History of Surgical Treatment of Breast Cancer - Empiricism and Science

A História do tratamento cirúrgico do cancro da mama é bem demonstrativa de que a verdade em Medicina é circunstancial, e que o caminho a percorrer no sentido de a alcançar é árduo. Mostra, também, como ao longo dos séculos o empirismo vai dando lugar ao método científico, e como os estudos prospectivos, controlados e randomizados determinam a alteração dos conceitos e a consequente modificação das técnicas cirúrgicas. Estas vão desde os métodos bárbaros, à luz dos conceitos actuais, que, da Grécia antiga se estendem até à descoberta da anestesia – em que se destacam nomes como Henri de Mondeville, Guy de Chaulliac e Lanfranco na Idade Média, von Hilden e Ambroise Paré no Renascimento, ou H.F. Le Dran, J.L. Petit e Benjamim Bell, no tempo do Iluminismo – até às técnicas cada vez mais meticulosas e racionais, já na Idade Contemporânea, sucessivamente devidas a James Paget, Joseph Pancoast, Charles Moore, William Stewart Halsted, William e Richard Handley, Geoffrey Keynes, Robert McWhirter, George Crile Jr., Cushman Haagensen, Dahl-Iversen, Jerome Urban, David Patey, Bernard Fisher e Umberto Veronesi, entre outros que souberam criar novos paradigmas na História do Tratamento Cirúrgico do Cancro da Mama, para se chegar à prática actual de cirurgia conservadora (mamária e axilar)com reconstrução

Prevalence and Factors Associated with Group A Rotavirus Infection Among Children with Acute Diarrhea in Mwanza, Tanzania.

Rotavirus infections frequently cause acute gastroenteritis in humans and are the most important cause of severe dehydrating diarrhea in young children in both developed and developing countries. This was a prospective cross-sectional, hospital-based study on 300 children ≤ 5 years with acute watery diarrhea who attended Bugando Medical Centre (BMC) and Nyamagana District hospital between May and November 2009. Stool specimens were tested for rotavirus infection using latex agglutination test. Data were cleaned and analyzed using SPSS 11.0. Of 300 children with acute watery diarrhea, 136 (45.3%) were female and the mean age was 12.63 months (SD = 10.4). Sixty-two (20.7%) children were found to have rotavirus infection. Of children with severe malnutrition three (37.5%) were infected with rotavirus. Fifty-two (84%) of children with rotavirus infection were below two years of age. Severe dehydration was present in 48 (16%) children of whom 12 (25%) were infected with rotavirus compared to 18 (16.6%) of 109 children with no dehydration. Living next door to a child with diarrhea was highly associated with rotavirus infection (43% versus 19%; p = 0.036). The mean hospital stay among children with rotavirus infection was 3.66 days versus 2.5 days for those without rotavirus (p = 0.005). Rotavirus infection is prevalent in Mwanza region and contributes to prolonged hospital stay. Proper education on hygiene to control diarrheal diseases among children should be emphasized. Extensive studies to determine the serotypes of rotavirus are warranted in the region before rotavirus vaccine is introduced

Type-Inference Based Short Cut Deforestation (nearly) without Inlining

Deforestation optimises a functional program by transforming it into another one that does not create certain intermediate data structures. In [ICFP'99] we presented a type-inference based deforestation algorithm which performs extensive inlining. However, across module boundaries only limited inlining is practically feasible. Furthermore, inlining is a non-trivial transformation which is therefore best implemented as a separate optimisation pass. To perform short cut deforestation (nearly) without inlining, Gill suggested to split definitions into workers and wrappers and inline only the small wrappers, which transfer the information needed for deforestation. We show that Gill's use of a function build limits deforestation and note that his reasons for using build do not apply to our approach. Hence we develop a more general worker/wrapper scheme without build. We give a type-inference based algorithm which splits definitions into workers and wrappers. Finally, we show that we can deforest more expressions with the worker/wrapper scheme than the algorithm with inlining

Analysis of instabilities in the Basque Coast Geopark coastal cliffs for its environmentally friendly management (Basque-Cantabrian basin, northern Spain)

