Responding to objections to gatekeeping for hormone replacement therapy

Florence Ashley has responded to our response to ‘Gatekeeping hormone replacement therapy for transgender patients is dehumanising.’ Ashley criticises some of our objections to their view that patients seeking hormone replacement therapy (HRT) for gender dysphoria should not have to undergo a prior psychological assessment. Here we clarify our objections, most importantly that concerning the parity between cosmetic surgery and the sort of intervention Ashley has in mind. Firstly, we show Ashley’s criticism of our comparison is insubstantial. We then examine their comments regarding the analogy between abortion and HRT, and the language of informed consent. We also scrutinize the data upon which Ashley relies to defend the claim that informed consent without assessment always yields positive outcomes, finding this conclusion to be overstated. Finally, even if Ashley’s arguments were vindicated, the claim that the gatekeeping of HRT is motivated by hostility towards transgender people remains unsupported

Levofloxacin-Based Triple Therapy versus Bismuth-Based Quadruple Therapy for Persistent Helicobacter pylori Infection: A Meta-Analysis

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/73094/1/j.1572-0241.2006.00637.x.pd

Benign paravertebral cyst of Hattori: A case report and review of literature

Hideo Hattori reported the first case of a mediastinal cyst with features characteristic of a Mullerian cyst in 2005. He presented a case of an 18-year-old woman who presented with an abnormal shadow on chest X-ray film during medical examination and who had no other anatomic abnormalities or clinical problems. We present a case of benign cyst within the mediastinum in the left paravertebral space at the level of the aortic arch in a 56-year-old woman. This patient was being investigated for unexplained shortness of breath and dry cough. As at the time writing this report, to our knowledge, this is the first case report of Hattori cyst in the United Kingdom (UK) following literature search

Primary lung cancer with metastasis to the ipsilateral breast-a case report

The metastasis of extra-mammary malignancy to breast is extremely rare; literature reports the incidence between 0.4-1.3%. Primary sites include the contralateral breast, leukaemia, lymphoma, malignant melanoma, sarcoma, lung, prostate, ovary, colon and the stomach. Here we present a rare case in which lung cancer was found to metastasise to the breast. Initially the patient presented with chest symptoms and a left breast lump was detected clinically. The radiological and histological investigations confirmed the diagnosis of primary lung cancer with breast metastases. Prognosis of such cases is generally poor

Ki-67 proliferative index correlation to the immunohistochemistry profile in early female breast cancer: a review of 515 cases

Introduction: Many biological markers are used as prognostic and predictive indicators in invasive breastcancers management. Among them, tumour size, grade, patho-morphological subtype, hormone receptorsstatus and HER2 receptor expression in addition to Ki-67 proliferative index. Also, they play a key role inadjuvant treatment decision making. Our aim was to evaluate the association between Ki-67 proliferativeindex and breast cancer immunological subtype.Material and methods: A total of 515 early invasive patients were enrolled, tumour biological characteristicsas histopathological subtype, immune-histo-chemistry (ER,PR,HER2) status and Ki-67 proliferation indexvalues have been collected. The Ki-67 index level of 20%, was used as the cut-off point to differentiatebetween low and high Ki-67 expression levels. Statistical analysis has been performed using the Chisquare test online tool.Results: In this cohort, about 42%, 33%, 7%, and 18% of the cases were grouped as luminal A-like, luminalB-like, HER2 enriched subtype, and triple-negative, respectively. All luminal A-like patients had Ki-67 levelless than 20%. About 3% of the cohort, are luminal B-like tumours with Ki-67 level less than 20%, where30.3% of the patients were luminal B-like tumours with Ki-67 level ≥ 20%. In HER2 enriched subtype, Ki-67 of < 20% level seen in 1.9% of cases, and Ki-67 levels ≥ 20% was observed in 5.2% of the cases. Inthe triple-negative group, Ki-67 was 20% or higher in 16% of cases, and only 1.7% of patients had Ki-67level less than 20%.Conclusion: Luminal A-like tumours were the most frequently encountered subtype, they have low Ki-67levels and are known to be of a low histological grade tumour, and usually associated with a good prognosis.Also, data indicates that high Ki-67 levels are seen more often in Luminal B-Like breast cancers aswell as in triple-negative breast cancers and HER2 enriched tumours

A moving grid finite element method applied to a model biological pattern generator

Many problems in biology involve growth. In numerical simulations it can therefore be very convenient to employ a moving computational grid on a continuously deforming domain. In this paper we present a novel application of the moving grid finite element method to compute solutions of reaction–diffusion systems in two-dimensional continuously deforming Euclidean domains. A numerical software package has been developed as a result of this research that is capable of solving generalised Turing models for morphogenesis

The Rare Diagnosis of Synchronous Breast and Colonic Cancers: A Case Report and Review of Literature

Any two or more primary malignant tumors, in which each tumor is not an extension, recurrence, or metastasis of the other lesion, are defined or described as multiple primary malignant neoplasms (MPMN). These tumors are increasingly diagnosed despite their rare occurrence rate. The term synchronous tumors is applied if two different tumors originating in the same patient are detected at the same time or within six months; if the second tumor is detected beyond six months, it is called metachronous. Aetiological factors that may predispose patients to MPMNs have been grouped into three broad categories: familial cancer syndromes and other genetic susceptibility factors, common exposures (e.g. tobacco), and carcinogenic effects of cancer treatment. The likelihood of missing asymptomatic synchronous tumors at the time of diagnosis is due to a lack of definitively set guidelines for synchronous tumors. Studying every individual case may aid us in understanding disease biology, developing diagnostic guidelines, and establishing patient-specific management strategies. We present a case report of synchronous breast and colonic cancer in a female patient