Cardiac tumours in children

Cardiac tumours are benign or malignant neoplasms arising primarily in the inner lining, muscle layer, or the surrounding pericardium of the heart. They can be primary or metastatic. Primary cardiac tumours are rare in paediatric practice with a prevalence of 0.0017 to 0.28 in autopsy series. In contrast, the incidence of cardiac tumours during foetal life has been reported to be approximately 0.14%. The vast majority of primary cardiac tumours in children are benign, whilst approximately 10% are malignant. Secondary malignant tumours are 10–20 times more prevalent than primary malignant tumours. Rhabdomyoma is the most common cardiac tumour during foetal life and childhood. It accounts for more than 60% of all primary cardiac tumours. The frequency and type of cardiac tumours in adults differ from those in children with 75% being benign and 25% being malignant. Myxomas are the most common primary tumours in adults constituting 40% of benign tumours. Sarcomas make up 75% of malignant cardiac masses. Echocardiography, Computing Tomography (CT) and Magnetic Resonance Imaging (MRI) of the heart are the main non-invasive diagnostic tools. Cardiac catheterisation is seldom necessary. Tumour biopsy with histological assessment remains the gold standard for confirmation of the diagnosis. Surgical resection of primary cardiac tumours should be considered to relieve symptoms and mechanical obstruction to blood flow. The outcome of surgical resection in symptomatic, non-myxomatous benign cardiac tumours is favourable. Patients with primary cardiac malignancies may benefit from palliative surgery but this approach should not be recommended for patients with metastatic cardiac tumours. Surgery, chemotherapy and radiotherapy may prolong survival. The prognosis for malignant primary cardiac tumours is generally extremely poor

Unsaturated Germanium and Phosphorus-compounds - Reactions of Germaphosphenes With Alpha-ethylene Aldehydes and Ketones

Germaphosphenes MeS2Ge=PR (R: 2,4,6-triisopropylphenyl (Is), 1; 2,4,6-tri-tert-butylphenyl (Ar), 2) react with a-ethylene aldehydes and ketones to give [2 + 2] and [2 + 4] cycloadditions (for aldehydes) and [2 + 4] cycloadditions and 1,2-additions (for ketones). Four- and six-membered ring derivatives can be easily differentiated by P-31 NMR chemical shifts which are, respectively, +36 to +89 ppm and -33 to -77 ppm. 5a', obtained from 2 and crotonaldehyde, has been structurally characterized by X-ray diffraction: the six-membered ring (germaoxaphosphorinene) conformation is a sofa form, with large folding along the Ge-C axis. A NMR study at various temperatures for 3a, 3a', and 5a' displays dynamic phenomenon including phosphorus and ring inversion. The low DELTAG* values (respectively 18.2,13.7, and 13.2 kcal/mol) seem mainly due to substitution of phosphorus by the electropositive germanium and particularly to large steric effects; the 2,4,6-tri-tert-butylphenyl group lowers the inversion barrier by 5 kcal/mol when compared with the 2,4,6-triisopropylphenyl group

Reliability of SM2RAIN precipitation datasets in comparison to gauge observations and hydrological modelling over arid regions

Numerous satellite-based precipitation datasets have been successively made available. Their precipitation estimates rely on clouds properties derived from microwave and thermal sensors in a so-named 'top-down' approach. Recently, a 'bottom-up' approach to infer precipitation from soil moisture (SM) estimates has resulted in the release of two new precipitation datasets (P-datasets). One uses satellite-based SM estimates from the European Spatial Agency (ESA) Climate Change Initiative (CCI) (SM2RAIN-CCI) while the other uses satellite-based SM from European Organization for the Exploitation of Meteorological Satellites (EUMETSAT) Advanced SCATterometer (ASCAT) (SM2RAIN-ASCAT). This study assesses SM2RAIN-ASCAT and -CCI reliability over two arid regions: Bolivian and Peruvian Altiplano and Pakistan (South Asia) using (a) direct comparisons with rain gauges and (b) testing the sensitivity of streamflow modelling to the P-datasets. Selecting two different regions and different indicators helps to assess whether the P-dataset reliability varies depending on the assessment method and location. For comparison purposes, the most reliable P-datasets from the literature are also considered (IMERG-E v.6, IMERG-L v.6, IMERG-F v.6, CHIRPS v.2 and MSWEP v.2.2). Compared to rain gauge observations and based on the modified Kling-Gupta Efficiency (KGE) values, the SM2RAIN-ASCAT and -CCI are more accurate in the Altiplano than in Pakistan. This difference is explained by a more favourable physical context for satellite-based SM estimates in the Altiplano. Over the Altiplano and despite an overall positive bias, SM2RAIN-ASCAT describes rain gauges temporal dynamics as well as IMERG-F v.6, CHIRPS v.2 and MSWEP v.2.2 and provides streamflow simulations very close to those obtained when using IMERG-F v.6, CHIRPS v.2 and MSWEP v.2.2 as forcing data

Age and stage at diagnosis: a hospital series of 11 women with intellectual disability and breast carcinoma

International audienceBACKGROUND: Breast cancer has been poorly studied in women with intellectual disability (ID), which makes designing a policy for screening the nearly 70 million women with ID in the world difficult. As no data is available in the literature, we evaluated breast cancer at diagnosis in women with ID.METHODS: Women with ID were searched retrospectively among all women treated for invasive breast cancer in a single hospital over 18 years. Age at diagnosis was compared among the whole group of women. Tumor size, lymph node involvement, SBR grade, TNM classification, and AJCC stage were compared to controls matched for age and period of diagnosis using conditional logistic regression.RESULTS: Among 484 women with invasive breast cancer, 11 had ID. The mean age at diagnosis was 55.6 years in women with ID and 62.4 years in the other women. The mean tumor size in women with ID was 3.53 cm, compared to 1.80 cm in 44 random controls from among the 473 women without ID. Lymph node involvement was observed in 9 of the 11 women with ID compared to 12 of the controls (OR = 11.53, p = 0.002), and metastases were found in 3 of the 11 women with ID compared to 1 of the 44 controls (OR = 12.00, p = 0.031). The AJCC stage was higher in women with ID compared to controls (OR = 3.19, p = 0.010).CONCLUSIONS: Women with ID presented at an earlier age with tumors of a higher AJCC stage than controls despite no significant differences in tumor grade and histological type. Thus, delayed diagnosis may be responsible for the differences between disabled and non-disabled women