Histopathological analysis of vascular malformations

OBJECTIVE: To propose and develop a histopathological criteria to help diagnose vascular malformations. METHODS: All patients who underwent surgical resection and had a confirmed histopathological diagnosis of vascular malformations from 01 March 2018-26 February 2020 were included. A criteria based on 10 parameters was developed to help diagnose vascular malformations. Discrepancies between clinical and histopathological diagnosis were evaluated. RESULTS: A total of 18 cases were identified. There was a discrepancy between the clinical diagnosis and the initially reported histopathological diagnosis in 16 cases (88.9%). This was reduced to 7 (38.9%) and 6 cases (33.3%) with first and second time revised histopathological analysis using proposed criteria. CONCLUSIONS: The discrepancy between clinical and histopathological diagnoses of vascular malformations has highlighted the requirement of an agreed criteria for histopathologists to help formulate their diagnosis. The proposed criteria may be used as a guide in addressing this and guide treatment and improve clinical practice

Expression of Bcl-2 in node-negative breast cancer is associated with various prognostic factors, but does not predict response to one course of perioperative chemotherapy.

The aim of this study was to assess relationships between Bcl-2 expression, response to chemotherapy and a number of pathological and biological tumour parameters in premenopausal, lymph node-negative breast cancer patients. Expression of Bcl-2 was determined using immunohistochemistry on paraffin-embedded sections in a series of 441 premenopausal, lymph node-negative breast cancers of patients randomised to receive perioperative chemotherapy (5-fluorouracil, doxorubicin, cyclophosphamide) or no perioperative chemotherapy. Immunohistochemistry of Bcl-2 was evaluated by scoring both staining intensity (0-3) and number of positive cells (0-2). Using these scores tumours were grouped into categories 0-6. It was found that 9.2% of the tumours were completely negative (0), 17.2% weakly (1 + 2), 41.6% moderately (3 + 4) and 31.9% strongly positive (5 + 6) for Bcl-2. A positive correlation was found between high Bcl-2 expression and oestrogen (P < 0.001) and progesterone receptor positivity (P < 0.001) and low tumour grade (P < 0.001), whereas high Bcl-2 expression was negatively correlated with p53 (P < 0.001) and c-erb-B-2 positively (P < 0.001), high Ki-67 index (P < 0.001), mitotic index (P < 0.001) and large tumour size (P = 0.006). Patients with tumours expressing high levels of Bcl-2 (overall score 3-6) had a significantly better disease-free (P = 0.004) and overall (P = 0.009) survival. However, in a multivariate model this association no longer remained significant. There was a trend for an effect of adjuvant chemotherapy on disease-free survival both for patients with Bcl-2-positive (HR-0.61, 95% CI 0.35-1.06, P = 0.07) and negative (HR = 0.55, 95% CI 0.27-1.12, P = 0.09) breast tumours at a median follow-up of 49 months. The level of Bcl-2 expression does not seem to predict response to perioperative chemotherapy in premenopausal, lymph node-negative breast cancer patients. High levels of Bcl-2 are preferentially expressed in well-differentiated tumours and are associated with favourable prognosis. However, Bcl-2 expression is not an independent prognostic factor in this patient series

Impact of the burden of caregivers of children with ASD on oral health

Abstract Introduction the caregiver's demand to meet the needs of individuals with autism spectrum disorder (ASD) can influence their quality of life. Objective the objective of the present study was to compare the burden on caregivers of individuals with ASD with individuals neurotypical (N) and to evaluate the correlation of the impact of oral health with the burden on these caregivers. Material and method participants were divided into two groups: ASD Group (ASD; n=35) and Neurotypical Group (N; n=35). A sociodemographic characteristics questionnaire was administered to caregivers. Caregiver burden was measured using the Burden Interview (BI) questionnaire. The visible plaque index (VPI) of children was analyzed. The data were submitted to statistical analysis (α=5%). Result in the group ASD, the majority of participants were partially dependent, with the majority being dependent on oral hygiene. In group N, the majority were independent and self-sufficient in oral hygiene. Half of the caregivers in the group ASD felt mild to moderate burden (54.3%), while in group N it was found that more than half of them had no burden (65.7%). In the comparative analysis of data from the BI questionnaire, significant differences were observed between the groups in questions (p <0.001), which are directly related to childcare. Regarding the VPI of children in the group ASD and N groups compared to the level of burden, it was observed that there were no significant differences between the groups. Conclusion ASD caregivers have a greater burden when compared to N caregivers and the degree of burden did not influence the oral hygiene of the child with ASD

