Uterine rupture in patients with a history of hysteroscopy procedures: Case series and review of literature

RATIONALE

Uterine rupture during pregnancy poses significant risks to both the fetus and the mother, resulting in high mortality and morbidity rates. While awareness of uterine rupture prevention after a cesarean section has increased, insufficient attention has been given to cases caused by pregnancy following hysteroscopy surgery.

PATIENT CONCERNS

We report 2 cases here, both of whom had a history of hysteroscopy surgery and presented with severe abdominal pain during pregnancy.

DIAGNOSES

Both patients had small uterine ruptures, with no significant abnormalities detected on ultrasonography. The diagnosis was confirmed by a CT scan, which showed hemoperitoneum.

INTERVENTIONS

We performed emergency surgeries for the 2 cases.

OUTCOMES

We repaired the uterus in 2 patients during the operation. Both patients recovered well. The children survived. No abnormalities were detected during their follow-up visits.

LESSONS

Attention should be paid to the cases of pregnancy after hysteroscopy.

Primary invasive squamous cell carcinoma of the nipple in an adult male: A case report and brief review of literature

This is a case report of a rare and uncommon primary invasive squamous cell carcinoma (SCC) of the nipple in a male patient. The patient presented with an ulcerated growth over the left nipple for the last 20 years, which progressed over the last 6 months. He underwent wide local excision with level II axillary lymph node dissection, and one out of 42 lymph nodes harvested showed metastatic deposit. The patient was planned for follow-up with no adjuvant treatment, and had no evidence of local-regional or distant recurrence at 24 months follow-up. The primary invasive SCC of male nipple is very rare, and its diagnosis is challenging as it can be confused with other clinical conditions. However, a histopathological examination with immunohistochemistry can differentiate primary SCC nipple from other differential diagnoses. The treatment options for cutaneous SCC include surgical excision, cryotherapy, electrosurgery, topical ointments, definitive radiation therapy, and photodynamic therapy. Regional lymph node dissection in SCC nipple could potentially have therapeutic and prognostic significance.

Angioleiomyoma in a 54-year-old Female: A Case Report of Distal Leg Tumor and Review of the Literature

Introduction

Angioleiomyomas are rare benign tumors originating from smooth muscle cells of blood vessels. Although they can occur in various anatomical locations, angioleiomyomas of the distal leg are relatively uncommon. Due to its clinical resemblance to other soft-tissue tumors, misdiagnosis can occur leading to inadequate treatment.

Case Report

We present a case of angioleiomyoma in a 54-year-old female who presented with a palpable mass in her distal leg. The tumor was surgically excised, and histopathological examination confirmed the diagnosis of angioleiomyoma. In this article, we discuss the clinical presentation, diagnostic evaluation, and management of angioleiomyoma, with a focus on distal leg tumors. Furthermore, we provide a comprehensive review of the existing literature on angioleiomyomas, emphasizing findings and treatment outcomes reported in previous studies.

Conclusion

Angioleiomyomas are uncommon soft-tissue tumors that can mimic other more common lesions such as ganglion cysts. Hence, diagnosis requires a high index of suspicion. Surgical excision is the treatment of choice for angioleiomyoma. Complete resection is generally curative, with a low rate of recurrence.

Relationship dynamics associated with emotional IPV perpetration and victimization: A meta-analysis

Emotional intimate partner violence (IPV) is the most common form of IPV and frequently co-occurs with other forms of IPV. Risk factors of IPV can give insight to potential pathways and consequences associated with IPV, enhancing treatment efforts. This meta-analysis examined relationship dynamics associated with IPV perpetration and victimization. Our study found victimization of controlling behavior, demand/withdrawal relationship pattern, perpetration of controlling behavior, jealousy, relationship distress, perpetrator's power in the relationship, anxious attachment, and traditional gender roles were all significantly associated with IPV perpetration. For IPV victimization, victimization of controlling behaviors, fear of the perpetrator, relationship distress, anxious and avoidant attachment, and traditional gender roles were all found to be significantly associated. Relationship satisfaction was found to be negatively associated with emotional IPV perpetration and victimization. Implications for clinicians are discussed.

