366 research outputs found

    Adenosquamous carcinoma of breast in a 19 years old woman: a case report

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    <p>Abstract</p> <p>Background</p> <p>Adenosquamous carcinoma of the breast is a rare form of metaplastic breast carcinoma. We report such a case in a 19 years old female.</p> <p>Case presentation</p> <p>Case notes and histopathology were reviewed. Adenosquamous carcinoma was diagnosed on wide local excision and patient underwent skin-sparing mastectomy with Latissimus dorsi flap reconstruction.</p> <p>Conclusions</p> <p>Adenosquamous carcinoma of the breast is a rare form of metaplastic breast carcinoma. Data on correct management, follow-up and prognosis are very limited but given the high potential for local recurrence, aggressive surgery may be the only option.</p

    Toward unsupervised outbreak detection through visual perception of new patterns

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    <p>Abstract</p> <p>Background</p> <p>Statistical algorithms are routinely used to detect outbreaks of well-defined syndromes, such as influenza-like illness. These methods cannot be applied to the detection of emerging diseases for which no preexisting information is available.</p> <p>This paper presents a method aimed at facilitating the detection of outbreaks, when there is no a priori knowledge of the clinical presentation of cases.</p> <p>Methods</p> <p>The method uses a visual representation of the symptoms and diseases coded during a patient consultation according to the International Classification of Primary Care 2<sup>nd </sup>version (ICPC-2). The surveillance data are transformed into color-coded cells, ranging from white to red, reflecting the increasing frequency of observed signs. They are placed in a graphic reference frame mimicking body anatomy. Simple visual observation of color-change patterns over time, concerning a single code or a combination of codes, enables detection in the setting of interest.</p> <p>Results</p> <p>The method is demonstrated through retrospective analyses of two data sets: description of the patients referred to the hospital by their general practitioners (GPs) participating in the French Sentinel Network and description of patients directly consulting at a hospital emergency department (HED).</p> <p>Informative image color-change alert patterns emerged in both cases: the health consequences of the August 2003 heat wave were visualized with GPs' data (but passed unnoticed with conventional surveillance systems), and the flu epidemics, which are routinely detected by standard statistical techniques, were recognized visually with HED data.</p> <p>Conclusion</p> <p>Using human visual pattern-recognition capacities to detect the onset of unexpected health events implies a convenient image representation of epidemiological surveillance and well-trained "epidemiology watchers". Once these two conditions are met, one could imagine that the epidemiology watchers could signal epidemiological alerts, based on "image walls" presenting the local, regional and/or national surveillance patterns, with specialized field epidemiologists assigned to validate the signals detected.</p

    Associação do reflexo vermelho em recém-nascidos com variáveis neonatais

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    Objetivou-se investigar o resultado do teste do reflexo vermelho, conhecido como teste do olhinho, e associar as impressões do reflexo com variáveis neonatais. Este é um estudo descritivo, quantitativo, realizado com 190 recém-nascidos de uma maternidade pública, dos quais 187 apresentaram resultado não alterado e três suspeitos. Observaram-se diferentes nuances de coloração do reflexo: em 50 (26,3%) a coloração do reflexo apresentou-se vermelha; 34 (17,9%) laranja-avermelhado; 92 (48,4%) alaranjado; 11 (5,8%) amarelo claro e três (1,6%) com manchas esbranquiçadas. Encontraram-se associações estatisticamente significantes entre o instrumento gradiente de cores e variáveis neonatais: peso (p=0,03), idade gestacional (p=0,019) e oxigenoterapia (p=0,024). Enfermeiros capacitados para prática e avaliação desse teste podem se tornar profissionais em potencial para a prevenção da cegueira infantil.The aim of this study was to investigate the results of the red reflex test and to associate these results with neonatal variables. This descriptive study was conducted with 190 newborns in a public maternity hospital. A total of 187 infants presented no alteration and three presented suspect results. Different shades of reflex color were observed: 50 (26.3%) presented red; 34 (17.9%) orange-red, 92 (48.4%) orange, 11 (5.8%) light yellow and three (1.6%) milky white spots. Statistically significant associations between the color gradient instrument and neonatal variables were found: weight (p=0.03), gestational age (p=0.019) and oxygen therapy (p=0.024). Nurses trained to practice and evaluate this test may become professionals in the potential for the prevention of childhood blindness.Se objetivó investigar el resultado de la prueba del reflejo rojo, conocido como prueba del ojito, y asociar las impresiones del reflejo con variables neonatales. Se trata de un estudio descriptivo, cuantitativo, realizado con 190 recién nacidos de una maternidad pública; de los cuales 187 presentaron resultados no alterados y tres sospechosos. Se observaron diferentes matices de coloración del reflejo: en 50 (26,3%) se presentó rojo; 34 (17,9%) naranja rojizo; 92 (48,4%) anaranjado; 11 (5,8%) amarillo claro y tres (1,6%) con manchas blanquecinas. Se encontraron asociaciones estadísticamente significativas entre el instrumento gradiente de colores y las variables neonatales: peso (p=0,03), edad de gestación (p=0,019) y oxigenoterapia (p=0,024). Enfermeros capacitados para la práctica y evaluación de esa prueba pueden tornarse profesionales en potencial para la prevención de la ceguera infantil

    Columnar cell lesions of the canine mammary gland: pathological features and immunophenotypic analysis

