ASO Visual Abstract: Prediction of Pathologic Complete Response in Breast Cancer Patients Comparing Magnetic Resonance Imaging with Ultrasound in the Neoadjuvant Setting

Annals of Surgical Oncology -     

Metabolic effects of insulin in the European eel, Anguilla anguilla L

Eels were injected intraperitoneally with insulin (100 IU/kg) and during 14 days the effects on different metabolites in blood, liver and muscle were studied.Exogenous insulin had a marked effect on carbohydrate metabolism. The observed changes (hypoglycemia, depletion of hepatic glycogen and an initial increase in muscle glycogen formation) indicate that insulin in eels induces effects on carbohydrate metabolism qualitatively similar to those found in mammals.Insulin also appears to have an important function in the regulation of lipid metabolism in eels, indicated by a rapid decrease in plasma FFA and a somewhat delayed decrease in other blood lipids.Protein metabolism and plasma inorganic ions were only slightly affected after insulin injection.     

Anthropology of health in Brazil: a border discourse

This article traces the development of anthropological research on health in Brazil in light of discussions on modernity/coloniality and world anthropologies. Originating in the 1970s, stimulated by external and internal pressures for scientific production and along with the expansion of graduate programs, a network of anthropologists has consolidated and multiplied in Brazil. We describe the development of research groups, meetings, and publications in order to characterize Brazilian anthropology of health as a research program that distinguishes itself from North Atlantic medical anthropology. We examine the visibility and circulation of references in academic publications to explore the participation of Brazilians in the global discourse and, more specifically, in the North-South dialogue. From a comparative perspective, we argue that anthropological investigations of health reflect a perspective and ethos distinctive to Brazil and its historical and political processes.     

Willingness to care for patients with HIV/AIDS

This study aims to describe and compare nurses' willingness to provide care for patients with HIV/AIDS and factors associated with this in three countries. An international cross-sectional survey was conducted among nurses working in medical, surgical and gynaecology units in Finland (n =427), Estonia (n =221) and Lithuania ( n =185) in early 2006. The response rates were 75% (n = 322) in Finland, 54% (n =119) in Estonia and 86% (n = 160) in Lithuania. A modified version of a scale developed in 1994 by Dubbert et al. was applied. Our findings showed a general willingness of the nurse participants to provide care for patients with HIV/AIDS. However, this willingness varied both among and within countries and was also related to specific nursing interventions. The results underline the importance of providing education on ethical issues related to HIV/AIDS care in Europe and tailoring the content of this education to meet nurses' national educational needs.     

Invasive lobular breast cancer. Prognostic significance of histological malignancy grading

Invasive lobular carcinoma (ILC) is the second most reported type of breast cancer in the Danish Breast Cancer Cooperative Group (DBCG). Several histological subtypes exist, with reports of different prognosis. The aim was to present the incidence of ILC in DBCG from 1977-2004, and evaluate tumours regarding diagnosis, histological subtype and grade, and relate to prognosis. Eight hundred and sixty tumours from patients with a diagnosis of ILC or ILC/non-ILC, who underwent breast cancer surgery in the period of 1990-1998, were evaluated. The impact of histological malignancy grade on disease-free survival and overall survival was analysed using a multivariate analysis adjusting for tumour size, hormone receptor status, axillary lymph node status and patient age. The incidence of pure ILC has risen from 5 to 12%, the ILC/non-ILC is constant at 2% of all reported breast cancers in DBCG. Most of the tumours were classical ILC grade II. The majority of the grade III tumours were among the non-classical subtypes, showing a statistically significant worse disease-free and overall survival compared to grade II, regardless of type. The prognosis was the same for grade I and grade II tumours. The number of positive axillary lymph nodes and hormone receptor negative tumours increased among grade III tumours. We conclude that histological malignancy grade has an independent significant impact on the prognosis of ILC, and it should be taken into consideration when planning the postoperative treatment in this group of patients.     

Nursing students' attitudes towards HIV/AIDS patients in Finland, Estonia and Lithuania

This paper presents baseline data on attitudes towards HIV/AIDS patients and homophobic levels among nursing students in three Baltic Sea countries: Finland, Estonia and Lithuania. The aim is to describe and compare nursing students' attitudes in these three countries and to explore how attitudes towards HIV/AIDS correlate with background variables. The total sample comprised 471 nursing students. The respondents demonstrated average attitude scores towards patients with HIV/AIDS and rather positive attitudes towards homosexually oriented patients. Significant country differences were found, with Finnish nursing students showing the most positive attitudes towards HIV/AIDS patients and homosexually oriented patients. Previous experience of HIV/AIDS patients was the single factor with the greatest positive impact on nursing students' attitudes. Nursing students' willingness to provide care for an HIV/AIDS patient was associated with a positive attitude towards these patients. Length of employment experience correlated negatively with general attitude, and older nursing students with more work experience showed a more negative attitude towards homosexual patients. Proper education to achieve a sound knowledge base and good nursing skills promotes a more positive attitude to HIV/AIDS. It is important that nursing students are sensitive and show respect for the patient's human dignity. There is need for greater harmonization of education in the three countries.     

