Does every woman require a post-lumpectomy mammogram and ultrasound before radiotherapy when negative margins?

PURPOSE: Most studies regarding the value of post lumpectomy imaging (PLI) studies rely on mammography alone and are often focused on patients that present with suspicious microcalcifications or in situ disease. This way, its true benefit remains controversial, which explained the heterogeneity between centers. This is the first study to evaluate the role of mammography with breast and axillary ultrasound undertaken before radiotherapy in patients with conservatively managed invasive and/or in situ carcinoma with negative margins. MATERIALS AND METHODS: In this retrospective study, medical records for patients referred to our External Radiotherapy Unit between January 2018 and December 2019 were reviewed. RESULTS: A total of 1251 patients (1262 breasts) were analyzed. A total of 3.4% had suspicious findings for local residual breast disease, with 1.0% having a re-excision positive for residual malignancy. Presentation with microcalcifications alone (OR=4.854), extension of microcalcifications>3cm (OR=13.500), histologic subtype pure ductal carcinoma in situ (OR=12.348), presence of invasive carcinoma≤1mm of the pathological margins (OR=4.630), stage pTis (5.630), and absence of invasive component (OR=4.629), were associated with an increased risk for residual malignancy. Only one patient (0.1%) had nodal residual involvement. CONCLUSION: PLI detected residual local cancer in 1.0% of the patients. PLI plays an important role in the evaluation of patients undergoing breast-conserving therapy with negative margins. The major question that remains is whether it changes survival outcomes.

Hormonal strategy to reduce suckled beef cow handling for timed artificial insemination with sex-sorted semen.

Two experiments were conducted to assess a hormonal strategy developed to reduce animal handling for timed artificial insemination (TAI) with sex-sorted semen. Four-hundred ninety-one (491) suckled beef cows received a progesterone (P4) intravaginal device and 2 mg intramuscular (im) injection of estradiol benzoate (EB) on a randomly chosen day of the estrus cycle (Day 0) in Experiment 1. Cows were treated with 500 µg of sodic cloprostenol (PGF2α) and with 300 IU of eCG at P4 device removal (Day 8); these cows were also randomly assigned to receive 1 mg of estradiol cypionate (EC) administered at P4 device removal (treatment EC-0h) or 1 mg of EB 24 h after P4 device removal (treatment EB-24h). Both treatments were timed inseminated (TAI) with sex-sorted semen 60 h after P4 device removal. Cows treated with EC-0h presented higher pregnancy rate per AI (P/AI) [45.0% (113/251)] than the ones treated with EB-24h [35.4% (85/240); P = 0.03)]. A subset of cows (n = 26) were subjected to ultrasound examination every 12 h after P4 device removal for 96 h in the row in order to determine the time of ovulation. Similar interval between device removal and ovulation was recorded for EB-24h = 70.0 ±â€¯2.9 h vs. EC-0h = 66.0 ±â€¯2.8 h (P = 0.52). Five-hundred ninety-one (591) cows were subjected to the same synchronization protocols and treatments (EC-0h or EB-24h). In addition, they were randomly assigned to a 2 × 2 factorial arrangement aiming at determining the effects of treatment with estradiol (EC-0h vs. EB-24h) and of semen type (Sex-sorted vs. Non-sex-sorted semen). All animals were timed inseminated 60 h after P4 device removal. There was no interaction (P = 0.07) between the ovulation inducer and semen type. The EC protocol led to greater P/AI than EB (P = 0.03). Greater (P = 0.01) P/AI was achieved through treatments with non-sex-sorted semen rather than with sex-sorted semen [sex-sorted (EB-24h = 49.0%; EC-0h = 51.0%) vs. non-sex-sorted semen (EB-24h = 52.4%; EC-0h = 68.2%)]. Therefore, EC administered at P4 device removal resulted in greater P/AI. Furthermore, the EC-0h protocol allowed reducing suckled beef cow handing for timed artificial insemination with sex-sorted semen.

Impact of puberty status and melengestrol acetate supplementation before the breeding period on reproductive efficiency of Bos indicus beef heifers.

