Perception testing in surgical pathology

A test predictive of mature pathologic expertise could be of great value in the selection of individuals entering the field. Some individuals may have an aptitude superior to others to discriminate images based on the discovery of distinctive image features. This may enhance their ability to draw pathologic conclusions from clinical images and may favorably affect their performance as pathologists. A form of the Facial Recognition Test was administered to pathology residents and faculty to test this hypothesis. Facial recognition results correlated well with resident performance measured by overall faculty ratings, but only marginally with performance measured by scores on "direct recognition" slides of the American Society of Clinical Pathologists' in-service pathology exams. These preliminary results indicate that testing of visual discrimination may be predictive of resident performance in pathology. A test of this type could eventually be useful in selection and self selection of resident candidates and in development of remedial training for residents experiencing difficulty in learning morphologic interpretation.     

Silencing is Not-So Golden: A New Model for Inheritance of Lynch Syndrome

Heritable somatic methylation and inactivation of MSH2 in families with Lynch syndrome due to deletion of the 3' exons of TACSTD1
Ligtenberg et al. (2009)
Nature Genetics 41: 112–117     

Assessment of 54 biomarkers for biopsy-detectable prostate cancer.

OBJECTIVE: We analyzed the association of 54 biomarkers from seven classes including adipokines, immune response metalloproteinases, adhesion molecules, and growth factors with prostate cancer risk adjusting for the Prostate Cancer Prevention Trial (PCPT) risk score. METHODS: A total of 123 incident prostate cancer cases and 127 age-matched controls were selected from subjects in the San Antonio Center for Biomarkers of Risk of Prostate Cancer cohort study. Prediagnostic serum concentrations were measured in the sample collected at baseline using LabMAP technology. The odds ratios (OR) of prostate cancer risk associated with serum concentrations of 54 markers were estimated using univariate conditional logistic regression before and after adjustment for the PCPT risk score. Two-way hierarchical unsupervised clustering techniques were used to evaluate whether the 54-marker panel distinguished cases from controls. RESULTS: Vascular endothelial growth factor, resistin, interleukin 1Ra (IL-1Ra), granulocyte colony-stimulating factor, matrix metalloproteinase-3, plasminogen activator inhibitor, and kallikrein-8 were statistically significantly (P < 0.05) underexpressed in prostate cancer cases, and alpha-fetoprotein was statistically significantly overexpressed in prostate cancer cases, but all had area underneath the receiver-operating characteristic curve <60%; none were statistically significant adjusting for multiple comparisons (P < 0.0008) or after adjustment for the PCPT risk score. Statistical clustering of patients by the marker panel did not distinguish a separate group of cases from controls. CONCLUSIONS: This age-matched case-control study did not support findings of increased diagnostic potential from a 54-marker panel when compared with the conventional risk factors incorporated in the PCPT risk calculator. Future discovery of new biomarkers should always be tested and compared against conventional risk factors before applying them in clinical practice.     

潍坊市职业卫生技术服务机构现状调查

2002年5月1日颁布实施的《中华人民共和国职业病防治法》是规范职业卫生技术服务行为的法律依据。这是职业卫生技术服务工作走上规范化、标准化、法制化的根本保障，是职业卫生技术服务机构参与市场竞争、提高服务质量、促进自身发展的必由之路，也是企业自主选择职业卫生技术服务机构、提高职业危害防治水平、促进经济发展的关键所在。4年多来，我市各级各类职业卫生技术服务机构的发展极不平衡，仪器设备配备水平、人员能力素质与我省同类地区相比也有较大差距。为了解我市职业卫生技术服务机构现状，我们进行了此项调查。     

Human cutaneous melanoma; a review of NRAS and BRAF mutation frequencies in relation to histogenetic subclass and body site

A majority of cutaneous melanomas show activating mutations in the NRAS or BRAF proto-oncogenes, components of the Ras-Raf-Mek-Erk signal transduction pathway. Consistent data demonstrate the early appearance, in a mutually exclusive manner, of these mutations. The purpose of this paper is to summarize the literature on NRAS and BRAF activating mutations in melanoma tumors with respect to available data on histogenetic classification as well as body site and presumed UV-exposure. Common alterations of the signal transducing network seem to represent molecular hallmarks of cutaneous melanomas and therefore should continue to strongly stimulate design and testing of targeted molecular interventions.     

