Military service and health-related quality of life among gay and bisexual prostate cancer survivors: Results from the Restore -2 study.

INTRODUCTION: There are notable disparities in health-related quality of life (HRQOL) between gay and bisexual men (GBM) and heterosexual patients with prostate cancer (PCa); however, the role of past military service is unclear. This study examines HRQOL differences in GBM PCa survivors based on reported military service history. METHODS: We used data from the 24-month follow-up survey of the Restore-2 study, a clinical trial which evaluated a rehabilitation programme for GBM PCa survivors. PCa HRQOL was assessed using the Expanded Prostate Cancer Index Composite (EPIC-50) and the Functional Assessment of Cancer Treatment-Prostate (FACT-P). Mental health quality of life was assessed using the Brief Symptom Inventory-18 (BSI-18) scale, while sexual functioning was measured using the Sexual Minorities and Prostate Cancer Scale (SMACS). Multivariable linear regression was used to estimate unadjusted and adjusted mean differences in HRQOL between GBM with and without a reported history of military service. RESULTS: In this cross-sectional study of 351 GBM PCa survivors, 47 (13.4%) reported a history of US military service. After adjusting for covariates, participants who reported a history of military service (compared with those with no military service) had clinically better scores on the FACT-P physical, social and emotional well-being domains, as well as higher total FACT-General, EPIC urinary bother and hormonal function scores. Additionally, men with a history of military service reported significantly fewer sexual problems, more sexual confidence and less urinary incontinence in sex. CONCLUSION: This exploratory study provides the first evidence that GBM PCa survivors with a military background may have clinically better outcomes than those without military service. Potential reasons may include the structured support and healthcare access associated with military service, fostering resilience and well-being. These findings underscore the need for further research to elucidate how military service influences PCa HRQOL.

Column selection considerations in compact capillary liquid chromatography.

Recent years have seen significant advances in compact, portable capillary LC instrumentation. This study explores the performances of several commercially available columns within the pressure and flow limits of both the columns and one of these compact LC instruments. The commercially available compact capillary LC system with UV-absorbance detector used in this study is typically operated using columns in the 0.15-0.3 mm internal diameter (i.d.) range. Efficiency measurements (i.e., theoretical plates, N) for six columns with i.d.s in this range and of varying lengths and pressure limits, packed with stationary phases of different particle diameters and morphologies, were made using a mixture of standard alkylphenones. Kinetic plot comparisons between columns that vary by one (or more) of these parameters are described, along with calculated kinetic performance and Knox-Saleem limits. These theoretical performance descriptions provide insight into optimal operating conditions when using capillary LC systems. Based on kinetic plot evaluation of available capillary columns in the 0.2-0.3 mm i.d. range with a conservative upper pressure limit of 330 bar packed with superficially porous particles, a 25 cm column could generate ∼47,000 plates in 7.85 min when operated at 2.4 µL/min. For comparison, more robust 0.3 mm i.d. columns (packed with fully porous particles) that can be operated at higher pressures than can be provided by the pumping system (conservative pump upper pressure limit of 570 bar), a ∼20 cm column could generate nearly 40,000 plates in 5.9 min if operated at 6 µL/min. Across all capillary LC columns measured, higher pressure limits and shorter columns can provide the best throughput when considering both speed and efficiency.

The Anxiolytic and Antidepressant Effects of Transcranial Magnetic Stimulation in Patients With Anxious Depression.

