Assess Vitamin A (VitA)/carotenoid status of university students and describe associations with diet quality measures and BMI.

Multi-system inflammatory syndrome is a rare yet serious complication of COVID-19 infection and can affect multiple organ systems including cardiovascular manifestations.

The delivery of health care to seafarers is described Maritime medicine refers to providing medical care for seafarers1 including the people working in the merchant marine, the commercial fishing fleets, offshore oil platforms, and the cruise ship industry, the segment best known to most of us. It also includes provision of care through shore based pre-employment and seafarer consultation clinics. These various maritime medical practices present very different alternatives to the clinics, emergency rooms, and hospital environments where most of us practice. They may provide a working vacation (often emphasis on “work”), a few months sabbatical, or a career. Practicing medicine at sea incorporates many aspects of “wilderness medicine.” Dr Warren Bowman’s editorial in Wilderness Medicine ,2 “Perspectives on being a wilderness physician” describes wilderness medicine as medical care delivery in situations where “definitive medical care may be hours or days away because of distance, adverse environmental conditions, lack of transportation, or difficulties in communication.” This definition applies to work in parks, forests, and other designated wilderness areas, but is equally applicable in other environments including Antarctic research stations, remote clinics in developed countries, healthcare facilities in many “third world” countries, rural or urban locales after natural disasters, and in most of the cruise industry. Cruise medicine provides the challenges and rewards of practicing medicine in a resource limited environment while providing the opportunity to travel to interesting, sometimes very remote, places and to meet people also intrigued by international travel …

Headaches are common in adolescents, and often interfere with their daily lives. Although increased family problems have been reported in adolescents with headaches, limited research has been conducted to link family factors to functional outcomes such as disability. This has hindered the development and testing of family-based interventions for chronic headaches. The aims of this pilot study are to: 1) examine the relationship between family factors and headache-related disability, 2) evaluate whether depressive symptoms mediate the relationship between family factors and functional disability, and 3) test the validity of an observational assessment of parent-adolescent interactions. A sample of 30 adolescents, ages 11 to 16 years, (mean age = 13.3 years, 66% female) receiving treatment through pediatric neurology for recurrent headaches have been enrolled. Adolescents and their parents completed measures of pain, functional disability, depressive symptoms, and family functioning (i.e., McMaster Family Assessment Device). Videotaped parent-teen interactions are currently being completed to assess expressions of autonomy and warmth in their relationship. Correlational analyses show moderate relationships between family factors and functional disability. Specifically, poor affective responsiveness (r = .41, p < .05) and poor general functioning (r = .42, p < .05) are associated with increased functional disability. Moreover, increased depressive symptoms are linked to increased family dysfunction (r = .49, p < .01). Mediational tests are significant for the total effect (family functioning to disability) and indirect effects (family functioning to depression and depression to disability). However statistical tests for mediation using Sobel's equation are not significant, indicating that depression may not be the primary mechanism by which family functioning affects adolescent disability. Preliminary findings suggest that family factors and depression are strongly linked to headache-related disability in adolescents. Further analyses will examine parent-teen interactions to determine the effect of autonomy and intimacy in family interactions on adolescent functional disability.

Background. The purpose of this report is to analyze preoperative and perioperative factors affecting operative mortality and cardiopulmonary morbidity after a completion pneumonectomy.Methods. We retrospectively reviewed all patients who underwent completion pneumonectomy from January 1985 through September 1998 at the Mayo Clinic in Rochester, MN. Factors affecting operative mortality and postoperative morbidity and were analyzed using univariate and multivariate analysis.Results. There were 115 patients (73 men and 42 women), with a median age of 64 years (range, 12 to 83 years). Indication for pneumonectomy was benign disease in 57 patients (49.6%), lung cancer in 51 (44.3%) and metastatic disease in 7 (6.1%). There were 24 deaths (mortality 20.9%, 95% CI 13.9% to 29.4%). Mortality for patients undergoing completion pneumonectomy for benign disease, lung cancer, and metastatic cancer was 26.3%,17.6%, and 0%, respectively (p = 0.24). Factors adversely affecting mortality with univariate analysis included advanced age (p = 0.004), preoperative corticosteriod use (p = 0.01), decreased preoperative diffusion capacity of lung to carbon monoxide (P = 0.01), intraoperative blood transfusion (P = 0.04), and excessive crystalloid infusion within the first 12 hours (P = 0.01) and 24 hours (0.03) postoperatively, respectively. Factors adversely affecting mortality with multivariate analysis included advanced age (p = 0.001), preoperative corticosteriod use (p = 0.002), and low preoperative hemoglobin (p = 0.02). Cardiopulmonary complications occurred in 72 patients (63.7%). Factors adversely affecting morbidity with univariate analysis included benign disease (p = 0.002), decreased preoperative diffusion capacity of lung to carbon monoxide (p = 0.04), bronchial stump reinforcement (p = 0.0001), and excessive crystalloid infusion within the first 12 hours (P = 0.006) and 24 hours (P = 0.02) postoperatively, respectively. Factors adversely affecting morbidity with multivariate analysis included advanced age (p = 0.005) and bronchial stump reinforcement (p = 0.001).Conclusions. Multiple factors adversely affect operative mortality and cardiopulmonary morbidity after completion pneumonectomy. Although completion pneumonectomy remains a high-risk procedure, especially for benign disease, it still should be considered a treatment option in selected patients. (C) 2002 by The Society of Thoracic Surgeons.

