IM ketorolac appears to be a safe non-opioid pain control measure that can be used with any topical and infiltrative local anesthesia regimen with or without sedation. It can potentially provide increased pain control resulting in a more pleasant experience for the patient and surgeon, and in patients undergoing more extensive rhinology procedures and anxious patients concerned about pain. Providing additional pain control with IM ketorolac in selected patients could be a significant variable allowing completion of planned office rhinology procedures in unexpectedly difficult cases. A well-designed clinical pain control study using IM ketorolac for office rhinology procedures has merit and should be performed, but until this occurs IM ketorolac is an option for the otolaryngologist that can be implemented now for those who desire an additional safe pain control measure.

An important aspect of the analysis of the proliferation of cell populations as composed of a set of intercommunicating logistic domains is the nature of the barriers between adjacent domains and the regulation of cellular migration between them. The nature of these inter-domain boundaries is discussed in relation to the central role of L-type calcium channels in the control of cell motility and it is proposed that domain boundaries are determined by proteoglycans which act as calcium chelators and hence regulate the local extracellular Ca++ concentration. The selective migratory advantage gained by overexpression of calcium channels is briefly alluded to.

A 43-year-old male presented with a 10-cm tumor in the left forearm that had grown progressively for 5 months. A pathological analysis confirmed a diagnosis of high-grade fibrosarcoma. The image on the rare entity contributes to the notion of this disease.

An increasing burden is loaded on clinical laboratories for daily testing of body fluids, including pleural fluid, peritoneal fluid (ascites), pericardial fluid, and cerebrospinal fluid. The request for detection of cellular components in the body fluid samples is usually delivered simultaneously to the hospital’s hematology laboratory and cytology laboratory. The medical technologists of hematology laboratory provide the screening result for suspicious malignant cells; meanwhile, the pathologists of cytology laboratory provide the presence of cancer cells at a diagnostic level. However, unfortunately, neither of these results reaches 100% sensitivity or specificity. To assess the clinical practice values, the present study performed a comparison of the hematology and cytology laboratories on the detection of malignancy in body fluids.

Esophageal granular cell tumors (GCT) represent a rare entity of tumors of the esophagus. Patients with esophageal GCTs are usually asymptomatic, with the lesion most commonly presenting as an incidental finding on endoscopy. The GCTs of the esophagus are poorly understood in medical literature. It is unknown if they undergo malignant degeneration, whether the malignancy can be diagnosed preoperatively, and how the tumor can be managed. The authors evaluated the clinical and pathologic features of all esophageal GCTs at their institution to understand them better.

Oxytocin and magnesium sulfate are high-alert medications with risks for significant patient harm. This paper describes experiences of 25 Labor and Delivery (LD) units which sought to apply safety science principles such as standardization, learning from defects, independent checks, teamwork and communication, and in situ simulation training for safe administration of oxytocin and magnesium sulfate. This effort was part of the Agency for Healthcare Research and Quality’s Safety Program for Perinatal Care.

A 53-year-old man with hypertension underwent CABG. Following surgery, he developed left leg numbness and weakness. Examination revealed left sciatic neuropathy, as well as a circumferential lesion over the left mid-thigh which was revealed to be due to a surgical tourniquet. He was diagnosed with tourniquet-induced left sciatic neuropathy, and by the end of his hospitalization, recovered full strength and sensation in his left lower extremity.

In a recent article, Reda et al. reported about a 41-year-old patient with a classical mitochondrial multiorgan disorder syndrome, manifesting as stroke-like episodes, epilepsy, ataxia, migraine, cognitive impairment, brain atrophy, hypoacusis, short stature, hypertrophic cardiomyopathy, heart failure, renal impairment, anemia, gout, and hyperlipidemia. The authors have some comments and concerns.

The author presents a case of BCC developed on an active lesion of mucocutaneous leishmaniasis as one of many cases of skin cancer frequently seen at the Regional Leishmaniasis Control Center (RLCC) clinics in Yemen.

The authors describe various patient and breast-related factors that influence surgical outcomes while also addressing some techniques and principles for aesthetic microsurgical reconstruction.