Severe toxicity following induction chemotherapy for acute myelogenous leukemia in a patient with Werner's syndrome

Werner's syndrome is an autosomal recessive disorder resulting in premature aging. Most patients die in their fifth decade from malignancies or heart disease. The gene for Werner's syndrome (WRN) encodes a recQ helicase. Cells from patients with Werner's syndrome have increased sensitivity to DNA-damaging drugs in vitro. Here we present a patient with Werner's syndrome who developed severe chemotherapy-induced toxicity during treatment for acute myelogenous leukemia. We propose that lack of WRN resulted in increased sensitivity of the patient's cells to the toxicity of chemotherapy.     

Reverse culture shock,distress symptoms and psychological well-being of fresh foreign degree holders in Pakistan

This study explored to what extent does reverse culture shock predict the level of anxiety, depression, and psychological well-being among fresh foreign degree holders in Pakistan, in addition to finding out the relationship between the study variables. Participants consisted of 124 fresh foreign degree holders (109 men and 15 women) who were recruited through purposive and snowball sampling techniques. Reverse Culture Shock Scale, Major Depression Inventory, Beck Anxiety Inventory, and WHO-5 Well-being Index were used to measure study variables. Results show that reverse culture shock is a strong predictor of psychological well-being explaining 23% variance in well-being scores of fresh foreign degree holders. As hypothesized, it has positive associations with distress symptoms including anxiety and depression, whereas, a negative correlation was found with psychological well-being and the age of fresh foreign degree holders. However, contrary to the hypothesis, reverse culture shock has no association with time passed since arrival back home and duration of stay abroad.     

Acute carpal tunnel syndrome from burns of the hand and wrist

Acute median nerve compression usually occurs from increased pressure within the carpal tunnel and forearm compartments. Although the hyperesthesia from burns may mimic symptoms of acute compression neuropathy, clinical diagnosis should be made from history, clinical signs and symptoms. Early recognition and decompression of the carpal tunnel either as part of the burn excision or along with escharotomy usually leads to full recovery.     

Identification and characterisation of common glow-worm RNA viruses

Virus Genes - The common glow-worms (Lampyris noctiluca) are best known for emission of green light by their larvae and sexually active adult females. However, both their DNA and RNA viruses remain...     

Familial social support and depression in breast cancer: an exploratory study on a Pakistani sample

This exploratory study investigated the relationship between familial social support and depression in a Pakistani sample of 80 female breast cancer patients, and whether the groups of demographic and medical variables differ on the levels of familial social support and depression. Familial social support and depression were measured by indigenous scales administered in Urdu language and found to be significantly inversely correlated. The groups based on age, number of children, financial sources of treatment, and disease stage differed significantly on familial social support and depression. No significant group differences were found on familial social support and depression between the groups of patients living in joint and nuclear families, and those who had and had not undergone mastectomy. Results are discussed in the respective social and cultural context.     

The relation between mitral annular calcification and mortality in patients undergoing diagnostic coronary angiography

To determine whether the observed association between mitral annular calcification (MAC) and mortality is independent of the severity of coronary artery disease (CAD), we analyzed data from 134 male veterans (age 63 +/- 10 years) followed for 5 years who had undergone diagnostic coronary angiography and transthoracic echocardiography within 6 months of each other. Echocardiograms were retrospectively reviewed for the presence of MAC. The relation of MAC to all-cause mortality was analyzed using logistic regression, and odds ratios (OR) were calculated. MAC was present in 49 (37%) subjects. Over the 5-year follow-up period, 38 (28%) patients expired. Five-year survival was 80% for subjects without MAC and 56% for subjects with MAC (P = 0.003). MAC (OR = 3.16, 95% confidence interval [CI]= 1.43-6.96, P = 0.003), ejection fraction (OR = 0.76, 95% CI = 0.59-0.97, P = 0.02), and left main CAD (OR = 2.70, 95% CI = 1.11-6.57, P = 0.02) were significantly associated with mortality in univariate analysis. After adjusting for left ventricular ejection fraction, number of obstructed coronary arteries and the presence of left main coronary artery stenosis, MAC significantly predicted death (OR = 2.48, 95% CI = 1.09-5.68, P = 0.03). Similarly, after adjusting for predictors of MAC, including ejection fraction, age, diabetes, peripheral vascular disease, and heart failure, MAC remained a significant predictor of death (OR = 2.38, 95% CI = 1.02-5.58, P = 0.04). MAC also predicted death independent of smoking status, hypertension, serum creatinine, low density lipoprotein cholesterol, high density lipoprotein cholesterol, and C-reactive protein levels (OR = 3.98, 95% CI = 1.68-9.40, P = 0.001). MAC detected by two-dimensional echocardiography independently predicts mortality and may provide an easy-to-perform and inexpensive way to improve risk stratification.     

Short breath-hold, volumetric coronary MR angiography employing steady-state free precession in conjunction with parallel imaging.

An ECG-gated, 3D steady-state free precession (SSFP) technique in conjunction with sensitivity encoding (SENSE)-based parallel imaging was implemented for short breath-hold, volumetric coronary MR angiograpy (CMRA). Two parallel imaging acquisition strategies (employing 1 R-R and 2 R-R intervals, respectively) were developed to achieve 1) very short breath-hold times (12 s for a heart rate of 60 bpm), and 2) small acquisition windows to minimize sensitivity to physiologic motion. Both strategies were examined in CMRA applications over a range of heart rates. A four-point scale blinded reading (with 4 indicating the most desirable features) revealed substantial image quality improvements for the accelerated data as compared to the nonaccelerated approach. The 1 R-R interval scheme yielded an image score of 3.39 +/- 0.60, and was found to be particularly suitable for low heart rates (P = 0.0008). The 2 R-R interval strategy yielded an image score of 3.35 +/- 0.64, and was more appropriate for higher heart rates (P = 0.03). The results demonstrate that 3D SSFP combined with parallel imaging is a versatile method for short breath-hold CMRA while maintaining high spatial resolution. This strategy permits imaging of the major coronary artery distributions in two to three breath-holds using targeted slabs, and offers the potential for single breath-hold, large-volume CMRA.