ABSTRACT
El estado de los ganglios axilares es el factor de predicción de sobrevida más importante en pacientes con cáncer de mama, siendo además considerado para la decisión de indicación de tratamientos adyuvantes.La biopsia del ganglio centinela (GC) es actualmente el procedimiento estándar para la estadificación axilar en cáncer de mama con axila clínicamente negativa. Esto redujo el número de ganglios axilares a ser estudiados por el patólogo; de un promedio de 15 a 20 ganglios en una pieza de linfadenectomía axilar a 1 a 3 ganglios en los casos de biopsia de GC. Asimismo, permitió un estudio más exhaustivo del GC y con ello aumentó la detección de metástasis de menor tamaño, sean estas micrometástasis (MMT) o células tumorales aisladas (CTA). Las primeras presentan un tamaño entre 0,2 mm y no mayor a 2,0 mm, y las segundas un tamaño que no supera los 0,2 mm. En la actualidad existen controversias respecto al impacto clínico y manejo de las MMT y CTA. El siguiente trabajo muestra la experiencia en el manejo de estos casos en el Hospital Universitario CEMIC y realiza una revisión de la literatura.
Subject(s)
Breast , Neoplasm Micrometastasis , Sentinel Lymph Node BiopsyABSTRACT
BACKGROUND: Transboundary animal movements facilitate the spread of pathogens across large distances. Cross-border cattle trade is of economic and cultural importance in West Africa. This study explores the potential disease risk resulting from large-scale, cross-border cattle trade between Togo, Burkina Faso, Ghana, Benin, and Nigeria for the first time. METHODS AND PRINCIPAL FINDINGS: A questionnaire-based survey of livestock movements of 226 cattle traders was conducted in the 9 biggest cattle markets of northern Togo in February-March 2012. More than half of the traders (53.5%) operated in at least one other country. Animal flows were stochastically simulated based on reported movements and the risk of regional disease spread assessed. More than three quarters (79.2%, range: 78.1-80.0%) of cattle flowing into the market system originated from other countries. Through the cattle market system of northern Togo, non-neighbouring countries were connected via potential routes for disease spread. Even for diseases with low transmissibility and low prevalence in a given country, there was a high risk of disease introduction into other countries. CONCLUSIONS: By stochastically simulating data collected by interviewing cattle traders in northern Togo, this study identifies potential risks for regional disease spread in West Africa through cross-border cattle trade. The findings highlight that surveillance for emerging infectious diseases as well as control activities targeting endemic diseases in West Africa are likely to be ineffective if only conducted at a national level. A regional approach to disease surveillance, prevention and control is essential.
Subject(s)
Cattle Diseases/epidemiology , Cattle Diseases/transmission , Africa, Western/epidemiology , Animals , Benin/epidemiology , Burkina Faso/epidemiology , Cattle , Data Collection , Emigration and Immigration , Ghana/epidemiology , Nigeria/epidemiology , Surveys and Questionnaires , Togo/epidemiologyABSTRACT
BACKGROUND: Although brucellosis (Brucella spp.) and Q Fever (Coxiella burnetii) are zoonoses of global importance, very little high quality data are available from West Africa. METHODS/PRINCIPAL FINDINGS: A serosurvey was conducted in Togo's main livestock-raising zone in 2011 in 25 randomly selected villages, including 683 people, 596 cattle, 465 sheep and 221 goats. Additionally, 464 transhumant cattle from Burkina Faso were sampled in 2012. The serological analyses performed were the Rose Bengal Test and ELISA for brucellosis and ELISA and the immunofluorescence assay (IFA) for Q Fever Brucellosis did not appear to pose a major human health problem in the study zone, with only 7 seropositive participants. B. abortus was isolated from 3 bovine hygroma samples, and is likely to be the predominant circulating strain. This may explain the observed seropositivity amongst village cattle (9.2%, 95%CI:4.3-18.6%) and transhumant cattle (7.3%, 95%CI:3.5-14.7%), with an absence of seropositive small ruminants. Exposure of livestock and people to C. burnetii was common, potentially influenced by cultural factors. People of Fulani ethnicity had greater livestock contact and a significantly higher seroprevalence than other ethnic groups (Fulani: 45.5%, 95%CI:37.7-53.6%; non-Fulani: 27.1%, 95%CI:20.6-34.7%). Appropriate diagnostic test cut-off values in endemic settings requires further investigation. Both brucellosis and Q Fever appeared to impact on livestock production. Seropositive cows were more likely to have aborted a foetus during the previous year than seronegative cows, when adjusted for age. This odds was 3.8 times higher (95%CI: 1.2-12.1) for brucellosis and 6.7 times higher (95%CI: 1.3-34.8) for Q Fever. CONCLUSIONS: This is the first epidemiological study of zoonoses in Togo in linked human and animal populations, providing much needed data for West Africa. Exposure to Brucella and C. burnetii is common but further research is needed into the clinical and economic impact.
