Diagnosis of lithokelyphos by computed tomography

An incidental stone child, lithokelyphos, presented as an undiagnosed abdominal mass in a woman with cervical cancer. Lithopedion formation is an uncommon result of an abdominal pregnancy. The types of lithopedions as well as their method of formation and clinical features are reviewed. In addition, the computed tomographic features of lithopedions are presented.     

Healthy & Active Communities Initiative: A foundation's response to the obesity epidemic

Missouri has the 12th highest rate of adult obesity and the 15th highest rate of overweight and obese youth in the United States. In response, Missouri Foundation for Health has implemented the Healthy and Active Communities Initiative (H&AC). Methods applied through H&AC include grantmaking, evaluation support, dissemination technical assistance, policy assessment, and development of local, regional, and statewide collaborations to increase access to physical activity and nutrition through environmental, policy and behavior change. Results to date demonstrate more than 49 counties in the state have been impacted through 79 grantee projects. Nearly half (45%) of these grantees have achieved more than their original goals and 60% of grantees can sustain at least half of their program activities post award. Fifty percent of grantees have helped to change the way the community works on public issues. Through the H&AC Initiative, Missouri Foundation for Health serves as a model for how a foundation can assist in efforts to mitigate and prevent rising rates of obesity.     

Ultrasound evaluation of the abductor hallucis muscle: Reliability study

Background

The Abductor hallucis muscle (AbdH) plays an integral role during gait and is often affected in pathological foot conditions. The aim of this study was to evaluate the within and between-session intra-tester reliability using diagnostic ultrasound of the dorso-plantar thickness, medio-lateral width and cross-sectional area, of the AbdH in asymptomatic adults.

Methods

The AbdH muscles of thirty asymptomatic subjects were imaged and then measured using a Philips HD11 Ultrasound machine. Interclass correlation coefficients (ICC) with 95% confidence intervals (CI) were used to calculate both within and between session intra-tester reliability.

Results

The within-session reliability results demonstrated for dorso-plantar thickness an ICC of 0.97 (95% CI: 0.99–0.99); medio-lateral width an ICC: of 0.97 (95% CI: 0.92–0.97) and cross-sectional area an ICC of 0.98 (95% CI: 0.98–0.99). Between-session reliability results demonstrated for dorso-plantar thickness an ICC of 0.97 (95% CI: 0.95 to 0.98); medio-lateral width an ICC of 0.94 (95% CI 0.90 to 0.96) and for cross-sectional area an ICC of 0.79 (95% CI 0.65 to 0.88).

Conclusion

Diagnostic ultrasound has the potential to be a reliable tool for evaluating the AbdH muscle in asymptomatic subjects. Subsequent studies may be conducted to provide a better understanding of the AbdH function in foot and ankle pathologies.     

Inactivation of HDAC1 or HDAC2 induces gamma globin expression without altering cell cycle or proliferation

Other than hydroxyurea, no pharmacologic agents are clinically available for fetal hemoglobin (HbF) induction in sickle cell disease (SCD). An optimal candidate would induce HbF without causing cell cycle inhibition and would act independently of hydroxyurea in order to yield additional HbF induction when combined. We explored whether inhibition of histone deacetylase (HDAC) 1 or HDAC2 could achieve these goals. In human erythroid progenitor cells, shRNA knockdown of the HDAC1 or HDAC2 genes induced gamma globin, without altering cellular proliferation in vitro, and without altering cell cycle phase. Treatment with hydroxyurea in combination with HDAC2 knockdown yielded a further increase in gamma globin expression. Additionally, when CD34+ cells were treated with both hydroxyurea and MS‐275 (an inhibitor of HDAC 1, 2, and 3), an additive induction of relative gamma globin expression was achieved. Our findings support further clinical investigation of HDAC inhibitors in combination with hydroxyurea in SCD patients. Am. J. Hematol. 90:624–628, 2015. © 2015 Wiley Periodicals, Inc.     

Impact on Health-Related Quality of Life in Adults with Eosinophilic Gastritis and Gastroenteritis: A Qualitative Assessment

Background

Eosinophilic gastritis (EG) and eosinophilic gastroenteritis (EGE) are chronic immune-mediated conditions of the digestive tract, which affect the stomach only, or the stomach and small intestines, respectively. Though these disorders are uncommon, they are being increasingly recognized and diagnosed. While health-related quality of life (HRQOL) has been evaluated in other eosinophilic gastrointestinal diseases, this study is the first to describe HRQOL impacts unique to EG/EGE.

Aims

This study aims to qualitatively describe experiences of adults diagnosed with EG and EGE. We aim to identify impacts on HRQOL in this population in order to inform clinical care and assessment.

Methods

Seven patients diagnosed with EG or EGE participated in semi-structured interviews assessing common domains of HRQOL.

Results

Four distinct themes emerged from qualitative analyses, which represent impacts to HRQOL: the psychological impact of the diagnosis, impact on social relationships, financial impact, and impact on the body. These generally improved over time and with effective treatment.

Conclusions

This study demonstrated that patients with EG/EGE experience impacts to HRQOL, some of which differ from HRQOL of other eosinophilic gastrointestinal diseases. These results support the development of a disease-specific measure, or adaptation of an existing measure, to assess HRQOL in EG/EGE.

     

The problem of benign pulmonary nodules in children receiving cytotoxic chemotherapy

Chest computed tomography (CT) is often used to detect and monitor pulmonary nodules in children undergoing chemotherapy for underlying sarcoma. Three children underwent resection of nodules which persisted during chemotherapy. In two children, all resected nodules were benign; in the other, a mixture of benign and malignant nodules was found. Our findings suggest that nodular scar formation after successful eradication by chemotherapeutic agents may be a mechanism for the persistence of pulmonary nodules. It should not be assumed that persistence of pulmonary nodules on CT after appropriate chemotherapy indicates inadequate response.     

Effects of Nutritional Interventions on Cardiovascular Disease Health Outcomes in Aboriginal and Torres Strait Islander Australians: A Scoping Review

Nutrition interventions can support Aboriginal and Torres Strait Islander peoples to reduce their risk of cardiovascular disease (CVD). This review examines nutritional interventions aiming to improve CVD outcomes and appraises peer-reviewed interventions using an Aboriginal and Torres Strait Islander Quality Appraisal Tool. Five electronic databases and grey literature were searched, applying no time limit. Two reviewers completed the screening, data extraction and quality assessment independently. The study quality was assessed using the South Australian Health and Medical Research Institute and the Centre of Research Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange Aboriginal and Torres Strait Islander Quality Appraisal Tool (QAT). Twenty-one nutrition programs were included in this review. Twelve reported on anthropometric measurements, ten on biochemical and/or hematological measurements and sixteen on other outcome domains. Most programs reported improvements in measurable CVD risk factors, including reduced body mass index (BMI), waist circumference (WC), weight, blood pressure and improved lipid profiles. Most programs performed well at community engagement and capacity strengthening, but many lacked the inclusion of Indigenous research paradigms, governance and strengths-based approaches. This review highlights the need for contemporary nutrition programs aimed at improving cardiovascular health outcomes to include additional key cultural components.