Ovarian tumor in a 12‐year old female with severe hypothyroidism: A case of Van Wyk and Grumbach syndrome

We report a 12‐year‐old female presenting with an abdominal tumor. Diagnostic workup revealed giant bilateral ovarian cysts, severe hypothyroidism as well as an elevation of CA 125. We refrained from ovariectomy, which would be necessary for a malignant tumor, in view of an evident Van Wyk and Grumbach syndrome. The patient promptly responded to L ‐thyroxine with complete regression of all symptoms. Hypothyroidism should be considered in the evaluation of ovarian cysts. Although the Van Wyk and Grumbach syndrome is rare, it is crucial to rule it out in order to avoid unnecessary ovarian surgery when thyroid replacement is completely sufficient. Pediatr Blood Cancer 2009;52:677–679. © 2009 Wiley‐Liss, Inc.     

Oral Caffeine During Voluntary Exercise Markedly Inhibits Skin Carcinogenesis and Decreases Inflammatory Cytokines in UVB-Treated Mice

Ultraviolet B (UVB)-pretreated SKH-1 mice were treated with water, caffeine (0.1 mg/ml), voluntary running wheel exercise (RW) or caffeine together with RW for 14 wk. Treatment of the mice with caffeine, RW, or caffeine plus RW decreased skin tumors per mouse by 27%, 35%, and 62%, respectively, and the tumor volume per mouse was decreased by 61%, 70%, and 85%, respectively. In mechanistic studies, mice were treated with water, caffeine, RW, or caffeine plus RW for 2 wk prior to a single irradiation with UVB. Caffeine plus RW increased RW activity by 22% when compared with RW alone. Caffeine ingestion was not significantly different between groups. Treatment of mice with caffeine plus RW for 2 wk decreased the weight of the parametrial fat pads and stimulated the formation of UVB-induced apoptosis to a greater extent than treatment with caffeine or RW alone. An antibody array revealed that caffeine plus RW administered to mice fed a high-fat diet and irradiated with UVB decreased the epidermal levels of lipopolysaccharide-induced CXC chemokine, soluble TNF alpha receptor-1, and macrophage inflammatory protein-1γ. Overall, caffeine during RW exerts a stronger effect than either treatment alone for decreasing tissue fat, increasing UVB-induced apoptosis, lowering the levels of cytokines associated with inflammation and for inhibiting UVB-induced carcinogenesis.     

Pulmonary Contusion in Contact Sports

Computed tomography (CT) is always more precise than chest x-ray for evaluating pulmonary contusions and other forms of lung trauma. CT is also valuable in guiding treatment for patients who have pulmonary contusions. As demonstrated by two case studies, not all sports-related pulmonary contusions are minor. Supportive treatment usually consists of maintaining the patient's oxygenation, treating associated injuries, and preventing complications.     

Systematische Bewertung und Steigerung der Qualität medizinischer Daten

Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz - Gesundheitsforschung ist auf empirische Informationen angewiesen, die auf Daten mit hoher Qualität basieren. Das Ziel der...     

Medical Student Dermatology Interest Groups

The Dermatology Interest Group (DIG) at the University of Texas Medical Branch (UTMB) blog (digutmb.blogspot.com) was created in 2004 with the aims of increasing communication and collaboration among students, faculty, residents, and alumni, promoting educational opportunities, and fostering the missions for which DIG was created. This blog is unique, because its frequent activity is directed toward the educational and professional needs of medical students and residents. We assessed the use of this blog by evaluating the number of blog views and audience members with relationship to the number of posts and post content over time via a tracking system. We found that there has been an increase in blog posts, views, and subscribers, as well as in areas of post content including dermatology resources/news/articles, residency applications, and resident-related information. Usefulness of such posts expands beyond UTMB students, which increases blog views and widens viewer audience. An international viewer population also was evaluated. Recorded blog viewing time was 1 minute, 57 seconds, which is more time than needed to read a post, suggesting use of additional blog information. This review of the DIG at the UTMB blog demonstrates how the use of web-based tools, in addition to the inherent benefits of medical student interests groups, are valuable resources for students, residents, and faculty.     