Coastal cliffs provide a high landscape value to many natural sites around the world. This means that an ever-increasing number of people are attracted to them. At this point, there is a growing need to manage these spaces from the safety of visitors, but with a view to preserving the environment. With this aim, this paper presents an approach to analyze and manage instabilities in these environments, particularly those subjected to significant anthropic activity, which has been implemented in the cliffs of the Basque Coast Geopark. The starting point is a detailed topographic information, obtained from UAV flights, and the identification on site of unstable elements, including their typology, active source areas, dynamics and reach. From this information, the simulation of rockfall processes, which basically correspond to toppling and infinite slope instabilities favored by differential erosion along the coastline, is approached in two and three dimensions. Results allow the design of precise actions by sectors, according to the energy, height and reach of the detached blocks, including barriers, middle slope actions, ditches and information strategies, depending on the different uses of the sectors. Therefore, this approach leads to a more detailed and environmentally friendly management of these environments. © 2021This study has been carried out by the UPV/EHU Research GroupIT-1029/16 (Government of the Basque Country) in the framework of the strategic project ?Analysis of instabilities in coastal environments of the Basque Country? PES-18/97 (University of the Basque Country) and the collaboration of the Basque Coast Geopark (Geoparkea). Finally, the authors are grateful to the reviewers and the handling editor, for the valuable comments that highly improved the paper

Knowledge, attitudes and practices regarding malaria and mosquito net use among women seeking antenatal care in Iringa, south-western Tanzania

To improve control measures against malaria, Tanzania has increased the distribution of free and subsidized insecticide-treated mosquito nets (ITNs) to pregnant women. However, data on knowledge, attitudes and practices of these women regarding malaria are scarce. This study was carried out to describe knowledge, attitudes and practices towards malaria, mosquito net ownership and use among women seeking antenatal care at Iringa Regional Hospital in south-western Tanzania. The study involved women attending the antenatal clinic of the hospital. A pre-tested structured questionnaire was applied to collect information on socio-demographic characteristics, mosquito net ownership and use, as well as knowledge, attitudes and practices about malaria and its control. Among the 222 pregnant women included, 173 (78%, 95%CI, 72-84.2) owned a mosquito net, and 150 (68%, 95%CI, 61-75) reported to sleep always under a mosquito net. The use of mosquito nets was mentioned by 142 (64%, 95%CI, 56.2-72). Of the 46 women who did not own a mosquito net, seven (15.2%) reported cost as the main obstacle for owning one. About 53% (95%CI, 44-62) preferred to use mosquito nets they bought rather than the one provided for free. Several factors such as gravidity, fearing of getting malaria, knowledge on the cause, marital status, and ways used to prevent malaria were significantly associated with mosquito net ownership (all

Digital PCR methods improve detection sensitivity and measurement precision of low abundance mtDNA deletions

Mitochondrial DNA (mtDNA) mutations are a common cause of primary mitochondrial disorders, and have also been implicated in a broad collection of conditions, including aging, neurodegeneration, and cancer. Prevalent among these pathogenic variants are mtDNA deletions, which show a strong bias for the loss of sequence in the major arc between, but not including, the heavy and light strand origins of replication. Because individual mtDNA deletions can accumulate focally, occur with multiple mixed breakpoints, and in the presence of normal mtDNA sequences, methods that detect broad-spectrum mutations with enhanced sensitivity and limited costs have both research and clinical applications. In this study, we evaluated semi-quantitative and digital PCR-based methods of mtDNA deletion detection using double-stranded reference templates or biological samples. Our aim was to describe key experimental assay parameters that will enable the analysis of low levels or small differences in mtDNA deletion load during disease progression, with limited false-positive detection. We determined that the digital PCR method significantly improved mtDNA deletion detection sensitivity through absolute quantitation, improved precision and reduced assay standard error

When crystals become dust: Speleothem degradation processes in Praileaitz I Cave (Northern Spain)

Within the Praileaitz cave there are evident signs of deterioration of different types and generations, affecting both the host rock and the speleothems. The supports of many of the paintings, specifically the drapes, are in a clear state of deterioration due to disintegration of the texture of the speleothem, resulting from selective dissolution of the crystals and the creation of intercrystalline porosity. To analyse and study the different types of degradation and their causes, we gathered a total of 14 samples of speleothems and rock throughout the cave. The speleothems sampled are of different types and come from different growth phases. In order to monitor the parameters that may be causing the pathologies of degradation, a protocol was drawn up for measuring the environmental parameters and the condensation water and drip water in the cave. To analyse the water from the cave, samples were taken at four representative drip points in the cave and from condensation water.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech