Body Image. 2014 Jun 25;11(4):346-349. doi: 10.1016/j.bodyim.2014.05.005. [Epub ahead of print]

An examination of body tracing among women with high body dissatisfaction.

Williams GA1, Hudson DL2, Whisenhunt BL2, Crowther JH3.

Author information

• 1Kent State University, Department of Psychology, 600 Hilltop Drive, Kent, OH 44242, United States; Missouri State University, Department of Psychology, 901 South National Avenue, Springfield, MO 65897, United States. Electronic address: gwilli18@kent.edu.
• 2Missouri State University, Department of Psychology, 901 South National Avenue, Springfield, MO 65897, United States.
• 3Kent State University, Department of Psychology, 600 Hilltop Drive, Kent, OH 44242, United States.

Abstract

Within eating disorder treatment programs, a body tracing activity is often used to address body dissatisfaction and overestimation of body size; however, the effects of this activity have never been empirically evaluated. This research examined the effects of body tracing on body dissatisfaction and mood among 56 female participants assigned to either a body tracing or control group. Scores were collected on trait body dissatisfaction and a series of Visual Analogue Scales (VAS). Results showed that trait body dissatisfaction moderated the relationship between group and levels of stateappearance dissatisfaction and anxiety. These results suggest that individuals experiencing higher levels of trait body dissatisfaction demonstrated greater state body dissatisfaction following participation in the body tracing activity. Individuals with lower trait body dissatisfaction experienced greater anxiety after drawing a human body. These findings have potential implications for the use of this strategy in the treatment of eating disorder patients.

I am a candidate for the College of American Pathologists Board of Governors. My vision is here.

I am a candidate for the College of American Pathologists Board of Governors.   My vision is here.

Umbilical cord blood banking

J Blood Med. 2014 Jun 18;5:87-97. doi: 10.2147/JBM.S64090. eCollection 2014.

Umbilical cord blood banking: from personal donation to international public registries to global bioeconomy.

Petrini C.

Author information

• Italian National Institute of Health, Rome, Italy.

Abstract

The procedures for collecting voluntarily and freely donated umbilical cord blood (UCB) units and processing them for use in transplants are extremely costly, and the capital flows thus generated form part of an increasingly pervasive global bioeconomy. To place the issue in perspective, this article first examines the different types of UCB biobank, the organization of international registries of public UCB biobanks, the optimal size of national inventories, and the possibility of obtaining commercial products from donated units. The fees generally applied for the acquisition of UCB units for transplantation are then discussed, and some considerations are proposed regarding the social and ethical implications raised by the international network for the importation and exportation of UCB, with a particular emphasis on the globalized bioeconomy of UCB and its commerciality or lack thereof.

From Harvard: "...until the public accepts that rationing, done right, is an ethical necessity, not an ethical abomination."

J Clin Ethics. 2014 Summer;25(2):116-119.

Detoxifying the Concept of Rationing.

Sabin J.

Author information

• Harvard Medical School, Department of Population Medicine, 133 Brookline Avenue, 6th Floor, Boston, MA 02215 USA. jim_sabin@harvardpilgrim.org.

Abstract

Andrew Hantel's proposal for dealing with cancer drug shortages exemplifies the kind of clinician-led discussion of rationing the U.S. political process requires. I argue that the U.S. will not get a grip on healthcare cost escalation until we set true budgets for healthcare. We will not be able to do that until the public accepts that rationing, done right, is an ethical necessity, not an ethical abomination. Because endorsing rationing is a third rail for politicians, "top down" leadership is currently impossible. As a result, health professionals must lead a "bottom up" educational process. Hantel shows how this can be done.

J Med Ethics. 2014 Jun 27. pii: medethics-2013-101824. doi: 10.1136/medethics-2013-101824. [Epub ahead of print]

Artificial gametes and the ethics of unwitting parenthood.

Smajdor A1, Cutas D2.

Author information

• 1Norwich School of Medicine, University of East Anglia, Norwich, UK.
• 2Department of Philosophy, University of Gothenburg, Gothenburg, Sweden.

