Tumor markers in breast cancer - European Group on Tumor Markers recommendations

Recommendations are presented for the routine clinical use of serum and tissue-based markers in the diagnosis and management of patients with breast cancer. Their low sensitivity and specificity preclude the use of serum markers such as the MUC-1 mucin glycoproteins ( CA 15.3, BR 27.29) and carcinoembryonic antigen in the diagnosis of early breast cancer. However, serial measurement of these markers can result in the early detection of recurrent disease as well as indicate the efficacy of therapy. Of the tissue-based markers, measurement of estrogen and progesterone receptors is mandatory in the selection of patients for treatment with hormone therapy, while HER-2 is essential in selecting patients with advanced breast cancer for treatment with Herceptin ( trastuzumab). Urokinase plasminogen activator and plasminogen activator inhibitor 1 are recently validated prognostic markers for lymph node-negative breast cancer patients and thus may be of value in selecting node-negative patients that do not require adjuvant chemotherapy. Copyright (C) 2005 S. Karger AG, Basel

Nomograms including the UBC® Rapid test to detect primary bladder cancer based on a multicentre dataset

Objectives: To evaluate the clinical utility of the urinary bladder cancer antigen test UBC Rapid for the diagnosis of bladder cancer (BC) and to develop and validate nomograms to identify patients at high risk of primary BC. Patients and Methods: Data from 1787 patients from 13 participating centres, who were tested between 2012 and 2020, including 763 patients with BC, were analysed. Urine samples were analysed with the UBC Rapid test. The nomograms were developed using data from 320 patients and externally validated using data from 274 patients. The diagnostic accuracy of the UBC Rapid test was evaluated using receiver-operating characteristic curve analysis. Brier scores and calibration curves were chosen for the validation. Biopsy-proven BC was predicted using multivariate logistic regression. Results: The sensitivity, specificity, and area under the curve for the UBC Rapid test were 46.4%, 75.5% and 0.61 (95% confidence interval [CI] 0.58–0.64) for low-grade (LG) BC, and 70.5%, 75.5% and 0.73 (95% CI 0.70–0.76) for high-grade (HG) BC, respectively. Age, UBC Rapid test results, smoking status and haematuria were identified as independent predictors of primary BC. After external validation, nomograms based on these predictors resulted in areas under the curve of 0.79 (95% CI 0.72–0.87) and 0.95 (95% CI: 0.92–0.98) for predicting LG-BC and HG-BC, respectively, showing excellent calibration associated with a higher net benefit than the UBC Rapid test alone for low and medium risk levels in decision curve analysis. The R Shiny app allows the results to be explored interactively and can be accessed at www.blucab-index.net. Conclusion: The UBC Rapid test alone has limited clinical utility for predicting the presence of BC. However, its combined use with BC risk factors including age, smoking status and haematuria provides a fast, highly accurate and non-invasive tool for screening patients for primary LG-BC and especially primary HG-BC

