Accessibility of blood affects the attractiveness of cattle to horn flies.

The burden of infestation of the horn fly, Haematobia irritans (Linnaeus) (Diptera: Muscidae), differs among bovines within the same herd. We hypothesized that these differences might be related to the epidermal thickness of the cattle and the blood intake capacity of the fly. Results showed that dark animals carried more flies and had a thinner epidermis than light-coloured animals, which was consistent with the greater haemoglobin content found in flies caught on darker cattle. Similarly, epidermal thickness increased with body weight, whereas haemoglobin content decreased. Overall, we suggest that accessibility of blood is a factor that partially explains cattle attractiveness to flies.

Communication between breast cancer patients and their physicians about breast-related body image issues.

Breast cancer patients encounter body image changes throughout their diagnosis, treatment, and recovery from breast cancer. No prospective studies were identified investigating communication between physicians and breast cancer patients related to body image. This qualitative pilot study determines (1) how breast cancer patients prefer their physicians communicate regarding body image changes and (2) how comfortable physicians are in discussing body image issues with their patients. Data were collected from patients over 12 weeks through the breast evaluation questionnaire (BEQ), a valid and reliable instrument, and a qualitative questionnaire. Ten physicians completed a qualitative questionnaire. The data were analyzed using frequency analysis. Nearly 70% of the patients reported there was more the physician could do to improve patient comfort in discussing breast-related body image concerns. Honesty, openness, and directness were important to the patients. Thirty-three percent of the patients answered that their physicians should be honest, open, and direct while discussing these issues. On a five-point Likert scale (1 = very uncomfortable and 5 = very comfortable), the physicians most frequently answered a 4 when asked how comfortable they are speaking about breast-related body image issues; however, only four out of 10 always address the topic themselves during the patient's visit. These data suggest that patients want honesty, openness, and directness from their physicians during the discussion of breast-related body image issues. The physicians report they are comfortable speaking about breast-related body image issues; yet, they do not directly initiate the topic.

Evaluation of a Cooperia oncophora double-domain ASP-based vaccine against Cooperia spp. infections in cattle and sheep.

A double-domain activation-associated secreted protein (dd-Co-ASP) isolated from the bovine small intestinal parasite Cooperia oncophora was previously shown to be an effective vaccine candidate to protect calves against a homologous challenge infection. The aim of this study was to investigate whether the dd-Co-ASP protein, purified from a Belgian C. oncophora isolate, would offer protection against a C. oncophora isolate from the southern hemisphere as well as other Cooperia species such as C. punctata in cattle and C. curticei in sheep. Two vaccination studies were performed, i.e. one in cattle and one in sheep, in which the protective effects of dd-Co-ASP, supplemented with Quil A as an adjuvant, were compared with an adjuvant control. Whereas our results showed a 75 % reduction in Cooperia spp. cumulative faecal egg counts, the results obtained in sheep demonstrated that dd-Co-ASP was ineffective in raising a protective immune response against a C. curticei challenge infection. Even though sequence analysis of the dd-Co-ASP gene revealed restricted sequence heterogeneity in the double domain ASP within and between bovine Cooperia species, the results of the vaccine study suggest that there is sufficient conservation at the protein level to yield cross-protection, holding promise for the development of a general Cooperia vaccine for use in cattle.

Identification of a novel HLA-A allele, A*3120.

A novel human leukocyte antigen (HLA)-A allele, HLA-A*3120, was first identified in a National Marrow Donor Program (NMDP) donor. The A*3120 allele resulted from a single nucleotide substitution (T to G) at codon 92 of exon 3 of A*310102. The substitution caused an amino acid change (serine to alanine). This novel allele was also seen in two other unrelated NMDP donors.

A contemporary, population-based study of lymphedema risk factors in older women with breast cancer.

BACKGROUND: We studied potential risk factors for lymphedema in a contemporary population of older breast cancer patients. METHODS: Telephone surveys were conducted among women (65-89 years) identified from Medicare claims as having initial breast cancer surgery in 2003. Lymphedema was classified by self-report. Surgery and pathology information was obtained from Medicare claims and the state cancer registries. RESULTS: Of 1,338 patients treated by 707 surgeons, 24% underwent sentinel lymph node biopsy (SLNB) and 57% axillary lymph node dissection (ALND). At a median of 48 months postoperatively, 193 (14.4%) had lymphedema. Lymphedema developed in 7% of the 319 patients who underwent SLNB and in 21% of the 759 patients who underwent ALND. When controlling for patient age, tumor size, type of breast cancer, type of breast and axillary surgery, receipt of radiation, chemotherapy, and hormonal therapy, and surgeon case volume, the independent predictors of lymphedema were removal of more than five lymph nodes [odds ratio (OR) 4.68-5.61, 95% confidence interval (CI) 1.36-19.74 for 6-15 nodes; OR 10.50, 95% CI 2.88-38.32 for >15 nodes] and presence of lymph node metastases (OR 1.98, 95% CI 1.21-3.24). CONCLUSIONS: Four years postoperatively, 14% of a contemporary, population-based cohort of elderly breast cancer survivors had self-reported lymphedema. In this group of predominantly community-based surgeons, the number of lymph nodes removed is more predictive of lymphedema rather than whether SLNB or ALND was performed. As more women with breast cancer undergo only SLNB, it is essential that they still be counseled on their risk for lymphedema.