Objective: To determine the extent that treatment with transcranial magnetic stimulation (TMS) in diverse clinical settings has anxiolytic and antidepressant effects in patients with major depressive disorder (MDD) and moderate-to-severe anxiety symptoms and to contrast anxious and nonanxious depression subgroups in antidepressant effects.Methods: Within the NeuroStar Advanced Therapy System Clinical Outcomes Registry, 1,820 patients were identified with a diagnosis of MDD (using ICD-9, ICD-10, or DSM-IV) who completed the Patient Health Questionnaire-9 (PHQ-9) and Global Anxiety Disoder-7 scale (GAD-7) at baseline and following at least 1 TMS treatment between May 2016 and January 2021. Anxious depression was defined as a baseline GAD-7 score of 10 or greater (n = 1,514) and nonanxious depression by GAD-7 scores below this threshold (n = 306). Intent-to-treat and Completer samples were defined for patients treated with any TMS protocol and for the subgroup treated only with high-frequency left dorsolateral prefrontal cortex stimulation.Results: Patients with anxious depression showed clinically meaningful anxiolytic and antidepressant effects, averaging approximately 50% or greater reductions in both GAD-7 and PHQ-9 scores following TMS in all samples. The anxious and nonanxious depression groups had equivalent absolute improvement in PHQ-9 scores (P values ≥ .29). However, the anxious group had higher scores both at baseline and following TMS resulting in significantly lower categorical rates of response (P values < .02) and remission (P values < .001) in depressive symptoms. Among those with anxious depression, the change in anxiety and depression symptoms strongly covaried (r1512 = 0.75, P < .001).Conclusions: Routine TMS delivered in diverse clinical settings results in marked anxiolytic and antidepressant effects in patients with anxious depression. The extent of improvement in anxiety and depression symptoms strongly covaries.

Comparison of clinical outcomes with left unilateral and sequential bilateral Transcranial Magnetic Stimulation (TMS) treatment of major depressive disorder in a large patient registry.

BACKGROUND: It has been suggested that sequential bilateral (SBL) TMS, combining high frequency, left dorsolateral prefrontal cortex (DLPFC) stimulation and low frequency, right DLPFC stimulation, is more effective than unilateral TMS. OBJECTIVE: To contrast treatment outcomes of left unilateral (LUL) and SBL protocols. METHODS: Registry data were collected at 111 practice sites. Of 10,099 patients, 3,871 comprised a modified intent-to-treat (mITT) sample, defined as a primary MDD diagnosis, age ≥18, and PHQ-9 completion before TMS and at least one PHQ-9 assessment after baseline. The mITT sample received high frequency (10 Hz) LUL TMS exclusively (N = 3,327) or SBL TMS in at least 90% of sessions (N = 544). Completers (N = 3,049) were responders or had received ≥20 sessions and had an end of acute treatment PHQ-9 assessment. To control for site effects, a Matched sample (N = 653) included Completers at sites that used both protocols. To control for selection bias, the SBL group was also compared to a Restricted LUL group, drawn from sites where no patient switched to SBL after substantial exposure to LUL TMS. Secondary analyses were conducted on CGI-S ratings. RESULTS: The LUL group had superior outcomes compared to the SBL group for multiple PHQ-9 and CGI-S continuous and categorical measures in the mITT, Completer and Matched samples, including in the specified primary analyses. However, outcome differences were not observed when comparing the Restricted LUL and SBL groups. Within SBL protocols, the LUL-RUL order had superior outcomes compared to the RUL-LUL order in all CGI-S, but not PHQ-9, measures. CONCLUSIONS: While limited by the naturalistic design, there was no evidence that SBL TMS was superior to LUL TMS. The sequential order of RUL TMS followed by LUL TMS may have reduced efficacy compared to LUL TMS followed by RUL TMS.

Online Monitoring of Small Volume Reactions Using Compact Liquid Chromatography Instrumentation.

A wide variety of analytical techniques have been employed for monitoring chemical reactions, with online instrumentation providing additional benefits compared to offline analysis. A challenge in the past for online monitoring has been placement of the monitoring instrumentation as close as possible to the reaction vessel to maximize sampling temporal resolution and preserve sample composition integrity. Furthermore, the ability to sample very small volumes from bench-scale reactions allows the use of small reaction vessels and conservation of expensive reagents. In this study, a compact capillary LC instrument was used for online monitoring of as small as 1 mL total volume of a chemical reaction mixture, with automated sampling of nL-scale volumes directly from the reaction vessel used for analysis. Analyses to demonstrate short term (~2 h) and long term (~ 50 h) reactions were conducted using tandem on-capillary ultraviolet absorbance followed by in-line MS detection or ultraviolet absorbance detection alone, respectively. For both short term and long term reactions (10 and 250 injections, respectively), sampling approaches using syringe pumps minimized the overall sample loss to ~0.2% of the total reaction volume.

Comparison of clinical outcomes with two Transcranial Magnetic Stimulation treatment protocols for major depressive disorder.

