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Purpose: An outbreak of the monkeypox virus has been documented in the United States with most cases occurring among gay, bisexual, and other men who have sex with men (MSM). As monkeypox cases increase among relatively rural states, current public health messaging may not resonate with rural at‐risk populations. Given this, there is a need to assess potential rural‐urban differences in monkeypox behaviors and attitudes among MSM. Methods: A total of 582 eligible MSM completed an online cross‐sectional survey between August 6 and 15, 2022. Participants answered questions about their demographics, sexual behaviors, monkeypox testing and vaccination behaviors, monkeypox media consumption and attitudes, and their intention and attitudes found in the Health Belief Model of getting the monkeypox vaccine. Rural‐urban differences in behaviors and attitudes were assessed with a chi‐square test of independence. Differences in intention to get vaccinated and Health Belief Model factors were assessed with a Mann‐Whitney U test. Findings: Rural MSM, in comparison to their urban counterparts, were found to be less likely to report modifying their behaviors to decrease monkeypox exposure, being susceptible to monkeypox, or perceiving severe consequences acquiring monkeypox. Similarly, rural MSM had a lower intention to get vaccinated for monkeypox. Conclusions: As vaccination uptake among rural populations for vaccine‐preventable diseases remains suboptimal, results from this novel study can inform the development of monkeypox prevention, testing, and vaccination messaging campaigns geared toward rural MSM and other at‐risk populations. It will be important to ensure that monkeypox prevention, testing, and vaccination interventions are available and accessible in rural areas. [ABSTRACT FROM AUTHOR]

Purpose: HIV rates are increasing in rural areas, and adolescents are disproportionately affected. HIV pre‐exposure prophylaxis (PrEP) is a daily pill that is effective at preventing HIV; however, PrEP uptake among adolescents is low. PrEP is dependent on primary care providers (PCPs) prescribing it, but research has overwhelmingly sampled urban PCPs. This study compared the PrEP awareness, practices, and comfort between rural and urban family medicine physicians. Methods: A total of 256 family medicine physicians in the United States were recruited from a Qualtrics panel to complete an online cross‐sectional survey between July 15 and August 9, 2022. Participants completed items assessing their demographic characteristics and PrEP awareness, practices, and comfort. A chi‐square test of independence and multiple logistic regression were used to determine rural/urban differences. Findings: Rural family medicine physicians were less comfortable than urban family medicine physicians in providing sexual risk reduction counseling to adolescents, telling an adolescent patient their HIV test result was HIV positive, and implementing all of the PrEP clinical activities for adolescents. Conclusions: Education, skill‐building, and collaborative partnership interventions could improve the comfort levels of rural family medicine physicians in implementing the PrEP guidelines for their adolescent patients. Future research is needed to understand the factors that explain the differences in PrEP‐related attitudes and practices between urban and rural family medicine physicians. Results from such studies could inform provider‐based interventions that ultimately increase PrEP use and decrease HIV rates among rural adolescents. [ABSTRACT FROM AUTHOR]

Context: Rapid on‐site evaluation (ROSE) optimises the performance of cytology, but requires skilled handling, and smearing can make the material unavailable for some ancillary tests. There is a need to facilitate ROSE without sacrificing part of the sample. Objective: We evaluated the image quality of inexpensive deconvolution fluorescence microscopy for optically sectioning non‐smeared fine needle aspiration (FNA) tissue fragments. Design: A portion of residual material from 14 FNA samples was stained for 3 min in Hoechst 33342 and Sypro™ Red to label DNA and protein respectively, transferred to an imaging chamber, and imaged at 200× or 400× magnification at 1 micron intervals using a GE DeltaVision inverted fluorescence microscope. A deconvolution algorithm was applied to remove out‐of‐plane signal, and the resulting images were inverted and pseudocoloured to resemble H&E sections. Five cytopathologists blindly diagnosed 2 to 4 representative image stacks per case (total 70 evaluations), and later compared them to conventional epifluorescent images. Results: Accurate definitive diagnoses were rendered in 45 (64%) of 70 total evaluations; equivocal diagnoses (atypical or suspicious) were made in 21 (30%) of the 70. There were two false positive and two false negative "definite" diagnoses in three cases (4/70; 6%). Cytopathologists preferred deconvolved images compared to raw images (P < 0.01). The imaged fragments were recovered and prepared into a ThinPrep or cell block without discernible alteration. Conclusions: Deconvolution improves image quality of FNA fragments compared to epifluorescence, often allowing definitive diagnosis while enabling the ROSE material to be subsequently triaged. [ABSTRACT FROM AUTHOR]