Abstract

In this paper, we explore the ethical and legal implications of a hypothetical use of artificial gametes (AGs): that of taking a person's cells, converting them to AGs and using them in reproduction-without that person's knowledge or consent. We note the common reliance on genetic understandings of parenthood in the law and suggest that injustices may arise if unwitting genetic parents are sued for child support. We draw parallels between the hypothetical use of AGs to facilitate unwitting parenthood and real examples of unwitting parenthood following cases of sperm theft. We also look at the harm that might be caused by becoming a genetic parent, independently of financial obligations, and ask whether such harm should be understood in terms of theft of property. These examples help to highlight some of the current and prospective difficulties for the regulation of genetic and legal parenthood, and show how existing regulatory assumptions are likely to be further challenged by the development of AGs. We conclude by suggesting that the reliance on genetic connections to generate parental responsibility (financial or otherwise) for offspring is flawed and that alternative ways of establishing parental responsibility should be considered.

"...it is not ethically appropriate to incorporate unsupervised HIV self-testing as part of a public health screening program in resource-poor environments."

AIDS Behav. 2014 Jun 29. [Epub ahead of print]

Unsupervised Self-testing as Part Public Health Screening for HIV in Resource-Poor Environments: Some EthicalConsiderations.

Scott PA.

Author information

• School of Nursing and Human Sciences, Dublin City University, Collins Ave, Dublin 9, Ireland, anne.scott@dcu.ie.

Abstract

The use of unsupervised self-testing as part of a national screening program for HIV infection in resource-poor environments with high HIV prevalence may have a number of attractive aspects, such as increasing access to services for hard to reach and isolated populations. However, the presence of such technologies is at a relatively early stage in terms of use and impact in the field. In this paper, a principle-based approach, that recognizes the fundamentally utilitarian nature of public health combined with a focus on autonomy, is used as a lens to explore some of the ethical issues raised by HIV self-testing. The conclusion reached in this review is that at this point in time, on the basis of the principles of utility and respect for autonomy, it is not ethically appropriate to incorporate unsupervised HIV self-testing as part of a public health screening program in resource-poor environments.

From Rhonda Yantiss and colleagues: Significance of Proximal Margin Involvement in Low-Grade Appendiceal Mucinous Neoplasms

Thomas Arnason, Michal Kamionek, Michelle Yang, Rhonda K. Yantiss, and Joseph Misdraji (2014) Significance of Proximal Margin Involvement in Low-Grade Appendiceal Mucinous Neoplasms. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

Significance of Proximal Margin Involvement in Low-Grade Appendiceal Mucinous Neoplasms

Thomas Arnason, MD; Michal Kamionek, MD; Michelle Yang, MD; Rhonda K. Yantiss, MD; Joseph Misdraji, MD

Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston (Drs Arnason, Kamionek, and Misdraji)

Division of Anatomical Pathology, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada (Dr Arnason)

Department of Pathology, University of Massachusetts Memorial Medical Center, Worcester (Dr Yang); and

Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, New York (Dr Yantiss). Dr Kamionek is now located at the Carolinas Pathology Group, Carolinas Medical Center, Charlotte, North Carolina.

Context.— Appendiceal adenomas and low-grade appendiceal mucinous neoplasms (LAMNs) confined to the appendix are cured by appendectomy. However, involvement of the proximal margin raises concern for residual disease. Some patients with a positive margin at appendectomy undergo cecal resection to eliminate a perceived risk for tumor recurrence or dissemination, although that likelihood is assumed rather than demonstrated.

Objective.— To determine whether involvement of the proximal appendiceal resection margin by adenoma or LAMN is a risk factor for local development of recurrence or pseudomyxoma peritonei.

Design.— Appendiceal adenomas and LAMNs confined to the appendix were considered for the study if they showed neoplasia or dissecting mucin at the proximal margin. The presence or absence of residual tumor in cecal resections was determined. Follow-up data were obtained from clinical records.

Results.— 16 patients (14 female, 2 male) with LAMN (n = 15) or adenoma (n = 1) and an involved proximal resection margin were identified, including 9 with neoplastic epithelium within the lumen and 7 with acellular mucin in the appendiceal wall at the margin. Six patients underwent cecal resection and the others were nonsurgically followed. No cecal resection had residual neoplasia. No patient developed recurrence or pseudomyxoma peritonei (mean follow-up, 4.7 years).

Conclusions.— In patients with LAMNs confined to the appendix, involvement of the appendectomy margin by neoplastic epithelium or acellular mucin does not predict recurrence of disease, even without further surgery. A conservative approach to managing these patients can be justified.