Two experiments were designed to evaluate the impact of puberty status and the administration of melengestrol acetate (MGA) before onset of the breeding period on ovulatory responses (Exp. 1) and conception rate after AI performed on estrus detection during 10 d and the pregnancy rate through 80 d of breeding period (Exp. 2) of pasture-grazed beef heifers. In Exp. 1, heifers (15 pubertal and 15 prepubertal) received 0.5 mg per heifer/d -1 of MGA over 14 d. No differences in the ovulatory responses were found 10 d after the MGA administration (pubertal = 46.7% vs. prepubertal P = 53.3%; P = 0.72). In Exp. 2, 368 heifers were randomly assigned to groups according to pubertal status and the MGA treatment. All heifers were inseminated on estrus detection for up 10 d after MGA administration and following exposure to bulls between 20 and 80 d. The MGA-treated heifers exhibited a greater AI service rate than control heifers (72.1 vs. 41.6%;P < 0.01); however, heifers receiving MGA had lower conception results following AI (51.6 vs. 71.4%; P = 0.01). In addition, MGA-treated heifers were more likely to have a corpus luteum in the middle of the breeding period (95.3 vs. 87.5%;P < 0.01), although the Cox proportional hazard of pregnancy rate was similar (P = 0.29) at the end of the breeding period. At onset of the breeding period, pubertal heifers presented a greater pregnancy rate following AI (pubertal P = 42.2% vs. prepubertal P = 24.9%; P = 0.01). Therefore, pubertal heifers seem to have greater overall reproductive efficiency than prepubertal heifers, particularly at the beginning of the breeding period. Interestingly, administration of MGA before the onset of the breeding period increased AI service rate but did not alter the rate of pregnancy throughout the breeding period of pasture-grazed beef heifers.

Reported tailings dam failures. A review of the European incidents in the worldwide context.

A detailed search and re-evaluation of the known historical cases of tailings dam failure was carried out. A corpus of 147 cases of worldwide tailings dam disasters, from which 26 located in Europe, was compiled in a database. This contains six sections, including dam location, its physical and constructive characteristics, actual and putative failure cause, sludge hydrodynamics, socio-economical consequences and environmental impacts. Europe ranks in second place in reported accidents (18%), more than one third of them in dams 10-20 m high. In Europe, the most common cause of failure is related to unusual rain, whereas there is a lack of occurrences associated with seismic liquefaction, which is the second cause of tailings dam breakage elsewhere in the world. Moreover, over 90% of incidents occurred in active mines, and only 10% refer to abandoned ponds. The results reached by this preliminary analysis show an urgent need for EU regulations regarding technical standards of tailings disposal.

Vigilancia de los virus de la gastroenteritis en los laboratorios nacionales del Brasil / National laboratory surveillance of viral agents of gastroenteritis in brazil

En 1984 se distribuyó a los laboratorios de 14 estados brasileños un estuche de inmunoensayo enzimático para la detección de rotavirus y adenovirus. El estuche fue preparado por el Departamento de Virología de la Fundación Oswaldo Cruz como parte de un proyecto para la detección de agentes virales en muestras fecales de niños con diarrea. La vigilancia ulterior duró de 3 a 5 años, y en un taller celebrado en Belém en 1991 se examinaron los resultados obtenidos por todos los laboratorios que analizaron mas de 300 muestras fecales. Los resultados revelaron la presencia de rotavirus en 13 por ciento a 20 por ciento de los especímenes investigados y una frecuencia máxima de resultados positivos de mayo a septiembre, que es la estación "invernal" o seca en los estados de las zonas central y meridional del Brasil pero no en las zonas tropicales situadas más al norte. Se detectaron adenovirus en 0,7 por ciento a 5,5 por ciento de las muestras analizadas, sin ninguna variación estacional. También se detectaron muchos otros agentes virales productores de gastroenteritis (entre ellos astrovirus, pequeños virus de estructura esférica, calicivirus y ratavirus del grupo C) en los centros donde se usó el microscopio electrónico. El picobirnavirus, microorganismo que hasta el momento no se había asociado con la gastroenteritis en el ser humano, se descubrió por medio de la electroforesis en gel de poliacrilamida en especímenes enviados a diversos centros que usaban esta técnica. Las vacunas contra los rotavirus, actualmente en fase de experimentación, serían de gran utilidad en el Brasil, donde tales virus son la causa más frecuente de diarrea infantil. Se necesitarán mejores técnicas de diagnóstico para determinar la importancia de los demás agentes virales

Vigilancia de los virus de la gastroenteritis en los laboratorios nacionales del Brasil / National laboratory surveillance of viral agents of gastroenteritis in brazil

