“C3, C4, C5 keep you alive,” or do they?

Contrary to traditional teaching in anatomy courses, historical data suggest that bilateral loss of phrenic nerve function does not necessarily result in death.     

Feeling “Pooped” and “Run Down?”: Fatigue Experiences in Latino Cancer Patients

The purpose of this study was to describe fatigue and the utility of the Multidimensional Fatigue Symptom Inventory‐Short Form (MFSI‐SF) to assess fatigue among Latino cancer patients. Twenty‐two female and thirteen male Latino cancer patients participated in one of seven focus groups that took place in the southern California USA‐Mexico border region. Participants were asked to describe their fatigue experiences; participants also completed the MFSI‐SF and provided feedback about the items. Content analyses indicate that there are gender differences in the salience of the challenges that fatigue poses. Men tended to focus on physical symptoms, whereas women tended to focus on the impairment in role fulfillment. Findings have implications for intervention and health education efforts in Latino cancer patients.     

B‐type suppression: A role played by “regulatory B cells” or “regulatory plasma cells”?

B‐cell depletion can improve disease in some patients with rheumatoid arthritis or multiple sclerosis, indicating the pathogenic contribution of B cells to autoimmunity. However, studies in mice have demonstrated that B cells have immunosuppressive functions as well, with IL‐10 being a critical mediator of B‐cell‐mediated suppression. IL‐10‐secreting B cells have been shown to promote disease remission in some mouse models of autoimmune disorders. Human B cells also produce IL‐10, and evidence is accumulating that human IL‐10‐producing B cells might inhibit immunity. There is considerable interest in identifying the phenotype of B cells providing IL‐10 in a suppressive manner, which would facilitate the analysis of the molecular mechanisms controlling this B‐cell property. Here, we review current knowledge on the B‐cell subpopulations found to provide suppressive functions in mice, considering both the pathological context in which they were identified and the signals that control their induction. We discuss the phenotype of B cells that have IL‐10‐dependent regulatory activities in mice, which leads us to propose that antibody‐secreting cells are, in some cases at least, the major source of B‐cell‐derived regulatory IL‐10 in vivo. Anti‐inflammatory cytokine production by antibody‐secreting cells offers a novel mechanism for the coordination of innate and humoral immune responses.     

Blepharophimosis,hypoplastic radius,hypoplastic left heart,telecanthus, hydronephrosis,fused metacarpals,and “prehensile” halluces: A new syndrome?

We report on the prenatal ultrasound and postnatal findings in an infant born to a healthy, nonconsanguineous couple. The infant had microcephaly, telecanthus, blepharophimosis, cleft palate, micrognathia, abnormally modeled ears, hypoplastic left heart, hypoplastic radii and ulnae with radial subluxation, pseudoarthrotic distal humeri, fused metacarpals, tibial bowing, unusual feet with long halluces, hydronephrosis, patent urachus, abnormal electroencephalogram, and normal karyotype. To our knowledge, this combination of anomalies has not been recognized previously and may represent a new condition. Am. J. Med. Genet. 80:309–313, 1998. © 1998 Wiley-Liss, Inc.     

Should heart rate variability be “corrected” for heart rate? Biological,quantitative, and interpretive considerations

Metrics of heart period variability are widely used in the behavioral and biomedical sciences, although somewhat confusingly labeled as heart rate variability (HRV). Despite their wide use, HRV metrics are usually analyzed and interpreted without reference to prevailing levels of cardiac chronotropic state (i.e., mean heart rate or mean heart period). This isolated treatment of HRV metrics is nontrivial. All HRV metrics routinely used in the literature exhibit a known and positive relationship with the mean duration of the interval between two beats (heart period): as the heart period increases, so does its variability. This raises the question of whether HRV metrics should be “corrected” for the mean heart period (or its inverse, the heart rate). Here, we outline biological, quantitative, and interpretive issues engendered by this question. We provide arguments that HRV is neither uniformly nor simply a surrogate for heart period. We also identify knowledge gaps that remain to be satisfactorily addressed with respect to assumptions underlying existing HRV correction approaches. In doing so, we aim to stimulate further progress toward the rigorous use and disciplined interpretation of HRV. We close with provisional guidance on HRV reporting that acknowledges the complex interplay between the mean and variability of the heart period.     

