Faculty Bibliography

Acute epiploic appendagitis is a rare cause of abdominal pain, often misdiagnosed as acute appendicitis or diverticulitis given similar clinical presentation and findings. The treatment is supportive care and is typically self-limited. The osteopathic structural exam can give insight into pathology and in this case, was suggestive of a non-appendiceal origin of her pain, in which emergent surgery could be avoided. Requiring computerized tomography to identify, acute epiploic appendagitis is a rare cause of abdominal pain and should be considered in the differential diagnosis.

INTRODUCTION/BACKGROUND:Subacute osteomyelitis (OM) is a difficult condition to diagnose and treat, further complicated with an atypical presentation of a Brodie's abscess (BA). BA is typically seen in pediatric, male populations, with minimal incidence in adult populations. Concern for malignancy and cold abscess can preempt oncological work-up. Duration of symptoms and radiological findings are often helpful but may not always match known classical findings. CASE REPORT/METHODS:Here we present a case of subacute OM in a 30-year-old Japanese male with a distant medical history of OM as a child with a subsequent review of Brodie's versus cold abscesses in the context of an atypical, asymptomatic presentation. CONCLUSION/CONCLUSIONS:Clinical history and suspicion can be crucial to determine the presence of a BA in comparison to a cold abscess in the context of subacute OM. Crossing multiple disciplines from primary care and emergency treatment to orthopedic and oncological surgery, providers must be aware of atypical presentations of OM. Recurrence is unlikely with correct diagnosis and adequate surgical debridement and antibiotics, which, in turn, can improve patient outcomes and decrease unnecessary testing.

Genotoxicity is thought to be the cause of many cancers. Genotoxicity due to environmental toxins may be partly responsible for the dramatic increase in the incidence of papillary thyroid cancer over the past two decades. Here, we present a fully automatable assay platform that directly quantifies the phosphorylation of nuclear histone gamma H2AX (γH2AX), a specific cellular marker for DNA double strand breaks (DSBs) via immunohistochemistry and laser scanning cytometry. It multiplexes γH2AX with total cell number measured as propidium iodide and calculates the percentage of cells with DSBs. Validation of this assay using NTHY-ori-3-1 human thyroid cells and etoposide showed that it was an excellent choice for high throughput applications. We used the assay to test the genotoxic effects of the EPA Toxcast Phase 1 pesticide library of 309 compounds. Compounds were evaluated in dose response and the DSB was quantified. We found that 19 pesticides induce DSB in vitro, highlighting a need to further assess these pesticides for their long-term oncogenic effects on the thyroid gland. Environ. Mol. Mutagen. 58:522-528, 2017. © 2017 Wiley Periodicals, Inc.