Advances in oncologic imaging

Imaging has become a pivotal component throughout a patient's encounter with cancer, from initial disease detection and characterization through treatment response assessment and posttreatment follow‐up. Recent progress in imaging technology has presented new opportunities for improving clinical care. This article provides updates on the latest approaches to imaging of 5 common cancers: breast, lung, prostate, and colorectal cancers, and lymphoma. CA Cancer J Clin 2012. © 2012 American Cancer Society.     

Adherence to medication for chronic disorders during pregnancy: results from a multinational study

Background For a variety of chronic disorders, low medication adherence during pregnancy may jeopardize maternal as well as foetal health. Little is known about how closely pregnant women follow their chronic pharmacotherapy regimens. Objective To explore the level of adherence to medication for a variety of chronic disorders, namely cardiovascular, rheumatic and bowel disorders, diabetes and epilepsy, during pregnancy and to identify determinants of low adherence during pregnancy. Setting This multinational, cross-sectional, internet-based study was undertaken in 18 countries in Europe, North America and Australia. Data originating from some South American countries were also collected. Methods The study period lasted from 1-October-2011 to 29-February-2012. By using an anonymous on-line questionnaire we collected information about maternal demographics, chronic disorders and related medication use during pregnancy, and women’s pregnancy-specific beliefs about medication. Main outcome measure Adherence to medication during pregnancy via the 8-item Morisky Medication Adherence Scale (MMAS-8). Results A total of 210 pregnant women reported chronic medication use during pregnancy and filled in the MMAS-8. Overall, 36.2 % had low medication adherence. On the basis of the MMAS-8, the rates of low adherence were 55.6 % for medication for rheumatic disorders, 40.0 % for epilepsy, 36.1 % for bowel disorders, 32.9 % for cardiovascular disorders, and 17.1 % for diabetes. A lack of folic acid use, having previous children, and individual pregnancy-specific beliefs about medication were significant determinants of low medication adherence during pregnancy. Conclusion Many pregnant women had low adherence to their chronic pharmacotherapy regimens during pregnancy. Women’s beliefs about medication were a central factor determining low adherence.     

Prostate volumes defined by magnetic resonance imaging and computerized tomographic scans for three-dimensional conformal radiotherapy

To compare the prostate volumes defined on magnetic resonance imaging (MRI), and noncontrast computerized tomographic (CT) scans used for three-dimensional (3D) treatment planning.

: Ten patients simulated for treatment using immobilization and a retrograde urethrogram. 3D images were used to compare prostate volumes defined by MRI (4–6 mm thick slices) and CT images (5 mm thick slices). Prostate volumes were calculated in cm³ using the Scanditronix 3D planning system. MRI/CT images were merged using bony anatomy to define the regions of discrepancy om prostate volumes.

: The mean prostate volume was 32% larger (range −5–63%) when defined by noncontrast CT compared to MRI. The areas of nonagreement tended to occur in four distinct regions of discrepancy: (a) the posterior portion of the prostate, (b) the posterior-inferior-apical portion of the prostate, (c) the apex due to diasgreement between a urothrogram based definition and the location defined by MRL, (d) regions corresponding to the neurovascular bundle.

: There is a tendency to overestimate the prostate volume by noncontrast CT compared to MRI. Awareness of this tendency should allow us to be to more accurately define the prostate during 3-D treatment planning.     

Memory encoding and retrieval on the ascending and descending limbs of the blood alcohol concentration curve

Rationale Little is known about acute effects of alcohol on memory encoding and retrieval on different limbs (ascending and descending) of the blood alcohol concentration (BAC) curve. Objectives This extensive experiment was designed to examine alcohol's effects on memory encoding and retrieval throughout a protracted drinking episode. Methods In a 9-h session, male participants consumed either alcohol (1 ml/kg) or placebo (n=32/32) over a period of 90 min and learned various materials in different memory tasks before, during, and after consuming the drinks, while their BAC levels were monitored. A week later, in a similar session, they were tested on learned materials before, during, and after drinking. Mood was assessed throughout both sessions. Results Alcohol impaired recall of words more than recognition, and cued recall most severely. Perceptual priming and picture recognition were not affected by alcohol. Alcohol impaired encoding in cued recall, recognition of completed word fragments, and free recall regardless of limb, but impaired retrieval in word recognition only during the ascending BAC. Alcohol increased negative mood on the descending limb during the first session, and on the ascending limb during the second session. Conclusions Under naturalistic drinking conditions, alcohol's effects on memory depend on task, memory process, and limb of the BAC curve. The differential effects of alcohol on retrieval during the ascending and descending limbs demonstrate the importance of examining the differential effects on the two limbs.