How safe is it for novice drivers to listen or sing to music?

http://www.ncbi.nlm.nih.gov/pubmed/23896043

Accid Anal Prev. 2013 Jul 2;59C:382-393. doi: 10.1016/j.aap.2013.06.022. [Epub ahead of print]

Background music as a risk factor for distraction among young-novice drivers.

Brodsky W, Slor Z.

Source

Music Science Research, Department of the Arts, Ben-Gurion University of the Negev, Beer-Sheva, Israel. Electronic address: wbrodsky@bgu.ac.il.

Abstract

There are countless beliefs about the power of music during driving. The last thing one would think about is: how safe is it to listen or sing to music? Unfortunately, collisions linked to music devices have been known for some time; adjusting the radio controls, swapping tape-cassettes and compact-discs, or searching through MP3 files, are all forms of distraction that can result in a near-crash or crash. While the decrement of vehicular performance can also occur from capacity interference to central attention, whether or not music listening is a contributing factor to distraction is relatively unknown. The current study explored the effects of driver-preferred music on driver behavior. 85 young-novice drivers completed six trips in an instrumented Learners Vehicle. The study found that all participants committed at-least 3 driver deficiencies; 27 needed a verbal warning/command and 17 required a steering or braking intervention to prevent an accident. While there were elevated positive moods and enjoyment for trips with driver-preferred music, this background also produced the most frequent severe driver miscalculations and inaccuracies, violations, and aggressive driving. However, trips with music structurally designed to generate moderate levels of perceptual complexity, improved driver behavior and increased driver safety. The study is the first within-subjects on-road high-dose double-exposure clinical-trial investigation of musical stimuli on driver behavior.

Attention Treblemakers: From Mass General/Harvard: Unicycle Injuries in the United States

http://www.ncbi.nlm.nih.gov/pubmed/23871477

J Emerg Med. 2013 Jul 18. pii: S0736-4679(13)00521-0. doi: 10.1016/j.jemermed.2013.05.024. [Epub ahead of print]

Unicycle Injuries in the United States.

Wang ML.

Source

Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.

Abstract

BACKGROUND:

Unicycles are single-wheel machines ridden for transportation or recreation. To our knowledge, no studies have been performed that describe injury rates of unicycle use.

OBJECTIVE:

The objective of this study was to describe the epidemiological characteristics of unicycle injuries treated in United States (US) emergency departments (EDs).

METHODS:

A retrospective analysis was performed using data from the National Electronic Injury Surveillance System (NEISS) of the US Consumer Product Safety Commission from 1991 through 2010.

RESULTS:

An estimated 3360 patients were treated for unicycle injuries from 1991 to 2010, averaging 168 injuries per year in the United States. Ten to fourteen-year-old patients represented 41% of the entire study cohort. Fractures represented approximately one third (32.9%) of all injuries treated. More than half (52.9%) of all injuries involved an extremity. Six of the 85 cases studied involved a head injury; all were aged younger than 18 years. Only 3.53% of all studied cases were admitted for further treatment. The rest were treated in the ED and discharged to home. Fractures were the primary diagnosis in all admitted cases.

CONCLUSIONS:

Based on NEISS data, unicycle injuries treated in EDs are relatively uncommon and rarely require admission. Of documented injuries, fractures and extremity injuries are most common. Additional research is needed to understand the underlying mechanisms of these injuries as well as the potential need for helmet use advocacy.

http://www.ncbi.nlm.nih.gov/pubmed/23897217

Adv Ther. 2013 Jul 30. [Epub ahead of print]

Reduction in Framingham Risk of Cardiovascular Disease in Obese Patients Undergoing Laparoscopic Adjustable Gastric Banding.

Largent JA, Vasey J, Bessonova L, Okerson T, Wong ND.

Source

Global Safety and Epidemiology, Allergan, Inc., 2525 Dupont Drive, MS AND-150, Irvine, CA, 92612, USA, largent_joan@allergan.com.

Abstract

BACKGROUND:

Obesity is a major risk factor for cardiovascular disease (CVD), with weight loss offering improvement in CVD risk factors.

AIMS:

To examine whether weight loss in laparoscopic adjustable gastric band (LAGB)-treated obese patients is associated with meaningful reductions in estimated 10- and 30- year Framingham CVD risk 12-15 months post-LAGB.