En 1984 se distribuyó a los laboratorios de 14 estados brasileños un estuche de inmunoensayo enzimático para la detección de rotavirus y adenovirus. El estuche fue preparado por el Departamento de Virología de la Fundación Oswaldo Cruz como parte de un proyecto para la detección de agentes virales en muestras fecales de niños con diarrea. La vigilancia ulterior duró de 3 a 5 años, y en un taller celebrado en Belém en 1991 se examinaron los resultados obtenidos por todos los laboratorios que analizaron mas de 300 muestras fecales. Los resultados revelaron la presencia de rotavirus en 13 por ciento a 20 por ciento de los especímenes investigados y una frecuencia máxima de resultados positivos de mayo a septiembre, que es la estación "invernal" o seca en los estados de las zonas central y meridional del Brasil pero no en las zonas tropicales situadas más al norte. Se detectaron adenovirus en 0,7 por ciento a 5,5 por ciento de las muestras analizadas, sin ninguna variación estacional. También se detectaron muchos otros agentes virales productores de gastroenteritis (entre ellos astrovirus, pequeños virus de estructura esférica, calicivirus y ratavirus del grupo C) en los centros donde se usó el microscopio electrónico. El picobirnavirus, microorganismo que hasta el momento no se había asociado con la gastroenteritis en el ser humano, se descubrió por medio de la electroforesis en gel de poliacrilamida en especímenes enviados a diversos centros que usaban esta técnica. Las vacunas contra los rotavirus, actualmente en fase de experimentación, serían de gran utilidad en el Brasil, donde tales virus son la causa más frecuente de diarrea infantil. Se necesitarán mejores técnicas de diagnóstico para determinar la importancia de los demás agentes virales

Se publica en inglés en Bull. PAHO. Vol. 27(3), 1993

Enteric viruses and diarrhea in HIV-infected patients. Enteric Opportunistic Infections Working Group.

BACKGROUND: Diarrhea occurs frequently among persons with the acquired immunodeficiency syndrome, but the cause often remains unknown. We used a group of diagnostic assays to determine which viruses were etiologic agents of diarrhea in a group of persons infected with the human immunodeficiency virus (HIV). METHODS: Stool and serum specimens were obtained from HIV-infected patients enrolled in a longitudinal study in Atlanta. Fecal specimens from patients with diarrhea and from control patients without diarrhea were screened by electron microscopy, polyacrylamide-gel electrophoresis, and enzyme immunoassays for rotaviruses, enteric adenoviruses, caliciviruses, picobirnaviruses, and astroviruses. Paired serum samples were tested for antibody responses to Norwalk virus and picobirnavirus. RESULTS: Viruses were detected in 35 percent of 109 fecal specimens from patients with diarrhea but in only 12 percent of 113 specimens from those without diarrhea (P < 0.001). Specimens from patients with diarrhea were more likely than those from patients without diarrhea to have astrovirus (12 percent vs. 2 percent, P = 0.003); picobirnavirus (9 percent vs. 2 percent, P = 0.017); caliciviruses, including small round structured viruses (6 percent vs. 1 percent, P = 0.062); and adenoviruses (9 percent vs. 3 percent, P = 0.047). They were also more likely to have a mixed viral infection (6 percent vs. 0 percent, P = 0.006). With the use of polyacrylamide-gel electrophoresis to analyze concentrated RNA extracts from stool, picobirnavirus was detected in fecal specimens from 6 of the 65 patients with diarrhea and was associated with prolonged viral shedding and chronic diarrhea. No rotaviruses, enteric adenoviruses, or instances of seroconversion to positivity for Norwalk virus were observed. CONCLUSIONS: Novel enteric viruses such as astrovirus and picobirnavirus may be more important etiologic agents of diarrhea in HIV-infected patients than previously recognized and may be more common than either bacterial or parasitic enteropathogens.

National laboratory surveillance of viral agents of gastroenteritis in Brazil.

In 1984 an enzyme immunoassay for rotavirus and adenovirus developed in the Virology Department of the Oswaldo Cruz Foundation was distributed to laboratories in 14 Brazilian states as part of a project to survey viral agents in fecal specimens from children with diarrhea. The ensuing surveillance continued for 3 to 5 years, and in 1991 the results obtained by all laboratories that tested 300 or more fecal specimens were reviewed at a workshop held in Belém. These results showed that rotavirus had been detected in 13% to 20% of the specimens tested, with positive specimens appearing to peak in the May to September "winter" or dry season in Brazil's central and southern states but not in the more tropical northern areas. Adenovirus, detected in 0.7% to 5.5% of the specimens tested for it, showed no seasonal variations. Many other viral agents known to cause gastroenteritis (e.g., astrovirus, small round-structured viruses, calcivirus, and group C rotavirus) were detected at centers that used electron microscopy. Picobirnavirus, a novel agent not yet associated with gastroenteritis in humans, was found by polyacrylamide gel electrophoresis in specimens from a number of centers using this technique. Vaccines to prevent rotavirus that are currently under development would be of great use in Brazil, where rotavirus is the most common cause of childhood diarrhea. Improved diagnostics will be required to assess the importance of the other viral agents.

