The impact of imagistic evaluation of premalignant and malignant lesions of the breast confirmed in histopathological terms.

Breast cancer is a condition with the highest incidence of all neoplasms and a frequent cause of death. Due to increased incidence and mortality, this disease motivates healthcare professionals to redirect efforts to develop effective strategies for secondary prophylaxis. Imagistic investigations play an important role both in detecting lesions and in post-therapeutic evolutionary follow-up. The objective of the paper is to study cases of premalignant and malignant tumors, with a view to their imagistic identification confirmed in terms of histopathology, to highlight the accuracy of the imagistic examination as an important factor in the diagnosis and adaptation of an appropriate therapeutic attitude. The study was performed on a batch of 768 patients admitted to the Department of Surgery III, "Prof. Dr. Alexandru Trestioreanu" Institute of Oncology, Bucharest, Romania. The classical examined hypothesis is local examination, mammography, ultrasound, with its variations, and histopathological (HP) confirmation, either by thick-needle biopsy puncture and∕or tumor excision. By correlating with HP examination of the imagistic representation of the lesion, we can show the importance or limitation of each imagistic investigation, but especially its usefulness in the choice of therapeutic behavior. Breast cancer screening using classical techniques currently requires implementation of modern techniques to diagnose this disease.

Blood sampling as a cause of anemia in a general ICU - a pilot study.

OBJECTIVE: The objective of our pilot study was to evaluate the influence of daily phlebotomy on patients' haemoglobin levels from our general intensive care unit. METHODS: We prospectively enrolled 35 patients who did not present with acute haemorrhage or developed it during the study period. For each patient we recorded: the diagnosis, age, sex, haemoglobin, hematocrit, SOFA and APACHE II score, blood volume drawn in standardized vials, number of blood tests ordered per day, fluid balance per day, number of ICU days. The collected data were analyzed using the linear regression model, paired t-test, receiver operating characteristic curves, and descriptive analysis. Statistical analysis was performed with SPSS v.17 trial version (IBM, NY, USA). RESULTS: The mean volume of blood drawn per day was 18.1 (SD ± 14.4) ml and the number of blood tests was 3.8 (SD ± 1.75) per day. On univariate linear regression analysis both the blood volume drawn daily (p = 0.04) and the number of blood tests per day (p = 0.009) correlated with a drop in mean haemoglobin concentration. The difference in the mean value of haemoglobin at admission and discharge correlated with overall mortality (p = 0.03). The sensitivity of admission haemoglobin equal to 10.6 g/dL in predicting mortality was 82.4% with a specificity of 50%, (p = 0.019, AUC = 0.732). CONCLUSIONS: We evidenced the predictive power of blood sampling and number of blood tests done on haemoglobin concentration. Besides the main objective of the study we noticed that the difference in the mean value of haemoglobin at admission and discharge correlated with overall mortality. Considering that blood sampling contributes to anemia among ICU patients, we should limit the daily tests undertaken, to the tests absolutely necessary for guiding our therapy.