METHODS:

Obese adult patients [body mass index (BMI) ≥30 kg/m²] treated with LAGB were identified in a large US healthcare database. Patients without CVD at baseline and with measures of BMI, systolic blood pressure, diabetes, and smoking status at baseline and follow-up were eligible. Non-LAGB patients were propensity score matched to LAGB patients on baseline BMI, age, and gender. Estimated 10- and 30-year risk of developing CVD using office-based data, including BMI, was calculated at baseline and 12-15 months follow-up.

RESULTS:

Mean BMI in LAGB patients (n = 647, average age 45.66 years, 81.1% female) decreased from 42.7 to 33.4 kg/m² (P < 0.0001), with 35.4% no longer obese; 10- and 30-year estimated CVD risk decreased from 10.8 to 7.6% (P < 0.0001) and 44.34 to 32.30% (P < 0.0001), respectively, 12-15 months post-LAGB. Improvements were significantly greater than in non-LAGB patients (N = 4,295) (P < 0.0001). In the subset with lipid data (n = 74), improvements in total (-20.6 mg/dL; P < 0.05) and high-density lipoprotein (+10.6 mg/dL, P < 0.0001) cholesterol 1 year post-LAGB were also observed.

CONCLUSIONS:

Data from a US healthcare database show that individuals undergoing LAGB have significant weight loss and reductions in estimated 10- to 30-year CVD risk within 1 year post-LAGB.

Adult obesity rate in San Antonio falls: "...fitter than most of Texas..."

http://www.mysanantonio.com/news/local/article/Adult-obesity-rate-in-SA-falls-4698125.php

Adult obesity rate in S.A. falls

BY MELISSA FLETCHER STOELTJE : JULY 31, 2013

"Mayor Julián Castro announced the results of a two-year survey by the U.S. Centers for Disease Control at a Wednesday press conference, where he proclaimed that San Antonio is now fitter than most of Texas, which has an adult obesity rate of 29.3 percent.

“People are getting more active and living healthier in San Antonio, whether it's walking, cycling or using our parks,” Castro said at a basketball court in Collins Gardens Park, nestled in a Southwest Side neighborhood. “We now have concrete evidence that our investments are paying off and positively impacting the health of our families and the overall quality of life in San Antonio.”

The statistic, derived from a telephone survey of 1,500 city and county residents, remains a far cry from the 10 percent adult obesity rate goal that is set out in SA2020, the mayor's blueprint of progress for San Antonio.

Still, it was a moment to celebrate."

From VO Speights and colleagues: TTF-1 and Napsin A Do Not Differentiate Metastatic Lung Adenocarcinomas From Primary Esophageal Adenocarcinomas: Proposal of a Novel Staining Panel

http://dx.doi.org/10.5858/arpa.2012-0305-OA

Kanwaijit S. Aulakh, Cary D. Chisholm, Daniel A Smith, and V.O. Speights (2013) TTF-1 and Napsin A Do Not Differentiate Metastatic Lung Adenocarcinomas From Primary Esophageal Adenocarcinomas: Proposal of a Novel Staining Panel. Archives of Pathology & Laboratory Medicine: August 2013, Vol. 137, No. 8, pp. 1094-1098.

ORIGINAL ARTICLES

TTF-1 and Napsin A Do Not Differentiate Metastatic Lung Adenocarcinomas From Primary Esophageal Adenocarcinomas: Proposal of a Novel Staining Panel

Kanwaijit S. Aulakh , MD; Cary D. Chisholm , MD; Daniel A Smith , DO, PhD; V.O. Speights , DO

From the Department of Pathology, Scott & White Healthcare, Temple, Texas. Dr Aulakh is now with the Department of Pathology, St John Medical Center, Tulsa, Oklahoma; Dr Smith is now with the Department of Pathology, Central Texas Pathology Laboratory, Waco; and Dr Chisholm is now with the Dermatopathology Laboratory, Cockerell & Associates, University of Texas, Southwestern Medical Center, Dallas.

Context.—When adenocarcinomas arise within the esophagus, particularly when located away from the gastroesophageal junction, it may be important in some patients to differentiate between a primary esophageal adenocarcinoma and metastasis from another site. Lung adenocarcinoma is one tumor that has been reported to frequently metastasize to the esophagus.

Objectives.—To create a panel of immunohistochemical markers that can reliably distinguish between an esophageal and pulmonary primary; within the gastrointestinal pathology literature, including published articles and textbooks, common lung immunohistochemical markers, such as TTF-1, are assumed to be negative in esophageal adenocarcinoma, yet, to our knowledge, no study has yet investigated the veracity of that presumption.

Design.—In this study, 24 cases each of pulmonary and esophageal adenocarcinomas were stained with TTF-1, napsin A, CDX2, 34βE12, N-cadherin, and IMP3 in an attempt to define an optimal panel for differentiation. Esophageal adenocarcinomas occurring at the gastroesophageal junction were excluded in this study because a gastric primary tumor cannot be excluded in those cases.

Results.—Surprisingly, TTF-1 and napsin A were positive in similar proportions of tumors from both sites. Those markers that differentiated statistically between esophageal and pulmonary adenocarcinoma were IMP3, CDX2, and N-cadherin.

Conclusions.—When differentiating the origin of a tumor as either esophageal or pulmonary, an immunohistochemical panel consisting of IMP3, CDX2, and N-cadherin is superior to either TTF-1 or napsin A.

From Kirk Jones and colleagues: Data Set for Reporting of Lung Carcinomas

http://dx.doi.org/10.5858/arpa.2012-0511-OA

Kirk D. Jones, Andrew Churg, Douglas W. Henderson, David M. Hwang, Jenny Ma Wyatt, Andrew G. Nicholson, Alexandra J. Rice, Mary Kay Washington, and Kelly J. Butnor (2013) Data Set for Reporting of Lung Carcinomas: Recommendations From International Collaboration on Cancer Reporting. Archives of Pathology & Laboratory Medicine: August 2013, Vol. 137, No. 8, pp. 1054-1062.

ORIGINAL ARTICLES

Data Set for Reporting of Lung Carcinomas: Recommendations From International Collaboration on Cancer Reporting

Kirk D. Jones , MD; Andrew Churg , MD; Douglas W. Henderson , MBBS, FRCPA; David M. Hwang , MD, PhD; Jenny Ma Wyatt ,MBBS, FRCPA; Andrew G. Nicholson , DM; Alexandra J. Rice , MB, BChir, FRCPath; Mary Kay Washington , MD, PhD; Kelly J.Butnor , MD

From the Department of Pathology, University of California-San Francisco, San Francisco (Dr Jones); the Department of Pathology, University of British Columbia, and Vancouver General Hospital, Vancouver, British Columbia, Canada (Dr Churg); the Department of Surgical Pathology, SA Pathology, Flinders Medical Centre, Adelaide, South Australia (Dr Henderson); the Department of Pathology, University Health Network, Toronto, Ontario, Canada (Dr Hwang); PathWest, QEII Medical Centre, Nedlands, Western Australia (Dr Ma Wyatt [currently at SA Pathology, Royal Adelaide Hospital, Adelaide, South Australia]); the Department of Histopathology, Royal Brompton and Harefield NHS Foundation Trust, and National Heart and Lung Division, Imperial College, London, United Kingdom (Drs Nicholson and Rice); the Department of Pathology, Vanderbilt University Medical Center, Nashville, Tennessee (Dr Washington); and the Department of Pathology, The University of Vermont/Fletcher Allen Health Care, Burlington (Dr Butnor).

Context.—The International Collaboration on Cancer Reporting (ICCR) is a quadripartite alliance formed by the Royal College of Pathologists of Australasia, the Royal College of Pathologists of the United Kingdom, the College of American Pathologists, and the Canadian Partnership Against Cancer. The ICCR was formed with a view to reducing the global burden of cancer data set development and reduplication of effort by different international institutions that commission, publish, and maintain standardized cancer-reporting data sets. The resultant standardization of cancer reporting would be expected to benefit not only those countries directly involved in the collaboration but also others not in a position to develop their own data sets.

Objectives.—To develop an evidence-based reporting data set for each cancer site.

