Axillary silicone lymphadenopathy presenting with a lump and altered sensation in the breast: a case report

<p>Abstract</p> <p>Introduction</p> <p>Silicone lymphadenopathy is a rare but recognised complication of procedures involving the use of silicone. It has a poorly understood mechanism but is thought to occur following the transportation of silicone particles from silicone-containing prostheses to lymph nodes by macrophages.</p> <p>Case presentation</p> <p>We report of a case involving a 35-year-old woman who presented to the breast clinic with a breast lump and altered sensation below her left nipple 5 years after bilateral cosmetic breast augmentations. A small lump was detected inferior to the nipple but clinical examination and initial ultrasound investigation showed both implants to be intact. However, mammography and magnetic resonance imaging of both breasts revealed both intracapsular and extracapsular rupture of the left breast prosthesis. The patient went on to develop a flu-like illness and tender lumps in the left axilla and right mastoid regions. An excision biopsy of the left axillary lesion and replacement of the ruptured implant was performed. Subsequent histological analysis showed that the axillary lump was a lymph node containing large amounts of silicone.</p> <p>Conclusion</p> <p>The exclusion of malignancy remains the priority when dealing with lumps in the breast or axilla. Silicone lymphadenopathy should however be considered as a differential diagnosis in patients in whom silicone prostheses are present.</p

Influência do óleo de linhaça sobre o desempenho e a qualidade dos ovos de poedeiras semipesadas Influence of linseed oil on performance and egg quality of semi-heavy laying hens

O experimento foi conduzido para avaliar a influência da adição de óleo de linhaça em substituição ao óleo de soja em rações para poedeiras semipesadas sobre o desempenho e a qualidade interna e externa dos ovos. Utilizaram-se 192 poedeiras da linhagem Bovans Godline com 29 semanas de idade, distribuídas em seis tratamentos, que consistiram de uma dieta controle (sem óleo vegetal) e de cinco dietas contendo 0,0; 0,5; 1,0; 1,5 e 2,0% de óleo de linhaça em substituição, respectivamente, a 100, 75, 50, 25 ou 0% do óleo de soja. Avaliaram-se a produção (PROD), o peso (PO) e a massa de ovo (MO), as conversões por massa (CMO) e por dúzia de ovos (CDZ), os pesos e as porcentagens de albúmen, gema e casca, a gravidade específica, os teores de matéria seca, cinzas e proteína do albúmen e da gema e o teor de colesterol e a coloração da gema. A produção, o peso do ovo, a massa de ovo e as conversões por massa e por dúzia de ovos, bem como a qualidade interna e externa dos ovos, não foram influenciados pelos níveis de óleo de linhaça na ração. Do mesmo modo, não houve efeito da inclusão de óleo de linhaça sobre a composição química dos ovos e somente a coloração da gema foi intensificada quando utilizados níveis acima de 1% de óleo de linhaça na dieta. A adição de até 2% de óleo de linhaça na ração não altera o desempenho de poedeiras semipesadas nem a qualidade interna e externa e o teor de colesterol dos ovos.<br>This experiment was carried out to evaluate the influence of the linseed oil addition in replacement of soybean oil in laying hens diets on performance and internal and external egg quality. A total of 192 laying hens Bovans Godline line with 29 week-old, were distributed to six treatments, that consisted of a control diet (without vegetal oil) and of five diets containing 2% of linseed oil in replacement of 0, 25, 50, 75 and 100% of soybean oil, generating levels of 0.0, 0.5, 1.0, 1.5 and 2.0 % of linseed oil in the diets. The evaluated parameters were: production (PROD), egg weight (EW) and mass (EM), feed:egg mass ratio (FEM) and feed:egg dozen ratio (FED), albumen, yolk and shell weights and percentages, specific gravity, albumen and yolk dry matter, ashes and protein, yolk cholesterol and coloration. The production , EW, EM, FEM and FED, as for internal and external egg quality, were not influenced by the linseed oil levels in the diet. Likewise, no effect was observed on egg chemical composition and only yolk coloration was intensified with the levels above 1% of linseed oil in the diet. The addition of up to 2% f linseed oil on diet did not alter the performance on semi-heavy laying hens, and the internal and external egg quality and cholesterol

Renal Drug Transporters and Drug Interactions.

Transporters in proximal renal tubules contribute to the disposition of numerous drugs. Furthermore, the molecular mechanisms of tubular secretion have been progressively elucidated during the past decades. Organic anions tend to be secreted by the transport proteins OAT1, OAT3 and OATP4C1 on the basolateral side of tubular cells, and multidrug resistance protein (MRP) 2, MRP4, OATP1A2 and breast cancer resistance protein (BCRP) on the apical side. Organic cations are secreted by organic cation transporter (OCT) 2 on the basolateral side, and multidrug and toxic compound extrusion (MATE) proteins MATE1, MATE2/2-K, P-glycoprotein, organic cation and carnitine transporter (OCTN) 1 and OCTN2 on the apical side. Significant drug-drug interactions (DDIs) may affect any of these transporters, altering the clearance and, consequently, the efficacy and/or toxicity of substrate drugs. Interactions at the level of basolateral transporters typically decrease the clearance of the victim drug, causing higher systemic exposure. Interactions at the apical level can also lower drug clearance, but may be associated with higher renal toxicity, due to intracellular accumulation. Whereas the importance of glomerular filtration in drug disposition is largely appreciated among clinicians, DDIs involving renal transporters are less well recognized. This review summarizes current knowledge on the roles, quantitative importance and clinical relevance of these transporters in drug therapy. It proposes an approach based on substrate-inhibitor associations for predicting potential tubular-based DDIs and preventing their adverse consequences. We provide a comprehensive list of known drug interactions with renally-expressed transporters. While many of these interactions have limited clinical consequences, some involving high-risk drugs (e.g. methotrexate) definitely deserve the attention of prescribers