Background Cutaneous squamous cell carcinoma (cSCC) causes more annual mortality than metastatic melanoma. However, risk stratification protocols remain based solely on clinicopathologic features, excluding tumor biology. (Table 1) Objective To illustrate how integration of 40-gene expression profile (GEP) testing influences prognostic assessment and post-treatment management in high-risk cSCC. Methods We present a case report of a 70-year-old male whose incidental cSCC was reclassified as high-risk following 40-GEP testing despite histologic clearance, resulting in enhanced surveillance. Results Tumor profiling yielded a Class 2A (higher risk) result, which altered post-operative follow-up strategies beyond conventional staging. Conclusion Gene expression profiling provides valuable, individualized prognostic data, which may improve management of high-risk cSCC patients and should be considered for broader integration into clinical guidelines.
Purpose: Past research highlights the different facilitators and barriers that caregivers of children on the autism spectrum experience during the transition to kindergarten and when navigating special education services. Caregivers who identify as Hispanic and/or Latine may face distinct challenges during this process, such as language differences, differences in understanding autism and special education, and barriers to advocating for their child. Hispanic and Latine caregivers also have strengths, resources, and strategies (i.e. cultural capital) that they use during this time. However, there is little research aimed at understanding the unique experiences of Hispanic and Latine caregivers of autistic children during their entry to kindergarten. Methods: To address this shortcoming, the current study used qualitative methods and thematic analysis to explore the transition to kindergarten experiences of four caregivers of autistic children. Results: This study identified strengths, supportive practices, and challenges that participants experienced fell under four major themes: importance of proactive and ongoing partnerships between caregivers and schools, navigating unfamiliar language and processes, the need for dissemination of information about autism to teachers and support from trusted systems. Themes highlighted challenges such as communication differences, unfamiliar school processes, community and teacher misconceptions about autism. Facilitators the transition included proactive communication, shared goals and partnerships with school. Yosso’s Community Cultural Wealth Framework is integrated into the discussion of themes and the forms of cultural capital participants used to support their child. Conclusion: Recommendations for practice and research to support Hispanic and Latine autistic children during the kindergarten transition are provided.
There is a growing recognition that Social Determinants of Health (SDoH) can inform some sources of physical and mental health disparities among the Latinx population. The current study sought to expand previous research by exploring the singular and interactive influence of financial strain and subjective social status—two common and clinically important SDoH factors—on pain intensity, pain disability, general depression, social anxiety, and anxious arousal. The current sample consisted of 155 Latinx adults (81.3
The Latinx population is the largest minority group in the United States (U.S.) and is expected to continue to grow through at least 2050. Although there is growing recognition of the importance of pain among Latinx individuals, few studies have examined individualized psychological processes governing pain severity and disability in Latinx populations. One psychological factor that has shown promise in relation to pain experience specifically and clinical conditions more generally is anxiety sensitivity. The present investigation sought to (1) characterize the severity of pain among an unselected sample of adult Latinx individuals attending a Federally Qualified Health Center (FQHC); (2) evaluate the severity of anxiety sensitivity as a function of pain severity; and (3) test the potential explanatory relevance of anxiety sensitivity as an individual difference factor for pain intensity, pain disability, psychological inflexibility for emotional distress, and global life impairment. Participants included 406 adult Spanish-speaking Latinx persons (87.2% female; M-age = 40.26 years, SD = 11.20, and 98.3% used Spanish as their first language) who attended an FQHC in Houston, Texas. Analyses revealed that 62.6% of the sample had at least some pain, and 21.9% of the same had high intensity, moderate interference, or severe interference chronic pain. Further, results provided evidence for anxiety sensitivity as a function of pain grade, such that individuals with grade 2 (high-intensity pain), grade 3 (moderate pain interference), and grade 4 (severe pain interference) chronic pain reported significantly higher levels of anxiety sensitivity than those with grade 0 pain (no chronic pain). Additionally, after controlling for age, gender, marital status, years of education, years living in the U.S., and generalized anxiety, anxiety sensitivity significantly accounted for significant variance in pain intensity, inflexibility in relation to emotional distress, and life impairment. Overall, the current study builds upon what is currently understood about anxiety sensitivity among the Latinx population and uniquely extends past work by linking individual differences in this construct to clinically relevant aspects of pain experience and life impairment among adults attending FQHC's. Additional clinical attention should be focused on anxiety sensitivity to offset pain disparities among this established health disparities group.
Objectives: Numerous studies have shown that links exist between exposure to acid suppression among adults and nutritional deficiencies, especially vitamin B12 and iron. While the use of acid suppression among children and infants is common, nutritional deficiency remains a concern but does not have numerous studies to support it. We conducted a cohort study to examine this concern; the hypothesis we proposed is that acid-suppressive therapy (AST) during infancy is linked to anemia in the first year of life. Methods: This retrospective cohort study included infants born between 2017 and 2018 who visited Legacy Community Health. The inclusion criteria were exposure to acid suppression for a minimum of 1 month and a hemoglobin reading at 12–15 months. Infants who had hemoglobinopathies, failure to thrive, or malabsorption syndromes were excluded. Mean hemoglobin was calculated, and student’s t -test was applied to find statistical differences between the two groups. Change in weight before and after treatment was recorded. Occurrence of respiratory and gastroenterological adverse events was recorded in the exposed group. Results: Overall, 135 exposed infants were identified 135 controls were selected. The majority of the sample included Hispanic girls. Ranitidine was the most commonly prescribed medicine. The duration of treatment was 3 months. Weight improved significantly at termination of the treatment. There was no significant difference between the hemoglobin level of cases and controls, and both were not considered anemic. Conclusion: AST was not linked to anemia, despite the slightly lower hemoglobin in some cases. There were few weaknesses in our study; therefore, further studies can examine this link by focusing further on medication type and close follow-up. We found that although proton pump inhibitors are considered the first line of treatment, histamine-2 receptor antagonists were more frequently prescribed. Strategies to familiarize general pediatricians with the NSAPGHAN guidelines might be needed.
