Search results for: diagnosis and treatment intervals
8737 Mycophenolate-Induced Disseminated TB in a PPD-Negative Patient
Authors: Megan L. Srinivas
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Individuals with underlying rheumatologic diseases such as dermatomyositis may not adequately respond to tuberculin (PPD) skin tests, creating false negative results. These illnesses are frequently treated with immunosuppressive therapy making proper identification of TB infection imperative. A 59-year-old Filipino man was diagnosed with dermatomyositis on the basis of rash, electromyography, and muscle biopsy. He was initially treated with IVIG infusions and transitioned to oral prednisone and mycophenolate. The patient’s symptoms improved on this regimen. Six months after starting mycophenolate, the patient began having fevers, night sweats, and productive cough without hemoptysis. He moved from the Philippines 5 years prior to dermatomyositis diagnosis, denied sick contacts, and was PPD negative both at immigration and immediately prior to starting mycophenolate treatment. A third PPD was negative following the onset of these new symptoms. He was treated for community-acquired pneumonia, but symptoms worsened over 10 days and he developed watery diarrhea and a growing non-tender, non-mobile mass on the left side of his neck. A chest x-ray demonstrated a cavitary lesion in right upper lobe suspicious for TB that had not been present one month earlier. Chest CT corroborated this finding also exhibiting necrotic hilar and paratracheal lymphadenopathy. Neck CT demonstrated the left-sided mass as cervical chain lymphadenopathy. Expectorated sputum and stool samples contained acid-fast bacilli (AFB), cultures showing TB bacteria. Fine-needle biopsy of the neck mass (scrofula) also exhibited AFB. An MRI brain showed nodular enhancement suspected to be a tuberculoma. Mycophenolate was discontinued and dermatomyositis treatment was switched to oral prednisone with a 3-day course of IVIG. The patient’s infection showed sensitivity to standard RIPE (rifampin, isoniazid, pyrazinamide, and ethambutol) treatment. Within a week of starting RIPE, the patient’s diarrhea subsided, scrofula diminished, and symptoms significantly improved. By the end of treatment week 3, the patient’s sputum no longer contained AFB; he was removed from isolation, and was discharged to continue RIPE at home. He was discharged on oral prednisone, which effectively addressed his dermatomyositis. This case illustrates the unreliability of PPD tests in patients with long-term inflammatory diseases such as dermatomyositis. Other immunosuppressive therapies (adalimumab, etanercept, and infliximab) have been affiliated with conversion of latent TB to disseminated TB. Mycophenolate is another immunosuppressive agent with similar mechanistic properties. Thus, it is imperative that patients with long-term inflammatory diseases and high-risk TB factors initiating immunosuppressive therapy receive a TB blood test (such as a quantiferon gold assay) prior to the initiation of therapy to ensure that latent TB is unmasked before it can evolve into a disseminated form of the disease.Keywords: dermatomyositis, immunosuppressant medications, mycophenolate, disseminated tuberculosis
Procedia PDF Downloads 2008736 A Systematic Review on the Whole-Body Cryotherapy versus Control Interventions for Recovery of Muscle Function and Perceptions of Muscle Soreness Following Exercise-Induced Muscle Damage in Runners
Authors: Michael Nolte, Iwona Kasior, Kala Flagg, Spiro Karavatas
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Background: Cryotherapy has been used as a post-exercise recovery modality for decades. Whole-body cryotherapy (WBC) is an intervention which involves brief exposures to extremely cold air in order to induce therapeutic effects. It is currently being investigated for its effectiveness in treating certain exercise-induced impairments. Purpose: The purpose of this systematic review was to determine whether WBC as a recovery intervention is more, less, or equally as effective as other interventions at reducing perceived levels of muscle soreness and promoting recovery of muscle function after exercise-induced muscle damage (EIMD) from running. Methods: A systematic review of the current literature was performed utilizing the following MeSH terms: cryotherapy, whole-body cryotherapy, exercise-induced muscle damage, muscle soreness, muscle recovery, and running. The databases utilized were PubMed, CINAHL, EBSCO Host, and Google Scholar. Articles were included if they were published within the last ten years, had a CEBM level of evidence of IIb or higher, had a PEDro scale score of 5 or higher, studied runners as primary subjects, and utilized both perceived levels of muscle soreness and recovery of muscle function as dependent variables. Articles were excluded if subjects did not include runners, if the interventions included PBC instead of WBC, and if both muscle performance and perceived muscle soreness were not assessed within the study. Results: Two of the four articles revealed that WBC was significantly more effective than treatment interventions such as far-infrared radiation and passive recovery at reducing perceived levels of muscle soreness and restoring muscle power and endurance following simulated trail runs and high-intensity interval running, respectively. One of the four articles revealed no significant difference between WBC and passive recovery in terms of reducing perceived muscle soreness and restoring muscle power following sprint intervals. One of the four articles revealed that WBC had a harmful effect compared to CWI and passive recovery on both perceived muscle soreness and recovery of muscle strength and power following a marathon. Discussion/Conclusion: Though there was no consensus in terms of WBC’s effectiveness at treating exercise-induced muscle damage following running compared to other interventions, it seems as though WBC may at least have a time-dependent positive effect on muscle soreness and recovery following high-intensity interval runs and endurance running, marathons excluded. More research needs to be conducted in order to determine the most effective way to implement WBC as a recovery method for exercise-induced muscle damage, including the optimal temperature, timing, duration, and frequency of treatment.Keywords: cryotherapy, physical therapy intervention, physical therapy, whole body cryotherapy
Procedia PDF Downloads 2288735 Indigenous Hair Treatment in Abyssinia
Authors: Makda Yeshitela Kifele
