12 research outputs found

    Traditional Healing in the Contemporary Life of the Antanosy People of Madagascar

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    Traditional healing among the Antanosy people of southeastern Madagascar requires medicinal plants used by highly trained ombiasa (shamen). Given the influence of globalization, we hypothesized diminishing reliance on traditional medicine among the Antanosy. We studied a community and its healer’s views on the current value of traditional medicine compared to past decades and relationships between western medicine and traditional healing. Methods included interviews with ombiasa community members and participant observation. Traditional healing remained important. The numbers of ombiasa and apprentices were stable. Traditional and western medicine were complementary, providing the advantages of both without sacrificing traditional culture. Ombiasa linked the living to the ancestors who strongly influence contemporary Antanosy life. Without the ombiasa and their traditional knowledge of medicinal plants, people’s link to their ancestors, and the ancestors’ influence on the future, would disappear along with the plants essential to traditional healing

    Breast MRI during Neoadjuvant Chemotherapy: Lack of Background Parenchymal Enhancement Suppression and Inferior Treatment Response.

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    Background Suppression of background parenchymal enhancement (BPE) is commonly observed after neoadjuvant -chemotherapy (NAC) at contrast-enhanced breast MRI. It was hypothesized that nonsuppressed BPE may be associated with -inferior response to NAC. Purpose To investigate the relationship between lack of BPE suppression and pathologic response. Materials and Methods A retrospective review was performed for women with menopausal status data who were treated for breast cancer by one of 10 drug arms (standard NAC with or without experimental agents) between May 2010 and November 2016 in the Investigation of Serial Studies to Predict Your Therapeutic Response with Imaging and Molecular Analysis 2, or I-SPY 2 TRIAL (NCT01042379). Patients underwent MRI at four points: before treatment (T0), early treatment (T1), interregimen (T2), and before surgery (T3). BPE was quantitatively measured by using automated fibroglandular tissue segmentation. To test the hypothesis effectively, a subset of examinations with BPE with high-quality segmentation was selected. BPE change from T0 was defined as suppressed or nonsuppressed for each point. The Fisher exact test and the Z tests of proportions with Yates continuity correction were used to examine the relationship between BPE suppression and pathologic complete response (pCR) in hormone receptor (HR)-positive and HR-negative cohorts. Results A total of 3528 MRI scans from 882 patients (mean age, 48 years ± 10 [standard deviation]) were reviewed and the subset of patients with high-quality BPE segmentation was determined (T1, 433 patients; T2, 396 patients; T3, 380 patients). In the HR-positive cohort, an association between lack of BPE suppression and lower pCR rate was detected at T2 (nonsuppressed vs suppressed, 11.8% [six of 51] vs 28.9% [50 of 173]; difference, 17.1% [95% CI: 4.7, 29.5]; P = .02) and T3 (nonsuppressed vs suppressed, 5.3% [two of 38] vs 27.4% [48 of 175]; difference, 22.2% [95% CI: 10.9, 33.5]; P = .003). In the HR-negative cohort, patients with nonsuppressed BPE had lower estimated pCR rate at all points, but the P values for the association were all greater than .05. Conclusions In hormone receptor-positive breast cancer, lack of background parenchymal enhancement suppression may indicate inferior treatment response. © RSNA, 2021 Online supplemental material is available for this article. See also the editorial by Philpotts in this issue
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