Proceedings of the African Pathologists Summit

African Pathologists' Summit Working Groups (2014) Proceedings of the African Pathologists Summit; March 22–23, 2013; Dakar, Senegal: A Summary. Archives of Pathology & Laboratory Medicine In-Press.

Early Online Release

Proceedings of the African Pathologists Summit; March 22–23, 2013; Dakar, Senegal: A Summary

African Pathologists' Summit Working Groups

From Adekunle M. Adesina, MD, PhD, the Department of Pathology and Immunology and the Section of Hematology-Oncology, Department of Pediatrics, Neuropathology and Molecular Neuropathology Laboratory, Texas Children's Hospital and Baylor College of Medicine, Houston.

Context.— This report presents the proceedings of the African Pathologists Summit, held under the auspices of the African Organization for Research and Training in Cancer.

Objectives.— To deliberate on the challenges and constraints of the practice of pathology in Sub-Saharan Africa and the avenues for addressing them.

Participants.— Collaborating organizations included the American Society for Clinical Pathology; Association of Pathologists of Nigeria; British Division of the International Academy of Pathology; College of Pathologists of East, Central and Southern Africa; East African Division of the International Academy of Pathology; Friends of Africa–United States and Canadian Academy of Pathology Initiative; International Academy of Pathology; International Network for Cancer Treatment and Research; National Cancer Institute; National Health and Laboratory Service of South Africa; Nigerian Postgraduate Medical College; Royal College of Pathologists; West African Division of the International Academy of Pathology; and Faculty of Laboratory Medicine of the West African College of Physicians.

Evidence.— Information on the status of the practice of pathology was based on the experience of the participants, who are current or past practitioners of pathology or are involved in pathology education and research in Sub-Saharan Africa.

Consensus Process.— The deliberations were carried out through presentations and working discussion groups.

Conclusions.— The significant lack of professional and technical personnel, inadequate infrastructure, limited training opportunities, poor funding of pathology services in Sub-Saharan Africa, and their significant impact on patient care were noted. The urgency of addressing these issues was recognized, and the recommendations that were made are contained in this report.

Obesity Is Undercounted in Children, Study Finds

Common measure may miss up to 25% of young people

By
SUMATHI REDDY

"Although BMI is a convenient way to classify children for obesity and being overweight, it must be followed by a set of questions about eating and physical activity to determine if a child faces health risks, said Sandra Hassink, medical director of the American Academy of Pediatrics' Institute for Healthy Childhood Weight.

"The take home is that BMI is an initial first step to assess risk," said Dr. Hassink, president-elect of the AAP. "I think we need another measure that really may speak in a more refined way to the relative amount of adiposity versus muscle."

Other methods measure body fat more accurately than BMI, but these are generally more difficult to implement on a wide scale. Bioelectric-impedance devices, including specialized weighing scales and small gadgets, send a small amount of electrical current across the body to estimate body fatness."

Fierce Medical Debate Hits the Stage

Fierce Medical Debate Hits the Stage

Doctors and researchers at Baylor College of Medicine, along with some prominent Houston attorneys, became actors for one night at they gathered on a stage at Diverse Works to read aloud a new play that looks at the thorny issues of disclosing information on genetic testing.

J Bioeth Inq. 2014 Jun 22. [Epub ahead of print]

Scientific Integrity in Brazil.

Lins L1, Carvalho FM.

Author information

• 1Bahiana School of Medicine and Public Health, R. Frei Henrique, 8, Nazaré Salvador, BA, CEP: 40050-420, Brazil, lilianelinskusterer@bahiana.edu.br.

Abstract

This article focuses on scientific integrity and the identification of predisposing factors to scientific misconduct in Brazil. Brazilian scientific production has increased in the last ten years, but the quality of the articles has decreased. Pressure on researchers and students for increasing scientific production may contribute to scientific misconduct. Cases of misconduct in science have been recently denounced in the country. Brazil has important institutions for controlling ethical and safety aspects of human research, but there is a lack of specific offices to investigate suspected cases of misconduct and policies to deal with scientific dishonesty.

Res Social Adm Pharm. 2014 May 29. pii: S1551-7411(14)00069-2. doi: 10.1016/j.sapharm.2014.05.004. [Epub ahead of print]

Impact of patients' religious and spiritual beliefs in pharmacy: From the perspective of the pharmacist.