Immunohistochemical and molecular detection of equine herpesvirus 1 in Uruguay.

Equine herpesvirus 1 (EHV-1) is a major cause of epidemic abortion, neonatal mortality, respiratory disease and neurological disorders in horses. In South America, the virus has been isolated in Brazil, Argentina and Colombia. In Chile pathological findings from one aborted foetus have been reported, and in Uruguay only serological data about EHV-1 activity have been found. Some pathological findings were reported in Uruguay several years ago, but these data have never been officially confirmed. The present work describes the relevant findings of a study of EHV-1 infections in the Uruguayan equine population using polymerase chain reaction (PCR) and histological and immunohistochemical analysis techniques. The sequence analysis of a portion of the glycoprotein C gene amplified by PCR confirmed EHV-1 activity. The real-time PCR revealed the association of the virus with the non-neuropathogenic genotype. This study describes for the first time the immunohistochemical and molecular detection of EHV-1 in Uruguay.

Evaluation of Hematobin as a Vaccine Candidate to Control Haematobia irritans (Diptera: Muscidae) Loads in Cattle.

The horn fly, Haematobia irritans (L.), is a blood-sucking livestock ectoparasite responsible for substantial livestock losses. In the present work, the potential use of recombinant hematobin (HTB), a horn fly salivary protein, as an antigen for cattle vaccination was investigated. In this trial, horn fly loads and H. irritans's blood intake were assessed in vaccinated (n = 4) and control (n = 4) crossbred dark-coated steers, which were naturally infected. The vaccinated group received a 1 ml subcutaneous injection of 100 µg of HTB protein emulsified in 500 µl of Incomplete Freund Adjuvant (AIF) on days 0 and 30. The control group received on the same days 1 ml of distilled water emulsified in 500 µl of AIF. The vaccinated group had significantly more HTB-specific IgG antibodies after the HTB booster and had a lower fly load than the control group (206 ± 23 vs. 285 ± 23 flies per animal, respectively). Blood intake by H. irritans did not differ between groups. In summary, these results suggest that vaccinating cattle with HTB could reduce cattle H. irritans load.

Sentinel node biopsy after neoadjuvant chemotherapy in breast cancer: results from National Surgical Adjuvant Breast and Bowel Project Protocol B-27.

PURPOSE: Experience with sentinel node biopsy (SNB) after neoadjuvant chemotherapy is limited. We examined the feasibility and accuracy of this procedure within a randomized trial in patients treated with neoadjuvant chemotherapy. PATIENTS AND METHODS: During the conduct of National Surgical Adjuvant Breast and Bowel Project trial B-27, several participating surgeons attempted SNB before the required axillary dissection in 428 patients. All underwent lymphatic mapping and an attempt to identify and remove a sentinel node. Lymphatic mapping was performed with radioactive colloid (14.7%), with lymphazurin blue dye alone (29.9%), or with both (54.7%). RESULTS: Success rate for the identification and removal of a sentinel node was 84.8%. Success rate increased significantly with the use of radioisotope (87.6% to 88.9%) versus with the use of lymphazurin alone (78.1%, P = .03). There were no significant differences in success rate according to clinical tumor size, clinical nodal status, age, or calendar year of random assignment. Of 343 patients who had SNB and axillary dissection, the sentinel nodes were positive in 125 patients and were the only positive nodes in 70 patients (56.0%). Of the 218 patients with negative sentinel nodes, nonsentinel nodes were positive in 15 (false-negative rate, 10.7%; 15 of 140 patients). There were no significant differences in false-negative rate according to clinical patient and tumor characteristics, method of lymphatic mapping, or breast tumor response to chemotherapy. CONCLUSION: These results are comparable to those obtained from multicenter studies evaluating SNB before systemic therapy and suggest that the sentinel node concept is applicable following neoadjuvant chemotherapy.

A Natural Cattle Immune Response Against Horn Fly (Diptera: Muscidae) Salivary Antigens May Regulate Parasite Blood Intake.

The horn fly, Haematobia irritans (L.), is a blood-sucking ectoparasite that is responsible for sizeable economic losses in livestock. The salivary gland products facilitate blood intake. Taking advantage of the identification of novel H. irritans salivary antigens (Hematobin, HTB and Irritans 5, IT5), we investigated the parasite loads, H. irritans blood intake, and antibody response of naturally infected bovines during the fly season. Fly loads and fly hemoglobin content fluctuated during the trial. Each time horn fly loads exceeded 200 flies per cattle, a reduction in horn fly blood intake was observed three weeks later. All of the cattle elicited an antibody response against HTB and IT5 that declined once the fly season was over. Cattle anti-IT5 titers were positively correlated with parasite loads and negatively correlated with fly blood intake. These results suggest that the natural changes in the H. irritans blood intake observed in this study were associated with a natural host response against horn fly salivary antigens.

