Correlates of Suicide in Building Industry Workers

Suicide within the construction industry in Queensland, Australia was reportedly high in a recent Royal Commission report. The current study examined the incidence and causes of suicide in this industry using psychological autopsy and focus group investigations. A total of 64 male suicides occurred over the seven-year period, representing a crude suicide rate of 40.3 per 100,000, significantly greater than the working age Australian male rate. Young employees were at excessive risk with separation/divorce, relationship problems, and untreated psychiatric conditions the major contributors. Focus groups emphasized the importance of work/home interface factors and industry-specific factors preceding suicide.     

Pulmonary function over 2 years in diabetic patients treated with prandial inhaled Technosphere Insulin or usual antidiabetes treatment: a randomized trial

Aims: Development of inhaled insulin has increased the need to understand its pulmonary safety. This study evaluated pulmonary function changes in diabetes patients receiving inhaled Technosphere Insulin (TI) or usual antidiabetes treatment (usual care). Methods: This randomized, open‐label study was conducted at 220 sites (25 July 2005 to 29 August 2008). Pulmonary function tests [forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC), total lung capacity (TLC) and lung diffusion capacity for carbon monoxide (DL_CO)] were prospectively followed over 2 years in patients with type 1 or type 2 diabetes receiving TI (n = 730) or usual care (n = 824), along with a cohort without diabetes not receiving any specific therapy (n = 145). Results: Baseline demographics and pulmonary function were similar between diabetes treatment groups. Lung function declined from baseline in all groups. TI was non‐inferior to usual care for mean change in FEV₁ from baseline to month 24 [mean (s.e.m.) 0.037 (0.0119) l; 95% CI 0.014 to 0.060] using mixed‐model repeated‐measure with a pre‐specified non‐inferiority margin of 50 ml/year. After a greater initial decline at month 3 with TI, rate of change (slope) in FEV₁, FVC and DL_CO (months 3–24) was not statistically different between treatment groups. TI was well tolerated; no serious safety concerns emerged. The most common respiratory event associated with TI was mild, transient cough, occurring within minutes of inhalation. Conclusions: Observed changes in lung function with TI were small, occurred early after therapy initiation, remained non‐progressive over 2 years and were unlikely to be clinically meaningful.     

How to recognize stent graft infection after endovascular aortic repair: the utility of 18F-FDG PET/CT in an infrequent but serious clinical setting

Annals of Nuclear Medicine - To evaluate the diagnostic performance of 18F-FDG PET/CT in the detection of stent graft infection (SGI). In a retrospective study, two nuclear medicine physicians have...     

MRI breast screening revisited

Contrast‐enhanced breast MRI is a standard evidence‐based component of supplemental screening in conjunction with mammography for higher‐risk populations because of its high sensitivity for detecting breast cancer; the use of breast MRI for screening in high‐risk populations is recommended in multiple national and international guidelines. The current MRI exam, however, is expensive relative to other screening technologies such as mammography, and relatively more time‐intensive. Recent investigations have focused on techniques that have the potential for improving efficiency of the breast MRI exam, decreasing acquisition and reading times, without impacting diagnostic accuracy. The purpose of this article is therefore to provide an overview of current MRI guidelines for screening for breast cancer and to discuss evolving technological approaches to breast MRI, in particular abbreviated and ultrafast MRI protocols, as well as MRI protocols without contrast that have the potential to improve MRI screening. Level of Evidence: 5 Technical Efficacy Stage: 2 J. Magn. Reson. Imaging 2019;49:1212–1221.     

The contribution of B cells to renal interstitial inflammation

Local B-cell infiltrates play a role in tissue fibrosis, neolymphangiogenesis, and renal allograft survival. We sought to characterize the B-cell infiltrates, factors involved in B-cell recruitment, and lymphangiogenesis in renal interstitial injury (ie, acute and chronic interstitial nephritis and chronic IgA nephropathy). CD20-positive B cells formed a prominent part of the interstitial infiltrating cells. Together with CD3-positive T cells, the CD20-positive B cells formed larger nodular structures. CD10-positive pre-B cells were rare, and the majority were mature CD27-positive B cells. Proliferating B cells were detected within nodular infiltrates. The level of mRNA expression of the chemokine CXCL13 was increased and correlated with CD20 mRNA in the tubulointerstitial space. CXCL13 protein was predominantly found at sites of nodular infiltrates, in association with CXCR5-positive B cells. Furthermore, sites of chronic interstitial inflammation were associated with a high number of lymphatic vessels. B-cell infiltrates form a prominent part of the interstitial infiltrates both in primary interstitial lesions and in IgA nephropathy. CXCR5-positive B cells might be recruited via the chemokine CXCL13 and seem to contribute to the formation of intrarenal lymphoid follicle-like structures. These might represent an intrarenal immune system.