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.     

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.     

“Who” should be focused? The influence of focus status on pronoun resolution

Focus is assumed to be able to enhance the salience of a focused constituent and thereby facilitate the interpretation of a pronoun that refers to a focused antecedent relative to an unfocused antecedent. To assess how discourse‐based focus structure influences the interpretation of a pronoun and whether this process is modulated by the grammatical role of the antecedent, we conducted an ERP study in which the focus status of a pronoun's potential antecedents was manipulated by means of a wh‐question‐answer structure. We found that, relative to those in the focused position, pronouns referring to antecedents in the unfocused position evoked enhanced positive responses in both early (180–230 ms) and late time windows (400–800 ms). Moreover, while a larger positivity was evoked by object‐referring pronouns compared to subject‐referring pronouns in the 400–800 ms time window over the right hemisphere, there was no effect of grammatical role in the 180–230 ms time window. These findings indicate that, while the initial stage of pronoun resolution is modulated by focus information assigned via a wh‐question structure, integration of the pronoun and its antecedent into a coherent discourse representation at the later stage could be constrained by various factors, including the focus status and possibly the grammatical role of the antecedent.     

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.     

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.     

“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.     

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.