BACKGROUND: Transcranial magnetic stimulation (TMS) is an effective treatment for major depressive disorder (MDD). The rest time between pulse trains is the inter-train interval (ITI). Since 2016, some TMS clinicians have adopted a stimulation protocol with shorter ITIs than were used in regulatory clinical trials. OBJECTIVE: To contrast treatment outcomes with the Standard TMS protocol (38.5 min per session) and the "Dash" protocol, which, at the shortest ITI, has a session duration of 18.75 min. METHODS: Registry data were collected at 103 practice sites. Of 7759 participants, 5010 were included in an intent-to-treat (ITT) sample, defined as a primary MDD diagnosis, age ≥ 18, and completion of the PHQ-9 before TMS and with at least one PHQ-9 assessment after baseline. Completers (N = 3814) were responders or had received ≥ 20 sessions and had an end of acute treatment PHQ-9 assessment. Within the ITT sample, 613 patients were treated with the Standard NeuroStar 38-min protocol and 1493 patients with the new Dash protocol. CGI-S ratings were obtained in smaller samples. Treatment outcomes were also examined in subgroups considered Completers, as well as the subgroups who met criteria for Full Adherence to the Standard or Dash protocol parameters. RESULTS: In the ITT, Completer, and Fully Adherent samples, response (58-72%) and remission (28-53%) rates were notably high across PHQ-9 and CGI-S ratings. The Standard and Dash protocols did not differ in number of treatment sessions, and both manifested strong antidepressant effects. CONCLUSIONS: The Standard and Dash protocols did not meaningfully differ in efficacy.

Clinical outcomes in a large registry of patients with major depressive disorder treated with Transcranial Magnetic Stimulation.

BACKGROUND: Randomized clinical trials have demonstrated that Transcranial Magnetic Stimulation (TMS) is an effective treatment for episodes of major depressive disorder (MDD). However, characterization of outcomes in routine clinical practice is needed, as well as identification of patient- and treatment-related outcome predictors. This study documented patient-rated (PHQ-9) and clinician-rated (CGI-S) clinical outcomes in the NeuroStar® Advanced Therapy System Clinical Outcomes Registry. METHODS: Registry data were collected at 103 practice sites. Of 7759 participants, 5010 patients were included in an intent-to-treat (ITT) sample, defined as a primary MDD diagnosis, age ≥ 18, and completion of the PHQ-9 before TMS and with at least one PHQ-9 assessment after baseline. Completers (N = 3,814) were responders or had received ≥ 20 sessions and had an end of acute treatment PHQ-9 assessment. CGI-S ratings were obtained in smaller samples. RESULTS: In the total ITT and Completer samples, response (58-83%) and remission (28-62%) rates were notably high across self-report and clinician-administered assessments. Female patients and those treated with a larger number of pulses per session had superior clinical outcomes. LIMITATIONS: Site participation in the registry was voluntary and treatment was open label. CONCLUSIONS: The extent of clinical benefit reported by patients and clinicians following TMS in routine practice compares favorably with alternative interventions for treatment-resistant depression. Strong efficacy and the low side effect and medical risk profile suggest that TMS be evaluated as a first-line treatment for MDD. The findings derive from the largest registry of clinical outcomes in MDD for any treatment.

Field Validation of a Development Data Set for Cochliomyia macellaria (Diptera: Calliphoridae): Estimating Insect Age Based on Development Stage.

Insect age estimates can be useful for estimating the postmortem interval when certain assumptions are met. Such estimates are based on species-specific development data that are temperature-dependent and variable, and therefore prone to different degrees of error depending on the combination of data sets, calculations, and assumptions applied in a specific instance. Because of this potential error, validating the methods employed is necessary for determining accuracy and precision of a given technique. For forensic entomology, validation of development data sets is one approach for identifying the uncertainty associated with insect age estimates. Cochliomyia macellaria (Fabricius) is a primary colonizer of remains across the United States and is commonly encountered in forensic investigations. A development study for this species was produced for a central Texas, U.S. population; the variation associated with this data set and the pre-appearance interval were previously explored in an ecological model. The objectives of this study were to determine the accuracy of the development data and the validity of the ecological model when applied to immatures of known age developing under field conditions. Results indicate this data set is an accurate predictor of insect age when using development stage, supporting the validity of the ecological model in central Texas. Age predictions made with all stages present in a sample were more accurate than predictions made with the most developed stage in a sample, and estimates of age when using the prepupal stage were overestimated regardless of prediction method, though thermal requirements for total development were similar.

