The accuracy of sentinel lymph-node biopsy in breast cancer after previous excisional biopsy

Scopo: La biopsia del linfonodo sentinella (BLS) nel carcinoma della mammella con linfonodi ascellari clinicamente negativi \ue8 considerato la migliore scelta per stadiare il cavo ascellare. Inizialmente una precedente biopsia escissionale del carcinoma era considerata una controindicazione. Esaminiamo il tasso di successo della BLS e la incidenza della recidiva a livello ascellare in pazienti con carcinoma della mammella precedentemente sottoposti a biopsia escissionale del tumore. Pazienti e metodi: 858 pazienti con carcinoma della mammella sono stati sottoposti a BLS e i pazienti con linfonodi sentinella metastatici a svuotamento del cavo ascellare; 82 pazienti erano stati sottoposti precedentemente a biopsia escissionale del tumore. Risultati: Il linfonodo sentinella \ue8 stato identificato nel 100% dei casi, \ue8 risultato indenne nel 74,4% e metastatico nel 23,1%. La dissezione del cavo ascellare \ue8 stata effettuata in tutti i casi con linfonodi sentinella metastatici e nel 74% dei casi non si sono ritrovati altri linfonodi ascellari metastatici. Il follow-up mediano \ue8 stato di 63,5 mesi e non si sono osservate recidive ascellari. Conclusioni: L\u2019accuratezza del BLS in pazienti con carcinoma della mammella sottoposte precedentemente a biopsia escissionale \ue8 uguale a quella dei pazienti non sottoposti a biopsia.Aim: Sentinel node biopsy (SLNB) is considered to be the standard of care for staging the axilla in clinically node-negative women with breast cancer. A previous breast excisional biopsy has been considered a contraindication to the use of SLNB.We examined the success rate of SLN localization and then the evaluation of the incidence of axillary relapse in patients with breast cancer undergoing excisional biopsy. Patients and Methods: 858 patients with breast carcinoma underwent a SLNB and only positive sentinel nodes were submitted to axillary dissection; 82 patients had undergone an excisional biopsy before. Results: The sentinel node was identified in 100% of cases, it was negative in 74.4% and positive in 23.1%. Complete axillary dissection was performed in all positive cases, and in 74% of cases no other positive nodes were found. The follow-up median was 63.5 months and no axillary recurrence was observed. Conclusions: SLNB accuracy in breast cancer patients who have previously undergone excisional biopsy is comparable with that in patients undergoing no excisional biopsy, so that it may be considered a standard procedure

Molecular characterization of the autochthonous grape cultivars of the region Friuli Venezia Giulia – North-Eastern Italy

A sample of 48 accessions belonging to important autochthonous grapevine varieties from Friuli Venezia Giulia (North-Eastern Italy) was analyzed using two sets of microsatellite markers. One marker set, based on di-nucleotide core repeats, was compared with a recently developed set of markers based on tri-, tetra-, and penta-nucleotide repeats in order to determine genetic identities, estimate genetic diversity, and establish the power of discrimination of the two sets. A total of 20 di-nucleotide SSR markers and 19 tri-, tetra-, and penta-nucleotide SSR markers were used to screen the accessions.All 39 primers produced PCR amplicons that were polymorphic and easily scorable in all of the accessions studied. Both datasets allowed the discrimination of all cultivars but two ('Refosco di Runcis' and 'Refoscone'). The observed heterozygosity ranged from 0.21 to 1.0 for the di-nucleotide markers, and from 0.21 to 0.88 for the tri-, tetra-, and penta-nucleotide repeat motif microsatellites, respectively.The population structure of the 48 autochthonous accessions was evaluated, together with 8 international cultivars included as references, providing evidence for significant population structure within the sample. Microsatellites composed of tri-, tetra-, and penta-nucleotide repeats, characterized by low ‘stuttering’ and larger relative size differences between incremental alleles, are now available for grape fingerprinting.

Lesbian and bisexual women's human rights, sexual rights and sexual citizenship: negotiating sexual health in England.

Lesbian and bisexual women's sexual health is neglected in much Government policy and practice in England and Wales. This paper examines lesbian and bisexual women's negotiation of sexual health, drawing on findings from a small research project. Themes explored include invisibility and lack of information, influences on decision-making and sexual activities and experiences of services and barriers to sexual healthcare. Key issues of importance in this respect are homophobic and heterosexist social contexts. Drawing on understandings of lesbian, gay and bisexual human rights, sexual rights and sexual citizenship, it is argued that these are useful lenses through which to examine and address lesbian and bisexual women's sexual health and related inequalities

Behavioral Predictors of Colonization with Lactobacillus crispatus or Lactobacillus jensenii after Treatment for Bacterial Vaginosis: A Cohort Study

