Inverse association for diagnosis of Alzheimer's disease subsequent to both melanoma and non-melanoma skin cancers in a large, urban, single-centre, Midwestern US patient population.

BACKGROUND: Although literature demonstrates a decreased risk of Alzheimer's disease (AD) in individuals with various cancers, including squamous cell cancers (SCC) and basal cell cancers (BCC) comprising non-melanoma skin cancers (NMSC), there is a paucity of literature to substantiate an association between malignant melanoma (MM) and AD. OBJECTIVE: The aim of this study was to determine whether an association exists between MM and AD as well as for NMSC and AD. METHODS: A large urban, Midwestern, US, single-centre, medical record (EMR) data repository was searched between January 2001 and December 2015, to identify all patients at age ≥60 and <89 years with a clinic follow-up of at least 1 year and no diagnosis for AD, MM or NMSC at the time of the study entry. Data collected included age, gender, race and duration of follow-up. MM and NMSC were detected by ICD-9 codes and ICD-10 codes. Incident diagnosis of AD was also detected by ICD-9 and ICD-10 codes. Logistic regression analysis was utilized to obtain crude and adjusted odds ratios (ORs). RESULTS: Data for a total of 82 925 patients with known race and gender and were detected. After adjusting for confounding factors (race, gender, age, cerebrovascular disease, peripheral vascular disease and diabetes), there was a significant decreased risk of subsequent AD in patients with MM (OR: 0.39; 95% CI: 0.16-0.96; P = 0.042) as well as in patients with BCC (OR: 0.18; 95% CI: 0.08-0.45; P < 0.0001) and for patients with SCC (OR: 0.08; 95% CI: 0.01-0.56; P = 0.013). CONCLUSION: These findings add to the growing body of evidence for a decreased risk of AD in patients with various cancers and highlight the need for ongoing research to elucidate both neurologic and biologic mechanisms that may underlie this apparent inverse association.

Intersexual differences in energy expenditure of Anolis carolinensis lizards during breeding and postbreeding seasons.

Although the amount of energy that males and females invest in reproduction is an integral component of theories explaining the evolution of particular mating strategies, few studies have actually determined the amount of energy that each sex allocates to reproduction. We compared how energy is expended by male and female Anolis carolinensis lizards during both the breeding and postbreeding seasons. We used laboratory respirometry to determine resting metabolic rates (RMRs) of inactive, freshly captured lizards and the doubly labeled water technique to determine field metabolic rates (FMRs) of free-ranging lizards. Both RMRs and FMRs were influenced by body mass but not by sex. Season did not influence FMRs; however, RMRs of both sexes increased approximately 40% from the breeding to the postbreeding season. The seasonal increase in RMRs was attributed to a postreproductive increase in feeding rate and specific dynamic action. We used RMRs, FMRs, and thermal profiles of lizards to calculate energy budgets for breeding and postbreeding seasons. Energy budgets partitioned daily field energy (DFE; calculated from FMRs) into daily activity energy (DAE) and daily resting energy (DRE; calculated from RMRs). Energy expended for reproduction was estimated as DAE during the breeding season plus egg production (for females). Despite males having 40% greater body mass, females expended 46% more energy for reproduction than did males (906 and 619 J/d, respectively). Total metabolizable energy (TME=DFE+egg production for females) expended during the breeding season was similar for males and females (1,280 and 1,365 J/d, respectively). Although TME of females decreased 44% from the breeding to the postbreeding season (1,365 vs. 766 J/d), TME of males was similar during both seasons (1,280 vs. 1,245 J/d). There were both seasonal and sexual differences in DRE and DAE. Compared with most lizards from semiarid/desert habitats, A. carolinensis in a temperate habitat expends more total energy during the breeding season, allocates more energy to eggs, and appears to have more total energy available for reproduction.

Descriptions of the mature spermatozoa of the lizards Crotaphytus bicinctores, Gambelia wislizenii (Crotaphytidae), and Anolis carolinensis (Polychrotidae) (Reptilia, Squamata, Iguania).

The spermatozoa of Crotaphytus bicinctores and Gambelia wislizenii (Crotaphytidae), and Anolis carolinensis (Polychrotidae) exhibit the squamate autapomorphies of a single perforatorium extending anteriorly from the apical tip of the paracrystalline subacrosomal cone, the presence of an epinuclear electron-lucent region, and extension of the fibrous sheath into the midpiece. Crotaphytid sperm differ from those of polychrotids in several respects, including: the structure of the perforatorium, the size of the epinuclear electron-lucent region, aspects of the acrosome complex, the arrangement and structure of intermitochondrial dense bodies, and in the distance the fibrous sheath extends into the midpiece. The sperm of C. bicinctores, G. wislizenii, and A. carolinensis are most similar to those of the agamids and phrynosomatids examined to date. No spermatozoal autapomorphies for Crotaphytidae or Polychrotidae were found. The condition of having the intermitochondrial dense bodies arranged in regular incomplete rings is tentatively defined as a synapomorphy of Iguania (although modified in Chamaeleonidae). Spermatozoal ultrastructure offers no characters that justify the separation of Iguanidae (sensu lato) into several separate families.

Structural abnormality of the clavicle associated with Sprengel's deformity. A case report.

Sprengel's deformity is the most common congenital anomaly of the shoulder girdle and is often accompanied by the presence of an omovertebral bone. Preoperative oblique roentgenograms or computed tomography may be necessary to define the abnormal structures in Sprengel's deformity. Sprengel's deformity in a six-year-old girl was corrected as follows. During clavicular exposure to osteotomy, an abnormal osseous bridge extending from the midportion of the clavicle to the spine of the scapula was identified and resected. A literature survey failed to identify other similar anomalies.

Open versus closed intramedullary nailing of femoral shaft fractures.

A retrospective study was performed including only fractures involving the middle three fifths of the femoral shaft with a minimum of 2 years followup. There were 65 fractures in Group I treated with the closed technique utilizing the image intensifier. These were compared with 65 fractures treated with open reduction and nailing. Followup averaged 4 years (Group II). Group 1 had 92% satisfactory results; Group II achieved 97% satisfactory, not statistically significantly different. Our recommendations are delaying the procedure did not appear to be advantageous; excluding the fractures with segmental bicortical loss, there are limited indications for locked nails in these fractures; the decision to use a specific type of internal fixation should be based on the fracture pattern, the surgeon's experience, and the equipment available; if a closed technique is chosen, be prepared to open the fracture if a satisfactory closed reduction cannot be attained. This, in our study, did not increase the risk of reducing the functional result.