Breast metastases from extramammary cancers are rare and usually related to poor prognosis. The extramammary tumours most frequently exhibiting breast metastases are melanoma, lymphomas, ovarian ...cancer, lung and neuroendocrine tumours, and sarcomas. Owing to the lack of reliable and specific clinical or radiological signs for the diagnosis of breast metastases, a combination of techniques is needed to differentiate these lesions from primary breast carcinoma or even benign breast lesions. Multiple imaging methods may be used to evaluate these patients, including mammography, ultrasound, MRI, CT and positron emission tomography CT. Clinical and imaging manifestations are varied, depend on the form of dissemination of the disease and may mimic primary benign and malignant breast lesions. Haematologically disseminated metastases often develop as a circumscribed mass, whereas lymphatic dissemination often presents as diffuse breast oedema and skin thickening. Unlike primary carcinomas, breast metastases generally do not have spiculated margins, skin or nipple retraction. Microlobulated or indistinct margins may be present in some cases. Although calcifications are not frequently present in metastatic lesions, they occur more commonly in patients with ovarian cancer. Although rare, secondary malignant neoplasms should be considered in the differential diagnosis of breast lesions, in the appropriate clinical setting. Knowledge of the most common imaging features can help to provide the correct diagnosis and adequate therapeutic planning.
To evaluate the effect of a clinical quality control program on the final quality of a mammography screening service.
We conducted retrospective assessment of the clinical quality of 5,000 mammograms ...taken in a Mammography Screening Program between November 2010 and September 2011, following the implementation of a Clinical Quality Control Program based on the European Guidelines.
Among the 105,000 evaluated quality items, there were 8,588 failures (8.2%) - 1.7 failures per examination. Altogether, 89% of the failures were associated with positioning. The recall rate due to a technical error reached a maximum of 0.5% in the early phase of the observation period and subsequently stabilized (0.09%).
The ongoing education and monitoring combined with personalized training increased the critical thinking of the involved professionals, reducing the technical failures and unnecessary exposure of patients to radiation, with substantial improvement in the final quality of mammography.
Accurate risk assessment is essential for the success of population screening programs in breast cancer. Models with high sensitivity and specificity would enable programs to target more elaborate ...screening efforts to high-risk populations, while minimizing overtreatment for the rest. Artificial intelligence (AI)-based risk models have demonstrated a significant advance over risk models used today in clinical practice. However, the responsible deployment of novel AI requires careful validation across diverse populations. To this end, we validate our AI-based model, Mirai, across globally diverse screening populations.
We collected screening mammograms and pathology-confirmed breast cancer outcomes from Massachusetts General Hospital, USA; Novant, USA; Emory, USA; Maccabi-Assuta, Israel; Karolinska, Sweden; Chang Gung Memorial Hospital, Taiwan; and Barretos, Brazil. We evaluated Uno's concordance index for Mirai in predicting risk of breast cancer at one to five years from the mammogram.
A total of 128,793 mammograms from 62,185 patients were collected across the seven sites, of which 3,815 were followed by a cancer diagnosis within 5 years. Mirai obtained concordance indices of 0.75 (95% CI, 0.72 to 0.78), 0.75 (95% CI, 0.70 to 0.80), 0.77 (95% CI, 0.75 to 0.79), 0.77 (95% CI, 0.73 to 0.81), 0.81 (95% CI, 0.79 to 0.82), 0.79 (95% CI, 0.76 to 0.83), and 0.84 (95% CI, 0.81 to 0.88) at Massachusetts General Hospital, Novant, Emory, Maccabi-Assuta, Karolinska, Chang Gung Memorial Hospital, and Barretos, respectively.
Mirai, a mammography-based risk model, maintained its accuracy across globally diverse test sets from seven hospitals across five countries. This is the broadest validation to date of an AI-based breast cancer model and suggests that the technology can offer broad and equitable improvements in care.
Apresentamos a profilaxia intermitente com diazepam via oral como opção de tratamento para convulsão febril. Justificamos essa proposta diante dos importantes efeitos colaterais que ocorrem com as ...duas medicações classicamente usadas na profilaxia contínua (fenobarbital e valproato). Foram tratados 19 pacientes. Obtivemos resultados favoráveis, pois apenas um caso apresentou recorrência de convulsão febril em vigência de dose adequada do diazepam. Houve efeitos colaterais transitórios em 36,8% da nossa casuística.
