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Objectives: The reported prevalence of chronic obstructive pulmonary disease (COPD) in people living with HIV (PLWHIV) varies widely. Our objective was to estimate the prevalence of airflow obstruction and COPD in unselected PLWHIV and identify characteristics that increase the risk of nonreversible airflow obstruction in order to guide case finding strategies for COPD. Methods: All adults attending the Chronic Viral Illness Service were invited to participate in the study, regardless of smoking status or history of known COPD/asthma. Individuals underwent spirometric testing both before and after use of a salbutamol bronchodilator. Airflow obstruction was defined as forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) < 0.7 post‐bronchodilation, whereas COPD was defined as FEV1/FVC < 0.7 post‐bronchodilation and Medical Research Council (MRC) score > 2. Multivariate logistic regression was used to evaluate risk factors associated with airflow obstruction, reported as adjusted odds ratios (aORs). Results: Five hundred and three participants successfully completed spirometry testing. The median (Q1; Q3) age was 52 (44; 58) years. The median (Q1; Q3) CD4 count was 598 (438; 784) cells/μL and the median (Q1; Q3) nadir CD4 count was 224 (121; 351) cells/μL. There were 119 (24%) current smokers and 145 (29%) former smokers. Among those screened, 54 (11%) had airflow obstruction whereas three (1%) of the participants had COPD. Factors that were associated with airflow obstruction included a history of smoking [aOR 2.2; 95% confidence interval (CI) 1.1; 4.7], older age (aOR 1.6; 95% CI 1.2; 2.2), and lower CD4 count (aOR 0.8; 95% CI 0.7; 1.0). Conclusions: Airflow obstruction was relatively uncommon. Our findings suggest that PLWHIV who are ≥50 years old, smokers and those with nadir CD4 counts ≤ 200 cells/μL could be targeted to undergo spirometry to diagnose chronic airflow obstruction. [ABSTRACT FROM AUTHOR]

Study design:Cross-sectional.Objectives:The objective of this study was to examine the association between the characteristics of individuals with spinal cord injury (SCI) and self-reported health-related quality of life (HRQoL).Setting:The United States.Methods:Questions from the Behavioral Risk Factor Surveillance System (BRFSS) survey were sent to veterans with SCI. The analyses included 2302 respondents. Logistic regression analysis was used to examine the association between subject characteristics and the following four measures of HRQoL: frequent physical distress (FPD), frequent mental distress (FMD), frequent depressive symptoms (FDS) and poor or fair self-reported health.Results:Approximately 19% of the respondents reported FMD, 27% reported FPD, 17% reported FDS and 29% reported poor or fair health. Veterans who self-reported chronic illnesses, had higher odds of reporting FPD, FMD, FDS and poor or fair health than veterans who did not report chronic illnesses. Smoking was significantly associated with decreased HRQoL. Older veterans had higher odds of reporting poor or fair health and FPD than younger veterans. Higher levels of education were associated with lower odds of FMD, FDS and poor or fair health.Conclusions:Chronic illnesses and smoking have a substantial effect on HRQoL for persons with SCI, suggesting the importance of continued efforts to improve smoking cessation methods and to treat and prevent chronic conditions.Spinal Cord (2008) 46, 507-512; doi:10.1038/sc.2008.2; published online 5 February 2008 [ABSTRACT FROM AUTHOR]

Background Detection of isolated tumor cells (TC) in BM from carcinoma patients can predict future relapse. Various molecular and immunocytochemical (ICC) methods have been used to detect these cells, which are present at extremely low frequencies of 10 -5 -10 -6 . The specificity and sensitivity of these techniques may vary widely. In 1996, a European ISHAGE Working Group was founded to standardize and optimize procedures used for the detection of minimal residual disease. We have attempted to develop objective criteria for the evaluation of immunocytochemically identifiable cancer cells. Methods An interlaboratory ring experiment was performed, to compare the screening and detection of micrometastasis-positive events between different laboratories. The discrepant results induced us to establish a common consensus on morphological criteria applicable to the identification of immunostained micrometastatic TC. Results Bared on this consensus evaluation, we propose a classification of stained elements into three groups: (1) 'TC's show pathognomonic signs of epithelial TC-nature, as defined by a clearly enlarged nucleus or clusters of ≥ 2 immunopositive cells. (2) 'Probable TC's represent morphological overlap between hematopoietic cells (HC) and TC which lack pathognomonic signs of TC-nature, but do not exhibit clear morphological features of HC. These cells are considered as TC if control staining with an isotype-specific, unrelated Ab is negative. (3) 'TC-negative' cells are defined as 'false positive' HC, skin squamous epithelial cells and artefacts. Discussion The proposed classification of immunostained events is a first step towards the development of standardized immunocytochemical assays for the detection of occult micrometastatic TC in BM or blood. [ABSTRACT FROM AUTHOR]

Counseling patients to trim fat from their diets -- and their waistlines -- doesn't have to be frustrating. They don't have to give up favorite foods or make a fetish of measuring ingredients. [ABSTRACT FROM AUTHOR]