Design.—A project to develop data sets for prostate, endometrium, and lung cancers and malignant melanoma was piloted by the quadripartite group.

Results.—A set of required and recommended data elements and appropriate responses for each element were agreed upon for the reporting of lung cancer.

Conclusions.—This review describes the process of development of the lung cancer data set.

Cytology of Spontaneous Nipple Discharge—Is It Worth It?

http://dx.doi.org/10.5858/arpa.2012-0231-CP

Ann T. Moriarty, Mary R. Schwartz, Rodolfo Laucirica, Christine N. Booth, Manon Auger, Nicole E. Thomas, and Rhona J. Souers (2013) Cytology of Spontaneous Nipple Discharge—Is It Worth It?: Performance of Nipple Discharge Preparations in the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology. Archives of Pathology & Laboratory Medicine: August 2013, Vol. 137, No. 8, pp. 1039-1042.

CAP LABORATORY IMPROVEMENT PROGRAMS

Cytology of Spontaneous Nipple Discharge—Is It Worth It?: Performance of Nipple Discharge Preparations in the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology

Ann T. Moriarty , MD; Mary R. Schwartz , MD; Rodolfo Laucirica , MD; Christine N. Booth , MD; Manon Auger , MD; Nicole E.Thomas , MPH, CT (ASCP); Rhona J. Souers , MS

From the Department of Pathology, AmeriPath Indiana, Indianapolis (Dr Moriarty); the Department of Pathology and Genomic Medicine, The Methodist Hospital, Houston, Texas (Dr Schwartz); the Department of Pathology, Baylor College of Medicine, Houston, Texas (Dr Laucirica); the Department of Anatomic Pathology, Cleveland Clinic, Cleveland, Ohio (Dr Booth); the  Department of Pathology, McGill University, Montreal, Canada (Dr Auger); and the Departments of Surveys (Ms Thomas) and Statistics/Biostatistics (Ms Souers), College of American Pathologists, Northfield, Illinois.

Context.—The usefulness of spontaneous nipple discharge analysis is controversial. Nipple discharge preparations are rare in clinical practice and malignant cases are exceptional. The College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology has included nipple discharge preparations since its inception.

Objectives.—To evaluate participant responses in the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology to assess the accuracy of cytologic interpretation of nipple discharge preparation.

Design.—General diagnostic category (benign, suspicious, malignant), participant type (pathologist, cytotechnologist), stain (Papanicolaou, modified Giemsa), and program year (2005–2009) were analyzed using χ² and a nonlinear mixed model for slide factor correlation structure.

Results.—Of 2506 responses, 1280 (51%) were malignant, 171 (7%) were papillary, and 1055 (42%) were benign. There were 222 discordant general category responses with a false–positive/suspicious rate of 12.8% and a false-negative rate of 3.4%. The most common false-negative diagnosis was mastitis/abscess (125 of 1272 responses; 9.8%). The most common false-positive response was papillary lesion (26 of 457 responses; 5.7%). There were no differences between stains or years. Cytotechnologists performed better than pathologists; pathologists had a higher false-negative rate than cytotechnologists (15.3% versus 7.9%, P < .001).

Conclusions.—There is poor accuracy in evaluating nipple discharge preparation in the College of American Pathologists Interlaboratory Comparison Program in Nongynecologic Cytopathology. If the findings in the program parallel clinical practice, nipple discharge preparations may adversely impact patient care. A benign nipple discharge cytologic diagnosis does not exclude malignancy, and the false–positive/suspicious rate requires confirmation of a malignant nipple discharge prior to definitive patient management.

http://dx.doi.org/10.5858/arpa.2012-0296-CP

John D. Olson, Mark T. Cunningham, Russell A. Higgins, Charles S. Eby, and John T. Brandt (2013) D-dimer: Simple Test, Tough Problems. Archives of Pathology & Laboratory Medicine: August 2013, Vol. 137, No. 8, pp. 1030-1038.