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Hair treatment prevents the hair from loss of volume, changing colour, and damaging its properties of the hair. Hair is the beauty of human beings that makes people beautiful and takes the other hearts to see them and to give them an appreciation for their effort to treat their hair and save it from damage. There are different methods to protect human hair from loss and damage that influence human psychology better than the problems. Chemicals products are available in the world that keeps safely the hair and provide beauty for the hair. But chemical products have side effects and are not cost-effective. Even some of the chemicals are allergic for users and left some changes in the hair. Indigenous hair treatment is an effective method that reduces the bad effects and the problems of the chemical that are lefts in human being’slife. Indigenous hair treatment can treat the hair safely and effectively that does not have much effect or spots in the human hair the users rather, it improves some attributes of the hair such that shine, quality, quantity improvements, length, and flexibility can be modified by these indigenous treatments. Rate is the local plant that plays a significant role in hair treatment. Rate is the local plant that can be available everywhere in the country, and anybody can be used for hair treatments. For this research, 50 women are identified as sample populations with different hair characteristics. The treatments were collected from the fields and squeezed into the pots to be prepared as specimens. The squeezed plants were deposited in the refrigerator for three days with some amounts of salts to prevent some bacteria. Chemical analysis has been done to sort out some detrimental substances. So the result showed that there are no detrimental substances that affect the hair properties and the health of the users. The sample population used the oil for one month without any other oily cosmetics that disturbs the treatment. The output is very effective and brings shining the hair, preventing greying of the hair, showing fast-growing, increasing the volume of the hair, and becoming flexible and curly, straight hair, thicker, and with no allergic effects.Keywords: indigenous, chemicals, curly, treatment
Procedia PDF Downloads 1018734 Effect of Pulmonary Rehabilitation towards Length of Stay and IL-6 Level on Community-Acquired Pneumonia Patients
Authors: Santony Santony, Teguh Rahayu Sartono, Iin Noor Chozin
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Introduction: Pneumonia is acute inflammation on lung parenchyma which is caused by bacteria, virus, fungi, or parasite. In Indonesia, Pneumonia is among the ten inpatient cases. Length of stay is related to the increased morbidity rate, nosocomial infection, and costs. The aim of this study is to assess the effect of pulmonary rehabilitation on the difference in length of stay and the level of Interleukin 6 (IL-6) as an inflammation biomarker for community-acquired pneumonia (CAP) patients in non-intensive rooms. Therefore, pulmonary rehabilitation as adjunctive therapy can be routinely exercised in order to shorten the length of stay, along with the decrease in IL-6 level. Methods: This study was conducted from May to October 2019 at Saiful Anwar General Hospital, Malang. 40 community-acquired pneumonia patients in non-intensive rooms were divided into two groups. 20 patients in the treatment group and 20 patients in the control group, all of them were selected through both inclusion and exclusion criteria. This study used simple consecutive random sampling. In the treatment group, pulmonary rehabilitation performed was composed of breathing exercise, effective coughing technique, clapping (percussion), postural drainage, as well as respiratory muscle training using incentive spirometry device. Pulmonary rehabilitation was conducted twice over five days with a minimum duration of 15 minutes. Blood samples were taken both on the first and the fifth day of the treatment to measure IL-6 level as an inflammation biomarker. Result: For the treatment group, the length of stay was 5.35 days whereas the control group 7.6 days. It can be seen that the treatment group had a shorter length of stay by 2.25 days (P<0,001). The IL-6 level on the first day for the treatment group was 36.27 pg/ml, whereas on the fifth day was 34.36 pg/ml. There was a decrease in IL-6 level on the fifth day of treatment even though it was not statistically significant (P=0.628). IL-6 level on the control group for the first day was 67.76 pg/ml, and after the fifth day, the level decreased to 54.43 pg/ml. There seemed to be a decrease in the IL-6, but it was not statistically significant (P=0.502). On the fifth day, the treatment group showed an average IL-6 level of 34.36 pg/ml. This value was lower than that of the control group which did not receive pulmonary rehabilitation having an IL-6 level of 54.43 pg/ml, even though it was not statistically significant (p=0.221). Conclusion: This study concluded that pulmonary rehabilitation as an adjunctive therapy shortened length of stay by 2.25 days for community-acquired pneumonia patients in a non-intensive room. Both groups experienced a decrease in IL-6 level on the fifth day in comparison with the first day even though it was not statistically significant P>0,05. IL-6 level as an inflammation biomarker decreased on the fifth day of treatment which was in accordance with improvement on pneumonia patients.Keywords: community-acquired pneumonia, interleukin-6, length of stay, pulmonary rehabilitation
Procedia PDF Downloads 978733 Alternating Electric fields-Induced Senescence in Glioblastoma
Authors: Eun Ho Kim
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Innovations have conjured up a mode of treating GBM cancer cells in the newly diagnosed patients in a period of 4.9 months at an improved median OS, which brings along only a few minor side effects in the phase III of the clinical trial. This mode has been termed the Alternating Electric Fields (AEF). The study at hand is aimed at determining whether the AEF treatment is beneficial in sensitizing the GBM cancer cells through the process of increasing the AEF –induced senescence. The methodology to obtain the findings for this research ranged across various components, such as obtaining and testing SA-β-gal staining, flow cytometry, Western blotting, morphology, and Positron Emission Tomography (PET) / Computed Tomography (CT), immunohistochemical staining and microarray. The number of cells that displayed a senescence-specific morphology and positive SA-ß-Gal activity gradually increased up to 5 days. These results suggest that p16, p21 and p27 are essential regulators of AEF -induced senescence via NF-κB activation. The results showed that the AEF treatment is functional in enhancing the AEF –induced senescence in the GBM cells via an apoptosis- independent mechanism. This research concludes that this mode of treatment is a trustworthy protocol that can be effectively employed to overcome the limitations of the conventional mode of treatment on GBM.Keywords: alternating electric fields, senescence, glioblastoma, cell death
Procedia PDF Downloads 808732 The Influence of Dietary Components on Acne; A Case-Control Survey
Authors: Atiya Mahmood, Mubasharah Hanif, Ghazala Butt, Mehwish Zahoor Ahmed
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Acne vulgaris affects millions of adults.Despite extensive research, its food related etiology remains elusive. Objective:To assess the correlation between dietary intake and acne through a case-control survey of 300,15-25 year old respondents living in Pakistan. 50 acne patients and 150 age-and ethnicity-matched controls completed a questionnaire.Cases and controls were separated using SPSS-22 and univariate analysis was performed using the chi-square test. p value < 0.05 was considered statistically significant. We used adjusted odds ratios to assess the strength of associations with 95% confidence intervals. Most of the respondents were females(91.3%).Most(48.7%)acne patients were 20-25 yearsold.Acne severity was mild in 50%,moderate in 34%,severe in14%and very severe in 2%.Frequent low-fat foods(p<0.001)(OR=3.22),fat intake(p=0.03)(OR = 1.629),sweet snacks i.e. biscuits and candies etc. (p=0.013) (OR=1.9254), soft drinks(p= 0.045)(OR= 1.9091),butter(p<0.001) (OR= 1.8185),dairy products(p=0.043)(OR=0.624),salty foods(p= 0.011)(OR=1.961),chocolate (p=0.028)(OR=1.669), were associated with increased acne risk.No association was found with consumption of fried foods, desserts, fruit juices, raw fruit, fast food, vegetables, cheese, soy products, salt, and corn. Increased butter and chocolate consumption were linked to more severe forms of acne(p=0.049 and p=0.005 respectively).Most respondents (n=218) considered themselves to have healthy eating habits, indicating they were not educated about the nutritional aspects of acne treatment.Certain food item intake was significantly higher in acne patients to give an association between the two. Further studies must be conducted to develop a causative relationship. Nutrition aawareness is critical to reduce acne.Keywords: correlation between dietary components and acne, dietary components, acne, nutrition