BACKGROUND Cervical cancer screening and follow-up guidelines have changed considerably in recent years, but to the authors' knowledge few published reports exist to estimate the impact of these changes in community-based settings. The authors examined the patterns and results of cervical cancer testing and follow-up over a decade in 4 geographically diverse US health care systems to inform the future evaluation of changes resulting from increased uptake of the human papillomavirus (HPV) vaccination. METHODS The authors studied women aged 21 to 65 years who were members of one of these health systems at any time between 1998 and 2007. Data were collected and standardized across sites, based on receipt of Papanicolaou (Pap) and HPV tests, HPV vaccination, cervical biopsies, and treatment of cervical dysplasia. Annual rates (per 1000 person-years) of Pap testing, HPV testing, and cervical biopsy and treatment procedures were calculated. Screening intervals and trends in the results of screening Pap tests and cervical biopsies also were examined. RESULTS Pap testing rates decreased (from 483 per 1000 person-years in 2000 to 412 per 1000 person-years in 2007) and HPV testing rates increased over the study period. Screening frequency varied across health care systems, and many women continued to receive annual testing. All 4 sites moved to less frequent screening over the study period without marked changes in the overall use of cervical biopsy or treatment. CONCLUSIONS Despite differences over time and across health plans in rates of cervical cancer testing and follow-up cervical procedures, the authors found no notable differences in Pap test results, diagnostic or treatment procedure rates, or pathological outcomes. This finding suggests that the longer screening intervals did not lead to more procedures or more cancer diagnoses. Cancer 2015;121:2976-2983. © 2015 American Cancer Society. [ABSTRACT FROM AUTHOR]

BACKGROUND To the authors' knowledge, few studies to date have examined adherence to recommended guidelines for follow-up and outcomes after an unsatisfactory Papanicolaou (Pap) test (UPT) with liquid-based technologies. METHODS Within 4 US health plans, the median time to follow-up and the percentage of patients with follow-up testing by 120 days was calculated after a UPT. Multivariable analyses evaluated the association between clinical factors and follow-up testing. The authors compared the risk of a diagnosis of cervical intraepithelial neoplasia of type 2 or worse (CIN2+) after a UPT with the risk after a satisfactory Pap test while controlling for study site, test year, and other covariates. RESULTS A total of 634,644 Pap tests performed between 2004 and 2010 were included in the current study. Of 1442 UPTs, 53.4% had follow-up testing within 120 days; follow-up differed across the health plans ( P<.001) and was found to be higher among patients aged <50 years (57.2% vs 48.8%; P = .01) and those with positive human papillomavirus (HPV) results (84.6% vs 53.9; P <.01). The risk of CIN2+ was similar for patients with both unsatisfactory and satisfactory Pap tests. However, after a UPT, the variables of age <50 years, having no previous history of Pap testing, having a history of a previous abnormal Pap test, and positive HPV status were all found to be risk factors for CIN2+; a positive HPV test was found to be the strongest risk factor for developing CIN2+. A negative HPV test result was protective for a CIN2+ diagnosis. CONCLUSIONS Various clinical factors associated with the risk of CIN2+ appear to influence the receipt of follow-up after a UPT. HPV test results in patients with UPTs might be used in follow-up strategies; specifically, a negative test result might reduce the urgency for repeat Pap testing. Cancer (Cancer Cytopathol) 2015;123:59-65. © 2014 American Cancer Society. [ABSTRACT FROM AUTHOR]