CAP LABORATORY IMPROVEMENT PROGRAMS

D-dimer: Simple Test, Tough Problems

John D. Olson , MD, PhD; Mark T. Cunningham , MD; Russell A. Higgins , MD; Charles S. Eby , MD; John T. Brandt , MD

From the Department of Pathology, University of Texas Health Science Center, San Antonio (Drs Olson and Higgins); the Department of Pathology, University of Kansas Medical Center, Kansas City (Dr Cunningham); and the Department of Pathology and Immunology, Washington University School of Medicine, St Louis, Missouri (Dr Eby). Dr Brandt is retired in Wenatchee, Washington.

Context.—D-dimer is widely used for exclusion, or as an aid in diagnosis, of venous thromboembolism (VTE); however, the D-dimer assay methods available from manufacturers and the laboratory application of those methods vary widely.

Objectives.—To describe the current laboratory practice regarding the assay and reporting of D-dimer.

Design.—Laboratories' D-dimer proficiency testing data were analyzed and laboratory practices regarding the performance and reporting of D-dimer were surveyed.

Results.—Initial grading of D-dimer proficiency testing demonstrated high variability within and among methods. This variability continued to be present for several years after attempts to intervene. The number of laboratories using D-dimer to exclude VTE grew from 1500 in 2004 to more than 3500 in 2012. Survey and proficiency testing data demonstrated that 33% of laboratories changed the type or magnitude of units from that recommended by the manufacturer, a practice associated with as much as a 20-fold increase in the failure of proficiency testing. Many laboratories used a threshold for the exclusion of VTE that is higher than that recommended by the manufacturer. Many laboratories continue to use qualitative assays with insufficient sensitivity for exclusion of VTE.

Conclusions.—There is considerable variability both within and among quantitative methods used to assay D-dimer by laboratories. Laboratory practice continues to vary widely regarding the type and magnitude of units reported and the setting of the threshold for the exclusion of VTE. Although improved, the variability continues despite initial efforts to intervene.

From Harvard: Larynx Preservation: A Debate Worth Preserving

http://jco.ascopubs.org/content/early/2013/07/29/JCO.2013.49.1332.long

J Clin Oncol. 2013 Jul 29. [Epub ahead of print]

Larynx Preservation: A Debate Worth Preserving.

Haddad R.

Source

Head and Neck Oncology Program, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA.

Governance in community based health programmes in Iran

http://www.ncbi.nlm.nih.gov/pubmed/23894897

J Pak Med Assoc. 2013 Feb;63(2):211-5.

Governance in community based health programmes in I.R of Iran.

Falahat K, Eftekhari MB, Malekafzali H, Forouzan AS, Dejman M.

Source

Undersecretary for Research and Technology, Ministry of Health and Medical, Tehran, Iran.

Abstract

OBJECTIVE:

To assess the nature of community-based health programme experience in Iran, and use the results in order to advocate more friendly policies in community, academy and funding organisations.

METHODS:

The qualitative study was done in 2010-11 at various locations in Iran using semi structural in-depth interviews with the principals and managers of programmes, and focus group discussions with volunteers and service users of 13 Community Based Health Programmes which were active for at least five years. A total of 21 in-depth interviews and 20 focus group discussions were conducted. Data analysis was based on deductive-inductive content analysis approach considering the pre-determined structure in accordance with the study questions. The participants' views were analysed within the main category of governance, including the three sub-categories of leadership, monitoring and evaluation, and resource mobilisation.

RESULTS:

According to the participants, governmental programmes have centralised decision-making and management processes and local volunteers have no role in selecting managers at different levels of a programme. Such programmes are funded by the governmental core resources. In non-government organisations, resources available for such purposes mainly come through charitable individuals, service delivery fees and profitable economical activities, financial participation of volunteers and by using other organisations' facilities. In most programmes, there were no systematic process for monitoring and evaluation.

CONCLUSION:

Community-based Health programmes in Iran need to be revised in line with the positive input.There is a need to have community-based units within the Ministry of Health and Medical Education and other relevant organisations.

From SUNY: Dowry in 21st-Century India: The Sociocultural Face of Exploitation

http://www.ncbi.nlm.nih.gov/pubmed/23897921

Trauma Violence Abuse. 2013 Jul 29. [Epub ahead of print]

Dowry in 21st-Century India: The Sociocultural Face of Exploitation.

Banerjee PR.

Source

1The College at Brockport, The State University of New York, Brockport, NY, USA.

