Assessment of acute myeloid leukemia molecular measurable residual disease testing in an interlaboratory study

The European LeukaemiaNet (ELN) measurable residual disease (MRD) working group has published consensus guidelines to standardize molecular genetic MRD testing of the t(8;21)(q22;q22.1) RUNX1::RUNX1T1, inv(16)(p13.1q22) CBFB::MYH11, t(15;17)(q24.1;q21.2) PML::RARA, and NPM1 type A markers. A study featuring 29 international laboratories was performed to assess interlaboratory variation in testing and the subsequent interpretation of results, both crucial to patient safety. Most participants in this study were able to detect, accurately quantify, and correctly interpret MRD testing results, with a level of proficiency expected from a clinical trial or standard-of-care setting. However, a few testing and interpretive errors were identified that, in a patient setting, would have led to misclassification of patient outcomes and inappropriate treatment pathways being followed. Of note, a high proportion of participants reported false-positive results in the NPM1 marker-negative sample. False-positive results may have clinical consequences, committing patients to unneeded additional chemotherapy and/or transplant with the attendant risk of morbidity and mortality, which therefore highlights the need for ongoing external quality assessment/proficiency testing in this area. Most errors identified in the study were related to the interpretation of results. It was noted that the ELN guidance lacks clarity for certain clinical scenarios and highlights the requirement for urgent revision of the guidelines to elucidate these issues and related educational efforts around the revisions to ensure effective dissemination.

Using retrospective health data from the Gombe chimpanzee study to inform future monitoring efforts

Disease outbreaks, either in isolation or in concert with other risk factors, can pose serious threats to the long-term persistence of mammal populations, and these risks become elevated as population size decreases and/or population isolation increases. Many chimpanzee study sites are increasingly isolated by loss of habitat due to human encroachment, and managers of parks that contain chimpanzees perceive that disease outbreaks have been and continue to be significant causes of mortality for chimpanzees. Major epidemics at Gombe National Park include suspected polio in 1966; respiratory diseases in 1968, 1987, 1996, 2000, and 2002; and sarcoptic mange in 1997. These outbreaks have led park managers and researchers working in Gombe to conclude that disease poses a substantial risk to the long-term survival of Gombe's chimpanzee population. We surveyed behavioral data records spanning 44 years for health-related data and found a combination of standardized and nonstandardized data for the entire period. Here we present the types of data found during the survey, discuss the usefulness of these data in the context of risk assessment, and describe how our current monitoring effort at Gombe was designed based on our findings.

Using retrospective health data from the Gombe chimpanzee study to inform future monitoring efforts

Disease outbreaks, either in isolation or in concert with other risk factors, can pose serious threats to the long-term persistence of mammal populations, and these risks become elevated as population size decreases and/or population isolation increases. Many chimpanzee study sites are increasingly isolated by loss of habitat due to human encroachment, and managers of parks that contain chimpanzees perceive that disease outbreaks have been and continue to be significant causes of mortality for chimpanzees. Major epidemics at Gombe National Park include suspected polio in 1966; respiratory diseases in 1968, 1987, 1996, 2000, and 2002; and sarcoptic mange in 1997. These outbreaks have led park managers and researchers working in Gombe to conclude that disease poses a substantial risk to the long-term survival of Gombe's chimpanzee population. We surveyed behavioral data records spanning 44 years for health-related data and found a combination of standardized and nonstandardized data for the entire period. Here we present the types of data found during the survey, discuss the usefulness of these data in the context of risk assessment, and describe how our current monitoring effort at Gombe was designed based on our findings.

Entrapment of an exchange wire by an inferior vena caval filter: a technique for removal

The anesthesiology literature does not describe entrapment of a guidewire by an inferior vena caval filter. Because anesthesiologists are involved in central access in various perioperative and intraoperative settings, consideration of this complication is important. A case of guidewire entrapment by an inferior vena caval filter and a unique technique for removal of the entrapped wire is presented.

Is there a role for in vivo methylene blue staining in the prediction of bladder tumour recurrence?

OBJECTIVE

To assess the role of in vivo staining with intravesical methylene blue in predicting tumour recurrence.

PATIENTS AND METHODS

Thirty-nine patients (27 men and 12 women, age range 43-75 years) newly diagnosed with bladder tumours were prospectively studied and followed for a minimum of 2 years. Potential biopsy sites were identified by staining intravesically with a 1% methylene blue solution and compared with random biopsy sites.

RESULTS

Biopsy directed by methylene blue staining detected carcinoma in situ more often than random biopsy. Rates of recurrence were similar in both stained and unstained groups.

CONCLUSION

Methylene blue staining does not add significantly to the management of patients presenting with bladder tumours.

Liver abscess due to Listeria monocytogenes: case report and review

Involvement of the liver in cases of Listeria monocytogenes infection is uncommon but has been manifested as solitary liver abscess, multiple liver abscesses, and hepatitis. We describe a 73-year-old diabetic woman who presented with a solitary liver abscess and prolonged fever, and we review the world literature on hepatic manifestations of L. monocytogenes infection. Patients presenting with solitary liver abscesses uniformly recovered with antimicrobial therapy and abscess drainage, whereas almost all patients presenting with multiple liver abscesses died.

Spatiotemporal contrast sensitivity and colour vision in multiple sclerosis

Measures of contrast sensitivity and colour vision were taken from a group of 18 multiple sclerosis patients. Contrast sensitivity losses, measured at 5 spatial frequencies and 4 temporal frequencies, were found to be significant in 11 patients. Red/green (Rayleigh equation) and green/blue (Engelking-Trendelenburg equation) Pickford-Nicolson anomaloscope settings were abnormal in 15 patients. Correlating each of the 20 spatiotemporal losses with the colour losses revealed that in 19 conditions the red/green loss was greater than the green/blue loss. None of the green/blue losses correlated significantly with spatiotemporal losses while between 2 and 8 cycles/deg 11/12 spatiotemporal conditions showed significant correlations with red/green colour loss. These results support a locus of damage before the cortex at a stage in the visual pathway where red/green chromatic information may be encoded in pathways which also code luminance information.

Making Mayhew and Frisby effortlessly discriminable

Mayhew and Frisby (1978) demonstrated that patterns which differ markedly in their spatial-frequency content may be very hard to discriminate. This they took as evidence against any model which proposes that the processes underlying texture discrimination have direct access to some local piecewise Fourier analysis of the patterns performed by spatial-frequency channels. It is shown that Mayhew and Frisby's patterns can be discriminated easily if their components have been incorporated into a pattern-contingent colour aftereffect. This demonstration suggests that the location in the visual pathway for contingent aftereffect adaptation must lie before the construction of the raw primal sketch, to which, according to Marr, we have conscious access. This location must also allow the orientation specificity seen in the aftereffect. This points to a locus in the striate cortex.

Deferred treatment for prostate cancer

The clinical outcome of 278 prostate cancer patients managed by a deferred treatment policy was analysed retrospectively. Following TURP or biopsy, all patients were asymptomatic and deemed suitable for management by a deferred treatment policy, i.e. hormone therapy or other forms of treatment were only initiated if and when symptomatic progression occurred. The overall 5-year survival rate was 30%; 18% of patients died from other causes without needing treatment for their prostate cancer; 11% were alive and untreated after 5 years' follow-up; 17% died from prostate cancer without further treatment. Poor tumour grade, anaemia, metastatic disease, a short history, presentation with retention, and a raised serum creatinine at presentation were associated with a poor prognosis.