Free radicals and brain damage due to transient middle cerebral artery occlusion: the effect of dimethylthiourea

The objective of this study was to assess whether dimethylthiourea (DMTU), an established free radical scavenger, ameliorates ischaemic damage due to 2–3 h of transient middle cerebral artery (MCA) occlusion, induced by an intraluminal filament. A major point adressed was whether DMTU given before MCA occlusion only delayed the maturation of the damage, or if it had a lasting effect on infarct size. The end point was morphological, and either encompassed triphenyltetrazolium chloride (TTC) staining of tissue slices after 24 h or 48 h of recovery, or histopathological assessment of infarct size after 7 days of recovery. In a preliminary series of experiments, rats were subjected to 3 h of MCA occlusion, and infarct volume was assessed by TTC staining after 24 h of recovery. DMTU in a dose of 750 mg/kg reduced infarct volume by more than 50%. However, due to a high mortality rate, that protocol was not subsequently pursued. When the ischaemia duration was reduced to 2 h and the DMTU dose to 400 mg/kg, a similar amelioration of the tissue damage was observed. However, since DMTU reduced a spontaneous rise in body temperature to 39.0–39.5°C, DMTU-treated animals in the main series of experiments with 24 and 48 h of recovery were treated so that they had the same temperature rise as the saline controls. Under such constant temperature conditions, the effect of DMTU at 24 h of recovery was borderline (P= 0.052) and at 48 h it was nil. The lack of a lasting effect of DMTU was supported by the findings on evaluation of infarct area after 7 days of recovery. The results raise the important question whether DMTU, and perhaps other free radical scavengers, delay rather than ameliorate the ischaemic lesion developing after transient MCA occlusion.     

Frontal cortex lesion prior to hyperglycemic ischemia: no decrease in ensuing substantia nigra pars reticulata damage or fatal post-ischemic seizures

Summary Preischemic hyperglicemia worsens brain damage after ischemia, and characteristically leads to post-ischemic seizures and a pan-necrotic lesion in substantia nigra pars reticulata (SNPR). The excitatory input to SNPR could contribute to the damage observed. By performing a unilateral frontal cortex lesion 6–19 days prior to the ischemia, we wanted to explore whether a decrease in excitatory input to the ipsilateral SNPR ameliorate the seizures or alter the light microscopical damage in SNPR. Our results demonstrate that unilateral frontal cortex lesion did not alter the development of fatal post-ischemic seizures after 10 min of ischemia in hyperglycemic subjects. Thus, 7/8 animals developed seizures and died within 20 h of recovery. This study also failed to show any difference between the left and right side in post-ischemic SNPR damage after 15 h of recovery in animals with preischemic unilateral frontal cortex lesion. Furthermore, no side difference was observed in any other brain region evaluated. The results thus suggest that the pan-necrotic lesion in SNPR after hyperglicemic ischemia is not caused by excessive excitatory input from frontal cortex. A decrease in the GABA-ergic inhibitory input from caudoputamen to SNPR may be a more important mechanism for the ensuing excitotoxic post-ischemic SNPR damage, and for seizure development.     

Changes in the bioenergetic state of rat hippocampus during 2.5 min of ischemia, and prevention of cell damage by cyclosporin A in hyperglycemic subjects

 A recent study from this laboratory has shown that brief transient ischemia (2 min 30 s) in normo- and hyperglycemic rats leads to moderate neuronal necrosis in CA1 cells of the hippocampus, of equal density in the two groups. However, hyperglycemic animals failed to depolarize during the ischemia, nor did they show a decrease in extracellular calcium concentration. The present study was undertaken to study the metabolic correlates to these unexpected findings. Normoglycemic (plasma glucose ∼6 mM) and hyperglycemic (∼20 mM) rats were subjected to ischemic periods of 1 min and 2 min 15 s (2 min 30 s with freezing delay considered), and their brains were frozen in situ. Samples of dorsal hippocampus were dissected at –22°C and extracted for the measurement of phosphocreatine (PCr), creatine, ATP, ADP, AMP, glucose, glycogen, and lactate. Normoglycemic animals showed rapid depletion of PCr, ATP, glucose, and glycogen, and a rise in lactate content to 10–12 mM·kg^–1 during the ischemia. Hyperglycemic animals displayed a more moderate rate of fall of PCr and ATP, with ATP values exceeding 50% of control after 2 min 30 s. Glycogen stores were largely maintained, but degradation of glucose somewhat enhanced the lactic acidosis. The results demonstrate that hyperglycemic rats maintained ATP at levels sufficient to prevent cell depolarization and calcium influx during the ischemic period. However, the metabolic perturbation observed must have been responsible for the delayed neuronal damage. We speculate that lowered ATP, increased inorganic P, and oxidative stress triggered a delayed mitochondrial permeability transition (MPT), which led to delayed neuronal necrosis. This assumption was supported by a second series of experiments in which CA1 damage in hyperglycemic rats was prevented by cyclosporin A, a virtually specific inhibitor of the MPT. Received: 24 May 1996 / Accepted: 30 September 1996