Systematic review of therapeutic nipple-sparing versus skin-sparing mastectomy.

Background: The use of nipple-sparing mastectomy (NSM) is increasing, despite unproven oncological safety in the therapeutic setting. The aim of this systematic review was to determine the safety and efficacy of NSM compared with skin-sparing mastectomy (SSM). Methods: A literature search of all original studies including RCTs, cohort studies and case-control studies comparing women undergoing therapeutic NSM or SSM for breast cancer was undertaken. Primary outcomes were oncological outcomes; secondary outcomes were clinical, aesthetic, patient-reported and quality-of-life outcomes. Data analysis was undertaken to explore the relationship between NSM and SSM, and preselected outcomes. Heterogeneity was assessed using the Cochrane tests. Results: A total of 690 articles were identified, of which 14 were included. There was no statistically significant difference in 5-year disease-free survival and mortality for NSM and SSM groups, where data were available. Local recurrence rates were also similar for NSM and SSM (3·9 versus 3·3 per cent respectively; P = 0·45). NSM had a partial or complete nipple necrosis rate of 15·0 per cent, and a higher complication rate than SSM (22·6 versus 14·0 per cent respectively). The higher overall complication rate was due to the rate of nipple necrosis in the NSM group (15·0 per cent). Conclusion: In carefully selected cases, NSM is a viable choice for women with breast cancer who need to have a mastectomy. More research is needed to help further refine which surgical approaches to NSM optimize outcomes.

Simple Co-Precipitation Synthesis and Characterization Studies of La(1-x)NixVO3 Perovskites Nanostructures for Humidity Sensing Applications.

Ni2+ -doped LaVO3 perovskites nanostructures were successfully prepared by a simple coprecipitation method. Powder X-ray diffraction (XRD) pattern confirms that all compositions crystallize with orthorhombic LaVO3 perovskites structure. The lattice parameter decreases with increase in Ni2+ content resulting in the reduction of lattice strain in LaVO3. High resolution scanning electron microscope (HR-SEM) images revealed that the as-prepared samples are crystalline with particle size distribution in 142-250 nm range. The BET studies revealed the surface area of the required samples. The samples were subjected to humidity sensing studies by solid-state electrical conductance studies. The studies revealed that La0.4Ni0.6VO3 is a good candidate for humidity sensors with a higher sensitivity factor (Sf) of 15623.02. The higher Sf of La0.4Ni0.6VO3 is due to the larger surface area of the sample.

Enzymes from isolates of Pseudomonas fluorescens involved in food spoilage.

AIMS: Psychrotrophic Gram-negative bacteria, such as Pseudomonas species, pose a significant spoilage problem in refrigerated meat and dairy products due to secretion of hydrolytic enzymes, especially lipases and proteases. This study characterized the enzymes produced by strains of Pseudomonas fluorescens isolated from pasteurized milk. METHODS AND RESULTS: Thirty-seven isolates of Ps. fluorescens from skimmed, semiskimmed and whole milk were all shown to be proteolytic and lipolytic on casein and tributyrin agar, respectively. The highest level of protease production by one isolate, SMD 31, from skimmed milk was in minimal salts medium containing 1 mmol x l(-1) calcium chloride at 20 degrees C. The proteases belonged to the class of metallo-proteases, as there was no residual activity with 10 mmol x l(-1) EDTA. They were heat stable and retained activity even after treatment at 121 degrees C for 20 min. One protease of 45-48 kDa was detected in unconcentrated supernatant fluid samples but, in three isolates from different milk sources, five proteases with molecular masses between 28 and 48 kDa were detected on a 12% zymogram casein gel following ultrafiltration. Attempts to purify the lipases proved unsuccessful. CONCLUSIONS: The characteristics of the major protease of 45-48 kDa correspond to those of proteases described for other Pseudomonas species isolated from a range of environments. However, the smaller proteases have not been described previously. SIGNIFICANCE AND IMPACT OF THE STUDY: In the absence of ultrafiltration the presence of the minor protease species may be missed and they may act as contaminants of the major protease in unpurified or semipurified samples.

First ever seizures in the elderly: a seven-year follow-up study.

The clinical characteristics and prognosis of first ever seizures among the elderly (aged 65 years or more) were ascertained by following up a cohort of patients for 7 years. Twenty-three patients (mean age, 69.9 +/- 4.9 years) were registered in the Neurology Service between January 1988 and March 1989. Twelve patients had partial seizures with or without generalization. Three patients had status epilepticus, whereas ten had presented for single seizure. On presentation 61.9% patients had neurological deficits and 73.9% had one or more systemic disorder. Head computerized tomography scans were abnormal in 17 cases. Seizures were attributed to acute stroke (26.1%), trauma (8.7%), subdural haematoma, degenerative diseases of the brain, cerebral metastasis, or central nervous system infections. The cause was unknown in 43.5% cases. At the end of 7 years, follow-up was complete for 15 patients (65.2%). The mean duration of follow-up was 68.6 +/- 28.7 months. Eight (53.3%) patients had died. Nine patients (60%) had attained 2-year remission of which three remained seizure free throughout. Six of the seven living patients were continuing antiepileptic drugs treatment. Forty per cent of them were dependent on others for the activities of daily life.