Early Detection of Undiagnosed Hypertension Based on Occupational Screening in the Hotel and Restaurant Industry

Blood pressure is the most important, modifiable risk factor for cardiovascular diseases. Lifestyle factors and also workload are the main, potential risk factors for the development of hypertension. This study focused on the early detection of unknown hypertension by screening employees in the hotel and restaurant industry (HRI). 148 HRI employees without hypertension (mean age: 34 years, men: 45%) self-measured their blood pressure during rest and for 24 hours of a normal workday. Individuals with a resting blood pressure ≥ 135/85 mmHg were classified as hypertensive. A further analysis investigated whether the currently applicable thresholds for hypertension during work, leisure, and sleep were exceeded on a working day. At rest, 36% of the study participants suffered from hypertension, which increased to 70% under workload and 46% during leisure time and dropped to 8% during sleep. Normal nocturnal dipping (10–20%) occurred only in 18% of cases; 78% were extreme dippers (>20%). Occupational hypertension screening is a suitable component of preventive healthcare. Resting blood pressure measurement alone is insufficient for the early detection of risk individuals and should be supplemented by 24-hour ambulatory blood pressure monitoring under working conditions. The impact of workload on blood pressure needs to be given more attention in the guidelines.

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Metastatic Renal Cell Carcinoma Presenting as a Solitary Gastric Polyp

A 77-year-old Caucasian man with a remote history of renal cell carcinoma status post nephrectomy 20 years ago underwent an esophagogastroduodenoscopy for persistent dyspepsia. The esophagogastroduodenoscopy showed a 10-mm friable pedunculated polyp in the gastric body (Figure A). Histopathology of the gastric polyp showed ulcerated mucosa containing large atypical cells with increased mitotic activity and abundant eosinophilic cytoplasm in the lamina propria (Figure B). These cells were positive for PAX8 (Figure C), with focal reactivity with CAM5.2 (Figure D) and OSCAR cytokeratin, consistent with metastatic renal cell carcinoma of the stomach.

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Magnetic resonance imaging assessment of the normal knee anterolateral ligament in children and adolescents

Abstract

Objective

To characterize the anterolateral ligament (ALL) in normal knees of pediatric patients by magnetic resonance imaging (MRI) and to establish the age at which it is possible to visualize its presence and whether there are differences between male and female populations.

Materials and methods

MRI scans of patients younger than 18 years were retrospectively evaluated. The exams were performed in 1.5-T scanners. The ALL was characterized dichotomously as visualized or not visualized based on the assessment criteria of this structure in adult patients. The characterization of the ALL was divided according to sex and age.

Results

A total of 363 knee MRI scans were evaluated, 200 from male and 163 from female patients. The ALL was more frequently visualized in coronal sequences. The mean ALL visualization in pediatric patients was 69.4% and was lower in younger patients and higher in patients close to 18 years. It was not possible to visualize the ALL in female patients younger than 7 years or in male patients younger than 6 years. In patients between 17 and 18 years of age, the ALL was visualized in 100% of cases in both sexes.

Conclusions

Visualization of the ALL increased with age in both sexes. Only after age 13 in females and age 15 in males was visualization of the ALL close to 70%; thus, below these ages, we believe that the characterization of this structure with conventional protocols is still imprecise.

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Comparison of thyroid transcription factor-1 expression by two monoclonal antibodies in schwannomas: the chosen clone matters

To the editor:

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High expression of synthesis of cytochrome c oxidase 2 and TP53-induced glycolysis and apoptosis regulator can predict poor prognosis in human lung adenocarcinoma

Synthesis of cytochrome c oxidase 2 (SCO2) and TP53-induced glycolysis and apoptosis regulator (TIGAR) are two p53-mediated proteins that can play a regulatory role in cancer energy metabolism. However, no study has examined the association of SCO2 and TIGAR with the prognosis of patients with lung adenocarcinoma (AC). In our study, the expression of SCO2 and TIGAR proteins in lung AC was detected, and the potential relation to prognosis was evaluated, aiming to take a further view of lung AC progression.

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Comparison of thyroid transcription factor-1 expression by two monoclonal antibodies in Scotchwoman: the chosen clone matters—reply

Dear Editor:

https://ift.tt/2GInI28

Genomic Profile of Appendiceal Goblet Cell Carcinoid Is Distinct Compared to Appendiceal Neuroendocrine Tumor and Conventional Adenocarcinoma

Goblet cell carcinoid (GCC) is a rare appendiceal tumor with unique morphologic features that shows glandular and neuroendocrine differentiation on immunohistochemistry. An additional component of adenocarcinoma (AC) can be present (GCC-AC). Both GCC and GCC-AC are staged and treated like AC. The histogenesis and genetic alterations underlying GCC and GCC-AC are unclear. Capture-based next-generation DNA sequencing targeting 479 cancer genes was performed on 19 appendiceal tumors: 4 GCC, 9 GCC-AC, 3 neuroendocrine tumors (NET), and 3AC (2 conventional, 1 mucinous).

https://ift.tt/2GF7PJy