Procedia PDF Downloads 538731 Early Detection of Breast Cancer in Digital Mammograms Based on Image Processing and Artificial Intelligence
Authors: Sehreen Moorat, Mussarat Lakho
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A method of artificial intelligence using digital mammograms data has been proposed in this paper for detection of breast cancer. Many researchers have developed techniques for the early detection of breast cancer; the early diagnosis helps to save many lives. The detection of breast cancer through mammography is effective method which detects the cancer before it is felt and increases the survival rate. In this paper, we have purposed image processing technique for enhancing the image to detect the graphical table data and markings. Texture features based on Gray-Level Co-Occurrence Matrix and intensity based features are extracted from the selected region. For classification purpose, neural network based supervised classifier system has been used which can discriminate between benign and malignant. Hence, 68 digital mammograms have been used to train the classifier. The obtained result proved that automated detection of breast cancer is beneficial for early diagnosis and increases the survival rates of breast cancer patients. The proposed system will help radiologist in the better interpretation of breast cancer.Keywords: medical imaging, cancer, processing, neural network
Procedia PDF Downloads 2538730 Comparative Pre-treatment Analysis of RNA-Extraction Methods and Efficient Detection of SARS-COV-2 and PMMoV in Influents and 1ˢᵗ Sedimentation from a Wastewater Treatment Plan
Authors: Jesmin Akter, Chang Hyuk Ahn, Ilho Kim, Fumitake Nishimura, Jaiyeop Lee
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This study aimed to compare two pre-treatment and two RNA extraction methods, namely PEG, and Nano bubble, Viral RNA Soil, and Mini Kit, in terms of their efficiency in detecting SARS-CoV-2 and PMMoV in influent and 1st sedimentation samples from a wastewater treatment plant. The extracted RNA samples were quantified and evaluated for purity, yield, and integrity. The results indicated that the nanobubble PEG method provided the highest yield of RNA, while the QIAamp Viral RNA Mini Kit produced the purest RNA samples. In terms of sensitivity and specificity, all these methods were able to detect SARS-CoV-2 and PMMoV in both influent and 1st sedimentation samples. However, the nanobubble PEG method showed slightly higher sensitivity compared to the other methods. These findings suggest that the choice of RNA extraction method should depend on the downstream application and the quality of the RNA required. The study also highlights the potential of wastewater-based epidemiology as an effective and non-invasive method for monitoring the spread of infectious diseases in a community.Keywords: influent, PMMoV, SARS-CoV-2, wastewater based epidemiology
Procedia PDF Downloads 918729 Medicompills Architecture: A Mathematical Precise Tool to Reduce the Risk of Diagnosis Errors on Precise Medicine
Authors: Adriana Haulica
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Powered by Machine Learning, Precise medicine is tailored by now to use genetic and molecular profiling, with the aim of optimizing the therapeutic benefits for cohorts of patients. As the majority of Machine Language algorithms come from heuristics, the outputs have contextual validity. This is not very restrictive in the sense that medicine itself is not an exact science. Meanwhile, the progress made in Molecular Biology, Bioinformatics, Computational Biology, and Precise Medicine, correlated with the huge amount of human biology data and the increase in computational power, opens new healthcare challenges. A more accurate diagnosis is needed along with real-time treatments by processing as much as possible from the available information. The purpose of this paper is to present a deeper vision for the future of Artificial Intelligence in Precise medicine. In fact, actual Machine Learning algorithms use standard mathematical knowledge, mostly Euclidian metrics and standard computation rules. The loss of information arising from the classical methods prevents obtaining 100% evidence on the diagnosis process. To overcome these problems, we introduce MEDICOMPILLS, a new architectural concept tool of information processing in Precise medicine that delivers diagnosis and therapy advice. This tool processes poly-field digital resources: global knowledge related to biomedicine in a direct or indirect manner but also technical databases, Natural Language Processing algorithms, and strong class optimization functions. As the name suggests, the heart of this tool is a compiler. The approach is completely new, tailored for omics and clinical data. Firstly, the intrinsic biological intuition is different from the well-known “a needle in a haystack” approach usually used when Machine Learning algorithms have to process differential genomic or molecular data to find biomarkers. Also, even if the input is seized from various types of data, the working engine inside the MEDICOMPILLS does not search for patterns as an integrative tool. This approach deciphers the biological meaning of input data up to the metabolic and physiologic mechanisms, based on a compiler with grammars issued from bio-algebra-inspired mathematics. It translates input data into bio-semantic units with the help of contextual information iteratively until Bio-Logical operations can be performed on the base of the “common denominator “rule. The rigorousness of MEDICOMPILLS comes from the structure of the contextual information on functions, built to be analogous to mathematical “proofs”. The major impact of this architecture is expressed by the high accuracy of the diagnosis. Detected as a multiple conditions diagnostic, constituted by some main diseases along with unhealthy biological states, this format is highly suitable for therapy proposal and disease prevention. The use of MEDICOMPILLS architecture is highly beneficial for the healthcare industry. The expectation is to generate a strategic trend in Precise medicine, making medicine more like an exact science and reducing the considerable risk of errors in diagnostics and therapies. The tool can be used by pharmaceutical laboratories for the discovery of new cures. It will also contribute to better design of clinical trials and speed them up.Keywords: bio-semantic units, multiple conditions diagnosis, NLP, omics
Procedia PDF Downloads 638728 Clinical Case Successful Surgical Treatment of Postinfarction Ventricular Septum Defect
Authors: Melikulov A. A., Toshpulotov Sh. G., Akhmedova M. F., Beshimov A. S., Rakhimov M. K. Zokirov N. K.