Comparison of Computed Tomography Pulmonary Angiograms at the University Hospital of the West Indies, Jamaica with Reported Cases in Literature / Comparación de las Angiografías Pulmonares por Tomografía Computarizada en el Hospital Universitario de West Indies, Jamaica, con los Casos Reportados en la Literatura

ABSTRACT Objective: This study was undertaken to determine the positive rate for computed tomography pulmonary angiograms (CTPAs) at the University Hospital of the West Indies (UHWI), to compare the positive rate at the UHWI to that reported in the literature and to compare the rates of positive CTPAs between the genders. Method: Data were obtained from the databases of the Radiology Department of the UHWI. All CTPAs performed to confirm a clinical diagnosis of pulmonary embolism and the results issued during the period January 1st 2013 and December 31st 2013 inclusive were reviewed. Only initial examinations of adequate diagnostic quality were included in the study. Results: Three hundred and thirteenth CTPAs were performed for initial diagnosis of pulmonary embolism. Sixteen examinations were excluded for inadequate diagnostic quality. Two hundred and ninety-seven examinations on 223 females and 74 males were included in the study. The means for age were 49.7 years and 55.1 years, respectively; the difference in the means was significant (p < 0.05). Ninety-four examinations (31.6%) on 22 males (7.4%, mean age 58.4 years) and 72 females (24.2%, mean age 57.5 years) were positive for pulmonary embolism. The difference in the means was not significant (p = 0.8). On Chi-squared test there was no significant difference in the percentage of positive CTPAs between males and females (p = 0.7). Conclusions: The percentage of positive CTPAs at the UHWI is high. There was no significant difference between the genders in the percentage of positive CTPAs or the mean age at which pulmonary emboli were detected.

ABSTRACT Objetivo: Este estudio se llevó a cabo con el propósito de determinar la tasa positiva de las angiografías pulmonares por tomografía computarizada (APTC) en el Hospital Universitario de West Indies (UHWI), comparar la tasa positiva en el UHWI con la que se reporta en la literatura, y comparar las tasas de APTC positivas entre géneros. Método: Se obtuvieron datos de las bases del Departamento de Radiología de UHWI. Se examinaron todas las APTC realizadas para confirmar un diagnóstico clínico de embolia pulmonar y los resultados emitidos durante el período del 1ero de enero de 2013 y 31 de diciembre de 2013 inclusive. En el estudio se incluyeron únicamente exámenes iniciales de calidad diagnóstica adecuada. Resultados: Trecientos trece APTC fueron realizadas para el diagnóstico inicial de embolia pulmonar. Se excluyeron 16 exámenes por poseer una calidad diagnóstica inadecuada. Doscientos noventa y siete exámenes de 223 hembras y 74 varones fueron incluidos en el estudio. Los promedios de edad fueron 49.7 años y 55.1 años respectivamente. La diferencia de los promedios fue significativa (p < 0.05). Noventa y cuatro exámenes (31.6%) de 22 varones (7.4%, edad promedio 58.4 años) y 72 hembras (24.2%, edad promedio 57.5 años) fueron positivos a la embolia pulmonar. La diferencia de los promedios no fue significativa (p = 0.8). En la prueba de Chi-cuadrado no hubo diferencias significativas en el porcentaje de APTC positivas entre varones y hembras (p = 0.7). Conclusiones: El porcentaje de APTC positivas en el UHWI es alto. No hubo diferencias significativas de género en el porcentaje de APTC positivas o la edad promedio a la que se detectaron los émbolos pulmonares.

Investigation of Optically Stimulated Luminescence and Signal Fading Properties of Several Materials.

