Trends in pre-operative needle biopsy use in invasive breast cancer diagnosis: a Dutch nationwide population study.

INTRODUCTION: In recent decades, the use of pre-operative needle biopsy for breast cancer diagnosis has shifted. There is also an increased demand for availability of predictive factors. This study aims to quantify these changes. MATERIAL AND METHODS: From the Dutch nationwide pathology database (PALGA), all reports on breast cancer for five periods of 3 months between 1996 and 2016 were retrieved. Reports were categorised using automatic recognition of keywords. Classification was checked manually for the first 200 reports per period. The first 100 resected cases in each period underwent detailed investigation. RESULTS: For automatic analysis 34,639 reports were retrieved. Accuracy was 98% compared to manual assessment. Fine needle aspiration cytology (FNAC) decreased from 77% (1996) to 58% (2001), 34% (2006), 25% (2011), and 17% (2016). For detailed assessment, 498 cases were analysed. Diagnostic surgical excision decreased from 24% in 1996 to 3% in 2016, cases with only cytology from 65% to 1%, respectively. Cytology and core needle biopsy (CNB) were combined in 21% of cases in 2016. Pre-operative availability of ER status increased from 3% in 1996 to 36% in 2006 and 78% in 2016 (as compared to 47%, 92%, and 97% for post-operative availability, respectively) and for HER2 status from 0% to 13% and 66% (as compared to 1%, 89%, and 96% for post-operative availability, respectively). CONCLUSION: Results suggest that nationwide, clinics prioritise reliability and availability of ER and HER2 status, replacing FNAC by CNB. However, for optimal treatment planning for all patients, availability of pre-operative receptor status warrants further improvement.

Comparison of the remineralisation effect of a glass ionomer cement versus a resin composite on dentin of primary teeth.

AIM: The aim of this study was to investigate the interaction of a high viscosity glass ionomer cement (GIC) and a composite resin with caries affected dentin and to determine the remineralization levels. MATERIALS AND METHODS: In a split mouth design 24 GIC and composite resin atraumatic restorative treatment restorations were made in vivo and the teeth were collected after 2 years and subsequently sectioned and examined using Vickers microhardness test; the latter was performed starting from the dentin surface adjacent to the restoration. Repeated Measure ANOVA and Bonferroni statistical methods were used for data analysis. RESULTS: The microhardness adjacent to the GIC restorative material resulted to be significantly higher. CONCLUSION: GIC resulted to be a better restorative material for the remineralization of caries affected dentin, though further studies are necessary for the corroboration of this finding. The GIC restored primary molar dentin had a higher level of remineralization and GIC could be the material of choice in pediatric dentistry.

A monocentric pilot study of an antioxidative defense and hsCRP in pediatric patients with glycogen storage disease type IA and III.

BACKGROUND AND AIMS: Patients with glycogen storage disease type Ia (GSD Ia) and III (GSD III) do not develop premature atherosclerosis despite hyperlipidemia. The aim of the study was to investigate the oxidative-antioxidative conditions and high sensitivity C-reactive protein (hsCRP) levels in patients with glycogen storage disease type Ia and III. METHODS: We measured lipid profile and lipid peroxidation products in comparison with hsCRP and antioxidative status: trolox equivalent antioxidant capacity, total antioxidant activity, proteinaceous antioxidant enzymes (catalase, superoxide dismutase, paraoxonase, arylesterase), aqueous antioxidants (vitamin C, uric acid, bilirubin, total protein) and lipid-soluble antioxidants (alpha-tocopherol, beta-carotene). The study included 50 individuals: 22 with GSD Ia, 9 with GSD III, and 19 healthy subjects. RESULTS: GSD Ia patients showed a marked hypertriglyceridemia, whereas GSD III patients demonstrated hypercholesterolemia with elevated LDL-cholesterol and decreased HDL-cholesterol levels. Lipid peroxidation levels increased in both GSD groups. The antioxidant activity elevated in GSD Ia group. No significant differences were found in the activities of antioxidant enzymes. Uric acid and alpha-tocopherol levels increased, however, vitamin C and beta-carotene reduced in both GSD groups. The hsCRP levels did not differ among the groups. CONCLUSIONS: In summary our study revealed normal levels of hsCRP in spite of the dyslipidemic status in both GSD patients. The increased plasma antioxidative defense in GSD Ia might be attributed not only to the elevated uric acid but also to the supplemented vitamin E levels. These findings should motivate further investigations in the area of atherosclerotic escape of GSDs.