BACKGROUND Pap test (PT) interpretations of low-grade squamous intraepithelial lesion (LSIL), cannot exclude high-grade squamous intraepithelial lesion (HSIL), or LSIL-H, are used in many laboratories; however monitoring its usage for quality assurance purposes is understudied. METHODS PTs from 2005 to 2010 were collected, and yearly frequencies of LSIL, HSIL, LSIL-H, and atypical squamous cells, cannot exclude HSIL (ASC-H) as a function of total PTs and total squamous intraepithelial lesions (SILs) were calculated. Two-year risk of cervical intraepithelial neoplasia 2 (CIN2) or worse (CIN2+) and CIN 3 or worse (CIN3+) was calculated. RESULTS A total of 352,220 PTs were identified including 17,301 abnormal PTs. LSIL-H usage increased from 2005 to 2010 (from 0.28% of total PTs in 2005 to 0.61% in 2010, P < .01; from 5.8% of total SILs in 2005 to 12% in 2010, P < .001). HSIL usage decreased significantly from 2005 to 2010 (from 0.7% of total PTs in 2005 to 0.48% in 2010, P = .048; from 14.5% of total SILs in 2005 to 9.5% in 2010, P < .01). Usage of LSIL and ASC-H did not change. Two-year risk of CIN2+ and CIN3+ for HSIL increased significantly from 2005 to 2010 ( P < .01). Two-year risk of CIN2+ and CIN3+ for LSIL-H did not change significantly from 2005 to 2010. CONCLUSIONS The frequency of LSIL-H interpretations is significantly increasing at our institution, with a significant decrease in HSIL interpretations over the same period. Two-year risk of CIN2+ and CIN3+ for HSIL increased significantly as usage of LSIL-H increased and that of HSIL decreased. Laboratories using LSIL-H may benefit from monitoring its frequency to ensure its appropriate use. Cancer (Cancer Cytopathol) 2014;122:123-7. © 2013 American Cancer Society. [ABSTRACT FROM AUTHOR]

BACKGROUND Atypical glandular cells (AGC) is a very important diagnosis in gynecological cytology. In the current study, the authors investigated the usefulness of Cellient cell blocks (CB) for characterizing AGC on Papanicolaou (Pap) tests. METHODS A total of 148 patients with an AGC diagnosis based on Pap tests by cytotechnologists and referred to cytopathologists were studied. Among these patients, there were 68 patients with CB preparations and 80 patients with Pap tests only (TP-AGC group). Follow-up results by Pap tests or biopsies were obtained in 117 of 148 patients. The median follow-up was 13 months (range, 1 month-36 months). RESULTS Of the 68 patients with CBs, 31 (46%) were reclassified as negative for dysplasia or low-grade intraepithelial lesion; 30 patients (44%) retained a diagnosis of AGC (CB-AGC group); and 7 patients (10%) were given specific diagnoses of high-grade intraepithelial lesion (3 patients), endocervical adenocarcinoma in situ (1 patient), and invasive adenocarcinoma (3 patients). On follow-up, the CB-AGC group was found to have a significantly lower rate of negative/low-grade squamous intraepithelial lesion diagnoses compared with the TP-AGC group (55% vs 85%; P = .006). The CB-AGC group had a significantly higher rate of endocervical or endometrial adenocarcinoma compared with the TP-AGC group (36% vs 8%; P = .003) at the time of follow-up. The rates of high-grade squamous intraepithelial lesion were not found to be statistically different between these 2 groups (9% vs 7%; P = .66). CONCLUSIONS The Cellient CB is a useful technique to further categorize a diagnosis of AGC on Pap tests. Using the Cellient CB system, the pathologist has the ability to improve the diagnostic accuracy of AGC so that unnecessary colposcopic evaluation or biopsies can be avoided. Cancer (Cancer Cytopathol) 2014;122:8-14. © 2013 American Cancer Society. [ABSTRACT FROM AUTHOR]