Subject(s)
Brucellosis/epidemiology , Q Fever/epidemiology , Zoonoses/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Animals , Brucella abortus/classification , Brucella abortus/genetics , Cattle , Child , Child, Preschool , Coxiella burnetii/classification , Female , Geography , Goats , Humans , Male , Middle Aged , Seroepidemiologic Studies , Sheep , Togo/epidemiology , Young AdultABSTRACT
More than 15 years ago, a new approach to quantum mechanics was suggested, in which Hermiticity of the Hamiltonian was to be replaced by invariance under a discrete symmetry, the product of parity and time-reversal symmetry, PT. It was shown that, if PT is unbroken, energies were, in fact, positive, and unitarity was satisfied. Since quantum mechanics is quantum field theory in one dimension--time--it was natural to extend this idea to higher-dimensional field theory, and in fact an apparently viable version of PT-invariant quantum electrodynamics (QED) was proposed. However, it has proved difficult to establish that the unitarity of the scattering matrix, for example, the Källén spectral representation for the photon propagator, can be maintained in this theory. This has led to questions of whether, in fact, even quantum mechanical systems are consistent with probability conservation when Green's functions are examined, since the latter have to possess physical requirements of analyticity. The status of PT QED will be reviewed in this paper, as well as the general issue of unitarity.
ABSTRACT
Two hundred cases of cholera-El Tor in Capiz province are presented. The epidemiology, clinical picture, complications and treatment are discussed.Emphasis is placed on the treatment outlined. The basic needs of a community are outlined to help combat this epidemic. (Summary)
ABSTRACT
This study aimed to analyze the role of DNA tsting in cervical cancer. In 1995, the International Agency for Research on Cancer defined the association between infections with human papilloma virus (HPV) and cervical cancer (CC), sustained in numerous epidemiologic and experimental evidences. However, even if the infection develops as a necessary condition to generate a CC in almost the 100 por ciento of the cases, it would not be sufficient enough without the support of other associated factors to break out the tumoral growth. Thus, human papilloma viruses are receiving increasing attention for their role in the pathogenesis of ulterine cervix cancer, and therefore efforts should be dedicated to avoid this infection as a mean to prevent CC, development of an effective vaccine. We examined a group of 111 females in order to evaluate the results obtained with human papilloma virus DNA testing aimed to generate indications to improve the management's condition of cost-effectiveness
Subject(s)
Humans , Female , Adult , Cervix Uteri/pathology , DNAABSTRACT
This study aimed to analyze the role of DNA tsting in cervical cancer. In 1995, the International Agency for Research on Cancer defined the association between infections with human papilloma virus (HPV) and cervical cancer (CC), sustained in numerous epidemiologic and experimental evidences. However, even if the infection develops as a necessary condition to generate a CC in almost the 100 por ciento of the cases, it would not be sufficient enough without the support of other associated factors to break out the tumoral growth. Thus, human papilloma viruses are receiving increasing attention for their role in the pathogenesis of ulterine cervix cancer, and therefore efforts should be dedicated to avoid this infection as a mean to prevent CC, development of an effective vaccine. We examined a group of 111 females in order to evaluate the results obtained with human papilloma virus DNA testing aimed to generate indications to improve the managements condition of cost-effectiveness
