Skin cancer risk and tanning in pageant contestants.

Since tanned skin may be perceived as a marker of beauty in American pageant culture, we evaluated pageant contestants regarding motivations for tanning, skin care behaviors, and possible tanning addiction. Responses were analyzed via summary statistics and compared across Fitzpatrick skin types. Statistically significant differences were found between skin types regarding tanning frequency, feelings of attractiveness after tanning, and perceptions of elevated mood after tanning. Contestants also demonstrated limited skin care behaviors; nearly 70% of respondents examined their skin for moles less than monthly. Of all respondents, 34% met tanning-modified Cut-Annoyed-Guilty-Eye-opener (CAGE) criteria, suggesting possible tanning addiction. This study raises several considerations regarding the possible addictive nature of tanning and the importance of skin safety in the pageant population.

Longitudinal magnetic resonance findings in delayed posthypoxic leukoencephalopathy.

Delayed posthypoxic leukoencephalopathy is a rare condition that can occur following prolonged cerebral hypo-oxygenation and manifests as acute onset of neuropsychiatric symptoms after a period of apparent recovery. We describe a case of a 76-year-old man who presented after an unwitnessed fall of unknown duration with initial recovery followed by progressive neurocognitive decline resulting in dementia, dysphasia, and gait apraxia. Initial brain magnetic resonance imaging was unremarkable but repeated brain imaging revealed progressive leukoencephalopathy, which started as small foci of abnormal diffusion restriction in bilateral frontal lobes and gradually evolved over the next 3 weeks to diffuse signal changes in the white matter.

Predictors and patterns of weight gain during treatment for tuberculosis in the United States of America.

OBJECTIVES: Patients with tuberculosis (TB) often present with weight loss. Lack of weight gain with TB treatment has been associated with treatment failure. The purpose of this study was to examine patterns of weight gain in patients with TB and determine the disease characteristics that predict weight gain. METHODS: This was a retrospective cohort study of adults with TB treated in a county health system in the USA. Demographic, clinical, radiographic, and microbiological data were recorded in addition to monthly weights during treatment. RESULTS: Overall, patients had a significant change in weight over the course of treatment (p<0.0001). After 2 months of treatment, 31.9% of patients had gained at least 5% body weight; by the end of treatment, 62.4% of patients had gained at least 5% weight. Patients who gained weight did so in a linear fashion throughout treatment. Cavitary and extensive disease, a positive smear, and a positive culture were predictors of weight gain (p<0.05). No patients had relapses during the time period of the study. CONCLUSIONS: Only a subset of patients treated for TB gain significant weight. A greater burden of disease was predictive of weight gain.

The use of endobronchial ultrasound-guided transbronchial needle aspiration in the diagnosis of thyroid lesions.

BACKGROUND: Non-palpable thyroid nodules can be difficult to access by conventional ultrasound-guided fine needle aspiration, particularly when they are intrathoracic. Many of these patients are subject to multiple follow up scans or invasive diagnostic procedures such as mediastinoscopy or surgical resection. We aim to describe the feasibility of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for diagnosis of thyroid lesions. METHODS: All EBUS-TBNA performed at our institutions from February 2010 to February 2013 were screened, and those in which a thyroid biopsy was performed were reviewed. RESULTS: We identified 12 cases of EBUS-TBNA thyroid biopsy. Nine patients had an indication for EBUS in addition to their thyroid lesions. The median age was 64 years (range 44 to 84 years), and 10 patients were male. Median lesion size was 22.5 mm (range, 10 to 43 mm). Five lesions were strictly intrathoracic. All cases were sampled with a 22G needle and rapid on-site cytologic examination. Adequate samples were obtained in all 12 cases. Malignancy was identified in 3 of the 12 patients (metastatic breast adenocarcinoma, large B-cell lymphoma, and metastatic lung adenocarcinoma). The remaining 9 samples were deemed to be benign nodules. Seven of these were confirmed by clinical follow-up (n = 3), biopsies (n = 3), or surgery (n = 1).There were no EBUS-related complications. CONCLUSIONS: EBUS-TBNA might be a safe and effective alternative for sampling thyroid lesions, particularly useful for those located below the thoracic inlet. Further prospective studies are required to compare its diagnostic yield and safety profile with standard techniques.

Functional characterization of TRPV4 as an osmotically sensitive ion channel in porcine articular chondrocytes.

OBJECTIVE: Transient receptor potential vanilloid 4 (TRPV4) is a Ca(2+)-permeable channel that can be gated by tonicity (osmolarity) and mechanical stimuli. Chondrocytes, the cells in cartilage, respond to their osmotic and mechanical environments; however, the molecular basis of this signal transduction is not fully understood. This study was undertaken to demonstrate the presence and functionality of TRPV4 in chondrocytes. METHODS: TRPV4 protein expression was measured by immunolabeling and Western blotting. In response to TRPV4 agonist/antagonists, osmotic stress, and interleukin-1 (IL-1), changes in Ca(2+) signaling, cell volume, and prostaglandin E(2) (PGE(2)) production were measured in porcine chondrocytes using fluorescence microscopy, light microscopy, or immunoassay, respectively. RESULTS: TRPV4 was expressed abundantly at the RNA and protein levels. Exposure to 4alpha-phorbol 12,13-didecanoate (4alphaPDD), a TRPV4 activator, caused Ca(2+) signaling in chondrocytes, which was blocked by the selective TRPV4 antagonist, GSK205. Blocking TRPV4 diminished the chondrocytes' response to hypo-osmotic stress, reducing the fraction of Ca(2+) responsive cells, the regulatory volume decrease, and PGE(2) production. Ca(2+) signaling was inhibited by removal of extracellular Ca(2+) or depletion of intracellular stores. Specific activation of TRPV4 restored the defective regulatory volume decrease caused by IL-1. Chemical disruption of the primary cilium eliminated Ca(2+) signaling in response to either 4alphaPDD or hypo-osmotic stress. CONCLUSION: Our findings indicate that TRPV4 is present in articular chondrocytes, and chondrocyte response to hypo-osmotic stress is mediated by this channel, which involves both an extracellular Ca(2+) and intracellular Ca(2+) release. TRPV4 may also be involved in modulating the production or influence of proinflammatory molecules in response to osmotic stress.