The role and scope of physiotherapy among Icelandic ball-sports clubs

Íþróttaiðkun er vinsæl leið til hreyfingar og heilsueflingar. Íþróttum fylgja þó oft líkamleg meiðsli sem geta haft mikil skerðandi áhrif á íþróttaiðkendur, liðið og aðstandendur. Sjúkraþjálfun hefur um ára raðir verið hluti af íþróttum, bæði sem meðferðar- og endurhæfingaraðild auk þess sem að sjúkraþjálfarar hafa komið að þjálfun íþróttamanna. Á Íslandi eru samtals um 35 þúsund iðkendur í þremur vinsælustu bolta-íþróttagreinunum; knattspyrnu, handknattleik og körfuknattleik. Meiðsli eru algeng meðal iðkenda þessara þriggja greina. Lítið hefur verið rannsakað varðandi umfang sjúkraþjálfunar hjá íþróttafélögum, hvorki erlendis né hér á landi. Markmið þessarar rannsóknar var að kanna hlutverk sjúkraþjálfara hjá íslenskum boltaíþróttafélögum og hvert magn og eðli þeirrar þjónustu er ásamt því að rannsaka mögulegan mun á þeirri þjónustu sem veitt er milli kynja, íþróttagreina og tveggja efstu deilda. Sendir voru út tveir sérhannaðir spurningalistar til íþróttafélaga sem voru með skráð lið til keppni í meistaraflokki karla og/eða kvenna í knattspyrnu, körfuknattleik og/eða handknattleik, í annarri af efstu tveimur deildum Íslandsmóts, á keppnistímabilinu sem lauk á árinu 2011. Svarhlutfall var 52,5% (21/40) meðal forsvarsmanna íþróttafélaga, og 37,7% (68/180) forsvarsmanna liða svöruðu spurningalistum. Við tölfræði úrvinnslu var notast við Cochran-Mantel-Haenszel próf þar sem notast var við gögn á raðkvarða sem ekki voru normal-dreifð. Helstu niðurstöður sýndu að 76% þeirra íþróttafélaga sem svöruðu sögðust vera með sjúkraþjálfara starfandi fyrir lið innan viðkomandi íþróttagreina. Rúmlega helmingur liða voru með sjúkraþjálfara á æfingum á keppnistímabilinu með mismikilli viðveru. Á keppnisleikjum voru sjúkraþjálfarar til staðar í 91,7% tilfella í handknattleik, 88,5% í knattspyrnu og 52,8% í körfuknattleik. Marktækur munur var á viðveru sjúkraþjálfara á keppnisleikjum milli íþróttagreina (p=0,04). Hins vegar var ekki marktækur munur á viðveru sjúkraþjálfara þegar borið var saman milli kynja eða deilda.Sports involvement and activity is a popular route taken towards increased levels of activity and general fitness. However, injury often follows as well as the associated detrimental impairments it may have on the athlete and team. For years physiotherapists have been a part of sports both in the therapeutic and rehabilitation aspect along with being involved in the training of athletes. In Iceland there are a combined around 35 thousand individuals practising football, handball and basketball, the three most popular ball sports. Injuries are common among athletes of these sports. Little research has been conducted on the scale/scope of physiotherapy to sports clubs, neither here in Iceland nor abroad. The goal of this research was to investigate the role, scale and nature of the service physiotherapists provide to Icelandic sports clubs, comparing potential differences between the sexes, the three different sports as well as the top two divisons. Two types of questionnaires specifically designed for this research were sent out to those sports clubs that had a mens and/or womens team assigned in either of the top two divisions in football, handball and/or basketball during the competitive season that ended in 2011. 52.5% (21/40) of sports club representatives and 37.7% (68/180) of team representatives answered their respective questionnaires. For statistical analysis the Cochran-Mantel-Haenszel test was used for data on an ordinal scale without normal distribution. Results showed that 76.0% of sports clubs had a physiotherapist working for an associated team in one of the three sports. Around half of individual teams reported having a physiotherapist present at practises during the competitive season with variable attendance. During competitive matches physiotherapists were present in 91.7% of cases in handball, 88.5% in football and 52.8% in basketball. Results also showed a significant difference in the attendance of a physiotherapist to the three different sports (p=0.04). A significant difference was not noted between men or women´s team nor between the top two divisions

The 2011 unrest at Katla volcano: Characterization and interpretation of the tremor sources

A 23-hour tremor burst was recorded on July 8\u20139th 2011 at the Katla subglacial volcano, one of the most active and hazardous volcanoes in Iceland. Thiswas associated with deepening of cauldrons on the ice cap and a glacial flood that caused damage to infrastructure. Increased earthquake activity within the caldera started a few days before and lasted for months afterwards and new seismic activity started on the southern flank. No visible eruption broke the ice and the question arose as to whether this episode relates to a minor subglacial eruption with the tremor being generated by volcanic processes, or by the flood. The tremor signal consisted of bursts with varying amplitude and duration.We have identified and described three different tremor phases, based on amplitude and frequency features. A tremor phase associatedwith the floodwas recorded only at stations closest to the river that flooded, correlating in timewith risingwater level observed at gauging stations. Using back-projection of double cross-correlations, two other phases have been located near the active ice cauldrons and are interpreted to be caused by volcanic or hydrothermal processes. The greatly increased seismicity and evidence of rapid melting of the glacier may be explained by a minor sub-glacial eruption. A less plausible interpretation is that the tremor was generated by hydrothermal boiling and/or explosions with no magma involved. This may have been induced by pressure drop triggered by the release of water when the glacial flood started. All interpretations require an increase of heat released by the volcano