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Postinfarction ventricular septal defect (PVSD) is a rare but life-threatening complication of acute myocardial infarction. Currently, an alternative direction of minimally invasive treatment of postinfarction ventricular septal defect (PVSD) is being developed - transcatheter closure of the defect using an occluder, but surgical closure of the defect remains the <> correction of post-infarction VSD. Our article presents a case of successful surgical treatment of a patient with a large post-infarction rupture of the interventricular septum (IVS) and post-infarction LV aneurysm under cardiopulmonary bypass and parallel perfusion.Keywords: echocardiography, myocardial infarction, ventricular septal defect, parallel perfusion
Procedia PDF Downloads 738727 Inactivation of Rhodotorula spp. 74 with Cold Atmospheric Plasma
Authors: Zoran Herceg, Višnja Stulić, Tomislava Vukušić, Anet Režek Jambrak
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High voltage electrical discharge is a new technology used for inactivation of pathogen microorganisms. Pathogen yeasts can cause diseases in humans if they are ingested. Nowadays new technologies have become the focus of researching all over the world. Rhodotorula is known as yeast that can cause diseases in humans. The aim of this study was to examine whether the high voltage electrical discharge treatment generated in gas phase has an influence on yeast reduction and recovery of Rhodotorula spp 74 in pure culture. Rhodotorula spp. 74 was treated in 200 mL of model solution. Treatment time (5 and 10 min), frequency (60 and 90 Hz) and injected gas (air or argon 99,99%) were changed. Titanium high voltage needle was used as high voltage electrode (positive polarity) through which air or argon was injected at the gas flow of 0.6 L/min. Experimental design and statistical analyses were obtained by Statgraphics Centurion software (StatPoint Technologies, Inc., VA, USA). The best inactivation rate 1.7 log10 reduction was observed after the 10 min of treatment, frequency of 90 Hz and injected air. Also with a longer treatment time inactivation rate was higher. After the 24 h recovery of treated samples was observed. Therefore the further optimization of method is needed to understand the mechanism of yeasts inactivation and cells recovery after the treatment. Acknowledgements: The authors would like to acknowledge the support by Croatian Science Foundation and research project ‘Application of electrical discharge plasma for preservation of liquid foods’.Keywords: rhodotorula spp. 74, electrical discharge plasma, inactivation, stress response
Procedia PDF Downloads 2328726 Targeting Apoptosis by Novel Adamantane Analogs as an Emerging Therapy for the Treatment of Hepatocellular Carcinoma Through EGFR, Bcl-2/BAX Cascade
Authors: Hanan M. Hassan, Laila Abouzeid, Lamya H. Al-Wahaibi, George S. G. Shehatou, Ali A. El-Emam
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Cancer is a major public health problem and the second leading cause of death worldwide. In 2020, cancer diagnosis and treatment have been negatively affected by the coronavirus 2019 (COVID-19) pandemic. During the quarantine, because of the limited access to healthcare and avoiding exposure to COVID-19 as a contagious disease; patients of cancer suffered deferments in follow-up and treatment regimens leading to substantial worsening of disease, death, and increased healthcare costs. Thus, this study is designed to investigate the molecular mechanisms by which adamantne derivatives attenuate hepatocllular carcinoma experimentally and theoretically. There is a close association between increased resistance to anticancer drugs and defective apoptosis that considered a causative factor for oncogenesis. Cancer cells use different molecular pathways to inhibit apoptosis, BAX and Bcl-2 proteins have essential roles in the progression or inhibition of intrinsic apoptotic pathways triggered by mitochondrial dysfunction. Therefore, their balance ratio can promote the cellular apoptotic fate. In this study, the in vitro cytotoxic effects of seven synthetic adamantyl isothiorea derivatives were evaluated against five human tumor cell lines by MTT assay. Compounds 5 and 6 showed the best results, mostly against hepatocellular carcinoma (HCC). Hence, in vivo studies were performed in male Sprague-Dawley (SD) rats in which experimental hepatocellular carcinoma was induced with thioacetamide (TAA) (200 mg/kg, i.p., twice weekly) for 16 weeks. The most promising compounds, 5 and 6, were administered to treat liver cancer rats at a dose of 10 mg/kg/day for an additional two weeks, and the effects were compared with doxorubicin (DR), the anticancer drug. Hepatocellular carcinoma was evidenced by a dramatic increase in liver indices, oxidative stress markers, and immunohistochemical studies that were accompanied by a plethora of inflammatory mediators and alterations in the apoptotic cascade. Our results showed that treatment with adamantane derivatives 5 and 6 significantly suppressed fibrosis, inflammation, and other histopathological insults resulting in the diminished formation of hepatocyte tumorigenesis. Moreover, administration of the tested compounds resulted in amelioration of EGFR protein expression, upregulation of BAX, and lessening down of Bcl-2 levels that prove their role as apoptosis inducers. Also, the docking simulations performed for adamantane showed good fit and binding to the EGFR protein through hydrogen bond formation with conservative amino acids, which gives a shred of strong evidence for its hepatoprotective effect. In most analyses, the effects of compound 6 were more comparable to DR than compound 5. Our findings suggest that adamantane derivatives 5 and 6 are shown to have cytotoxic activity against HCC in vitro and in vivo, by more than one mechanism, possibly by inhibiting the TLR4-MyD88-NF-κB pathway and targeting EGFR signaling.Keywords: adamantane, EGFR, HCC, apoptosis
Procedia PDF Downloads 1418725 Transgressing Gender Norms in Addiction Treatment
Authors: Sara Matsuzaka
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At the center of emerging policy debates on the rights of transgender individuals in public accommodations is the collision of gender binary views with transgender perspectives that challenge conventional gender norms. The results of such socio-political debates could have significant ramifications for the policies and infrastructures of public and private institutions nationwide, including within the addiction treatment field. Despite having disproportionately high rates of substance use disorder compared to the general population, transgender individuals experience significant barriers to engaging in addiction treatment programs. Inpatient addiction treatment centers were originally designed to treat heterosexual cisgender populations and, as such, feature gender segregated housing, bathrooms, and counseling sessions. Such heteronormative structural barriers, combined with exposures to stigmatic al attitudes, may dissuade transgender populations from benefiting from the addiction treatment they so direly need. A literature review is performed to explore the mechanisms by which gender segregation alienates transgender populations