Surveillance mammography after treatment for male breast cancer

Breast Cancer Research and Treatment - To identify the practice patterns related to use of surveillance mammography in male breast cancer (MaBC) survivors. Using administrative claims data from...     

Normal values for a clinical test of letter-recognition contrast thresholds

PURPOSE: To investigate the contrast thresholds (CTs) in normal subjects using a high-luminance, letter-recognition task under clinically relevant testing conditions. SETTING: Texas Tech University Health Sciences System, Lubbock, Texas, USA. METHODS: Sixty normal subjects aged 20 to 49 years with a best corrected visual acuity of 20/20 or better in both eyes participated. M & S Technologies software was used to display black-on-white Sloan letters at contrast levels of 25%, 20%, 15%, 12%, and 10% through 1% in 1% decrements. The effects of age, sex, optotype size, eye dominance, ambient illumination level (bright = 625 - 630 lux; dim = <3 lux), and direction of approach to threshold were analyzed using a multivariate, ordinary, least-squares analysis. RESULTS: Age and sex did not influence CTs. Ascending versus descending testing was not statistically significant (P>.5). The effects of room illumination and eye dominance were significant (P<.01). Significant differences were found between 20/30 and 20/50, 20/30 and 20/70, and 20/50 and 20/70 optotype sizes (P<.01 for all comparisons). CONCLUSIONS: A commercially available, computer-based test of CTs was easy to administer and apparently easy for inexperienced subjects to perform. The results suggest criteria for detecting visual problems concerned with familiar but complex spatial-image shapes. This information might be used to assess the effects of treatments such as laser refractive surgery on recognition contrast. Further study is warranted.     

Probably Benign Solid Breast Lesions on Ultrasound: Need for Biopsy Reassessed

Objective: To determine the negative predictive value of ultrasound for breast masses with probably benignmorphology, and to assess whether follow-up may be an acceptable alternative to biopsy. Methods: After InstitutionalReview Board approval, all solid breast masses categorized as probably benign (American College of Radiology BreastImaging Reporting and Data System [BI-RADS] 3) on ultrasound from January 2014 to December 2015, and havingeither tissue diagnosis or imaging stability for 24 months, or downgrading to BIRADS 2 during imaging surveillancewere included. Result: A total of 157 lesions in 40 patients constituted the study population. The mean patient age was31.3 years (range, 20-56 years). Seventeen of these 157 lesions underwent tissue diagnosis with no invasive breast cancer.Out of the remaining 140 lesions, 115 were stable on imaging for 24 months or more. The rest 25 were deemed benignbecause of decrease in size on follow up (n=1), non-recommendation of further imaging by the second radiologist onfollow up ultrasound (n= 13) or presence of benign tissue diagnosis in the largest lesion (n=11). Conclusion: Ultrasoundhas 100% negative predictive value for breast lesions with probably benign morphology, whether palpable or not.Follow up is an appropriate option to immediate biopsy of such lesions keeping in mind that noncompliance withsurveillance may be a potential problem.     

Patterns of HIV infection among native and refugee Afghans

The current study was conducted to explore the origins of the HIV epidemics among the Afghan refugees in Pakistan and the native Afghans in Afghanistan. Phylogenetic analysis of HIV gag gene from 40 samples showed diverse HIV variants, originating from a number of countries. Intermixing of diverse HIV variants among Afghans may give rise to seeding of infections with rare HIV strains which may pose serious challenges for the treatment and control of infection.     

High prevalence of vitamin D deficiency in Pakistani mothers and their newborns

Objective

To determine the prevalence of vitamin D deficiency in Pakistani parturients and their newborns and to assess the correlation between maternal and newborn serum levels of the vitamin D metabolite 25-hydroxy vitamin D3.

Methods

A prospective study of parturients presenting to the labor suite with a singleton pregnancy. Maternal and cord blood were collected for estimation of serum 25-hydroxy vitamin D3.

Results

In total, 89% of the gravidae were deficient in vitamin D (serum 25-hydroxy vitamin D3 < 30 ng/mL). There was a positive correlation between maternal and cord blood 25-hydroxy vitamin D3 levels(r = 0.68; P < 0.001). Inverse correlations were noted between cord blood 25-hydroxy vitamin D3 and a longer duration of gestation (r = − 0.33; P = 0.003) and with the newborn's birth weight (r = − 0.23; P = 0.048). Maternal 25-hydroxy vitamin D3 levels were inversely correlated with maternal mean arterial pressure (r = 0.029; P < 0.020).

Conclusion

There was a high prevalence of vitamin D deficiency in the Pakistani parturients and their newborns. There was a correlation between higher maternal vitamin D levels and lower blood pressure in the mothers.     

Human herpesvirus 7 in pediatric hematopoietic stem cell transplantation

BACKGROUND: Little is known about the significance of human herpesvirus 7 (HHV-7) in pediatric hematopoietic stem cell transplantation (HSCT). OBJECTIVE: To evaluate children post autologous and allogeneic HSCT, with a positive PCR or immunohistochemistry for HHV-7 either from blood, cerebrospinal fluid (CSF) or any other pathology specimen. Clinical data for these patients were collected examining symptoms and signs, engraftment, acute infectious complications, graft versus host disease (GVHD) where applicable, and survival. RESULTS: Between June 1999 and June 2003, 265 HSCT were performed in The Hospital for Sick Children, Toronto, allogeneic (n = 163) and autologous (n = 102). Nine children were positive for HHV-7 at a median of 21 days (range 16-27 days) post-HSCT. All had allogeneic transplantation. The most common underlying diagnosis was acute leukemia and 7 had matched unrelated donor (MUD) transplantation. Eight of the nine patients had grade II-IV acute GVHD and all of them had multiple infectious episodes with fungal, bacterial and other viral pathogens. Although not fully attributed to HHV-7, the clinical syndrome varied from fever, vomiting and diarrhea to septic shock. Four patients died due to GVHD and sepsis. CONCLUSION: HHV-7 was uncommon post-HSCT. It was associated with severe GVHD and sepsis secondary to severe immunosuppression.