Effect of gender on the reliability of COVID-19 rapid antigen test among elderly

Defining con-founders that affect the reliability of diagnostic tests for coronavirus disease 2019 is vital to breaking the chain of infection. The elderly population is a higher risk group for the emerging virus. However, gender seems to exert a critical role in modifying the infection risk among women owing to hormonal changes. The menopause transition is an exceptional period for older women where the protective and immunomodulatory effects of the estrogen hormone are lost. Accordingly, attention should be given to postmenopausal women since they will have an increased risk compared to their pre-menopausal peers.     

Intraoperative radiotherapy in stage I and II lung cancer

Lung cancer is the leading cause of cancer deaths in both men and women in the United States. Treatment depends on the type and stage of lung cancer. For stage I and II cancer, surgery is usually the treatment of choice. Radiation therapy is used in patients who are considered poor risks for surgical resection. Intraoperative brachytherapy is an effective alternative to external irradiation in this group of patients. From 1958 to 1984, 55 patients with non-small-cell lung cancer were explored at Memorial Sloan Kettering Cancer Center and found to have surgical stage I or II tumors, which were considered to be unresectable mainly because of severe obstructive pulmonary disease precluding adequate resection. All these patients were treated with intraoperative brachytherapy at the time of the thoracotomy. Forty-four percent of these patients received in addition external irradiation, mainly to the mediastinum. The overall 5-year survival calculated by the Kaplan-Meier Method was 32%, and the local disease-free survival was 63%. Cox regression multivariant analysis demonstrated that there is a distinct subgroup with a better prognosis based on tumor site and patient's age--ie, patients who were younger than 58 years of age and had right-side lesions.     

125iodine reimplantation for locally progressive prostatic carcinoma

We treated 13 patients with a second 125iodine implant for local recurrence of prostatic carcinoma. All patients had biopsy proved palpable recurrence without evidence of distant metastases. Full doses of irradiation were used (median matched peripheral dose 170 Gy.). Six patients had complete regression of palpable recurrence, 2 had partial regression, 2 had no apparent response and 3 were unevaluable for local response. Actuarial freedom from local disease progression at 5 years was 51%. Despite a relatively high rate of local disease control the actuarial rate of distant metastases reached 100% at 6 years after reimplantation. There were 2 severe rectal complications and 4 instances of mild to moderate urinary incontinence among the 13 patients. Local regression of recurrent prostatic carcinoma may be achieved with 125iodine reimplantation but most patients still had distant metastases.     

Cocaine decreases self-control in rats: a preliminary report

Cocaine abuse is often associated with behavior that takes into account short-term, but not long-term consequences. However, there has been no empirical research concerning the effects of cocaine on self-control (choice of a larger, more delayed reinforcer over a smaller, less delayed reinforcer). In the present research, when food-deprived rats repeatedly chose between a larger, more delayed food reinforcer and a smaller, less delayed food reinforcer, chronic intraperitoneal injections of 15 mg/kg cocaine (but not 10 mg/kg fluoxetine) decreased the rats' choices of the larger, more delayed reinforcer. Cocaine can decrease rats' self-control.     

Antibodies against hepatitis C virus in hemodialysis patients in the central Italian region of Umbria: evaluation of some risk factors.

The epidemiology of non-A, non-B hepatitis (NANBH) is still incomplete. To define the prevalence of antibodies against the main causative agent of NANBH, the hepatitis C virus (HCV) and the role of some risk factors, we tested sera from 269 patients on chronic dialysis at the hemodialysis units in our region in central Italy. We utilized the recently developed serological assay. Twenty-nine hemodialysis patients (13.3%) and 3 peritoneal dialysis patients (4.8%) were anti-HCV positive. Of these, 13 (40.6%) had antibodies to hepatitis B core antigen (anti-HBc) indicating prior hepatitis B infection. The anti-HCV seropositive patients had been on dialysis longer than the seronegative ones; they had received more transfusions than the others but without a significant difference. The prevalence rate of anti-HCV was statistically significantly higher among hemodialysis patients utilizing the same dialysis equipment for the previous 12 months.     

Immunohistochemical and in situ hybridization detection of growth-hormone-producing cells in human thymoma.

We have studied 25 thymomas by both immunohistochemistry and in situ hybridization for the presence of growth hormone (GH)-producing cells. Our results indicate that 1) GH-immunoreactive cells were present in 13 of 17 thymomas of cortical and predominantly cortical type but not in medullary (spindled) thymomas (n = 3) or low- to high-grade thymic carcinomas (n = 5), 2) GH-positive cells were mainly located at the periphery of the neoplastic lobules, at the periphery of the perivascular spaces and in the areas of medullary differentiation, 3) cells containing GH mRNA appeared at locations similar to those of GH-immunoreactive cells, and 4) GH-immunoreactive material was present only in the epithelial cell component as revealed by immunoelectron microscopy. In conclusion, this paper demonstrates the occurrence of GH-producing cells in noncarcinoid thymic tumors. The relevance of GH in thymoma cell biology requires additional investigations.     

