The effects of breast augmentation surgery on future ability to lactate

The majority of women receiving breast augmentation surgery do so at a time in their lives when both reproduction and lactation are common. It does not occur to most women to consider the possible effects breast augmentation surgery may have on their future ability to exclusively breast-feed their baby. Most women raise concerns about their inability to exclusively breast-feed years after surgery when they have a child. It is therefore important that women considering breast augmentation surgery be fully informed of the possible effects surgery may have on their future ability to lactate. The possible direct effects of surgery on the breast tissue and the complications of breast surgery on future ability to lactate are discussed. Surgical technique, i.e., implant type and placement, are also discussed. The types of incisions made into the breast tissue and the positioning of the implants once inside the breast parenchyma are analyzed and their possible effects on future ability to lactate are explored. Women who undergo breast augmentation surgery have a greater incidence of lactation insufficiency. Factors directly related to the surgical procedure as well as short- and long-term complications of surgery compromise future ability to exclusively breast-feed a baby. Factors directly related to surgery include severing of the lateral and medial branches of the fourth intercostal nerve or the nerve endings of the nipple-areolar complex, which, lead to reduced sensation and loss of the suckling reflex resulting in decreased milk production. Hematoma formation increases the risk of developing capsular contracture therefore necessitating the need for further surgical intervention. Infection also requires further intervention and as a result, further risk to the breast tissue. Long-term breast pain, capsular contracture, and pressure effects on the breast from the implant are all possible long-term complications that compromise a woman's future ability to lactate and exclusively breast-feed her baby. With good surgical technique and proper postoperative management, most of the complications associated with surgery that may result in insufficient milk production can be minimized but not always avoided. Compared with nonaugmented women, women who have had augmentation surgery have a higher incidence of lactation insufficiency.     

A polyepitope DNA vaccine targeted to Her-2/ErbB-2 elicits a broad range of human and murine CTL effectors to protect against tumor challenge

A cDNA vaccine (pVax1/pet-neu) was designed to encode 12 different Her-2/ErbB-2-derived, HLA-A*0201-restricted dominant and high-affinity heteroclitic cryptic epitopes. Vaccination with pVax1/pet-neu triggered multiple and ErbB-2-specific CTL responses in HLA-A*0201 transgenic HHD mice and in HLA-A*0201 healthy donors in vitro. Human and murine CTL specific for each one of the 12 ErbB-2 peptides recognized in vitro both human and murine tumor cells overexpressing endogenous ErbB-2. Furthermore, vaccination of HHD mice with pVax1/pet-neu significantly delayed the in vivo growth of challenged ErbB-2-expressing tumor (EL4/HHD/neu murine thymoma) more actively when compared with vaccination with the empty vector (pVax1) or vehicle alone. These data indicate that the pVax1/pet-neu cDNA vaccine coding for a poly-ErbB-2 epitope is able to generate simultaneous ErbB-2-specific antitumor responses against dominant and cryptic multiple epitopes.     

Seven-days-ahead forecasting of childhood asthma admissions using artificial neural networks in Athens, Greece

Artificial Neural Network (ANN) models were developed and applied in order to predict the total weekly number of Childhood Asthma Admission (CAA) at the greater Athens area (GAA) in Greece. Hourly meteorological data from the National Observatory of Athens and ambient air pollution data from seven different areas within the GAA for the period 2001-2004 were used. Asthma admissions for the same period were obtained from hospital registries of the three main Children's Hospitals of Athens. Three different ANN models were developed and trained in order to forecast the CAA for the subgroups of 0-4, 5-14-year olds, and for the whole study population. The results of this work have shown that ANNs could give an adequate forecast of the total weekly number of CAA in relation to the bioclimatic and air pollution conditions. The forecasted numbers are in very good agreement with the observed real total weekly numbers of CAA.     

Association of serum total homocysteine with the extent of ischemic heart disease in a Mediterranean cohort

High total homocysteine (tHcy) concentrations increase coronary disease risk. Therefore, the authors examined the relation between tHcy concentrations and the number of stenotic arteries in patients with ischemic heart disease (IHD). They enrolled 155 patients with IHD (135 men) who had undergone selective coronary angiography during the previous 2 years. These patients were divided into 4 groups according to the number of vessels (0, 1, 2, and 3) with > or = 70% stenosis. They also reviewed the major coronary risk factors for each patient (age, gender, hypertension, diabetes mellitus, dyslipidemia, cigarette smoking, obesity), and measured serum concentrations of tHcy, folate, vitamin B12 and lipids. There was a significant positive correlation (rs = 0.19; p = 0.017; n = 155) between tHcy serum concentration and the extent of coronary atherosclerosis, expressed by the number of coronary arteries with significant stenosis. Moreover, the number of affected vessels displayed a significant positive correlation with the presence of diabetes mellitus (rs = 0.30; p < 0.0001; n = 155) and serum concentrations of lipoprotein (a) (rs = 0.25; p < 0.05; n = 67) and a negative correlation with apolipoprotein A-I serum concentration (rs = -0.27; p < 0.01; n = 67). In this study, the serum concentrations of tHcy correlated with the extent of coronary atherosclerosis, independently of other classical risk factors, with the exception of diabetes mellitus.