BACKGROUND Papanicolaou (Pap) testing has transitioned from conventional preparations (CPs) to liquid-based preparations (LBPs) because of the perceived superiority of LBPs. Many studies conclude that LBPs reduce unsatisfactory Pap tests; however, some believe that the evidence substantiating this claim is weak. The authors studied the effect of the transition from CPs to LBPs on the proportion of unsatisfactory Pap tests in 4 health care systems in the United States participating in the National Institutes of Health-funded Screening Effectiveness and Research in Community-Based Healthcare (SEARCH) project. METHODS The study cohort consisted of 548,174 women ages 21 to 65 years who had 1443,725 total Pap tests between 2000 and 2010. Segmented regression analysis was used to estimate the effect of adopting LBPs on the proportion of unsatisfactory Pap tests after adjusting for age. RESULTS Three sites that implemented SurePath LBP experienced significant reductions in unsatisfactory Pap tests (estimated effect: site 1, −2.46%; 95% confidence interval [CI], −1.47%, −3.45%; site 2, −1.78%; 95% CI, −1.54%, −2.02%; site 3, −8.25%; 95% CI, −7.33%, −9.17%). The fourth site that implemented ThinPrep LBP did not experience a reduction in unsatisfactory Pap tests. The relative risk of an unsatisfactory Pap test in women aged ≥50 years increased after the transition to LBPs (SurePath: relative risk, 2.1; 95% CI, 1.9-2.2; ThinPrep: relative risk, 1.7; 95% CI, 1.5-2.0). CONCLUSIONS The observed changes in the proportion of unsatisfactory Pap tests varied across the participating sites and depended on the type of LBP technology, the age of women, and the rates before the implementation of this technology. Cancer (Cancer Cytopathol) 2013;121:568-575. © 2013 American Cancer Society. [ABSTRACT FROM AUTHOR]

BACKGROUND: Urine cytology represents a major portion of testing volume in many cytopathology laboratories. METHODS: The authors previously reported a template designed to standardize urothelial diagnostic categories to enable clinicians to uniformly manage their patients. In this study, they examined the common cytomorphologic features observed in specimens diagnosed with atypical urothelial cells, cannot exclude high-grade urothelial carcinoma (AUC-H), which prove most predictive of high-grade urothelial carcinoma (HGUC). RESULTS: The most common morphologic features observed in the AUC-H specimens were hyperchromasia, irregular nuclear borders, increased nucleus-to-cytoplasm ratio, and anisonucleosis. Of the 58 patients who had specimens diagnosed with AUC-H, 95% ultimately were diagnosed with HGUC on follow-up biopsy over the study period. The small number of patients who had AUC-H with non-HGUC follow-up did not allow for a statistical comparison to determine the predictive ability of the selected criteria for HGUC. Next, the authors used the same features to examine a subset of urine samples that were diagnosed with atypical urothelial cells of unknown significance (AUC-US) in an attempt to improve the predictive value of this clinically frustrating category. A blind review was performed of 290 urine specimens from 217 patients. In contrast to the AUC-H specimen cohort, the majority of specimens with AUC-US did not contain atypical cells with the 4 common morphologic features. All 4 features significantly predicted HGUC in surveillance patients, but not in patients with hematuria. CONCLUSIONS: Hyperchromasia was the strongest predictor of HGUC by far in patients who were undergoing surveillance (odds ratio, 9.81). Hyperchromasia remained statistically significant in multivariate analysis, indicating its predictive strength even in the absence of other features. Cancer (Cancer Cytopathol) 2013;121:21-28 © 2012 American Cancer Society. [ABSTRACT FROM AUTHOR]

Urine cytology continues to play an important role in the diagnosis and management of urothelial carcinoma, a common cancer of adults with significant morbidity and mortality. Because of its high sensitivity for high-grade urothelial tumors, including lesions that may be cystoscopically occult, urine cytology nicely compliments cystoscopic examination, a method that detects most low-grade tumors. Over the decades, several reporting schemes for urine cytology have been published in the literature, each of which has relative strengths and weaknesses. Unlike cervical cytology, there has not been widespread acceptance and use of any particular reporting scheme for urine cytology studies. Thus, terminology and criteria for urine cytology reporting are not uniform among pathologists, which can frustrate clinicians and hinders interlaboratory comparisons. Cancer (Cancer Cytopathol) 2013;121:9-14 © 2012 American Cancer Society. [ABSTRACT FROM AUTHOR]