Abstract

The World Health Organization (2009) implicates deep-rooted cultural and social norms as influential contributing factors toward physical and intimate partner violence against women. The dowry system is a social practice that perpetuates the oppression, torture, and murder of women in India. The practice of dowry is an expected part of marriage in cultures where arranged marriages are the norm. Violence can occur when the dowry or bride-price is deemed unsatisfactory by the recipient. In India, in spite of laws prohibiting the practice, not much has changed over the last 30 years. The National Crime Records Bureau of India, recorded a total of 8,618 female deaths related to dowry disputes in 2011, and the Asian Women's Human Rights Council (2009) estimates that the practice of dowry is implicated in 25,000 deaths and maiming of women between the ages of 15-34 in India every year. The current review of literature reveals that despite efforts on the part of the Indian government, social activists and feminists organizations in India, not much has changed over the past decade, in fact, the problem has increased, resulting in an unprecedented amount of mortality and morbidity among women in India.

http://www.ncbi.nlm.nih.gov/pubmed/23897928

Chron Respir Dis. 2013;10(3):127-33. doi: 10.1177/1479972313493098.

Depression in patients with idiopathic pulmonary fibrosis.

Akhtar AA, Ali MA, Smith RP.

Source

1Department of Respiratory Medicine, Ninewells Hospital, Dundee, Scotland.

Abstract

Depression carries enormous global morbidity and is 1.5-7 times likelier to occur in individuals with chronic illness than in the general population. Idiopathic pulmonary fibrosis (IPF) has a rising incidence with a severe impact on quality of life. An indication of the prevalence of depression in this group is therefore of paramount interest. A prospective study was performed. A total of 118 participants with IPF who attended the interstitial lungdisease clinic in Ninewells Hospitals, Dundee, Scotland, from May 2010 to September 2011 were recruited. Informed consent was obtained. The male to female ratio was 60:58. The Wakefield Self-assessment of Depression Inventory was used (scores ≥15 denote a depressed state). Pulmonary function tests were measured to correlate disease severity with depression scores. Of them, 58 patients had significant depressive symptoms scoring ≥15; only nine were taking antidepressant medication. The mean depression score of female participants was 15.0 ± 0.77 (SD 5.9), compared with a mean male score of 13.1 ± 0.99 (SD 7.5). Disease severity, age, duration since diagnosis and number of co-morbidities were not significantly correlated with depression. The study population had a high prevalence of depressive symptoms. Medical therapy for pulmonary fibrosis is limited and therefore palliation of symptoms and pulmonary rehabilitation form the main strategy for management. Depression should be actively screened in patients with IPF.

From U Wuerzburg: Intratumoral chemotherapy for lung cancer: re-challenge current targeted therapies

http://www.ncbi.nlm.nih.gov/pubmed/23898222

Drug Des Devel Ther. 2013 Jul 18;7:571-583. Print 2013.

Intratumoral chemotherapy for lung cancer: re-challenge current targeted therapies.

Hohenforst-Schmidt W, Zarogoulidis P, Darwiche K, Vogl T, Goldberg EP, Huang H, Simoff M, Li Q, Browning R, Turner FJ, Le Pivert P, Spyratos D,Zarogoulidis K, Celikoglu SI, Celikoglu F, Brachmann J.

Source

II Medical Clinic, Coburg Hospital, University of Wuerzburg, Coburg, Germany.