Bardet-Biedl Syndrome Presenting With Bifid Epiglottis: A Case Report and Review of Literature

Bifid epiglottis is a rare congenital laryngeal anomaly that is most commonly a syndromic rather than an isolated entity. It has been associated with specific syndromes, such as Pallister-Hall syndrome, Bardet-Biedl syndrome, and other related syndromes. Bardet-Biedl syndrome is a rare autosomal-recessive disorder characterized by hand and/or feet polydactyly, obesity, short stature, mental retardation, renal anomalies, and genital anomaly. Here we report a case involving a 25-year-old Saudi male patient who presented with hoarseness of voice since birth with no diurnal or diet association or other associated symptoms. On examination, he was noted to have craniofacial dysmorphism and polydactyly of the right hand and left foot. Fiberoptic nasopharyngolaryngoscopy (NPLS) revealed a laryngeal pedunculated rounded glottic mass and subglottic bulging with expiration and involuting with inspiration along with an abnormal-looking epiglottis having a separate cartilaginous framework with space in-between and bilateral mobile vocal cords. Computed tomography (CT) showed the vocal cord mass and a bifid epiglottis. Other investigations and labs were within normal range. The patient underwent vocal cord mass excision and soft tissue histopathology revealed a benign growth. On follow-up, the patient showed clinical improvement. In conclusion, this is a rare case of bifid epiglottis associated with Bardet-Biedl syndrome, which serves to highlight the significance of such anomalies in any syndromic patient presenting with airway symptoms. Our aim is to add more cases to the literature and to consider it as a differential diagnosis.

A Critical Appraisal of the Chronic Pain Rate After Inguinal Hernia Repair

Purpose: To critically appraise highly cited studies reporting on the rate of chronic pain after inguinal hernia repair. Methods: Google Scholar was searched on 23 May 2022. We only included publications with more than 10 citations per year since publication and more than 100 citations in total. Both reports of original data and systematic reviews were included. Risk of bias and quality of the included studies were assessed with either the Joanna Briggs Institute Checklist for Prevalence Studies or the AMSTAR 2 depending on study design. Results: Twenty studies were included and evaluated. The rate of chronic postoperative inguinal pain of any degree ranged from 10%-63%, and the rate of moderate-to-severe pain ranged from 1%-18%. All studies reported the rate of pain of any degree, and most studies reported the rate of moderate-to-severe pain influencing daily activities. Studies used different temporal definitions of chronic pain, but most studies defined it as pain persisting either three or six months postoperatively. Ten studies used unvalidated questionnaires or significantly modified versions of validated questionnaires. Eleven studies primarily included patients receiving open repair. Included studies had median 21 citations per year (range 10-39) and median 387 citations in total (range 127-788). Conclusion: The rates of chronic postoperative inguinal pain reported in the included highly cited studies are possibly inaccurate, excessive, and outdated. New prospective studies based on uniform definitions and standards of measurement are warranted to better assess a contemporary chronic pain rate after inguinal hernia repair.

Couple and family therapy for substance use disorders: Evidence-based update 2010-2019

This article updates the evidence-based on couple and family therapy interventions for substance use disorders (SUD) since publication of the previous JMFT reviews in 2012. It first summarizes previous reviews along with findings from more recent reviews and meta-analytic studies. It then presents study design and methods criteria used to select 13 studies of couple and family therapy for level of support evaluation. Cumulative level of support designations are then determined for identified treatment approaches. Findings indicate that systemic family therapy is well-established as a standalone treatment, and behavioral family therapy and behavioral couple therapy are probably efficacious as standalone treatments and well-established as part of a multicomponent treatment. The article then suggests practice guidelines with regard to treatment modality considerations and implementation challenges. It concludes with future directions for delivering couple and family interventions in routine systems of care for SUD.

Videoconferencing psychotherapy for couples and families: A systematic review

The delivery of videoconferencing psychotherapy (VCP) has been found to be an efficacious, acceptable and feasible treatment modality for individual therapy. However, less is known about the use of VCP for couple and family therapy (CFT). The focus of this systematic review was to examine the efficacy, feasibility and acceptability of using VCP as a treatment delivery modality for CFT. A systematic search was conducted, data relating to efficacy, feasibility and acceptability were extracted from included studies. The search returned 7,112 abstracts, with 37 papers (0.005%) included. The methods of the review were pre-registered (PROSPERO; CRD42018106137). VCP for CFT was demonstrated to be feasible and acceptable. A meta-analysis was not conducted; however, results from the included studies indicate that VCP is an efficacious delivery method for CFT. Recommendations for future research and implications regarding clinical practice are made, which may be of interest to practitioners given the COVID-19 pandemic.

