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Muir-Torre syndrome (MTS) is a rare genetic disorder, considered a subtype of Lynch syndrome, that causes sebaceous cutaneous tumors and increases the risk of internal visceral tumors. We present a case of a 63-year-old male with a history of MTS with sebaceous tumors, colorectal, and urothelial cancers who underwent fluorine-18-deoxyglucose positron emission tomography/ computed tomography [18F]FDG PET/CT to follow-up on multiple [18F]FDG avid skin lesions and right pelvic lymph nodes. Although few reports are available detailing the utility of [18F]FDG PET/CT in this rare disease, this modality appears useful, and superior, to computed tomography in the diagnosis and follow-up of MTS.

Introduction: The purpose of this retrospective study was to determine the relationship between pretherapy hemoglobin levels and progression-free survival among women with uterine cervix cancer undergoing concurrent weekly cisplatin and radiotherapy followed by brachytherapy., Methods: Patients with advanced-stage II-IVA uterine cervix cancer were grouped by hemoglobin level (Hgb ≥ 12.0, 11.9-10.0, or < 10.0 g/dL). Endpoints were progression-free survival, overall survival, and local control., Results: Between 01/2001 and 07/2022, 168 patients contributed demographic, tumor, pretherapy hemoglobin, and outcome data with a median follow-up of 31 months. Progression-free survival at three years was 73% (95% confidence interval: 58%-84%), 71% (95% confidence interval: 56%-82%), and 62% (95% confidence interval: 44%-75%) for the Hgb ≥ 12.0, 11.9-10.0, or < 10.0 g/dL groups, respectfully (P < 0.001). In addition, pretherapy hemoglobin levels were significant with treatment outcome when included in a multivariate analysis of prognostic variables., Discussion: In conclusion, the difference in pretherapy hemoglobin level was prognostic of progression-free survival., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Kunos, Fabian, Fredericks, Baldwin, Dietrich, Miller and Ueland.)

High-pressure paint injection injury to the orbit is a rare type of orbital trauma. We present an unfortunate case of high-pressure paint injury to the right orbit of a young patient. High-pressure injection injury presents with a unique injury mechanism and resultant deep tissue damage. The superficial appearance of the entry site injury is deceiving; therefore, a thorough evaluation is necessary. Debridement is usually required if foreign body material is present. Antibiotics and steroids are commonly used in such cases., (© 2023. The Author(s), under exclusive licence to American Society of Emergency Radiology (ASER).)

Leiomyosarcoma (LMS) is the most common soft tissue sarcoma in adults and can occur in any part of the body. Uterine leiomyosarcoma (uLMS) is the most common location for LMS, making up 2% to 5% of all uterine malignancies. It is an aggressive tumor that is challenging to treat because of its resistance to standard therapy. The majority of patients (60%) are diagnosed with early-stage disease. However, regardless of the stage, uLMS has a poor prognosis. Surgical resection is the cornerstone of treatment for patients with localized LMS independent of the site of origin. Adjuvant chemotherapy for early-stage disease remains controversial as multiple clinical trials have failed to demonstrate benefit on overall survival. Progress has been made in therapy for advanced and recurrent disease. This case study will highlight the current and emerging data regarding novel therapies for women with uLMS., Competing Interests: The authors have no conflicts of interest to disclose., (© 2022 Harborside™.)

Background: Increased collagen expression and deposition are associated with cancer progression and poor prognosis in breast cancer patients. However, function and regulation of membrane-associated collagen in breast cancer have not been determined. Collagen XIII is a type II transmembrane protein within the collagen superfamily. Experiments in tissue culture and knockout mouse models show that collagen XIII is involved in cell adhesion and differentiation of certain cell types. In the present study, we determined roles of collagen XIII in breast cancer progression and metastasis., Methods: We analyzed the association of collagen XIII expression with breast cancer development and metastasis using published gene expression profiles generated from human breast cancer tissues. Utilizing gain- and loss- of function approaches and 3D culture assays, we investigated roles of collagen XIII in regulating invasive tumor growth. Using the tumorsphere/mammosphere formation assay and the detachment cell culture assay, we determined whether collagen XIII enhances cancer cell stemness and induces anoikis resistance. We also inhibited collagen XIII signaling with β1 integrin function-blocking antibody. Finally, using the lung colonization assay and the orthotopic mammary tumor model, we investigated roles of collagen XIII in regulating breast cancer colonization and metastasis. Cox proportional hazard (log-rank) test, two-sided Student's t-test (two groups) and one-way ANOVA (three or more groups) analyses were used in this study., Results: Collagen XIII expression is significantly higher in human breast cancer tissue compared with normal mammary gland. Increased collagen XIII mRNA levels in breast cancer tissue correlated with short distant recurrence free survival. We showed that collagen XIII expression promoted invasive tumor growth in 3D culture, enhanced cancer cell stemness, and induced anoikis resistance. Collagen XIII expression induced β1 integrin activation. Blocking β1 integrin activation significantly reduced collagen XIII-induced invasion and mammosphere formation. Importantly, silencing collagen XIII in MDA-MB-231 cells reduced lung colonization and metastasis., Conclusions: Our results demonstrate a novel function of collagen XIII in promoting cancer metastasis, cell invasion, and anoikis resistance.

