Quadricuspid aortic valve and single coronary ostium

We describe an autopsy patient in whom a rare congenital anomaly of quadricuspid semilunar aortic valve and coronary arteries originating from a single orifice of one aortic sinus occurred. To the best of our knowledge, this combination of cardiac anomalies has not been reported.     

Evaluation of commercial blood-containing media for cultivation of Mycobacterium haemophilum.

Mycobacterium haemophilum requires hemin for growth, and thus it is unlikely to be isolated by current routine methods. This study evaluated growth of M. haemophilum on commercially available blood agar and on different basal media and with other sources of hemin. The effect of dyes, crystal violet and malachite green, in controlling contamination was tested. Results showed that although M. haemophilum can grow on a variety of commercially prepared blood agars, contamination is a significant deterrent. Both malachite green and crystal violet inhibited the growth of contaminants without affecting the growth of M. haemophilum. The following medium (MMV: McBride's Mycobacterium Haemophilum) is recommended: Casman's blood agar base containing 5% sheep blood heated and 5 micrograms/mL crystal violet, prepared in screw-topped vials, tightly capped and incubated at 30 degrees C under atmospheric conditions.     

Stimulus range influences intensity and hedonic ratings of flavour

Five concentrations of an artificial orange drink were presented for sensory evaluation in three overlapping concentration ranges. Three sensory panels, each of 30 subjects, rated the concentrations for intensity of flavour (intensity scale), relation to ideal flavour intensity (ideal-point scale), and pleasantness (hedonic scale). Except for the two extreme concentrations, neither of which was presented in more than one range, in all three response tasks the mean rating for a given concentration varied with the concentration range in which it was presented. However, the mean ratings showed good correspondence across response tasks (e.g. the concentration perceived as "moderately sweet" on the intensity scale was perceived as "just right" on the ideal-point scale and of maximal pleasantness on the hedonic scale), suggesting a link between the intensity and hedonic dimensions of sensory experience.     

Effect of arylsulfatase A and sialidase on the biochemical and immunological properties of creatine kinase isoenzyme BB

This work describes the action of the lysosomal enzymes arylsulfatase A (EC 3.1.6.1) and sialidase (EC 3.2.1.18) on human creatine kinase (CK, EC 2.7.3.2) isoenzyme BB. The isoenzyme, which gives a positive reaction with the periodic acid-Schiff reagent, contains 12 molecules of sulfate and two molecules of sialic acid per molecule. On treatment with arylsulfatase, CK-BB lost enzyme activity but retained immunoreactivity, its isoelectric point was altered, and it was partly bound to a "Glyco-gel" affinity column. On treatment with sialidase, the isoenzyme lost activity, its immunoreactivity was decreased by 70%, and the inactivated CK-BB would not bind to either "Glyco-gel" or concanavalin A. We propose that the sulfate groups are involved in maintaining the integrity of the active site of the enzyme but are not involved in antigenic recognition sites on the molecule. Sialic acid plays an important role in both the structural pattern of the antigenic determinant and the active site of CK-BB.     

Psychological Distress in Women Living with Polycystic Ovary Syndrome: The Role of Illness Perceptions

IntroductionPolycystic ovary syndrome (PCOS) is an endocrine and metabolic condition linked to increased risk of anxiety and depression (psychological distress). This study examined the relationship between illness perceptions and psychological distress in women living with PCOS.MethodsWe used a cross-sectional survey to assess psychological distress (Hospital Anxiety and Depression Scale) and illness perceptions (Illness Perception Questionnaire-Revised) in women living with PCOS in the UK (N = 487). Hierarchical multiple linear regression tested the associations between illness perceptions and psychological distress, adjusting for age, years since PCOS diagnosis, education, body mass index, current depression, and current anxiety disorder.ResultsIn the fully adjusted regression model, illness perceptions explained 18.6% of the variance in psychological distress, F(7,458) = 21.0, p < .001. Reporting more symptoms (B = 0.226), higher perceived consequences (B = 0.204), lower personal control (B = –0.184), and lower illness coherence (B = –0.127) were significantly associated with higher psychological distress (all p < .001).ConclusionsIllness perceptions may play an important role in psychological distress, even after adjusting for relevant demographics and clinical characteristics. Our findings highlight key areas where researchers and clinicians could develop targeted self-management interventions for women with PCOS, focused on altering maladaptive illness perceptions to reduce psychological burden.     

