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The female genital system is rarely affected in von ReckIinghausen neurofibromatosis. The vulva is the most frequent genital location, but vaginal, cervical, uterine, and ovarian neurofibromas have rarely been reported. We describe a case of plexiform neurofibroma affecting the uterine cervix in a patient with chronic pelvic pain and menorrhagia who had multiple cutaneous neurofibromas and 1 large paraspinal neurofibroma. A small plexiform neurofibroma, which was not grossly visible, was confined to the uterine cervix and coexisted with a uterine Ieiomyoma and adenomyosis. There were no neurofibromas in the myometrium, fallopian tubes, or ovaries. Plexiform neurofibroma is a neoplasm that should be considered in the differential diagnosis of spindle cell neoplasms of the uterine cervix, especially in specimens from patients with neurofibromatosis. [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa strain 10265 was recovered from a patient with pneumonia in a Chinese public hospital, and it displays the carbapenem resistance phenotype due to the acquisition of a nonconjugative but mobilizable IncP-6-type plasmid p10265-KPC. p10265-KPC carries a Tn5563-borne defective mer locus and a novel ΔISEc33-associated blaKPC-2 gene cluster without paired invert repeats and direct repeats at both ends. Mobilization of this ΔISEc33-associated element in p10265-KPC would attribute to homologous recombination-based insertion of a foreign structure Tn3-ISApu1-orf7-ISApu2- ISKpn27-ΔblaTEM-1-blaKPC-2-ΔISKpn6-korC-orf6-klcA-ΔrepB into a pre-existent intact ISEc33, making ISEc33 truncated at the 3' end. The previously reported pCOL-1 represents the first sequenced KPC-producing IncP-6 plasmid, while p10265-KPC is the second one. These two plasmids carry two distinct blaKPC-2 gene clusters, which are inserted into the different sites of the IncP-6 backbone and have different evolutionary histories of assembly and mobilization. This is also the first report of identification of the IncP-6-type resistance plasmid in China.

Dormancy inhibits seed and bud growth of perennial plants until the environmental conditions are optimal for survival. Previous studies indicated that certain co-regulation pathways exist in seed and bud dormancy. In our study, we found that seed and bud dormancy are similar to some extent but show different reactions to chemical treatments that induce breaking of dormancy. Whether the abscisic acid (ABA) regulatory networks are similar in dormant peach seeds and buds is not well known; however, ABA is generally believed to play a critical role in seed and bud dormancy. In peach, some genes putatively involved in ABA synthesis and catabolism were identified and their expression patterns were studied to learn more about ABA homeostasis and the possible crosstalk between bud dormancy and seed dormancy mechanisms. The analysis demonstrated that two 9-cis-epoxycarotenoid dioxygenase-encoding genes seem to be key in regulating ABA biosynthesis to induce seed and bud dormancy. Three CYP707As play an overlapping role in controlling ABA inactivation, resulting in dormancy-release. In addition, Transcript analysis of ABA metabolism-related genes was much similar demonstrated that ABA pathways was similar in the regulation of vegetative and flower bud dormancy, whereas, expression patterns of ABA metabolism-related genes were different in seed dormancy showed that ABA pathway maybe different in regulating seed dormancy in peach.

Living organisms are constantly subject to DNA damage from environmental sources. Due to the sessile nature of plants, UV irradiation is a major genotoxic agent and imposes a significant threat on plant survival, genome stability and crop yield. In addition, other environmental chemicals can also influence the stability of the plant genome. Eukaryotic organisms have evolved a mechanism to cope with replication-blocking lesions and stabilize the genome. This mechanism is known as error-free DNA damage tolerance, and is mediated by K63-linked PCNA polyubiquitination. Genes related to K63-linked polyubiquitination have been isolated recently from model plants like Arabidopsis and rice, but we are unaware of such reports on the crop model Brachypodium distachyon. Here we report the identification and functional characterization of two B. distachyon UBC13 genes. Both Ubc13s form heterodimers with Uevs from other species, which are capable of catalyzing K63 polyubiquitination in vitro. Both genes can functionally rescue the yeast ubc13 null mutant from killing by DNA-damaging agents. These results suggest that Ubc13-Uev-promoted K63-linked polyubiquitination is highly conserved in eukaryotes including B. distachyon. Consistent with recent findings that K63-linked polyubiquitination is involved in several developmental and stress-responsive pathways, the expression of BdUbc13s appears to be constitutive and is regulated by abnormal temperatures.

