Male Breast Cancer Presenting as Nipple Discharge

Male breast cancer (MBC) is a rare disease and constitutes less than 1% of all breast carcinoma cases. Although MBC most often presents with a palpable mass, failure to recognise the significance of other symptoms may lead to a delay in diagnosis. Nipple discharge (ND) is a rare symptom in men, but it may herald an underlying malignancy. We present two cases of (MBC) presenting with ND and emphasise the importance of this clinical sign in suspecting underlying malignancy and an opportunity for early diagnosis. We also discuss the clinical significance of ND in men in relation to current literature

Morphology of the Esophageal Hiatus: Is It Different in 3 Types of Hiatus Hernias?

Background/aimsThe esophageal hiatus is formed by the right crus of the diaphragm in the majority of subjects. Contraction of the hiatus exerts a sphincter-like action on the lower esophageal sphincter (LES). The aim is to study the hiatal anatomy (using CT scan imaging) and function (using high-resolution manometry [HRM]), and esophageal motor function in patients with sliding and paraesophageal hiatal hernia.MethodsWe assessed normal subjects (n = 20), patients with sliding type 1 hernia (n = 18), paraesophageal type 2 hernia (n = 19), and mixed type 3 hernia (n = 19). Hernia diagnosis was confirmed on the upper gastrointestinal series. The hiatal morphology was constructed from the CT scan images. The LES pressure and relaxation, percent peristalsis, bolus pressure, and hiatal squeeze pressure were assessed by HRM.ResultsThe CT images revealed that the esophageal hiatus is formed by the right crus of the diaphragm in all normal subjects and 86% of hernia patients. The hiatus is elliptical in shape with a surface area of 1037 mm2 in normal subjects. The hiatal dimensions were larger in patients compared to normal subjects. The HRM revealed impaired LES relaxation and higher bolus pressure in patients with paraesophageal compared to the sliding hernia. The hiatal pinch on HRM was recognized in significantly higher number of patients with sliding as compared to paraesophageal hernia.ConclusionsUsing a novel approach, we provide details of the esophageal hiatus in patients with various kinds of hiatal hernia. Impaired LES relaxation in paraesophageal hernia may play a role in its pathophysiology and genesis of symptoms

The Importance of Attributional Trust to Corporate Reputation

This article proposes the simplified trust-reputation model that relates attributional trust and issue resolution to corporate reputation. In effect, individuals on a project are very forgiving of supply chain members with regard to issues because of concern for their company's reputation. Hence, while trust may vary, there was no breakdown in trust because this would affect their company's reputation as a good partner. Furthermore, although there was a reported variance in trust by the project managers, it did not affect the project's outcome, but it did affect the ease of doing business

Movement patterns of cheetahs ( Acinonyx jubatus ) in farmlands in Botswana

Botswana has the second highest population of cheetah (Acinonyx jubatus) with most living outside protected areas. As a result, many cheetahs are found in farming areas which occasionally results in human-wildlife conflict. This study aimed to look at movement patterns of cheetahs in farming environments to determine whether cheetahs have adapted their movements in these human-dominated landscapes. We fitted high-time resolution GPS collars to cheetahs in the Ghanzi farmlands of Botswana. GPS locations were used to calculate home range sizes as well as number and duration of visits to landscape features using a time-based local convex hull method. Cheetahs had medium-sized home ranges compared to previously studied cheetah in similar farming environments. Results showed that cheetahs actively visited scent marking trees and avoided visiting homesteads. A slight preference for visiting game farms over cattle farms was found, but there was no difference in duration of visits between farm types. We conclude that cheetahs selected for areas that are important for their dietary and social needs and prefer to avoid human-occupied areas. Improved knowledge of how cheetahs use farmlands can allow farmers to make informed decisions when developing management practices and can be an important tool for reducing human-wildlife conflict

Precise charm to strange mass ratio and light quark masses from full lattice QCD

By using a single formalism to handle charm, strange and light valence quarks in full lattice QCD for the first time, we are able to determine ratios of quark masses to 1%. For $m_c/m_s$ we obtain 11.85(16), an order of magnitude more precise than the current PDG average. Combined with 1% determinations of the charm quark mass now possible this gives $\bar{m}_s(2{\rm GeV}) =$ 92.4(1.5) MeV. The MILC result for $m_s/m_l = 27.2(3)$ yields $\bar{m}_l(2{\rm GeV})$ = 3.40(7) MeV for the average of $u$ and $d$ quark masses.Comment: 4 pages, 2 figures. Version accepted by Physical Review Letters. Changes include modifying the title, using the MILC value for m_s/m_l which changes slightly the resulting up and down quark masses and their average, adding some references and making other small adjustments to the text for space reasons

Radiative corrections to the lattice gluon action for highly improved staggered quarks (HISQ) and the effect of such corrections on the static potential

We perform a perturbative calculation of the influence of dynamical HISQ fermions on the perturbative improvement of the gluonic action in the same way as we have previously done for asqtad fermions. We find the fermionic contributions to the radiative corrections in the Luescher-Weisz gauge action to be somewhat larger for HISQ fermions than for asqtad. Using one-loop perturbation theory as a test, we estimate that omission of the fermion-induced radiative corrections in dynamical asqtad simulations will give a measurable effect. The one-loop result gives a systematic shift of about -0.6% in (r_1/a) on the coarsest asqtad improved staggered ensembles. This is the correct sign and magnitude to explain the scaling violations seen in Phi_B on dynamical lattice ensembles.Comment: 10 pages, 5 figures. Minor corrections suggested by refere

Ogilvie's syndrome with caecal perforation after Caesarean section: a case report

<p>Abstract</p> <p>Introduction</p> <p>Ogilvie's syndrome describes the phenomenon of an acute colonic pseudo-obstruction without a mechanical cause. It is rare but has been reported to occur after Caesarean section. It can lead to bowel perforation or ischaemia.</p> <p>Case presentation</p> <p>A healthy, 28-year-old Caucasian woman presented 2 weeks past her expected date of delivery for her first pregnancy. She underwent an uncomplicated elective Caesarean section but developed abdominal pain and bloating postoperatively and was subsequently diagnosed with acute colonic pseudo-obstruction, also known as Ogilvie's syndrome.</p> <p>Conclusion</p> <p>This case report highlights the rare, but potentially dangerous, diagnosis of Ogilvie's syndrome after Caesarean section. It is of particular interest to obstetricians, midwifery staff and general surgeons and shows the importance of accurate diagnosis, regular abdominal reassessment and early senior input to ensure appropriate and rapid treatment.</p

Ascertaining women’s preferred mode of address and preferred choice of title during pregnancy and childbirth

To determine how women in pregnancy would like to be addressed and to ascertain their preferred choice of title during pregnancy. A questionnaire was administered to 925 antenatal women. Midwifery and medical staff (183) were invited to respond to a similar questionnaire.The response rate was 71.2% from the survey of pregnant women. The vast majority (82.1%) preferred to be addressed by their first name. Women were in favour of being called ’patient’ (32.8%) as their first choice. The staff survey yielded a response rate of 77%. The majority (81.8%) of health professionals preferred to address women by their first name. ’Mother’ (28.7%) was the most popular first choice. We conclude that women in pregnancy do have a preference on how they would like to be addressed and this is predominantly by first name. Health professionals also prefer to call pregnant women by their first name. The term ’patient’ was the most popular first choice of title of women in pregnancy but the term ’mother’ was the preferred choice of the health professionals. Medical staff were more likely to choose ’patient’ than midwives