Fine-needle Aspiration Biopsy For Breast Lesions: A Comparison Between Two Devices For Obtaining Cytological Samples

Context and Objective: Fine-needle aspiration biopsy has been accepted worldwide for breast lesions. However, some questions remain, including the appropriateness of the puncture method. The objective of this work was to compare aspirates obtained by the auto-vacuum device and by the syringe pistol holder. Design and Setting: Randomized trial for validation of diagnostic method, at Hospital das Clinicas do Universidade Federal de Goiás and Hospital Araújo Jorge, Goiânio. Methods: 351 patients presenting breast lumps underwent fine-needle aspiration biopsy, either with the auto-vacuum device or the syringe pistol holder. A single cytopathologist analyzed all of the cytology slides. The rates of insufficient material, cellularity, cell distortion and background hemorrhage were evaluated. Results: The percentages of insufficient material were 16% and 22% (p = 0.18), for the auto-vacuum and pistol aspirates, respectively. Good cellularity was seen in 34% of autovacuum and 29% of pistol samples (p = 0.4). Cell distortion was seen in 31 and 26 cases, respectively (p = 07). Background hemorrhage occurred in 63 (35%) and 54 cases (31%) (p = 0.2), for auto-vacuum and pistol. The sensitivity was 88% and 86%; specificity 99% and 100%, positive predictive value 96% and and 100%, negative predictive value 96% and 95% and total occuracy 76% and 75% for the auto-vacuum and pistol, respectively. Conclusion: The results obtained from the two fine-needle aspiration biopsy methods were equivalent. Therefore, the auto-vacuum device is a good option for obtaining aspirates for cytology.1236271276Catania, S., Ciatto, S., Breast cytology: Instruments and technique (1992) Breast Cytology in Clinical Practice, pp. 11-60. , In: Ciatto S, editor. London: Martin DunitzDe Freitas Jr., R., Hamed, H., Fentiman, I., Fine needle aspiration cytology of palpable breast lesions (1992) Br J Clin Pract, 46 (3), pp. 187-190Franzen, S., Zajicek, J., Aspiration biopsy in diagnosis of palpable lesions of the breast. Critical review of 3479 consecutive biopsies Acta (1968) Radiol Ther Phys Biol, 7 (4), pp. 241-262Souza, J.A., Freitas Jr., R., Moreita, M.A.R., Philocreon, G.R., Acurácia da sensação tátil da PAAF no diagnóstico de less̄ocs mamárias (1995) Rev Bras Mastologia, 5 (3), pp. 7-10Freitas Júnior, R., Hamed, H., Millis, R.R., Tomas, N.M.A., Fentiman, I.S., Fine needle aspiration of breast lesions using auto-vacuum dispositive (1996) Rev Bras Mastologia, 6 (3), pp. 126-128de Freitas Júnior, R., Giraldo, P.C., Rerrori, O., Vieira-Matos, A.N., Tambascia, J.K., Fine needle aspiration biopsy of solid tumours by auto-vacuum system: A study in rats (1992) Eur J Surg Oncol, 18 (6), pp. 605-607Boccato, P., How to treat the aspirated material (1992) Breast Cytology in Clinical Practice, pp. 61-64. , In: Ciatto, S, editor London: Martin Dunitz(1987) International Union Against Cancer, , UICC. TNM classification of malignant tumors. Berlin: Springer-Verlag(1982) Am J Clin Pathol, 78 (6), pp. 806-816. , The World Health Organization Histological Typing of Breast Tumors - Second Edition. The World OrganizationGelabert, H.A., Hsiu, J.G., Mullen, J.T., Jaffe, A.H., D'Amato, N.A., Prospective evaluation of the rate of fine-needle aspiration biopsy in the diagnosis and management of patiencs with palpable solid breast lesions (1990) Am Surg, 56 (4), pp. 263-267Rouquayrol, M.Z., Epidemiologia e saúde (1988), Rio de Janeiro: Medsi - Editora CientíficaRoberts, J.C., Rainsbury, R.M., 'Tactile sensation: A new clinical sign during fine needle aspiration of breast lumps Ann (1994) R Coll Surg Eng, 76 (2), pp. 136-138Henderson, M.A., McCready, D.R., A simple technique for fine needle aspiration cytology (1994) J Am Coll Surg, 179 (4), pp. 471-473Sasaki, J., Izu, K., Automatic fine needle aspiration pistol specially designed for small tumors (1998) Acta Cytol, 42 (3), pp. 829-830Tao, L.C., Smith, J.W., Fine-needle aspiration biopsy using a newly-developed pencil-grip syringe holder (1999) Diagn Cytopathol, 20 (2), pp. 99-104Parel, J.J., Garrell, P.C., Smallwood, J.A., Fine needle aspiration cytology of breast masses: An evaluation of its accuracy and reasons for diagnostic failure (1987) Ann R Coll Surg Engl, 69 (4), pp. 156-159Abele, J., Stanley, M.W., Rollnis, S.D., Miller, T.R., What constitutes an adequate smear in fine-needle aspiration cytology of the breast? (1998) Cancer, 84 (1), pp. 57-61Zajdela, A., Ghossein, N.A., Pilleron, J.P., Ennuyer, A., The value of aspiration cytology in the diagnosis of breast cancer: Experience at the Fondation Curie (1975) Cancer, 35 (2), pp. 499-506Layfield, L.J., Dodd, L.G., Cytologically low grade malignancies: An important interpretative pitfall responsible for false negative diagnoses in fine-needle aspiration of the breast (1996) Diagn Cytopathol, 15 (3), pp. 250-259Feichter, G.E., Haberthür, F., Gobat, S., Dalquen, P., Breast cytology. Statistical analysis and cytohistologic correlations (1997) Acta Cytol, 41 (2), pp. 327-332Arisio, R., Cuccorese, C., Accinelli, G., Mano, M.P., Bordon, R., Fessia, L., Role of fine-needle aspiration biopsy in breast lesions: Analysis of a series of 4,110 cases (1998) Diagn Cytopathol, 18 (6), pp. 462-467Ariga, R., Bloom, K., Reddy, V.B., Fine-needle aspiration of clinically suspicious palpable breast masses with histopathologic correlation (2002) Am J Surg, 184 (5), pp. 410-41

