Pathologic assessment of non-palpable probably benign breast masses at sonography: can instant intervention be avoided and is follow-up adequate?

Aim of the study: To evaluate the pathologic results, determine the negative predictive value of non-palpable probably benign lesions at ultrasound and asses whether follow-up is adequate and immediate biopsy can be avoided. Materials and methods: Four hundred and eight cases which were referred to our breast imaging unit between 2004 and 2008 for biopsy evaluation were enrolled into the study. Two hundred and thirteen probably benign solid masses are classified as BI-RADS 3 in 205 of the enrollees. All masses were sonographically detectable and were classified through the guidelines of BI-RADS lexicon for sonography before the final pathological examination. All pathologic results were evaluated and the negative predictive value, false negativity rate and 95% confidence interval were calculated. Results: Of the 213 masses, fine needle aspiration cytology was performed in 120. US-guided wire localization and eventual surgery were carried out in the remaining 93 masses. Finally, 211 of the punctured lesions turned out to be benign and only two malignant lesions were detected. The resulting negative predictive value was found to be 99.1% while the false negative rate value was 0.9%. Conclusion:With the results provided, we think that in the patients with sonographically detected probably benign breast lesions, short term follow-up seems to be a strong alternative to immediate biopsy with its reliable high negative predictivity as well as low false negativity

The HELLP syndrome: Clinical issues and management. A Review

<p>Abstract</p> <p>Background</p> <p>The HELLP syndrome is a serious complication in pregnancy characterized by haemolysis, elevated liver enzymes and low platelet count occurring in 0.5 to 0.9% of all pregnancies and in 10–20% of cases with severe preeclampsia. The present review highlights occurrence, diagnosis, complications, surveillance, corticosteroid treatment, mode of delivery and risk of recurrence.</p> <p>Methods</p> <p>Clinical reports and reviews published between 2000 and 2008 were screened using Pub Med and Cochrane databases.</p> <p>Results and conclusion</p> <p>About 70% of the cases develop before delivery, the majority between the 27th and 37th gestational weeks; the remainder within 48 hours after delivery. The HELLP syndrome may be complete or incomplete. In the Tennessee Classification System diagnostic criteria for HELLP are haemolysis with increased LDH (> 600 U/L), AST (≥ 70 U/L), and platelets < 100·10⁹/L. The Mississippi Triple-class HELLP System further classifies the disorder by the nadir platelet counts. The syndrome is a progressive condition and serious complications are frequent. Conservative treatment (≥ 48 hours) is controversial but may be considered in selected cases < 34 weeks' gestation. Delivery is indicated if the HELLP syndrome occurs after the 34th gestational week or the foetal and/or maternal conditions deteriorate. Vaginal delivery is preferable. If the cervix is unfavourable, it is reasonable to induce cervical ripening and then labour. In gestational ages between 24 and 34 weeks most authors prefer a single course of corticosteroid therapy for foetal lung maturation, either 2 doses of 12 mg betamethasone 24 hours apart or 6 mg or dexamethasone 12 hours apart before delivery. Standard corticosteroid treatment is, however, of uncertain clinical value in the maternal HELLP syndrome. High-dose treatment and repeated doses should be avoided for fear of long-term adverse effects on the foetal brain. Before 34 weeks' gestation, delivery should be performed if the maternal condition worsens or signs of intrauterine foetal distress occur. Blood pressure should be kept below 155/105 mmHg. Close surveillance of the mother should be continued for at least 48 hours after delivery.</p

Synthesis and characterization of metal complexes of acebutolol, atenolol, and propranolol antihypertension drugs

The complexation of two transition metal ions with the ß-blocker drugs acebutolol (HL1), atenolol (HL2), and propranolol (HL3) was studied in methanol and acetonitrile media at M:L (metal:ligand) molar ratio from 1:1 to 1:10. Cu(II) complexes with ligands having the stoichiometric ratio 1:4 (mononuclear copper(II) complexes) and 1:1 (binuclear copper(II) complexes) were prepared. The analytical data show that the metal to ligand ratio in the mononuclear Co(II) complexes was 1:2. The complexes were characterized on the basis of analytical data, magnetic moments, atomic absorption, infrared and electronic spectral data. Molar conductivities of the complexes at room temperature were measured. The conductivity values of the mononuclear Cu(II) complexes indicate weak electrolyte behavior, whereas the binuclear Cu(II) and mononuclear Co(II) complexes are non-electrolytes. The thermal properties of all complexes have been studied by the DTA and TG.01.02.2001The authors gratefully acknowledge the funding of this work by the Research Fund (Project No: 2001/2-1) of Kahramanmaras¸ Sütc¸ü 'mam University, Kahramanmaras¸, Turkey. They also greatly thank Prof. Dr. Nevzat Külcü and his assistants (University of Mersin, Faculty of Science and Arts, Department of Chemistry, Mersin, Turkey) for DTA-TG analyses

Spectrophotometric determination of some beta-blockers in dosage forms based on complex formation with Cu(II) and Co(II)

PubMedID: 15178312Four sensitive and accurate spectrophotometric methods have been developed for the assay of Acebutolol Hydrochloride (ACH), Atenolol (ATE) and Propranolol Hydrochloride (PRH), which are based on the complexation of drugs with copper(II) (Cu(II)) and cobalt(II) (Co(II)). The coloured products are measured at 613, 694, 548 and 614 nm for ACH-Co(II), ATE-Cu(II), PRH-Cu(II) and PRH-Co(II) method, respectively. The optimization of various experimental conditions is described. Conformity with Beer's Law was evident over a concentration range in the of 2x10-5- 1x10-2 mol/L. The molar absorptivity, detection and quantification limits are calculated. The results obtained showed good recoveries of 100.2 ± 1.1, 100.3 ± 1.2, 100.75 ± 1.0 and 99.55 ± 1.1 % with relative standart deviations of 0.410, 0.490, 0.161 and 0.140 % for ACH-Co(II), ATE-Cu(II), PRH-Cu(II) and PRH-Co(II) method, respectively. They were applied to the analysis of tablet forms of the drugs and the results were statistically compared with those obtained by official and literature methods using t- and F-tests. There were no significant difference among the mean values and precisions of the methods at 95% confidence level. © 2004 Elsevier SAS. All rights reserved.01.02.2001The authors grateful to University of Kahramanmaras Sutcu İmam, Research Fund for finansal support (Project no: 2001/2-1)