Screening for breast cancer in Catalonia: Which policy is to be preferred?

Background: the effects and costs of different policies forbreast cancer screening in Catalonia (Spain) were analysed,to give a basis for setting priorities and deciding on the introductionof a screening programme. Methods: the MISCAN (MIcrosimulationSCreening ANalysis) model of the natural history of breast cancerwas used. The epidemiology of breast cancer in Catalonia andthe demography of the Catalan population was taken into accountas well as the results on mortality reduction from a Swedishoverview of breast cancer screening trials. Results: the reductionin breast cancer mortality in the total female population dueto a screening programme for the age group 50–64 yearswould be 16, 12 and 9%, with screening intervals of one, twoand three years respectively. The cost-effectiveness ratios(CE ratios) for these scenarios were 924,000, 730,000 and 719,000pesetas (P_t) per life-year gained respectively (5% discounting).The most cost-effective screening scenario is the one in whichwomen aged 50–69 years are screened with an interval ofthree years with a mortality reduction of approximately 12%in the total female population (CE ratio = 694,000 P_t). Screeninguntil the age of 69 years (two year interval) was almost ascost-effective as screening the age group 50–64 yearswith a two year interval, with a reduction in breast cancermortality of 15%. Extension to under the age of 50 years resultedin diverging results depending on the assumptions for improvementin prognosis for younger women (40–49 years). Conclusion:if the extension of a two yearly screening programme for womenaged 50–64 years is considered (mortality reduction of12%), extension to older women would be more advisable, basedon proven benefits and costs, than extension to younger agegroups.     

Efficacy of Low-Level Laser Therapy for Chronic Cutaneous Ulceration in Humans: A Review and Discussion

Chronic wounds, particularly venous ulcerations, are notoriously difficult to heal. Because current therapies are variable in their ability to induce complete healing, there remains a need to develop adjunctive treatments that can improve or accelerate the healing process. The use of low-energy lasers to stimulate wound healing has been pursued over many decades in studies of varying quality. This form of treatment has had high appeal due to its novelty, relative ease, and low morbidity profile. The authors reviewed the available published literature on low-level laser technology in an attempt to provide cumulative insight on the effect of this treatment for wound healing.     

Ossifying Fibroma of Long Bone — Report of Two Cases

Two cases of ossifying fibroma of long bone with long term follow-up are described. Although the diagnosis can usually be established from the plain radiographs, computerised tomography can be of considerable value. Because of therapeutic implications it is important to distinguish this lesion from other fibro-osseous lesions of bone.     

INTERACTIONS OF OESTRADIOL BENZOATE AND PROMEGESTONE UPON BASAL AND TRH-INDUCED PROLACTIN SECRETION IN POSTMENOPAUSAL WOMEN

The interactions of ovarian steroids with PRL secretion in women are still controversial. Ten healthy postmenopausal women, on no medication, received during the first period of 2 months later in a cross-over design study, i.m. injections of 0.625 mg of oestradiol benzoate (EB) alone for 10 d or in combination with 750 micrograms/d of a pure progestin promegestone for 10 d. A TRH (200 micrograms i.v.) stimulation test was performed before the start and at the completion of each treatment period. Basal plasma gonadotrophins, PRL and oestradiol were measured every day by radioimmunoassay. The EB-induced rise in oestradiol levels was similar during the two periods. In response to EB treatment serum PRL levels increased from 6.1 +/- 0.9 ng/ml to 22.9 +/- 3.4 ng/ml. With the addition of promegestone, the increase in PRL, from 6.7 +/- 1.3 ng/ml to 13.8 +/- 2.5 ng/ml, was significantly diminished (P less than 0.001). The PRL release induced by TRH was significantly greater with EB treatment than was the response with the combined treatment (P less than 0.05, Wilcoxon test to compare the areas under the curves). These data suggest that in postmenopausal women oestrogens act as stimulators of PRL release and promegestone is able to partially counteract the stimulatory effect of oestradiol benzoate upon basal and TRH-stimulated PRL secretion.     

The effect of dental education and dental treatment on the dental status of a handicapped population: a longitudinal study

Thirty-nine patients, aged 3 to 22, who have handicapping conditions were examined twice in a range of 1 1/2 years to determine oral hygiene level, periodontal treatment needs, and level of caries. During this period, each patient was given periodontal treatment, including scaling, caries treatment, and oral health education, which also was given to hospital staff members. Findings showed a slight increase in the DMF rate, a minor improvement in oral hygiene, and a significant reduction in periodontal treatment needs. The results showed that without cooperation of the staff members, a dental education program would not succeed in this setting.     

Short-term decrease of skin-test sensitivity after rush desensitization in Hymenoptera venom hypersensitivity

Thirty-seven patients with a history of systemic anaphylactic stings were desensitized by the rush method. Patients were evaluated by skin testing twice, before and 6 weeks after desensitization. An additional control group of 10 patients, not yet desensitized, were tested for skin test technique reproducibility at 6-week intervals. Results were compared with IgE and IgG antibody levels, and with platelet reactivity towards specific Hymenoptera venom. Before desensitization, the maximum skin-test sensitivity was observed at 10(-5) micrograms venom/ml in 56% of patients and decreased to 10(-1) micrograms venom/ml after desensitization (48.6% of patients). Decrease of cutaneous tests was observed in 28/37 patients (75%) (P less than 0.001) and was not associated with significant variations of specific IgE or IgG antibody levels, but was correlated with the decrease of platelet reactivity (P less than 0.05). Conversely, variations of skin-test sensitivity in the control group was not significant.