'Information is information': a public perspective on incidental findings in clinical and research genome-based testing.

The potential for genomic incidental findings is increasing with the use of genome-based testing. At the same time approaches to clinical decision making are shifting to shared decision-making models involving both the healthcare community and the public. The public's voice has been nearly absent in discussions on managing incidental findings. We conducted nine focus groups and nine interviews (n = 63) with a broad cross-section of lay public groups to elucidate public viewpoints on incidental findings that could occur as a result of genome-based testing in clinical and research situations. Data were analyzed using qualitative content analysis. Participants wanted incidental findings disclosed to them whether or not these were clinical or research findings. Participants used different terms to define and describe incidental findings; they wanted to know that incidental findings are possible and be given a choice to learn about them. Personal utility was an important reason for disclosure, and participants believed that managing information is a shared responsibility between professionals and themselves. Broad public input is needed in order to understand and incorporate the public's perspective on management of incidental findings as disclosure guidelines, and policies are developed in clinical and research settings.

Bedside peritoneal drainage in very low birth weight infants.

BACKGROUND: Bedside peritoneal drainage is emerging as a useful therapy for premature infants with intestinal perforation in the newborn period. Some authors recommend that bedside drainage be primary therapy for very low birth weight neonates. Surprisingly, some series report up to 70% of neonates so treated never require further or definitive surgery. METHODS: This is a retrospective chart review of all premature newborns with a diagnosis of either necrotizing enterocolitis or bowel perforation between November 1996 and May 2000. RESULTS: Sixty-seven patients were identified, of whom 27 were treated medically only and not considered here. Thirty-two neonates were treated with laparotomy primarily, with 26 survivors. Eight neonates were treated first with bedside peritoneal drainage. Of these, 4 survived, 6 required secondary surgery for obstruction or infection, and 2 died before any further intervention. CONCLUSIONS: Bedside peritoneal drainage is a useful adjunct in the approach to treating the very sick, very low birth weight neonate with evidence of intestinal perforation. Our experience does not support drainage as definitive therapy.

Corticosteroids in the management of unresected plasma cell granuloma (inflammatory pseudotumor) of the lung.

The case of a 10-year-old girl with plasma cell granuloma of the lung and an associated hypergammaglobulinemia is reported. A thoracotomy and biopsy were done. Total resection would have required a pneumonectomy. She was treated with an immunosuppressive course of prednisone, which resulted in a reversal of the infiltrative process and the hypergammaglobulinemia.