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The geographic dispersion of the U.S. immigrant population has occurred alongside a dramatic increase in state-level immigration laws that has unfolded unevenly across states, creating markedly different state immigrant policy climates. Although not all such laws are health-related, they have potential implications for immigrants' health care utilization. Using data from the 2014 Survey of Income and Program Participation, we leverage the geographic variation in the restrictiveness of state immigrant policy climates to examine the association between state-level immigrant policies and health provider visits-a fundamental indicator of health care utilization-among immigrant adults. Results indicate that restrictive immigrant policy climates exacerbate nativity gaps in health provider visits among working-age adults and, to a lesser extent, among older adults. Our findings suggest that even immigrant policies not directly related to health have consequences for immigrants' health care utilization. © 2020 The Authors.Pelvic circumferential compression devices (PCCDs) have gained wide acceptance in the management of patients with pelvic fracture. These devices are considered safe due to their noninvasive nature and significant hazards associated with the use of PCCDs have not been reported previously. However, we present herein the cases of three patients who received PCCD application and eventually developed major complications presumably caused by PCCDs. Tanespimycin As a result, one patient developed surgical site infection following internal fixation and required several debridements. Another patient ended up with a walking disability. The remaining patient eventually died from exsanguination following application of the PCCD. Clinicians should be aware of the potential for deleterious effects, including bladder rupture, muscle necrosis, and vessel injuries. In particular, application for acetabular fractures and prolonged application of PCCDs should be avoided. © 2020 The Authors.Osteoporotic patients being treated with bisphosphonates present an interesting dilemma when removing hardware such as dynamic hip screws "DHS". In this paper, we describe the case of a 66-year-old osteoporotic patient who was placed on long term bisphosphonate therapy after sustaining an intertrochanteric hip fracture which was stabilized with a DHS. She presented with a subtrochantric fracture on the ipsilateral side. She was planned for DHS removal and intramedullary nailing. Removal of the dynamic hip screw proved to be difficult, likely due to possible cold welding of the DHS to the barrel of the side plate and sclerotic bone formation around the hardware secondary to the extended bisphosphonate use. The patient had an intra-operative femoral neck fracture while attempting the DHS removal. We had to convert to an unanticipated total hip replacement. Careful considerations should be taken when removing hardware from patients on long term bisphosphonate treatment. © 2020 Published by Elsevier Ltd.We report an 85-year-old patient with severe osteoporosis who had suffered from multiple episodes of periprosthetic fracture of the femur. Revision fixation with long-spanning cable plate for bisphosphonate-induced atypical periprosthetic femoral fracture was performed. Nonunion and implant failure occurred at 16 months requiring revision surgery using long-stem femoral prosthesis with cable-plate fixation. To further facilitate bone healing, allograft and bone morphogenetic protein (BMP) were added. Eventually bone union was achieved after one year. © 2020 The Author(s).Large cystic ovarian tumors usually require surgical removal because of symptoms and the possibility of malignancy. The ideal surgical approach would minimize the risk of spillage of tumor contents while minimizing surgical morbidity. The present study aims to demonstrate a novel technique to drain large cystic ovarian tumors without spillage. A mini-laparotomy is performed and the tumor surface is exposed. Dermabond Advanced™ (USA Medical and Surgical Supplies 2019a) is applied to the tumor and a surgical glove (USA Medical and Surgical Supplies 2019b) is applied to the glue area. A small incision is made in the center of the portion of the glove that is adherent to the tumor. The cyst fluid is allowed to drain into the glove where it is suctioned away, collapsing the tumor. Once the tumor is sufficiently decompressed, it is exteriorized and resected with the glove still attached. The technique was initially developed in a pig model and subsequently successfully performed by mini-laparotomy on two patients with >20 cm ovarian masses. This novel technique uses inexpensive and readily available materials for draining large cystic ovarian tumors without spillage so that they can be removed via mini-laparotomy. © 2020 The Authors.Cervical Mullerian adenosarcoma is a tumor that affects reproductively aged women.•Hysterectomy had been the standard of care for these premenopausal women.•This case reports the most minimally invasive approach with no recurrence.•Accurate pathology interpretation is essential to diagnose and treat patients.•This is a rare tumor that if misdiagnosed or mischaracterized could be lethal. © 2019 Published by Elsevier Inc.Introduction Activating mutations in the tyrosine kinase domain of the epidermal growth factor receptor (EGFR) gene in non-small cell lung cancer (NSCLC) patients predicts response to EGFR tyrosine kinase inhibitors (TKIs). The Idylla™ system (Biocartis, Mechelen, Belgium) is a fully integrated, cartridge-based platform that provides automated sample processing and real-time PCR-based mutation detection in a single-use cartridge. This study evaluated the Idylla™ EGFR Mutation Assay cartridges against next-generation sequencing (NGS) using formalin fixed, paraffin embedded (FFPE) lung cancer tissue samples. Methods Thirty-four FFPE lung adenocarcinoma tissue samples were tested on the Idylla™ system. 21 had at least one mutation in EGFR and 13 had no EGFR mutation as determined by NGS analysis using the Ion AmpliSeq 50-gene Cancer Hotspot Panel v2 (Thermo Fisher Scientific). One 10 μm FFPE tissue section was used for each Idylla™ test and all cases met the Idylla™ minimum tumor content requirement (≥10%). Results Idylla™ results were in complete agreement with those obtained by NGS for EGFR mutations targeted by the Idylla™.
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