within inpatient addiction treatment. The constituent parts of the current debate on the rights of transgender individuals in public accommodations are situated the context of inpatient addiction treatment facilities. Minority Stress Theory is used as a theoretical framework for understanding substance abuse issues among transgender populations as a maladaptive behavioral response for coping with chronic stressors related to gender minority status and intersecting identities. The findings include that despite having disproportionately high rates of substance use disorder compared to the general population, transgender individuals experience significant barriers to engaging in and benefiting from addiction treatment. These barriers are present in the form of anticipated or real interpersonal stigma and discrimination by service providers and structural stigma in the form of policy and programmatic components in addiction treatment that marginalize transgender populations. Transphobic manifestations within addiction treatment may dissuade transgender individuals from seeking help, if not reinforce a lifetime of stigmatic experience, potentially exacerbating their substance use issues. Conclusive recommendations for social workers and addiction treatment professionals include: (1) dismantling institutional policies around gender segregation that alienate transgender individuals, (2) developing policies that provide full protections for transgender clients against discrimination based on their gender identity, and (3) implementing trans-affirmative cultural competency training requirements for all staff. Directions for future research are provided.Keywords: addiction treatment, gender segregation, stigma, transgender
Procedia PDF Downloads 2038724 Heat Treatment on Malaysian Hardwood Timbers: The Effect of Heat Exposure at Different Levels of Temperature on Bending Strength Properties
Authors: Nur Ilya Farhana Md Noh, Zakiah Ahmad
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Heat treatment on timbers is a process of applying heat to modify and equip the timbers with new improvised characteristics. It is environmental friendly compared to the common practice of treating timber by chemical preservatives. Malaysian hardwood timbers; Pauh Kijang and Kapur in green condition were heat treated at 150°C, 170°C, 190°C and 210°C in a specially design electronic furnace in one hour duration. The objectives were to determine the effect of heat treatment on bending strength properties of heat treated Pauh Kijang and Kapur in term of Modulus of Elasticity (MOE) and Modulus of Rupture (MOR) and to examine the significance changes at each temperature levels applied. Untreated samples for each species were used as a control sample. The results indicated that the bending strength properties for both species of timbers were affected by the heat exposure. Both MOE and MOR values for heat treated Pauh Kijang were increased when subjected to the specified temperature levels except at 210°C. The values were dropped compared to the control sample and sample treated at 190°C. Heat treated Kapur shows the same pattern of increment on its MOE and MOR values after exposure to heat at three temperature levels used and the values dropped at 210°C. However, differ to Pauh Kijang, even though there were decrement occurred at 210°C but the value is still higher compared to the control sample. The increments of MOE and MOR values are an indicator that heat treatment had successfully improvised the bending strength properties of these two species of hardwood timber. As the good strength of Malaysian timbers used as structural material is limited in numbers and expensive, heat treating timber with low strength properties is an alternative way to overcome this issue. Heat treatment is an alternative method need to be explored and made available in Malaysia as this country is still practicing chemical preservative treatment on the timbers.Keywords: bending strength, hardwood timber, heat treatment, modulus of elasticity (MOE), modulus of rupture (MOR)
Procedia PDF Downloads 2568723 Water Absorption Studies on Natural Fiber Reinforced Polymer Composites
Authors: G. L. Devnani, Shishir Sinha
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In the recent years, researchers have drawn their focus on natural fibers reinforced composite materials because of their excellent properties like low cost, lower weight, better tensile and flexural strengths, biodegradability etc. There is little concern however that when these materials are put in moist conditions for long duration, their mechanical properties degrade. Therefore, in order to take maximum advantage of these novel materials, one should have a complete understanding of their moisture or water absorption phenomena. Various fiber surface treatment methods like alkaline treatment, acetylation etc. have also been suggested for reduction in water absorption of these composites. In the present study, a detailed review is done for water absorption behavior of natural fiber reinforced polymer composites, and experiments also have been performed on these composites with varying the parameters like fiber loading etc. for understanding the water absorption kinetics. Various surface treatment methods also performed to reduce the water absorption behavior of these materials and effort is made to develop a proper understanding of water absorption mechanism mathematically and experimentally for full potential utilization of natural fiber reinforced polymer composite materials.Keywords: alkaline treatment, composites, natural fiber, water absorption
Procedia PDF Downloads 2788722 Atypical Familial Amyotrophic Lateral Sclerosis Secondary to Superoxide Dismutase 1 Gene Mutation With Coexistent Axonal Polyneuropathy: A Challenging Diagnosis
Authors: Seraj Makkawi, Abdulaziz A. Alqarni, Himyan Alghaythee, Suzan Y. Alharbi, Anmar Fatani, Reem Adas, Ahmad R. Abuzinadah
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Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, is a neurodegenerative disease that involves both the upper and lower motor neurons. Familial ALS, including superoxide dismutase 1 (SOD1) mutation, accounts for 5-10% of all cases of ALS. Typically, the symptoms of ALS are purely motor, though coexistent sensory symptoms have been reported in rare cases. In this report, we describe the case of a 47- year-old man who presented with progressive bilateral lower limb weakness and numbness for the last four years. A nerve conduction study (NCS) showed evidence of coexistent axonal sensorimotor polyneuropathy in addition to the typical findings of ALS in needle electromyography. Genetic testing confirmed the diagnosis of familial ALS secondary to the SOD1 genetic mutation. This report highlights that the presence of sensory symptoms should not exclude the possibility of ALS in an appropriate clinical setting.Keywords: Saudi Arabia, polyneuropathy, SOD1 gene mutation, familial amyotrophic lateral sclerosis, amyotrophic lateral sclerosis
Procedia PDF Downloads 1388721 Elimination Study of Organic Pollutants from Leachate Technical Landfill; Using Fenton and Photo-Fenton Systems Combined with Biological Treatment
Authors: Belahmadi M. S. O., Abdessemed A., Benchiheub M., Doukali H., Kaid Kasbah K. M.
