Androgen receptor-positive triple negative breast cancer: a unique breast cancer subtype.

BACKGROUND: The significance of androgen receptor (AR) expression in triple-negative breast cancer (TNBC) is unclear, and published studies so far have been inconclusive. METHODS: A tissue microarray was constructed using tissue obtained from 119 patients with primary TNBC and stained for AR expression. Other tissue types obtained included recurrent TNBC, normal breast tissue, adjacent ductal carcinoma-in situ (DCIS), lymph node (LN) and distant metastases. Positive AR expression was defined as ≥10% nuclear staining. RESULTS: Epithelial tissue was present and evaluable in 94 TNBC patients with a total of 177 tissue cores. AR expression in TNBC was 22 of 94 (23%). AR expression was higher in normal breast tissue (88%) and adjacent DCIS (73% overall). All LN metastases from AR-positive TNBC patients were also AR positive; in addition, no AR-negative TNBC patient had AR-positive LNs. AR expression was associated with older patient age (63 vs. 57 years, respectively, p = 0.051) and LN metastases (p = 0.033). Locoregional recurrence and overall/disease-specific survival were similar between AR-positive and AR-negative patients, although AR-positive patients had more advanced disease. On multivariate analysis, the presence of LN metastases was associated with poorer recurrence-free survival in AR-positive patients (hazard ratio, 4.34) (p = 0.031). CONCLUSIONS: The AR is expressed in normal breast tissue, and expression decreases with advancement to DCIS and invasive cancer. AR-positive TNBC was more common in older patients and had a higher propensity for LN metastases. AR-positive TNBC may represent a breast cancer subtype with unique features that may be amenable to treatment with alternative targeted therapies.

Prevalence and etiology of dentoalveolar trauma in 1,592 United States military working dogs: A 1-year retrospective study.

The objective of this study was to quantify the overall prevalence and classification of traumatic dentoalveolar injury (TDI) in a large population of military working dogs (MWDs). The medical records of 1,592 MWDs undergoing routine oral exam and periodontal treatment over a 1-year period were reviewed. The MWDs were located at over 100 military veterinary treatment facilities across the globe. Patient signalment, occupational duty certification, tooth injured, and trauma etiology were recorded. The overall prevalence of TDI was 43.6%. The mean number of TDI per MWD was 1.2. Maxillary tooth fractures were the most common at 60.9% compared to mandibular tooth fractures 39.1%. The most common TDI was enamel-dentin-pulp fractures which accounted for 59.9% of all injuries. Specialized Search Dogs (SSDs) had the highest average of enamel-dentin and enamel-dentin-pulp tooth trauma. Incidental findings with an unknown cause accounted for the majority of tooth trauma 69.2% followed by housing 18.2%, bite work 6.2%, and blunt force trauma 6.0%. The frequency of TDI in the MWD population was substantial, with more than one out of every four MWDs requiring treatment. The probability of a tooth injury in the MWD population was nearly double compared to the pet dog population. Tooth type and age were significant predictors of severe tooth trauma requiring treatment. Improved understanding of MWD tooth trauma prevalence and risk factors will help drive change while maintaining deployment readiness of the team.

Long-Term Outcome of Horses Undergoing Unilateral Mandibular Condylectomy and Meniscectomy for Temporomandibular Joint Disease.

Background: There are no reports describing the long-term outcome of sport horses undergoing unilateral mandibular condylectomy with meniscectomy (UMC) for treatment for severe temporomandibular joint (TMJ) disease (TMD). Whether horses undergoing UMC require a specialized diet, can return to riding with a bit, or return to intended function after surgery is unknown. Objective: To determine the long-term outcome of horses undergoing UMC for treatment of severe TMD. Study Design: A multi-institutional, retrospective study. Methods: Medical records obtained from seven equine referral hospitals of horses with severe TMD that underwent UMC were reviewed. Details regarding the presenting complaints, results of clinical examination, findings of diagnostic imaging, surgical technique, and outcome (including long-term follow-up with an owner questionnaire) were recorded. Results: Eleven horses fit the inclusion criteria. Three had severe idiopathic osteoarthritis, and eight had confirmed septic osteoarthritis of the TMJ. The most common post-operative complications were drainage and peri-incisional swelling (n = 5). One horse developed a hematoma at the surgical site because the facial artery was inadvertently transected during the approach, causing the condylectomy to be postponed. All horses were discharged alive from the hospital, and 10 returned to their previous or intended use. All had complete resolution of clinical signs of TMD. One mare was retired from athletic use due to her genetic value as a broodmare. One horse was euthanized 2 years after UMC due to progressively worsening of clinical signs of temporohyoid osteoarthropathy (THO), which were not present before surgery. When available, owner satisfaction of the results of the procedure was excellent. Main Limitations: Sample size; multiple institutions; owner bias. Conclusions: Unilateral mandibular condylectomy should not be considered a salvage procedure. Horses treated for severe TMD by UMC can return to their previous or intended level of athletic performance and do not require a specialized diet.

PCR rapidly detects methicillin-resistant staphylococci periprosthetic infection.

Optimal treatment of methicillin-resistant staphylococcal periprosthetic infections is predicated on rapid and reliable detection of these organisms. Culture has served as the gold standard for identification of these organisms despite shortcomings with sensitivity and processing time. The objective of the current study was to investigate a polymerase chain reaction assay aimed at rapid genomic detection of methicillin-resistance in staphylococci (mecA gene). The feasibility of the molecular approach first was validated using a septic arthritis model consisting of 73 synovial fluid samples inoculated with methicillin-resistant staphylococci and four negative controls. MecA polymerase chain reaction then was done on 35 clinical samples from 18 patients obtained at the time of revision arthroplasty. Results of the polymerase chain reaction were compared with culture. MecA polymerase chain reaction successfully predicted the presence of methicillin-resistant staphylococci in the septic arthritis model. In the clinical samples studied, the polymerase chain reaction results were concordant with culture results in 34 of the 35 samples tested. The one discordant result represented a false-positive culture result. The molecular assay was processed in less than 5 hours compared with 2 to 3 days for culture. Detection of methicillin-resistant staphylococci involved in periprosthetic infections by the polymerase chain reaction is a rapid and reliable approach.