Survival in Norwegian BRCA1 mutation carriers with breast cancer

Several studies of survival in women with BRCA1 mutations have shown either reduced survival or no difference compared to controls. Programmes for early detection and treatment of inherited breast cancer, have failed to demonstrate a significant improvement in survival in BRCA1 mutation carriers

Which New Approaches to Tackling Neglected Tropical Diseases Show Promise?

This PLoS Medicine Debate examines the different approaches that can be taken to tackle neglected tropical diseases (NTDs). Some commentators, like Jerry Spiegel and colleagues from the University of British Columbia, feel there has been too much focus on the biomedical mechanisms and drug development for NTDs, at the expense of attention to the social determinants of disease. Burton Singer argues that this represents another example of the inappropriate “overmedicalization” of contemporary tropical disease control. Peter Hotez and colleagues, in contrast, argue that the best return on investment will continue to be mass drug administration for NTDs

Androgen receptor expression in male breast carcinoma: lack of clinicopathological association

Androgen receptor (AR) expression was retrospectively analysed in 47 primary male breast carcinomas (MBCs) using a monoclonal antibody on formalin-fixed, paraffin-embedded tissues. AR immunopositivity was detected in 16 out of 47 (34%) cases. No association was found with patient age, tumour stage, progesterone receptor (PGR) or p53 protein expression. Well-differentiated MBCs tended to be AR positive more often than poorly differentiated ones (P= 0.08). A negative association was found between ARs and cell proliferative activity: MIB-1 scores were higher (25.4%) in AR-negative than in AR-positive cases (21.11%; P= 0.04). A strong positive association (P= 0.0001) was found between ARs and oestrogen receptors (ERs). In univariate analysis, ARs (as well as ERs and PGRs) were not correlated with overall survival; tumour histological grade (P= 0.02), size (P= 0.01), p53 expression (P= 0.0008) and MIB-1 scores (P= 0.0003) had strong prognostic value. In multivariate survival analysis, only p53 expression (P= 0.002) and histological grade (P= 0.02) retained independent prognostic significance. In conclusion, the lack of association between AR and most clinicopathological features and survival, together with the absence of prognostic value for ER/PGR status, suggest that MBCs are biologically different from female breast carcinomas and make it questionable to use antihormonal therapy for patients with MBC. © 1999 Cancer Research Campaig

Primary repair of colon injuries: clinical study of nonselective approach

<p>Abstract</p> <p>Background</p> <p>This study was designed to determine the role of primary repair and to investigate the possibility of expanding indications for primary repair of colon injuries using nonselective approach.</p> <p>Methods</p> <p>Two groups of patients were analyzed. Retrospective (RS) group included 30 patients managed by primary repair or two stage surgical procedure according to criteria published by Stone (S/F) and Flint (Fl). In this group 18 patients were managed by primary repair. Prospective (PR) group included 33 patients with primary repair as a first choice procedure. In this group, primary repair was performed in 30 cases.</p> <p>Results</p> <p>Groups were comparable regarding age, sex, and indexes of trauma severity. Time between injury and surgery was shorter in PR group, (1.3 vs. 3.1 hours). Stab wounds were more frequent in PR group (9:2), and iatrogenic lesions in RS group (6:2). Associated injuries were similar, as well as segmental distribution of colon injuries. S/F criteria and Flint grading were similar.</p> <p>In RS group 15 primary repairs were successful, while in two cases relaparotomy and colostomy was performed due to anastomotic leakage. One patient died. In PR group, 25 primary repairs were successful, with 2 immediate and 3 postoperative (7-10 days) deaths, with no evidence of anastomotic leakage.</p> <p>Conclusions</p> <p>Results of this study justify more liberal use of primary repair in early management of colon injuries.</p> <p>Trial registration</p> <p>Current Controlled Trials ISRCTN94682396</p

6 Year Prospective Clinical Trial of Primary Repair Versus Diversion Colostomy in Colonic Injury Cases

Management pathway of colonic injury has been evolving over last three decades. There has been general agreement that surgical methods dealing with colonic injury did not affect the outcome but there are certain independent risk factors for complications. These risk factors are still not clear and studies are going on to specify these risk factors. The primary objective of this study was to demonstrate that primary closure of colonic injury without colostomy in selective patient is safe. This was a prospective study of 6 year duration. All the colonic injuries operated and divided into two groups: primary repair and colostomy. The criteria for exclusion of primary repair taken were; injury time >8 hour, patient need >4 unit of blood transfusion till surgery, devascularization injury of colon, any pre existing disease of bowel, any severe co morbid disease like uncontrolled diabetes mellitus, tuberculosis, malignancy etc. Both groups are analyzed by assessing complications with special emphasis on leak rate. Patients died within 72 hours of admission were excluded from study. Total 55 colonic injury cases operated and primary repair was done in 35 cases and colostomy in 20 cases. There was 1 mortality in colostomy group and no major morbidity in both groups. The complications in primary repair group were; 1 leak (treated conservatively), 5 wound infections 1 incisional hernia and 1 intra abdominal abscess. In colostomy group 8 cases of wound infections, 2 incisional hernias and 2 intra abdominal abscesses occurred. Primary repair of colon injuries can be safely done in selected patient

Ecological Specialization of Two Photobiont- Specific Maritime Cyanolichen Species of the Genus Lichina

22 páginas, 4 tablas, 4 figurasAll fungi in the class Lichinomycetes are lichen-forming and exclusively associate with cyanobacteria. Two closely related maritime species of the genus Lichina (L. confinis and L. pygmaea) show similar distribution ranges in the Northeast Atlantic, commonly co-occurring at the same rocky shores but occupying different littoral zones. By means of 16S rRNA and phycocyanin operon markers we studied a) the phylogenetic relationships of cyanobionts associated with these species, b) the match of divergence times between both symbionts, and c) whether Lichina species differ in photobiont association and in how geography and ecology affect selectivity. The cyanobionts studied are closely related to both marine and freshwater strains of the genus Rivularia.We found evidence of a high specificity to particular cyanobiont lineages in both species: Lichina pygmaea and L. confinis incorporate specific lineages of Rivularia that do not overlap at the haplotype nor the OTU levels. Dating divergences of the fungal and cyanobacterial partners revealed an asynchronous origin of both lineages. Within each fungal species, selectivity varied across the studied area, influenced by environmental conditions (both atmospheric and marine), although patterns were highly correlated between both lichen taxa. Ecological speciation due to the differential association of photobionts to each littoral zone is suspected to have occurred in marine Lichina.Both ROA (BES-2013-066105) and SPO (CTM2012-38222-C02-02) were supported in the form of salary by grants from the Spanish Ministry of Economy and Competitiveness.Peer reviewe