Search

The local control of desmoid tumors constitutes a continuing treatment dilemma due to its high recurrence rates. The purpose of this systematic review was to critically examine the current treatment of these rare tumors and to specifically evaluate the local failure and response rates of surgery, radiation and systemic therapy. We comprehensively searched the literature for relevant studies across Cinahl, Embase, Medline and the Cochrane databases. Articles were categorized as surgery, radiation, surgery + radiation and systemic therapy (including cytotoxic and non cytotoxic). Methodological quality of included studies was assessed using the Newcastle- Ottawa Scale. Pooled odd ratios (OR) for comparative studies and weighted proportions with 95% confidence intervals (CI) are reported. Thirty-five articles were included in the final analysis. Weighted mean local failure rates were 22% [95% CI (16-28%)], 35% [95% CI (26-44%)] and 28% [95% CI (18-39%)] for radiation alone, surgery alone and surgery + radiation respectively. In the analysis of comparative studies, surgery and radiation in combination had lower local failure rates than radiation alone [OR 0.7 (0.4, 1.2)] and surgery alone [OR 0.7 (0.4, 1.0)]. Weighted mean stable disease rates were 91% [95% CI (85-96%)] and 52% [95% CI (38-65%)] for non cytotoxic and cytotoxic chemotherapy respectively. The current evidence suggests that surgery alone has a consistently high rate of local recurrence in managing extra-abdominal desmoid tumors. Radiation therapy in combination with surgery improves local control rates. However, the limited data on systemic therapy for this rare tumor suggests the benefit of using both cytotoxic and non cytotoxic chemotherapy to achieve stable disease. [ABSTRACT FROM AUTHOR]

There is increased congressional awareness of, and attention paid to, elder abuse, yet the need for resources, research, and capacity-building support is especially acute in Adult Protective Services (APS), the nation's direct victim-services system. And there are still very limited resources for those dealing with elder abuse. The Elder Justice Act (EJA) was enacted into law, but hasn't been funded. With caseloads in APS increasing by leaps and bounds, strategies and actions are needed to build up the APS system. [ABSTRACT FROM AUTHOR]

The article discusses challenges facing U.S. Adult Protective Services (APS) programs established by state laws to receive reports of abuse, neglect and exploitation of elders and of young persons with disabilities. APS evolved from Social Security Act amendments in 1962 authorizing states to establish protective services for persons with physical or mental limitations unable to manage their affairs. With no national infrastructure, it is stated that APS rely solely on state funding decisions. INSET: Case Scenario.

Sexual abuse, the fasters growing type of abuse complaint, often raises issues concerning the credibility of individual allegations. This paper discusses historical, developmental, and societal factors affecting children's credibility and recommended assessment methods that maximize a child's capacity to relate his or her experience. Clinical factors leading to false allegations are discussed. [ABSTRACT FROM AUTHOR]

The clinical impact of Tarasoff (1976) has meant an increased emphasis on violence as a topic in treatment and a concern for therapists. This paper discusses the limits of confidentiality and the management of dangerous patients both before and after the landmark decision of Tarasoff. The existing research surveys on therapists' responses to Tarasoff arc reviewed. Some of the clinical implications of recent court cases such as Jablonski are described. Recommendations for the management of threatening patients are made. [ABSTRACT FROM AUTHOR]

In North Carolina ... researchers compared police reports with animal cruelty reports and found almost equal numbers of each at the same addresses. [ABSTRACT FROM AUTHOR]

References for the articles published in the journal "Hesperia: The Journal of the American School of Classical Studies at Athens" are presented .

Significant morbidity in cystic fibrosis (CF) results from chronic lung inflammation, most commonly due to Pseudomonas aeruginosa infection. Recent data suggest that IL-17 contributes to pathological inflammation in the setting of abnormal mucosal immunity, and type 17 immunity-driven inflammatory responses may represent a target to block aberrant inflammation in CF. Indeed, transcriptomic analysis of the airway epithelium from CF patients undergoing clinical bronchoscopy revealed upregulation of IL-17 downstream signature genes, implicating a substantial contribution of IL-17-mediated immunity in CF lungs. Bromodomain and extraterminal domain (BET) chromatin modulators can regulate T cell responses, specifically Th17-mediated inflammation, by mechanisms that include bromodomain-dependent inhibition of acetylated histones at the IL17 locus. Here, we show that, in vitro , BET inhibition potently suppressed Th17 cell responses in explanted CF tissue and inhibited IL-17-driven chemokine production in human bronchial epithelial cells. In an acute P. aeruginosa lung infection murine model, BET inhibition decreased inflammation, without exacerbating infection, suggesting that BET inhibition may be a potential therapeutic target in patients with CF.

This article describes common forensic evaluations requested of juvenile court mental health evaluators. There has been a legal shift toward criminalization of juvenile court, with a greater emphasis on rights, abandonment of the rehabilitative model, and greater movement of adolescents into the adult criminal court. A resulting shift has been the redefinition of juvenile court forensic evaluations toward the specificity of adult forensic work. The challenge for evaluators is to refine their knowledge of the forensic standards and bring knowledge of development, assessment, and diagnosis in juveniles and interview techniques appropriate to juveniles to improve the evaluation and forensic reports.