Postnatal stress in mice: Does “stressing” the mother have the same effect as “stressing” the pups?

Short- and long-term effects of brief maternal separation, maternal exposure to novel male odor, and standard rearing were compared in NMRI mice. The first condition consisted of 15 min of daily exposure of pups to clean bedding (CB), and the second condition consisted of 15 min of mothers' exposure to the odor of strange males (SM), for 14 days after birth starting from postnatal Day 1. Thus, both conditions entailed the same period of maternal separation. A control mother-offspring group was left undisturbed (nonhandled, N-H). Corticosterone levels of mothers and pups were measured at the end of the last manipulation session. Corticosterone levels were higher in SM mothers, differing from both those of CB and of control dams; CB pups showed the highest corticosterone levels in comparison with the pups belonging to the other groups. Maternal behavior observed as furthest as possible from the daily separation session did not differ among the three groups. The behavioral response to 0.5 mg/kg of apomorphine in 15-day-old pups was enhanced in both CB and SM animals, which suggests an alteration of dopaminergic functioning. Finally, adult CB and SM male mice showed an increase in the percentage of time and entries into the open arms of the plus-maze in comparison to nonhandled males. This study indicates that exposure to ecologically relevant stimuli elicited a stress response in lactating dams. This "social stress" brings about short- and long-term effects in the offspring, even in the absence of any direct manipulation of the pups.     

Can the serological status of “anti‐HBc alone” be considered a sentinel marker for detection of “occult” HBV infection?

Some individuals have "occult" infection with hepatitis B virus (HBV), defined as presence of HBV genome in the serum or liver tissue without HBV surface antigen (HBsAg) in the serum. The aim of this study was to investigate whether serum antibodies against HBV core antigen in isolation ("anti-HBc alone") are a useful marker of "occult" HBV in patients with or without hepatitis C virus (HCV) infection. "Anti-HBc alone" was detected in the sera of 119/6,544 (1.8%) asymptomatic outpatients referred to the diagnostic laboratory for routine testing for viral hepatitis, 62/607 (10.2%) drug users, and 42/195 (21.5%) patients with hepatocellular carcinoma. Using three in-house nested-PCR amplification assays to detect HBV preS-S (S), precore-core (C), and Pol viral regions, respectively, "occult" HBV sequences were found in 9 of the 223 sera (4.0%) with "anti-HBc alone." The highest prevalence of "occult" HBV sequences (5.9%) was detected in "anti-HBV alone" sera of individuals referred to the diagnostic laboratory without HCV antibodies. Direct sequencing of all PCR products confirmed the specificity of the PCR reactions and revealed the predominance of HBV genotype D. The data presented in this study suggest that detection of "anti-HBc alone" could reflect unrecognized "occult" HBV infection and that physicians should consider investigating such patients with HBV molecular tests.     

The concept of “we”: A community social psychology myth?

This paper questions the conceptions of community found in the literature on community psychology, as well as those employed in everyday life, which reflect the notion of community as a “we”. This notion is understood as a compact and homogenous group, assuming that their members feel, think, and behave in similar and predictable ways, as corresponds to their belonging to the community. It implies a set of processes such as membership, inclusion, identity, feeling of belonging, and an emotional bond or sense of community which do not seem to vary across time and within members of the community. Thus, this meaning of “we” appeals to an idealized vision of the community, and as we shall argue in this paper, it is rather a dialectic and dynamic process, in which shared needs and group processes built across time afford intragroup diversity, disagreements, and fluctuations in dimensions such as participation in collective actions, among others. © 1996 John Wiley & Sons, Inc.     