Les séries historiques entre la fiction et le réel : quand les scénaristes rivalisent avec les historiens

This article explores the links between the narratives that historians construct in their books and the narratives proposed by historic television series in order to bring to light how the latter can compete with the former. Its first part shows the assets at the disposition of authors of televised fictions to deal with the past in a particularly rich and vivid way, even more so than cinema. Its second part establishes that so-called historical series often draw from a work of memory rather than of history, precisely because the past is understood as living in an approach where affect wins out over reason. Its third part attempts to define a series that could be considered truly “historian”, which is to say constructed according to a perspective similar to that of historians towards their objects of study

Les séries historiques entre la fiction et le réel : quand les scénaristes rivalisent avec les historiens

Cet article explore les liens entre les récits que construisent les historiens dans leurs livres et ceux que nous proposent les séries télévisées historiques afin de mettre en lumière comment les seconds peuvent concurrencer les premiers. Sa première partie montre les atouts dont disposent les auteurs de fictions télévisées pour traiter du passé de manière particulièrement vivante et riche, plus encore qu’au cinéma. Sa deuxième partie établit que les séries dites historiques relèvent davantage d’un travail de mémoire que d’histoire puisque justement le passé est saisi comme vivant dans une démarche où l’affect l’emporte sur la raison. Sa troisième partie essaie de définir ce que serait une série véritablement « historienne », c’est-à-dire construite selon un regard similaire à celui que l’historien porte sur l’objet de son étude.This article explores the links between the narratives that historians construct in their books and the narratives proposed by historic television series in order to bring to light how the latter can compete with the former. Its first part shows the assets at the disposition of authors of televised fictions to deal with the past in a particularly rich and vivid way, even more so than cinema. Its second part establishes that so-called historical series often draw from a work of memory rather than of history, precisely because the past is understood as living in an approach where affect wins out over reason. Its third part attempts to define a series that could be considered truly “historian”, which is to say constructed according to a perspective similar to that of historians towards their objects of study

Evaluation of the effect of the use of fluid sensitive sequences on the classification of Modic type endplate changes in the lumbar spine

