The impact of oral contraceptive use on breast cancer risk: State of the art and future perspectives in the era of 4P medicine.

Breast cancer is the most commonly occurring cancer in women, the second most frequent cancer overall, and it causes the greatest number of cancer-related deaths among women. The significant increased concern of breast cancer worldwide may be attributed to the prolonged life expectancy and the adoption of the western lifestyle with its related risks factors. A woman's risk for breast cancer is linked to her reproductive history and with her lifetime hormonal exposure. Among the known risk factors for breast cancer, several studies investigated the possible role of the assumption of hormonal "pills" in both breast cancer incidence and development. Nevertheless, data about the association between the assumption of oral contraceptives and breast cancer incidence are still controversial and not conclusive. Given the public health importance of breast cancer and the popularity of hormonal "pills" as contraceptive, the impact of oral contraceptive use on breast cancer risk assumes relevance from both a clinical and a social point of view. Therefore, in this review we wanted to illustrate this issue by addressing the following major themes: a) the role of sex steroid hormones in female breast development and carcinogenesis; b) the clinical impact of hormonal oral contraception according to the state of the art literature; c) the actual scientific debate and future perspectives.

Ultrasound measurement of reproductive organs in juvenile European sea bass Dicentrarchus labrax.

In this study, ultrasonographic examination was performed thrice, 15 days apart, on juvenile European sea bass Dicentrarchus labrax, from 330 to 360 days of age, to assess the size and the morphology of male and female. Results have proved this method as a suitable and non-invasive procedure to assess sexual differentiation.

Mechanistic investigation of ionization suppression in electrospray ionization.

We show results from experiments designed to determine the relative importance of gas phase processes and solution phase processes into ionization suppression observed in biological sample extracts. The data indicate that gas phase reactions leading to the loss of net charge on the analyte is not likely to be the most important process involved in ionization suppression. The results point to changes in the droplet solution properties caused by the presence of nonvolatile solutes as the main cause of ionization suppression in electrospray ionization of biological extracts.

The effects of sample preparation methods on the variability of the electrospray ionization response for model drug compounds.

A post-column infusion system was developed in order to analyze suppression of electrospray ionization (ESI) tandem mass spectrometry response in the presence of endogenous plasma interferences. By enabling direct detection of these interfering components, this experimental system was used to analyze the ability of several common extraction procedures to remove endogenous plasma components that cause changes in the ESI response of model drug substances. Methyl-t-butyl ether (MTBE) liquid-liquid, Oasis and Empore solid-phase, and acetonitrile (ACN) protein precipitation sample preparation methods were tested using the post-column infusion system. In all cases, ACN protein precipitation samples showed the greatest amount of ESI response suppression while liquid-liquid extracts demonstrated the least. In addition, the three test compounds, phenacetin, caffeine, and a representative Merck compound, demonstrated that ESI response suppression is compound dependent. Suppression was greatest with caffeine, the most polar analyte, and the smallest for the Merck compound, the least polar analyte. Copyright 1999 John Wiley & Sons, Ltd.

Limiting restraint use for behavior control: the brain injury rehabilitation unit as a model.

Physical or pharmacologic restraints are often used to control the behavior of patients who are agitated or who demonstrate behavior that is inappropriate or potentially dangerous. Centers that specialize in traumatic brain injury rehabilitation treat many patients who manifest agitated behavior. This article reviews behavior management within a brain injury rehabilitation setting and describes less restrictive restraint systems. A case study of the management of an agitated patient with traumatic brain injury is presented. Possible future trends in the use of restraint systems are discussed.

Industrial rehabilitation medicine. 3. Treatment.

This self-directed learning module highlights the important aspects of the physiatric approach to treatment of the injured worker. It is part of the chapter on industrial rehabilitation medicine in the Self-Directed Medical Knowledge Program for practitioners and trainees in physical medicine and rehabilitation. This article discusses treatment of the worker who has sustained acute or chronic industrial injury.

Industrial rehabilitation medicine. 4. Assessment of the outcome of treatment in industrial medicine, program development, documentation, and testimony.

This self-directed learning module highlights new advances in this topic area. It is part of the chapter on industrial rehabilitation medicine in the Self-Directed Medical Knowledge Program for practitioners and trainees in physical medicine and rehabilitation. This article contains sections comparing the results of surgical versus nonsurgical treatment of low back pain and discussing the efficacy of ergonomic changes in the treatment of low back pain and cumulative trauma disorder, the effectiveness of chronic pain programs, directions for future research and program development in occupational medicine, and physiatric testimony in workers' compensation cases.