RESUMEN
Fibromatoses encompass a broad group of histopathologically similar fibroblastic/myofibroblastic proliferations with divergent clinical manifestations and behavior. Deep (desmoid-type) fibromatoses are typically large, rapidly growing, and locally aggressive tumors that occur in the abdominal wall, mesentery, and extra-abdominal soft tissue, principally the musculature of the trunk and extremities. Most sporadic cases of desmoid fibromatosis harbor inactivating mutations in CTNNB1, the gene encoding beta-catenin. Tumors occurring in the context of familial adenomatous polyposis and Gardner syndrome bear inactivating mutations in APC. By contrast, mutations in CTNNB1 or APC have not been identified in cases of superficial fibromatosis. Cutaneous involvement by desmoid fibromatosis is exceedingly rare. Here we present a 78-year-old male with desmoid-type fibromatosis arising in the dermis of the right medial calf with a pathogenic mutation in CTNNB1 and a variant of unknown significance in APC.
Asunto(s)
Poliposis Adenomatosa del Colon/patología , Dermis/patología , Fibromatosis Agresiva/diagnóstico , Síndrome de Gardner/patología , Poliposis Adenomatosa del Colon/genética , Proteína de la Poliposis Adenomatosa del Colon , Anciano , Diagnóstico Diferencial , Fibromatosis Agresiva/genética , Fibromatosis Agresiva/cirugía , Síndrome de Gardner/genética , Humanos , Masculino , Mutación , Resultado del Tratamiento , beta Catenina/metabolismoRESUMEN
Recent academic and popular conversations regarding #MeToo, sexual violence and harassment, and rape culture have begun to focus on K-12 educational spaces in the U.S., but they rarely examine how educational curricula actually foster or combat these dynamics. In this article, we present a qualitative content analysis of health education textbooks, which explores the following question: What implicit and explicit messages do youth receive about sexual violence, and specifically, sexual violence prevention in health education textbooks? As we explored this question, we analyzed the roles that sex education curricula may play in shaping (e.g., contributing to, intervening upon) rape culture. We found the following messages across textbooks: abstinence is the only way to preserve one's safety; lack of abstinence increases risks, including the risk of being raped; and girls/women must assume personal responsibility and enact strategies that preserve one's abstinence and prevent them from being raped. This article concludes by teasing out how curricula can shape interactions, relationships, and culture, and by offering recommendations for improving sex education curricula.
Asunto(s)
Violación/prevención & control , Educación Sexual/métodos , Delitos Sexuales/estadística & datos numéricos , Abstinencia Sexual/estadística & datos numéricos , Libros de Texto como Asunto/normas , Femenino , Humanos , MasculinoRESUMEN
There are many potential sources of error in clinical practice. An astute clinician must not only work hard to prevent errors but also minimize harmful sequelae that could arise from errors that do occur. A rare but real source of error is cross-contamination of pathology specimens. Such contaminants are colloquially referred to as floaters. If not recognized expediently, floaters can lead to misdiagnoses that may prompt unnecessary and inappropriate treatment. We report the case of a patient with a benign adnexal neoplasm on the face that, due to cross-contamination of pathology specimens, was initially diagnosed as an aggressive invasive melanoma that would have warranted wide local excision and sentinel lymph node biopsy.
Asunto(s)
Biopsia/efectos adversos , Nevo Pigmentado/diagnóstico , Neoplasias Cutáneas/diagnóstico , Anciano , Mejilla , Diagnóstico Diferencial , Errores Diagnósticos , Humanos , Masculino , Melanoma/diagnóstico , Melanoma/patología , Nevo Pigmentado/patología , Neoplasias Cutáneas/patologíaRESUMEN
PURPOSE: The requirement for postural stability during the performance of motor skills has been clearly demonstrated in infants, but the necessity for such a postural substrate is not well documented in adults. The present study investigated the role of postural stability during a ballistic ball-kicking task in adults by providing varying degrees of external postural support. METHOD: In the 1st experiment, 30 participants performed 20 maximal-velocity kicks under each of 3 conditions: grasping a rigid stable handle, light fingertip touch, and grasping a suspended elastic tube. A 2nd experiment with 16 participants varied the position of the stable handle to examine if the handle position in Experiment 1 might simply act as a fulcrum to enhance torque generation. RESULTS: In Experiment 1, ball velocity was significantly higher in the stable-grasp condition in both men and women with the men showing greater improvement relative to the other conditions. Experiment 2 showed that the position of the stable handle did not significantly affect kicking velocity, indicating that the handle was not simply acting as a fulcrum during the kick. CONCLUSION: Together, the findings suggest that postural stability may be a rate limiter in the performance of dynamic motor tasks in adults.
Asunto(s)
Destreza Motora/fisiología , Equilibrio Postural , Análisis y Desempeño de Tareas , Adolescente , Adulto , Femenino , Humanos , Extremidad Inferior/fisiología , Masculino , Factores Sexuales , Fútbol/fisiología , Adulto JovenRESUMEN
Objectives. A systematic review of parental surveys about HPV and/or child HPV vaccination to understand parental knowledge, attitudes, and behaviour before and after FDA approval of the quadrivalent HPV vaccine and the bivalent HPV vaccine. Search Strategy. Searches were conducted using electronic databases limited to published studies between 2001 and 2011. Findings. The percentage of parents who heard about HPV rose over time (from 60% in 2005 to 93% in 2009), as did their appreciation for the HPV infection and cervical cancer link (from 70% in 2003 to 91% in 2011). During the FDA approval, there was a stronger vaccine awareness but it has waned. The same pattern is seen with parents whose children received the HPV vaccine (peak at 84% in 2010 and now 36% in 2011) or the intention to vaccinate (peak at 80% in 2008 and now 41% in 2011). Conclusions. Parents had safety concerns and wanted more information their physician from to recommend and to confidently HPV vaccinate their children.