Women awaiting mammograms at a breast clinic were given questionnaires to investigate the role of psychosocial variables in the development of breast cancer while controlling for established breast cancer risk factors. Questionnaires to determine loneliness, emotional repression, marital quality, and major life changes were completed by 826 female volunteers who were later classified into groups according to their diagnoses. The total emotional repression score showed a hierarchy of most repression to least repression for the most-diseased to the most-healthy subjects. A breakdown of the emotional repression scale revealed that each group was significantly different from the other in suppression of anger and unhappiness. Women in the new cancer group showed significantly more loneliness than the women in the fibrocystic and normal groups. The newly diagnosed cancer group also had a higher proportion of women who experienced the death of a spouse or close family member within the past two years compared to the other groups.
Ultrasound image characteristics and radiographic features of 31 benign and 41 malignant breast masses were cross-tabulated and analyzed to determine the ultrasound image characteristics most useful for diagnosis and the frequency with which some imaging features occurred. The most common malignant mass (the ductal carcinoma) exhibited a jagged wall (88%), homogeneous internal echoes (12%), nonhomogeneous internal echoes (70%), internal echoes not discernible due to attenuation effects (18%), and attenuation shadowing (97%). In contrast, the fibroadenoma (the most common benign mass in this study), exhibited smooth walls (94%), homogeneous internal echoes (89%), and no demonstrable posterior shadowing (67%).
Six subspecialists with considerable experience in fetal ultrasound viewed a selection of pre-recorded ultrasound scans. Scans from 18 patients recorded on VHS video-tape were supplied from five centres in the UK and Ireland, each made on a high-resolution ultrasound machine by an experienced sonologist at a referral centre. Each observer viewed the scans on a large display monitor in an individual viewing booth. The scans were viewed in random order, at randomly selected bandwidths. Observers, who were blinded to both recording and bandwidth, assessed the technical quality on a five-point Likert scale. They also recorded their diagnosis. The six observers each carried out 32 viewing sessions, which gave a total of 192 viewings. There was no significant difference in the perceived technical quality of the scans between the two bandwidths used (P = 0.09). Of the 84 recordings transmitted at 1920 kbit/s, 71 (85%) were diagnosed correctly or 'half correctly' and 13 (15%) were misdiagnosed. Of the 95 recordings transmitted at 384 kbit/s, 66 (69%) were diagnosed correctly or 'half correctly' and 29 (31%) were misdiagnosed. This difference was significant (P = 0.03). The results indicate that although there were no perceived differences in technical quality between recordings transmitted at 384 or 1920 kbit/s, diagnostic accuracy was marginally worse at the lower bandwidth. This suggests that the higher bandwidth conveys more detail and information to the observer, which in turn enables more accurate diagnosis. However, further work is required before a definitive choice can be made about the optimum transmission bandwidth for remote fetal ultrasound studies.
The chest radiographs of asthmatic patients in an emergency room setting over a four-year period were reviewed. A total of 997 radiographs was reviewed; radiographic findings were compared with history and clinical data. In adults 2.2% of the radiographs were abnormal; in children 13%. It is concluded that a chest radiograph in adults in unnecessary unless the patient is unresponsive to bronchodilators and is being admitted to the hospital. In children, however, if rales and rhonchi are present, in addition to wheezing, a chest radiograph may be useful.
rIVCFs in our cohort of high-risk bariatric surgery patients was associated with an acceptably low incidence of DVT (5%) and no clinically evident PE. Despite safe removal after long dwell times, previous data suggest that rIVCFs are associated with a higher incidence of VTE. Thus, filters, if placed, should be removed once the risk of VTE has passed. Larger multicenter studies are needed to truly identify long-term safety and efficacy of rIVCFs.
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