Native Hawaiian and Pacific Islander (NHPI) meeting recommended physical activity guidelines for Americans (PAG) and determine differences in physical activity (PA) by sex and between NHPI and Asians when data are disaggregated.

Age and Sex Differences in Orofacial Strength

This study explored age- and sex-related differences in orofacial strength. Healthy adult men (N = 88) and women (N = 83) participated in the study. Strength measures were obtained using the Iowa Oral Performance Instrument (IOPI). Anterior and posterior tongue elevation strength measures were obtained using a standard method. Tongue protrusion and lateralization, cheek compression, and lip compression measures utilized adaptors allowing the participant to exert pressure against the bulb in different orientations. Lip and cheek strength measures were greater for men than women, but tongue strength did not differ between sex groups. Strong correlations between age and strength were not observed. However, group comparisons revealed lower tongue protrusion and lateralization strength in the oldest participants. The oldest participants also exhibited lower anterior and posterior tongue elevation strength relative to the middle-age group. Cheek and lip compression strength demonstrated no age-related differences. The current study supplements and corroborates existing literature that shows that older adults demonstrate lower tongue strength than younger adults. Sex differences were noted such that men demonstrated greater lip and cheek strength but not tongue strength. These data add to the literature on normal orofacial strength, allowing for more informed interpretations of orofacial weakness in persons with dysphagia.     

Structure-based design of potent and selective 2-(quinazolin-2-yl)phenol inhibitors of checkpoint kinase 2

Structure-based design was applied to the optimization of a series of 2-(quinazolin-2-yl)phenols to generate potent and selective ATP-competitive inhibitors of the DNA damage response signaling enzyme checkpoint kinase 2 (CHK2). Structure-activity relationships for multiple substituent positions were optimized separately and in combination leading to the 2-(quinazolin-2-yl)phenol 46 (IC(50) 3 nM) with good selectivity for CHK2 against CHK1 and a wider panel of kinases and with promising in vitro ADMET properties. Off-target activity at hERG ion channels shown by the core scaffold was successfully reduced by the addition of peripheral polar substitution. In addition to showing mechanistic inhibition of CHK2 in HT29 human colon cancer cells, a concentration dependent radioprotective effect in mouse thymocytes was demonstrated for the potent inhibitor 46 (CCT241533).     

Breastfeeding Among Chinese Immigrants in the United States

X.W.C. is a 37‐year‐old gravida 3, para 1011 at 39 weeks and 6/7 days' gestation. She has no medical problems. Her obstetric history revealed that she had a normal spontaneous vaginal birth of a 4000‐g live infant male 12 years earlier in China. By her account, the infant had been exclusively bottle‐fed. Her primary language is Mandarin. Her prenatal course was mostly uncomplicated. She had a positive purified protein derivative (PPD) test, but a chest radiograph was negative for tuberculosis. She also had a condyloma that was ruled safe for vaginal birth, and a pronounced rectocele and cystocele that were to be followed postpartum. During each of the first 10 prenatal visits, X.W.C. was handed a pamphlet with facts about the benefits of breastfeeding. Toward the end of her prenatal course, she was asked what method of infant feeding she preferred, and she indicated that she would try breastfeeding. Shortly after being admitted to the labor unit she was given Pitocin to augment her labor because she presented with prelabor rupture of membranes (PROM) at term. Two hours later, she had a normal spontaneous vaginal birth of a live 3515‐g female newborn; her 1‐and 5‐minute Apgar scores were 9 and 9, respectively. The baby was placed on the mother's abdomen and warmed and dried. After the delivery of the placenta, and after a second‐degree laceration was repaired, she was asked if she would like to breastfeed or bottle‐feed. She hesitated for a moment before answering that she would like to try both. Her husband then looked at X.W.C. and asked if that would be the best thing for them. Sensing her husband's wishes and possibly having discussed feeding methods with him beforehand, X.W.C. then took a minute before telling the nurse that she had changed her mind—she wanted to bottle‐feed. On her first day postpartum, she and her baby were both doing well. Her baby was by her side, and she was exclusively bottle‐feeding.     

All-Terrain Vehicle Safety and Use Patterns in Central Illinois Youth

Context: All-terrain vehicles' (ATVs) popularity and associated injuries among children are increasing in the United States. Currently, most known ATV use pattern data are obtained from injured youth and little documented data exist characterizing the typical ATV use patterns and safety practices among American children in general.
Purpose: To describe the typical ATV safety and use patterns of rural youth.
Methods: A cross-sectional anonymous mail survey was conducted of youth participants (ages 8-18) in the 4-H Club of America in four Central Illinois counties. Questions examined ATV use patterns, safety knowledge, safety equipment usage, crashes, and injuries.
Findings: Of 1,850 mailed surveys, 634 were returned (34% response rate) with 280 surveys (44% of respondents) eligible for analysis. Respondents were principally adolescent males from farms or rural locations. Most drove ≤1 day per week (60.2%) and used ATVs for recreation (36%) or work (22.6%) on farms and/or private property (53.4%). Most never used safety gear, including helmets (61.4%), and few (14.6%) had received safety education. Of the 67% who experienced an ATV crash, almost half (44%) were injured. Children with safety training had fewer crashes ( P = .01), and those riding after dark ( P = .13) or without adult supervision ( P = .042) were more likely injured.
Conclusions: ATV use is common in a rural 4-H population. Most child ATV users were adolescent boys, had little safety training and did not use safety equipment or helmets. ATV injury prevention efforts should focus on these areas.