One-day core needle biopsy in a breast clinic: 4 years experience

Many attempts have been made to combine the high diagnostic accuracy and conclusive rate of core needle biopsy (CNB) with the speed of fine needle aspiration cytology in evaluation of solid breast lesions. Multiple hybrid techniques have been developed to achieve this. We describe a cohort of patients for whom we used a relatively new, accelerated method of CNB processing, allowing for a definitive diagnosis the same day. All patients visiting the Radboud University Nijmegen Medical Centre breast clinic during a 4-year period were reviewed to identify all CNBs in this period performed in a same-day diagnosis track. CNB result was compared to post-operative pathology reports when available, and to follow-up when patients were not surgically treated. 1,060 patients underwent CNB of 1,383 lesions, 898 of which in a same-day diagnosis track with a sensitivity of 96.9 % and a specificity of 99.4 %. The inconclusive rate was 9.2 %. For a same-day diagnosis for solid breast lesions, we could give a conclusive diagnosis with accelerated CNB processing in 65 % of our patients requiring CNB. This technique can be used reliably in a same-day diagnosis breast clinic with a very high sensitivity, specificity, and conclusive rate.     

Of monkeys and men: Spitz and Harlow on the consequences of maternal deprivation

In this contribution the reciprocal influence of Harlow and Spitz concerning the consequences of maternal deprivation of monkeys and men, respectively, is described. On the basis of recently disclosed correspondence between Harlow and Spitz, it is argued that not only was Spitz's work on hospitalism an inspiration for Harlow to start his cloth and wire surrogate work with rhesus monkeys but, at the same time, Harlow's work was a new impetus for Spitz's work on the sexual development of (deprived) infants. It is described how the two men first established personal contact in the early 1960s, after Harlow had published his first surrogate papers, how they became close friends subsequently, and inspired each other mutually.     

Examining the nutritional quality of breakfast cereals marketed to children

There are both public health and food industry initiatives aimed at increasing breakfast consumption among children, particularly the consumption of ready-to-eat cereals. The purpose of this study was to determine whether there were identifiable differences in nutritional quality between cereals that are primarily marketed to children and cereals that are not marketed to children. Of the 161 cereals identified between January and February 2006, 46% were classified as being marketed to children (eg, packaging contained a licensed character or contained an activity directed at children). Multivariate analyses of variance were used to compare children's cereals and nonchildren's cereals with respect to their nutritional content, focusing on nutrients required to be reported on the Nutrition Facts panel (including energy). Compared to nonchildren's cereals, children's cereals were denser in energy, sugar, and sodium, but were less dense in fiber and protein. The proportion of children's and nonchildren's cereals that did and did not meet national nutritional guidelines for foods served in schools were compared using chi2analysis. The majority of children's cereals (66%) failed to meet national nutrition standards, particularly with respect to sugar content. t tests were used to compare the nutritional quality of children's cereals with nutrient-content claims and health claims to those without such claims. Although the specific claims were generally justified by the nutritional content of the product, there were few differences with respect to the overall nutrition profile. Overall, there were important differences in nutritional quality between children's cereals and nonchildren's cereals. Dietary advice for children to increase consumption of ready-to-eat breakfast cereals should identify and recommend those cereals with the best nutrient profiles.     

Preoperative unintended weight loss and low body mass index in relation to complications and length of stay after cardiac surgery

BACKGROUND: Several studies reported increased adverse outcomes after cardiac surgery in patients with low body mass index (BMI; in kg/m(2)). Little is known yet, however, about the effect of preoperative unintended weight loss (UWL) in cardiac surgery patients. OBJECTIVE: We explored the prevalence and effect of UWL in view of low BMI and vice versa adjusted for a validated set of preoperative risks, inflammatory activity, and duration of extracorporeal circulation on postoperative adverse outcome. DESIGN: A prospective cohort study was performed. Nutritional data of cardiac surgery patients were collected within 24 h of admission and linked to the standard postoperative complication registration database. RESULTS: The cohort consisted of 331 cases. Multivariate logistic regression analyses showed that preoperative UWL of >or=10% in the past 6 mo (>or=10%UWLin6m) was associated with a prolonged length of stay in the hospital independent from low BMI [odds ratio (OR): 7.06; 95% CI: 1.78, 28.04]. Preoperative BMI or=10%UWLin6m (OR: 4.62; 95% CI: 1.20, 17.82; and OR: 5.27; 95% CI: 1.28, 21.76, respectively). Preoperative undernutrition in cardiac surgery patients (>or=10%UWLin6m or BMI or=10%UWLin6m or BMI 相似文献   

Judgments of body weight based on food intake: a pervasive cognitive bias among restrained eaters

OBJECTIVE: Two studies examined the influence of meal-size information on restrained and unrestrained eaters' judgments of body weight and size. METHOD: In Study 1, restrained and unrestrained eaters made body-weight and body-size judgments of a woman who had eaten either a small meal or a large meal. In Study 2, participants watched a video of a woman eating a small or large meal, and selected from two photographs of women's bodies (a heavier one and a thinner one), the woman whom they had seen in the video. RESULTS: Restrained eaters were influenced by meal-size information, judging women who had eaten a smaller meal as being thinner and weighing less (Study 1), and also choosing the thinner body to represent the woman who had eaten a smaller meal (Study 2). Unrestrained eaters were not influenced by food-intake information. CONCLUSION: Restrained eaters' (but not unrestrained eaters') judgments of others appear to be biased by meal-size information, suggesting that restrained eaters' food- and weight-related cognitive biases might be more pervasive than has previously been assumed.     

Multiple-unit and second transfusions of red cells enzymatically converted from group B to group O: report on the end of phase 1 trials

BACKGROUND: It has previously been shown that 1 and 2 units (200 - 400 mL) of red cells (RBCs) enzymatically converted from group B to group O by treatment with alpha-galactosidase (ECO RBCs) are safe and efficacious when transfused to normal group O or A persons. STUDY DESIGN AND METHODS: The current report describes studies in which 1) normal group A and O subjects received large volumes of these cells (3 units), 2) some group O subjects underwent transfusion several months later, and 3) ECO RBCs were prepared by the use of recombinant coffee bean alpha-galactosidase and transfused to a group O subject, to demonstrate the in vivo equivalence of ECO RBCs, whether prepared with native or recombinant alpha-galactosidase. RESULTS: Clinical evaluation (hematologic tests, chemistry analysis, urinalysis) and serologic analyses did not reveal any evidence of subtle or acute transfusion reaction or significant increase in preexisting anti-B titer. ECO RBC survival within the circulation of the recipients was normal (24-hour survival, 95.5 +/− 0.9%; t1/2, 34.7 +/− 6.1 days; n = 8 transfusions), and the efficacy of the transfusions was manifested in elevations in recipient hemoglobin and hematocrit (hemoglobin increase, 1.5 +/− 0.6 g/dL; hematocrit increase, 3.6 +/− 1.6%; n = 8 transfusions). CONCLUSION: ECO RBCs are safe and efficacious when transfused more than once or in multiple-unit volumes to group O or A subjects, and ECO RBCs prepared with recombinant or native enzyme are equivalent in vivo.