Interpersonal stressors and resources as predictors of parental adaptation following pediatric traumatic injury

The authors examined the relationship of preinjury interpersonal resources and stressors to parental adaptation following pediatric traumatic brain injury (TBI) and orthopedic injury. Parents of children with severe TBI (n = 53), moderate TBI (n = 56), and orthopedic injuries (n = 80) were assessed soon after injury, 6 and 12 months after the initial evaluation, and at an extended follow-up with a mean of 4 years postinjury. General linear model analyses provide support for both main and moderating effects of stressors and resources on parental adjustment. Support from friends and spouse was associated with less psychological distress, whereas family and spouse stressors were associated with greater distress. The results also reveal a marked decline in injury-related stress over follow-up for families in the severe TBI group who reported a combination of high stressors and high resources. The decline suggests that interpersonal resources attenuated long-term family burden because of severe TBI. The findings are discussed in terms of their implications for intervention following TBI.     

L'epilessia postoperatoria nei meningiomi endocranici

Riassunto Gli AA. studiano le manifestazioni epilettiche postoperatorie osservate in una statistica di 196 casi di meningiomi sopratentoriali radicalmente asportati. II periodo medio di osservazione di questi malati corrisponde a oltre 6 anni. 112 di essi presentavano disturbi epilettici già prima dell'intervento. Postoperatoriamente questi disturbi si risolvevano subito in 49 casi (43%); persistevano transitoriamente in 38 (34%); persistono tuttora in 25 (23%) con caratteri clinici ed EEG. sostanzialmente uguali a quelli preoperatori nella maggioranza dei casi. Ció lascia supporre che, in questi, il focolaio epilettico costituitosi in conseguenza del tumore persista dopo l'asportazione del tumore stesso. Nei casi, invece, nei quali i disturbi comiziali si modificavano dopo l'intervento l'effetto delle lesioni corticali indotte dalle manovre di exeresi del tumore potrebbe giustificare queste modifiche.84 casi non presentavano preoperatoriamente disturbi comiziali. Dopo l'intervento, questi insorgevano in 19 casi (22.6%). Le forme precoci (7 casi) si risolvevano quasi sempre nell'immediato decorso postoperatorio: le forme tardive, invece, (12 casi), cronicizzavano nella metà dei casi.Gli AA. prendono in esame i possibili fattori responsabili del costituirsi dei focolai epilettici cronici e rilevano che nei malati nei quali l'epilessia si risolve ciò non é da attribuirsi alla terapia anticonvulsiva.

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Summary The authors investigated the development of postoperative epilepsy in a series of 196 supratentorial meningioma patients who underwent radical surgery. The mean follow-up period was 6 years. One hundred and twelve patients had had epileptic disturbances before the operation. Postoperatively, the fits stopped immediately in 49 patients (43%); the fits persisted for a short time in 38 patients (34%); in 25 patients (23%) the fits continued with the clinical and E.E.G. characteristics virtually unchanged from the preoperative state in the majority of patients. From this one could conclude that in these patients the epileptogenic focus produced by the tumor, continued to exist in spite of removal of the tumour. On the other hand it is to be assumed that with patients in whom the operation led to a change in the frequency of fits, this alteration was caused by manipulation of the cortex during the tumour removal.Eighty-four patients had no fits pre-operatively. Of these patients 19 (22.6%) developed fits postoperatively. The early form (7 patients) almost always cleared up in the early postoperative period. In contrast, with the twelve patients with late fits half of them developed chronic epilepsy.The authors took into consideration all the factors which could possibly lead to the development of a chronic epileptogenic focus and stressed that in their patients cured of epilepsy this cure is not to be attributed to anticonvulsivant therapy.

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Zusammenfassung Die Autoren untersuchten das Auftreten postoperativer Epilepsie an einer Serie von 196 supratentoriellen, radikal operierten Meningeomen. Die mittlere Nachbeobachtungszeit betrug 6 Jahre. 112 Fälle hatten bereits vor dem Eingriff epileptische Störungen gehabt. Postoperativ hörten diese Störungen bei 49 Fällen (43%) sofort auf; vorübergehend traten bei 38 Fällen (34%) noch welche auf; bei insgesamt 25 (23%) blieben sie bestehen, wobei die charakteristischen klinischen und EEG-Befunde bei den meisten dieser Fälle gegenüber den praeoperativen praktisch unverändert blieben. Daraus läßt sich schließen, daß bei diesen Fällen der epileptogene Fokus, der vom Tumor verursacht worden war, trotz Entfernung des Tumors weiterbestand. Andererseits ist anzunehmen, daß bei Fällen, bei denen es nach dem Eingriff zu einer Änderung des Anfallsgeschehens gekommen ist, diese Änderung durch das Manipulieren am Kortex bei der Tumorentfernung verursacht worden ist.84 Fälle hatten praeoperativ kein Anfallsleiden. Davon entstand eines postoperativ bei 19 Fällen (22,6%). Die Frühformen (7 Fälle) heilten fast immer schon im anfänglichen postoperativen Verlauf; bei den Fällen mit später Manifestation (12) entwickelte sich dagegen bei der Hälfte ein chronisches Anfallsleiden.Die Autoren stellten Überlegungen über die Faktoren an, die möglicherweise für die Entstehung eines bleibenden epileptogenen Fokus verantwortlich sind und heben hervor, daß bei den Patienten, bei denen die Anfälle ausgeheilt sind, dieses unabhängig von antikonvulsiver Behandlung erfolgte.

