Lymph node harvest in breast cancer patients with and without preoperative scintigraphy

Background: Sentinel lymph node biopsy (SLNB) is the standard of care for women with node negative breast cancer. Tc99 nanocolloid is a popular tracer, facilitating preoperative lymphoscintigraphy to identify sentinel nodes. This study compares the number of sentinel lymph nodes identified at the time of surgery in women who had lymphoscintigraphy with those who did not.Method: All women with primary breast cancer undergoing a SLNB from 2003­2017 who were node negative and did not have neoadjuvant chemotherapy were retrospectively reviewed in this study.Results: 576 women who had Tc99 preoperative injection were included in the study. Three hundred patients (Group 1) underwent lymphoscintigraphy preoperatively and 276 (Group 2) had no lymphoscintigraphy. The mean age at diagnosis for Groups 1 and 2 were 56 and 58 years, respectively. Both groups were also found to be similar in terms of histological subtype, tumour location, size, and HER2- and Estrogen receptor (ER) status. The surgery for the breast primary was similar in groups 1 and 2. While both groups had a median number of 2 nodes identified, the mean number of nodes identified for Group 2 (2.12) was 10% higher than for Group 1 (1.92) (p = 0.0026).Conclusion: This is the largest series to show that a preoperative lymphoscintigram (scan) can safely be omitted when performing a SLNB. As newer tracers are being used (e.g. Iron Oxide), it is important to know that accuracy of SLNB is not compromised by omission of a scan

Incidental Pathology and Anatomic Variations in Oral and Maxillofacial Cone-beam Computed Tomographic Scans.

Aims: To determine the occurrence of incidental pathological and anatomical findings in CBCT scans. Study Design: Retrospective cross sectional descriptive study which was done at a private imaging center from 2010 to 2012. Methodology: 97 CBCT scans of the oral and maxillofacial area were reviewed. Results: Scans of the maxilla were the commonest 60 (62%) and only 37 (38%) were mandibular scans. There were 55 (57%) scans whose indication for imaging could be ascertained. These were used to study the incidental findings. Majority (36, 65%) of the examinations were done on female patients while 19 (35%) were for males. Most 32 (58%) of the scans were required for implant site assessment. There were incidental findings in 40 (73%) scans, 35 (64%) had pathologies while 9 (16%) had significant anatomical findings. The highest overall rate of incidental pathological finding was in the airway area (18, 33%), followed by dental (16, 29%), periapical (13, 24%), periodontal lesions (7, 13%) and foreign bodies (2, 4%). Scans with incidental anatomical findings included variations in root canal morphology (6, 11%), nerve foramina (2, 4%) and dental roots protruding into the maxillary antrum (2, 4%). Conclusion: Various incidental findings in CBCT images are to be expected. Pathological findings were the commonest while airway findings were the majority. A thorough review of CBCT scans will ensure early diagnosis and management of incidental pathologies while a good documentation of significant anatomical variations will provide important pre-operative information.

Use of tactile cues by Notiosorex crawfordi (Insectivora) in response to topographical features in the environment.

The present studies were conducted on the ability of males of the gray shrew, Notiosorex crawfordi to use tactile cues to detect and respond to changes in topographical features of their environment. The animals were videotaped, digitized, and analyzed through video recordings. All subjects showed habituation (decrease in distance traveled) to arena conditions, followed by dishabituation when positions of the blocks were changed. Intact (INT) and sham controls (SHC) shrews traveled significantly greater distances and showed higher exploration velocities as compared to animals with shaved vibrissae (SHV). Results provide empirical evidence that N. crawfordi can effectively use tactile cues to detect and respond to changes in its environment.

Effects of azadirachtin on mortality, fertilization, and swimming speed in larvae of the cane toad, Bufo marinus (Anura: Bufonidae).

Experiments were conducted to assess the effects of azadirachtin (AZ) on survival capacity, fertilization success, and swimming speed in larval stages of the cane toad, Bufo marinus . LC50 values (96-hr) for various larval stages exposed to 0.50 mg/l AZ were as follows: 5.35 (stage 12), 5.77 (stage 16), 787 (stage 20), 13.43 (stage 24), and 21.54 (stage 30). Tadpoles did not exhibit any apparent disorientation or production of mucous in response to AZ concentrations ranging from 0.3 to 0.5 mg/l. Mortality was significantly higher at 0.50 mg/l AZ than at lower concentrations. At 0.50 mg/l, mortality rate decreased significantly from 36% for stage 12 tadpoles, to 24% for stage 20 tadpoles. Mortality for early stages (stage 12) dropped significantly, from 36% at 0.50 mg/l, to 21% at 0.40 mg/l AZ There were no significant differences in percent mortality for any developmental stage at an AZ concentration of 0.3 mg/l, or for controls (no AZ). Exposure of gametes to 0.30 mg/l AZ did not reduce fertilization success as compared to controls (89.8 vs. 83.7%). At 0.40 mg/l, percent fertilization decreased significantly (68.8%). This effect was even more pronounced at 0.50 mg/l. No significant difference was found in swimming speeds between controls and subjects exposed to 0.30 mg/l AZ. However, at a concentration of 0.40 mg/l, tadpoles required a significantly longer period of time to swim a distance of 140 cm as compared to controls. The potential impact of AZ on amphibian populations is discussed.