Peripheral blood involvement in angioimmunoblastic T-cell lymphoma: a case report and review of the literature

Angioimmunoblastic T-cell lymphoma (AITL) is an aggressive variant of peripheral T-cell lymphoma, occurring in elderly patients without any gender predisposition. It accounts for 1-2% of all non-Hodgkin lymphoma. Although characterized by some peculiar histological features, diagnosis of AITL can sometimes be challenging and a definite diagnosis requires a complete immunophenotypic and molecular workup. Peripheral Blood (PB) involvement in AITL has not been studied in detail and there is a paucity of published data about leukemic presentation of AITL. We present a case of a 38-year-old female diagnosed as AITL with PB involvement. Flow cytometric (FCM) examination of PB showed 40% abnormal lymphoid cells which were CD45+, CD4+, CD2+, cCD3+, CD5+, CD10+, CD16+ and TCRγδ restricted. PB involvement by AITL appears to be more common and under-reported. Nevertheless, detection of these tumoral T lymphocytes needs to be assessed in large case studies for assessing the true incidence of PB involvement. FCM analysis is an effective and reliable approach in the identification of leukemic phase of AITL and can lead to timely and effective intervention.

Scholarship Development Series Part I: Writing a Review of the Literature

As part of National Association of Hispanic Nurses' Strategic Plan, our organization focuses on the development of scholarship in our members. Scholarship is what moves nursing science forward and includes not only research but also teaching/education and clinical practice. Part of scholarship is identifying what is in the literature or what is the "evidence" which is detrimental to identifying the best practices for our Latino communities. This article is part of a scholarship development series that will run in Hispanic Health Care International. The purpose of this first article is to provide a background on how to conduct a review of the literature. The objectives of the article are to (1) define what a review of the literature is, (2) discuss various types of review articles that can be used for research, practice, or education, (3) identify the process of synthesizing evidence, (4) present standardized formats that can be used in writing a review, and (5) provide steps to begin the process of writing a review.

A holistic approach to remove the bottlenecks and to improve the quality of medical research in India

The current trend of conducting research and publishing the same to fulfill the academic or professional requirements can jeopardise what research actually means in health sciences. Rather than highlighting how many publications one can have, or showcase the expertise as a researcher, research can inform knowledge gaps and address the same in a replicable and scientific manner. More importantly, for low- and middle- income countries like India, research can be a powerful tool to assess healthcare problems at the primary care and develop innovative solutions to strengthen health systems at the grass root level. It can be argued that, enriching research portfolio for an individual is a misleading approach whereas research has much more to offer to the society at large. In the context of in primary care, academic and implementation research is important for several distinct reasons. The practice-based research can inform better practice through communicating the concerns or findings from research with key stakeholders of primary care. If the primary care practitioners are equipped with fundamental research skills, it may help them to become better critics and evidence-based practitioners. Publishing research findings in a good scientific journal is not an easy job. A lot of time and resources are often required from the submission process to publication. There are many obstacles for publishing a research, some are inherent some are man-made. In this article we describe our experiences about the bottlenecks that we have faced while conducting medical research and we have also prescribed some possible solutions which can help to the researchers in future while conducting medical research.

Thymic lesions of the paediatric age group: a comprehensive review of non-neoplastic and neoplastic etiologies

Thymus is an important part of the immune system of the paediatric age group. Thymic lesions are rare causes of anterior mediastinal pathology. Their occurrence in children is rarer, nevertheless, knowledge about their pathologies help in clinching the correct diagnosis. All lesions both non-neoplastic as well as neoplastic are found in children, however, they differ from adults not only in the clinical presentation but also in the pathogenesis and natural history of the disease. Thymic hyperplasia may not actually be true if age is taken into consideration. Similarly, a type B thymoma may be mistakenly diagnosed as a lymphoblastic lymphoma especially on small biopsies. This review has been carried out after extensive search of literature using the Google and Pubmed search engines. An attempt has been made to comprehensively cover all aspects of thymic pathology of the paediatric age group having historical significance as well as the recent updates.

Patient education in dental medicine: A review of the literature

INTRODUCTION

In dental medicine, chronic diseases and chronic conditions (such as chronic periodontitis, temporomandibular disorders, chronic orofacial pain) justify patient education to self-care. This strategy of secondary or tertiary prevention, even if officially recognised, is still less known compared to health education, a form of primary prevention. The aim of the study was to make the point of recent studies devoted to patient education. Thus, the purpose of the study was to give an updated picture of patient education in odontology, describing, through an analysis of the international literature from 2006 to 2016, its characteristics and development.

METHODS

The main databases selected were: PubMed, EMBASE, CINAHL, Web of Sciences, DOSS, 302 articles published between 2006 and 2016 on patient education among which four RCTs and a case study were analysed because of their rigorous scientific quality.

RESULTS

Patient education concerns chronic diseases and conditions also in the field of orthodontics. This limited number of studies, showed that patient education in odontology can bring real bio-clinic, cognitive, psychological and economic benefits to patients. Overall, it allows patients to better understand their illness and treatment and, thus, to improve their health behaviours and self-care techniques, which would reduce the treatment costs. Educational interventions in odontology should constitute a component of patient education in several chronic systemic diseases such as diabetes. It would be necessary to train future practitioners in this field and to develop a scientific research on this practice.

[Current trends of the choice and processing of materials for dental implantation]

For assessment of the modern situation about the choice of materials for manufacture of dental implants and the processing of their surface the scientific literature for the last 2 years was study. On the basis of a large number of contradictory results of the researches devoted to each of dental implantation problems it is possible to draw a conclusion that any of primal problems of implantology is finally not solved. There is no unique opinion at the choice of optimum material for manufacture of dental implants, at the way of processing and modification of their surface. The problem of improvement of quality of dental implantation and fight against complications of this procedure cannot be solved simple drawing other substances on the implanted material surface, this task more easily and more successfully is solved via changes of product structure and various modification of implant surface. Up to the present the researches of an opportunity to influence on characteristics of the implanted materials, changing their structure and character of a surface, continue. And the publications reporting about the considerable positive effect of artificially created roughnesses on product surfaces, and the articles claiming that there are no big differences between the rough and polished implants are confirmed by objective measurements with statistical processing of the obtained data. It should be noted that among articles there are very many works of the doubtful plan or with insufficiently valid conclusions. This review leads to the conclusion that further clinical and experimental studies and about the choice of materials for manufacture of implants and at the ways of processing of their surface are necessary.

The Growing Incidence of Bullous Pemphigoid: Overview and Potential Explanations

Bullous pemphigoid (BP) is the most common type of subepidermal autoimmune bullous diseases. BP characteristically affects the elderly and is seen mainly in patients older than 70 years. While the annual incidence of BP has been estimated to be between 2.4 and 23 cases per million in the general population, it rises exponentially to 190-312 cases per million in individuals older than 80 years. In addition, a growing body of evidence reports a remarkable trend of increased incidence of BP, showing a 1.9- to 4.3-fold rise over the past two decades. This demonstrable increase warrants a higher awareness of the increased risk to develop BP. This review summarizes the current understanding of the epidemiological features of BP and sheds light on the putative explanations for its growing incidence.

An Integrative Neuroscience Framework for the Treatment of Chronic Pain: From Cellular Alterations to Behavior

Chronic pain can result from many pain syndromes including complex regional pain syndrome (CRPS), phantom limb pain and chronic low back pain, among others. On a molecular level, chronic pain syndromes arise from hypersensitization within the dorsal horn of the spinal cord, a process known as central sensitization. Central sensitization involves an upregulation of ionotropic and metabotropic glutamate receptors (mGluRs) similar to that of long-term potentiation (LTP). Regions of the brain in which LTP occurs, such as the amygdala and hippocampus, are implicated in fear- and memory-related brain circuity. Chronic pain dramatically influences patient quality of life. Individuals with chronic pain may develop pain-related anxiety and pain-related fear. The syndrome also alters functional connectivity in the default-mode network (DMN) and salience network. On a cellular/molecular level, central sensitization may be reversed through degradative glutamate receptor pathways. This, however, rarely happens. Instead, cortical brain regions may serve in a top-down regulatory capacity for the maintenance or alleviation of pain. Specifically, the medial prefrontal cortex (mPFC), which plays a critical role in fear-related brain circuits, the DMN, and salience network may be the driving forces in this process. On a cellular level, the mPFC may form new neural circuits through LTP that may cause extinction of pre-existing pain pathways found within fear-related brain circuits, the DMN, and salience network. In order to promote new LTP connections between the mPFC and other key brain structures, such as the amygdala and insula, we propose a holistic rehabilitation program including cognitive behavioral therapy (CBT) and revolving around: (1) cognitive reappraisals; (2) mindfulness meditation; and (3) functional rehabilitation. Unlike current medical interventions focusing upon pain-relieving medications, we do not believe that chronic pain treatment should focus on reversing the effects of central sensitization. Instead, we propose here that it is critical to focus on non-invasive efforts to promote new neural circuits originating from the mPFC.