Attitudes towards CPR training and performance in family members of patients with heart disease

Considering that heart patients may be at higher risk for cardiac arrest, this study was conducted to evaluate the preparedness and willingness of cardiac patient family members to perform cardiopulmonary resuscitation (CPR). A cross-sectional survey of 100 family members of cardiac patients was conducted at a tertiary care emergency department over a 1.5-month period. Response rate was 95%. While 49% reported prior CPR training, only 7% trained within the past year. The majority received training (59%) because of a school or job requirement with only 8% trained because of 'concern for a family member.' The most frequent reasons for not being trained were 'never thought about it' or 'not interested' (57%). However, 49% of the untrained group did report an interest in future training. While 2% of respondents recalled a healthcare professional suggesting such training, 58% stated they would be influenced positively by such a recommendation. The most frequently reported barriers to performing CPR included fear of harming the patient or a lack of knowledge and skill to help. Despite a presumed higher risk for sudden cardiac death, most family members of cardiac patients do not maintain skills in basic CPR. Healthcare professionals may have the ability to significantly alter this concerning statistic through education and routine recommendations to patients' families.     

Transient colonization of the gut of newborn infants by orally administered bifidobacteria and lactobacilli

We investigated if orally administered bifidobacteria and/or lactobacilli could be cultured from faeces of infants after antibiotic treatment, when these bacterial species are usually absent. Lyophilized Bifidobacterium longum, strain BB-536, B. breve, strain BB-576, or Lactobacillus acidophilus, strain LAC-343, were used. Doses of 3 x 10(9) cells of one strain, or a mixture of all three strains 3 x 10(9) cells each were fed three times daily at mealtimes to 11 infants aged 0-8 weeks. Treatment was started the first day after antibiotic treatment and was continued for 5 days. The bacterial species were isolated in 9 of 11, 7 of 10 and 2 of 9 specimens obtained on the last day of bifidobacteria or lactobacilli administration, 5 and 15 days thereafter, respectively. No side effects were noted.     

Prediagnostic toenail cadmium and zinc and subsequent prostate cancer risk

BACKGROUND: Cadmium is a recognized human lung carcinogen that has also been positively associated with prostate cancer mainly in occupationally exposed men. The association between dietary and supplemental zinc intake and prostate cancer has not been consistent in epidemiologic studies. We evaluated the association between prediagnostic toenail cadmium and zinc concentrations and risk of prostate cancer in a cohort in which the primary route of exposure to cadmium and zinc is the diet. METHODS: Included in the analysis were 115 prostate cancer cases and 227 age-matched controls nested in the prospective CLUE II study located in Washington County, MD. Participants provided toenail samples at baseline in 1989. Furnace atomic absorption and flame atomic absorption were used to determine toenail cadmium and zinc concentrations, respectively. Odds ratios (OR) and 95% confidence intervals (CI) were estimated from conditional logistic regression models. RESULTS: Median toenail cadmium and zinc concentrations did not statistically significantly differ between prostate cancer cases (cadmium, 45.9 ppb; zinc, 155.3 ppm) and controls (cadmium, 54.5 ppb; zinc, 164.0 ppm). Prostate cancer risk did not increase with increasing concentrations of cadmium (P trend = 0.9) and did not decrease with increasing concentrations of zinc (P trend = 0.2). For both metals, the ORs for the top four fifths were each below 1.0 when compared with the bottom fifth. CONCLUSION: Men who have high toenail cadmium concentrations in the range observed in this general population sample were not at an increased risk for prostate cancer. Although there was no evidence of a linear dose-response, these findings suggest that risk of prostate cancer may be slightly lower among men with moderate and higher zinc intake.