Background: Standard BRCA genetic testing criteria include young age of diagnosis, family history, and Jewish ancestry. The purpose of this study was to assess the effect of these criteria on BRCA test utilization in breast cancer patients., Methods: Breast cancer patients aged 18 to 64 years living in Pennsylvania in 2007 completed a survey on family history of breast and ovarian cancer and BRCA testing (N = 2,213). Multivariate logistic regression was used to estimate odds of BRCA testing by patient characteristics, and predicted probabilities of testing were calculated for several clinical scenarios., Results: Young age at diagnosis (<50 years) was strongly associated with BRCA testing, with women diagnosed before age 50 years having nearly five times the odds of receiving BRCA testing compared to women diagnosed at age 50 or older (OR = 4.81; 95% CI, 3.85-6.00; P < 0.001). Despite a similar BRCA mutation prevalence estimate (8-10%), a young Jewish patient <50 years with no family history had markedly higher predicted probability of testing (63%) compared with an older, non-Jewish breast cancer patient with more than one first-degree relative (43%)., Conclusion: Age at diagnosis, Jewish ancestry, and both maternal and paternal family history are strongly predictive of BRCA testing. However, among women diagnosed at age 50 or older, family history may be an underused criterion that may benefit from targeted intervention., Impact: Robust methods specific to ascertaining detailed family history, such as through electronic medical records, are needed to accurately identify patients for BRCA testing.

Introduction and Aims: To describe needle and syringe distribution trends of needle and syringe programs (NSP) between 1990 and 2009 in Western Australia, and explore contributing factors within the national and state strategic and legislative environment., Design and Methods: The number of needles and syringes distributed by each of the four NSP types [needle and syringe exchange program (NSEP); health service; pharmacy; vending machine] between 1990 and 2009 were stratified by time period and geographic location using Microsoft Excel., Results: Total needle and syringe distribution over the 20-year period increased by eight-fold. Regional areas experienced the highest growth: 20-fold increase compared with seven-fold increase in metropolitan areas. The proportion of needles and syringes distributed through NSEPs increased from 33% to 62% between 1990 and 2009, and through health services increased from 3% to 8% between 1994 and 2009. The proportion distributed through pharmacies decreased from 67% to 28% between 1990 and 2009, and through vending machines from 7% to 1.3% between 1992 and 2009. National and state HIV and hepatitis C strategies guided NSP provision at an early stage, and expedited legislative amendments to allow for the operation of approved NSPs., Discussion and Conclusions: The majority of growth occurred through the NSEPs and health service NSPs, which are publicly funded NSPs and provide injecting equipment either on 'exchange' or free-of-charge respectively. The Health Department of Western Australia recognises the increasing reliance on publicly funded NSPs and the need to continue this cost-effective public health program., (© 2012 Australasian Professional Society on Alcohol and other Drugs.)

The term CTD has been used to refer to those musculoskeletal impairments that appear to be work-related and tend to be chronic. Upper extremity CTD are categorized in three major groups: tendon disorders, neurovascular disorders, and nerve. Kienböck's disease, on the other hand, has been documented in the workplace and has a similar etiology, but due to current anatomic classifications cannot be considered a CTD. With this in mind, the present article reviews risk factors, diagnosis, and treatment, with the purpose of providing physicians, engineers, and designers with information to reduce the risk of workers developing this potentially debilitating disease. Furthermore, additional support will be accumulated and combined with Part I of this article with the intent of introducing into the literature a new category of upper extremity CTD: Bone Disorders.

Cumulative trauma disorders (CTD) pose a major industrial problem in terms of increased medical costs, lost productivity and degraded worker health and safety. From an anatomical view, CTD's are classified into three major categories: tendon disorders, neurovascular disorders and nerve disorders. Up until recently these categories seemed to cover CTD of the upper extremity, however, Kienböck's disease, a typically less common disease and one that does not fit into the established CTD categories, has been observed to exhibit CTD characteristics and does appear in the manufacturing environment. The most common types of employment observed to exhibit individuals with this disease are carpentry, jobs involving the use of pneumatic tools (wrench), spot welders, sheet metal work, farmers and factory workers. The present article makes a critical examination of the relevant anatomy and etiologic aspects of this disease.

This paper presents a study on a combination lift and lower manual handling task and was designed to simulate the loading of grocery bags into a car trunk. Twelve male subjects performed an externally paced task of lifting grocery bags loaded with weights from 15 cm above the floor and over a wooden sill. There were two different sill heights of 70 cm and 90 cm, and for each of these heights there were two frequencies of 3 and 6 lifts per cycle. The dependent variables were maximum acceptable weight of lift (MAWOL). A unique lifting sequence and a modified version of the psychophysical methodology were used to determine MAWOL. There was a significant difference in the MAWOL across the two sill heights as well as the MAWOL at the two different frequencies. Plastic bags were determined to increase the average load lifted by 27% as compared to paper bags. At normal grocery bag weights, the increased load carrying capacity represents an increase in the safety factor. Not only can the risk of lower back injuries be decreased by using plastic bags with handles but the risk of developing a cumulative trauma disorder could also be decreased.

The desirable attributes of a computer-based diagnostic aid are proposed. These include ease of use, ready accessibility, sound reasoning, completeness, the ability to justify its recommendations, and a system for updating. These principles are illustrated by examples from the authors' diagnostic system (PROVIDES).PROVIDES is a computer-aided diagnosis and medical information system designed for in-office use on a wide variety of microcomputers using the MS-DOS or PC-DOS operating systems. It is organized by the clinical problems frequently encountered in practice. Relevant historical, physical, and routine laboratory findings are collected through a series of menus. These findings are used to generate a ranked differential diagnostic list. Up-to-date information on diagnostic tests, recommended treatments, and expected outcomes is available for each suggested disease.