ABSTRACT
Dermatofibrosarcoma protuberans (DFSP) is an uncommon soft tissue tumor characterized by a relatively high risk of local recurrence and low risk of metastasis. The NCCN Guidelines for DFSP provide multidisciplinary recommendations on the management of patients with this rare disease. These NCCN Guidelines Insights highlight the addition of the Principles of Pathology section, which provides recommendations on the pathologic assessment of DFSP. Because DFSP can mimic other lesions, immunohistochemical studies are often required to establish diagnosis. Cytogenetic testing for the characteristic translocation t(17;22)(q22;q13) can also be valuable in the differential diagnosis of DFSP with other histologically similar tumors.
Subject(s)
Dermatofibrosarcoma/genetics , Diagnosis, Differential , Neoplasm Recurrence, Local/genetics , Skin Neoplasms/genetics , Biomarkers, Tumor , Dermatofibrosarcoma/diagnosis , Dermatofibrosarcoma/pathology , Humans , Neoplasm Metastasis , Neoplasm Recurrence, Local/diagnosis , Neoplasm Recurrence, Local/pathology , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Translocation, GeneticABSTRACT
BACKGROUND: Migrant farm workers are exposed to job hazards in Tennessee, which is among the top five tomato-producing states. OBJECTIVES: This project sought to cultivate and evaluate a partnership to marshal greater resources to address migrants' concerns and to better prepare future health professionals to address occupational issues. METHODS: In the spring of 2008, an interprofessional student-faculty team at a regional university catalyzed a partnership with a clinic for migrants and a national network caring for the itinerant underserved. RESULTS: Several community-based participatory research (CBPR) activities are underway. The partnership has resulted in the following projects: Use of the Rapid Entire Body Assessment (REBA) method to identify job tasks likely to be injurious, development and use of a health screening questionnaire to capture more information about occupational health, and continuing education seminars for providers and a case-based curriculum module for third-year medical students. CONCLUSIONS: Interprofessional service learning about migrant occupational health issues may have its greatest impact as participating students enter the regional workforce, caring for patients employed in slow-to-change agricultural operations.
Subject(s)
Agricultural Workers' Diseases/ethnology , Agricultural Workers' Diseases/prevention & control , Community Health Services/organization & administration , Interinstitutional Relations , Transients and Migrants , Universities/organization & administration , Adolescent , Adult , Aged , Appalachian Region , Community-Based Participatory Research , Education, Medical, Continuing/organization & administration , Female , Hispanic or Latino , Humans , Male , Medically Underserved Area , Middle Aged , Occupational Exposure/prevention & control , Occupational Health , Risk Factors , Tennessee , Young AdultABSTRACT
The purpose of this article was to study an infant who suffered from asphyxia undergoing induced hypothermia with regard to (1) describe the pain and stress as measured by physiological variables skin conductance algesimeter (SCA) and pain rating scales, (2) the correlation between SCA and pain rating scales, and (3) how temperature cycles in the cooling blanket affect the response of the sympathetic nervous system as measured by the SCA and physiological variables. A single prospective case study was used for this article. Data were recorded every 15 minutes for 96 hours. Each observation was categorized according to treatment phase: cooling 0 to 72 hours, rewarming, and controlled normal temperature up to 96 hours. Structured observations were carried out and all nursing care was documented. In addition, 5 periods with no other nursing interventions were identified in which data were recorded every minute for analysis. Skin conductance algimetry showed a variable response during treatment. During cooling, 68% of the 15-minute periods, signs of stress and pain were recorded. During rewarming, the corresponding figure was 83%. During the time sequences with normal temperature, 89% of the periods were associated with stress and pain. During 80% of the nursing procedures, the SCA showed stress and pain. There was no correlation between the pain-rating scales and SCA. When the cooling blanket temperature was lower than core temperature, the infant had more stress and pain according to SCA (P < .001) and an increase in heart rate and blood pressure (P < .001). In infants during induced hypothermia, SCA seem to detect pain and stress. Future evaluation of SCA for the detection of pain and stress during hypothermia treatment is necessary. Pain-rating scales do not appear reliable in this case report.
Subject(s)
Asphyxia Neonatorum/therapy , Hypothermia, Induced/methods , Pain/physiopathology , Stress, Physiological , Asphyxia Neonatorum/diagnosis , Blood Pressure Determination , Body Temperature , Follow-Up Studies , Galvanic Skin Response/physiology , Heart Rate/physiology , Humans , Infant Behavior/physiology , Infant, Newborn , Male , Monitoring, Physiologic/methods , Pain Measurement , Risk Assessment , Term BirthABSTRACT
The present study was designed to evaluate the clinical utility of the Spinal Function Sort (SFS), in a group of postoperative and nonoperative low back pain patients who completed a functional restoration program. The SFS was administered to 38 spinal pain patients (16 nonoperative and 21 postoperative), before and after completing a functional restoration program. Results revealed that the SFS detected a significant improvement in Ratings of Perceived Capacity scores, and that the postoperative patients appeared to improve more than nonoperative patients. These findings demonstrate the clinical utility of the SFS as an effective assessment tool of functional capacity in both postoperative and nonoperative spinal disorder patients. It provides a time-efficient method for evaluating a patient's functional status.