A Spectral Bernstein Theorem

We study the spectrum of the Laplace operator of a complete minimal properly immersed hypersurface $M$ in $\R^{n+1}$. (1) Under a volume growth condition on extrinsic balls and a condition on the unit normal at infinity, we prove that $M$ has only essential spectrum consisting of the half line $[0, +\infty)$. This is the case when $\lim_{\tilde{r}\to +\infty}\tilde{r}\kappa_i=0$, where $\tilde{r}$ is the extrinsic distance to a point of $M$ and $\kappa_i$ are the principal curvatures. (2) If the $\kappa_i$ satisfy the decay conditions $|\kappa_i|\leq 1/\tilde{r}$, and strict inequality is achieved at some point $y\in M$, then there are no eigenvalues. We apply these results to minimal graphic and multigraphic hypersurfaces.Comment: 16 pages. v2. Final version: minor revisions, we add Proposition 3.2. Accepted for publication in the Annali di Matematica Pura ed Applicata, on the 05/03/201

POLAR registry (Promus eluting stent registry in Latin America ):1 year follow-up results

BACKGROUND: Drug-eluting stents have been used since 2002 in different patient populations aiming to achieve high success rates with low clinical and angiographic restenosis rates. With the late thrombosis adverse events associated to the first generation sirolimus and paclitaxel-eluting stents, second-generation everolimus and zotarolimus-eluting stents has been recently developed. METHODS: The POLAR registry is a prospective, non-randomized, multicenter study, which included 988 patients, totaling 1,362 lesions treated with the everolimus-eluting stent Promus®. In order to represent the clinical practice, almost all subtypes of patients and lesions were included in this registry. Clinical follow-up was planned to be performed 1, 6, 12 and 24 months after the procedure. RESULTS: Most patients were male (69.8%), with mean age of 64.9 ± 9.4 years, 35.2% were diabetics and 55% had been treated for acute coronary syndrome. Vessel diameter was 2.95 ± 0.43 mm and lesion extension was 20.5 ± 5.6 mm. A total of 1.14 ± 0.38 stent/patient were implanted and the procedural success rate was 96.6%. Major adverse cardiac events occurred in 4.5% of patients, and stent thrombosis was observed in 5 patients (0.5%) after a clinical follow-up of 12 months. CONCLUSIONS: The present registry suggests that everolimus-eluting stents are safe and effective in daily clinical practice patients, with a low rate of major adverse cardiac events at the end of the first year of follow-up.INTRODUÇÃO: Desde 2002, os stents farmacológicos são utilizados em diversas populações de pacientes objetivando alcançar elevados índices de sucesso, com baixas taxas de reestenose angiográfica e clínica. Com os resultados adversos em relação à trombose tardia associados aos stents farmacológicos de primeira geração eluidores de sirolimus e paclitaxel, surgiram recentemente os stents farmacológicos de segunda geração eluidores de zotarolimus e everolimus. MÉTODOS: O registro POLAR é um registro prospectivo, não-randomizado, multicêntrico, que incluiu 988 pacientes totalizando 1.362 lesões tratadas com o stent Promus®. Objetivando representar a prática clínica, praticamente todos os subtipos de pacientes e lesões foram incluídos neste registro. O seguimento clínico foi planejado para ser realizado 1 mês, 6 meses, 12 meses e 24 meses após o procedimento. RESULTADOS: A maioria dos pacientes era do sexo masculino (69,8%), com média de idade de 64,9 ± 9,4 anos, 35,2% eram diabéticos e 55% tinham sido tratados na vigência de síndrome coronária aguda. O diâmetro do vaso foi de 2,95 ± 0,43 mm e a extensão da lesão, de 20,5 ± 5,6 mm. Foi implantado 1,14 ± 0,38 stent/paciente e o sucesso do procedimento foi alcançado em 96,6% dos casos. Eventos cardíacos adversos maiores ocorreram em 4,1% dos pacientes, e trombose de stent esteve presente em 5 pacientes (0,5%) após o seguimento clínico de 12 meses. CONCLUSÕES: O presente registro sugere que os