BACKGROUND: The most important indicator for urologic surgeons at The Johns Hopkins Hospital to have a patient undergo cystoscopy is a cytologic diagnosis of high-grade urothelial carcinoma. The template was designed to standardize diagnostic categories so clinicians can manage their patients uniformly. The template was based in part on the Bethesda System for cervical cytology. METHODS: According to the template, reactive/inflammatory changes were included in the negative group (no urothelial atypia or malignancy identified). The category atypical urothelial cells of undetermined significance (AUC-US) was akin to atypical squamous cells of undetermined significance (ASC-US), as was the category of atypical urothelial cells, favor high-grade carcinoma (AUC-H). The categories high-grade urothelial carcinoma (HGUC) and low-grade urothelial carcinoma also were added. RESULTS: The Pathology Data System at the Johns Hopkins Hospital was searched for cases that met the following criteria over a period from July 1, 2007 to June 30, 2009: all cytologic specimens from the urinary tract and all surgical specimens with a diagnosis of HGUC, regardless of invasion status. All cytologic specimens were then matched with biopsies during the same period, and all surgical specimens from patients who had a cytologic diagnosis of AUC-US or AUC-H were retrieved for 18 months after the end of the 2-year study period. Greater than 50% of patients who had biopsy-confirmed HGUC had a preceding cytologic diagnosis of AUC-H or HGUC. When patients with AUC-US were added to the analysis, 80% of patients with HGUC had at least 1 abnormal urinary cytology result. Of those patients who had a diagnosis of AUC-H, 38% had urothelial cancer discovered at biopsy compared with only 10% of those with an AUC-US diagnosis. CONCLUSIONS: The authors concluded that their template is effective in targeting those patients who need to undergo cystoscopy. Cancer (Cancer Cytopathol) 2013;121:15-20 © 2012 American Cancer Society. [ABSTRACT FROM AUTHOR]

BACKGROUND: Although thyroid fine-needle aspiration (TFNA) is an excellent test in evaluating thyroid nodules, there are occasionally false negatives (FN). The clinical impact and pathologic features of FN TFNA is understudied in the peer-reviewed literature. METHODS: A cohort of patients with thyroid cancer was separated into those with referring FN TFNA and those with referring true positive (TP) TFNA. Preoperative characteristics, pathologic finding, and clinical outcomes were compared within the 2 groups. RESULTS: A total of 192 patients with TP TFNA (n = 162) and FN TFNA (n = 30) were included in the study. There were no significant differences in the demographics or length of follow-up of the 2 groups. The FN TFNA group was more likely to have a larger clinical nodule size and experienced a significant delay from initial TFNA to surgery. The FN TFNA group was more likely to be diagnosed with the follicular variant of papillary thyroid cancer (73.3% vs 25.9%, P < .001), less likely to have positive lymph nodes at surgery (6.7% vs 35.8%, P = .001), and more likely to undergo 2-step surgery (30% vs 9.9%, P = .007). Despite the delay in diagnosis, persistent/recurrent or metastatic disease, incidence of aggressive histologic variants, and pT4 disease was not different in the 2 groups. CONCLUSIONS: The clinical impact of FN TFNA at our high-volume center is minimal. Cancers in this setting are low grade, and outcomes are not adversely affected despite the delay in diagnosis. Cancer (Cancer Cytopathol) 2012. © 2012 American Cancer Society. [ABSTRACT FROM AUTHOR]

BACKGROUND: Intrapancreatic accessory spleen (IPAS) is a rare benign lesion of the pancreas that frequently clinically and radiographically mimics a solid neoplasm. Very rarely, epidermoid cysts may form in IPAS and be mistaken for a cystic neoplasm of the pancreas on radiographic imaging. IPAS and epidermoid cyst involving intrapancreatic cyst (ECIPAS) are benign, and, if recognized, do not require surgical intervention. There are few reports of the cytopathologic features of IPAS diagnosed by fine-needle aspiration (FNA). METHODS: Here we report a series of 6 cases of endoscopic ultrasound (EUS)-guided FNA of IPAS, 3 of which had histological confirmation, including 1 case of histologically confirmed ECIPAS. RESULTS: Cytomorphologic features of IPAS include a polymorphous population of hematopoietic cells, including lymphocytes, eosinophils, histiocytes, plasma cells, and red blood cells, admixed with numerous small blood vessels representing splenic sinusoids. CD8 immunostaining of cell block or core biopsy material highlights splenic endothelial cells and confirms the diagnosis. FNA of ECIPAS reveals predominantly macrophages and proteinaceous debris. CONCLUSIONS: Diagnostic pitfalls include pancreatic neuroendocrine tumor. If IPAS is recognized as a diagnostic consideration on EUS-FNA, unnecessary surgical resection may be avoided. Cancer (Cancer Cytopathol) 2012. © 2012 American Cancer Society. [ABSTRACT FROM AUTHOR]

The article presents a study on endothelial dysfunction and arterial stiffness and their possible link to hemodynamic instability during dialysis. Findings showed that every 5% decline in flow-mediated dilation was linked to a 7.5 millimeter of mercury (mmHg) reduction in systolic blood pressure (SBP) after adjusting for phosphorus, body mass index, atherosclerosis, and ultrafiltration. Every 5 meters per second (m/s) increase in pulse wave velocity was linked to an 8 mmHg increase in SBP after adjusting for predialysis SBP and ultrafiltration.