National laboratory surveillance of viral agents of gastroenteritis in Brazil

In 1984 an enzyme immunoassay for rotavirus and adenovirus developed in the Virology Department of the Oswaldo Cruz Foundation was distributed to laboratories in 14 Brazilian states as part of a proyect to survey viral agents in fecal specimens from children with diarrhea. The ensuing surveillance continued for 3 to 5 years, and in 1991 the results obtained by all laboratories that tested 300 o more fecal specimens were reviewed at a workshop held in Belém. These results showed that rotavirus had been detected in 13 percent to 20 percent of the specimens tested, with positive specimens appearing to peak in the May to September "winter" or dray season in Brazil's central and southern states but not in the more tropical northern areas. Adenovirus, detected in 0.7 percent to 5.5 percent of the specimens tested for it, showed no seasonal variations. Many other viral agent know to cause gastroenteritis (e.g., astrovirus, small round-structured viruses, calcivirus, and group C rotavirus) were detected at centers that used electron microscopy. Picobirnavirus, a novel agent no yet associated with gastroenteritis in humans, was found by polyacrylamide gel electrophoresis in specimens from a number of centers using this technique. Vaccines to prevent rotavirus that are currently under development would be of great use in Brazil, where rotavirus is the most common cause of childhood diarrhea. Improved diagnostics will be required to assess the importance of the other viral agents

National laboratory surveillance of viral agents of gastroenteritis in Brazil

In 1984 an enzyme immunoassay for rotavirus and adenovirus developed in the Virology Department of the Oswaldo Cruz Foundation was distributed to laboratories in 14 Brazilian states as part of a proyect to survey viral agents in fecal specimens from children with diarrhea. The ensuing surveillance continued for 3 to 5 years, and in 1991 the results obtained by all laboratories that tested 300 o more fecal specimens were reviewed at a workshop held in Belém. These results showed that rotavirus had been detected in 13 percent to 20 percent of the specimens tested, with positive specimens appearing to peak in the May to September "winter" or dray season in Brazil's central and southern states but not in the more tropical northern areas. Adenovirus, detected in 0.7 percent to 5.5 percent of the specimens tested for it, showed no seasonal variations. Many other viral agent know to cause gastroenteritis (e.g., astrovirus, small round-structured viruses, calcivirus, and group C rotavirus) were detected at centers that used electron microscopy. Picobirnavirus, a novel agent no yet associated with gastroenteritis in humans, was found by polyacrylamide gel electrophoresis in specimens from a number of centers using this technique. Vaccines to prevent rotavirus that are currently under development would be of great use in Brazil, where rotavirus is the most common cause of childhood diarrhea. Improved diagnostics will be required to assess the importance of the other viral agents

This article will also be published in Spanish in the Bol. Oficina Sanit. Panam. Vol. 116(5):27-36, 1994

A novel avian virus with trisegmented double-stranded RNA and further observations on previously described similar viruses with bisegmented genome.

The occurrence in chickens of small viruses with bisegmented double-stranded RNA (dsRNA) genome is confirmed and a new virus with similar properties but with three genome segments is described. Both differ from birnaviruses (Intervirology 25, 141-143, 1986) in having indistinct surface structure, smaller diameters (35 nm), and higher buoyant density (1.4 g/ml) in CsCl but are similar in these respects to viruses previously described in several mammals (Lancet 2, 103-104, 1988; J. Gen. Virol. 69, 2749-2754, 1988; Res. Vet. Sci, in press) under the tentative name of picobirnaviruses (PBV). Genome segment length estimations gave values of 2.6 and 1.9 kbp for the avian PBV and 2.9, 2.4 and 0.9 kbp for the trisegmented viruses. The source and pathogenic potential of these viruses remain to be established.

Preliminary characterization of a new virus isolated from the spinal fluid of patients with meningitis in São Paulo, Brazil.

