Dermatofibrosarcoma protuberans mamario en un varón / Dermatofibrosarcoma protuberans in a man

El dermatofibrosarcoma protuberans (DFSP) es un tumor rarode la piel, localmente agresivo con elevado rango de recidivas ybaja incidencia de metástasis a distancia. Puede originarse comouna pequeña lesión asintomática y pasar desapercibido. La extirpacióncon amplios márgenes ha sido el tratamiento de elecciónaunque la cirugía micrográfica de Mohs puede ser el mejor tratamiento.Se presenta un paciente con un dermatofibrosarcomaprotuberans mamario y se revisa la literatura

Dermatofibrosarcoma protuberans is an uncommon tumorof the dermis (DFSP) is a locally agressive tumor with a highrecurrence rate but rare systemic metastasis. It may start as asmall asymtomatic lesion, which is likely ignored. Surgical excisionwith wide margins has been considered the standardtherapy though Mohs micrographic surgery may be the besttreatment option. We study the case of a man with DFSP inthe breast. Literature is also reviewed

Relevance of multicultural training to students' applications to clinical psychology programs.

Interest in the efficacy of multicultural training for practitioners and scientists working with multicultural populations has led to questions about the characteristics of students who seek this training. Students of ethnic minority background, as compared with White students, may be more likely to seek programs that offer this training, and their ethnic or racial identity may be related to this preference. This study explores the relevance of multicultural training to White and ethnic minority graduate students in accredited clinical psychology programs. Students rated the relevance of multicultural and general training components to their decisions about where to apply to graduate school. The ethnic minority students' mean ratings of the relevance of multicultural components were higher than those of White students, and the degree of ethnic minority students' ethnic identification was positively correlated to these relevance ratings.

Are clinical psychologists prepared for service and research with ethnic minorities? Report of a decade of progress.

Longitudinal data on the status of training of clinical psychologists for service and research with ethnic minority populations were presented in order to assess progress. Data from an earlier survey by Bernal and Padilla (1982), which were collected in 1979-1980, were compared with similar survey data collected in 1990-1991. Results revealed a mixed picture of progress: Key aspects of minority training have improved, and there is a substantial block of programs committed to minority training. However, two changes are needed: engagement in a change process leading to training for cultural competence rather than minimal exposure to culture, and a significant increase in the numbers of minority faculty, which can occur only by a sharp increase in the numbers of minority students admitted into the educational pipeline.

The analysis of trenbolone and the human urinary metabolites of trenbolone acetate by gas chromatography/mass spectrometry and gas chromatography/tandem mass spectrometry.

The electron impact mass spectrometric properties of trimethylsilyl ether and fluoroacyl ester derivatives of trenbolone, combined or not combined with a methoxime group, are presented. Some derivatization problems were observed and were due to the formation of enol derivatives at the 3C-position in several tautomeric forms, which in their turn were not stable and lost two or four hydrogens under the conditions studied. The enolization could be minimized by carefully selecting the reaction conditions or could be prevented by the introduction of a methoxime group at the 3C-position. The limits of detection and identification of the methoxime heptafluorobutyryl ester and the methoxime trimethylsilyl ether derivative of trenbolone were determined using a mass selective detector in the electron impact mode and a triple-stage quadrupole in the methane positive chemical ionization mode. Selected reaction monitoring in tandem mass spectrometry did not improve the limit of detection, but because of the gain in selectivity did improve the limit of identification. The glucuronides of trenbolone and epitrenbolone could be identified in three urine specimens out of 200 samples in routine doping control.

Factors associated with parent labeling of children referred for conduct problems.

Clinicians have suggested that in some cases normal children have been inappropriately labeled as deviant by their parents and taken to psychological clinics for treatment. Reasons given for such inappropriate labeling have included factors such as the parents' marital distress and intolerance of normal child behavior. This study provided an empirical examination of the appropriateness or inappropriateness of parent labeling of 5--12-year-old children referred by their parents for treatment of conduct problems. The definition of inappropriate labeling derived by the present investigators required that the relationship between the child's actual behavior and the parent's negative label be so imperfect as to raise questions about the justification for the label, and that some identifiable factors other than the child's behavior account for the negative label. Three parent factors evaluated for their contribution to the parent negative label were martial distress, parent negative behavior toward the child, and parent distress about child deviant behavior. The statistical model of hierarchical multiple regression permitted analysis of this definition. The association found between observed child deviant behavior and the parent negative label suggested that parents of this sample perceived their children reasonably accurately. The three parent factors were found to be negligibly related to the parent label. Therefore, the conditions for inappropriate labeling of the children by the parents of this sample were not met.

Outcome evaluation of behavioral parent training and client-centered parent counseling for children with conduct problems.

The central question addressed was, how effective is parent training in reducing conduct problems in children in comparison to client-centered parent counseling? A secondary question was the relative effectiveness of the two treatment groups in comparison to a wait control group that when untreated during the 8-week period of treatment provided the other groups. Families of 36, 5- to 12-year-old conduct problem children were screened and assigned at random to treatment groups, but wait control group assignment depended upon therapist availability. Supervised graduate student therapists conducted 10 treatment sessions for each family. Parent reports and paper and pencil tests of child deviance and parent satisfaction showed a superior outcome for behavioral over the client-centered and wait control groups, and no differences between the latter two groups. At follow-up there was no maintenance of this superiority. Home observation data showed no advantage of behavioral over client-centered treatment, and these two groups did not improve significantly more than the wait control group. These results were discussed in the light of possible interactions between treatment and measurement, and methodological and sampling differences between this and other studies.

A survey of parent training manuals.

Twenty-six commercially available parent training manuals were surveyed with the goal of providing helpful information to the professional for selection of manuals. Included were manuals for parents as well as manuals for professionals for use in conducting individual or group treatment. The following information was given for all manuals: the characteristics of the target populations for whom the manuals were intended, readability levels, use made of technical language, provision of glossary, organization and format of the book, availability of supplementary materials such as leaders' guides, and references to reviews by other authors. In an additional section, the research literature dealing with evaluation of these manuals was reviewed and summarized as a means of acquainting the reader with the available scientific information on their effectiveness. A report on the status of each manual in terms of evaluation was provided in tabular form. The evaluation of manuals by conduct of empirical research to determine their usefulness to the consumer was emphasized.

Temporal and climatic variables in naturalistic observation.

Home-observation data on 5- to 7-yr-old boys collected over 2 yr were examined for systematic variations in rates of desirable and undesirable behaviors associated with several temporal and climatic variables. Significant effects associated with time of day, day of the week, precipitation, and temperature were found. No significant effects on the naturalistic observation data were found for environmental factors associated with lunar phase. It was noted that the correlational nature of the findings did not obviate the necessity for control of the influence of temporal and climatic variables. Several methodological strategies for such control were discussed.

A device for recording automatic audio tape recording.

Adaptation of a commercially available timer for use as a means of operating an audio tape recorder several times during the day is described. Data on a mother's rates of commanding her children were collected via both physically present observer and recorder methods in order to compare the usefulness of the recordings with direct observation. There was a high positive relationship between observer-recorder command rates, with the observer rates being consistently higher, when data were collected via both methods simultaneously as well as at different points in time.