Daher M1, Chaar B1, Saini B2.

Author information

• 1Faculty of Pharmacy, University of Sydney, Sydney, NSW 2006, Australia.
• 2Faculty of Pharmacy, University of Sydney, Sydney, NSW 2006, Australia. Electronic address: bandana.saini@sydney.edu.au.

Abstract

BACKGROUND:

Socio-cultural perspectives including religious and spiritual beliefs affect medicine use and adherence. Increasingly communities that pharmacists serve are diverse and pharmacists need to counsel medicine use issues with ethical and cultural sensitivity as well as pharmaceutical competence. There is very little research in this social aspect of pharmacy practice, and certainly none conducted in Australia, an increasingly multicultural, diverse population.

OBJECTIVES:

The purpose of this study was to explore, from a pharmacy practitioner's viewpoint, the frequency and nature of cases where patients' articulated religious/spiritual belief affect medicine use; and pharmacist perspectives on handling these issues.

METHODS:

Qualitative method employing semi-structured interviews with pharmacy practitioners, constructed around an interview guide. Pharmacist participants were recruited purposively from areas of linguistic diversity in Sydney, New South Wales, Australia. Verbatim transcription and thematic analyses were performed on the data.

RESULTS:

Thematic analyses of 21 semi-structured interviews depicted that scenarios where religious and spiritual belief and medication use intersect were frequently encountered by pharmacists. Patient concerns with excipients of animal origin and medication use while observing religious fasts were the main issues reported. Participants displayed scientific competence; however, aspects of ethical sensitivity in handling such issues could be improved. This novel study highlights the urgent need for more research, training and resource development for practitioners serving patients in multi-faith areas.

"...adhering to stare decisis was especially appropriate in a case involving interpretation of the securities laws..."

The Volokh Conspiracy

Prof. Charles Korsmo on the Supreme Court’s Halliburton decision

"Instead, Chief Justice Roberts, in an opinion joined by five other Justices, took a more minimalist approach.  He held that Halliburton had showed no “special justification” for overturning the quarter-century-old holding of Basic, and that adhering to stare decisis was especially appropriate in a case involving interpretation of the securities laws, which Congress could presumably amend if they were so inclined.  Instead of wiping out the fraud on the market doctrine altogether, Roberts sought to chart a middle course, allowing defendants the opportunity to rebut the presumption of reliance at the class certification stage by showing that the alleged misrepresentations had no impact on the market price.  In taking this course, the Court largely adopted the position advocated by the law professors Adam Pritchard and Todd Henderson in an amicus brief that was heavily discussed at oral argument."

First trimester coffee and tea intake and risk of gestational diabetes mellitus: ("...possibly may have a protective effect.")

BJOG. 2014 Jun 20. doi: 10.1111/1471-0528.12930. [Epub ahead of print]

First trimester coffee and tea intake and risk of gestational diabetes mellitus: a study within a national birth cohort.

Hinkle S1, Laughon S, Catov J, Olsen J, Bech B.

Author information

• 1Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA.

Abstract

OBJECTIVE:

Coffee and tea consumption is associated with a decreased type 2 diabetes risk in non-pregnant adults. We examined the relation between first trimester coffee and tea consumption and gestational diabetes mellitus (GDM) risk.

DESIGN:

Population-based cohort study.

SETTING:

Denmark 1996-2002.

POPULATION:

Non-diabetic women with singleton pregnancies in the Danish National Birth Cohort (n = 71 239).

METHODS:

Estimated adjusted relative risks (RR) and 95% confidence intervals (95%CI) for the association between first trimester coffee and tea or estimated total caffeine and GDM.

MAIN OUTCOME MEASURES:

GDM ascertained from the National Hospital Discharge Register or maternal interview.

