Routine Anal Cytology Screening for Anal Squamous Intraepithelial Lesions in an Ethnically Diverse Urban HIV Clinic

Anal cancer, like cervical cancer, is associated with Human Papillomavirus (HPV) infection. HIV+ patients have 38-60 fold increased risk of anal cancer compared to HIV- patients prompting many to suggest routine screening given the success of cervical Pap screening. Our goal is to describe our experience with routine anal Pap screening, determine which patients are most likely to have abnormal results, if anal disease on physical exam is predictive of cytology, and correlate cytology with histology findings. Charts of all patients with an anal Pap followed at the Hospital of Saint Raphael HIV Clinic were reviewed. Demographics, immune status, sexually transmitted disease history, cytology and histology data was extracted from medical charts. Patients with an anal Pap between November 1, 2002-November 30, 2004 were included. Those with an insufficient sample were excluded. Analysis was done using χ2 for comparison of proportions and student t-test for continuous variables. Overall, 265/560 HIV+ patients had at least one anal Pap. Seventy-four of these 265 patients had an abnormal anal Pap. Mean age was 44 yrs, and 68% were men. Fifty-nine percent were African American, 34% White, and 17% Hispanic. Those with an abnormal Pap were more likely to be White (p=.03), and be gay or bisexual men (p=.02). They were also more likely to have lower CD4+ nadir (142 vs 223, p=.005) and CD4+ at time of anal Pap (353 vs 497, p\u3c.001). Those with an abnormal anal Pap also had more anal disease (30% vs 9%, p\u3c.001), history of warts (23% vs 12%, p=.02) and herpes (35% vs 22%, p=.02). Anal disease on physical exam had a sensitivity of 56% and specificity of 77% for abnormal cytology findings. On histology two patients had Anal Intraepithelial Neoplasia (AIN ) I, 2 AIN II, 3 AIN III, and 2 Squamous Cell Carcinoma In Situ. There was no correlation between cytology and histology. Routine anal cytology screening is a feasible tool to incorporate into an ethnically diverse HIV clinic for identifying precancerous anal lesions, a group which has been largely overlooked. Anal disease on physical exam is a poor predictor of abnormal cytology and there was no correlation between severity of disease on cytology and histology. However, further follow-up study is required to determine the impact on morbidity and mortality

Low-Frequency Radio Transients in the Galactic Center

We report the detection of a new radio transient source, GCRT J1746-2757, located only 1.1 degrees north of the Galactic center. Consistent with other radio transients toward the Galactic center, this source brightened and faded on a time scale of a few months. No X-ray counterpart was detected. We also report new 0.33 GHz measurements of the radio counterpart to the X-ray transient source, XTE J1748-288, previously detected and monitored at higher radio frequencies. We show that the spectrum of XTE J1748-288 steepened considerably during a period of a few months after its peak. We also discuss the need for a more efficient means of finding additional radio transients

GCRT J1742-3001: A New Radio Transient Towards the Galactic Center

We report the detection of a new transient radio source, GCRT J1742-3001, located ~1 degree from the Galactic center. The source was detected ten times from late 2006 to 2007 May in our 235 MHz transient monitoring program with the Giant Metrewave Radio Telescope (GMRT). The radio emission brightened in about one month, reaching a peak observed flux density of ~100 mJy on 2007 January 28, and decaying to ~50 mJy by 2007 May when our last monitoring observation was made. Two additional faint, isolated 235 MHz detections were made in mid-2006, also with the GMRT. GCRT J1742-3001 is unresolved at each epoch, with typical resolutions of ~20 arcsec x 10 arcsec. No polarization information is available from the observations. Based on nondetections in observations obtained simultaneously at 610 MHz, we deduce that the spectrum of GCRT J1742-3001 is very steep, with a spectral index less than about -2. Follow-up radio observations in 2007 September at 330 MHz and 1.4 GHz, and in 2008 February at 235 MHz yielded no detections. No X-ray counterpart is detected in a serendipitous observation obtained with the X-ray telescope aboard the Swift satellite during the peak of the radio emission in early 2007. We consider the possibilities that GCRT J1742-3001 is either a new member of an existing class of radio transients, or is representative of a new class having no associated X-ray emission.Comment: 19 pages, 3 figures, submitted to Ap