Optically stimulated luminescence (OSL) dosimetry involves the illumination of an irradiated sample on an appropriate material to produce a stimulated emission of light, whose intensity is indicative of the radiation dose. This technique is currently used for personnel dosimetry, environmental dosimetry, and geological dating applications. While a great deal of published research focusing on α-Al2O3:C and natural materials used for geological dating exist, relatively little is known about the OSL properties of thermoluminescent (TL) materials. This paper reports the results of an experiment conducted to characterize the OSL behavior of KBr, CaSO4:Tm, CaSO4:Dy, CaSO4:Dy+P, LiF:Mg,Cu,Na,Si, and LiF:Mg,Cu,Si. The OSL signal responses to seven excitation wavelengths from 625 nm to 455 nm for each material were measured at 12 time periods post-irradiation from 6 h to 120 d. The magnitude and fading characteristics of the OSL response of each material were then analyzed. The data demonstrated that significant OSL responses exist for CaSO4:Tm, LiF:Mg,Cu,Na,Si, and LiF:Mg,Cu,Si. In addition, it was found that the fading rates of OSL signals depend on the excitation wavelength used to elicit the signals and that these fading rates and the corresponding excitation wavelengths correlate well with the material's TL behavior. Thus, the various fading rates with respect to the excitation wavelengths could be used to obtain temporal dose information.

Persistent Organic Pollutants in albacore tuna (Thunnus alalunga) from Reunion Island (Southwest Indian Ocean) and South Africa in relation to biological and trophic characteristics.

The contamination of albacore tuna (Thunnus alalunga) by Persistent Organic Pollutants (POPs), namely polychlorinated biphenyls (PCBs) and dichlorodiphenyl-trichloroethane (DDT), was investigated in individuals collected from Reunion Island (RI) and South Africa's (SA) southern coastlines in 2013, in relation to biological parameters and feeding ecology. The results showed lower PCB and DDT concentrations than those previously reported in various tuna species worldwide. A predominance of DDTs over PCBs was revealed, reflecting continuing inputs of DDT. Tuna collected from SA exhibited higher contamination levels than those from RI, related to higher dietary inputs and higher total lipid content. Greater variability in contamination levels and profiles was identified in tuna from RI, explained by a higher diversity of prey and more individualistic foraging behaviour. PCB and DDT contamination levels and profiles varied significantly in tuna from the two investigated areas, probably reflecting exposure to different sources of contamination.

An affordable optically stimulated luminescent dosimeter reader utilizing multiple excitation wavelengths.

A lower-cost optically stimulated luminescence (OSL) reader with increased flexibility for pursuing laboratory research into OSL theory and application was designed and constructed. This was achieved by using off-the-shelf optical components and higher-power light emitting diodes. The resulting reader includes more wavelengths of excitation light than current commercial readers, as well as the ability to swap out filters and other components during an experiment.

Understanding human original actions directed at real-world goals: the role of the lateral prefrontal cortex.

Adaptive, original actions, which can succeed in multiple contextual situations, require understanding of what is relevant to a goal. Recognizing what is relevant may also help in predicting kinematics of observed, original actions. During action observation, comparisons between sensory input and expected action kinematics have been argued critical to accurate goal inference. Experimental studies with laboratory tasks, both in humans and nonhuman primates, demonstrated that the lateral prefrontal cortex (LPFC) can learn, hierarchically organize, and use goal-relevant information. To determine whether this LPFC capacity is generalizable to real-world cognition, we recorded functional magnetic resonance imaging (fMRI) data in the human brain during comprehension of original and usual object-directed actions embedded in video-depictions of real-life behaviors. We hypothesized that LPFC will contribute to forming goal-relevant representations necessary for kinematic predictions of original actions. Additionally, resting-state fMRI was employed to examine functional connectivity between the brain regions delineated in the video fMRI experiment. According to behavioral data, original videos could be understood by identifying elements relevant to real-life goals at different levels of abstraction. Patterns of enhanced activity in four regions in the left LPFC, evoked by original, relative to usual, video scenes, were consistent with previous neuroimaging findings on representing abstract and concrete stimuli dimensions relevant to laboratory goals. In the anterior left LPFC, the activity increased selectively when representations of broad classes of objects and actions, which could achieve the perceived overall behavioral goal, were likely to bias kinematic predictions of original actions. In contrast, in the more posterior regions, the activity increased even when concrete properties of the target object were more likely to bias the kinematic prediction. Functional connectivity was observed between contiguous regions along the rostro-caudal LPFC axis, but not between the regions that were not immediately adjacent. These findings generalize the representational hierarchy account of LPFC function to diverse core principles that can govern both production and comprehension of flexible real-life behavior.

