Although a high prevalence of hepatitis C virus (HCV) infection among non-Hodgkin's lymphoma (NHL) patients had been reported, subsequent epidemiological studies conducted to examine a causal association between HCV and NHL have provided inconsistent results across studies. A strikingly positive association has been reported primarily from Italy and Japan, while no association was found in other regions of the world. To clarify the association between HCV and NHL, we conducted a systematic literature review. Eligible study designs were nested casecontrol studies, population-based case-control studies, and hospital-based case-control studies using non-cancer subjects as controls. The studies published through January 1991 to August 2003 were searched through Medline. Ultimately, 23 studies with 4049 NHL patients and 1,813,480 controls were identified. Summary statistics were crude odds ratios (ORs) comparing the anti-HCV seropositive and seronegative subjects. As we identified heterogeneity between studies, summary statistics were calculated based on a random-effect model. We did not find any evidence of publication bias. The major sources of variation were the use of blood donor controls and year of publication. The summary OR for NHL was 5.70 (95% confidence interval (CI), 4.09-7.96, P < < < <0.001). The subgroup analysis by phenotype showed a similar trend for B-cell on-Hodgkin's lymphoma (NHL) is a set of malignant diseases arising from lymphoid tissues. As it is heterogeneous in terms of classification and has relatively low incidence, epidemiological studies regarding causative factors for NHL have not been satisfactorily conducted compared with other malignant diseases. However, several possible causative factors have been identified, including pesticides, blood transfusion, immunodeficiency, radiation, smoking and several types of diet, as summarized elsewhere.1) Among them, infectious agents, such as Helicobacter pylori, human T-cell leukemia virus (HTLV-I), and human immunodeficiency virus (HIV), are promising factors from the viewpoint of prevention.Hepatitis C virus (HCV) is a hepatotrophic virus contributing to the development of chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Extrahepatic manifestations resulting from HCV, including lymphoproliferative syndromes such as type II mixed cryoglobulinemia (MC),2) have received increased attention. High prevalence of HCV infection among NHL patients was reported in the early 1990s, 3) suggesting a causal association between HCV and NHL. Subsequent epidemiological studies examined this potential association, but yielded inconsistent results across studies. The studies reporting a significantly positive association are from HCV endemic areas such as Italy and Japan, while other studies reporting no association come from non-endemic countries. 4)The aim of this study is to clarify the association between HCV infection and risk of NHL by means of a systematic review of the literature. Materials and MethodsSelection of studies. We used Medline to i...

Consensus guidelines, further evidence-based approaches for PTV margin selection, and greater resident involvement are needed for standardized use of IGRT practices.

Prenatal diagnosis has been shown to improve preoperative morbidity in newborns with congenital heart defects (CHDs), but there are conflicting data as to the association with mortality. We performed a population-based, retrospective, cohort study of infants with prenatally versus postnatally diagnosed CHDs from 1994 to 2005 as ascertained by the Metropolitan Atlanta Congenital Defects Program. Among infants with isolated CHDs, we estimated 1-year Kaplan-Meier survival probabilities for prenatal versus postnatal diagnosis and estimated Cox proportional hazard ratios adjusted for critical CHD status, gestational age, and maternal race/ethnicity. Of 539,519 live births, 4,348 infants had CHDs (411 prenatally diagnosed). Compared with those with noncritical defects, those with critical defects were more likely to be prenatally diagnosed (58% vs 20%, respectively, p <0.001). Of the 3,146 infants with isolated CHDs, 1-year survival rate was 77% for those prenatally diagnosed (n = 207) versus 96% for those postnatally diagnosed (n = 2,939, p <0.001). Comparing 1-year survival rate among those with noncritical CHDs alone (n = 2,455) showed no difference between prenatal and postnatal diagnoses (96% vs 98%, respectively, p = 0.26), whereas among those with critical CHDs (n = 691), prenatally diagnosed infants had significantly lower survival rate (71% vs 86%, respectively, p <0.001). Among infants with critical CHDs, the adjusted hazard ratio for 1-year mortality rate for those prenatally versus postnatally (reference) diagnosed was 2.51 (95% confidence interval 1.72 to 3.66). In conclusion, prenatal diagnosis is associated with lower 1-year survival rate for infants with isolated critical CHDs but shows no change for those with isolated noncritical CHDs. More severe disease among the critical CHD subtypes diagnosed prenatally might explain these findings.

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Studies of the association between breast size, as a proxy for mammary gland mass, and breast cancer risk have given equivocal results. Most have been case-control studies with limited statistical power. We conducted a prospective analysis of the relation between breast size as measured by self-reported bra cup size and breast cancer risk among premenopausal women enrolled in the Nurses' Health Study II. Bra cup size at age 20 was assessed among 89,268 premenopausal women aged 29-47 in 1993. Subsequent incident cases of invasive breast cancer were assessed until 2001. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated with a Cox proportional hazards model adjusting for potential confounders and risk factors for breast cancer. During 622,732 person-years of follow-up, 803 premenopausal women were newly diagnosed with invasive breast cancer. For women with a BMI below 25 kg/m 2 , those with a bra cup size of ''D or larger'' had a significantly higher incidence of breast cancer than women who reported ''A or smaller'' (covariate adjusted HR 5 1.80; 95% CI 1.13-2.88; p trend 5 0.01). There was no significant association among women with a BMI of 25 kg/m 2 or higher. Stratifying by BMI at age 18 at a cutoff point of 21 kg/m 2 gave similar results. Larger bra cup size at a young age is associated with a higher incidence of premenopausal breast cancer, though this association is limited to leaner women. ' 2005 Wiley-Liss, Inc.Both cell number and rate of cell division have been proposed to predict overall cancer risk. [1][2][3] Following this theory, breast cancer risk might be positively correlated with the total number of mammary gland cells and more generally, mammary gland mass. [4][5][6] Because a large number of susceptible cells should correspond to increased risk, breast size, as a proxy for mammary gland mass, could serve as a plausible risk factor for breast cancer. Several indirect lines of evidence support the theory that breast size may influence breast cancer risk: (i) Breast cancer occurs more frequently in the left breast, 7 and the left breast is typically slightly larger than the right breast, 8 and (ii) breast cancer is overwhelmingly more common in women than in men.In 1969, Wynder noted that studies of breast cancer in Japanese women indicated that subjects with breast cancer had larger breasts than controls. 9 Several studies have indicated that women who undergo breast augmentation surgery have a decreased risk of breast cancer, 10,11 presumably because these women compose a group of smaller-breasted, lower-risk individuals. Women who undergo surgical reduction mammoplasty, which reduces breast size, also experience lower than expected rates of breast cancer. 12 Ecological evidence supports the association between breast size and breast cancer risk. On average, breast size is smaller in women in Asian countries compared to those in western countries, and correspondingly, breast cancer is much less common in Asia. 13 With respect to male breast cancer, patients suffering from ...

Purpose: Physicians caring for patients with cancer frequently encounter individuals who will die as a result of their disease. The primary aim of this study was to examine the frequency and nature of bereavement practices among cancer care and palliative care physicians in the Pacific Northwest United States. Secondary aims included identification of factors and barriers associated with bereavement follow-up. Methods: An institutional review board (IRB) -approved,anonymous online survey of cancer specialists and palliative care physicians in Alaska, Washington, Oregon, Idaho, Montana, and Wyoming was performed in fall 2010. Potential participants were identified through membership in national professional organizations. Summary statistics and logistic regression methods were used to examine frequency and predictors of bereavement practices.

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