Objective: Evaluate predictors of vaginal colonization with lactobacilli after treatment for bacterial vaginosis (BV). Methods. Vaginal fluid specimens from women with BV underwent qPCR for Lactobacillus crispatus, L. jensenii, and L. iners pre- and posttreatment. Results. Few women with BV were colonized with L. crispatus (4/44, 9%) or L. jensenii (1/44, 2%), though all had L. iners. One month posttreatment 12/44 (27%) had L. crispatus, 12/44 (27%) L. jensenii, and 43/44 (98%) L. iners. Presence of L. jensenii posttreatment was associated with cure (Risk Ratio (RR) 1.67; 95% CI 1.09–2.56); L. crispatus showed a similar trend (RR 1.41; 95% CI 0.89–2.24, P = 0.14). Receptive oral sex was associated with 2.2-log10 lower concentration of L. crispatus (95% CI −4.38, −.02), and digital-vaginal sex with 2.6-log10 lower concentration (95% CI −4.87, −.33). Conclusion. One month after BV treatment, few women established colonization with L. crispatus or L. jensenii. Few behaviors were associated with colonization

Sexually transmitted infections: challenges ahead.

: WHO estimated that nearly 1 million people become infected every day with any of four curable sexually transmitted infections (STIs): chlamydia, gonorrhoea, syphilis, and trichomoniasis. Despite their high global incidence, STIs remain a neglected area of research. In this Commission, we have prioritised five areas that represent particular challenges in STI treatment and control. Chlamydia remains the most commonly diagnosed bacterial STI in high-income countries despite widespread testing recommendations, sensitive and specific non-invasive testing techniques, and cheap effective therapy. We discuss the challenges for chlamydia control and evidence to support a shift from the current focus on infection-based screening to improved management of diagnosed cases and of chlamydial morbidity, such as pelvic inflammatory disease. The emergence and spread of antimicrobial resistance in Neisseria gonorrhoeae is globally recognised. We review current and potential future control and treatment strategies, with a focus on novel antimicrobials. Bacterial vaginosis is the most common vaginal disorder in women, but current treatments are associated with frequent recurrence. Recurrence after treatment might relate to evidence that suggests sexual transmission is integral to the pathogenesis of bacterial vaginosis, which has substantial implications for the development of effective management approaches. STIs disproportionately affect low-income and middle-income countries. We review strategies for case management, focusing on point-of-care tests that hold considerable potential for improving STI control. Lastly, STIs in men who have sex with men have increased since the late 1990s. We discuss the contribution of new biomedical HIV prevention strategies and risk compensation. Overall, this Commission aims to enhance the understanding of some of the key challenges facing the field of STIs, and outlines new approaches to improve the clinical management of STIs and public health.<br/

Mucinous breast cancer: A narrative review of the literature and a retrospective tertiary single-centre analysis

We reviewed literature and our data to find out mucinous breast cancer's overall survival (OS), disease free survival (DFS) and if there are differences between pure mucinous breast cancer and mixed mucinous breast cancer in terms of OS and DFS

Single-Dose Zoliflodacin (ETX0914) for Treatment of Urogenital Gonorrhea

BACKGROUND Antibiotic-resistant Neisseria gonorrhoeae has prompted the development of new therapies. Zoliflodacin is a new antibiotic that inhibits DNA biosynthesis. In this multicenter, phase 2 trial, zoliflodacin was evaluated for the treatment of uncomplicated gonorrhea. METHODS We randomly assigned eligible men and women who had signs or symptoms of uncomplicated urogenital gonorrhea or untreated urogenital gonorrhea or who had had sexual contact in the preceding 14 days with a person who had gonorrhea to receive a single oral dose of zoliflodacin (2 g or 3 g) or a single 500-mg intramuscular dose of ceftriaxone in a ratio of approximately 70:70:40. A test of cure occurred within 6±2 days after treatment, followed by a safety visit 31±2 days after treatment. The primary efficacy outcome measure was the proportion of urogenital microbiologic cure in the microbiologic intention-to-treat (micro-ITT) population. RESULTS From November 2014 through December 2015, a total of 179 participants (167 men and 12 women) were enrolled. Among the 141 participants in the micro-ITT population who could be evaluated, microbiologic cure at urogenital sites was documented in 55 of 57 (96%) who received 2 g of zoliflodacin, 54 of 56 (96%) who received 3 g of zoliflodacin, and 28 of 28 (100%) who received ceftriaxone. All rectal infections were cured in all 5 participants who received 2 g of zoliflodacin and all 7 who received 3 g, and in all 3 participants in the group that received ceftriaxone. Pharyngeal infections were cured in 4 of 8 participants (50%), 9 of 11 participants (82%), and 4 of 4 participants (100%) in the groups that received 2 g of zoliflodacin, 3 g of zoliflodacin, and ceftriaxone, respectively. A total of 84 adverse events were reported: 24 in the group that received 2 g of zoliflodacin, 37 in the group that received 3 g of zoliflodacin, and 23 in the group that received ceftriaxone. According to investigators, a total of 21 adverse events were thought to be related to zoliflodacin, and most such events were gastrointestinal. CONCLUSIONS The majority of uncomplicated urogenital and rectal gonococcal infections were successfully treated with oral zoliflodacin, but this agent was less efficacious in the treatment of pharyngeal infections

