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Histopathological Evaluation of Geriatric Ophthalmic Veins: A Cadaveric Study
Get PDFContext: The ophthalmic vein (OV) has become a source of increasing curiosity since many aspects of vascular surgery of the orbit have become feasible. At the same time, histochemical analysis of veins, in general, tends to skip the OV. Moreover, age‑related changes in the OVs remain untouched. Aims: Our research explores features of aging in the OV. Settings and Design: We immunohistochemically evaluated the superior and inferior OVs in 49 orbits of 28 formalin‑embalmed human cadavers (age 77.86 ± 13.38) without visible vascular malformations. Materials and Methods: Specimens were stained by hematoxylin and eosin. Verhoeff, laminin, and CD31 stains were used on a subset of the OVs. Statistical Analysis Used: Simple descriptive statistics. Results: The findings include vasa vasorum (VV) in OVs smaller than 0.5 mm, a valvular structure in one of the VV, the presence of platelet endothelial adhesion molecule granules in donors older than 80 years of age, and changes in the pattern of elastin and collagen in different age categories. Conclusion: The study visualizes new aspects in the veins of elderly individuals and reveals OVs’ structures unreported previousl
Exploring the Role of Pain on Physical Activity Among Youth With Acute Lymphoblastic Leukemia Using the Biopsychosocial Model
No full textBackground: Engaging in physical activity (PA) throughout cancer treatment offers many benefits, but may be challenging due to cancer-related pain. Pain research in pediatric cancer has primarily focused on procedural pain, with fewer studies exploring how pain affects PA. The current study qualitatively investigated the impact of pain on PA in youth with acute lymphoblastic leukemia (ALL) using a biopsychosocial framework.
Procedure: As part of a larger study, caregivers (N = 17) of a child diagnosed with ALL and on treatment for less than 1 year completed a semi-structured interview about perceptions of their child\u27s health behaviors during ALL treatment. This secondary analysis focused specifically on discussions about pain and its impact on PA. We followed Braun and Clarke\u27s (2006) six-step thematic analysis framework to identify themes of pain-related barriers to PA.
Results: Key pain-related barriers endorsed by caregivers included: interactions among pain and treatment effects, caregiver distress around seeing their child in pain, and fear of interfering with medical equipment. Despite these barriers, caregivers found creative solutions to adapt activities for their child. Caregivers were reassured by PA advice from their medical team; however, advice varied between teams.
Conclusion: The relationship between pain and PA during ALL treatment is influenced by an intricate system of biological (e.g., treatment effects), psychological (e.g., parental distress), and social (e.g., communication among families and medical teams) factors. Future directions include identifying evidence-based PA recommendations and exploring family-team communication dynamics. This study also highlights a need to prioritize ALL pain management and involve caregivers in behavioral treatment protocols to improve PA
Adolescent Trauma and the Development of Fibromyalgia
No full textThere is minimal research concerning the mechanisms by which trauma experienced specifically in adolescence later predisposes one to chronic illness and, namely, fibromyalgia. The syndrome of fibromyalgia is in question due to fibromyalgia now being understood as a disease of the Central Nervous System (CNS) and research pointing toward early life trauma being an antecedent. It is known that adverse childhood experiences (ACEs) predispose individuals to experience significant health disparities later in life. However, little is known about the long-term impact of trauma exposure occurring specifically in adolescence has on chronic illness. Adolescence is commonly referred to as a sensitive period in human development and is thought to commence a myriad of biopsychosocial trajectories that continue to manifest themselves into later stages of development. This literature review sought to determine if there is a valid link between the experience of trauma in adolescence and an increased predisposition to developing fibromyalgia as an adult. A review of 12 studies produced mixed results in accounts of trauma occurring in childhood and adolescence among fibromyalgia patients. Emotional neglect was found to be the most common type of childhood trauma reported, and physical and sexual abuse were often the least frequent types of early life trauma among fibromyalgia patients. Although fibromyalgia patients consistently evidence higher rates of ACEs and early life trauma when compared to healthy controls, this relationship is frequently mediated by the presence of mental illness. This study elucidated varying trajectories of health disparities early life trauma can take, as well as identified patterns and prevalence of trauma subtypes among fibromyalgia patients. Further, this review underscored the importance and lack of identification and measurement of developmental stage in case-control and cross-sectional studies involving early life trauma among fibromyalgia patients
The Clinical Anatomy Fellowship: Revolutionizing Curricular Experiences for Faculty and Students
No full textFellows completing the Clinical Anatomy Fellowship at Kansas City University assist Anatomy faculty in the Gross Anatomy laboratory, complete robust research projects, and support other departments. The program\u27s positive impact on participants has been reported; however, the impact on individuals interfacing with Fellows has not been investigated. A follow-up, survey-based (Likert scale, multiple-choice, open-ended) study was conducted to evaluate faculty, staff, and student perceptions of the program. Ninety-five percent of surveyed faculty and staff (n = 22) perceived the Fellows as beneficial to students, faculty, and the university (p \u3c 0.05) by acting as role models (95%) and mentors (90%), contributing to educational processes (90%), and reducing faculty work burden (81%) (p \u3c 0.05). Student responses (n = 95) were also positive: 97% perceived interactions with Fellows as beneficial (p \u3c 0.05). A passion for Anatomy (mean, 4.6; p \u3c 0.05) and the opportunity to increase competitiveness for residency (mean, 4.5; p \u3c 0.05) were the most important factors driving interest in the Fellowship (Cronbach\u27s alpha, 0.766). In contrast, diverting a year from the school\u27s curriculum (mean, 4.4; p \u3c 0.05) and delaying clinical experiences (mean, 4.3; p \u3c 0.05) were the most important deterrents (Cronbach\u27s alpha, 0.505). Additionally, the financial investment required by the program is lower than that associated with hiring full-time faculty. Analysis comparing employment of Fellows versus associate-level faculty identified annual net savings of $370,000. Not only does the Fellowship augment faculty and student experiences at the university, but it also allows for substantial cost savings. Collectively, these data are evidence for other health professional institutions to consider adopting a similar program