Does the new automated “HALO” nipple aspiration fluid system really deliver as promised? The answer is “No,but…”: A literature review of the role of breast fluid cytology in cancer risk assessment

The HALO breast Pap test is a new automated nipple aspiration fluid (NAF) system that was recently introduced into the market. In an extensive marketing campaign directed principally toward OB/GYN practices, including endorsements from few local news media, HALO has been promoted as the “new Pap screening test for breast.” Physicians are encouraged to perform this test on all women, as part of their annual examination, with claims that HALO will detect breast cancers as early as 10 years before mammography. These arguments are made more appealing to physician's offices by highlighting the potential positive financial impact on their practices, without consuming physician time, as medical assistants or technicians can perform this test. As a result of this directed campaign, cytology laboratories are increasingly confronted with implementing the HALO system and clinicians are increasingly soliciting pathologist's input regarding its validity. Yet, there is no data available regarding this new system, outside rare reports sponsored by the manufacturer. In this discussion, I examine the pros and cons of this new NAF system, including literature review of breast fluid cytology, and how it relates to breast cancer risk assessment. Diagn. Cytopathol. 2009. © 2009 Wiley‐Liss, Inc.     

Severe facial clefting,limbic dermoid,hypoplasia of the corpus callosum,and multiple skin appendages: Severe frontofacionasal “dysplasia” or newly recognised syndrome?

We report on a child with severe midline facial cleft, bilateral cleft lip and palate, telecanthus, S-shaped palpebral fissures, limbic dermoid, midface hypoplasia, hypoplastic corpus callosum, and multiple skin appendages. This case may be an example of severe frontofacionasal “dysplasia” or a newly recognised syndrome. © 1996 Wiley-Liss, Inc.     

Does subdivision of the “atypical” urine cytology increase predictive accuracy for urothelial carcinoma?

Urine cytology is routinely used for early diagnosis and monitoring of patients with hematuria or a history of urothelial carcinoma, but its clinical utility is greatly diminished by a high frequency of “atypical” specimens, reportedly around 20% in the literature. We compared our results with double‐stained urine cytology specimens (papanicolaou and acid hematoxylin stains) with published results with only a single or double papanicolaou stain. The acid hematoxylin stain enhanced nuclear chromatin staining, eliminated significant background debris, and improved visibility of diagnostic cells in the presence of obscuring blood. Medical records of all urine cytologies received between 2005 and 2012 in our laboratories were reviewed. The study group consisted of all cases with bladder biopsy follow‐up within one year of cytology. Of 43,131 urine cytologies diagnosed in our laboratories, biopsy follow‐up results were available within one year in 10,473 cases, including 852 for symptoms and 1,461 for follow‐up of bladder cancer. An additional 6,427 cases had cystoscopy results in which no biopsy was obtained. Cases were classified as negative (81.6%), atypical, favor reactive (2.9%), atypical, favor neoplastic (7.3%), suspicious (5.7%), and malignant (2.5%), with subsequent frequencies for urothelial cancer on biopsy of 13.3%, 31.1%, 37.6%, 53.6%, and 74.3%, respectively. No significant difference was found if atypical was subdivided into two categories: favor reactive and favor neoplastic. Subdivision of the atypical category did not improve diagnostic accuracy. Addition of the acid hematoxylin stain decreased the incidence of atypical urine cytologies from about 20% to 10.2%. Diagn. Cytopathol. 2014;42:1034–1044. © 2014 Wiley Periodicals, Inc.     

Autosomal dominant osteopetrosis type II with “malignant” presentation: further support for heterogeneity?

The osteopetroses are a heterogeneous group of disorders characterised by generalised bony sclerosis. The autosomal dominant form usually has a "benign" prognosis, in contrast to the "malignant" course of the autosomal recessive variety. In this paper we describe a kindred in which the phenotypic spectrum varied from an asymptomatic condition in adults to a severely affected infant, presenting with anaemia, hepatosplenomegaly, hydrocephalus and blindness. The findings in this family are reported and discussed to elucidate further the possible genetic heterogeneity in autosomal dominant osteopetrosis.