Clinicopathological Profile of Myelomatous Pleural Effusion: Single-center Real-world Experience and Review of Literature

Background

Multiple myeloma (MM) is a hematologic malignancy of plasma cell origin. MM primarily affects bone marrow, but extramedullary sites can also be involved. Myelomatous pleural effusion (MPE) is an atypical and rare complication of MM. We aimed to systematically study the incidence and clinicopathologic profile of patients with MPE in a real-world setting.

Food group intake patterns and associated nutrient profiles of the US population

We developed a method for evaluating food group intake patterns using dietary recall data (n = 11,529) from the second National Health and Nutrition Examination Survey. We used this method to examine the relationship of these food group intake patterns to nutrient intake and to selected biochemical indexes of nutritional status. We evaluated each 24-hour dietary intake recall for the presence or omission of five broad food groups--dairy, meat, grain, fruit, and vegetable. The five most prevalent patterns and the proportion of the population reporting them was as follows: all food groups, 33.6%; no fruit, 23.9%; no dairy and fruit, 9.0%; no dairy, 8.0%; and no fruit and vegetable, 5.6%. In the most prevalent pattern, all food groups were consumed; this was the only pattern that provided mean amounts of all of the key vitamins and minerals at levels greater than or equal to the Recommended Dietary Allowances (RDAs). This pattern also was reported by the lowest proportion of individuals consuming less than 100% RDA of the key nutrients. Patterns in which both fruit and vegetables were consumed were associated with highest levels of serum vitamin C. The consistency of these results indicates that screening diets for food group consumption can quickly provide meaningful information about their quality.     

Influence of pain and urinary symptoms on quality of life in young men with chronic prostatitis-like symptoms

BACKGROUND: Our aims in the present study were to estimate the influences of pain and urinary symptoms on quality of life, and to determine which of these two variables has the most predictive power with respect to quality of life in young men with chronic prostatitis-like symptoms. METHODS: Chronic prostatitis-like symptoms were measured by the National Institutes of Health-Chronic Prostatitis Symptom Index. Of the 28,841 men aged 20 years who lived in the study community, 18,495 men (a response rate 64.1%) agreed to participate in the study. A total of 1057 men who complained of symptoms indicative of chronic prostatitis were included in the study. The influences of pain and urinary symptoms on quality of life were determined using logistic regression analysis. The receiver operating characteristic (ROC) curve was used to estimate the predictive ability of each of these variables with respect to quality of life. RESULTS: Results from multivariate analysis showed that both pain and urinary symptoms were associated with an increased likelihood of impaired quality of life, although pain contributed more to a reduced quality of life than urinary symptoms. Relative to men who experienced mild pain, men who experienced moderate pain had a 3.9-fold risk of poor quality of life (odds ratio [OR], 3.87; 95% confidence interval [CI], 2.86-5.23; P < 0.001) and those who experienced severe pain had a 15.7-fold risk of reduced quality of life (OR, 15.68; 95% CI, 6.59-37.35; P < 0.001). Moderate urinary symptoms were associated with a 1.4-fold risk of bother (OR, 1.41; 95% CI, 1.01-1.99; P < 0.001) and severe urinary symptoms were associated with 2.4-fold risk (OR, 2.39; 95% CI, 1.37-4.12; P < 0.001), relative to mild urinary symptoms. Comparison of the effects of pain and urinary symptoms showed that pain severity had the most predictive power for bother, quality of life, and quality-of-life impact. The areas under the ROC curves for bother, quality of life, and quality-of-life impact were 71.3%, 69.3% and 72.5%, respectively. CONCLUSION: Urinary symptoms and pain might be associated with an increased likelihood of impaired quality of life in young men with chronic prostatitis-like symptoms. In addition, our findings suggest that pain severity is the most influential variable for determining quality of life in this population.     

Severe thoracic trauma: under what accident and resuscitation conditions can it still be treated?

Severe thoracic trauma is a major cause of early death following road accident. 569 non-surviving and 112 surviving victims of traffic casualties were documented by the Accident Research Unit of the Clinic of Trauma Surgery, Hannover Medical School from 1973 to 1987. Medical data and measures of rescue were evaluated with a view to way of clinical therapies, lethal outcome and time of death. Primary intubation and chest draining seems to be the most successful initial treatment on the scene and during transport.     

Marrow fibrosis associated with a Philadelphia chromosome.

Three patients had marked marrow fibrosis and an apparent Philadelphia (Ph) chromosome. Hematologic, cytogenetic, and molecular studies demonstrated the heterogeneity of such cases, including the first example of clinically typical myelofibrosis (MF) associated with a bcr gene rearrangement characteristic of chronic myelogenous leukemia (CML).     

Effects of controllable vs. uncontrollable stress on circadian temperature rhythms

The effects of sustained stress on body temperature were investigated in rats implanted with mini-transmitters that permitted remote measurement of body temperature. Temperature was first monitored during control conditions. Following the control period, rats were either shaped to avoid/escape signalled around-the-clock intermittent footshock (controllable stress) or yoked to the controlling rats such that the controlling rat and the yoked rat received shock of the same duration, but only the controlling rat could terminate shock by pulling a ceiling chain. Under control conditions, rats demonstrated regular rhythms in body temperature which averaged 1 degree higher during the 12-h dark cycle than the light cycle. Stress disrupted the rhythm and markedly decreased the night-day difference in temperature, especially in the yoked rats in which almost no difference between light and dark cycle temperature was seen. The disruption was most marked for the first days of stress. A regular temperature rhythm was reestablished following about 5 days of stress although the stress condition continued. Leverpressing for food was also affected by the stress conditions with both stress groups leverpressing less than controls and the uncontrollable stress group pressing less than the controllable stress group. These data offer additional evidence of the increased pathophysiological effects of uncontrollable as compared to controllable stress.