stents farmacológicos eluidores de everolimus são seguros e eficazes em pacientes da prática clínica diária, com baixas taxas de eventos cardíacos adversos maiores ao término do primeiro ano de seguimento.Universidade Federal de São Paulo (UNIFESP)Instituto Dante Pazzanese de CardiologiaStatus CorHospital Israelita Albert EinsteinENCORE Hospital Lúcio RebeloReal e Benemérita Associação Portuguesa de BeneficênciaHospital Cardiológico CostantiniHemodinâmica Meridional Intercath MeridionalInstituto de Cardiologia do Espírito SantoFundação Universitária de Cardiologia Instituto de Cardiologia do Rio Grande do SulUNIFESPSciEL

Genetic transformation of Citrus sinensis with Citrus tristeza virus (CTV) derived sequences and reaction of transgenic lines to CTV infection

Transgenic Citrus sinensis (L.) Osb. plants, cvs. Valencia and Hamlin, expressing Citrus tristeza virus (CTV) derived sequences were obtained by genetic transformation. The gene constructs were pCTV-CP containing the 25 kDa major capsid protein gene (CTV-CP), pCTV-dsCP containing the same CTV-CP gene in an intron-spliced hairpin construct, and pCTV-CS containing a 559 nt conserved region of the CTV genome. The transgenic lines were identified by PCR and the transgene integration was confirmed by Southern blot. Transgene mRNA could be detected in most transgenic lines containing pCTV-CP or pCTV-CS transgene. The mRNA of pCTV-dsCP transgene was almost undetectable, with very light bands in most analyzed plants. The transgene transcription appears to be closely linked to the type of gene construct. The virus challenge assays reveals that all transgenic lines were infected. However, it was possible to identify propagated clones of transgenic plants of both cultivars studied with a low virus titer, with values similar to the non-inoculated plants (negative control). These results suggested that the transgenic plants present some level of resistance to virus replication. The higher number of clones with low virus titer and where mRNA could not be detected or was presented in a very light band was found for pCTV-dsCP-derived transgenic lines561162166CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPsem informaçã

A influência do sexo e da idade na prevalência de bolsas periodontais

The aim of this study was to evaluate the influence of risk factors on the prevalence of periodontal pockets in patients attending the clinic of the School of Dentistry of Piracicaba - Unicamp. The sample consisted of 100 patients attended by the students from the third and fourth years of undergraduation. The data were taken from anamneses and clinical - periodontal records. Probing depths were considered to be 3, 5, 7 and 10 mm, according to the WS diagnosis system (SALLUM, 1996). The results were compared regarding pockets depths and the risk factors age and gender. Also, the distribution of pockets among the sextants was observed. This study indicated a major prevalence of periodontal pockets in men and an increase in probing depth in patients older than 31 years. The distribution of pockets among the sextants was relatively uniform in all studied groups.Este trabalho teve como objetivo avaliar a influência dos fatores de risco na prevalência de bolsas periodontais em pacientes atendidos na clínica do terceiro e quarto anos da Faculdade de Odontologia de Piracicaba - Unicamp. Foram avaliados 100 pacientes através do levantamento dos dados contidos nas fichas clínico-anamnésicas, sendo consideradas bolsas de profundidade: 3 mm, 5 mm, 7 mm e 10 mm, de acordo com o sistema diagnóstico WS (SALLUM; SALLUM27, 1996). Os resultados foram comparados entre as profundidades de sondagem e as variáveis idade, sexo, bem como sua distribuição por sextantes. Observou-se maior prevalência de bolsas periodontais no sexo masculino, bem como maior profundidade de sondagem em pacientes acima de 31 anos. A distribuição de bolsas periodontais entre os sextantes foi homogênea

