Practical consensus recommendations on management of triple-negative metastatic breast cancer.

Patients with breast cancer along with metastatic estrogen and progesterone receptor (ER/PR)- and human epidermal growth factor receptor 2 (HER2)-negative tumors are referred to as having metastatic triple-negative breast cancer (mTNBC) disease. Resistance to current standard therapies such as anthracyclines or taxanes limits the available options for previously treated patients with metastatic TNBC to a small number of non-cross-resistant regimens, and there is currently no preferred standard chemotherapy. Clinical experience suggests that many women with triple-negative metastatic breast cancer (MBC) relapse quickly. Expert oncologist discussed about new chemotherapeutic strategies and agents used in treatment of mTNBC and the expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.

Practical consensus recommendations regarding the management of sentinel lymph node issues in early breast cancer.

Axillary lymph node involvement is a very important poor prognostic factor in the clinical staging and management of breast cancer patients. Traditionally, axillary lymph node dissection (ALND) has been used for determining the status of the axillary lymph nodes. More recently the sentinel lymph node biopsy (SLNB) procedure has gained wider acceptance as the standard of care, having the advantage of being less invasivewhile providing good accuracy. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at these practical consensus recommendations in regards with the use of the two different procedures and other issues in patients with early breast cancer for the benefit of community oncologists.

Glucosamine modulates chondrocyte proliferation, matrix synthesis, and gene expression.

OBJECTIVE: To investigate the effects of glucosamine (GlcN) on chondrocyte proliferation, matrix production, and gene expression for providing insights into the biochemical basis of its reported beneficial effects in osteoarthritis (OA). METHODS: Dose-dependent effect of GlcN on cell morphology, proliferation, cartilage matrix production and gene expression was examined by incubating primary bovine chondrocytes with various amounts of GlcN in monolayers (2D) and in cell-laden hydrogels (3D constructs). Histology, immunofluorescent staining and biochemical analyses were used to determine the effect of GlcN on cartilage matrix production in 3D constructs. The impact of GlcN on gene expression was evaluated with real-time polymerase chain reaction (PCR). RESULTS: GlcN concentration and culture conditions significantly affected the cell behavior. Quantitative detection of matrix production in cell-laden hydrogels indicated a relatively narrow window of GlcN concentration that promotes matrix production (while limiting cellular proliferation, but not cell viability). Notably, GlcN enhanced cartilage specific matrix components, aggrecan and collagen type II, in a dose-dependent manner up to 2 mM but the effect was lost by 15 mM. Additionally, GlcN treatment up-regulated transforming growth factor-beta1 (TGF-beta1) mRNA levels. CONCLUSION: Results indicate that culture conditions play a significant role in determining the effect of GlcN on chondrocytes, explaining both the previously reported beneficial and deleterious effects of this sugar. The ability of GlcN to alter TGF-beta1 signaling provides a biochemical mechanism for GlcN activity on chondrocytes that up to now has remained elusive. The observed anabolic effect of optimal GlcN concentrations on chondrocytes may be useful in formulating effective cartilage repair strategies.

Giant hairy 'bathing trunk' naevus with multiple congenital melanocytic naevi.

A 23-day-old male infant had hairy 'bathing trunk' naevus covering, neck and upper trunk along with multiple congenital melanocytic naevi scattered all over the body.

Comparative effect of dimethindene maleate and chlorpheniramine maleate on histamine-induced weal and flare.

Antihistaminic activity of 3 or 6 mg dimethindene maleate was compared with that of placebo and 12 mg chlorpheniramine maleate in 60 healthy volunteers in a randomized, crossover study. Activity of each drug was assessed by measuring 2 micrograms histamine-induced weal and flare areas. Compared with placebo, both doses of dimethindene and chlorpheniramine significantly (P less than 0.001) reduced weal area. Both doses of dimethindene (P less than 0.001) and chlorpheniramine (P less than 0.05) also significantly reduced flare area. Dimethindene (6 mg) brought about the maximum reduction in weal area (28.8%) and flare area (39.1%). Dimethindene (6 mg) also reduced weal area significantly (P less than 0.01) compared with chlorpheniramine and reduced flare area significantly (P less than 0.05) compared with 3 mg dimethindene. Using a 100 mm visual analogue scale for assessment of weal and flare intensities, 6 mg dimethindene again produced the maximum response. The study confirmed that the antihistamine activity of dimethindene was better than that of chlorpheniramine.

Attitude of unmarried girls towards family planning: a study in an Orissa City.

PIP: In 1987-88, 281 females from the Government Women's College in Berhampur, Ganfam District, Orissa State in India were surveyed to determine their knowledge and attitude toward family planning (FP). 80% came from urban areas. Educated fathers (72%) had considerable influence over the education of their daughters (p.001). Higher income families (70%) were more able to educate their children than lower income families (30%; p.001). 50% of the students had discussed FP and family ties with their parents. 91% recognized the need for FP. 95% did not favor early marriage (p.02). 66% knew the legal marriage age for females to be 18 years, but only 47% knew it to be 21 for males. In fact, 46% believed the age for males to be 25 years. 24% k new of only 1 FP method, 23% of 2 methods, and 14% of 3 methods. The leading method to be used after marriage according to the students was condoms (16%) followed by IUDs and oral contraceptives (OCs) (6%). The predominant method to use after childbirth was sterilization (13%) followed by IUDs (8%) and condoms and OCs (5%). Most students did not advocate using any method after marriage or after childbirth. 45% mentioned the best time to start FP was after 2 children and 26% after 1 child. Most, (83%) preferred 2 children (p.001) because of better child care and education (37%). 71% felt couples should wait 3 years before having another child. No one believed 1 or 4 years to be adequate birth spacing. Birth spacing was needed in the interest of the mother's health (30%) and for better health of the next child (29%). The mass media provided 50% of the students with FP knowledge. Most (70%) felt that insufficient FP education and basic education were the reasons for unplanned families. 82% believed the FP program would be successful in the future. 68% considered population control important to national development.^ieng