The SPORTSMART study: a pilot randomised controlled trial of sexually transmitted infection screening interventions targeting men in football club settings

Background: Uptake of chlamydia screening by men in England has been substantially lower than by women. Non-traditional settings such as sports clubs offer opportunities to widen access. Involving people who are not medically trained to promote screening could optimise acceptability. Methods: We developed two interventions to explore the acceptability and feasibility of urine-based sexually transmitted infection (STI) screening interventions targeting men in football clubs. We tested these interventions in a pilot cluster randomised control trial. Six clubs were randomly allocated, two to each of three trial arms: team captain-led and poster STI screening promotion; sexual health adviser-led and poster STI screening promotion; and poster-only STI screening promotion (control/comparator). Primary outcome was test uptake. Results: Across the three arms, 153 men participated in the trial and 90 accepted the offer of screening (59%, 95% CI 35% to 79%). Acceptance rates were broadly comparable across the arms: captain-led: 28/56 (50%); health professional-led: 31/46 (67%); and control: 31/51 (61%). However, rates varied appreciably by club, precluding formal comparison of arms. No infections were identified. Process evaluation confirmed that interventions were delivered in a standardised way but the control arm was unintentionally ‘enhanced’ by some team captains actively publicising screening events. Conclusions: Compared with other UK-based community screening models, uptake was high but gaining access to clubs was not always easy. Use of sexual health advisers and team captains to promote screening did not appear to confer additional benefit over a poster-promoted approach. Although the interventions show potential, the broader implications of this strategy for UK male STI screening policy require further investigation

Ancient DNA from domestic animal species remains : preliminary approaches

DNA analysis from ancient and old remains offers new tools to answer archaeozoological questions and investigate the origin of the genetic variability in domestic animal species. Molecular genetics techniques contribute to identify the species supporting classical osteological studies and to establish the relationship to modern species and breeds. Mitochondrial DNA (mtDNA) sequences are useful to reconstruct the history of maternal lineages comparing haplotype variations of present and old DNA samples. Mitochondrial data from modern cattle populations show a high diversity in Anatolia and in the Middle East supporting a near-Eastern matrilineal centre of origin. On the contrary in Europe a single family of mitochondrial haplotypes strongly dominates. A number of recent studies reported the successful recovery of ancient and old nuclear DNA (nuDNA) sequences. Such studies represent an important breakthrough, as nuDNA can be used for the characterisation of genetic loci directly involved in phenotypic traits, answering challenging questions. A bright example is offered by the study on the single nuclear exon of melanocortin type 1 receptor gene from a ca. 43,000 years old mammoth bone from Siberia, showing that mammoth populations were polymorphic with regard to hair colour, harbouring both dark and light haired animals. In contrast, these studies on ancient and old DNA sequences need great caution, due to the analytical problems caused by post-mortem damage of DNA, contamination from exogenous sources of mt- and nuDNA, and the consequent reliability of observed polymorphisms. The present research describes the preliminary analytical approach to DNA study of faunal remains (103 animal bones of different domestic species: Bos taurus 51; Ovis aries/Capra hircus 39; Sus scrofa/Sus domesticus 10; Gallus gallus 1; Equus caballus/Equus sp. 2), collected in seven archaeological sites located within the province of Trento, in the Alpine region of Trentino Alto-Adige (N-E Italy). The chosen sites, dating from the Bronze Age to the late Middle Ages, display different settlement typology and include Iron Age retic houses, votive Bronze Age contexts, a 4th century roman villa and several 13th century medieval buildings. Archaeozoological data will be collected on species, skeletal parts, age of slaughter, method of butchery, evidence of bone working and presence of paleopathologies. We describe the analytical procedure used in preparing and collecting samples and in extracting and analysing DNA from a subset of the bones previously described

Data acquisition system for a proton imaging apparatus

New developments in the proton-therapy field for cancer treatments, leaded Italian physics researchers to realize a proton imaging apparatus consisting of a silicon microstrip tracker to reconstruct the proton trajectories and a calorimeter to measure their residual energy. For clinical requirements, the detectors used and the data acquisition system should be able to sustain about 1 MHz proton rate. The tracker read-out, using an ASICs developed by the collaboration, acquires the signals detector and sends data in parallel to an FPGA. The YAG:Ce calorimeter generates also the global trigger. The data acquisition system and the results obtained in the calibration phase are presented and discussed