Abstract

Strategies to enhance the already established doublet chemotherapy regimen for lung cancer have been investigated for more than 20 years. Initially, the concept was to administer chemotherapy drugs locally to the tumor site for efficient diffusion through passive transport within the tumor. Recent advances have enhanced the diffusion of pharmaceuticals through active transport by using pharmaceuticals designed to target the genome of tumors. In the present study, five patients with non-small cell lung cancer epidermal growth factor receptor (EGFR) negative stage IIIa-IV International Union Against Cancer 7 (UICC-7), and with Eastern Cooperative Oncology Group (ECOG) 2 scores were administered platinum-based doublet chemotherapy using combined intratumoral-regional and intravenous route of administration. Cisplatin analogues were injected at 0.5%-1% concentration within the tumor lesion and proven malignant lymph nodes according to pretreatment histological/cytological results and the concentration of systemic infusion was decreased to 70% of a standard protocol. This combined intravenous plus intratumoral-regional chemotherapy is used as a first line therapy on this short series of patients. To the best of our knowledge this is the first report of direct treatment of involved lymph nodes with cisplatin by endobronchial ultrasound drug delivery with a needle without any adverse effects. The initial overall survival and local response are suggestive of a better efficacy compared to established doublet cisplatin-based systemic chemotherapy in (higher) standard concentrations alone according to the UICC 7 database expected survival. An extensive search of the literature was performed to gather information of previously published literature of intratumoral chemo-drug administration and formulation for this treatment modality. Our study shows a favorable local response, more than a 50% reduction, for a massive tumor mass after administration of five sessions of intratumoral chemotherapy plus two cycles of low-dose intravenous chemotherapy according to our protocol. These encouraging results (even in very sick ECOG 2 patients with central obstructive non-small cell lung cancer having a worse prognosis and quality of life than a non-small cell lung cancer in ECOG 0 of the same tumor node metastasis [TNM]-stage without central obstruction) for a chemotherapy-only protocol that differs from conventional cisplatin-based doublet chemotherapy by the route, target site, and dose paves the way for broader applications of this technique. Finally, future perspectives of this treatment and pharmaceutical design for intratumoral administration are presented.

The best action sequence ever filmed

http://theactionelite.com/2013/04/classic-action-scene-hospital-shootout-hard-boiled/

From Nature: Science and the public: promotional tactics corrupt research

http://www.ncbi.nlm.nih.gov/pubmed/23868252

Nature. 2013 Jul 18;499(7458):284. doi: 10.1038/499284c.

Science and the public: promotional tactics corrupt research.

Kelly M.

"With more than US$1 trillion spent globally on research and development in 2007 (see go.nature.com/5wdd9p), sheer scale seems to be corrupting the scientific enterprise as individuals take ever more extreme measures to stand out."

http://www.ncbi.nlm.nih.gov/pubmed/23892338

Am J Hosp Palliat Care. 2013 Jul 26. [Epub ahead of print]

Fatigue in Healthy and Diseased Individuals.

Finsterer J, Mahjoub SZ.

Source

1Krankenanstalt Rudolfstiftung, Vienna, Austria.

Abstract

Objectives:Although fatigue is experienced by everyone, its definition and classification remains under debate.

METHODS:

A review of the previously published data on fatigue.

RESULTS:

Fatigue is influenced by age, gender, physical condition, type of food, latency to last meal, mental status, psychological conditions, personality type, life experience, and the health status of an individual. Fatigue may not only be a symptom but also a measurable and quantifiable dimension, also known as fatigability. Additionally, it may be classified as a condition occurring at rest or under exercise or stress, as physiologic reaction or pathologic condition, as spontaneous phenomenon or triggerable state, as resistant or irresistant to preconditioning, training, or attitude, as prominent or collateral experience, and as accessible or inaccessible to any type of treatment or intervention. Fatigue may be the sole symptom of a disease or one among others. It may be also classified as acute or chronic. Quantification of fatigability is achievable by fatigue scores, force measurement, electromyography, or other means. Fatigue and fatigability need to be delineated from conditions such as sleepiness, apathy, exhaustion, exercise intolerance, lack of vigor, weakness, inertia, or tiredness. Among neurological disorders, the prevalence of fatigue is particularly increased in multiple sclerosis, amyotrophic lateral sclerosis, Parkinson disease, traumatic brain injury, stroke, and bleeding and also in neuromuscular disorders. Fatigue may be influenced by training, mental preconditioning, or drugs.

CONCLUSIONS:

Fatigue needs to be recognized as an important condition that is not only a symptom but may also be quantified and can be modified by various measures depending on the underlying cause.

From U Bradford-UK: Archaeological, radiological, and biological evidence offer insight into Inca child sacrifice

http://www.ncbi.nlm.nih.gov/pubmed/23898165

Proc Natl Acad Sci U S A. 2013 Jul 29. [Epub ahead of print]

Archaeological, radiological, and biological evidence offer insight into Inca child sacrifice.

