Citations

Summary Aging is associated with the development of insulin resistance, increased adiposity, and accumulation of ectopic lipid deposits in tissues and organs. Starting in mid‐life there is a progressive decline in lean muscle mass associated with the preferential loss of glycolytic, fast‐twitch myofibers. However, it is not known to what extent muscle loss and metabolic dysfunction are causally related or whether they are independent epiphenomena of the aging process. Here, we utilized a skeletal‐muscle‐specific, conditional transgenic mouse expressing a constitutively active form of A kt1 to examine the consequences of glycolytic, fast‐twitch muscle growth in young vs. middle‐aged animals fed standard low‐fat chow diets. Activation of the A kt1 transgene led to selective skeletal muscle hypertrophy, reversing the loss of lean muscle mass observed upon aging. The A kt1‐mediated increase in muscle mass led to reductions in fat mass and hepatic steatosis in older animals, and corrected age‐associated impairments in glucose metabolism. These results indicate that the loss of lean muscle mass is a significant contributor to the development of age‐related metabolic dysfunction and that interventions that preserve or restore fast/glycolytic muscle may delay the onset of metabolic disease.

AbstractBackground and ObjectivesPrevious studies have established the relationship between tobacco use and pain severity among patients suffering from chronic pain. Unfortunately, many physicians feel underprepared to counsel patients on smoking cessation. The purpose of this study was to identify the attitudes, beliefs, and practices of pain medicine fellowship directors in regard to tobacco control interventions and trainee education.MethodsProgram directors of ACGME‐accredited pain medicine fellowships were surveyed via a web‐based form to assess current practices in tobacco intervention and to gauge interest in incorporating tobacco control into their current fellowship training curriculum.ResultsOf the respondents, the majority indicated that they frequently asking their patients about tobacco use and advise them to quit. In addition, most agreed that presenting tobacco control is a responsibility of pain physicians. However, few consistently provided any assistance with quitting. Finally, the majority of program directors felt that pain medicine fellowships should include tobacco control training and were interested in incorporating an educational module about smoking and pain into their training program.ConclusionsThis survey of pain medicine fellowship program directors indicates that although smoking cessation interventions are not being consistently applied in academic pain practices, there is a strong interest in doing so. Furthermore, the majority of program directors recognized the importance of incorporating tobacco control training into pain medicine fellowships. This recognition may provide an opportunity to develop a web‐based training module that could be easily incorporated into the upcoming milestones in pain medicine training.

Objective To assess recommendations for prostate‐specific antigen ( PSA ) screening in a national survey of radiation oncologists and urologists following the recent USA P reventive S ervices T ask F orce ( USPSTF ) grade D recommendation. Methods A random sample of 1366 radiation oncologists and urologists were identified from the A merican M edical A ssociation P hysician M asterfile. From N ovember 2011 to A pril 2012, a mail survey was sent to query PSA screening recommendations for men at average risk of prostate cancer for the following age groups: 40–49, 50–59, 60–69, 70–74, 75–79 and ≥80 years. Multivariable logistic regression was used to test for differences in PSA ‐based screening recommendations by physician characteristics. Results Response rates were similar at 52% for radiation oncologists and urologists ( P = 0.92). Overall, 51.5% of respondents recommended PSA ‐based screening for men aged 40–49 years, while nearly all endorsed it for those aged 50–74 years (96.1% for 50–59, 97.3% for 60–69, and 87.7% for 70–74 years). However, screening recommendations decreased to 43.9% and 12.8% for men aged 75–79 and ≥80 years, respectively. On multivariable analysis, urologists were more likely to recommend screening for men aged 40–49 (odds ratio [ OR ] 3.09; P < 0.001) and 50–59 years ( OR 3.81; P = 0.01), but less likely for men aged 75–79 ( OR 0.66; P = 0.01) and ≥80 years ( OR 0.45; P = 0.002) compared with radiation oncologists. Conclusion While radiation oncologists and urologists recommended PSA screening for men aged 50–69 years, there was less agreement about screening for younger (40–49 years old) and older (≥70 years) men at average risk for prostate cancer.

AbstractBackgroundHibernomas are rare, benign tumors of brown adipose tissue uncommonly found in the head and neck.MethodsA review of the English‐language literature was conducted for this study. We present a series of 2 laryngeal hibernomas treated with transoral laser microsurgical resection at a tertiary referral center over a period of 18 years.ResultsOnly 2 cases of laryngeal hibernoma have been previously described in the literature. Two additional cases were encountered at our institution. Preoperative imaging demonstrated a well‐circumscribed neoplasm with fat density compatible with lipoma, but internal heterogeneity and vascularity seen in the context of liposarcoma. Transoral laser microsurgical resection was successfully performed in each case.ConclusionDespite unique radiographic features, hibernomas are difficult to distinguish from well‐differentiated liposarcoma and lipoma variants without pathologic correlation. Complete surgical resection is indicated. In our experience, transoral laser microsurgical excision of laryngeal hibernomas is a safe, effective treatment modality with little associated morbidity. © 2013 Wiley Periodicals, Inc. Head Neck 36: E39–E43, 2014