Coverage of Antimicrobial Resistance in the German Press: 1993–2013

The present study explores the coverage of antimicrobial resistance (AMR) and its associated risks in the German press between 1993 and 2013. Using quantitative content analysis, we explored the corpus of newspaper articles to evaluate the quality of risk reporting. Our findings show an overall increase in the quality of risk-related information: articles contain more substantiating statements describing objectively cognizable phenomena with absolute numbers, prevalences, estimations, and tendencies over time. There is also an increase in the level of precision of such statements. On the other hand, the results suggest that there is little contextualization of risk information and mortality data is often communicated in absolute numbers, which makes it harder to understand and interpret the information. While the debate about the risks of AMR is led by the scientific community, the overall tone of the coverage is alarmist, which can result in growing skepticism of scientific expertise.     

Phase I/II trial of intravenous NDV-HUJ oncolytic virus in recurrent glioblastoma multiforme.

We undertook a Phase I/II trial in patients with apparent recurrent glioblastoma multiforme (GBM) based on imaging studies to determine the safety and tumor response of repetitive intravenous administration of NDV-HUJ, the oncolytic HUJ strain of Newcastle disease virus. The first part of the study utilized an accelerated intrapatient dose-escalation protocol with one-cycle dosage steps of 0.1, 0.32, 0.93, 5.9, and 11 billion infectious units (BIU) of NDV-HUJ (1 BIU = 1 x 10(9) EID(50) 50% egg infectious dose) followed by three cycles of 55 BIU. Virus was administered by intravenous infusion over 15 min. In the second part, patients received three cycles of 11 BIU. All patients without progressive disease were maintained with two doses of 11 BIU iv weekly. Eleven of the 14 enrolled patients (11-58 years, Karnofsky performance scale 50-90%) received treatment. Toxicity was minimal with Grade I/II constitutional fever being seen in 5 patients. Maximum tolerated dose was not achieved. Anti-NDV hemagglutinin antibodies appeared within 5-29 days. NDV-HUJ was recovered from blood, saliva, and urine samples and one tumor biopsy. One patient achieved a complete response. Intravenous NDV-HUJ is well tolerated. The findings of good tolerability and encouraging responses warrant the continued evaluation of NDV-HUJ in GBM, as well as other cancers.     

Seasonal influenza vaccination trends from 2007–2011 in privately insured children and adults in the United States

Background

To ensure adequate protection from seasonal influenza in the US, the Advisory Committee on Immunization Practices recommends vaccination of all persons aged 6 months or older, with rare exceptions. It also advises starting vaccination as soon as available and continuing throughout the influenza season. This study examined US seasonal vaccination trends during five consecutive influenza seasons in privately-insured children and adults.

Methods

This retrospective, observational cohort study examined trends in influenza vaccination during the 2007–2008 through 2011–2012 influenza seasons using administrative claims data from a large national insurer.

Results

The size of analysis population ranged from 1144,098 to 1245,487 (children, ≥6 months-17 years of age) and from 3931,622 to 4158,223 (adults, 18–64 years of age). Vaccination frequency increased through 2010–2011, was most frequent in young children, and decreased with age. Vaccination rates were highest in the Northeast and lowest in the West and were higher in individuals with frequent outpatient office visits than in those with no or rare visits, with larger differences seen in children. Between 2007 and 2011, the use of preservative-free inactivated vaccine increased, the use of multidose vaccines containing preservatives decreased, and the use of live attenuated influenza vaccines increased among children 2–17 years of age. From 2007–2008 through 2009–2010, the timing of vaccination each year began earlier than the previous one; it remained stable from 2009–2010 through 2011–2012.

Conclusion

Annual influenza vaccination claims for privately-insured children and adults increased and shifted earlier from 2007 through 2009–2011. During the 2011–2012 influenza season, 25.4% of children aged 6 months-17 years and 12.3% of adults aged 18–64 years were vaccinated. Increasing influenza vaccination should remain a priority, and alternative venues for seasonal influenza vaccination should be considered in order to meet the Healthy People 2020 goal of 80% to 90% coverage among children.     

CORE needle biopsy of orbital tumors

Background

In some orbital mass lesions, histology may be the only way to establish an accurate diagnosis. Core needle biopsy (CNB) is widely performed in oncology, and unlike fine needle aspiration biopsy (FNAB), it can provide sufficient tissue sample for histology and immunohistochemistry. The purpose of this study was to evaluate the usefulness and possible complications of CNB of orbital tumors.

Methods

Fifty orbital lesions from 46 patients (age: 2–84 years) were biopsied using 20-gauge and 18-gauge semi-automated needles; 11 procedures were performed under ultrasound guidance. All 50 samples received routine histopathological examination and immunohistochemical analysis.

Results

Specimens diagnostically sufficient for histological analysis were obtained in all biopsies. The histopathological diagnosis was established in 94 % of specimens: 30 tumors were malignant: lymphoma (20); rhabdomyosarcoma (six); lacrimal gland carcinoma (one); breast carcinoma metastasis (two); melanoma (one); three were benign; ten inflammatory; and four were orbital fibrosis. Three biopsies were nondiagnostic: two (lymphoma, angiofibroma) showed undetermined identification and one was a false-negative (lacrimal gland adenocarcinoma was misdiagnosed as fibrous tissue). The diagnoses were confirmed by excisional or incisional biopsy in 26 patients. The concordance rate in patients with a surgically confirmed diagnosis was 88 %. The sensitivity, specificity and accuracy for differentiating malignant from benign lesions were 94 %, 100 %, and 96 %, respectively. Two patients suffered complications: mild retrobulbar hematoma with no decreased visual acuity. There was no damage to the globe or optic nerve, motility disorder, or infection.

Conclusions

CNB of orbital mass lesions is a safe procedure that provides a sufficient amount of tissue for histology and immunohistochemistry, and may be useful for improving the quality of the pathological diagnosis of orbital tumors.     

Using health-related quality of life to predict cardiovascular disease events

Quality of Life Research - Although strong associations between self-reported health and mortality exist, quality of life is not conceptualized as a cardiovascular disease (CVD) risk factor. Our...     

Gamna‐Gandy bodies in fine‐needle aspiration from abdominal splenosis: A clue to underlying portal hypertension

A 40‐year‐old woman presented with abdominal pain and jaundice. Past medical history was significant only for splenectomy following a motor vehicle accident. Owing to presence of multiple peritoneal nodules on computerized tomography (CT) and elevated serum CA‐125, ovarian peritoneal carcinomatosis was suspected. Ultrasound‐guided fine‐needle aspiration (FNA) revealed presence of abundant hemosiderin, leukocytes, endothelial cells, and fungal hypha‐like structures. No evidence of neoplasia was found. Findings were consistent with Gamna‐Gandy bodies (GGBS) within splenic tissue. Based on history of splenectomy and FNA findings, a diagnosis of abdominal splenosis with presence of GGBS was made. Workup for hepatic cirrhosis and portal hypertension was recommended. Liver biopsy confirmed presence of cirrhosis. To our knowledge, this is the first report of GGBS identified within abdominal splenosis. It is important for pathologists to be able to recognize GGBS and to be aware of their relationship to portal hypertension and other conditions associated with severe vascular congestion or hemorrhage. History and pathogenesis of GGBS, their diagnostic morphologic features and a review of cases of GGBS diagnosed via cytology are given.