Determinants of Prognosis in Triple-Negative Breast Cancer: Report from a Large Breast Cancer Registry.

BACKGROUND: The outcome of patients with triple-negative breast cancer (TNBC) is highly dependent on demographic factors and ethnicity. We aimed to evaluate the clinicopathological determinants of prognosis among women with TNBC using data from one of the largest breast cancer (BC) registries. METHODS: A total of 6145 patients with BC from our referral center were evaluated from 1995 to 2018, among whom 523 had TNBC. The baseline, menstrual and reproductive, treatment and pathology related characteristics were evaluated. RESULTS: Among TNBC patients, the rate of stage 3 and 4 BC (29.9% vs. 14.4% and 7.8% vs. 0% for stage 3 and 4, respectively; P<0.001), invasive ductal carcinoma (90.7% vs. 75.6%; P=0.004), nodal involvement (46.7% vs. 33.4%; P=0.026), mastectomy (57.3% vs. 37.8%; P=0.001) and axillary node dissection (76.7% vs. 59.8%; P=0.019) was significantly higher in the group that developed recurrence. Disease-free-survival was 80.6% (157.76 ± 9.48 months) and overall-survival was 90.1% (182.73 ± 3.28 months). For death, stage 3 BC (compared to stages 0 and 1 as base) showed a higher risk of earlier death (adjusted HR: 4.191, 95% CI=1.392-12.621; P=0.011). For recurrence, stage 3 BC (adjusted HR: 1.044, 95% CI=1.209-6.673; P=0.017) (compared to stages 0 and 1 as base) showed significantly higher risk for developing earlier recurrence. Moreover, those who had invasive ductal carcinoma (compared to other types of BCs) had a higher risk for developing earlier recurrence (adjusted HR: 3.307, 95% CI=1.191-0.724; P=0.012). CONCLUSION: BC stage plays a significant role in both earlier recurrence and earlier mortality among patients with TNBC.

Introducing an efficient model for the prediction of placenta accreta spectrum using the MCP regression approach based on sonography indexes: how efficient is sonography in diagnosing accreta?

BACKGROUND: For the first time, we aimed to introduce a model for prediction of placenta accreta spectrum (PAS), using existing sonography indices. METHODS: Women with a history of Cesarean sections were included. Participants were categorized "high risk" for PAS if the placenta was previa or low-lying. Sonography indices including abnormal placental lacuna, loss of clear zone, bladder wall interruption, myometrial thinning, placental bulging, exophytic mass, utero-vesical hypervascularity, subplacental hypervascularity, existence of bridging vessels, and lacunar flow, were registered. To investigate simultaneous effects of 15 variables on PAS, Minimax Concave Penalty (MCP) was used. RESULTS: Among 259 participants, 74 (28.5%) were high risk and 43 individuals had PASs. All sonography indices were higher among patient with PAS (p < 0.001) in the high risk group. Our model showed that utero-vesical hypervascularity, bladder interruption and new lacunae have significant contribution in PAS. Optimal cut off point was p = 0.51 in ROC analysis. Probability of PAS for women with lacunae was between 96 and 100% and probability of PAS for women without lacunae was between 0 to 7%, therefore accuracy of the proposed model was equal to 100%. CONCLUSIONS: Using the introduced model based on three factors of abnormal lacuna structures (grades 2 and 3), bladder wall interruption and utero-vesical vascularity, 100% of all cases of PASs are diagnosable. If supported by future studies our model eliminates the need for other imaging assessments for diagnosis of invasive placentation among high risk women with previous history of Cesarean sections.

The antimicrobial effects of zinc oxide-calcium hydroxide mixture fillers: determining the ideal mixture ratio.

BACKGROUND AND OBJECTIVES: Although zinc oxide (ZO)-calcium hydroxide (CaOH) mixtures have been successful regarding their absorption rate compatibility with dissolving primary teeth, no study has been conducted on the appropriate mixture ratio to obtain effective antibacterial properties. In this study, we compared antibacterial activity of CaOH-ZO pastes using different mixture ratios sagainst Enterococcus faecalis as an important bacterium in root canal treatment failure. MATERIALS AND METHODS: Seven types of pastes were prepared in our laboratory. The first group included one gram of ZO+eugenol, second group included one gram of CaOH+distilled water, third group included 0.5gram ZO+0.5gram CaOH+distilled water (1:1), forth group included 0.75gramCaOH+0.25gramZO+distilled water (3:1), the fifth group included 0.33gram of CaOH+0.66gram of ZO+distilled water (1:2), the sixth group included 0.75gram of ZO+0.25 CaOH+distilled water (3:1), the seventh group included 0.66 gram CaOH+0.33 gram ZO+distilled water (2:1), and the final group included one gram of gelatin+distilled water (as the control group). These pastes were compared regarding their antibacterial effects against Enterococcus faecalis using agar diffusion and microdilution methods. RESULTS: Except for the control group, all prepared pastes showed antibacterial properties. Order of minimum inhibitory concentration for pastes were as followed: CaOH-ZO (1:3)=CaOH-ZO (1:2)>CaOH-ZO (1:1)>CaOH-ZO (3:1)=CaOH-ZO (2:1)>CaOH=ZO-eugenol. Order of minimum bactericidal concentration, which shows a weaker bactericidal effect, according to type of paste, were as followed: CaOH-ZO (1:3)>CaOH-ZO mixture (1:2)>CaOH-ZO mixture (1:1)>CaOH-ZO mixture (3:1)=CaOH-ZO (2:1)>CaOH=ZO-eugenol. Only CaOH-ZO (1:3) and CaOH-ZO (1:2), showed significantly weaker MICs and MBCs (p < 0.001). CONCLUSION: Considering the limitations of an in-vitro study, in terms of anti-bacterial effects against Enterococcus faecalis, CaOH-ZO mixture (2:1) is equivalent to ZO-eugenol as the most commonly used material in polypectomy of primary teeth.