Supersymmetric Monojets at the Large Hadron Collider

Supersymmetric monojets may be produced at the Large Hadron Collider by the process qg -> squark neutralino_1 -> q neutralino_1 neutralino_1, leading to a jet recoiling against missing transverse momentum. We discuss the feasibility and utility of the supersymmetric monojet signal. In particular, we examine the possible precision with which one can ascertain the neutralino_1-squark-quark coupling via the rate for monojet events. Such a coupling contains information on the composition of the neutralino_1 and helps bound dark matter direct detection cross-sections and the dark matter relic density of the neutralino_1. It also provides a check of the supersymmetric relation between gauge couplings and gaugino-quark-squark couplings.Comment: 46 pages, 10 figures. The appendix has been rewritten to correct an error that appears in all previous versions of the appendix. This error has no effect on the results in the main body of the pape

Fitting Neutrino Physics with a U(1)_R Lepton Number

We study neutrino physics in the context of a supersymmetric model where a continuous R-symmetry is identified with the total Lepton Number and one sneutrino can thus play the role of the down type Higgs. We show that R-breaking effects communicated to the visible sector by Anomaly Mediation can reproduce neutrino masses and mixing solely via radiative contributions, without requiring any additional degree of freedom. In particular, a relatively large reactor angle (as recently observed by the Daya Bay collaboration) can be accommodated in ample regions of the parameter space. On the contrary, if the R-breaking is communicated to the visible sector by gravitational effects at the Planck scale, additional particles are necessary to accommodate neutrino data.Comment: 19 pages, 3 figures; v2: references added, constraints updated, overall conclusions unchange

Contraints on unified models for dark matter and dark energy using H(z)

The differential age data of astrophysical objects that have evolved passivelly during the history of the universe (e.g. red galaxies) allows to test theoretical cosmological models through the predicted Hubble function expressed in terms of the redshift $z$, $H(z)$. We use the observational data for $H(z)$ to test unified scenarios for dark matter and dark energy. Specifically, we focus our analysis on the Generalized Chaplygin Gas (GCG) and the viscous fluid (VF) models. For the GCG model, it is shown that the unified scenario for dark energy and dark matter requires some priors. For the VF model we obtain estimations for the free parameters that may be compared with further analysis mainly at perturbative level.Comment: Latex file, 10 pages, 19 figures in eps format. Accepted for publication in European Journal of Physics

Soil biochemistry and microbial activity in vineyards under conventional and organic management at Northeast Brazil.

The São Francisco Submedium Valley is located at the Brazilian semiarid region and is an important center for irrigated fruit growing. This region is responsible for 97% of the national exportation of table grapes, including seedless grapes. Based on the fact that orgThe São Francisco Submedium Valley is located at the Brazilian semiarid region and is an important center for irrigated fruit growing. This region is responsible for 97% of the national exportation of table grapes, including seedless grapes. Based on the fact that organic fertilization can improve soil quality, we compared the effects of conventional and organic soil management on microbial activity and mycorrhization of seedless grape crops. We measured glomerospores number, most probable number (MPN) of propagules, richness of arbuscular mycorrhizal fungi (AMF) species, AMF root colonization, EE-BRSP production, carbon microbial biomass (C-MB), microbial respiration, fluorescein diacetate hydrolytic activity (FDA) and metabolic coefficient (qCO2). The organic management led to an increase in all variables with the exception of EE-BRSP and qCO2. Mycorrhizal colonization increased from 4.7% in conventional crops to 15.9% in organic crops. Spore number ranged from 4.1 to 12.4 per 50 g-1 soil in both management systems. The most probable number of AMF propagules increased from 79 cm-3 soil in the conventional system to 110 cm-3 soil in the organic system. Microbial carbon, CO2 emission, and FDA activity were increased by 100 to 200% in the organic crop. Thirteen species of AMF were identified, the majority in the organic cultivation system. Acaulospora excavata, Entrophospora infrequens, Glomus sp.3 and Scutellospora sp. were found only in the organically managed crop. S. gregaria was found only in the conventional crop. Organically managed vineyards increased mycorrhization and general soil microbial activity