Change-of-state Paradigms and the middle in Kinyarwanda

This paper investigates the derivational relationships among members of verbal paradigms in Kinyarwanda (Bantu JD.61; Rwanda) by pursuing two interrelated goals. First, I describe a variety of derivational strategies for marking transitive and intransitive variants in change-of-state verb paradigms. Second, I focus on the detransitivizing morpheme –ik which serves as one possible marking for intransitive members of these paradigms. Ultimately, I argue that this morpheme is a marker of middle voice, and the variety of readings which appear with this form can be subsumed under a single operation of argument suppression. Finally, I provide a discussion of reflexives and the apparent lack of a reflexive reading with –ik by arguing that this reading is blocked by either lexical reflexives or the reflexive prefix i–

Multidisciplinary consensus on the therapeutic recommendations for iatrogenic hyperprolactinemia secondary to antipsychotics

Hyperprolactinemia is an underappreciated/unknown adverse effects of antipsychotics. The consequences of hyperprolactinemia compromise therapeutic adherence and can be serious. We present the consensus recommendations made by a group of experts regarding the management of antipsychotic-induced hyperprolactinemia. The current consensus was developed in 3 phases: 1, review of the scientific literature; 2, subsequent round table discussion to attempt to reach a consensus among the experts; and 3, review by all of the authors of the final conclusions until reaching a complete consensus. We include recommendations on the appropriate time to act after hyperprolactinemia detection and discuss the evidence on available options: decreasing the dose of the antipsychotic drug, switching antipsychotics, adding aripiprazole, adding dopaminergic agonists, and other type of treatment. The consensus also included recommendations for some specific populations such as patients with a first psychotic episode and the pediatric-youth population, bipolar disorder, personality disorders and the elderly population

First case of transformation for breast fibroadenoma to high-grade malignant phyllodes tumor in an in vitro fertilization patient: misdiagnosis of recurrence, treatment and review of the literature.

INTRODUCTION: Cystosarcoma phyllodes are very rare tumors and may be difficult to diagnose clinically. BACKGROUND: Fibroadenomas have long been considered benign hyperplastic lesions rather than true neoplastic processes. However, previous clonality studies have shown differing results. AIM: to assess diagnostic and treatment options for phyllodes tumor. MATERIALS AND METHODS: A 41-year-old female patient undergoing assisted fertilization treatment. The patient underwent fine needle aspiration biopsy that confirmed fibroadenoma before the IVF attempt. At 17 weeks of gestation, due to an increase in volume of the fibroadenoma, an excisional biopsy was performer that showed a malignant phyllodes tumor. Then she underwent quadrantectomy and chemiotherapy After 1 year there was a recurrence of phyllodes tumors and she underwent mastectomy and chemotherapy. RESULTS: Fibroadenoma that was transformed into high-grade malignant cystosarcoma after ovarian stimulation, relapsed after one year and it was not immediately diagnosed. The patient underwent mastectomy and chemotherapy. DISCUSSION: it is difficult to diagnose recurrence and to determine tehe frequency and the right treatment for such a rare cancer, so it is important to report any case in the literature. CONCLUSIONS: We recommend to remove a fibroadenoma before attempting IVF for the risk of malignant transformation