Marine Group (MG) I (currently known as Thaumarchaeota) and MG II Archaea were first reported over two decades ago. While significant progress has been made on MG I microbiology and ecology, the progress on MG II has been noticeably slower. The common understanding is that while MG I mainly function as chemolithoautotrophs and occur predominantly in the deep ocean, MG II reside mostly in the photic zone and live heterotrophically. Studies to date have shown that MG II are abundant in the marine aquatic environment and display great seasonal and spatial variation and phylogenetic diversity. They also show unique patterns of organic carbon degradation and their energy requirements may be augmented by light in the photic zone. However, no pure culture of MG II has been obtained and thus their precise ecological role remains elusive.

Leaf economics spectrum (LES), characterizing covariation among a suite of leaf traits relevant to carbon and nutrient economics, has been examined largely among species but hardly within species. In addition, very little attempt has been made to examine whether the existence of LES depends on spatial scales. To address these questions, we quantified the variation and covariation of four leaf economic traits (specific leaf area, leaf dry matter content, leaf nitrogen and phosphorus contents) in a cosmopolitan wetland species (Phragmites australis) at three spatial (inter-regional, regional and site) scales across most of the species range in China. The species expressed large intraspecific variation in the leaf economic traits at all of the three spatial scales. It also showed strong covariation among the four leaf economic traits across the species range. The coordination among leaf economic traits resulted in LES at all three scales and the environmental variables determining variation in leaf economic traits were different among the spatial scales. Our results provide novel evidence for within-species LES at multiple spatial scales, indicating that resource trade-off could also constrain intraspecific trait variation mainly driven by climatic and/or edaphic differences.

DNA phosphorothioation (PT) is the first discovered physiological DNA backbone modification, in which a non-bridging oxygen atom of the phosphodiester bond is replaced with a sulfur atom in Rp (Rectus for plane) configuration. PT modification is governed by a highly conserved gene cluster dndA/IscS-dndBCDE that is widespread across bacterial and archaeal species. However little is known about how these proteins coordinately react with each other to perform oxygen–sulfur swap. We here demonstrated that IscS, DndC, DndD and DndE formed a protein complex of which the molecular ratio for four proteins in the complex is approximate 1:1:1:1. DndB here displayed little or weak affinity to the complex and the constructs harboring dndACDE can confer the host in vivo PT modification. Using co-purification and pull-down strategy, we demonstrated that the four proteins assembly into a pipeline in collinear to its gene organization, namely, IscS binding to DndC, DndC binding to DndD, and DndD binding to DndE. Moreover, weak interactions between DndE and IscS, DndE and DndC were also identified.

Insect prophenoloxidase (PPO) is an important innate immunity protein due to its involvement in cellular and humoral defense. It belongs to a group of type-3 copper-containing proteins that occurs in almost all organisms. Insect PPO has been studied for over a century, and the PPO activation cascade is becoming clearer. The insect PPO activation pathway incorporates several important proteins, including pattern-recognition receptors (PGRP, βGRP and C-type lectins), serine proteases, and serine protease inhibitors (serpins). Due to their complexity, PPO activation mechanisms vary among insect species. Activated phenoloxidase (PO) oxidizes phenolic molecules to produce melanin around invading pathogens and wounds. The crystal structure of Manduca sexta PPO shows that a conserved amino acid, phenylalanine (F), can block the active site pocket. During activation, this blocker must be dislodged or even cleaved at the N-terminal sequence to expose the active site pockets and allow substrates to enter. Thanks to the crystal structure of M. sexta PPO, some domains and specific amino acids that affect PPO activities have been identified. Further studies of the relationship between PPO structure and enzyme activities will provide an opportunity to examine other type-3 copper proteins, and trace when and why their various physiological functions evolved. Recent researches show that insect PPO has a relationship with neuron activity, longevity, feces melanization (phytophagous insects) and development, which suggests that it is time for us to look back on insect PPO beyond the view of immunity in this review.

