Verrucous carcinoma of the skin associated with syringadenoma papilliferum: a case report

We report the case of a 67-year-old man with a granular, cauliflower-pink lesion on the skin of the thigh. Histopathological study showed a typical verrucous carcinoma associated with a syringadenoma papilliferum. To our knowledge this association has not been previously reported.     

Telomere Length and Preterm Birth in Pregnant Mexican-Origin Women

Objectives

Despite the obstacles of limited education and employment opportunities—and the stress associated with immigration and pregnancy—Mexican immigrant women have low rates of preterm birth (PTB) compared to the US national average for all races and ethnicities. Stressors during pregnancy, and stressors associated with acculturation, may accelerate cellular aging manifested by shortened telomere length (TL) in pregnant women. Our objectives were to: (1) determine whether women with PTBs had shorter telomere lengths compared to women who had full term births; (2) assess the association of acculturation with TL and PTB.

Methods

This prospective pilot study collected data from 100 self-identified Mexican-origin pregnant women. Survey data included self-administered sociodemographic and acculturation measures and was collected from participants via paper and pen, while biologic data was collected via a single blood draw during a regularly scheduled prenatal visit between 26 and 36 weeks gestation. PTB data was collected from the participant’s medical record after delivery.

Results

TL was significantly associated with PTB; the median TL of the women with PTB was less than the median TL for the full sample (p?=?0.02). Based on regression analysis for PTB vs acculturation, we found no significant associations between acculturation and PTB or TL.

Conclusions for Practice

This study provides important evidence of the association between shortened maternal TL and adverse birth outcomes. By linking social, clinical and biologic data, we can enhance our understanding of social determinants that may affect racial and ethnic disparities in preterm birth.

     

Do catastrophizing and autonomic-reduced flexibility mediate pain outcomes in chronic headache?

Neurological Sciences - Maladaptive cognitive strategies and reduced autonomic flexibility have been reported in chronic pain conditions. No study to date addressed the effects of maladaptive...     

Chronic daily headache in childhood and adolescence: clinical aspects and a 4-year follow-up

Chronic daily headache (CDH) represents a challenge in clinical practice and the scientific field. CDH with onset in children and adolescents represent a matchless opportunity to understand mechanisms involved in adult CDH. The aim of this study was to evaluate the diagnosis, prognosis and psychiatric co-morbidity of CDH with young onset in the young. Fifty-nine CDH patients has been followed from 1997 to 2001 in our department. Headache and psychiatric diagnoses were made on the basis of the international system of classification (International Headache Society, 1988; DSM-IV). Chi2 test and multinomial logistic regressions were applied to analyse factors predicting outcome. The current diagnostic system allows a diagnosis in 80% of CDH patients, even if age-related characteristics have been evidenced. Psychiatric disorders are notable in CDH (about 64% of patients) and predict (mainly anxiety) a poorer outcome. Surprisingly, analgesic overuse is not involved in the chronicization process. Diagnosis of CDH needs further study. Psychiatric disorders predict a worse outcome and greater account should be taken of them in treatment planning.     

Pattern of lateral neck metastases in N0 papillary thyroid carcinoma

Background  

Indication and extent of lateral prophylactic neck dissection (PLND) in papillary thyroid carcinoma (PTC) is very controversial.     

Proximal femoral geometry and hip fractures

There is increasing evidence that proximal femoral geometry has an important role in the aetiology of hip fractures. We performed a simple radiological study to investigate the relationship between proximal femoral geometry and intracapsular and extracapsular fractures of the proximal femur. Measurements of proximal femoral geometry were made on pelvic radiographs on the contralateral hip of 50 consecutive patients with intracapsular and 50 with extracapsular fractures. The groups were matched for age and sex with a mean age of 79 and a female :male ratio of 4 :1. There were no statistical differences in head diameter, neck width or Head Trochanter Length between the two groups of fractures. Hip Axis Length, neck length and the neck length :width ratio were significantly greater in the intracapsular group, suggesting an aetiological link. This may have implications for future screening and prevention of proximal hip fractures, particularly intracapsular fractures.     

A case of Verruconis gallopava infection in a heart transplant recipient successfully treated with posaconazole

Verruconis gallopava is an environmental dematiaceous fungus that is recognized increasingly as a cause of human disease, especially for immunocompromised persons. Infection can range from superficial and localized lesions to pulmonary involvement and disseminated disease, including central nervous system abscesses. Optimal therapy is undefined. We report a patient post cardiac transplant who had pulmonary infection with V gallopava and was treated successfully with posaconazole.