RESULTS:

Coffee or tea intake was reported in 81.2% (n = 57 882) and 1.3% (n = 912) of pregnancies were complicated by GDM. Among non-consumers, 1.5% of pregnancies were complicated by GDM. Among coffee drinkers, GDM was highest among women who drank ≥8 cups/day (1.8%) with no significant difference across intake levels (P = 0.10). Among tea drinkers, there was no difference in GDM across intake levels (1.2%; P = 0.98). After adjustment for age, socio-occupational status, parity, pre-pregnancy body mass index, smoking, and cola, there was suggestion of a protective, but non-significant association with increasing coffee (RR ≥8 versus 0 cups/day = 0.89 [95%CI 0.64-1.25]) and tea (RR ≥8 versus 0 cups/day = 0.77 [95%CI 0.55-1.08]). Results were similar by smoking status, except a non-significant 1.45-fold increased risk with ≥8 coffeecups/day for non-smokers. There was a non-significant reduced GDM risk with increasing total caffeine.

CONCLUSIONS:

Our results suggest that moderate first trimester coffee and tea intake were not associated with GDM increased risk and possibly may have a protective effect.

"Arguments against denying pathologists payment for the work they do in the clinical laboratory—even if that work is frequently measured indirectly—are strong and convincing."

Timothy Craig Allen (2014) Once More Unto the Breach. Archives of Pathology & Laboratory Medicine: June 2014, Vol. 138, No. 6, pp. 727-727.

EDITORIALS

Once More Unto the Breach

Timothy Craig Allen, MD, JD

From the Department of Pathology, University of Texas Medical Branch.

"Arguments against denying pathologists payment for the work they do in the clinical laboratory—even if that work is frequently measured indirectly—are strong and convincing. Court decisions have almost consistently held that pathologists provide a valuable medical service in the clinical laboratory for which payment is due. And indeed courts should; most pathologists spend half of their residency years developing their clinical pathology skills. Some pathologists subspecialize, ultimately practicing entirely in the various realms of clinical pathology. Patients reap many tangible benefits from the pathologists' involvement in the clinical laboratory, including safe blood products, accurate blood tests, and timely microbiologic assessment, to name a few."

"Patients who were Black, Hispanic, and/or enrolled in Medicaid or Medicare Advantage were less likely to have [post-discharge] follow-up visits."

Medicare Medicaid Res Rev. 2014 May 9;4(1). pii: mmrr.004.02.a01. doi: 10.5600/mmrr.004.02.a01. eCollection 2014.

Post-discharge follow-up visits and hospital utilization by medicare patients, 2007-2010.

DeLia D1, Tong J1, Gaboda D1, Casalino LP2.

Author information

• 1Rutgers University-Center for State Health Policy.
• 2Weill Cornell Medical College-Division of Outcomes and Effectiveness.

Abstract

OBJECTIVE:

Document trends in time to post-discharge follow-up visit for Medicare patients with an index admission for heart failure (HF), acute myocardial infarction (AMI), or community-acquired pneumonia (CAP). Determine factors predicting whether the first post-discharge utilization event is a follow-up visit, treat-and-release emergency department (ED) visit, or readmission.

METHODS:

Using Medicare claims data from 2007-2010, we plotted annual cumulative incidence functions for the time frame post-discharge to follow-up visit, accounting for competing risks with censoring at 30 days. We used multinomial probit regression to determine factors predicting the probability of first-occurring post-discharge utilization events within 30 days.

RESULTS:

For each cohort, the cumulative incidence of follow-up visits increased during the study period. For example, in 2010, 54.6% of HF patients had a follow-up visit within 10 days of discharge compared to 47.9% in 2007. Within each cohort, the largest increase in follow-up visits took place between 2008 and 2009. Follow-up visits were less likely for patients who were Black, Hispanic, and enrolled in Medicaid or Medicare Advantage, and they were more likely for patients with greater comorbidities and prior procedures as well as those with private or supplemental Medicare coverage. There were no changes in 30-day readmission rates.

DISCUSSION:

Although increases in follow-up visits may have been inf luenced by the introduction of publicly reported readmission rates in 2009, these increases did not continue in 2010 and were not associated with a change in readmissions. Patients who were Black, Hispanic, and/or enrolled in Medicaid or Medicare Advantage were less likely to have follow-up visits.

Sci Rep. 2014 May 27;4:4938. doi: 10.1038/srep04938.

Opinion dynamics on interacting networks: media competition and social influence.

Quattrociocchi W1, Caldarelli G2, Scala A3.