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The aim of this study is to evaluate the quality of leachate generated by the Batna landfill site, and to verify the performance of various advanced oxidation processes, in particular the Fenton and Photo-Fenton systems combined with biological treatment to eliminate the recalcitrant organic matter contained in this effluent, and to preserve reverse osmosis membranes used for leachate treatment. The average values obtained are compared with national and international discharge standards. The results of physico-chemical analyses show that the leachate has an alkaline pH =8.26 and a high organic load with a low oxygen content. Mineral pollution is represented by high conductivity (38.3 mS/cm), high Kjeldahl nitrogen content (1266.504 mg/L) and ammoniacal nitrogen (1098.384 mg/L). The average pollution indicator parameters measured were: BOD5 = 1483.333 mg O2 /L, COD = 99790.244 mg O 2/L, TOC = 22400 mg C/L. These parameters exceed Algerian standards. Hence, there is a necessity to treat this effluent before discharging it into the environment. A comparative study was carried out to estimate the efficiency of two oxidation processes. Under optimum reaction conditions, TOC removal efficiencies of 63.43% and 73.4% were achieved for the Fenton and Photo-Fenton processes, respectively. COD removal rates estimated at 88% and 99.5% for the Fenton and Photo- Fenton processes, respectively. In addition, the Photo-Fenton + bacteria + micro- algae hybrid treatment gave removal efficiencies of around 92.24% for TOC and 99.9% for COD; -0.5 for AOS and 0.01 for CN. The results obtained during this study showed that a hybrid approach combining the PhotoFenton process and biological treatment appears to be a highly effective alternative for achieving satisfactory treatment, which aimed at exploiting the advantages of this method in terms of organic pollutant removal.Keywords: leachate, landfill, advanced oxidation processes, Fenton and Photo-Fenton systems, biological treatment, organic pollutants
Procedia PDF Downloads 618720 Evaluating the Potential of Microwave Treatment as a Rock Pre-Conditioning Method in Achieving a More Sustainable Mining
Authors: Adel Ahmadi Hosseini, Fatemeh Tavanaei, Alessandro Navarra, Ferri Hassani
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Mining engineering, as a part of geoscience, must address modern concerns. Traditional mining methods incorporate drill and blast technologies, which are followed by different issues, including excessive noise, vibration, air pollution, and safety hazards. Over the past two decades, mining engineers have sought alternative solutions to move from drill and blast to continuous methods to prevent such issues and improve sustainability in mining. Among the suggested methods, microwave treatment has shown promising results by creating micro/macro cracks in the rock structure prior to the operations. This research utilizes an energy-based analysis methodology to evaluate the efficiency of the microwave treatment in improving mining operations. The data analysis shows that increasing the input microwave energy dosage intensifies the rock damage. However, this approach can decrease the energy efficiency of the method by more than 50% in some cases. In this study, rock samples were treated with three power levels (3 kW, 7 kW, and 12 kW) and two energy dosages (20 kWh/t and 50 kWh/t), resulting in six conditions. To evaluate the impact of microwave treatment on the geomechanical behavior of the rocks, Unconfined Compressive Strength (UCS) tests were conducted on the microwave-treated samples, yielding stress-strain curves. Using the stress-strain curves, the effect of the different powers and energy dosages of microwaves are discussed. This research shows the potential of using microwave treatment to lead the industry to more sustainable mining.Keywords: microwave treatment, microwave energy dosage, sustainable mining, rock fragmentation
Procedia PDF Downloads 278719 Treatment of Acid Mine Lake by Ultrasonically Modified Fly Ash at Different Frequencies
Authors: Burcu Ileri, Deniz Sanliyuksel Yucel, Onder Ayyildiz
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The oxidation of pyrite in water results in the formation of acid mine drainage, which typically forms extremely acid mine lake (AML) in the depression areas of abandoned Etili open-pit coal mine site, Northwest Turkey. Nine acid mine lakes of various sizes have been located in the Etili coal mine site. Hayirtepe AML is one of the oldest lake having a mean pH value of 2.9 and conductivity of 4550 μS/cm, and containing elevated concentrations of Al, B, Ba, Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Na, Ni, Pb, and Zn. The water quality of the lake has been deteriorated due to its high chemical composition, in particular, increasing heavy metal pollution. In this study, fly ash (FA), a coal combustion by-product from fluidized bed thermal power plant in the northwestern part of Turkey, was used as an adsorbent for the treatment of Hayirtepe AML. The FA is a relatively abundant and cost effective material, but its use in adsorption processes usually require excessive adsorbent doses. To increase adsorption efficiency and lower the adsorbent dose, we modified the FA by means of ultrasonic treatment (20 kHz and 40 kHz). The images of scanning electron microscopy (SEM) have demonstrated that ultrasonic treatment not only decreased the size of ash particles but also created pits and cracks on their surfaces which in turn led to a significant increase in the BET surface area. Both FA and modified fly ash were later tested for the removal of heavy metals from the AML. The effect of various operating parameters such as ultrasonic power, pH, ash dose, and adsorption contact time were examined to obtain the optimum conditions for the treatment process. The results have demonstrated that removal of heavy metals by ultrasound-modified fly ash requires much shorter treatment times and lower adsorbent doses than those attained by the unmodified fly ash. This research was financially supported by the Scientific and Technological Research Council of Turkey (TUBITAK), (Project no: 116Y510).Keywords: acid mine lake, heavy metal, modified fly ash, ultrasonic treatment
Procedia PDF Downloads 1938718 Correction of Skeletal Deformity by Surgical Approach – A Case Report
Authors: Davender Kumar, Virender Singh, Rekha Sharma
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Correction of skeletal deformities in adult patients with orthodontics is limited. In adult severe cases, the combined approach, orthodontic and orthognathic surgery, is always the treatment of choice, and the results obtained usually ensure a better esthetic, functional, and stable results Orthognathic surgery is the best option for cases when camouflage treatment is questionable and growth modulation is not possible. This case report illustrates the benefit of the team approach in correcting mandible retrusion along with class II skeletal deformity with 100% deep bite. Correction was achieved by anterior repositioning of mandible osteotomy along with orthodontic treatment. The patient's facial appearance was markedly improved along with functional and stable occlusion.Keywords: camouflage, skeletal, orthognathic, dental
Procedia PDF Downloads 4228717 Personal Egocentrism as an Indicator of the Management Activity Efficiency
Authors: Lusine S. Stepanyan, Elina V. Asriyan.