Wilson AS, Brown EL, Villa C, Lynnerup N, Healey A, Ceruti MC, Reinhard J, Previgliano CH, Araoz FA, Gonzalez Diez J, Taylor T.

Source

Department of Archaeological Sciences, and Centre for Chemical and Structural Analysis, University of Bradford, Bradford BD7 1DP, United Kingdom.

Abstract

Examination of three frozen bodies, a 13-y-old girl and a girl and boy aged 4 to 5 y, separately entombed near the Andean summit of Volcán Llullaillaco, Argentina, sheds new light on human sacrifice as a central part of the Imperial Inca capacocha rite, described by chroniclers writing after the Spanish conquest. The high-resolution diachronic data presented here, obtained directly from scalp hair, implies escalating coca and alcohol ingestion in the lead-up to death. These data, combined with archaeological and radiological evidence, deepen our understanding of the circumstances and context of final placement on the mountain top. We argue that the individuals were treated differently according to their age, status, and ritual role. Finally, we relate our findings to questions of consent, coercion, and/or compliance, and the controversial issues of ideological justification and strategies of social control and political legitimation pursued by the expansionist Inca state before European contact.

From MLN Medical College-India: Morality and moral development: Traditional Hindu concepts

http://www.ncbi.nlm.nih.gov/pubmed/23858269

Indian J Psychiatry. 2013 Jan;55(Suppl 2):S283-7. doi: 10.4103/0019-5545.105552.

Morality and moral development: Traditional Hindu concepts.

Srivastava C, Dhingra V, Bhardwaj A, Srivastava A.

Source

Psychiatry Unit, Department of Medicine, MLN Medical College, Allahabad, India.

Abstract

Morality (from the Latin word moralitas that means "manner, character, proper behavior") is the differentiation of intentions, decisions, and actions between those that are good (or right) and those that are bad (or wrong). It is determined by how one's genetic makeup interacts with the environment. The development of morality has been a subject of investigation for a number of decades, and our understanding of neuro-biological and psychological mechanisms has increased manifolds in the last few decades. Development of morality has been of particular significance to psychiatric literature because of its significant contribution to the development of one's personality and it's aberration in various disorders. Cultures that have been just, equal and moral have been widely accepted and appreciated. In this review, we shall summarize the modern theories of moral development and then look into a part of our past and cultural heritage and review the traditional Hindu concepts of morality and their contribution to development of one's personality and their relevance in the current times.

http://www.ncbi.nlm.nih.gov/pubmed/23897273

Am J Psychiatry. 2013 Jul 30. doi: 10.1176/appi.ajp.2013.12121558. [Epub ahead of print]

New Ethical Issues for Genetic Counseling in Common Mental Disorders.

Gershon ES, Alliey-Rodriguez N.

Abstract

OBJECTIVE Recent genetic findings of high-impact genetic variants in bipolar disorder, schizophrenia, and autism spectrum disorder (ASD) must lead to profound changes in genetic and family counseling. The authors present risk calculations, discuss the ethical implications of these findings, and outline the changes now required in the risk counseling process. 

METHOD The authors use data from recent mega-analyses and reviews of common and rare risk variants in bipolar disorder, schizophrenia, and ASD to calculate risks of illness based on genetic marker tests. They then consider new ethical issues in mental disorders presented by these risks, including within-family conflicts over genetic testing; effects of genetic discoveries on stigma, abortion, preimplantation procedures, and population screening for susceptibility; and genetic tests as a factor in marital choice. 

RESULTS New structural mutations (de novo copy number variants [CNVs], which are chromosomal microdeletions and microduplications) are present in 4%-7% of patients with bipolar disorder, schizophrenia, or ASD and can occur almost anywhere in the genome. For a person with a de novo CNV, the absolute risk of bipolar disorder, schizophrenia, or ASD is 14%, much higher than the population risk. Rare CNVs have also been identified that are generally not new mutations but constitute very high-effect risk factors, ranging up to 82%. 

CONCLUSIONS A substantial minority of patients with bipolar disorder, schizophrenia, and ASD have high-impact detectable genetic events. This greatly changes psychiatric genetic counseling for these patients and families. A psychotherapeutic approach may be needed as a routine part of risk counseling, particularly for resolution of ethical issues and for within-family stigma and conflicts over genetic test results.