Revisiting the Case of Sarah Newbury's Death from Mollities Ossium.

Multiple myeloma and its precursor and variant types represent some of the most common hematologic malignancies in adults. These plasma cell dyscrasias are well-known in modern medicine. There are well-established clinical, laboratory, and pathologic criteria for diagnosis and staging. There is debate about the diagnosis of some of the earliest cases of myeloma described in the literature. We present a critical review of one such case.

Variability of thyroid blood flow Doppler parameters in healthy women.

The purpose of this study was to estimate variability of flow Doppler parameters in the superior thyroid artery (STHA) during the menstrual cycle in young women and to explore the influence of endogenous 17-b-estradiol (E2) and progesterone (PRG) on the velocity waveform. The plasma concentration of these hormones was correlated with flow velocities, pulsatility index (PUI), resistance index (RI) and acceleration index (accI) and time (accT), which were measured with color-coded duplex sonography 8 times during the cycle in 14 healthy women (age range: 23 to 25 years). Coefficient of variation (CV), interclass correlation (ICC), repeatability (repC) and pooled Pearson correlation (r) coefficients were used to estimate the variability of the parameters. The highest variability was found for accI and accT: CV = 48% and 31%; ICC = 0.51 and 0.45; repC = 2.8 and 95; r = 0.37 and 0.4, respectively. The CV for flow velocities varied from 25% to 26%, ICC from 0.53 to 0.56, repC from 8 to 17 and r has a value of 0.46. The respective values for RI and PUI were: 11%, 18%; 0.48, 0.55; 0.15, 0.48; and 0.46, 0.48. The diastolic blood pressure decreased significantly by 7 mmHg (p < 0.01) in the luteal phase, whereas other physiological variables were stable during the cycle. Although the fluctuations of the flow parameters during the cycle were not statistically significant, a weak linear correlation between flow velocities and concentration of E2 was found; for mean velocity r = 0.16, p < 0.05. Impedance indices showed an increasing trend in the luteal phase, along with increase of the pulse pressure index (PPI). The results showed that variability of the flow parameters in the STHA is substantial and that higher flow velocities are associated with increase of plasma concentration of 17-b-estradiol during the menstrual cycle in young women.