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It is known, that the efficiency of management depend on individual characteristics of manager. In case, was shown the role of personal position in the efficiency of management. Current research is aimed at reveal psychological and psychophysiological basis efficiency of management and finding ways of increasing the productivity of management that is most essential and topical problems of modern society. To understand the investigated phenomenon it was applied a complex approach. The Eysenk questionnaire was used for determining the level of aggression, frustration, anxiety and rigidity. The test of egocentric associations was used for determining the level of egocentrism. The test of COS (communicativeness and organizational skills) was used for diagnosing the level of communicativeness. The integral index of job satisfaction was used for diagnosis the efficiency of management activity. Then, the relationship between the above mentioned mental state, communicativeness, self-esteem, job satisfaction, locus of control, and egocentrism was investigated. The obtained results have shown the positive correlation between the egocentrism and frustration, anxiety and also the negative correlation with job satisfaction and communicativeness. Intergroup analyses has revealed the significant differences by communicativeness and the internality’ level. The revealed results can be used for diagnosis of efficiency of management.Keywords: egocentrism, locus control, mental state, job satisfaction, professional activity
Procedia PDF Downloads 3598716 Catalytic Applications of Metal-Organic Frameworks for Organic Pollutant Removal in Wastewater Treatment: A Review
Authors: Matthew Ndubuisi Abonyi, Christopher Chiedozie Obi, Joseph Tagbo Nwabanne
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This review focuses on the application of Metal-Organic Frameworks (MOF)-based catalysts in the degradation of organic pollutants in wastewater. The degradation of organic pollutants in wastewater remains a critical environmental challenge, necessitating innovative solutions for effective treatment. MOFs have garnered significant attention as promising catalysts for this purpose, owing to their exceptional surface area, tunable porosity, and diverse chemical functionalities. It explores various catalytic mechanisms, including photocatalysis, Fenton-like reactions, and other advanced oxidation processes facilitated by MOFs. The review also explores the design strategies that enhance the catalytic performance of MOFs, such as structural modifications, composite formation, and post-synthetic modifications. Furthermore, real-world case studies are presented, highlighting the practical applications and environmental impact of MOF-based catalysts in wastewater treatment. Challenges associated with the scalability and stability of these materials are discussed, along with future directions for research and development. This review highlights the significant potential of MOF-based catalysts in addressing the pressing issue of water pollution and advocates for continued innovation to optimize their application in wastewater treatment.Keywords: metal-organic frameworks (MOFs), catalysis, wastewater treatment, organic pollutant degradation, photocatalysis
Procedia PDF Downloads 98715 Improvement of the Calciferous Minerals Floatability through the Application of High-Power Electromagnetic Pulses
Authors: Valentine A. Chanturiya, Igor Zh. Bunin, Maria V. Ryazantseva
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The modification of structural and chemical properties of fluorite, scheelite and calcite under the impact of high-power electromagnetic pulses (HPEMP-treatment) were studied with the help of adsorption of acid-base indicators and atomic – force microscopy (AFM). The HPEMP-treatment during the space of 30 seconds resulted in the intensification of fluorite surface the electron-donating ability and acceptor properties of calcite and scheelite surfaces. High-power electromagnetic treatment of the single minerals resulted in the improvement of the calciferous minerals floatability. The rising of the scheelite recovery is 10 – 12%, fluorite – 5 – 6%, calcite – 7 – 8%.Keywords: calcite, fluorite, scheelite, high power electromagnetic pulses, floatability
Procedia PDF Downloads 2808714 Effect of Fiber Content and Chemical Treatment on Hardness of Bagasse Fiber Reinforced Epoxy Composites
Authors: Varun Mittal, Shishir Sinha
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The present experimental study focused on the hardness behavior of bagasse fiber-epoxy composites. The relationship between bagasse fiber content and effect of chemical treatment on bagasse fiber as a function of Brinell hardness of bagasse fiber epoxy was investigated. Bagasse fiber was treated with sodium hydroxide followed by acrylic acid before they were reinforced with epoxy resin. Compared hardness properties with the untreated bagasse filled epoxy composites. It was observed that Brinell hardness increased up to 15 wt% fiber content and further decreases, however, chemical treatment also improved the hardness properties of composites.Keywords: bagasse fiber, composite, hardness, sodium hydroxide
Procedia PDF Downloads 2808713 Combined Treatment of Estrogen-Receptor Positive Breast Microtumors with 4-Hydroxytamoxifen and Novel Non-Steroidal Diethyl Stilbestrol-Like Analog Produces Enhanced Preclinical Treatment Response and Decreased Drug Resistance
Authors: Sarah Crawford, Gerry Lesley
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This research is a pre-clinical assessment of anti-cancer effects of novel non-steroidal diethyl stilbestrol-like estrogen analogs in estrogen-receptor positive/ progesterone-receptor positive human breast cancer microtumors of MCF 7 cell line. Tamoxifen analog formulation (Tam A1) was used as a single agent or in combination with therapeutic concentrations of 4-hydroxytamoxifen, currently used as a long-term treatment for the prevention of breast cancer recurrence in women with estrogen receptor positive/ progesterone receptor positive malignancies. At concentrations ranging from 30-50 microM, Tam A1 induced microtumor disaggregation and cell death. Incremental cytotoxic effects correlated with increasing concentrations of Tam A1. Live tumor microscopy showed that microtumos displayed diffuse borders and substrate-attached cells were rounded-up and poorly adherent. A complete cytotoxic effect was observed using 40-50 microM Tam A1 with time course kinetics similar to 4-hydroxytamoxifen. Combined treatment with TamA1 (30-50 microM) and 4-hydroxytamoxifen (10-15 microM) induced a highly cytotoxic, synergistic combined treatment response that was more rapid and complete than using 4-hydroxytamoxifen as a single agent therapeutic. Microtumors completely dispersed or formed necrotic foci indicating a highly cytotoxic combined treatment response. Moreover, breast cancer microtumors treated with both 4-hydroxytamoxifen and Tam A1 displayed lower levels of long-term post-treatment regrowth, a critical parameter of primary drug resistance, than observed for 4-hydroxytamoxifen when used as a single agent therapeutic. Tumor regrowth at 6 weeks post-treatment with either single agent 4-hydroxy tamoxifen, Tam A1 or a combined treatment was assessed for the development of drug resistance. Breast cancer cells treated with both 4-hydroxytamoxifen and Tam A1 displayed significantly lower levels of post-treatment regrowth, indicative of decreased drug resistance, than observed for either single treatment modality. The preclinical data suggest that combined treatment involving the use of tamoxifen analogs may be a novel clinical approach for long-term maintenance therapy in patients with estrogen-receptor positive/progesterone-receptor positive breast cancer receiving hormonal therapy to prevent disease recurrence. Detailed data on time-course, IC50 and tumor regrowth assays post- treatment as well as a proposed mechanism of action to account for observed synergistic drug effects will be presented.Keywords: 4-hydroxytamoxifen, tamoxifen analog, drug-resistance, microtumors
Procedia PDF Downloads 628712 Management of H. Armigera by Using Various Techniques
Authors: Ajmal Khan Kassi, Humayun Javed, Syed Abdul Qadeem
