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Ocular Expressions involving Neuronal Ceroid Lipofuscinoses.
PURPOSE The aim of this study was to evaluate the effectiveness of percutaneous injection of bleomycin combined with fibrin glue in treating massive venous malformations (MVMs) in the head and neck region. MATERIALS AND METHODS A retrospective case series analysis of 22 patients who underwent percutaneous sclerotherapy between June 2015 and December 2018 was performed. All the patients were examined by comparing the size of the venous malformations (VMs) and their responses to treatment including complications in the follow-up. RESULTS The follow-up period ranged from 6 to 24 months. Ten patients (10/22) were completely cured and 10 patients (10/22) exhibited excellent size reduction of their VMs. Two patients (2/22) exhibited reasonable size reduction and were recommended to undergo a second sclerotherapy procedure. However, both patients were satisfied with the outcomes and refused subsequent treatment. Neither systemic nor local complications occurred in this study. All the patients were satisfied with their significant size reductions and symptom improvements without recurrences during follow-up. CONCLUSION Percutaneous injection of bleomycin combined with fibrin glue is a promising treatment option that yielded excellent size reduction with a low risk of complications on MVMs in the head and neck region. OBJECTIVES Resident burnout is an increasing issue in graduate medical education programs. Military graduate medical education is unique in numerous ways and may have different rates of burnout as well as different causes. This study aims to assess resident burnout rates and contributing factors among military general surgery residents. DESIGN, SETTING, AND PARTICIPANTS Using Department of Defense approved software, an anonymous survey was created and distributed to all general surgery residents (n = 180) in 6 US medical centers where there are general surgery residency programs. The survey contained an Abbreviated Maslach Burnout Index questionnaire, multiple choice questions including several military-specific questions, and 2 open ended questions. Rates of burnout and potential risk factors associated with burnout were analyzed. RESULTS After the collection period, 92 of 180 (51%) residents completed all Abbreviated Maslach Burnout Index questions, demographics, and military specific questions with an oppoties, and efforts to increase resident camaraderie should be more closely evaluated. Ruboxistaurin price Published by Elsevier Inc.OBJECTIVES China has the world's largest aging population, of which 46% have multimorbidity and 38% have functional impairment. Older adults with multimorbidity often suffer functional impairment as well; however, it is not clear how current health care services have been used in this population. This study aimed to compare health care utilization among Chinese older adults at different levels of chronic disease and functional impairment. DESIGN A cross-sectional design. Multivariate 2-part models were used to examine the probability and frequency of health care utilization. SETTING AND PARTICIPANTS Data were from 5166 adults aged 65 or older from the 2015 wave of the China Health and Retirement Longitudinal Study. The sample included 22% without any chronic condition, 27% with 1 chronic condition, 44% with multimorbidity, and 7% with multimorbidity and functional impairment. MEASURES Health care utilization included outpatient visits, inpatient visits, and unmet hospitalization needs. RESULTS As the number of chronic conditions and functional impairments increased, older adults tend to access health care more. Older adults with both multimorbidity and functional impairment tend to use health care services most, but still reported the highest level of unmet hospitalization needs among all groups. CONCLUSIONS AND IMPLICATIONS Chinese older adults with multimorbidity and functional impairment may have experienced multiple barriers in accessing health care. Social programs should be created to make health care more accessible among older adults. The health care delivery system could be oriented to home-based medical care, which have been found effective in delivering high-quality care and reducing health care costs. Improvements in chemistry, molecular biology, genetics, and bioinformatics have allowed broad use of transcriptomic profiling. Understanding the population of ribonucleic acid (RNA) transcripts can provide important clinical information relevant to kidney cancer care. This includes a better understanding of kidney cancer subtype and distinct clusters within these categories. RNA-sequencing (RNA-seq) is typically done on a region within the tumor, which represents thousands to millions of heterogeneous cells and various components of the microenvironment. Computational tools can deconvolute these populations to provide insight into the microenvironment. Specific signatures of hypoxia, proliferation, angiogenesis and immune infiltration can predict response and survival. Prognostic signatures can risk stratify tumors to aid in identification of patients who might derive benefit from adjuvant therapy. As the cost of sequencing continues to decline and improved bioinformatic tools are developed, the barriers to clinical use of transcriptomic data continue to crumble. Here we review the current literature around the use of transcriptomics in kidney cancer diagnosis and management. BACKGROUND Impaired social functioning is a core feature of schizophrenia spectrum (SZS) and bipolar spectrum disorders (BDS). Childhood traumatic events are more frequent in SZS and BDS than in healthy individuals (HC), and could represent a cumulative risk for reduced social functioning beyond experiencing ongoing clinical symptoms. METHODS The study comprised 1039 individuals (SZS [n = 348]; BDS [n = 262], and HC [n = 429]). Childhood trauma and level of social functioning was assessed by the Childhood Trauma Questionnaire (CTQ) and the Social Functioning Scale (SFS), respectively. Diagnosis was obtained by the Structured Clinical Interview (SCID) for the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). RESULTS Patients had poorer social functioning (F = 819.18, p ˂ 0.001, Cohen's d = 0.44) and reported more childhood trauma experiences than HC (X2 = 289.0, p less then .001) than HC. Patients with at least one moderate to severe trauma had poorer social functioning than patients without childhood trauma (F = 8.
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