A Systematic Review of the Evidence for the Decipher Genomic Classifier in Prostate Cancer

ContextMolecular biomarkers aim to address the established limitations of clinicopathologic factors to accurately risk stratify patients with prostate cancer (PCa). Questions remain as to whether sufficient evidence supports adoption of these biomarkers for clinical use.ObjectiveTo perform a systematic review of the available evidence supporting the clinical utility of the Decipher genomic classifier (GC).Evidence acquisitionThe review was performed as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines by searching PubMed and conference abstracts from January 2010 to June 2020. Evidence was then graded using the criteria of Simon et al (Simon RM, Paik S, Hayes DF. Use of archived specimens in evaluation of prognostic and predictive biomarkers. J Natl Cancer Inst 2009;101:1446–52) and American Urology Association (AUA) criteria.Evidence synthesisIn total, 42 studies and 30 407 patients were included. GC performance data were available for localized, postprostatectomy, nonmetastatic castration-resistant, and metastatic hormone-sensitive PCa as part of retrospective studies (n = 12 141), prospective registries (n = 17 053), and prospective and post hoc randomized trial analyses (n = 1213). In 32 studies (n = 12 600), the GC was independently prognostic for all study endpoints (adverse pathology, biochemical failure, metastasis, and cancer-specific and overall survival) on multivariable analysis and improved the discrimination over standard of care in 24 studies (n = 8543). GC use changed the management in active surveillance (number needed to test [NNT] = 9) and postprostatectomy (NNT = 1.5–4) settings in five studies (n = 4331). Evidence strength was levels 1 and 2 by the Simon criteria for all disease states other than high-risk PCa, and grades A and B by AUA criteria depending on disease state.ConclusionsConsistent data are now present from diverse levels of evidence, which when viewed together, have demonstrated clinical utility of the GC in PCa. The utility of the GC is strongest for intermediate-risk PCa and postprostatectomy decision-making.Patient summaryIn this paper, we review the evidence of the Decipher genomic classification tool for men with prostate cancer. We found consistent evidence that the test helps identify which cancers are more or less aggressive, which in turn aids in personalized treatment decision-making.     

The changing face of reoperative parathyroidectomy: a single-centre comparison of 147 parathyroid reoperations

IntroductionReoperative parathyroidectomy for persistent and recurrent primary hyperparathyroidism is dependent on radiology. This study aimed to compare outcomes in reoperative parathyroidectomy at a single centre using a combination of traditional and newer imaging studies.Materials and methodsRetrospective case note review of all reoperative parathyroidectomies for persistent and recurrent primary hyperparathyroidism over five years (June 2014 to June 2019; group A). Imaging modalities used and their positive predictive value, complications and cure rates were compared with a published dataset spanning the preceding nine years (group B).ResultsFrom over 2000 parathyroidectomies, 147 were reoperations (101 in group A and 46 in group B). Age and sex ratios were similar (56 vs 62 years; 77% vs 72% female). Ultrasound use remains high and shows better positive predictive value (76% vs 57 %). 99mTc-sestamibi use has declined (79% vs 91%) but the positive predictive value has improved (74% vs 53%). 4DCT use has almost doubled (61% vs 37%) with better positive predictive value (88% vs 75%). 18F-fluorocholine positron emission tomography-computed tomography and ultrasound-guided fine-needle aspiration for parathyroid hormone are novel modalities only available for group A. Both carried a positive predictive value of 100%. Venous sampling with or without angiography use has decreased (35% vs 39%) but maintains a high positive predictive value (86% vs 91%). Cure rates were similar (96% vs 100%). Group A had 5% permanent hypoparathyroidism, 1% permanent vocal cord palsy and 1% haematoma requiring reoperation. No complications for group B.ConclusionOptimal imaging is key to good cure rates in reoperative parathyroidectomy. High-quality, non-interventional imaging techniques have produced a shift in the preoperative algorithm without compromising outcomes.