Author information

• 11] Laboratory for the modeling of biological and socio-technical systems, Northeastern University, Boston, MA 02115 USA [2] LIMS the London Institute of Mathematical Sciences, 22 South Audley St Mayfair London W1K 2NY, UK [3] IMT Alti Studi Lucca, piazza S. Ponziano 6, 55100 Lucca, Italy.
• 21] IMT Alti Studi Lucca, piazza S. Ponziano 6, 55100 Lucca, Italy [2] ISC-CNR Physics Dept., Univ. "La Sapienza" Piazzale Moro 5, 00185 Roma, Italy [3] LIMS the London Institute of Mathematical Sciences, 22 South Audley St Mayfair London W1K 2NY, UK.
• 31] ISC-CNR Physics Dept., Univ. "La Sapienza" Piazzale Moro 5, 00185 Roma, Italy [2] IMT Alti Studi Lucca, piazza S. Ponziano 6, 55100 Lucca, Italy [3] LIMS the London Institute of Mathematical Sciences, 22 South Audley St Mayfair London W1K 2NY, UK.

Abstract

The inner dynamics of the multiple actors of the informations systems - i.e, T.V., newspapers, blogs, social network platforms, - play a fundamental role on the evolution of the public opinion. Coherently with the recent history of the information system (from few main stream media to the massive diffusion of socio-technical system), in this work we investigate how main stream media signed interaction might shape the opinion space. In particular we focus on how different size (in the number of media) and interaction patterns of the information system may affect collective debates and thus the opinions' distribution. We introduce a sophisticated computational model of opinion dynamics which accounts for the coexistence of media and gossip as separated mechanisms and for their feedback loops. The model accounts also for the effect of the media communication patterns by considering both the simple case where each medium mimics the behavior of the most successful one (to maximize the audience) and the case where there is polarization and thus competition among media memes. We show that plurality and competition within information sources lead to stable configurations where several and distant cultures coexist.

From June's CAP Today: Cancer biomarker use varies widely, needs a 'broader view'

From June's CAP Today:

Cancer biomarker use varies widely, needs a 'broader view'

Am J Public Health. 2014 Jun;104(6):e9-e12. doi: 10.2105/AJPH.2013.301861. Epub 2014 Apr 17.

The Haverstraw experience: the first tobacco product display ban in the United States.

Curry LE1, Schmitt CL, Juster H.

Author information

• 1Laurel E. Curry and Carol L. Schmitt are with the Public Health Research Division, RTI International, Washington, DC. Harlan Juster is with the Bureau of Tobacco Control, New York State Department of Health, Albany.

Abstract

In April 2012, the village of Haverstraw, New York, passed the first tobacco retail display ban in the United States. Community groups funded by the New York State Department of Health Tobacco Control Program mobilized community members to support an initiative to protect youths in their area from tobacco marketing via methods consistent with a community transformation framework. The law was soon rescinded after 7 tobacco companies and the New York Association of Convenience Stores filed a federal lawsuit against the village that challenged the law's constitutionality. We discuss lessons learned and next steps for adoption of local point-of-sale policies.

Respirology. 2014 Jun 19. doi: 10.1111/resp.12328. [Epub ahead of print]

Interventional therapies for malignant pleural effusions: The present and the future.

Thomas R1, Francis R, Davies HE, Lee YC.

Author information

• 1Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia; School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia; Pleural Disease Unit, Lung Institute of Western Australia, Perth, Western Australia, Australia.

Abstract

The approach to management of malignant pleural effusions (MPE) has changed over the past few decades. The key goals of MPE management are to relieve patient symptoms using the least invasive means and in the most cost-effective manner. There is now a realization that patient-reported outcome measures should be the primary goal of MPE treatment, and this now is the focus in most clinical trials. Efforts to minimize patient morbidity are complemented by development of less invasive treatments that have mostly replaced the more aggressive surgical approaches of the past. Therapeutic thoracentesis is simple, effective and generally safe, although its benefits may only be temporary. Pleurodesis is the conventional and for a long time the only definitive therapy available. However, the efficacy and safety of talc pleurodesis has been challenged. Indwelling pleural catheter (IPC) drainage is increasingly accepted worldwide and represents a new concept to improve symptoms without necessarily generating pleural symphysis. Recent studies support the effectiveness of IPC treatment and provide reassurance regarding its safety. An unprecedented number of clinical trials are now underway to improve various aspects of MPE care. However, choosing an optimal intervention for MPE in an individual patient remains a challenge due to our limited understanding of the underlying pathophysiology of breathlessness in MPE and a lack of predictors of survival and pleurodesis outcome. This review provides an overview of common pleural interventional procedures used for MPE management, controversies and limitations of current practice, and areas of research most needed to improve practice in future.