The prevalence of antibodies directed against the enterically transmitted hepatitis A virus (HAV) was measured in 2 groups of people living in Rio de Janeiro, Brazil. Of 1,056 health care workers ...(HCWs), 778 (73.7%) were anti-HAV positive. A high prevalence of anti-HAV antibodies (85.7%) was also found among 274 voluntary blood donors (BDs). TT virus (TTV) is a DNA virus that has been found in the sera of patients with post-transfusion hepatitis of unknown etiology. Occurrence of virus shedding suggests that the fecal-oral route may be an important mode of TTV transmission, particularly in the developing world. The presence of TTV DNA was analyzed by PCR in the sera of 191 HCWs and 151 BDs. TTV was detected in 65.4% of HCWs and 79.5% of BDs. In both groups, a family income of B US$400 per month and a level of education of B 11 y of schooling were found to be risk factors for HAV infection. Furthermore, a low family income was associated with TTV viremia in the HCW group. However, the presence of TTV DNA was associated with neither low level of education nor anti-HAV positivity.
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Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Apresentamos a profilaxia intermitente com diazepam via oral como opção de tratamento para convulsão febril. Justificamos essa proposta diante dos importantes efeitos colaterais que ocorrem com as ...duas medicações classicamente usadas na profilaxia contínua (fenobarbital e valproato). Foram tratados 19 pacientes. Obtivemos resultados favoráveis, pois apenas um caso apresentou recorrência de convulsão febril em vigência de dose adequada do diazepam. Houve efeitos colaterais transitórios em 36,8% da nossa casuística.
Intermittent prophylaxis with oral diazepam is presented as an optional treatment for febrile seizures. This proposition is justified by the severe side effects of the currently used chronic anticonvulsant drug therapy in febrile seizures (phenobarbital and valproate). Nineteen patients aged between 3 months and 5 years were treated. They had either simple) or complex febrile seizures. Sixteen patients, had at least one prognostic factor for recurrence of febrile seizures: first febrile seizure before 15 months of age, positive family history for epilepsy or febrile seizures, occurrence of a complex febrile seizure or abnormal neurological examination. Three patients had none, (cases 8, 12 and 13). We recommended 2.5mg b.i.d. for children younger than 12 months, 5mg b.i.d. for children older than 12 months and younger than 3 years, and 7.5 b.i.d. for children older than 3 years. The results showed that only one patient had febrile convulsions while taking adequate diazepam dosage. Transient side effects occurred in 36.8% of the cases.
Biodegradable aliphatic polyesters are an alternative to reduce the use of synthetic plastic materials that cause severe damage to the environment. Formulations based on poly (lactic acid) (PLA) and ...poly (butylene adipate-co-terephthalate) (PBAT), were mixed in a 60:40 ratio, adding different concentrations of pine essential oil through the use of extrusion technology to obtain biodegradable polymer fibers. Some formulations were coated with chitosan. All the elaborated fibers were characterized by Scanning Electron Microscopy (SEM), Fourier Transform Infrared Spectroscopy-Attenuated Total Reflection (FTIR-ATR), Differential Scanning Calorimetry (DSC), X-ray Diffraction (XRD) and mechanical properties. The SEM studies showed that the PBAT improves the tenacity and provides greater elasticity promoting the interaction between the blends phases with fibril formation. In the FTIR-ATR analysis, compatibility between the blends was observed due to a possible interaction of the carbonyl group of PBAT with PLA. The DSC and the mechanical properties showed partial miscibility of the blends, indicating, that the plasticizing action of the essential oil gave greater mobility, flexibility, less rigidity and crystallization in the blends. A lower Young's modulus and greater elongation at break was also observed.
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•Polylactic acid and polybutylene adipate-co-terephthalate blends were elaborated.•Pine essential oil was added to 60:40 polymer blends using extrusion process.•SEM studies showed that polybutylene adipate-co-terephthalate improves elasticity.•In the FTIR-ATR analysis, compatibility between the blends was observed.•DSC and mechanical properties showed partial miscibility of the blends.
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