A total of 138 patients with the age of 4 months to 57 years were attended in different hospitals of São Paulo State with aseptic meningitis. A probable new agent was isolated from the cerebrospinal fluid of 35 of 53 specimens examined. Replication of the agent with similar characteristics was detected by CPE produced in the MDCK cell line. Virus-like particles measuring about 40 nm in diameter were observed by negative staining electron microscopy. No hemagglutinating activity was detected at pH 7.2 by using either human, guinea pig, chicken and at pH ranged 6.0-7.2 with goose red blood cells. The agent was not pathogenic to newborn or adult mice. Virus infectivity as measured by CPE was sensitive to chloroform and not inhibited by BuDR, suggesting that agent is an enveloped virus with RNA genome.

Viruses with bisegmented double-stranded RNA in pig faeces.

Viruses similar to the bisegmented double-stranded (ds) RNA picobirnaviruses described in human faeces and the intestinal contents of Oryzomys nigripes rats and guinea pigs were isolated from the faeces of pigs taken from several areas in the state of Sao Paulo, Brazil. Samples were collected from 912 pigs of several breeds, aged nine to 61 days, and assayed by polyacrylamide gel electrophoresis with silver staining and a combined enzyme immunoassay for rotavirus and adenovirus, using the simian rotavirus SA11 as control. Electrophoretic profiles resembling the bisegmented dsRNA viruses were detected in 106 pigs with 15.3 per cent occurring in animals with diarrhoea compared to 9.6 per cent in animals without diarrhoea.

A serological investigation of rotavirus infections in a shanty town population in Rio de Janeiro.

The presence of antibodies against rotavirus was investigated by enzyme immunosorbent assay (ELISA) in two distinct groups of children living in a shanty town in Rio de Janeiro. One hundred and thirty six plasma samples were randomly collected from children of 0 to 33 months (first group) and 255 serum samples were collected from other 85 children at ages of 2, 6 and 9 months (second group). A high percentage of antibodies were found in the newborn children and this rate decreased progressively until the age of 11 months, after which it increased again. At the age of 7 months, geometric mean antibody titers increased indicating that infection had occurred.

New genome types of adenovirus types 1, 3, and 5 isolated from stools of children in Brazil.

During an epidemiological survey made in São Paulo (Brazil), fecal specimens were periodically collected from 100 randomly chosen babies from birth to the age of 18 months. The stools, routinely collected each month and also collected each time a child presented any sign of disease, were screened for the presence of adenoviruses. Sixteen adenovirus strains, isolated from the stools of healthy and ill children, were characterized by restriction enzyme analysis. Five isolates were from subgenus A, five were from subgenus B, four were from subgenus C, and two were from subgenus D. All but two showed some restriction patterns different from those of the 42 human adenovirus prototypes and all the genome types described up to now. No fastidious adenovirus (subgenus F, serotypes 40 and 41) was encountered in the stools examined. We report here the restriction enzyme analysis of isolates of subgenera B and C. The following new designation genome types are proposed: Ad3e1 (subgenus B) and Ad1d, Ad5a1, and Ad5a2 (subgenus C).

Serological evidence of rotavirus infection in guinea pig colony

Evidência sorológica de infecçäo por rotavírus em uma colônia de cobaios - Anticorpos reagindo com rotavírus símio SA11 foram demonstrados por ensaio imuno-enzimático (EIE) e por "Western blot assay" (WBA) em soros de cobaios mantidos para fins experimentais na Fundaçäo Oswaldo Cruz, Rio de Janeiro, Brasil. A proporçäo de animais soro-positivos e os níveis de anticorpos subiram rapidametne em 1985, mantiveram-se altos em 1986 e baixaram em 1987. Näo foram observados sinais de doença coincidente com a elevaçäo de anticorpos. Resultados de WBA sugerem que o rotavírus responsável pela resposta sorológica pertence ao subgrupo do grupo A

A virus with a bisegmented double-stranded RNA genome in rat (Oryzomys nigripes) intestines.

Examination of the intestinal contents of free-living Oryzomys nigripes rats by PAGE revealed two sharply defined bands that could be stained by ethidium bromide or by silver nitrate with comparable intensities. The molecules forming these bands were susceptible to digestion by pancreatic RNase A but not by RNase T1 or by DNase I. Their lengths were estimated to be about 2.6 and 1.5 kbp, respectively, by comparison with rotavirus SA11 genome segments. They cosedimented in CsCl gradients at a density of 1.39 to 1.40 g/ml, together with uniform particles approximately 35 nm in diameter with indistinct surface structure. It is suggested that these particles represent an as yet undescribed virus with a bisegmented double-stranded RNA genome, for which the name 'picobirnavirus' is proposed.