Demonstration of an algorithm to overcome health system-related barriers to timely diagnosis of breast diseases in rural Zambia

Background Long delays to diagnosis is a major cause of late presentation of breast diseases in sub-Saharan Africa. Aims We designed and implemented a single-visit breast care algorithm that overcomes health system-related barriers to timely diagnosis of breast diseases. Methods A multidisciplinary team of Zambian healthcare experts trained a team of mid- and high-level Zambian healthcare practitioners how to evaluate women for breast diseases, and train trainers to do likewise. Working collaboratively, the two teams then designed a clinical platform that provides multiple breast care services within a single visit. The service platform was implemented using a breast outreach camp format, during which breast self-awareness, psychosocial counseling, clinical breast examination, breast ultrasound, ultrasound-guided biopsy, imprint cytology of biopsy specimens and surgical treatment or referral, were offered within a single visit. Results Eleven hundred and twenty-nine (1129) women attended the camps for breast care. Mean age was 35.9 years. The majority were multiparous (79.4%), breast-fed (76.0%), and reported hormone use (50.4%). Abnormalities were detected on clinical breast examination in 122 (10.8%) women, 114 of whom required ultrasound. Of the 114 who underwent ultrasound, 48 had identifiable lesions and were evaluated with ultrasound-guided core needle biopsy (39) or fine-needle aspiration (9). The concordance between imprint cytology and histopathology was 100%, when breast specimens were classified as either benign or malignant. However, when specimens were classified by histopathologic subtype, the concordance between imprint cytology and histology was 85.7% for benign and 100% for malignant lesions. Six (6) women were diagnosed with invasive cancer. Eighteen (18) women with symptomatic breast lesions had next-day surgery. Significance Similar to its impact on cervical cancer prevention services, a single visit breast care algorithm has the potential to overcome health system-related barriers to timely diagnosis of breast diseases, including cancer, in rural African settings

Transient Studies of the Elementary Steps of FischerTropsch Synthesis

International audienceThe pulse transient method has been used to study the kinetics of several key steps of Fischer-Tropsch (FT) synthesis over cobalt supported catalysts. These elementary steps involve chemisorption of hydrogen and propene, and chemisorption and hydrogenation of carbon monoxide. It is found that at the conditions of Fischer-Tropsch synthesis, hydrogen chemisorption is reversible and quasi-equilibrated, while carbon monoxide adsorption is generally irreversible. Chemisorption of propene on cobalt metal sites results in its rapid autohydrogenation to propane and simultaneous formation of C xHy surface species. The transient response curves produced during hydrogenation of carbon monoxide pulses in a flow of hydrogen have been analyzed using the modified Kobayashi model, which involves irreversible chemisorption and dissociation of carbon monoxide, quasi-equilibrated adsorption of hydrogen and reversible adsorption of water. The kinetic analysis suggests that oxygen-containing species are probably the most abundant surface intermediates. Desorption of water from the catalysts seems to be much slower than hydrogenation of surface carbon species. © 2005 Elsevier B.V. All rights reserved

Cell therapy of pseudarthrosis

Objective: To assess the safety and efficiency of cell therapy for pseudarthrosis. Implant of the bone marrow aspirate was compared to mononuclear cells purified extemporaneously using the Sepax® equipment. Methods: Six patients with nonunion of the tibia or femur were treated. Four received a percutaneous infusion of autologous bone marrow aspirated from the iliac crest, and two received autologous bone marrow mononuclear cells separated from the aspirate with the Sepax®. The primary fixation method was unchanged, and the nonunion focus was not exposed. Physical examination and radiographies were performed 2, 4 and 6 months after the treatment by the same physician. After consolidation of the fracture the satisfactio