Increased prevalence of testicular microlithiasis in men with familial testicular cancer and their relatives

Testicular germ cell tumours (TGCT) cluster in families, but responsible genes remain unidentified. The association between testicular microlithiasis (TM) and testicular carcinoma in situ (CIS) suggests that TM may be a TC risk factor. We report testicular ultrasound findings in men with familial TGCT (FTGCT) and their unaffected relatives. A total of 81 men (48 affected and 33 unaffected) from 31 families with ⩾2 TC cases underwent testicular ultrasound. Testicular microlithiasis was defined as either ‘classic' (⩾5 microliths) or ‘limited' (<5 microliths). Statistical analyses used Fisher's exact test and permutation testing. Testicular microlithiasis was more frequent in the contralateral testicles of men with a history of TGCT (affected men) than in unaffected men (48 vs 24%, P=0.04). The association appeared stronger for classic TM (21 vs 9%) than for limited TM (27 vs 15%). Testicular microlithiases were bilateral in six out of seven (87%) unaffected men. Among affected men, TM was not associated with histology, age at diagnosis or cancer treatment. Of the 31 families, 10 accounted for a majority (61%) of the TM cases identified (P=0.11). Testicular microlithiasis was more prevalent among FTGCT family members than described previously in the general population, and was more common among FTGCT cases vs unaffected blood relatives. Testicular microlithiasis appeared to cluster in certain families. These findings suggest both a familial predisposition to TM and an association between TM and FTGCT. If proven, this could be clinically important to men in FTGCT families, and may be useful in identifying specific genes involved in FTGCT

Functional analysis and functional communication training in the classroom for three children with Angelman syndrome

Item does not contain fulltextEffectiveness of functional analysis (FA) and functional communication training (FCT) on challenging behavior was assessed in three children with Angelman syndrome (AS). Analogue FA conditions were used to assess the behavioral function of the challenging behavior. FA and FCT protocols were administered in the children's classroom and were performed by their teachers. Replacement behavior was prompted upon the onset of precursor behavior. One or more function(s) of their challenging behavior were identified and challenging behavior appeared to be escape or tangibly motivated. Making physical contact with the teacher was found to be a precursor of challenging behavior in one child. In all children, challenging behavior decreased as a function of FCT. Functional equivalence of both challenging and replacement behavior was evinced. Clinical and research implications are discussed.15 p