Case 79: pituitary duplication.
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Abnormalities, Multiple↗
Biomedical subjects
Laura S Martin
Publications and source records attributed to Laura S Martin.
Ethical use of tissue samples in genetic research.
Many centrally based cancer protocols have begun to address the ethical issues concerning tissue banking for genetic research. A multidisciplinary subcommittee of the Madigan Army Medical Center Institutional Review Board was established to determine the scope of the problem and offer a concise, user-friendly policy with guidelines on how to control and monitor the use of stored tissue for future genetic and molecular research. Our institution participates in 69 Southern Oncology Group or National Surgical Adjuvant Breast and Bowel Project protocols and 47 Children's Oncology Group protocols. Of these protocols, 22 of 69 and 36 of 47, respectively, asked for tissue to be stored for future biologic study. Only 4 of 69 and 3 of 47, respectively, deal with specific consent for future genetic/biologic research. The multidisciplinary committee developed a policy that dealt with the following areas: exempt status, waived consent, informed consent, deceased status, family studies, and information flow. An algorithm was created to establish a system of checks and balances concerning privacy, protection and an appeals process.
Adult↗
Relationship between the extent of histologic villous mineralization and stillbirth in aneuploid and euploid fetuses.
OBJECTIVE: To describe the relationship between the degree of placental histologic villous mineralization (VM) and stillbirth in aneuploid and euploid fetuses. METHODS: The extent of VM for aneuploid and gestational age-matched euploid placentas was graded semiquantitatively on a 0 to 3 scale based on the number of terminal or stem villi containing mineralizations in forty x10 fields of view. The extent of VM was analyzed in relation to fetal status at delivery (liveborn or stillborn) for both aneuploid and euploid fetuses. RESULTS: For 14 available aneuploid placentas, grade 0 or 1 VM was recorded for seven aneuploid specimens, of which two were stillborn. Grade 2 or 3 VM was recorded for seven aneuploid specimens, of which six were stillborn. Fourteen gestational age-matched euploid placentas served as controls. Grade 0 or 1 VM was observed in nine euploid specimens, of which four were stillborn. Grade 2 or 3 VM was observed in five euploid specimens, of which four were stillborn. For aneuploid fetuses, stillbirth was significantly more frequent with grade 2 or 3 VM compared with grade 0 or 1 VM (chi(2) = 4.667, P <.05). This relationship did not exist for euploid fetuses (chi(2) = 1.659, P >.05). CONCLUSION: Histologic VM is not a universal finding in, or exclusive to, stillbirths. Aneuploid but not euploid stillbirths show increased histologic VM compared with livebirths. This may implicate impaired placental or circulatory function as a mechanism for death in aneuploid fetuses.
Aneuploidy↗
Pilot evaluation of citalopram for the relief of hot flashes.
Symptoms associated with premature menopause are a significant problem for women with a history of breast cancer who cannot take hormone replacement therapy. Thus, effective nonhormonal alternatives are needed to manage hot flashes, the most prevalent symptom of menopause. Previous studies have defined that venlafaxine, an anti-depressant, is an effective treatment for such hot flashes. Based on suggestive anecdotal information, we set out to evaluate, in a pilot trial, whether the antidepressant citalopram might be a good nonhormonal treatment option to add to our armamentarium for controlling hot flashes. A prospective pilot study was developed in which patients were studied for 5 weeks, with the first week used to establish a baseline, followed by 4 weeks of treatment with citalopram. During the first week of treatment, 10 mg/day of citalopram was taken while 20 mg/day was taken during each of the following three weeks. Hot-flash diaries were completed daily, symptom diaries and quality-of-life items were completed weekly and the Profile of Mood States was completed at baseline and at week 5. Evaluable patients who completed the study had a mean hot-flash frequency reduction of 58% and a mean hot-flash score reduction of 64% from baseline to week 5. The patients finishing the study also reported decreased anger, tension and depression, as well as improved mood. This pilot trial suggests that citalopram may be an effective non-hormonal treatment for hot flashes in women who can tolerate it.
Affect↗