Ciprofloxacino en exacerbaciones agudas de enfermedad pulmonar obstructiva crónica / Ciprofloxacin in acute exacerbations of chronic obstructive pulmonary disease

Las exacerbaciones agudas de la EPOC son desencadenadas principalmente por infecciones bacterianas. Recientemente se ha revisado la racionalidad para la selección de antibióticos y se ha propuesto el empleo de ciproflaxacino como alternativa terapéutica. El objetivo de este trabajo fue evaluar la eficacia clínica y microbiológica del ciprofloxacino 750 mg (Baycip Bayer) 2 veces al día durante 9 días en pacientes EPOC con exacerbación aguda. Se realizó un estudio prospectivo, longitudinal, abierto no comparativo, multicéntrico en 57 pacientes. Existió cura clínica en 52 (96,3 por ciento) al día 10 y 49 (90,7 por ciento) al día 21. La eficacia microbiológica se midió en los 17 pacientes con cultivo positivo en la visita inicial. Hubo erradicación bacteriológica en 16 pacientes al día 10 y en 14 al día 21. Hubo 15 eventos adversos, 6 con relación posible o probable con la droga. Ciprofloxacino oral puede ser considerado un antibiótico útil en el tratamiento de las exacerbaciones agudas de EPOC

Respuesta analgésica y efectos secundarios en pacientes con metástasis osteoblásticas tratados con samario-153 etilendiaminotetrametilenfosfato / Samarium 153 EDTMP in the treatment of metastatic bone pain: evaluation of analgesic response and secondary effects

Background: Samarium153 EDTMP, a beta and gamma emitter, is used in the palliative therapy of painful bone metastases. Aim: To evaluate the analgesic effects and myelotoxicity of Samarium153 EDTMP in patients with prostate, breast and renal carcinoma. Patients and methods: Twenty patients with bone metastases (11 males), aged 65 years old as a mean, received a 1 to 2 mCi/kg intravenous dose of Samarium153 EDTMP, produced in Chile. Patients were followed thereafter during 4 to 40 weeks. Pain was assessed using a visual analogue scale. Results: Pain decreased from a score of 6.4 prior to treatment, to 2.7 at the fourth week of therapy and the effect lasted a mean of 12.5 weeks. Myelotoxicity was observed in 68percent of cases (WHO stage I in 21 percent, stage II in 37 percent, stage III in 11percent and no patients in stage IV). Platelets were the most affected series and neutrophils the least affected. Cell counts returned to normal between the sixth and eighth week. Seventy nine percent of patients decreased their basal analgesic therapy at the sixth week and 88percent did so at the eighth week. Forty one percent of these patients discontinued all analgesics. Conclusions: Samarium153 EDTMP is effective in the treatment of pain in patients with bone metastases and its myelotoxicity is low to moderate. It should be considered as a therapy for this type of pain, with the precaution of performing periodical bood counts

Antraciclinas y cardiotoxicidad: papel de los estudios isotópicos / Antracyclines and cardiotoxicity: isotopic studies

La pesquisa y seguimiento de cardiotoxicidad secundaria a antraciclinas debe ser considerada, debido a su acción acumulativa y al grave pronóstico en casos con factores de riesgo. La ventriculografía radioisotópica permite: a) evaluar la función ventricular en forma seriada simple y reproducible; b) modificar la terapia, en caso de demostrarse alteración de fracción de eyección ventricular y/o indicar biopsia selectivamente

Chondroprotection and the role of non steroidal anti-inflammatory drugs (NSAID) / O papel dos antiinflamatórios näo hormonais (AINHs) na condroproteçäo: um estudo do metabolismo da cartilagem humana

O termo condroproteçäo foi originalmente cunhado para descrever os possíveis efeitos da inibiçäo do processo catabólico imaginado responsável pela lesäo da matriz da cartilagem articular artrítica. Apesar de diversas evidências laboratoriais de possíveis inibidores da degradaçäo proteolítica do glicosaminoglicano da cartilagem (GAG) e colágeno, nunca houve validaçäo desses resultados em ensaios in vivo, possivelmente devido à complexidade dos mecanismos enzimáticos responsáveis pela degeneraçäo tecidual. Assim, o conceito condroproteçäo começou a ser encarado como uma meta inatingível. Estudos recentes, que têm demonstrado a importância da atividade sintética da cartilagem humana no prolongamento de sua integridade estrutural durante processos patológicos, têm levado a uma reavaliaçäo da possibilidade de condroproteçäo. É possível que alguns antiinflamatórios näo hormonais (AINHs) sejam capazes de diminuir a açäo da IL-1 na síntese da matriz, permitindo assim o reparo desta, enquanto outros possam diminuir de forma importante o metabolismo dos condrócitos. Os AINHs têm sido divididos em três categorias: grupo I, exemplificado pelo aceclofenaco, säo capazes de causar estímulo, auxiliados pela presença de outros fatores; grupo II, exemplificados pelo diclofenaco, em doses moderadas näo apresentam efeitos relevantes sobre o metabolismo da cartilagem, embora em doses maiores possam ser inibitórios; e o grupo III é exemplificado pela indometacina, que é altamente inibitória em termos de atividade sintética da matriz e provavelmente diminui o processo reparativo normal. Concluímos que é desejável que os clínicos considerem as possíveis propriedades protetoras ou destrutivas dos diversos AINHs ao decidir por seu uso em terapêutica prolongada