Secondary malignancy after urologic reconstruction procedures: a multi-institutional case series.

Urinary diversion and reconstructive urologic procedures are most often performed by incorporating various intestinal segments into the urinary tract. Although the risk of malignancy, among other complications, is well recognized and occurs most frequently after ureterosigmoidostomies and cystoplasties, data on the histopathologic and immunohistochemical characteristics of these tumors are scant. This study aims to evaluate the clinicopathological features of secondary tumors arising after urologic reconstruction procedures. Eleven cases were identified among five collaborating academic institutions. The average age was 51.7 years, and the M:F ratio was 8:3. Surgical procedures included 7 ileal conduits, 2 gastrocystoplasties, 1 augmentation cystoplasty not otherwise specified (NOS), and 1 Indiana pouch. Median time from reconstruction to malignancy was 36 years. Malignancy included adenocarcinoma in 10 patients (intestinal type in 6, gastric in 2, signet-ring cell in 1, undetermined type after neoadjuvant treatment in 1) and squamous cell carcinoma in 1. By immunohistochemistry, the adenocarcinomas were CK7 (45%), CK20 (89%), CK903 (78%), CDX2 (89%), SATB2 (67%), and beta-catenin (100%) positive. GATA-3 was negative in all cases. Pathologic stage was T1 (30%), T2 (40%), T3 (20%), and T4 (10%). Regional lymph node and distant metastasis were present in 60% and 20%, respectively. Treatment included multimodality therapy in most patients. On follow-up (mean, 27.4 months), 2 patients were dead (1 of disease), 3 were alive with disease, 4 were alive without disease, and 2 were lost to follow-up. Secondary malignancy arising within urologic reconstruction is rare, most frequently has adenocarcinoma morphology, presents late, and behaves aggressively.

What parents know and want to learn about healthy eating and body image in preschool children: a triangulated qualitative study with parents and Early Childhood Professionals.

BACKGROUND: Interventions for parents to encourage healthy eating in children often do not address parental feeding practices and body image development. METHODS: The current study investigated what parents (of children aged 1-6 years) understand about child healthy eating and body image, and what they would like in future interventions, by using structured focus groups with parents, and individual interviews with Early Childhood Professionals. Forty three parents (M(age) = 36.95 years, 93% female, 79% university degree) participated across 9 focus groups. Eleven Early Childhood Professionals (M(age) = 51.04, 100% female, 64% university degree, 64% Maternal and Child Health Nurses, 36% Childcare Centre Directors) completed individual telephone interviews. RESULTS: Parents described healthy eating as a variety, balance, and range of foods as well as limiting certain foods, such as the intake of sugar, salt, and processed foods. Most often parents defined child body image as a child's physical appearance and did not mention thoughts and feelings related to appearance or body experiences. Body image was most commonly considered a problem in early adolescence and often not an issue of relevance in early childhood. Parents appeared knowledgeable about nutrition and accessed information about healthy eating across a range of resources though rarely accessed information about child body image. They desired more practical information about how to avoid encouraging negative body image when promoting healthy eating. Professionals' responses confirmed these findings. CONCLUSIONS: Results suggest future interventions need to stress the important role positive body image plays in encouraging healthy attitudes to food and weight management, and the benefits positive body image can have on the health and mental health of preschool children.

Parents and prevention: a systematic review of interventions involving parents that aim to prevent body dissatisfaction or eating disorders.

OBJECTIVE: To systematically review the literature on interventions involving parents that aim to prevent body dissatisfaction or eating disorders in children, and provide directions for future research by highlighting current gaps. METHOD: The literature was searched for articles using key concepts: parents, prevention and eating disorders or disordered eating or body dissatisfaction. All English language publications between 1992 and 2013 were searched across a range of academic databases. Studies were reviewed if they: (i) delivered an intervention designed to reduce eating disorders or body dissatisfaction or their risk factors, in children or adolescents; (ii) provided some intervention component for parents; and (iii) included some outcome measure of intervention effectiveness on disordered eating or body dissatisfaction. A scoring matrix based on the Critical Appraisal Skills Program (CASP) screening questions was used to assess each study's sample representativeness, relevance and data quality. RESULTS: From 647 novel records uncovered by the search, 20 separate studies met inclusion criteria. The CASP scoring matrix revealed eight studies provided no relevant data, four relevant and eight highly relevant data on the effects of involving parents in prevention programs. Two of four high-quality studies reported that parental involvement significantly improved child outcomes on measures of body dissatisfaction or disordered eating. DISCUSSION: Although a greater focus on engaging and retaining parents is needed, this review demonstrates that a small number of prevention studies with parents have led to significant reductions in risk of body image and eating problems, and future research is indicated.