Bochdalek hernia and intrathoracic ectopic kidney: Presentation of two case reports and review of the literature

Bochdalek hernia is a congenital abnormality with high morbidity and mortality characterized by passage of the abdominal organs into the thoracic cavity through a diaphragmatic defect. Intrathoracic location of abdominal organs such as kidneys is very rare, with a reported incidence of only 0.25% in the literature. Herein, we present two cases of Bochdalek hernia with a herniation of intra-abdominal organ such as kidney that was treated in our clinic and compare this rare case with those in the literature. In both cases, the functionally normal kidneys were left in situ during diaphragmatic repair. No complications were observed during the postoperative period, and 10- and 1-year follow-ups. In cases with Bochdalek hernia associated with an intrathoracic ectopic kidney, the functionally normal ectopic kidneys were left in situ during repair of the diaphragmatic defect without complications.

First Occurrence of Plasmablastic Lymphoma in Adenosine Deaminase-Deficient Severe Combined Immunodeficiency Disease Patient and Review of the Literature

Adenosine deaminase-deficient severe combined immunodeficiency disease (ADA-SCID) is a primary immune deficiency characterized by mutations in the ADA gene resulting in accumulation of toxic compounds affecting multiple districts. Hematopoietic stem cell transplantation (HSCT) from a matched donor and hematopoietic stem cell gene therapy are the preferred options for definitive treatment. Enzyme replacement therapy (ERT) is used to manage the disease in the short term, while a decreased efficacy is reported in the medium-long term. To date, eight cases of lymphomas have been described in ADA-SCID patients. Here we report the first case of plasmablastic lymphoma occurring in a young adult with ADA-SCID on long-term ERT, which turned out to be Epstein–Barr virus associated. The patient previously received infusions of genetically modified T cells. A cumulative analysis of the eight published cases of lymphoma from 1992 to date, and the case here described, reveals a high mortality (89%). The most common form is diffuse large B-cell lymphoma, which predominantly occurs in extra nodal sites. Seven cases occurred in patients on ERT and two after haploidentical HSCT. The significant incidence of immunodeficiency-associated lymphoproliferative disorders and poor survival of patients developing this complication highlight the priority in finding a prompt curative treatment for ADA-SCID.

TAFRO Syndrome in Caucasians: A Case Report and Review of the Literature

Background

TAFRO syndrome has been reported in Japan among human herpesvirus 8 (HHV-8)-negative/idiopathic multicentric Castleman’s disease (iMCD) patients. To date, the majority of iMCD patients with TAFRO syndrome originate from Japan.

Case presentation

Herein, we report a 67-year-old HIV/HHV-8-negative Caucasian iMCD patient diagnosed with TAFRO. He presented with marked systemic inflammation, bicytopenia, terminal renal insufficiency, diffuse lymphadenopathies, and anasarca. Lymph node and bone marrow biopsies revealed atrophic germinal centers variably hyalinized and megakaryocytic hyperplasia with mild myelofibrosis. Several other biopsies performed in kidneys, liver, gastrointestinal tract, prostate, and lungs revealed unspecific chronic inflammation. The patient had a complete response to corticosteroids, tocilizumab, and rituximab. He relapsed twice following discontinuation of rituximab. When reviewing the literature, we found seven other Caucasian cases with TAFRO syndrome. There were no significant differences with those described by the Japanese cohort except for the higher frequency of kidney failure and auto-antibodies in Western patients.

Conclusion

This case illustrates that patients with TAFRO syndrome can develop non-specific inflammation in several tissue sites. Furthermore, this case and our review of the literature demonstrate that TAFRO syndrome can affect Caucasian and Japanese patients highlighting the importance of evaluating for this syndrome independently of ethnic background.

Management of High-Grade Penile Curvature Associated With Hypospadias in Children

Penile curvature is a frequent feature associated with hypospadias with also a great variability of severity among each patient. While the low-grade curvature (<30°) can be relatively easily corrected by simple techniques like penile degloving and dorsal plication, severe cases often demand more complex maneuvers to manage it. A great number of surgical techniques have been developed to adequately correct curvatures greater than 30°; however, each one of them should be individualized to different patients and local conditions encountered. In this article, we will review the evaluation of the pediatric patient with penile curvature associated with hypospadias with a special attention to high-grade cases, their management, indications for surgical treatment, and several surgical options for their definitive treatment.

Spontaneous intraventricular rupture of pyogenic brain abscess: A short series of three cases and review of literature

BACKGROUND

Spontaneous intraventricular rupture of brain abscess (IVROBA) is a dreaded complication of pyogenic brain abscess (PBA) and is associated with very high mortality. We discuss the clinical, radiological, and therapeutic aspects associated with this potentially fatal complication of PBAs.