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Resumen Los autores han estudiado las epilepsías post-operatorias en una série de 196 enfermos que habían sido sometidos a una ablación total de meningiomas supratentoriales. Estos operados fueron seguidos durante 6 años. Ciento doce enfermos presentaban crisis comiciales antes de la intervención. Después de la operación las crisis desaparecieron inmediatamente en 49 casos (43%). Las crisis persistieron durante un corto periodo de tiempo en 38 casos (34%). En 25 casos (23%) las crisis han persistido con las mismas características clinicas, asi como el E.E.G. preoperatorio. Estos últimos casos hacen suponer que el foco epileptógeno engendrado por el tumor persistía a pesar de la extirpación del tumor. Por el contrario en los operados en los cuales la operacion ha modificado la frecuencia de las crisis es evidente que esta modificación está unida a la manipulación de la corteza durante la extirpación del tumor.Ochenta y cuatro enfermos no habían tenido crisis epilépticas antes de la intervención. Entre ellos 19 (22,6%) presentaron crisis después de la intervención. Las crisis precoces (7 casos) casi siempre han desaparecido en el curso post-operatorio. Por el contrario los 12 operados que presentaron crisis tardías han desarrollado una opilepsía crónica.Los autores han tenido en cuenta todos los factores capaces de favorecer el desarrollo de un foco epileptógeno crónico, e insisten sobre la necesidad de tratamiento con anticonvulsivantes en todos los enfermos portadores de un foco epileptógeno aunque las crisis hayan o no desaparecido.

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Résumé Les auteurs ont étudié les épilepsies post-opératoires dans une série de 196 malades ayant subi une ablation totale de méningiome supratentoriel. Ces opérés ont été suivis pendant 6 ans. Cent douze malades avaient présenté des crises comitiales avant l'intervention. Après l'intervention, les crises ont disparu immédiatement dans 49 cas (43%). Les crises ont persisté pendant une courte période dans 38 cas (34%). Dans 25 cas (23%) les crises ont persisté avec les mêmes caractères cliniques et E. E. G. qu'avant l'intervention. Ces derniers cas laissaient supposer que le foyer épileptogène engendré par la tumeur demeurait malgré l'ablation de la tumeur. Par ailleurs, chez les opérés dont l'intervention a modifié la fréquence des crises, il est certain que cette modification est liée à la manipulation du cortex au cours de l'exérèse de la tumeur.Quatre vingt quatre malades n'avaient pas eu de crises épileptiques avant l'intervention. Parmi eux, 19 (22,6%) ont présenté des crises après l'intervention. Les crises précoces (7 cas) ont presque toujours disparu dans les suites opératoires. Au contraire, parmi les 12 opérés qui ont présenté des crises tardives, 6 ont développé une épilepsie chronique.Les auteurs ont envisagé tous les facteurs favorisant le développement du foyer épileptogène chronique. Ils ont insisté que dans les cas guéris de l'épilepsie, la guérison n'était par la conséquence d'une traitement anticonvulsivant.

     

Is normal β-hCG regression curve helpful in the diagnosis of persistent trophoblastic disease?

OBJECTIVE: The aim of this study was to evaluate the probable usefulness of normal beta-human chorionic gonadotropin (beta-hCG) regression curve in the diagnosis of persistent trophoblastic disease (PTD). METHODS: A log-value regression curve was developed from the means and 95% confidence limits of serial weekly serum beta-hCG titers of 43 patients with uneventful complete hydatidiform moles and 14 patients, who were previously confirmed as PTD. RESULTS: All 14 PTD patients (100%) had abnormal values, beyond normal range, within 4 weeks. beta-hCG was in its upper values, compared to normal regression curve at 2.29 +/- 0.19 weeks. This was earlier than plateau or rise detection at 4.21 +/- 0.33 weeks (P < 0.001). Within 3 weeks of evacuation, 13 of 14 (92.86%) PTD patients' beta-hCG values exceeded the normal range, whereas only six of 14 (42%) showed a rise or plateau. CONCLUSION: Our finding indicates that the normal beta-hCG regression curve may be useful for quicker detection of PTD than the plateau or rise of level.