Tumor-Associated Antibodies in the Serum of Patients with Ocular Melanoma: IV. Correction for Smooth Muscle Antibodies

Serum samples from patients with choroidal malignant melanoma, carcinoma metastatic to the choroid and “normal” controls containing tumor-associated antibodies (TAA) to tissue cultured melanoma cells were examined for the presence of smooth muscle antibody (SMA). Sera found to contain SMA were absorbed with actin or thrombosthenin and reassayed for TAX With this modification, 72% (78% before absorption) of patients with uveal melanoma, 26% (78% before absorption) of patients with carcinoma metastatic to the choroid and 13% (24% before absorption) of “normal” controls were found to have tumor-associated antibodies in their serum.     

Angioid streaks. I. Ophthalmoscopic variations and diagnostic problems.

Fifty-six patients with angioid streaks were evaluated ophthalmologically. Most had repeated fundus photography and fluorescein angiography during a follow-up period of 6 months to 7 years. The ophthalmoscopic variations and diagnostic difficulties which occurred were noted. In most instances, the angioid streaks were not initially recognized and the patient was referred with another diagnosis. In several cases, the peripapillary, macular, and peripheral changes seen with angioid streaks were found to simulate other better known fundus conditions, resulting in the erroneous diagnosis and improper treatment. In some cases, the angioid streaks were so subtle that they were overlooked and in others they were observed, but initially interpreted as something else. Because of the medical significance of angioid streaks, ophthalmologists should be aware of their variable features. These are discussed, with emphasis upon those subtleties which differentiate angioid streaks from other conditions which they may simulate. On the basis of these observations, an ophthalmoscopic differential diagnosis of angioid streaks is proposed.     

Prevention of toxoplasmosis in pregnancy: knowledge of risk factors

BACKGROUND: Infection with Toxoplasma gondii is common and usually asymptomatic, although it can have catastrophic consequences in a pregnant woman if passed to her developing fetus. Counseling of pregnant women about risk factor reduction may reduce the risk of congenital toxoplasmosis. This study was undertaken to assess and compare the knowledge of obstetricians and internists or family practitioners regarding well-established risk factors for toxoplasmosis infection. METHODS: The study surveyed 102 obstetricians, internists and family practitioners to assess their knowledge of risk factors for toxoplasmosis infection as well as their practices for primary prevention counseling of pregnant women. Responses were analyzed for differences. RESULTS: Obstetricians were more likely than internists or family practitioners to provide appropriate counseling on reducing the two most common risk factors for toxoplasmosis infection (undercooked meat consumption and gardening without gloves). However, over one quarter of all participants inappropriately advised pregnant women to avoid all cat contact. Obstetricians, internists and family practitioners were all likely to fail to identify undercooked meat consumption as the primary risk factor for toxoplasmosis transmission. CONCLUSIONS: Obstetricians appear to provide more appropriate counseling for primary prevention of toxoplasmosis than internists and family practitioners, but both groups of physicians inappropriately advised avoidance of all cat contact. Education of obstetricians, internists and family practitioners on risk factors for toxoplasmosis transmission is needed and may lower the rate of congenital toxoplasmosis as well as decrease the frequency of cat abandonment during pregnancy.     

Estimated cumulative radiation dose from PET/CT in children with malignancies: a 5-year retrospective review

Background  

The increasing use of serial PET/CT scans in the management of pediatric malignancies raises the important consideration of radiation exposure in children.     

Incidence of and factors associated with achieving target lipid levels in patients with peripheral arterial disease

BACKGROUND: Patients with peripheral arterial disease (PAD) have increased mortality compared with patients without PAD. Coronary artery disease (CAD) accounts for almost 75% of deaths in PAD patients. Studies suggest that PAD is underdiagnosed and atherosclerotic risk factors undertreated when compared with CAD. OBJECTIVE: To determine whether cholesterol guidelines are being met in patients with PAD and to determine whether any independent factors increase the likelihood of reaching goal low-density lipoprotein (LDL). DESIGN: A retrospective chart review of subjects diagnosed with PAD in 2001 at 2 Veterans Affairs Medical Centers. MEASUREMENTS: Univariate analysis compares baseline characteristics between those reaching goal and those who do not. Multivariate logistic regression analysis identified predictors of meeting LDL goal among PAD patients. RESULTS: Of 315 patients, 62% reached goal LDL. Those more likely to reach goal were older, had hypertension, and a history of CAD and stroke. Positive predictors of LDL goal were age and CAD, while smoking was a negative predictor. CONCLUSION: The majority of veterans with PAD received lipid-lowering medication and achieve goal LDL, but they are more likely to do so if they are older than 70 and have a history of CAD.