Alcohol as a Correlate of Unprotected Sexual Behavior Among People Living with HIV/AIDS: Review and Meta-Analysis

The present investigation attempted to quantify the relationship between alcohol consumption and unprotected sexual behavior among people living with HIV/AIDS (PLWHA). A comprehensive search of the literature was performed to identify key studies on alcohol and sexual risk behavior among PLWHA, and three separate meta-analyses were conducted to examine associations between unprotected sex and (1) any alcohol consumption, (2) problematic drinking, and (3) alcohol use in sexual contexts. Based on 27 relevant studies, meta-analyses demonstrated that any alcohol consumption (OR = 1.63, CI = 1.39–1.91), problematic drinking (OR = 1.69, CI = 1.45–1.97), and alcohol use in sexual contexts (OR = 1.98, CI = 1.63–2.39) were all found to be significantly associated with unprotected sex among PLWHA. Taken together, these results suggest that there is a significant link between PLWHA’s use of alcohol and their engagement in high-risk sexual behavior. These findings have implications for the development of interventions to reduce HIV transmission risk behavior in this population.     

A TSH secreting pituitary tumour causing hyperthyroidism: presentation of a case and review of the literature.

A 45 year old male with a 12 year history of mild hyperthyroidism and a pituitary tumour is presented. He had both clinical and laboratory evidence of hyperthyroidism and his serum TSH was persistently and markedly elevated. A TRH test resulted in no further rise in serum TSH. No evidence of pituitary or peripheral endocrine deficiencies existed and prolactin levels were normal. Craniotomy was performed and a pituitary adenoma was removed. On light microscopy, it was mostly composed of chromophobes. However, occasional granulated cells were observed, and on electron microscopy, most of the cells contained fine granules, which suggested possible thyrotroph origin of the tumour. One week post-operatively the patient's serum TSH returned to normal. Again, TRH produced no response in TSH. The patient became hypothyroid by clinical and laboratory findings and is currently on thyroid replacement therapy. The previously reported TSH secreting tumours associated with hyperthyroidism are reviewed.     

American Orthopaedic Foot and Ankle Society ankle–hindfoot scale: A cross-cultural adaptation and validation study from Iran

Background

The use of valid and reliable outcome rating scales is essential for evaluating the result of different treatments and interventions. The purposes of this study were to translate and culturally adapt the American Orthopaedic Foot and Ankle Society ankle–hindfoot scale (AOFAS-AHFS) into Persian languages and evaluate its psychometric properties.

Effects of education and experience on detection of proximal caries on digital radiographs

Objectives

Early detection of proximal caries can result in less-invasive treatments. This study aimed to assess the effects of education and experience on accurate detection of proximal caries on digital radiographs.

Methods

Third-year and sixth-year dental students, maxillofacial radiology postgraduate students, and general dentists comprised the study population (total, 28). Standard digital bitewing radiographs were obtained for 50 extracted teeth, and evaluated for proximal caries on a monitor. All assessments were performed under ambient light (<50 lux). The teeth were subsequently sectioned into 1-mm-thick slices. After reaching the lesion, it was visually inspected, and then determined for its depth in each slice using a caries detector solution. A four-scale grading system for assessment of lesion depth. These results were considered to be the gold standard, and compared with the opinions of the observers. Data were analyzed using SPSS16 software for kappa, sensitivity, specificity, false-negative, false-positive, negative predictive value, and positive predictive value statistics. The kappa coefficients were used to compare the accuracy of diagnoses of the observers and the extents of involvement of tooth structures.

Results

The diagnostic accuracy for grade I caries was 21.9 % among third-year dental students, 17.4 % among sixth-year dental students, 34.5 % among maxillofacial radiology postgraduate students, and 14.3 % among general dentists. The respective diagnostic accuracies were 16.2, 15.2, 5.7, and 7.6 % for grade II caries and 3.5, 32.1, 25, and 14.2 % for grade III caries.

Conclusions

Although education played a great role in improving caries detection skill, it failed to raise it to an acceptable range.

     

Intracystic breast carcinoma: case study and review

Breast carcinoma is the most common cancer in women, the second leading cause of cancer-related mortality in women, and the leading cause of death from cancer in women between the ages of 40 and 44. While cystic breast disease is the most frequent cause of benign breast masses, intracystic breast cancers are rare. We present a case of a postmenopausal woman with a large cystic breast carcinoma with its interesting radiologic and cytopathologic findings and review the literature.     

Familial colorectal cancer syndrome X

In recent decades there have been significant advances in our understanding of the genes that underlie hereditary susceptibility to colorectal cancer (CRC). In 2007 it is well established that mutations in DNA repair genes (MLH1, MSH2, MSH6, MYH) and Wnt pathway signal transduction inhibitors (APC) underlie a significant percentage of hereditary CRC susceptibility. However, it also is clear that the known CRC susceptibility genes do not explain fully the inherited risk seen even in families meeting the revised Bethesda guidelines. Furthermore, the optimal medical management of these syndromes is still being defined. What underlies CRC susceptibility in these highly unusual families that do not have identifiable mutations in the known genes, often referred to as syndrome X? This review addresses this important question that is relevant to our current understanding of the management of individuals with hereditary predisposition to CRC.