Sex Differences in Adult Incarceration After Pediatric Traumatic Brain Injury
Get PDFPediatric traumatic brain injury (pTBI) is a major risk factor associated with adulthood incarceration. Most research into the link between pTBI and adulthood incarceration has focused on incarcerated males, who comprise the vast majority of incarcerated adults, particularly in industrialized nations. In this review, we sought to identify sex-related differences in the incidence and pathophysiology of pTBI and subsequent risk of adulthood incarceration. A scoping review was undertaken using PubMed, Scopus, Ovid, and the Cochrane Library. Articles analyzing sex-related differences in pTBI and adult incarceration rates, studies conducted on an incarcerated population, and cohort studies, cross-sectional studies, clinical trials, systematic reviews, or meta-analyses were included in this review. Of the 85 unique results, 25 articles met our inclusion criteria. Male children are 1.5 times more likely to suffer a TBI than females; however, the prevalence of incarcerated adults with a history of pTBI is ~35–45% for both sexes. Neurophysiologically, female sex hormones are implicated in neuroprotective roles, mitigating central nervous system (CNS) damage post-TBI, although this role may be more complex, given that injury severity and sequelae have been correlated with male sex whereas increased mortality has been correlated with female sex. Further investigation into the relationship between estrogen and subsequent clinical measurements of CNS function is needed to develop interventions that may alleviate the pathophysiological consequences of pTBI
Presentation, Management, and Outcomes of Central Nervous System Metastases in Africa: Systematic Review and Meta-Analysis
Get PDFBackground: Central nervous system (CNS) metastases are a significant health challenge, particularly in Africa. This study evaluates the preclinical characteristics, primary causes, management strategies, and outcomes of CNS metastases in Africa.
Methods: A systematic review of the literature was conducted using PubMed, Google Scholar, and Web of Science following PRISMA guidelines to identify studies on CNS metastases in Africa.
Results: Thirty-one articles were reviewed, including 28 retrospective studies and 3 case reports. The retrospective studies comprised 12 552 patients, with 681 (5.42%) diagnosed with CNS metastases. Nigeria reported the highest number of cases (323), followed by Tunisia (180). The mean patient age was 48.20 years (range: 44.48-51.93), with a higher proportion in women (69.97%, 95% confidence interval [CI]: 54.59-85.35). Common symptoms were headaches (44.87%, 95% CI: 20.76-68.97) and motor deficits (21.39%, 95% CI: 6.40-36.38). Diagnostic tools included MRI (38.27%, 95% CI: 18.08-58.47) and CT (51.28%, 95% CI: 29.13-73.42). The most common primary tumor sites were breast (41.33%, 95% CI: 24.87-57.79) and lung (14.85%, 95% CI: 4.90-24.79). Treatment strategies involved surgery (62.01%, 95% CI: 33.01-91.01), radiotherapy (68.97%, 95% CI: 41.31-96.63), and chemotherapy (60.72%, 95% CI: 32.95-88.50). Outcomes included improved disease status in 34.99% (95% CI: 13.92-56.07), mortality in 44.88% (95% CI: 20.88-68.89), and loss to follow-up in 1.83% (95% CI: 0-3.72).
Conclusion: CNS metastases in Africa show a higher proportion in women, with breast and lung cancers as the primary sources. Improved diagnostic and treatment strategies are essential to better patient outcomes
Retinoids for the Treatment of Refractory Grover’s Disease: A Case Series and Review of the Literature
No full textGrover’s disease, also known as transient acantholytic dermatosis (TAD), currently has no published randomized control trials regarding the treatment of the disease; thus, evidence for treatment is largely derived from case studies and case reports. In this case series, we summarize the current treatment options for Grover’s disease and discuss two cases of refractory Grover’s disease treated with low-dose oral isotretinoin in patients who previously failed to reach clearance with multiple treatment options. Our aim is to highlight the efficacy of low-dose systemic retinoid therapy in Grover\u27s disease when other treatment options prove unsatisfactory
A Cadaveric Study of the Deep and Superficial Dorsal Veins for Penile Transplant
No full textObjective: It is crucial to know the lengths of the neurovasculature proximal to a penile allograft to allow for better viability of a penile transplant. We performed a cadaveric exploration focused on the deep and superficial dorsal veins as identified in a microsurgical dissection of the penis to help expand the anatomical knowledge for such a procedure.
Methods: We examined 18 cadavers and measured the (1) vertical distance from the pubic symphysis to the point at which the superficial dorsal vein is no longer on the erectile tissue; (2) point at which the superficial dorsal vein is no longer on the erectile tissue to where its tributary meets the great saphenous vein; and (3) point at which the deep dorsal vein is no longer on the external erectile tissue to its contribution into the prostatic plexus near the prostate. Moreover, we noted the variations of the deep and superficial veins of the penis. We used IBM SPSS in all statistical analyses.
Results: The average length of the superficial dorsal vein when no longer on the external penis to its tributary was 84.9 ± 10.4 mm. The average length of the deep dorsal vein was 72.9 ± 6.43 mm. Three different drain patterns were observed for the superficial dorsal vein, whereas the deep dorsal vein was consistently midline. No statistically significant correlations were identified between cadaveric demographic data and lengths of venous structures.
Conclusions: Further studies regarding the anatomy and dissection of penile allografts would be helpful. More research regarding donor and recipient anatomy and vasculature is needed to establish surgical guidelines