Unexpected Metastasis of High Grade Serous Ovarian Cancer to Breast: Case Report and Literature Review

Introduction: Metastasis of ovarian serous carcinoma to breast and/or axillary lymph nodes represents an unusual event. Nevertheless, their detection and distinction from mammary carcinoma are of huge clinical importance because the treatment and prognosis diverge significantly. Case presentation: We report a case of a 47 year-old Caucasian female patient with unforeseen metastasis to the breast and to axillary lymph nodes due to ovarian serous carcinoma. Conclusion: In patients with history of OSC who present with axillary or breast mass, an accurate histological diagnosis should be obtained since this has a great impact on treatment outcomes

Blood cyanide determination in two cases of fatal imtoxication: comparison between headspace gas chromatography and a spectrophotometric method

Blood samples of two cases were analyzed preliminarily by a classical spectrophotometric method (VIS) and by an automated headspace gas chromatographic method with nitrogen-phosphorus detector (HS-GC \u2044 NPD). In the former, hydrogen cyanide (HCN) was quantitatively determined by measuring the absorbance of chromophores forming as a result of interaction with chloramine T. In the automated HS-GC \u2044NPD method, blood was placed in a headspace vial, internal standard (acetonitrile) and acetic acid were then added. This resulted in cyanide being liberated as HCN. The spectrophotometric (VIS) and HS-GC\u2044NPD methods were validated on postmortem blood samples fortified with potassium cyanide in the ranges 0.5\u201310 and 0.05\u20135 lg \u2044 mL, respectively. Detection limits were 0.2 lg \u2044mL for VIS and 0.05 lg \u2044mL for HS-GC\u2044NPD. This work shows that results obtained by means of the two procedures were insignificantly different and that they compared favorably. They are suitable for rapid diagnosis of cyanide in postmortem cases

Inclusive growth? The relationship between economic growth and poverty in British cities

There is growing concern in many developed economies that the benefits of economic growth are not shared equitably. This is particularly the case in the UK, where economic growth has been geographically uneven and often biased towards already affluent cities. Yet there is relatively little evidence on the relationship between growth and poverty in the UK. This paper addresses this gap with an analysis of the links between economic growth and poverty in British cities between 2000 – 2008. We find little evidence that output growth reduced poverty. While growth was associated with wage increases at the top of the distribution, it was not associated with wage growth below the median. And there was no relationship between economic growth and the low skilled employment rate. These results suggest that growth in this period was far from inclusive

Refining the accuracy of validated target identification through coding variant fine-mapping in type 2 diabetes.

We aggregated coding variant data for 81,412 type 2 diabetes cases and 370,832 controls of diverse ancestry, identifying 40 coding variant association signals (P < 2.2 × 10-7); of these, 16 map outside known risk-associated loci. We make two important observations. First, only five of these signals are driven by low-frequency variants: even for these, effect sizes are modest (odds ratio ≤1.29). Second, when we used large-scale genome-wide association data to fine-map the associated variants in their regional context, accounting for the global enrichment of complex trait associations in coding sequence, compelling evidence for coding variant causality was obtained for only 16 signals. At 13 others, the associated coding variants clearly represent 'false leads' with potential to generate erroneous mechanistic inference. Coding variant associations offer a direct route to biological insight for complex diseases and identification of validated therapeutic targets; however, appropriate mechanistic inference requires careful specification of their causal contribution to disease predisposition

Sexual dimorphism of the thoracic vertebrae in a modern Cretan population: a comparison of the individual vertebrae in terms of accuracy in estimating sex.

Estimation of sex is one of the first steps when developing a biological profile for recovered human remains. Several studies have been concerned with sexual dimorphism in the human vertebrae in general, yet few are concerned specifically with the thoracic vertebrae. This thesis examines the presence and extent of sexual dimorphism in the thoracic vertebrae of a documented Greek population from the island of Crete, and establishes a method for sex assessment. A total of 16 linear measurements were taken from all twelve thoracic vertebrae, using a sample of 70 adult individuals. Out of the 16 measurements, the minimum number of dimorphic variables in a vertebra was eleven. The univariate discriminant function analysis yielded results with up to 89.4% total accuracy. Using a stepwise method of discriminant function analysis, two variables in T1 predicted sex with 90.6% total accuracy. In comparison to previous research on other vertebrae, the current study yielded similar results in terms of accuracy and significance of individual variables. Nevertheless, comparative data for thoracic vertebrae are only available for T12. The applicability of this method to other collections cannot be drawn, as no similar studies exist. It is concluded that the thoracic vertebrae of the Greek population are sexually dimorphic and that the method used in this study shows great potential. Nevertheless, it needs to be tested in other populations in order to further evaluate its applicability