How to Create a World Class Dose Reduction Program.

"Effective dose reduction is best accom- plished using a multifaceted approach. Protocol optimization, proper use of scanner features, patient dose tracking and analysis, and staff training are among the many,important elements that should be addressed. *A dose reduction committee should be composed of the radiology administrator or center manager, the chief or supervising radiologist, the diagnostic medical physicist, and the chief technologist for each x-ray based modality. "Once responsibilities have been assigned and a timeline set, start with CT and establish baseline doses, make sure existing hardware and software is being used properly, optimize proto- cols, evaluate new hardware and software needs, and,then track and analyze patient doses to measure progress. " Once the dose reduction program is up and running, ensure that key stakeholders are educated about it and that its existence, purpose and results are communicated to patients and the surrounding community.

Ultrasound detected asymptomatic cholelithiasis: an age-based protocol for management / Colelitiasis asintomática detectada por ultrasonido: un protocolo basado en la edad para el tratamiento

OBJECTIVE: This study was undertaken to examine the correlation between age and gender and the presence of ultrasound findings of acute or chronic cholecystitis in adult patients with cholelithiasis. METHOD: The demographic data of all patients diagnosed with cholelithiasis and cholecystitis on ultrasound between January 1, 2002 and December 31, 2006 were reviewed and statistically analysed. RESULTS: Five hundred adults, 373 females (74.6%) and 127 males (25.4%), were diagnosed with cholelithiasis during the five-year period. Ages ranged from 18 to 94 years with a median age of 47 years. The diagnosis of cholecystitis was equivocal in 11 patients. Of the remaining 489, 22.1% (108) were diagnosed as positive for cholecystitis by ultrasound, the remaining 77.9% (381) being negative. No association was found between gender and cholecysytitis in bivariate analysis, (χ² = 1.82, df =1, p = 0.177). A statistically significant relation was found between age group category and ultrasound-determined cholecystitis status (χ² = 32.58, df = 4, p < 0.001). Higher proportions of persons in the 20-39-year (40.9%) and 40-59-year (20.4%) age groups had cholecystitis on ultrasound examination compared to other age categories where corresponding rates were approximately 11% or less. CONCLUSION: Patients 60 years or older who were diagnosed with cholelithiasis on ultrasound examination were less likely to have cholecystitis than younger patients.

OBJETIVO: Este estudio fue emprendido para examinar la correlación entre edad y género, y los hallazgos en ultrasonidos de colecistitis aguda o crónica en pacientes adultos con colelitiasis. MÉTODO: Se revisaron y analizaron estadísticamente los datos demográficos de todos los pacientes diagnosticados con colelitiasis y colecistitis a partir de ultrasonidos realizados entre el enero 1 de 2002 y diciembre 31 de 2006. RESULTADOS: Quinientos adultos - 373 hembras (74.6%) y 127 varones (25.4%) - fueron diagnosticados con colelitiasis durante el periodo de cinco años. Las edades fluctuaron de 18 a 94 con una edad mediana de 47 años. El diagnóstico de colecistitis fue equívoco en 11 pacientes. De los restantes 489, 22.1% (108) fueron diagnosticados positivos a la colecistitis por ultrasonido, resultando los restantes 7.9% (381) negativos. No se halló ninguna asociación entre el género y la colecistitis en el análisis bivariado, (χ² = 1.82, df =1, p = 0.177). Se halló una relación estadísticamente significativa entre la categoría del grupo etario y la condición de colecistitis determinada por el ultrasonido (χ² = 32.58, df = 4, p < 0.001). Las proporciones más altas de personas en los grupos de edad de 20 - 39 años (40.9%) y 40 - 59 años (20.4%) tenían colecistitis al ser examinadas con ultrasonido, comparadas a otras categorías de edad en las que las tasas correspondientes fueron aproximadamente 11% o menos. CONCLUSIÓN: Los pacientes de 60 o más años de edad, a quienes se les diagnosticó colelitiasis en el examen de ultrasonido, presentaban menos probabilidad de tener colecistitis que los pacientes más jóvenes.