CASE DESCRIPTIONS

Three cases of spontaneous IVROBA presenting to our institute over a period of 6 months were reviewed with respect to their clinical and radiological presentation, their therapeutic plan, and neurological outcome. Individualized approach to our patients with IVROBA with abscess drainage/excision, intrathecal and intravenous antibiotic therapy, cerebrospinal fluid (CSF) diversion (if under high pressure), and close monitoring of clinical status, CSF reports, and computed tomography (CT) scan findings enabled us to achieve good neurological outcome in two patients presenting in conscious state; however, one patient presenting in poor neurological status succumbed to IVROBA due to fulminant septic arteritis.

CONCLUSION

In the present neurosurgical era, IVROBA is rarely encountered; however when it occurs, patient outcome is adversely affected. Early detection and prompt aggressive management, as seen in our short series, can give the patient a fighting chance and significantly improve the neurological outcome.

Current Status of CTCs as Liquid Biopsy in Lung Cancer and Future Directions

Circulating tumor cells (CTCs) have garnered a lot of attention in the past few decades. Isolation of these rare cells from the billions of blood cells has been a challenge until recent times. With the advent of new sensitive technologies that permit live cell isolation and downstream genomic analysis, the existing paradigm of CTC research has evolved to explore clinical utility of these cells. CTCs have been identified as prognostic and pharmacodynamic biomarkers in many solid tumors, including lung cancer. As a means of liquid biopsy, CTCs could play a major role in the development of personalized medicine and targeted therapies. This review discusses the state of various isolation strategies, cell separation techniques and key studies that illustrate the application of liquid biopsy to lung cancer.

Primary synovial chondromatosis of the hip - is arthroscopy sufficient? A review of the literature and a case report

The purpose of this article was to evaluate the different techniques of operative treatment of primary synovial chondromatosis (PSC) of the hip. We performed a systematic review of literature of PSC and also present one case report about arthroscopic treatment of PSC. Our study compares both established operative procedures, open versus arthroscopic surgery, and shows each advantages and complications. One hundred and forty-seven publications were found in a PubMed literature review searching the terms: "synovial chondromatosis", "synovial osteochondromatosis", "synovial metaplasia" and "hip". All included studies were divided into open surgery or arthroscopic surgery concerning the therapeutic strategy and the corresponding results. We could find a total number of 3 reviews about PSC of the hip relating to operative procedures. One patient presented to our outpatient clinic with PSC. After other pathologies causing hip pain were excluded, the patient underwent hip arthroscopy with excision of the loose bodies and partial synovectomy. Diagnosis of PSC was confirmed by histopathology. The patient was examined before and one year after surgery with the Visual Analogue Scale (VAS) and the Hip Outcome Score (HOS ADL). Resecting PSC by hip arthroscopy is a minor surgical, but demanding procedure with minimal risks, even useful in the treatment of elderly patients with moderate osteoarthritis.

Efficacy of Transcranial Magnetic Stimulation (TMS) in the Treatment of Schizophrenia: A Review of the Literature to Date

We reviewed the literature on transcranial magnetic stimulation and its uses and efficacy in schizophrenia. Multiple sources were examined on transcranial magnetic stimulation efficacy in relieving positive and negative symptoms of schizophrenia. Literature review was conducted via Ovid Medline and PubMed databases. We found multiple published studies and metaanalyses that give evidence that repetitive transcranial magnetic stimulation can have benefit in relieving positive and negative symptoms of schizophrenia, particularly auditory hallucinations. These findings should encourage the psychiatric community to expand research into other applications for which transcranial magnetic stimulation may be used to treat patients with psychiatric disability.

Leininger's Ethnonursing Research Methodology and Studies of Cancer Survivors: A Review

The purpose of this article is to present the findings of a literature review regarding the use of Leininger's ethnonursing research methodology (ENRM) in studies addressing adult cancer survivors. It is important to learn about differences and similarities among cancer survivors' experiences so that patient-centered, culturally congruent care can be provided. A review of the literature was conducted using databases such as CINAHL and MEDLINE. Search terms included variations on ENRM and cancer survivors. The results were a small number of published studies that used the ENRM examining breast cancer survivors' perceptions and experiences. A review instrument was developed to estimate study quality based on established criteria. The studies are critiqued in relation to the theory-based methodology, evaluation criteria for qualitative research, and study findings are summarized. The author concludes that although there is a paucity of research using ENRM with adult cancer survivors, the preliminary findings of the included studies contribute to what is known about breast cancer survivors. Implications for research include recommendations to increase the use of ENRM to discover the universal and diverse experiences of care practices in adult cancer survivors and use the evidence to develop patient-centered, culturally congruent, quality care for cancer survivors.

