Association of marital status and colorectal cancer screening participation in the USA.

AIM: In the USA, for both men and women, colorectal cancer (CRC) ranks third in incidence and second in mortality. Despite evidence that it decreases mortality, CRC screening in the USA remains under-utilized. Some European studies have suggested that marital status affects participation in CRC screening, but the effect of marital status on CRC screening participation in the USA is unknown. In this study, the aim was to compare CRC screening participation rates among married and unmarried couples, separated, widowed, never married and divorced adults living in the USA. METHOD: This was a retrospective data analysis of the 2010 Behavioural Risk Factor Surveillance System survey. The population studied included 239,300 participants, aged 50-75 years, who completed the 2010 survey. Logistic regression analysis was conducted to assess the association between adherence with CRC screening guidelines and marital status while accounting for survey stratum/weight and covariates. RESULTS: Individuals who were divorced or separated, never married or widowed had decreased odds of adherence with CRC screening guidelines compared with individuals who were married and unmarried couples. CONCLUSION: In this study, individuals living in the USA who were married and unmarried couples had increased odds of undergoing CRC screening compared to individuals in other marital status groups. Public health interventions are needed to promote CRC screening participation in these other groups.

Hypercalcaemia secondary to hypervitaminosis a in a patient with chronic renal failure.

Vitamin A toxicity is a well-described medical condition with a multitude of potential presenting signs and symptoms. It can be divided into acute and chronic toxicity. Serum vitamin A concentrations are raised in chronic renal failure even with ingestion of less than the usual toxic doses. Hypercalcaemia can occasionally be associated with high levels of vitamin A but it is rare. In this report, we describe a 67- year old female patient with chronic kidney disease who was taking vitamin A supplements for approximately 10 years. The patient had worsening of her chronic kidney disease over the last years and developed chronic hypercalcaemia. Her vitamin A level was elevated with a daily intake of 7000 IU. The vitamin A supplement was stopped. A few months later, vitamin A level diminished substantially and serum calcium levels returned to normal.

Hypercalcaemia secondary to Hypervitaminosis A in a patient with chronic renal failure / Hipercalcemia secundaria a la Hipervitaminosis A en un paciente con insuficiencia renal crónica

Vitamin A toxicity is a well-described medical condition with a multitude of potential presenting signs and symptoms. It can be divided into acute and chronic toxicity. Serum vitamin A concentrations are raised in chronic renal failure even with ingestion of less than the usual toxic doses. Hypercalcaemia can occasionally be associated with high levels of vitamin A but it is rare. In this report, we describe a 67-year old female patient with chronic kidney disease who was taking vitamin A supplements for approximately 10 years. The patient had worsening of her chronic kidney disease over the last years and developed chronic hypercalcaemia. Her vitamin A level was elevated with a daily intake of 7000 IU. The vitamin A supplement was stopped. A few months later, vitamin A level diminished substantially and serum calcium levels returned to normal.

La toxicidad de la vitamina A es una condición médica bien descrita que presenta un sinnúmero de potenciales signos y síntomas. Puede ser dividida en toxicidad aguda y crónica. Las concentraciones séricas de vitamina A se elevan con la insuficiencia renal crónica, incluso con la ingestión de dosis tóxicas por debajo de lo habitual. En ocasiones, la hipercalcemia puede estar asociada con altos niveles de vitamina A, pero esto raramente ocurre. En este informe, describimos a una paciente de 67 años de edad con enfermedad renal crónica, que estuvo tomando suplementos de vitamina A por aproximadamente 10 años. La paciente sufrió un empeoramiento de su enfermedad renal crónica en los últimos años, y desarrolló hipercalcemia crónica. Su nivel de vitamina A se elevó con una ingesta diaria de 7000 UI. El suplemento de vitamina A fue suspendido. Unos meses más tarde, el nivel de vitamina A nivel disminuyó sustancialmente, y los niveles de calcio sérico volvieron a la normalidad.

Neurosarcoidosis presenting as trigeminal nevralgia: a case report and review of the literature.

Sarcoidosis is a granulomatous disease that can present systemically, but primarily has pulmonary manifestations. It is reported across all races, but has a higher incidence among African Americans. Neurological involvement in sarcoidosis is rare, with cranial nerve seven being the most commonly reported neurological finding. Trigeminal neuralgia, as presented in this case, is very rare. A 38-year-old African American female, with history of refractory trigeminal neuralgia, cutaneous sarcoidosis, and an extensive psychiatric history, presented to the hospital for fifth cranial nerve decompression. She had failed medical therapy and gamma knife therapy. Prior to surgery, magnetic resonance imaging (MRI) revealed a mass of 1.5 cm x 0.6 cm x 1.1 cm in the left Meckel's cave, which, when compared with prior imaging, was not present. A partial craniotomy was done to excise the mass. Frozen pathological sections showed granulomatous inflammation consistent with sarcoidosis. Stains for acid fast bacilli and fungi remained negative. Quantiferon Gold and HIV serum studies were negative. High resolution computed tomography (CT) scan the chest showed patchy infiltrates in the lungs that presented as chronic interstitial lung disease. The patient's neurological symptoms resolved after surgical resection. She was dismissed home on a tapering dose of dexamethasone and follow-up with a rheumatologist. This case illustrates that when a patient with sarcoidosis presents with neurological symptoms, neurosarcoid should be considered. Most cases are diagnosed during autopsies. Recognizing and correctly diagnosing neurosarcoid leads to proper treatment and decreased morbidity in patients.