Ultrasound detected asymptomatic cholelithiasis: an age-based protocol for management.

OBJECTIVE: This study was undertaken to examine the correlation between age and gender and the presence of ultrasound findings of acute or chronic cholecystitis in adultpatients with cholelithiasis. METHOD: The demographic data of all patients diagnosed with cholelithiasis and cholecystitis on ultrasound between January 1, 2002 and December 31, 2006 were reviewed and statistically analysed. RESULTS: Five hundred adults, 373 females (74.6%) and 127 males (25.4%), were diagnosed with cholelithiasis during the five-year period. Ages ranged from 18 to 94 years with a median age of 47 years. The diagnosis of cholecystitis was equivocal in 11 patients. Of the remaining 489, 22.1% (108) were diagnosed as positive for cholecystitis by ultrasound, the remaining 77.9% (381) being negative. No association was found between gender and cholecysytitis in bivariate analysis, (chi2 = 1.82, df =1, p = 0.177). A statistically significant relation was found between age group category and ultrasound-determined cholecystitis status (chi2 = 32.58, df= 4, p < 0.001). Higher proportions of persons in the 20-39-year (40.9%) and 40-59-year (20.4%) age groups had cholecystitis on ultrasound examination compared to other age categories where corresponding rates were approximately 11% or less. CONCLUSION: Patients 60 years or older who were diagnosed with cholelithiasis on ultrasound examination were less likely to have cholecystitis than younger patients.

Ameloblastoma in Jamaica--predominantly unicystic: analysis of 47 patients over a 16-year period and a case report on re-entry cryosurgery as a new modality of treatment for the prevention of recurrence.

OBJECTIVE: To analyse all the cases of ameloblastoma seen in the two major public Hospitals in Jamaica over a 16-year period, and to compare the results with what has been previously documented by other authors in the literature. A new treatment modality for prevention of recurrence of ameloblastoma is described. SUBJECTS AND METHODS: The case files of patients histologically diagnosed to have ameloblastoma at both the Kingston Public Hospital and Cornwall Regional Hospital in Jamaica from 1980 to 1995 were retrieved and information about this odontogenic tumour was documented. The analysis revealed that uncystic ameloblastoma was predominant (95%) and solid ameloblastoma was about 5%. It was not therefore surprising that the average age in the study was 29.1 years, with a peak in the 10-19-year age group. No peripheral ameloblastoma was diagnosed. RESULTS: A total of 47 new cases of ameloblastoma was recorded between 1980 and 1995. This number accounted for 16.03% of all jaw bone lesions in Jamaica and 38.2% of jaw bone lesions of odontogenic origin during this period. These cases of ameloblastoma accounted for 67% of odontogenic tumours with the exception of the odontomas. The mean age was 29.1 (range 13-67) years. The male:female ratio was 1:1.14). Only 3 cases involved the maxilla. Of significance, is the case of bilateral ameloblastoma with no continuity to the anterior region, and also the case of unilateral involvement of the mandible and the maxilla in the same patient. Re-entry cryosurgery (a procedure in which cryosurgery is done after a specified period from the primary surgical procedure) after excisional biopsy of a relatively small cystic ameloblastoma of the maxilla was negative for recurrence. CONCLUSION: The clinicopathological presentation of ameloblastoma in Jamaica is not different from what has been documented by other authors throughout the world; however; we report two unique cases --a case of bilateral ameloblastoma of the mandible and a case of unilateral involvement of the mandible and maxilla in the same patient. We suggest that re-entry cryosurgery before recurrence be considered in the management of ameloblastoma for the prevention of recurrence.