Does breast tumor location influence success of sentinel lymph node biopsy?

BACKGROUND: Controversy exists regarding the influence of sentinel lymph node (SLN) mapping technique or patient variables on the success rate of SLN mapping. We undertook a prospective study in a single institution series to evaluate multiple variables that could adversely affect SLN identification rates. STUDY DESIGN: Data were collected on 174 patients who underwent 177 SLN mapping procedures followed by axillary dissection from October 1996 through January 2000. Patient demographics, body mass index (BMI), biopsy method, tumor size, palpability, and location were recorded. SLNs were identified by blue dye only (n = 31), Tc-99m sulfur colloid only (n = 34), or combined techniques (n = 112). Data were analyzed by logistic regression analysis and expressed as the probability of failure to map the SLN. RESULTS: SLNs were identified successfully in 150 of 177 procedures (85%) with a false negative rate of 3.7%. Mapping success reached 93% using combination blue dye and isotope. Variables found to adversely affect SLN mapping success and the odds ratio of failure (OR) included lower inner quadrant (LIQ) location (OR 35.6), blue dye only (OR 42.4), BMI >30 and upper outer quadrant (UOQ) location (OR 14.6), and nonpalpable UIQ location (OR 25). LIQ location adversely affects mapping success independent of technique, tumor size, or obesity. Obesity and nonpalpability were adverse factors when tumors were located in the UOQ and UIQ, respectively. Age, biopsy technique, and tumor diameter did not affect SLN mapping success. CONCLUSIONS: SLN mapping success is influenced by technique and tumor location, with best results achieved using combined techniques and for lesions located in quadrants other than the LIQ. Obesity and tumor palpability influence success in the context of tumor location.

Randomised trial of SPf66 vaccine against Plasmodium falciparum malaria in children in southern Tanzania.

Malaria, especially that due to Plasmodium falciparum, is one of the most important parasitic disease in man. It causes more than 400 million cases per year and between 1 to 3 million deaths, mainly among young children and pregnant women in sub-Saharan Africa. The current malaria control strategies using rapid diagnosis and treatment as well as methods to reduce the man-vector contact have had limited success. In Kilombero district (Southern Tanzania), malaria transmission is perennial (parasite prevalence > or = 80% all year) and intense (approximatively 300 infectious bites per year). At the household level, each under-5 child suffers on average 3 clinical fever episodes per year. Minimum estimated community rates for serious malaria (cerebral malaria or malaria and anaemia) affect approximatively 5% of all children. Under conditions of a field experiment, the annual incidence of a febrile illness (axillary temperature > or = 37.5 degrees C) reported to the curative primary health services in each child was 0.86 of which 0,35 can be attributed to Plasmodium falciparum malaria. The best estimate of the SPf66 vaccine protective efficacy in the Kilombero was 31% (95% CI : 0.52).

Sequelae of cryotherapy in breast tissue.

Cryotherapy is a novel treatment for benign and malignant breast lesions that is under evaluation. We assessed the acute and subacute outcomes of breast cryotherapy in normal goat teats using physical, microscopic, and imaging modalities. Eight goats were subjected to two freeze-thaw cycles of breast tissue producing a 2cm iceball and sacrificed either 2 or 7 weeks later. Acute skin changes were minimal unless obvious tissue injury occurred during cryotherapy; however, depigmentation developed over several weeks in dark-skinned goats despite the presence of melanocytes. By histology, breast epithelial elements could not be identified at cryotherapy sites. There was no cystic degeneration, which is common at surgical excision sites. Neither calcifications nor prominent scarring could be attributed to cryotherapy on imaging studies after 2 or 7 weeks. When compared to standard breast surgery, the sequelae of cryotherapy using histologic, radiographic, and sonographic criteria were decreased. Our study suggests that cryotherapy, with technical modifications, is feasible within breast tissue and warrants further study.

Biometrial - associated infections in surgery: part I clinical application, etiology and pathogenesis

Nas ultimas decadas presenciamos um aumento consideravel em relacao ao numero e a variedade de biometrias disponiveis para o uso medico, sem que, no entanto, um correspondente aumento na seguridade de seu uso fosse observada. Considerada uma complicacao de rara ocorrencia, a infeccao esta geralmente associada a uma alta morbidade e suas consequencias podem ser catastroficas para o paciente. Sua incidencia esta diretamente relacionada a reacao tecidual, fatores relacionados ao microorganismo e as caracteristicas do biomaterial. Atualmente, as opcoes terapeuticas estao limitadas as medidas profilaticas, antibioticoterapia e a remocao da protese...