Synovial sarcoma of the kidney in a young patient with a review of the literature

Synovial sarcoma (SS) is a soft tissue, generally deep seated neoplasms that occurs generally in the proximity of large joints. We report of a case of a 33-year-old man who was diagnosed with primary SS of the kidney which is an extremely rare tumor that accounts for less than 2% of malignant renal tumors. Contemporary management of renal synovial sarcoma includes surgical resection and ifosfamide-based chemotherapy and they remain the mainstay of therapy of synovial sarcoma, which is often applied, combined as part of an aggressive treatment approach. Fewer than 50 patients have been described in the English literature. Physicians should be aware of the possibility of malignancy in cystic renal masses and raise the suspicion of synovial sarcoma, especially when patients with renal masses are young adults. Along with the case report a literature review on primary synovial sarcomas of the kidney is provided with focus on the renal tumors' differential diagnosis.

A systematic review of cognitive function in first-episode psychosis, including a discussion on childhood trauma, stress, and inflammation

OBJECTIVE

To carry out a systematic review of the literature addressing cognitive functions in first-episode psychosis (FEP), divided into domains. Although this is not a full "cognitive-genetics-in-schizophrenia review," we will also include putative ideas of mechanism(s) behind these impairments, focusing on how early stress, and genetic vulnerability may moderate cognitive function in psychosis.

METHOD

Relevant studies were identified via computer literature searches for research published up to and including January 2013, only case-control studies were included for the neurocognitive meta-analysis.

RESULTS

Patients with FEP present global cognitive impairment compared to healthy controls. The largest effect size was observed for verbal memory (Cohen's d effect size = 2.10), followed by executive function (effect size = 1.86), and general IQ (effect size = 1.71). However, effect sizes varied between studies.

CONCLUSION

Cognitive impairment across domains, up to severe level based on Cohen's effect size, is present already in FEP studies. However, differences in levels of impairment are observed between studies, as well as within domains, indicating that further consolidation of cognitive impairment over the course of illness may be present. Cognitive abnormalities may be linked to a neurodevelopmental model including increased sensitivity to the negative effect of stress, as well as genetic vulnerability. More research on this field is needed.

Breast care in the transgender individual

INTRODUCTION

Transgender individuals undergo hormone therapy and/or alter their breasts or genitals to facilitate a transition from male to female or female to male. Changes in the breast tissue from hormone therapy, breast binding, mastectomy, or breast augmentation are of specific interest to women's health care providers. To provide competent care, providers must be knowledgeable about unique aspects of breast health in this vulnerable population, including screening guidelines and client education. The purpose of this integrative literature review is to compile the current research on breast health for transgender individuals and to serve as a resource for providers.

METHODS

A search of the literature was performed using CINAHL, Ovid, and PubMed. Results were reviewed for relevant articles, and the reference lists of these were reviewed for additional resources. When available, studies specific to the transgender population are presented; studies of other populations are also included when relevant. Theories of human endocrinology, physiology, and anatomy will provide the foundation for the review and discussion.

RESULTS

Research into breast care for transgender individuals is limited. Often, practitioners must draw conclusions for practice from scattered case studies or research with nontransgender populations. Many of the procedures and practices transgender individuals choose to undergo, such as implantation, injection, binding, and mastectomy, carry serious risks.

DISCUSSION

Transgender individuals should be counseled on all the possible outcomes of their decisions, so they are capable of making informed choices. They must also be followed with careful consideration of these choices. More research in many areas of transgender breast care is necessary.