Dietary treatment of urinary risk factors for renal stone formation. A review of CLU Working Group

OBJECTIVE: Diet interventions may reduce the risk of urinary stone formation and its recurrence, but there is no conclusive consensus in the literature regarding the effectiveness of dietary interventions and recommendations about specific diets for patients with urinary calculi. The aim of this study was to review the studies reporting the effects of different dietary interventions for the modification of urinary risk factors in patients with urinary stone disease. MATERIALS AND METHODS: A systematic search of the Pubmed database literature up to July 1, 2014 for studies on dietary treatment of urinary risk factors for urinary stone formation was conducted according to a methodology developed a priori. Studies were screened by titles and abstracts for eligibility. Data were extracted using a standardized form and the quality of evidence was assessed. RESULTS: Evidence from the selected studies were used to form evidence-based guideline statements. In the absence of sufficient evidence, additional statements were developed as expert opinions. CONCLUSIONS: General measures: Each patient with nephrolithiasis should undertake appropriate evaluation according to the knowledge of the calculus composition. Regardless of the underlying cause of the stone disease, a mainstay of conservative management is the forced increase in fluid intake to achieve a daily urine output of 2 liters. HYPERCALCIURIA: Dietary calcium restriction is not recommended for stone formers with nephrolithiasis. Diets with a calcium content 65 1 g/day (and low protein-low sodium) could be protective against the risk of stone formation in hypercalciuric stone forming adults. Moderate dietary salt restriction is useful in limiting urinary calcium excretion and thus may be helpful for primary and secondary prevention of nephrolithiasis. A low-normal protein intake decrease calciuria and could be useful in stone prevention and preservation of bone mass. Omega-3 fatty acids and bran of different origin decreases calciuria, but their impact on the urinary stone risk profile is uncertain. Sports beverage do not affect the urinary stone risk profile. HYPEROXALURIA: A diet low in oxalate and/or a calcium intake normal to high (800-1200 mg/day for adults) reduce the urinary excretion of oxalate, conversely a diet rich in oxalates and/or a diet low in calcium increase urinary oxalate. A restriction in protein intake may reduce the urinary excretion of oxalate although a vegetarian diet may lead to an increase in urinary oxalate. Adding bran to a diet low in oxalate cancels its effect of reducing urinary oxalate. Conversely, the addition of supplements of fruit and vegetables to a mixed diet does not involve an increased excretion of oxalate in the urine. The intake of pyridoxine reduces the excretion of oxalate. HYPERURICOSURIA: In patients with renal calcium stones the decrease of the urinary excretion of uric acid after restriction of dietary protein and purine is suggested although not clearly demonstrated. HYPOCITRATURIA: The administration of alkaline-citrates salts is recommended for the medical treatment of renal stone-formers with hypocitraturia, although compliance to this treatment is limited by gastrointestinal side effects and costs. Increased intake of fruit and vegetables (excluding those with high oxalate content) increases citrate excretion and involves a significant protection against the risk of stone formation. Citrus (lemons, oranges, grapefruit, and lime) and non citrus fruits (melon) are natural sources of dietary citrate, and several studies have shown the potential of these fruits and/or their juices in raising urine citrate levels. CHILDREN: There are enought basis to advice an adequate fluid intake also in children. Moderate dietary salt restriction and implementation of potassium intake are useful in limiting urinary calcium excretion whereas dietary calcium restriction is not recommended for children with nephrolithiasis. It seems reasonable to advice a balanced consumption of fruit and vegetables and a low consumption of chocolate and cola according to general nutritional guidelines, although no studies have assessed in pediatric stone formers the effect of fruit and vegetables supplementation on urinary citrate and the effects of chocolate and cola restriction on urinary oxalate in pediatric stone formers. Despite the low level of scientific evidence, a low-protein ( 3 liters/day) is strongly advised in children with cystinuria. ELDERLY: In older patients dietary counseling for renal stone prevention has to consider some particular aspects of aging. A restriction of sodium intake in association with a higher intake of potassium, magnesium and citrate is advisable in order to reduce urinary risk factors for stone formation but also to prevent the loss of bone mass and the incidence of hypertension, although more hemodynamic sensitivity to sodium intake and decreased renal function of the elderly have to be considered. A diet rich in calcium (1200 mg/day) is useful to maintain skeletal wellness and to prevent kidney stones although an higher supplementation could involve an increase of risk for both the formation of kidney stones and cardiovascular diseases. A lower content of animal protein in association to an higher intake of plant products decrease the acid load and the excretion of uric acid has no particular contraindications in the elderly patients, although overall nutritional status has to be preserved

Sexual dimorphism of the metacarpals in contemporary Cretans:Are there differences with mainland Greeks?