Ameloblastoma in Jamaica - predominantly unicystic: analysis of 47 patients over a 16-year period and a case report on re-entry cryosurgery as a new modality of treatment for the prevention of recurrence / El ameloblastoma en Jamaica - predominantemente unicístico: análisis de 47 pacientes por un período de más de 16 años y un reporte de caso de criocirugía de reentrada como nueva modalidad de tratamiento para prevenir la recurrencia

OBJECTIVE: To analyse all the cases of ameloblastoma seen in the two major public Hospitals in Jamaica over a 16year period, and to compare the results with what has been previously documented by other authors in the literature. A new treatment modality for prevention of recurrence of ameloblastoma is described. SUBJECTS AND METHODS: The case files of patients histologically diagnosed to have ameloblastoma at both the Kingston Public Hospital and Cornwall Regional Hospital in Jamaica from 1980 to 1995 were retrieved and information about this odontogenic tumour was documented. The analysis revealed that uncystic ameloblastoma was predominant (95%) and solid ameloblastoma was about 5%. It was not therefore surprising that the average age in the study was 29.1 years, with a peak in the 10-19year age group. No peripheral ameloblastoma was diagnosed. RESULTS: A total of 47 new cases of ameloblastoma was recorded between 1980 and 1995. This number accounted for 16.03% of all jaw bone lesions in Jamaica and 38.2% of jaw bone lesions of odontogenic origin during this period. These cases of ameloblastoma accounted for 67% of odontogenic tumours with the exception of the odontomas. The mean age was 29.1 (range 13-67) years. The male: female ratio was 1: 1.14). Only 3 cases involved the maxilla. Of significance, is the case of bilateral ameloblastoma with no continuity to the anterior region, and also the case of unilateral involvement of the mandible and the maxilla in the same patient. Reentry cryosurgery (a procedure in which cryosurgery is done after a specified period from the primary surgical procedure) after excisional biopsy of a relatively small cystic ameloblastoma of the maxilla was negative for recurrence. CONCLUSION: The clinicopathological presentation of ameloblastoma in Jamaica is not different from what has been documented by other authors throughout the world; however, we report two unique cases - a case of bilateral ameloblastoma of the mandible and a case of unilateral involvement of the mandible and maxilla in the same patient. We suggest that reentry cryosurgery before recurrence be considered in the management of ameloblastoma for the prevention of recurrence.

OBJETIVO: Analizar todos los casos de ameloblastoma vistos en los dos principales hospitales públicos en Jamaica durante un período de 16 años, y comparar los resultados con la información previamente documentada por otros autores en la literatura. Se describe una nueva modalidad de tratamiento para prevenir la recurrencia del ameloblastoma. SUJETOS Y MÉTODO: Se recuperaron los expedientes de los pacientes diagnosticados histológicamente con ameloblastoma en el Hospital Público de Kingston y el Hospital Regional de Cornwall en Jamaica desde 1980 a 1995, y se obtuvo información documentada acerca de este tumor odontogénico. El análisis reveló que el ameloblastoma unicístico era predominante (95%), en tanto que el ameloblastoma sólido fue de alrededor del 5%. Por lo tanto, no fue sorprendente que la edad promedio en el estudio fuera 29.1 años, con un pico en el grupo etario de 10 a 19 años. No se diagnosticó ningún ameloblastoma periférico. RESULTADOS: Entre 1980 y 1995, se registró un total de 47 nuevos casos de ameloblastoma. Este número representaba el 16.03% de todas las lesiones óseas de mandíbula en Jamaica y 38,2% de las lesiones de hueso de la mandíbula de origen odontogénico durante este período. Estos casos de ameloblastoma representaron el 67% de los tumores odontogénicos con la excepción de los odontomas. La edad promedio fue 29.1 años (rango 13-67). La proporción hombre:mujer fue de 1: 1.14. Sólo tres casos implicaron el maxilar. Resulta particularmente importante el caso del ameloblastoma bilateral sin ninguna continuidad a la región anterior, así como el caso de la participación unilateral de la mandíbula y el maxilar en el mismo paciente. La criocirugía de reentrada (un procedimiento en el cual la criocirugía se realiza después de un período especificado a partir del procedimiento quirúrgico primario) después de la biopsia por escisión de un ameloblastoma quístico del maxilar relativamente pequeño, fue negativa para la recurrencia. CONCLUSIÓN: La manifestación clínicopatológica del ameloblastoma en Jamaica no difiere de lo que ha sido documentado por otros autores en todo el mundo. Sin embargo se reportan dos casos únicos: un caso de ameloblastoma bilateral de la mandíbula y un caso de compromiso unilateral de la mandíbula y el maxilar en el mismo paciente. Sugerimos que se tenga en cuenta la criocirugía de reentrada a la hora de tratar el ameloblastoma para prevenir la recurrencia.