Recommendations on performance characteristics of diagnostic exposure meters: report of AAPM Diagnostic X-Ray Imaging Task Group No. 6.

Task Group 6 of the Diagnostic X-Ray Imaging Committee of the American Association of Physicists in Medicine (AAPM) was appointed to develop performance standards for diagnostic x-ray exposure meters. The recommendations as approved by the Diagnostic X-Ray Imaging Committee and the Science Council of the AAPM are delineated in this report and provide specifications on meter precision, calibration accuracy, calibration reference points, linearity, energy dependence, exposure rate dependence, leakage, amplification gain settings, directional dependence, the stem effect, constancy checks, and calibration intervals. The report summarizes recommendations for meters used in mammography, general purpose radiography including special procedures, computed tomography, and radiation safety surveys for x-ray radiography.     

Conventional and enhanced plaque neutralization assay for polio antibody

HEp-2 cells were more suitable as a cell substrate than Vero cells for plaque assay of wild or attenuated strains of poliovirus. Polio antibody titration by plaque neutralization was on the average 3.4 to 4.8 times more sensitive than antibody titration by virus CPE assay. The most pronounced effect on virus neutralization was achieved by extending the time of serum-virus interaction. Incubating the virus-antiserum mixture for 20 h instead of 1 h at 36 degrees C increased antibody titer to all three poliovirus types about 11- to 28-fold. Potentiation of poliovirus neutralization by heterologous antiglobulin was considerably less effective than with other virus-antibody systems. The virus plaque neutralization technique described should be capable of measuring minute amounts of antibody as required in special circumstances.     

Theology and bioethics: a marriage not made in heaven

Boone reviews the 20th volume in the Philosophy and medicine series, Theology and Bioethics: Exploring the Foundations and Frontiers, edited by Earl E. Shelp (D. Reidel; 1985). The volume's theme, if and how "theology can make a unique contribution to bioethics in our time," is addressed by L. Walters, B. Mitchell, R. McCormick, M. Farley, P. Lehmann, C. Hartshorne, H.T. Engelhardt, S. Hauerwas, J. Childress, and W. Frankena, with a prologue by J. Nelson and an epilogue by J. Cobb. Boone briefly summarizes and critiques each essay. While he responds favorably to the volume, he also believes the work would have been stronger if more attention had been focused directly on the metaethical issues arising from the "gap between theological belief and moral action."     

Development and Measurement of the Treatment Perceptions Survey (TPS) for Clients with Substance Use Disorders

The Journal of Behavioral Health Services & Research - Statistical reliability of the Treatment Perceptions Survey (TPS) questionnaire was examined using data from 19 California counties. The...     

Does the false-negative rate for 1 or 2 negative sentinel nodes after neo-adjuvant chemotherapy translate into a high local recurrence rate?

Prospective trials demonstrate that sentinel node (SN) biopsy after neo-adjuvant chemotherapy (NACT) has a significant false-negative rate (FNR) when only 1 or 2 SNs are removed. It is unknown whether this increased FNR correlates with an elevated risk of recurrence. Tumor Registry data at an NCI-Designated Comprehensive Cancer Center were reviewed from 2004 to 2018 for patients having a negative SN biopsy after NACT. Among 190 patients with histologically negative nodes after NACT having 1 (n = 42), 2 (n = 46), and ≥3 (n = 102) SNs, axillary recurrences occurred in 7.14%, 0%, and 1.96% (p = 0.09), breast recurrences occurred in 2.38%, 6.52%, and 0.98% (p = 0.12), and distance recurrences occurred in 16.67%, 8.70%, and 7.84% (p = 0.27), respectively. Time to first recurrence did not differ by SN count (p = 0.41). After adjustment for age, race, clinical stage, and receptor status, there were no differences in the rates of axillary (p = 0.26), breast (p = 0.44), or distance recurrence (p = 0.24) by numbers of SNs harvested. Median follow-up was 46.8 months. Despite higher post-NACT FNRs reported in randomized trials for patients having <3 sentinel nodes, recurrence rates were not significantly different for 1 versus 2 versus ≥3 SNs. This suggests that patients having 1 or 2 post-NACT SNs identified may not necessitate axillary dissection.     

The anatomy of the anterior inferior tibiofibular ligament and its relationship with the Wagstaffe fracture

BackgroundOur aim in this study was to identify the fibular footprint of the Anterior Inferior Tibiofibular Ligament (AITFL) and its relation to Wagstaffe fracture fragment size.MethodsWe examined 25 cadaveric lower limbs which were carefully dissected to identify the lateral ankle ligaments. The AITFL anatomy was compared to 40 Wagstaffe fractures identified from our ankle fracture database.ResultsThe AITFL origin was from the anterior fibular tubercle with an average length of 21.61 mm (95% CI 20.22, 22.99). The average distance of the distal aspect of the AITFL footprint to the distal fibula margin was 11.60 mm (95% CI 10.49, 12.71). In the ankle fractures analyzed, the average length of the Wagstaffe fragment was 17.88 mm (95% CI 16.21, 19.54). The average distance from the distal tip of the fibula to the Wagstaffe fracture fragment was 21.40 mm (95% CI 19.78, 23.01).In total there were 22 syndesmosis injuries. There was no statistical difference in Wagstaffe fragment size between stable and unstable groups.ConclusionThe AITFL fibular origin was both larger and more distal than the Wagstaffe fracture fragments seen in our institution. Therefore, this suggests that a ligamentous failure will also have to occur to result in syndesmotic instability. The size of fracture fragment also did not confer to syndesmotic instability on testing.Level of Evidence - 3