A powerful bursting radio source towards the Galactic Centre

Transient astronomical sources are typically powered by compact objects and usually signify highly explosive or dynamic events. While radio astronomy has an impressive record of obtaining high time resolution observations, usually it is achieved in quite narrow fields-of-view. Consequently, the dynamic radio sky is poorly sampled, in contrast to the situation in the X- and gamma-ray bands in which wide-field instruments routinely detect transient sources. Here we report a new transient source, GCRT J1745-3009, detected in 2002 during a moderately wide-field radio transient monitoring program of the Galactic center (GC) region at 0.33 GHz. The characteristics of its bursts are unlike those known for any other class of radio transient. If located in or near the GC, its brightness temperature (~10^16 K) and the implied energy density within GCRT J1745-3009 vastly exceeds that observed in most other classes of radio astronomical sources, and is consistent with coherent emission processes rarely observed. We conclude that GCRT J1745-3009 is the first member of a new class of radio transient sources, the first of possibly many new classes to be identified through current and upcoming radio surveys.Comment: 16 pages including 3 figures. Appears in Nature, 3 March 200

Pain location and widespread pain in youth with orthopaedic conditions: Exploration of the reliability and validity of a body map

BackgroundPain location and widespread pain are important but underexamined dimensions of paediatric pain. Body map tools to assess pain location in youth have been used for several decades, but few studies have established reliability and validity of these measures. The purpose of this study was to explore the reliability and validity of a pain body map among youth with orthopaedic conditions before surgery.MethodYouth ages 10â 17 years completed the body map and other selfâ reported outcomes at their preoperative clinic visit and at their day of surgery.ResultsMost (91.7%) youth had small discrepancy between body map scores at preoperative clinic visit (baseline) and day of surgery (second assessment), and siteâ toâ site agreement ranged from 78% to 98%. Those with back and lower extremity diagnoses had high correspondence between body map sites and diagnostic sites. Body map scores and widespread pain were associated with other dimensions of pain, as well as other patientâ reported outcomes. Higher pain intensity and widespread pain predicted greater discrepancy between body map scores.ConclusionsThese results support the use of body map tools in further research examining widespread pain among youth by demonstrating adequate reliability, descriptive validity and associative validity.SignificanceThese results contribute to the limited information regarding psychometric properties of paediatric pain body maps, provide novel information about widespread pain among youth undergoing orthopaedic surgeries, and pave the way for improved assessment and treatment of paediatric pain.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147159/1/ejp1282.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147159/2/ejp1282_am.pd

Numerical computation of travelling breathers in Klein-Gordon chains

We numerically study the existence of travelling breathers in Klein-Gordon chains, which consist of one-dimensional networks of nonlinear oscillators in an anharmonic on-site potential, linearly coupled to their nearest neighbors. Travelling breathers are spatially localized solutions having the property of being exactly translated by $p$ sites along the chain after a fixed propagation time $T$ (these solutions generalize the concept of solitary waves for which $p=1$). In the case of even on-site potentials, the existence of small amplitude travelling breathers superposed on a small oscillatory tail has been proved recently (G. James and Y. Sire, to appear in {\sl Comm. Math. Phys.}, 2004), the tail being exponentially small with respect to the central oscillation size. In this paper we compute these solutions numerically and continue them into the large amplitude regime for different types of even potentials. We find that Klein-Gordon chains can support highly localized travelling breather solutions superposed on an oscillatory tail. We provide examples where the tail can be made very small and is difficult to detect at the scale of central oscillations. In addition we numerically observe the existence of these solutions in the case of non even potentials

High Resolution, High Sensitivity Imaging of the Galactic Center at 330 MHz

We present results derived from a wide field, sub-arcminute resolution VLA image of the Galactic Center region at 330 MHz (λ = 90 cm). With a resolution of ∼7″ × 12″ and an rms noise of 1.6 mJy beam−1, this image represents a significant increase in resolution and sensitivity over the previously published VLA image at this frequency (eg. LaRosa et al. 2000). The improvement in sensitivity has significantly increased the census of small diameter sources in the region, resulted in the detection of two new Non-Thermal Filaments (NTFs) and 18 new NTF candidates, and resulted in the lowest frequency (tentative) detection of Sgr A*