Background. This study was designed to determine the prognostic value of immunohistochemical tumor marker expression in a population of patients with node-negative esophageal cancer treated with complete resection alone.Methods. Resection specimens were collected from 61 patients with node-negative T1 (n = 31), T2 (n = 14), and T3 (n = 16) esophageal cancer. A panel of 10 tumor markers was chosen for immunohistochemical analysis, based on associations with differing oncologic mechanisms: apoptosis (p53), growth regulation (transforming growth factor-alpha, epidermal growth factor receptor, and Her2-neu), angiogenesis (factor VIII), metastatic potential (CD44), platinum resistance (p-glycoprotein and metallothionein), 5-fluorouracil resistance (thymidylate synthetase), and carcinogenic detoxification (glutathione S-transferase-pi).Results. Complete resection was performed in all patients (44 adenocarcinoma, 17 squamous cell carcinoma), with no operative deaths. Multivariable analysis demonstrated a significant relationship between cancer-specific death and the following variables: low-level P-gp expression (p = 0.004), high-level expression of p53 (p = 0.04), and low-level expression of transforming growth factor-alpha (P = 0.03). In addition, the number of involved tumor markers present was strongly predictive of negative outcome (p = 0.0001).Conclusions. This study supports the prognostic value of immunohistochemical tumor markers, specifically the expression pattern of P-gp, p53, and transforming growth factor-alpha, in patients with esophageal carcinoma treated with complete resection alone. (C) 2001 by The Society of Thoracic Surgeons.

Background. Esophageal cancer patients with M1a disease are reported to have poor survival. We hypothesized that patients with celiac lymph node metastases (CLN) identified by endoscopic ultrasonography (EUS) would predict a cohort with significantly worse survival postoperatively. Accurate preoperative identification of this group will facilitate future adjuvant studies.

Kim, E. E.; Korkmaz, M.; Wong, F.; Podoloff, D.; Wong, W-H; Tilbury, R. S.; Haynie, T. P.; Lee, J.; Putnam, J. Author Information

Flourishing relationships are at the core of teachers' work and effective pedagogy. This paper presents an exploratory case study of 59 secondary schoolteachers to investigate the role that gratitude may have in enhancing teacher–student relationships. Although the potential of gratitude has been gaining international attention in the areas of positive and social psychology, there have only been a few studies on the effect of teachers' gratitude. The paper presents a conceptual framework that postulates the meaning and significance of gratitude in this context and then describes a qualitative case study. Results indicate that gratitude impacted positively on the teachers, classroom and school environment.

A study of the effect of continuous light on the weight of the pineal organ in rats following gonadectomy, hypophysectomy or adrenalectomy, and in animals fed thiouracil, was undertaken in an effort to determine whether or not the reduction in pineal weight induced by light is hormone-dependent. Immediately after the removal of their gonads, adrenals or pituitaries, or with the institution of a thiouracil diet, 307 22-day-old male and/or female rats of the Sprague-Dawley strain were placed in continuous light or under usual day-night conditions. Nine to 10 weeks later, body and pineal weights were taken, as well as thyroid weights in the thiouracil series. The weight of the pineal body was found to be reduced significantly in all animals housed in continuous light, indicating that this change is mediated through the central nervous system and is not dependent upon secretions of the pituitary, the gonads, the adrenals or the thyroid. A slight increase in the pineal weight of gonadectomized animals under usual day-night conditions and an equal hypertrophy of the thyroid in rats fed thiouracil, irrespective of their exposure to light, were also observed. The response of the pineal organ to gonadectomy suggests that a negative feedback system exists between the pituitary and the pineal. The similarity in the degree of thyroid hypertrophy in thiouracil-fed animals reflects an equal release of the thyroid-stimulating hormone in rats exposed to continuous light or housed under usual laboratory conditions.