The professional antigen presenting cells (APCs), including many subsets of dendritic cells and macrophages, not only mediate prompt but nonspecific response against microbes, but also bridge the antigen-specific adaptive immune response through antigen presentation. In the latter, typically activated B cells acquire cognate signals from T helper cells in the germinal center of lymphoid follicles to differentiate into plasma cells, which generate protective antibodies. Recent advances have revealed that many APC subsets provide not only signal 1 (the antigen), but also signal 2 to directly instruct the differentiation process of plasma cells in a T cell-independent manner. Herein, the different signals provided by these APC subsets to direct B cell proliferation, survival, class switching and terminal differentiation are discussed. We furthermore propose that the next generation of vaccines for boosting antibody response could be designed by targeting APCs.

Vocalizations serving a variety of social functions have been reported in many bat species (Order Chiroptera). While echolocation by big brown bats (Eptesicus fuscus) has been the subject of extensive study, calls used by this species for communication have received comparatively little research attention. Here, we report on a rich repertoire of vocalizations produced by big brown bats in a large flight room equipped with synchronized high speed stereo video and audio recording equipment. Bats were studied individually and in pairs, while sex, age, and experience with a novel foraging task were varied. We used Discriminant Function Analysis to classify six different vocalizations that were recorded when two bats were present. Contingency table analyses revealed a higher prevalence of social calls when males were present, and some call types varied in frequency of emission based on trial type or bat age. Bats flew closer together around the time some social calls were emitted, indicating that communicative calls may be selectively produced when conspecifics fly near one another. These findings are the first reports of social calls from flying big brown bats and provide insight into the function of communicative vocalizations emitted by this species.

Background: Knowledge of melanoma presentations among pediatric and adolescent and young adult (AYA) patients are limited due to studies with small sample sizes., Objective: To determine the incidence trends and melanoma presentations based on age, sex, race and ethnicity using a large cohort of diagnoses from 1997-2020., Methods: A retrospective cohort study was completed using the National Childhood Cancer Registry (NCCR) from 1997-2020., Results: Incidence rates were 1.74 (95% CI 1.64-1.84) and 62.05 (95% CI 61.6-62.5) per one-million-person years for pediatric and AYA patients, respectively. Females encompassed 62.3% of the cohort. Non-Hispanic White patients represented 87.5% of all diagnoses, with significantly higher incidence rates of melanoma compared to all other racial and ethnic groups in both age groups, respectively (p <0.001; p < 0.001). Superficial spreading was the most common of the specified histologic subtypes. The most common location in pediatric patients was the lower extremity, compared to trunk in AYA. There were statistically significant differences in the distributions of primary tumor location by sex, as well as by race and ethnicity, in both pediatric and AYA groups., Limitations: Limitations in this study include retrospective data, selection, and miscoding from individual registries., Conclusion: There are significant differences in tumor characteristics among pediatric and AYA patients with cutaneous melanoma. Trends in incidence rates are decreasing for young patients diagnosed with cutaneous melanoma., (Copyright © 2024. Published by Elsevier Inc.)

Inflammatory dermatologic diseases have long been viewed as a "skin limited" disease process. Current literature on inflammatory dermatologic diseases investigates their relationship and influence on thromboembolic states and thromboembolic complications and the understanding of their pathophysiology and molecular mechanisms.Studies specifically discuss known inflammatory skin diseases including alopecia areata, vitiligo, psoriasis, hidradenitis suppurativa, atopic dermatitis, chronic spontaneous urticaria, and autoimmune bullous diseases, and their effects on systemic inflammation, associated cardiovascular comorbidities, and thromboembolic or hypercoagulable states. The limited current literature shows potential for links between inflammatory skin diseases and hypercoagulable states. Biomarkers such as F1 + 2, D-dimer, eosinophilic cationic protein, and PAI-1 are currently being studied to outline the mechanisms connecting inflammatory skin disease to the coagulation system. Further study and larger amounts of data are needed to draw definitive conclusions, especially when interpreting biomarkers alone such as PAI-1.The mechanisms, rates of systemic inflammation, and clinical outcomes of traditionally "skin limited" inflammatory diseases remain chronically understudied in dermatology. Many organ systems have well established connections between inflammatory disease and hypercoagulable states, but there are significant gaps in the literature regarding skin diseases. There is a significant need for comprehensive investigation of molecular mechanisms behind inflammatory dermatologic disease and hypercoagulability, how hypercoagulability effects clinical outcomes, and proper intervention to optimize patient outcomes., Competing Interests: Declarations Ethics approval and consent to participate N/A. Consent for publication N/A. Competing interests CDB has patents issued or pending related to coagulation/fibrinolysis diagnostics. CDB has previously received grant support from the Genentech, Inc., Werfen, Hikari Dx, and consulting fees from Atheneum Partners. CDB is an Associate Editor of the Thrombosis Journal. All other authors have nothing to disclose., (© 2024. The Author(s).)

Dedicated care of Skin of Color (SOC) individuals is crucial for increasing access and culturally-sensitive management of this population [1]. Although SOC specialty clinics (SOCSC) are becoming increasingly popular, data on these is limited. We seek to describe the first detailed experience from a SOCSC. Demographic and clinical data of the University of Nebraska Medical Center Department of Dermatology's Ethnic Skin/SOC Clinic were collected. Of 252 patients, 82% were female; mean age was 45.1 years. Self-reported race consisted of Black/African-Americans (86.9%), Other (6.0%), and Asians (3.6%). Hispanics/Latinos constituted 4.8%. The top chief complaints (CC) included acne, itch/rash, and hair loss. Among patients previously seen by a dermatologist, 20.3% had a diagnosis change, 24.3% received a new diagnosis unrelated to CC, and 48.6% had a treatment change. Patients with a prior dermatology visit showed a higher rate of change in diagnosis (20.3% vs. 2.8%) and change in treatment (48.6% vs. 28.0%) than those without. The most common diagnosis changes were itch/rash (29.3%) and hair loss (19%). Changes in treatment were mostly seen in patients with acne (20.8%), and the most common were discontinuation (50%) and switch in antibiotics (11%). In patients with previous dermatologic contact, one out of five patients (20.3%) previously seen by a non-SOC dermatologist had a diagnosis change, one out of four (24.3%) had a new diagnosis, half (48.6%) had a change in treatment, and 17.6% were being diagnosed and treated for the first time after being seen in SOCSC, highlighting the importance of SOC-specialized dermatologists in patient care., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Objective: To assess the prevalence of psychological distress (PD) among thyroid cancer patients (TCPs) and identify clinical, demographic, and socioeconomic factors associated with PD., Study Design: Retrospective population-based cohort study., Setting: 2016 to 2018 National Health Interview Survey., Methods: Adults with cancer were included. The primary outcome measure was moderate-to-severe psychological distress (MSPD), defined as a respondent score ≥5 on the validated K6 Psychological Distress Scale. χ 2 tests were used to assess differences in MSPD by cancer type. Weighted multivariable logistic regression was used to elucidate factors associated with MSPD among TCPs., Results: The majority of TCPs (n = 684,674) were white (75.4%), female (78.5%), and on average 55.65 years old (SD = 13.2). 28.4% reported MSPD. On weighted analysis, TCPs were more likely to have MSPD than prostate (14.9%, P < .001), bladder (16.4%, P = .011), and nonmelanoma skin cancer (16.3%, P < .001) patients but less likely than pancreatic cancer (30.0%, P = .030) patients. TCPs who were older when surveyed (odds ratio [OR], 0.93; 95% confidence interval [CI, 0.88-0.98), previously drank alcohol (OR, 0.23; 95% CI, 0.06-0.91), and saw a general physician (GP) in the past year (OR, 0.14; 95% CI, 0.03-0.56) were less likely to have MSPD. Female sex (OR, 8.12; 95% CI, 1.61-40.89), increased number of medical comorbidities (OR, 1.46; 95% CI, 1.00-2.14), and functional limitations (OR, 4.55; 95% CI, 1.33-15.74) were associated with increased likelihood of MSPD., Conclusion: Nearly 30% of TCPs have MSPD, especially younger patients who do not regularly see GPs. Future work to identify the most at-risk patients is needed to improve prevention and develop meaningful psychosocial interventions., (© 2024 American Academy of Otolaryngology–Head and Neck Surgery Foundation.)

Competing Interests: Conflicts of interest None is disclosed.

Background : Recent surgical innovations have increased treatment options for patients with facial nerve disorders (FNDs), leading to substantial improvements in functional and psychosocial outcomes. However, it is unclear whether sociodemographic factors are associated with the likelihood of undergoing dynamic facial reanimation procedures. Objective : In patients undergoing FND surgical treatment, what sociodemographic variables are associated with undergoing dynamic facial reanimation compared with static facial reanimation within a 16-year period? Methods : This was a retrospective study of adults undergoing surgical management for FND from 2007 to 2022 using the Merative ™ Marketscan ® Research Databases. Chi-squared and logistic regression analyses were performed. Results : Among 4,730 adults who underwent FND surgical intervention, 1,390 (34.2%) underwent dynamic facial reanimation. In multivariable regression analyses, more recent treatment year, younger age, and living in the Northeast United States were significant predictors of undergoing dynamic reanimation. Secondary analysis demonstrated that FND patients who were younger, female, and living in the Northeast United States were more likely to undergo concurrent selective neurectomy. Conclusions : These analyses demonstrate significant sociodemographic and temporal associations in the surgical management of FND. Future work is needed to evaluate how sociodemographic factors might influence access and decisions to pursue different types of reanimation procedures.

Competing Interests: Conflicts of interest None disclosed.

Key Points: Complications in combined surgery are equivalent to ESS but are higher than rhinoplasty alone. The most common complications are pneumonia, stroke, and epistaxis. Rhinoplasty surgeries with graft use have a higher risk of complications., (© 2024 ARS‐AAOA, LLC.)

The use of medications which target the JAK-STAT signaling pathway, also known as janus kinase (JAK) inhibitors, has rapidly increased in recent years. Patient perceptions, opinions, and concerns regarding the use of JAK inhibitors are largely uninvestigated. Our objective is to better understand patient concerns, reported side effects, and sentiments regarding the use of JAK inhibitors for dermatologic disease. The authors performed a cross-sectional analysis of the most frequented subreddits for dermatologic disease in which JAK inhibitors have obtained FDA approval (r/atopic dermatitis, r/psoriasis, r/alopecia areata, r/vitiligo, and r/eczeJAKS). The sentiment, central theme, and engagement level of each post was evaluated using previously utilized methods. Nine hundred twenty-three posts were analyzed, with the majority focusing on efficacy (433, 47%) and medication-related side effects (150, 16%). Other themes of interest to patients were Payment/Insurance (84, 9%), Study Results/News (69, 7%), Administration/Dosage (33, 4%), and Medication Interactions (31, 3%). The most frequently reported side effects were acne/folliculitis (24, 22%), nausea/gastrointestinal disturbance (11,10%), and fatigue/muscle aches (10, 9%). At the same time, the medication interactions garnering the most concern were sunscreens/facial moisturizers (5, 16%), topical calcineurin inhibitors (4, 13%), and Marijuana/THC (3, 9.%). This analysis highlights that patients are most concerned about the efficacy and side effects of JAK inhibitors in addition to issues regarding access to JAK inhibitors. Providers can use the insights gained from this study to address hesitancy better and guide comprehensive, patient-centered discussions with patients regarding JAK inhibitor use., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Competing Interests: Conflicts of interest None disclosed.

Competing Interests: Conflicts of interest None disclosed.

Competing Interests: Conflicts of interest None disclosed.

Competing Interests: Conflicts of interest None disclosed.