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    <p>Abstract</p> <p>Background</p> <p>It has been suggested that columnar cell lesions indicate an alteration of the human mammary gland involved in the development of breast cancer. They have not previously been described in canine mammary gland. The aim of this paper is describe the morphologic spectrum of columnar cell lesions in canine mammary gland specimens and their association with other breast lesions.</p> <p>Methods</p> <p>A total of 126 lesions were subjected to a comprehensive morphological review based upon the human breast classification system for columnar cell lesions. The presence of preinvasive (epithelial hyperplasia and in situ carcinoma) and invasive lesions was determined and immunophenotypic analysis (estrogen receptor (ER), progesterone receptor (PgR), high molecular weight cytokeratin (34βE-12), E-cadherin, Ki-67, HER-2 and P53) was perfomed.</p> <p>Results</p> <p>Columnar cell lesions were identified in 67 (53.1%) of the 126 canine mammary glands with intraepithelial alterations. They were observed in the terminal duct lobular units and characterized at dilated acini may be lined by several layers of columnar epithelial cells with elongated nuclei. Of the columnar cell lesions identified, 41 (61.2%) were without and 26 (38.8%) with atypia. Association with ductal hyperplasia was observed in 45/67 (67.1%). Sixty (89.5%) of the columnar cell lesions coexisted with neoplastic lesions (20 in situ carcinomas, 19 invasive carcinomas and 21 benign tumors). The columnar cells were ER, PgR and E-cadherin positive but negative for cytokeratin 34βE-12, HER-2 and P53. The proliferation rate as measured by Ki-67 appeared higher in the lesions analyzed than in normal TDLUs.</p> <p>Conclusions</p> <p>Columnar cell lesions in canine mammary gland are pathologically and immunophenotypically similar to those in human breast. This may suggest that dogs are a suitable model for the comparative study of noninvasive breast lesions.</p

    Prognostic factors in metaplastic carcinoma of the breast: A multi-institutional study

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    Background: Metaplastic breast carcinoma (MBC) is a rare type of breast cancer that has basal-like characteristics and is perceived to have poorer prognosis when compared with conventional no specific type/ductal carcinomas (ductal/NST). However, current data on MBC are largely derived from small case series or population-based reports. This study aimed to assess the clinicopathological features and outcome of MBC identified through an international multicentre collaboration. Methods: A large international multicentre series of MBC (no=405) with histological confirmation and follow-up information has been included in this study. The prognostic value of different variables and outcome has been assessed and compared with grade, nodal status and ER/HER2 receptor-matched ductal/NST breast carcinoma. Results: The outcome of MBC diagnosed in Asian countries was more favourable than those in Western countries. The outcome of MBC is not different from matched ductal/NST carcinoma but the performance of the established prognostic variables in MBC is different. Lymph node stage, lymphovascular invasion and histologic subtype are associated with outcome but tumour size and grade are not. Chemotherapy was associated with longer survival, although this effect was limited to early-stage disease. In this study no association between radiotherapy and outcome was identified. Multivariate analysis of MBC shows that histologic subtype is an independent prognostic feature. Conclusions: This study suggests that MBC is a heterogeneous disease. Although the outcome of MBC is not different to matched conventional ductal/NST breast carcinoma, its behaviour is dependent on the particular subtype with spindle cell carcinoma in particular has an aggressive biological behaviour. Management of patients with MBC should be based on validated prognostic variables

    How Habitat Change and Rainfall Affect Dung Beetle Diversity in Caatinga, a Brazilian Semi-Arid Ecosystem

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    The aim of the present study was to evaluate how dung beetle communities respond to both environment and rainfall in the Caatinga, a semi-arid ecosystem in northeastern Brazil. The communities were sampled monthly from May 2006 to April 2007 using pitfall traps baited with human feces in two environments denominated “land use area” and “undisturbed area.” Abundance and species richness were compared between the two environments and two seasons (dry and wet season) using a generalized linear model with a Poisson error distribution. Diversity was compared between the two environments (land use area and undisturbed area) and seasons (dry and wet) using the Two-Way ANOVA test. Non-metric multidimensional scaling was performed on the resemblance matrix of Bray-Curtis distances (with 1000 random restarts) to determine whether disturbance affected the abundance and species composition of the dung beetle communities. Spearman's correlation coefficient was used to determine whether rainfall was correlated with abundance and species richness. A total of 1097 specimens belonging to 13 species were collected. The most abundant and frequent species was Dichotomius geminatus Arrow (Coleoptera: Scarabaeidae). The environment exerted an influence over abundance. Abundance and diversity were affected by season, with an increase in abundance at the beginning of the wet season. The correlation coefficient values were high and significant for abundance and species richness, which were both correlated to rainfall. In conclusion, the restriction of species to some environments demonstrates the need to preserve these areas in order to avoid possible local extinction. Therefore, in extremely seasonable environments, such as the Caatinga, seasonal variation strongly affects dung beetle communities

    Bayesian molecular clock dating of species divergences in the genomics era

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    It has been five decades since the proposal of the molecular clock hypothesis, which states that the rate of evolution at the molecular level is constant through time and among species. This hypothesis has become a powerful tool in evolutionary biology, making it possible to use molecular sequences to estimate the geological ages of species divergence events. With recent advances in Bayesian clock dating methodology and the explosive accumulation of genetic sequence data, molecular clock dating has found widespread applications, from tracking virus pandemics, to studying the macroevolutionary process of speciation and extinction, to estimating a timescale for Life on Earth
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