The MBI-C captures global and domain-specific NPS across cognitive stages. Both the MBI-C and NPI-Q have utility in characterizing NPS.

The GR of epilepsy surgery satisfaction showed good measurement properties, distinguished among clinically different patient groups, and appears well-suited for use in clinical practice and research.

Abstract Background Up to 57% of adolescents and young adults (AYA) with chronic physical health conditions experience mental health conditions, the presence of which contributes to increased morbidity and poor quality of life. AYA with co-occurring physical and mental health conditions, therefore, may experience additional challenges as they transition from pediatric to adult services. While transition readiness – the acquisition of self-management and advocacy skills – contributes to successful transitions to adult care, this concept has not been adequately explored for AYA with co-occurring physical and mental health conditions. Research is needed to identify whether the presence of a mental health comorbidity is associated with transition readiness, and what the experiences of AYA with co-occurring conditions are as they exit pediatric services. This paper outlines the protocol for the R eadiness and E xperiences of AD olescents and Y oung Adults with Co-occurring Physical and Mental Health Conditions Exit ing Pediatric Services (READY2Exit) study; the first study to address this gap using a patient-oriented, mixed methods design. Methods A sequential explanatory mixed methods design will be used to understand the transition readiness of 16–21 year olds with physical and mental health conditions using quantitative and qualitative data. First, Transition Readiness Assessment Questionnaire (TRAQ) scores will be compared among AYA with chronic health conditions, with and without mental health comorbidity. Interviews will then be conducted with approximately 15 AYA with co-occurring health and mental health conditions and analyzed using qualitative description. The READY2Exit study will be conducted in collaboration with five Young Adult Research Partners (YARP) aged 18–30 with lived experience in the health/mental health systems across Canada. The YARP will partner in key tasks such as interview guide co-design, data interpretation, and knowledge translation tool development. Discussion AYA with co-occurring physical and mental health conditions may have unique needs as they prepare for health care transitions. The results of this study will inform the refinement of transition readiness practices to improve care for this group. The active involvement of the YARP across study phases will bring the critical perspectives of young adults to READY2Exit, ensuring the methods, research approaches and outputs align with their needs.

The diagnosis of new onset of neurocognitive disorders is associated with ICU-acquired delirium. In this study, significant associations were not observed for depressive, anxiety, and trauma-and-stressor-related disorders.

Later life emergent neurospychiatric symptoms (NPS) are now recognized as potential early indicators of dementia. The syndrome of mild behavioural impairment (MBI) defines emergent and sustained NPS in non-demented patients as a potential consequence of neurodegeneration, and a marker of risk for future dementia. The MBI-Checklist (MBI-C) was developed to operationalize MBI, with applicability to pre-dementia populations. Our aim is to validate domains specified a priori in the MBI-C (consisting of apathy, mood and anxiety symptoms, impulse dyscontrol, social cognition, and psychosis)in a clinic sample using exploratory factor analysis. Subjective cognitive decline (SCD, n=69) and MCI (n=108) patients were recruited through a tertiary dementia clinic in Calgary, Alberta, Canada.Factors were obliquely rotated and internal consistency was measured using Cronbach's alpha (STATA v.13). Factors with eigenvalue over one and factor loadings over 0.3 were kept. A five-factor model was found with 29/34 items loading onto factors. Factors followed our hypothesized domains. Apathy consisted of eight items including loss of interest, curiosity, spontaneity, motivation, affection, care, pleasure and appetite (α=0.838). Mood and anxiety consisted of five items including sadness, discouragement, viewing self as a burden, anxiety and tenseness, and excluded anhedonia which loaded on the apathy factor (α=0.743). Impulse dyscontrol consisted of six items including agitation, argumentativeness, impulsivity, impatience, stubbornness and insensitivity (α=0.789). Social cognition consisted of four items including open discussion of private matters, rudeness, lack of social judgement and talking to strangers and excluded insensitivity which loaded on the impulse dyscontrol factor (α=0.609).Psychosis consisted of six items including beliefs about danger, suspiciousness, unrealistic beliefs, hearing voices, seeing imaginary things and trouble regulating behaviour (α=0.679). The MBI-C is a valid five-factor questionnaire in a pre-dementia clinic sample, with most items loading onto the appropriate a priori determined domains. Subsequent steps will include assessing the prognostic utility of MBI-C global and domain scores for incident cognitive decline and dementia.

Primary lung melanoma is an extremely rare tumour. Approximately 50 cases have been reported. Because melanocytes are not normally found in the tracheobronchial tree, it is difficult to explain its histogenesis. Of the proposed explanations, origin from neuroendocrine precursor cells in lung tissue appears the most plausible. Minimal criteria on which the diagnosis should be based, including clinical and pathologic features, have been proposed. A recent Sydney Melanoma Unit study suggested that detailed staging investigations and prolonged follow-up are probably necessary before accepting a definitive diagnosis of primary pulmonary melanoma. If no other focus of primary or secondary melanoma in the body can be demonstrated by the best available imaging techniques in patients presenting with a solitary pulmonary tumor, radical surgical treatment for suspected primary lung melanoma offers the best chance of cure. Nonetheless, the prognosis of patients with primary pulmonary melanoma is generally very poor.

A 75-year-old Caucasian man presented with foreign-body-type irritation of the left eye. Physical examination revealed a 12 x 10-mm nodule in his left upper eyelid, which reportedly had been present unchanged for more than 40 years. No other ophthalmological abnormalities were present. Incisional biopsy of the lesion revealed a malignant tumour that was thought to possibly represent a sebaceous carcinoma. However, a subsequent wide surgical excision showed that the tumour was an eccrine porocarcinoma, a rare sweat gland adenocarcinoma arising from the acrosyringium.

The increase in tumor-infiltrating lymphocytes induced by treatment with BRAF inhibitors provides strong support for conducting trials that combine BRAF inhibitors with immunotherapy in the hope of prolonging clinical responses.

Targeted therapies are increasingly being used to treat a variety of cancers. Their efficacy depends upon the accurate detection and targeting of a specific mutation or aberration in the tumor. All cancers, such as melanoma, are molecularly heterogeneous, with drug-resistant subclones present before the treatment or emerging as a result of targeted therapies. Here, we show intralesional molecular heterogeneity in a progressing V600E BRAF-mutant melanoma metastasis from a patient treated for 7 months with the BRAF inhibitor vemurafenib. In the single metastasis, two distinct subclones were observed, both V600E BRAF-mutant and only one with an additional G13R NRAS mutation. Molecular heterogeneity even at the intralesional level shows that personalizing or adjusting therapies based on genotyping of a portion of a single lesion may not accurately depict the molecular profile or drivers of oncogenesis across the entire patient's melanoma.