Breast neoplasms: duplex sonographic imaging as an adjunct in diagnosis

Sonographic breast imaging has been useful in the differentiation of cystic from solid masses. It has also been helpful in the characterization of palpable breast masses in the absence of corresponding abnormalities. The authors undertook a prospective study that incorporated pulsed Doppler analysis into sonographic real-time imaging of solid breast masses. Thirty-eight patients were examined. In 12 of the patients there were positive Doppler signals, while in 26 patients there were no Doppler signals. The 12 patients showing positive Doppler signals proved to have infiltrating ductal carcinoma, while the 26 patients with negative Doppler signals proved to have benign breast disorders. Pulsed Doppler analysis as a supplement to sonographic real-time imaging shows promise for the identification of breast carcinoma.     

Validation of the quality of life scale: living with HIV

A grounded theory of Salvaging Quality of Life provided the conceptual framework for the development of the Living with HIV scale which was validated in this study. The HIV+ convenience sample ( n =187) was 66% male, with a mean age of 40·6 years, 69% African-American, and with an average CD4 count of 229  mm³. A principal components factor analysis with varimax rotation was conducted on the final 32-item scale and nine factors with Eigenvalues >1 explained 60% of the variance. A second order factor analysis of these nine factors resulted in a two factor solution (HIV Struggles and HIV Reverence) which explained 49·4% of the variance. Cronbach alpha reliability coefficient for the total scale was 0·84. Differences between gender, ethnicity, education and presence of an AIDS diagnosis, and quality of life, were explored. Females had higher total scores which suggested they had a more positive quality of life than males. The Living with HIV scale can be used as a method of obtaining input from patients for care planning and for evaluating the effectiveness of nursing care intervention using quality of life as an outcome of care.     

Destructive arthritis due to silicone: a foreign-body reaction

The authors report 3 cases of erosive arthritis resulting from a foreign-body reaction to a silicone implant in the wrist. No patient had a history of inflammatory arthritis. Radiographic changes included well-defined lytic lesions with thin, sclerotic margins, normal mineralization, and loss of volume of the implant. Pathologically, a destructive foreign-body reaction was seen, with intra- and extracellular silicone debris.