Results of a combination of bleomycin and triamcinolone acetonide in the treatment of keloids and hypertrophic scars

While treatment of keloids and hypertrophic scars normally shows modest results, we found that treatment with bleomycin was more promising. The present study was divided into two parts. In the first part the aim was to show the results using a combination of bleomycin and triamcinolone acetonide per cm² (BTA). In the second part the objective was to determine the response to both drugs in large keloids that were divided into 1 cm² squares, treating each square with the dose previously used. In the first part of the study, the clinical response of 37 keloids ranging from 0.3 to 1.8 cm² treated with BTA were followed up over a period of 1- 2 years. 0.375 IU bleomycin and 4 mg triamcinolone acetonide were injected every 3 months. In the second part of the study we reviewed the clinical response in six patients with large keloids. The monthly dose administered never exceeded 3 IU of bleomycin. The first study showed 36 keloids (97.29%) softening after the first dose. In the second study, 5 showed different responses (the response was complete in the four smaller keloids). The largest keloid needed 9 doses to achieve an improvement of 70%. In conclusion, combined treatment with 0.375 IU of bleomycin and 4mg of triamcinolone acetonide to 1 cm² was considered to be an acceptable procedure for the treatment of keloids. The best results were obtained in keloids over 1 cm² or when divided into 1 cm² square areas. Larger series need to be performed in order to confirm these results..     

HPTN 068: A Randomized Control Trial of a Conditional Cash Transfer to Reduce HIV Infection in Young Women in South Africa—Study Design and Baseline Results

Young women in South Africa are at high risk for HIV infection. Cash transfers offer promise to reduce HIV risk. We present the design and baseline results from HPTN 068, a phase III, individually randomized trial to assess the effect of a conditional cash transfer on HIV acquisition among South African young women. A total of 2533 young women were randomized to receive a monthly cash transfer conditional on school attendance or to a control group. A number of individual-, partner-, household- and school-level factors were associated with HIV and HSV-2 infection. After adjusting for age, all levels were associated with an increased odds of HIV infection with partner-level factors conveying the strongest association (aOR 3.05 95 % CI 1.84–5.06). Interventions like cash transfers that address structural factors such as schooling and poverty have the potential to reduce HIV risk in young women in South Africa.     

Acute Pancreatitis

Hypertension is a frequent complication of chronic pyelonephritis. Modern drug therapy can control bacterial infection of the kidney. Hypertension due to pyelonephritis should be prevented by adequate treatment of the primary infection. If hypertension does occur, it can be controlled by elimination of the renal infection.     

Unexpected nondenitrifier nitrous oxide reductase gene diversity and abundance in soils

Agricultural and industrial practices more than doubled the intrinsic rate of terrestrial N fixation over the past century with drastic consequences, including increased atmospheric nitrous oxide (N₂O) concentrations. N₂O is a potent greenhouse gas and contributor to ozone layer destruction, and its release from fixed N is almost entirely controlled by microbial activities. Mitigation of N₂O emissions to the atmosphere has been attributed exclusively to denitrifiers possessing NosZ, the enzyme system catalyzing N₂O to N₂ reduction. We demonstrate that diverse microbial taxa possess divergent nos clusters with genes that are related yet evolutionarily distinct from the typical nos genes of denitirifers. nos clusters with atypical nosZ occur in Bacteria and Archaea that denitrify (44% of genomes), do not possess other denitrification genes (56%), or perform dissimilatory nitrate reduction to ammonium (DNRA; (31%). Experiments with the DNRA soil bacterium Anaeromyxobacter dehalogenans demonstrated that the atypical NosZ is an effective N₂O reductase, and PCR-based surveys suggested that atypical nosZ are abundant in terrestrial environments. Bioinformatic analyses revealed that atypical nos clusters possess distinctive regulatory and functional components (e.g., Sec vs. Tat secretion pathway in typical nos), and that previous nosZ-targeted PCR primers do not capture the atypical nosZ diversity. Collectively, our results suggest that nondenitrifying populations with a broad range of metabolisms and habitats are potentially significant contributors to N₂O consumption. Apparently, a large, previously unrecognized group of environmental nosZ has not been accounted for, and characterizing their contributions to N₂O consumption will advance understanding of the ecological controls on N₂O emissions and lead to refined greenhouse gas flux models.