Limited English proficiency and breast and cervical cancer screening in a multiethnic population

OBJECTIVES: We examined the relationship between ability to speak English and receipt of Papanicolaou tests, clinical breast examinations, and mammography in a multiethnic group of women in the United States. METHODS: We used longitudinal data from the Study of Women Across the Nation to examine receipt of breast and cervical cancer screening among Chinese, Japanese, Hispanic, and White women who reported reading and speaking (1) only a language other than English, (2) another language more fluently than English, or (3) only English or another language and English with equal fluency. Logistic regression was used to analyze the data. RESULTS: Reading and speaking only a language other than English and reading and speaking another language more fluently than English, were significantly and negatively associated with receipt of breast and cervical cancer screening in unadjusted models. Although these findings were attenuated in adjusted models, not speaking English well or at all remained negatively associated with receipt of cancer screening. CONCLUSIONS: These findings suggest that language barriers contribute to health disparities by impeding adequate health communication.     

Resistance Training Improves Sleep Quality in Older Adults a Pilot Study

Older individuals, as a group, tend to experience difficulty sleeping compared to younger adults. Improving sleep in the elderly would have beneficial public health consequences. This study utilized 8 sedentary, older adults, 78.1 ± 3.1 years of age, who participated in a six-month long resistance training (RT) program. The Pittsburgh Sleep Quality Index (PSQI) was used to examine sleep quality, and a 1 repetition max test (1-RM) was used to determine upper (bench press) and lower (leg press) body strength. Total strength, defined as the sum of the bench press and leg press 1-RM results, was also reported. The training resulted in significant improvements (p < 0.05) in total (19%) and upper body (52%) strength and in sleep quality (38%). Future studies should examine the effects of strength gain/loss and time-of-day training on sleep quality.

Key Points

• Compromised sleep and deterioration of skeletal muscle mass and function are commonly found among the aged.
• Results show that RT led to improvements in upper and total body strength in older participants who trained three times per week in the morning.
• The resistance training led to improvements in sleep as measured by a self-report sleep questionnaire, the Pittsburgh Sleep Quality Index.
• The small sample size used, lack of control group, and the fact that the participants on average were characterized as “good ”sleepers at the study onset, necessitates that further investigation occur.
• We suggest that further research is required to explore the effects of RT performed at different times of the day as well as to determine the relationship between sleep gains or losses upon changes in sleep quality.

Key words: Chronic disease, resistance training, older participants, strength, sleep     

Minor physical anomalies in young psychotic children

The authors examined three groups of children for minor physical anomalies: 52 autistic children, 34 nonautistic siblings of these patients, and 29 normal controls. The total number of anomalies and the weighted score were significantly higher in the autistic children. The formation of these anomalies in the first three months of fetal life may concur with the developmental deviation of the central nervous system in some of these individuals.     

Diagnostic utility of positron emission tomography-computed tomography for predicting malignancy in cystic neck masses in adults

OBJECTIVES: Combined positron emission tomography and computed tomography (PET-CT) is used for the diagnostic evaluation and staging of squamous cell carcinoma of the head and neck (SCCHN). By superimposing anatomic localization of CT with the physiologic data of PET, occult primary and metastatic neoplasms might be identified. Because the diagnostic algorithm for cystic neck masses in adults often overlaps with the work-up of cancer of unknown primary site, we evaluated the utility of PET-CT scans to identify the presence of malignancy and the location of primary tumor. STUDY DESIGN: Single-institution retrospective case review series. METHODS: We reviewed the PET-CT imaging of cystic neck masses occurring in five patients over 40 years of age with significant risk factors for SCCHN and correlated this information with histopathology. RESULTS: In each patient in our series, the PET portion of a combined PET-CT was misleading, whereas the CT examination was more suggestive of the correct pathology. Ultimately, clinical judgment and endoscopic evaluation, guided by CT findings, were most valuable for distinguishing malignant versus benign processes and identifying the primary tumor sites. CONCLUSIONS: PET-CT may not be a reliable modality for identifying malignancy in adults with suspicious cystic neck masses. A thorough clinical evaluation by an experienced head and neck surgeon, in conjunction with contrast-enhanced CT, may be sufficient to facilitate the optimal management of such patients.