Sex in the adult skeleton can usually be reliably determined through an assessment of features found on the pelvis and cranium. In the lack of these elements it is necessary to elaborate other methods to establish sex in skeletonised remains recovered in forensic cases. Standards for other bones (e.g. humerus, metacarpals and metatarsals) have already been established for the Greek population. The aim of this study is to determine whether the standards for metacarpals provided from a study on the Athens collection are representative of a modern Cretan population.Using a digital caliper we took 7 measurements on each one of the left and right metacarpal bones of 108 adult individuals from a modern collection from Crete. Totally twenty formulae for left and right bones created from the Athens collection were used to sex the sample of this study.The overall classification accuracy obtained for our sample was very close to the cross-validated accuracy reported by the authors. However, looking at the classification accuracy for males and females, a consistent trend for low classification rates in females was observed. New formulae were developed for the Cretan sample yielding up to 85% classification accuracy.This study clearly indicates that the standards for metacarpals developed from the Athens collection are not appropriate for application in forensic cases for the island of Crete as they do not represent the local population efficiently. This may hold true for other regions of Greece thus great caution should be taken when applying these standards. Obviously more research is needed to confirm these results

Can MR Imaging Diagnose Adult-Onset Alexander Disease?

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Moving to a better place? The outcomes of residential mobility among families with young children in the Millennium Cohort Study

This paper assesses how far residential moves can result in improvement or deterioration of the housing and neighbourhood circumstances for families with young children. It uses data from the UK Millennium Cohort Study concentrating on the time between infancy and age five, 2001 to 2006. First we ask which families moved home and in what circumstances. We then examine how moving changed several aspects of housing: space standards, damp problems, and tenure. We show that the majority of moves resulted in improvements to housing conditions, especially in reducing overcrowding. We also consider neighbourhood circumstances, proxied by a measure of local poverty at small area level. Movers generally ended up in neighbourhoods with lower levels of poverty, or no worse, but almost one fifth of moves were downward or remained in the 30 percent poorest areas. We ask whether locating in an area with more local poverty may help achieve a larger home. There is evidence of such a trade-off – one in five families moved to a larger home which was either in a poorer area than before or remained in the 30 percent poorest areas. We conclude by showing how the path of upward housing mobility, while numerically dominant, was far less common among families with relatively low resources and/or whose moves were attendant on partnership changes. For them, moves often result in smaller homes in poorer areas

Empresas B: Una gestión estratégica apoyada en el conocimiento

Companies play a decisive role in development. However, actually, they are blamed for part of the world's environmental degradation and social inequality. To improve this image, business models have emerged, such as B companies, which in addition to generating economic returns provide environmental and social solutions to society. The aim of the study was to analyse the strategic management adopted by these companies. Methodologically, a documentary analysis was carried out. Also, some successful cases of companies that operate in Latin America and have a great impact on society were analysed.  The conclusions highlight that the B companies have as a base of their strategic management, the identification of the needs of the stakeholders and the production of knowledge; those allows them to generate innovations that contribute with the creation of products and services that besides generating an economic yield, they improve the quality of life of their groups of interest.DOI: https://doi.org/10.53766/ACCON/2021.42.05Las empresas juegan un papel determinante en el desarrollo. No obstante, actualmente se les atribuye parte del deterioro ambiental y la desigualdad social del mundo. Para mejorar esta imagen, han surgido modelos empresariales, como las empresas B, las cuales además de generar un rendimiento económico, aportan soluciones ambientales y sociales a la sociedad. El estudio tuvo como objetivo analizar la gestión estratégica adoptada por estas empresas. Metodológicamente, se realizó el análisis documental de artículos, sobre algunos casos exitosos de empresas que funcionan en Latinoamérica y con gran impacto en la sociedad. Las conclusiones destacan, que las empresas B tienen como base de su gestión estratégica la identificación de necesidades de los stakeholders y la producción de conocimiento en esta área; esto les permite generar innovaciones que contribuyen con la creación de productos y servicios que además de generar un rendimiento económico, mejoran la calidad de vida de sus grupos de interés