Tubular Adenoma of the Breast: A Rare Presentation and Review of the Literature

Tubular adenomas, also known as pure adenomas, are rare epithelial tumors of the breast. Only a few cases have been reported in the literature, especially in young women of reproductive age. Postmenopausal women are very rarely affected. We describe here a very rare case of tubular breast adenoma in a postmenopausal woman who presented with a gradually enlarging breast lump. Clinical examination and imaging studies revealed a non-tender well circumscribed left breast tumor suggestive of a fibroadenoma. Due to the history of progressive enlargement of the breast lump, a surgical excision was performed. Histological findings were suggestive of a tubular breast adenoma. We conclude that although tubular breast adenoma is rare, it should always be considered in the differential diagnosis in postmenopausal patients presenting with a gradually enlarging breast mass. Preoperative diagnosis is difficult because tubular adenoma is indistinguishable from a fibroadenoma on physical examination and breast imaging. Surgical excision is necessary to establish a definitive diagnosis. Clinical presentation and management of our patient are discussed along with a review of the literature

Biochemical adaptations of the retina and retinal pigment epithelium support a metabolic ecosystem in the vertebrate eye

Here we report multiple lines of evidence for a comprehensive model of energy metabolism in the vertebrate eye. Metabolic flux, locations of key enzymes, and our finding that glucose enters mouse and zebrafish retinas mostly through photoreceptors support a conceptually new model for retinal metabolism. In this model, glucose from the choroidal blood passes through the retinal pigment epithelium to the retina where photoreceptors convert it to lactate. Photoreceptors then export the lactate as fuel for the retinal pigment epithelium and for neighboring Mu ̈ ller glial cells. We used human retinal epithelial cells to show that lactate can suppress consumption of glucose by the retinal pigment epithelium. Suppression of glucose consumption in the retinal pigment epithelium can increase the amount of glucose that reaches the retina. This framework for understanding metabolic relationships in the vertebrate retina provides new insights into the underlying causes of retinal disease and age-related vision loss

Automated office blood pressure measurements in primary care are misleading in more than one third of treated hypertensives: The VALENTINE-Greece Home Blood Pressure Monitoring study

Abstract Background This study assessed the diagnostic reliability of automated office blood pressure (OBP) measurements in treated hypertensive patients in primary care by evaluating the prevalence of white coat hypertension (WCH) and masked uncontrolled hypertension (MUCH) phenomena. Methods Primary care physicians, nationwide in Greece, assessed consecutive hypertensive patients on stable treatment using OBP (1 visit, triplicate measurements) and home blood pressure (HBP) measurements (7 days, duplicate morning and evening measurements). All measurements were performed using validated automated devices with bluetooth capacity (Omron M7 Intelli-IT). Uncontrolled OBP was defined as ≥140/90 mmHg, and uncontrolled HBP was defined as ≥135/85 mmHg. Results A total of 790 patients recruited by 135 doctors were analyzed (age: 64.5 ± 14.4 years, diabetics: 21.4%, smokers: 20.6%, and average number of antihypertensive drugs: 1.6 ± 0.8). OBP (137.5 ± 9.4/84.3 ± 7.7 mmHg, systolic/diastolic) was higher than HBP (130.6 ± 11.2/79.9 ± 8 mmHg; difference 6.9 ± 11.6/4.4 ± 7.6 mmHg, p Conclusions In primary care, automated OBP measurements are misleading in approximately 40% of treated hypertensive patients. HBP monitoring is mandatory to avoid overtreatment of subjects with WCH phenomenon and prevent undertreatment and subsequent excess cardiovascular disease in MUCH

The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with >80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes

Gravity and effective temperature distribution on the surface of contact binary systems

The aim of this work is to study the gravity and the effective temperature distribution on the outer equipotential surface of a contact binary. In particular, the lines of constant g, (the iso-g curves), are computed and plotted on the outer surface Cs of contact configurations. Since the gravity distribution would also specify the effective temperature distribution on the binary's common photosphere through the gravity darkening effect, these lines correspond to isothermals too. Applications have been made to two contact binaries; namely, to AW UMa and OO Aql, two systems with very different mass ratios. © 2008 Wiley-VCH Verlag GmbH & Co. KGaA

Efficacy and toxicity of orally administrated anti-coccidial drug treatment on Enteromyxum leei infections in sharpsnout seabream (Diplodus puntazzo C.)

Three drugs effective against myxosporeans and commonly used to treat spore-forming para- sites were tested in sharpsnout sea bream (Diplodus puntazzo) infected by Enteromyxum leei. Two medicated diets were applied, one containing salinomycin and amprolium and the second containing fumagillin. Compared to untreated fish, both treatments resulted in significant reduc- tions in prevalence, intensity of all developmental myxosporean stages, and mortality. The effect was more prominent with the salinomycin and amprolium combination, where the significant reductions in intensity, prevalence, and mortality were unaccompanied by any histopathological evidence of toxic side effects or growth reduction. Sporoblasts and mature spores with distorted structures were observed in both drug treatments, but were more prevalent in the salinomycin and amprolium treatment than in the fumagillin treatment, indicating direct effectiveness on the parasite. Salinomycin with amprolium is a promising treatment for myxosporean infections in intensively cultured warmwater fish, leading to parasite elimination

Radiation pressure and surface gravity of close binaries: First results from observational data analysis

We present the results from a sample of early type binaries, for which the surface gravity of their primary components was computed using two different ways. From a comparison of the derived gravity values, is found that the existing difference between them turns to vanish or even to inverse as the luminosity and temperature ratios increase. This implies the presence of radiation pressure, which strongly affects the calculations. A conclusion that has to be further investigated with a larger sample. © Springer Science+Business Media B.V. 2006

THE FIRST PHOTOMETRIC STUDY AND ORBITAL SOLUTION/PERIOD ANALYSIS OF THE MISCLASSIFIED BINARY SYSTEM V380 CAS

We present the first multicolor CCD photometry for the eclipsing binary V380 Cassiopeia (V380 Cas) observed on 34 nights in 2009 and 2010 at the University of Patras Observatory. The PHOEBE program based on the Wilson-Devinney algorithm was used to analyze the first complete BVRcIc light curves. It was found that V380 Cas was misclassified and it is a well-detached system consisting of two main-sequence stars. A range of solutions found to give satisfactory fits to the observations is also investigated. The first orbital solution based on the photometric mass ratio q = 1.08 of almost equal temperatures and masses and orbital inclination of i = 86 degrees.57 was obtained. In addition, based on all available times of light minima, including 12 new ones, a new orbital period of P = 2.714539884 days is given