From UCSD: Banking placental tissue

Placenta. 2014 Jun 6. pii: S0143-4004(14)00197-0. doi: 10.1016/j.placenta.2014.05.005. [Epub ahead of print]

Banking placental tissue: An optimized collection procedure for genome-wide analysis of nucleic acids.

Wolfe LM1, Thiagarajan RD1, Boscolo F2, Taché V3, Coleman RL4, Kim J5, Kwan WK1, Loring JF4, Parast M5, Laurent LC6.

Author information

• 1Department of Reproductive Medicine, University of California San Diego, San Diego, CA 92103, USA.
• 2Department of Reproductive Medicine, University of California San Diego, San Diego, CA 92103, USA; Department of Chemical Physiology, Center for Regenerative Medicine, The Scripps Research Institute, La Jolla, CA 92037, USA.
• 3Department of Reproductive Medicine, University of California San Diego, San Diego, CA 92103, USA; Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, University of California Davis, Sacramento, CA 95817, USA.
• 4Department of Chemical Physiology, Center for Regenerative Medicine, The Scripps Research Institute, La Jolla, CA 92037, USA.
• 5Department of Pathology, University of California San Diego, San Diego, CA 92103, USA.
• 6Department of Reproductive Medicine, University of California San Diego, San Diego, CA 92103, USA. Electronic address: louise.laurent@gmail.com.

Abstract

INTRODUCTION:

Banking of high-quality placental tissue specimens will enable biomarker discovery and molecular studies on diseases involving placental dysfunction. Systematic studies aimed at developing feasible standardized methodology for placental collection in a typical clinical setting are lacking.

METHODS:

To determine the acceptable timeframe for placental collection, we collected multiple samples from first and third trimester placentas at serial timepoints in a 2-h window after delivery, simultaneously comparing the traditional snap-freeze technique to commercial solutions designed to preserve RNA (RNAlater™), and DNA (DNAgard®). The performance of RNAlater for preserving DNA was also tested. Nucleic acid quality was assessed by determining the RNA integrity number (RIN) and genome-wide microarray profiling for gene expression and DNA methylation.

RESULTS:

We found that samples collected in RNAlater had higher and more consistent RINs compared to snap-frozen tissue. Similar RINs were obtained for tissue collected in RNAlater as large (1 cm3) and small (∼0.1 cm3) pieces. RNAlater appeared to better stabilize the time zero gene expression profile compared to snap-freezing for first trimester placenta. DNA methylation profiles remained quite stable over a 2 h time period after removal of the placenta from the uterus, with DNAgard being superior to other treatments.

DISCUSSION AND CONCLUSION:

The collection of placental samples in RNAlater and DNAgard is simple, and eliminates the need for liquid nitrogen or a freezer on-site. Moreover, the quality of the nucleic acids and the resulting data from samples collected in these preservation solutions is higher than samples collected using the snap-freeze method and easier to implement in busy clinical environments.

From NYU: No One Likes a Snitch

Sci Eng Ethics. 2014 Jun 17. [Epub ahead of print]

No One Likes a Snitch.

Redman B1, Caplan A.

Author information

• 1Division of Medical Ethics, NYU Langone Medical Center, New York, NY, USA, bkredman@comcast.net.

Abstract

Whistleblowers remain essential as complainants in allegations of research misconduct. Frequently internal to the research team, they are poorly protected from acts of retribution, which may deter the reporting of misconduct. In order to perform their important role, whistleblowers must be treated fairly. Draft regulations for whistleblower protection were published for public comment almost a decade ago but never issued (Dahlberg 2013). In the face of the growing challenge of research fraud, we suggest vigorous steps, to include: organizational responsibility to certify the accuracy of research including audit, required whistleblower action in the face of imminent or grave harm to subjects, strengthened legal protections against retaliation including prompt enactment of Federal whistleblower protections and consideration of criminalizing the most egregious cases of research misconduct.

I am a candidate for the College of American Pathologists Board of Governors. My vision is here.

I am a candidate for the College of American Pathologists Board of Governors.  

My vision is here.