BACKGROUND: ThinPrep (TP) liquid-based preparations are increasingly being used in nongynecologic specimens. Few studies have evaluated TP as a sole diagnostic modality in the setting of thyroid fine-needle aspiration (T-FNA). Herein, the authors evaluate the usefulness of TP as a sole diagnostic modality in a nonsplit sample. METHODS: Consecutive T-FNAs were identified at 2 tertiary care institutions; 1 institution processed thyroid FNA entirely with TP, and the other used a combination of TP and conventional preparations (CP). Cytodiagnoses, surgical pathology, and/or clinical follow-up were recorded. Performance parameters for the 2 settings were compared. RESULTS: A cytologic diagnosis of positive for malignancy was correct in 98.8% of TP + CP cases and in 100% of TP cases. Papillary thyroid carcinoma cases were definitively diagnosed in 53.1% of T-FNAs prepared by TP + CP compared with 34.4% of T-FNAs prepared with TP alone ( P = .0015 by Fisher 2-tailed exact test). Of patients ultimately diagnosed with papillary thyroid carcinoma, 89% were initially treated by total thyroidectomy in the TP + CP group compared with 79.5% in the TP-only group ( P = .027 by Fisher exact test). CONCLUSIONS: TP as a sole preparatory technique does not improve the usefulness of T-FNA as a screening test. However, combining CP and TP increases the rate of definitive cytologic diagnosis of malignancy in papillary thyroid carcinoma. Thus, combining TP and CP enhances the diagnostic component of T-FNA. Cancer (Cancer Cytopathol) 2011. © 2010 American Cancer Society. [ABSTRACT FROM AUTHOR]

The search for effective Hepatitis C antiviral therapies has recently focused on host sterol metabolism and protein prenylation pathways that indirectly affect viral replication. However, inhibition of the sterol pathway with statin drugs has not yielded consistent results in patients. Here, we present a combination chemical genetic study to explore how the sterol and protein prenylation pathways work together to affect hepatitis C viral replication in a replicon assay. In addition to finding novel targets affecting viral replication, our data suggest that the viral replication is strongly affected by sterol pathway regulation. There is a marked transition from antagonistic to synergistic antiviral effects as the combination targets shift downstream along the sterol pathway. We also show how pathway regulation frustrates potential hepatitis C therapies based on the sterol pathway, and reveal novel synergies that selectively inhibit hepatitis C replication over host toxicity. In particular, combinations targeting the downstream sterol pathway enzymes produced robust and selective synergistic inhibition of hepatitis C replication. Our findings show how combination chemical genetics can reveal critical pathway connections relevant to viral replication, and can identify potential treatments with an increased therapeutic window. [ABSTRACT FROM AUTHOR]

Lower extremity peripheral vein bypass grafts (LE-PVBG) imaged with high-resolution black blood three-dimensional (3D) inner-volume (IV) fast spin echo (FSE) MRI at 1.5 Tesla possess a two-layer appearance in T1W images while only the inner layer appears visible in the corresponding T2W images. This study quantifies this difference in six patients imaged 6 months after implantation, and attributes the difference to the T2 relaxation rates of vessel wall tissues measured ex vivo in two specimens with histologic correlation. The visual observation of two LE-PVBG vessel wall components imaged in vivo is confirmed to be significant ( P < 0.0001), with a mean vessel wall area difference of 6.8 ± 2.7 mm2 between contrasts, and a ratio of T1W to T2W vessel wall area of 1.67 ± 0.28. The difference is attributed to a significantly ( P < 0.0001) shorter T2 relaxation in the adventitia (T2 = 52.6 ± 3.5 ms) compared with the neointima/media (T2 = 174.7 ± 12.1 ms). Notably, adventitial tissue exhibits biexponential T2 signal decay ( P < 0.0001 vs monoexponential). Our results suggest that high-resolution black blood 3D IV-FSE can be useful for studying the biology of bypass graft wall maturation and pathophysiology in vivo, by enabling independent visualization of the relative remodeling of the neointima/media and adventitia. Magn Reson Med, 2009. © 2009 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