Malignant melanoma is a common and aggressive skin cancer with a high incidence of metastases. Diagnosis is usually straightforward, based on a combination of histomorphology and immunohistochemistry. However, metastatic melanoma is notorious for its phenotypic diversity and loss of differentiation markers. Through recent developments in diagnostic immunohistochemistry and molecular pathology, several new markers are identified to be of use in confirming melanoma diagnosis, especially in undifferentiated and dedifferentiated cases. Here we report a challenging case of a 59-year-old male with splenic metastatic melanoma which revealed a loss of four diagnostic melanocytic markers including S100, SOX-10, HMB45, and MART-1, but a gain of SOX-11., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Ozluk et al.)

Importance: Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe cutaneous adverse reaction occurring 2 to 8 weeks after medication initiation. Diagnosis is clinical; RegiSCAR scoring includes biopsy "suggestive of DRESS," undefined in the literature., Objective: This study correlates DRESS dermatopathology, culprit drugs, disease course, and outcome severity compared with maculopapular drug reactions (MDR)., Methods: Between 2014 and 2023, a retrospective cohort study at a tertiary care institute reviewed 55 patients with DRESS, assessing demographics, culprit drug, illness course, and histopathology. Biopsies of 15 patients with DRESS and 15 MDR patients were graded by a predefined histopathological scoring system. Statistical analysis (significant P -value<0.05) included the Fisher exact probability, ANOVA, and correlation tests., Results: Among 55 patients with DRESS (mean age 50.13, 28 female/27 male), 15 (mean age 50.4, 7 female/8 male) had diagnostic biopsies. Compared with MDR patients, patients with DRESS exhibited significantly more interface dermatitis ( P = 0.04), lichenoid dermatitis ( P = 0.0007), pigment incontinence ( P = 0.04), and periadnexal interface dermatitis ( P = 0.002). MDR biopsies displayed perivascular inflammation and higher eosinophils than DRESS, trending toward significance., Conclusions: Key histopathologic features are interface dermatitis, periadnexal interface dermatitis, lichenoid dermatitis, pigment incontinence, and neutrophils dominance over eosinophils indicate DRESS clinically., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Patients with symptoms of body dysmorphia often seek consultation for aesthetic rhinoplasty. While body dysmorphic disorder is a formal psychiatric diagnosis, recent evidence indicates that patients with symptoms of this condition who seek rhinoplasty may experience increased satisfaction with their appearance following surgery., Objectives: To determine the psychological impact of rhinoplasty in patients screened preoperatively and postoperatively with a body dysmorphia screening questionnaire., Methods: Retrospective chart review was performed of patients who underwent aesthetic and/or functional rhinoplasty by a single surgeon from June 2021 to April 2023. Adult patients with a complete preoperative and postoperative Body Dysmorphic Disorder-Aesthetic Surgery questionnaire (BDDQ-AS), Standardized Cosmesis and Health Nasal Outcomes Survey-Obstruction and Cosmesis (SCHNOS), and visual analog scale (VAS) were included. Patient characteristics and outcomes were analyzed, stratifying by BDDQ-AS screen., Results: One-hundred fifteen patients (88% female) met criteria for inclusion. There was an 83% resolution rate of BDDQ-AS positive screening following rhinoplasty. Positive BDDQ-AS screening status preoperatively and postoperatively correlated with worse aesthetic satisfaction (all P < .002). No patient-reported outcome measures were indicative of which patients with a BDDQ-AS positive screen preoperatively would experience "resolution" postoperatively., Conclusions: Body dysmorphia screening resolution following surgical intervention correlated with improved patient aesthetic satisfaction, pointing to a potential positive psychological impact of undergoing rhinoplasty., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Objectives: Vestibular vertigo has been shown to have a high lifetime prevalence. Previous studies have described the increased morbidities associated with vestibular vertigo., Design: In this cross-sectional study of the 2016 National Health Interview Study, we sought to explore whether individuals with vestibular vertigo were more likely to utilize healthcare resources compared with those without vestibular vertigo. We characterized utilization of specific healthcare resources including general doctors, specialist doctors, emergency departments, mental health professionals, and others among individuals with vestibular vertigo to better understand how individuals with vertigo interact with the US healthcare system., Results: In multivariable analyses, participants with vestibular vertigo had an increased number of nights in the hospital in the last 12 months (mean difference = 0.67 days, 95% confidence interval [CI] = 0.37 to 0.97), increased odds of receiving healthcare 10 or more times in the last 12 months (odds ratio = 2.22, 95% CI = 1.99 to 2.48) and increased number of visits to a healthcare professional in the last 2 weeks (mean difference = 0.17 visits, 95% CI = 0.14 to 0.21). In addition, participants with vestibular vertigo had increased odds of visiting both general doctors, specialist doctors, and other healthcare professionals., Conclusions: These findings characterize how individuals with vestibular vertigo utilize and interact with healthcare resources compared with those without vestibular vertigo., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Competing Interests: None to declare.