As alterações de sinal no osso subcondral dos corpos vertebrais foram descritas primeiramente por Modic, correlacionando o espectro das alterações da medula óssea no corpo vertebral relacionadas a discopatias degenerativas. O Modic tipo I representa a alteração de sinal do tipo edema, já o Modic II representa a alteração de sinal com padrão de lipossubstituição e o Modic III representa alteração de sinal relacionada a esclerose óssea. O objetivo primário deste estudo foi avaliar se há alteração na detecção dos padrões da classificação Modic na coluna lombar comparando a técnica Dixon com o protocolo tradicional. Como objetivo secundário avaliamos a correlação intra-observador e interobservador. O estudo foi realizado de forma retrospectiva com a inclusão de pacientes cujas ressonâncias magnéticas (RM) foram realizadas na Central de Diagnóstico Ribeirão Preto (CEDIRP). Dois médicos radiologistas de forma independente classificaram as alterações do tipo Modic permitindo uma avaliação interobservador e um dos radiologistas realizou uma segunda análise dos exames possibilitando uma avaliação intra-observador. Os resultados evidenciaram que a técnica Dixon apresentou superioridade na detecção do Modic I em todas as análises e também apresentou médias mais altas da espessura das alterações no osso subcondral. Houve correlações intra-observador moderadas e substanciais no protocolo tradicional e substanciais a altas com a técnica Dixon. A correlação interobservador demonstrou uma correlação moderada na avaliação deste tipo de alteração nos platôs superior e inferior de L3 e correlação inversa e não significativa para a o platô superior de L5 utilizando o protocolo tradicional. Já a correlação interobservador com a técnica Dixon evidenciou concordância perfeita entre os observadores na avaliação de tipo de alteração de sinal no osso subcondral do platô inferior de L1, correlação inversa para o platô inferior de L3 e superior de L4, correlação substancial entre o platô inferior de L2, platô inferior de L5 e superior de L5. Concluímos que a técnica Dixon apresentou superioridade na detecção do Modic I em relação ao protocolo tradicional, assim como permitiu detectar médias mais altas da espessura das alterações no osso subcondral. Também conclui-se que houve boa reprodutibilidade intra-observador e correlação interobservador variável entre os platôs vertebrais analisadosSignal changes in the subchondral bone of the vertebral bodies were first described by Modic, correlating the spectrum of bone marrow changes in the vertebral body to degenerative disc diseases. Modic type I represents the change of edema type signal, while Modic II represents the change of signal with liposubstitution pattern and Modic III represents signal change related to bone sclerosis. The main objective of this study was to evaluate if there is difference in the detection of Modic classification in the lumbar spine comparing the Dixon technique with the traditional protocol. We evaluated the intraobserver and interobserver correlation as a secondary objective. The study was performed retrospectively, including patients whose magnetic resonance imaging (MRI) was performed at the Ribeirão Preto Diagnostic Center (CEDIRP). Two radiologist physicians independently classified the Modic type endplate changes allowing an interobserver evaluation and one of the radiologists performed a second analysis of the exams making possible an intraobserver evaluation. The results showed that the Dixon technique presented superiority in the detection of Modic I in all the analyzes and also presented higher averages of the thickness of the alterations in the subchondral bone. There were moderate and substantial intraobserver correlations in the traditional protocol and substantial to high Dixon technique. The interobserver correlation was moderate in the evaluation of this type of alteration for the upper and lower plateau of L3 and inverse and nonsignificant for the upper plateau of L5 using the traditional protocol. On the other hand, the interobserver correlation with the Dixon technique showed perfect agreement among the observers in the evaluation of type of signal change in the subchondral bone of the lower plateau of L1, an inverse correlation for the lower plateau of L3 and higher of L4, a substantial correlation between the lower plateau of L2, lower of L5 and higher of L5. We conclude that the Dixon technique presented superiority in the detection of Modic I compared with the traditional protocol, as well as allowed the detection higher averages of the thickness of alterations in the subchondral bone. It was also concluded that there was good intraobserver reproducibility and a variable interobserver correlation between the vertebral plateaus analyze

Étude de la cinétique d’ablation en réacteur a lit fixe du système tétraoxyde d’azote liquide-diphénylamine solide

L’étude de l’influence de différents paramètres, notamment de l’écoulement et de la pression, sur la vitesse d’ablation VB de la diphénylamine solide par le tétraoxyde d’azote liquide en réacteur à lit fixe, a permis de mettre en évidence deux domaines séparés par une discontinuité dans les variations de la vitesse pour une pression de 4,5 bars :

Étude de la cinétique d’ablation, en réacteur à lit fixe, du système tétraoxyde d’azote liquide-diphénylamine solide

On présente une interprétation théorique des phénomènes observés avec le système tétraoxyde d’azote liquide-diphénylamine solide (1). On a adapté à ces résultats la théorie précédemment émise au laboratoire lors des études liquide-solide, théorie qui suppose l’existence d’une couche d’oxydant adsorbé à la surface du solide.Des expressions théoriques de la vitesse d’ablation sont également développées. Les représentations graphiques des transformées linéaires de ces expressions sont en bon accord avec l’expérience.L’influence de la température d’injection du tétraoxyde d’azote ainsi qu’un essai d’interprétation de la discontinuité observée dans les variations de la vitesse d’ablation sont en outre formulés