Current evidence linking polyunsaturated Fatty acids with cancer risk and progression

There is increasing evidence that polyunsaturated fatty acids (PUFAs) play a role in cancer risk and progression. The n-3 family of PUFAs includes alpha-linolenic acid (ALA), eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) while the n-6 family includes linolenic acid (LA) and arachidonic acid (AA). EPA and DHA are precursors for anti-inflammatory lipid mediators while AA is a precursor for pro-inflammatory lipid mediators. Collectively, PUFAs play crucial roles in maintaining cellular homeostasis, and perturbations in dietary intake or PUFA metabolism could result in cellular dysfunction and contribute to cancer risk and progression. Epidemiologic studies provide an inconsistent picture of the associations between dietary PUFAs and cancer. This discrepancy may reflect the difficulties in collecting accurate dietary data; however, it also may reflect genetic variation in PUFA metabolism which has been shown to modify physiological levels of PUFAs and cancer risk. Also, host-specific mutations as a result of cellular transformation could modify metabolism of PUFAs in the target-tissue. Clinical trials have shown that supplementation with PUFAs or foods high in PUFAs can affect markers of inflammation, immune function, tumor biology, and prognosis. Pre-clinical investigations have begun to elucidate how PUFAs may mediate cell proliferation, apoptosis and angiogenesis, and the signaling pathways involved in these processes. The purpose of this review is to summarize the current evidence linking PUFAs and their metabolites with cancer and the molecular mechanisms that underlie this association. Identifying the molecular mechanism(s) through which PUFAs affect cancer risk and progression will provide an opportunity to pursue focused dietary interventions that could translate into the development of personalized diets for cancer control.

Genealogy of instruments for prodrome evaluation of psychosis

OBJECTIVE

Over the last 15 years, researchers from around the world have developed instruments for assessing the risk of conversion to psychosis. The objective of this article is to review the literature on these instruments by focusing on genealogy links and on their performance in predicting conversion to psychosis.

METHOD

A systematic review of articles published since 1980 relating to risk assessment instruments for conversion to psychosis by manual search and consultation of electronic databases MEDLINE, EMBASE, and PsycINFO.

RESULTS

Three hundred ninety one (391) publications were selected and analyzed. Among these, 22 instruments were identified. These instruments are briefly described and placed on a timeline according to their year of publication. A code of positions, patterns, and forms is used to schematize the characteristics of each instrument. A table is presented to show changes in rates of conversion to psychosis within cohorts of subjects considered at risk according to the instruments. A second code of shades and outlines is used to schematize the characteristics of each cohort of patients. The two graphics set the stage for a discussion about the major strategies that were adopted to improve the performance of risk assessment instruments.

CONCLUSION

These graphics allow a better understanding of the origin, evolution, current status, strengths, shortcomings, and future prospects of research on risk assessment instruments. Clinical ImplicationsThe integration of theoretical approaches, the multicenter studies, and the pre-selection of patients with short questionnaires were the main strategies to improve the performance of instruments assessing the risk of conversion to psychosis.These instruments are better at predicting conversion to psychosis than conventional variables within a more limited time span and can therefore enable the evaluation of various risk factors and biomarkers that may be associated with psychosis. LimitationsThe studies selected for this review of literature were not classified according to their methodological quality.These studies are based on heterogeneous populations and this must be taken into account when comparing the rates of conversion to psychosis.This review of literature was based on published data only and they were no direct communication with the authors of these instruments.

A meta-analysis of social capital and health: a case for needed research

Social capital refers to various levels of social relationships formed through social networks. Measurement differences have lead to imprecise measurement. A meta-analysis of eligible studies assessing the bivariate association between social capital and self-reported health and all-cause mortality was performed. Thirty-nine studies met inclusion criteria, showing social capital increased odds of good health by 27 percent (95% confidence intervals [CI] =21%, 34%). Social capital variables, reciprocity increased odds of good health by 39 percent (95% CI = 21%, 60%) and trust by 32 percent (95% CI =19%, 46%). Future research suggests operationalizing measures by assessing differences by race/ethnicity, gender and socioeconomic status.

Nephrotic syndrome in The Netherlands: a population-based cohort study and a review of the literature

Nephrotic syndrome (NS) is a clinical diagnosis with proteinuria, hypoalbuminaemia and oedema. NS is rare in children, and its incidence in The Netherlands is unknown. The aim of this study was to estimate the incidence of idiopathic NS in the Netherlands. All paediatric patients (age 0-18 years) with a newly diagnosed NS in the Netherlands were registered by the Dutch Pediatric Surveillance Unit during the years 2003 until 2006, secondary NS was excluded. All paediatricians filled out questionnaires about the first clinical findings of the patients and incidences were calculated. A literature review on incidences of childhood NS was conducted. The incidence of NS in children in the Netherlands in the years 2003 until 2006 was 1.52/ 100, 000 children/ year. The median age at diagnosis was 3.88 years with a mean age of 5.08 years. A significant male:female ratio of 2.04:1 was found. This prospective study of NS in the Netherlands revealed an incidence of 1.52:100, 000 children/year, and is similar to the incidences found all over the world.