Primary mandibular telangiectatic osteosarcomas are very rare lesions, with only nine cases reported. Histologically, these lesions show multiple cystic blood-filled cavities traversed by neoplastic bone in septa lined by high-grade malignant cells. Here, we report an 81-year-old woman who presented with a mandibular mass, which was surgically resected and analyzed by histologic examination and whole exome DNA sequencing. A diagnosis of telangiectatic osteosarcoma was given. Comparative sequencing data analysis of paired benign and tumor DNA revealed 1577 variants unique to the tumor DNA, which clustered into several gene families, including those regulating DNA repair and apoptosis. Comparison of benign and tumor DNA revealed many shared gene polymorphisms associated with an increased cancer risk. These included polymorphisms in the ATM, p53, BRCA1, and BRCA2 and many other genes. Interestingly, the patient's family history showed an unusually high cancer incidence, likely related to these cancer risk-associated polymorphisms. To our knowledge, this is the first-time sequencing applied to a mandibular telangiectatic osteosarcoma. Our findings may shed light on the molecular origins of these rare tumors and how they may relate to other tumors in related kindreds., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Muhammad Tahir et al.)

Parosteal lipomas and osteochondromas of the head and neck are uncommon benign tumors, constituting a small fraction of lipoma and bone tumor cases. We present a unique case of a 66-year-old male with a parosteal lipoma overlying an osteochondroma in the anterior midline neck, causing dysphagia. Surgical excision confirmed the diagnosis, and a literature review revealed similar cases predominantly adjacent to the mandible or calvaria. This case emphasizes the need to have parosteal lipoma and osteochondroma on the differential diagnosis for patients presenting with a firm mass of the central neck, especially with a history of trauma. Laryngoscope, 134:2844-2847, 2024., (© 2023 The American Laryngological, Rhinological and Otological Society, Inc.)

Background: Many patients with body dysmorphic disorder (BDD) seek out cosmetic surgery to alleviate their symptoms of distress related to a perceived defect in their appearance; however, the prevalence and risk factors for BDD among patients with cosmetic concerns have not been well characterized. Methods: We screened adult patients presenting to the clinic from June 2021 through September 2022 for BDD using the BDD Questionnaire-Aesthetic Surgery (BDDQ-AS) who were seen in consultation for rhinoplasty, aging face, and injectables. Results: Among 488 patients, the prevalence of screening positive for BDD was 41.0%. The prevalence of a positive BDD screen was highest among patients who were younger ( p  = 0.02), and those who had a positive self-reported psychiatric history ( p  = 0.02). Among rhinoplasty patients, those with aesthetic/cosmetic motivations, and those seeking revision rhinoplasty had higher rates of positive BDD screen. Higher scores on the Standardized Cosmesis and Health Nasal Outcomes Survey-Nasal Obstruction Score (SCHNOS-O) ( p  = 0.01) and Standardized Cosmesis and Health Nasal Outcomes Survey-Nasal Obstruction Score-Nasal Cosmesis Score (SCHNOS-C) ( p  < 0.0001) were predictive of a positive BDD screen, while question 5 of the SCHNOS was highly predictive of positive BDD screening ( p  < 0.0001). Conclusions: Our study characterizes relationships between positive BDD screening and age, gender, self-reported psychiatric history, and motivations for consultation, among patients seen for cosmetic surgery evaluation in a facial plastic and reconstructive surgery setting.