A 3D inner-volume fast spin echo (3D IV-FSE) sequence was developed for ECG-gated, black-blood, T1- and T2-weighted vessel wall imaging of peripheral vein bypass grafts (PVBG). The sequence utilizes nonselective refocusing excitations to minimize echo spacings and a highly selective IV excitation scheme to minimize the need for oversampling of z-encode slice selections. The method was tested in eight PVBG patients who also underwent 2D FSE graft imaging. High-quality 3D imaging was achieved in all subjects, with significant spatial resolution and volume coverage gains compared to the more conventional 2D FSE sequences normalized for signal-to-noise ratios (SNRs) and scan times. Compared to previously proposed 3D IV-FSE methods, nonselective refocusing resulted in a more than 20% FSE echo train sampling efficiency increase while the use of highly selective IV excitation resulted in a 30% improvement in slice oversampling efficiency. Magn Reson Med, 2008. © 2008 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Objectives.— To assess migraine prophylactic drug utilization in the Idaho Medicaid population and to evaluate responsiveness of practitioners to an educational intervention from the Idaho Medicaid Drug Utilization Review (DUR) Program. Background.— While established guidelines recommend migraine prophylactic therapies for defined patient populations and several drugs have demonstrated efficacy, their actual utilization is reportedly low. Methods.— Profiles for Idaho Medicaid patients were reviewed retrospectively to identify candidates for migraine prophylactic therapy based on excessive triptan utilization. Use of a prophylactic agent was then characterized for these patients, and an educational mailing was sent to practitioners directly involved in the care of patients who did not appear to be using prophylaxis. Patient profiles were again assessed 6 months following the mailing to determine if a trial of a prophylactic drug had been attempted. Results.— A total of 1909 patients were identified as having at least one claim for a triptan drug in the year studied. Of these patients, 360 appeared to be candidates for prophylaxis, but 154 had no record of prophylactic drug use. In the 6 months following the intervention mailing, 27 of the 91 non-prophylaxis patients (30%) who were still active clients of Idaho Medicaid and who had seen their physician during that time, appeared to have been given a trial of a migraine prophylactic drug. Conclusions.— Following an educational intervention for Idaho Medicaid patients identified through retrospective DUR, a trial of a migraine prophylactic drug was initiated for approximately one-third of potential candidates. [ABSTRACT FROM AUTHOR]

The article discusses deep fibromatosis or desmoid tumor (DF/DT). It is suggested that studies on DF/DT and fine-needle aspiration (FNA) should be explored more by researchers for a better understanding of its roles and limitations in different scenarios. Also, clinicians are encouraged to implement the appropriate diagnosis of DF/DT or FNA on patients when an open-biopsy is not safe. Also discussed are fibromatosis, cytology, and antibodies.

Plasmodium vivaxis one of fourPlasmodiumspecies that cause human malaria.P. vivaxand a related simian malaria parasite,Plasmodium knowlesi, invade erythrocytes by binding the Duffy antigen/receptor for chemokines (DARC) through their respective Duffy binding proteins. Here we show that tyrosines 30 and 41 of DARC are modified by addition of sulphate groups, and that the sulphated tyrosine 41 is essential for association of the Duffy binding proteins ofP. vivax(PvDBP) andP. knowlesi(PkDaBP) with DARC-expressing cells. These sulphated tyrosines also participate in the association of DARC with each of its four known chemokine ligands. Alteration of tyrosine 41 to phenylalanine interferes with MCP-1, RANTES and MGSA association with DARC, but not with that of IL8. In contrast, alteration of tyrosine 30 to phenylalanine interferes with the association of IL8 with DARC. A soluble sulphated amino-terminal domain of DARC, but not one modified to phenylalanine at residue 41, can be used to block the association of PvDBP and PkDaBP with red blood cells, with an IC50 of approximately 5 nM. These data are consistent with a role for tyrosine sulphation in the association of many or most chemokines with their receptors, and identify a key molecular determinant of erythrocyte invasion byP. vivax. [ABSTRACT FROM AUTHOR]