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The study was conducted to find out the best management practices against American bollworm on Okra variety Arka Anamika during 2016. The three different management practices viz. Release of Trichogramma chilonis, hoeing and weeding, clipping and lufenuron insect growth regulator (IGR) which were tested individually and with all possible combinations for the controlling of American bollworm at 3 diverse areas viz. University Research Farm Koont, NARC and Farmer Field Taxila. All the treatment combinations regarding damage of fruit showed significant results. The minimum fruit infestation i.e. 3.20% and 3.58% was recorded with combined treatment (i.e. T. chilonis + hoeing + weeding + lufenuron) in two different localities. This combined treatment also resulted in maximum yield at NARC and Taxila i.e. 57.67 and 62.66 q/ha respectively. This treatment gave the best results to manage H. armigera. On the basis of different integrated pest management techniques, Arka Anamika variety proved to be comparatively resistant against H. armigera in different localities. So this variety is recommended for the cultivation in Pothwar region to get maximum yield.Keywords: management, american bollworm, arka anamika, okra
Procedia PDF Downloads 488711 Low Enrollment in Antiretroviral Treatment among Pregnant Women Screened HIV Infected in Informal Health Centers in Cameroon
Authors: Lydie Audrey Amboua Schouame, Sylvie Kwedi Nolna, Antoine Socpa, Alexandre Benjamin Nkoum
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Background: Despite the struggle of the Cameroonian Ministry of Public Health against informal health centers (IHCs) because of their illegality, IHCs are booming in Cameroon and a large part of the population uses them. In 2017, more than 3.000 IHCs were counted across the country. Most of these IHCs have antenatal clinics and they screen pregnant women for HIV. However, there is no data on the Prevention of Mother-To-Child Transmission of HIV (PMTCT) in this informal health sector in Cameroon. This study aimed to investigate the initiation of Antiretroviral treatment (ART) in pregnant women screened HIV positive in IHCs and associated factors. Methods: From January 01, 2018, to June 30, 2020, we carried out a cohort study of pregnant women attending their first antenatal visit and screened HIV positive in informal health centers in the cities of Douala and Ebolowa in Cameroon. Consenting participants were interviewed at two points: at least one week after delivery of the HIV result and three months later. The collected data were entered into Kobo collected and analyzed in SPSS V23.0 software. Results: A total of 182 HIV-infected pregnant women were enrolled in the study. The median age at enrollment was 30 years (IQR, 24-34) and the median gestational age at first ANC was 25 weeks (IQR, 19-31). Overall 61% (111/182) had a secondary level of education, 65% (118/182) were married/in a common-law relationship and 69% (126/182) had no income activity. At their first ANC, 91% (166/182) were naïve to ARV treatment. Among them, only 45% (74/166) initiated ART. The median delay in initiating ARV treatment was 5 days (IQR, 0-25). Of those who have started ART, only 64% (48/74) remained on treatment 3 months later. Conclusion: In order to eliminate mother-to-child transmission of HIV, attention should be paid to IHCs.Keywords: informal health centers, human immunodeficiency, antiretroviral treatment, pregnant women
Procedia PDF Downloads 1438710 Schoolwide Implementation of Schema-Based Instruction for Mathematical Problem Solving: An Action Research Investigation
Authors: Sara J. Mills, Sally Howell
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The field of special education has long struggled to bridge the research to practice gap. There is ample evidence from research of effective strategies for students with special needs, but these strategies are not routinely implemented in schools in ways that yield positive results for students. In recent years, the field of special education has turned its focus to implementation science. That is, discovering effective methods of implementing evidence-based practices in school settings. Teacher training is a critical factor in implementation. This study aimed to successfully implement Schema-Based Instruction (SBI) for math problem solving in four classrooms in a special primary school serving students with language deficits, including students with Autism Spectrum Disorders (ASD) and Intellectual Disabilities (ID). Using an action research design that allowed for adjustments and modification to be made over the year-long study, two cohorts of teachers across the school were trained and supported in six-week learning cycles to implement SBI in their classrooms. The learning cycles included a one-day training followed by six weeks of one-on-one or team coaching and three fortnightly cohort group meetings. After the first cohort of teachers completed the learning cycle, modifications and adjustments were made to lesson materials in an attempt to improve their effectiveness with the second cohort. Fourteen teachers participated in the study, including master special educators (n=3), special education instructors (n=5), and classroom assistants (n=6). Thirty-one students participated in the study (21 boys and 10 girls), ranging in age from 5 to 12 years (M = 9 years). Twenty-one students had a diagnosis of ASD, 20 had a diagnosis of mild or moderate ID, with 13 of these students having both ASD and ID. The remaining students had diagnosed language disorders. To evaluate the effectiveness of the implementation approach, both student and teacher data was collected. Student data included pre- and post-tests of math word problem solving. Teacher data included fidelity of treatment checklists and pre-post surveys of teacher attitudes and efficacy for teaching problem solving. Finally, artifacts were collected throughout the learning cycle. Results from cohort 1 and cohort 2 revealed similar outcomes. Students improved in the number of word problems they answered correctly and in the number of problem-solving steps completed independently. Fidelity of treatment data showed that teachers implemented SBI with acceptable levels of fidelity (M = 86%). Teachers also reported increases in the amount of time spent teaching problem solving, their confidence in teaching problem solving and their perception of students’ ability to solve math word problems. The artifacts collected during instruction indicated that teachers made modifications to allow their students to access the materials and to show what they knew. These findings are in line with research that shows student learning can improve when teacher professional development is provided over an extended period of time, actively involves teachers, and utilizes a variety of learning methods in classroom contexts. Further research is needed to evaluate whether these gains in teacher instruction and student achievement can be maintained over time once the professional development is completed.Keywords: implementation science, mathematics problem solving, research-to-practice gap, schema based instruction
Procedia PDF Downloads 1218709 An Audit on the Role of Sentinel Node Biopsy in High-Risk Ductal Carcinoma in Situ and Intracystic Papillary Carcinoma
Authors: M. Sulieman, H. Arabiyat, H. Ali, K. Potiszil, I. Abbas, R. English, P. King, I. Brown, P. Drew
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Introduction: The incidence of breast ductal Carcinoma in Situ (DCIS) has been increasing; it currently represents up 20-25% of all breast carcinomas. Some aspects of DCIS management are still controversial, mainly due to the heterogeneity of its clinical presentation and of its biological and pathological characteristics. In DCIS, histological diagnosis obtained preoperatively, carries the risk of sampling error if the presence of invasive cancer is subsequently diagnosed. The mammographic extent over than 4–5 cm and the presence of architectural distortion, focal asymmetric density or mass on mammography are proven important risk factors of preoperative histological under staging. Intracystic papillary cancer (IPC) is a rare form of breast carcinoma. Despite being previously compared to DCIS it has been shown to present histologically with invasion of the basement membrane and even metastasis. SLNB – Carries the risk of associated comorbidity that should be considered when planning surgery for DCIS and IPC. Objectives: The aim of this Audit was to better define a ‘high risk’ group of patients with pre-op diagnosis of non-invasive cancer undergoing breast conserving surgery, who would benefit from sentinel node biopsy. Method: Retrospective data collection of all patients with ductal carcinoma in situ over 5 years. 636 patients identified, and after exclusion criteria applied: 394 patients were included. High risk defined as: Extensive micro-calcification >40mm OR any mass forming DCIS. IPC: Winpath search from for the term ‘papillary carcinoma’ in any breast specimen for 5 years duration;.29 patients were included in this group. Results: DCIS: 188 deemed high risk due to >40mm calcification or a mass forming (radiological or palpable) 61% of those had a mastectomy and 32% BCS. Overall, in that high-risk group - the number with invasive disease was 38%. Of those high-risk DCIS pts 85% had a SLN - 80% at the time of surgery and 5% at a second operation. For the BCS patients - 42% had SLN at time of surgery and 13% (8 patients) at a second operation. 15 (7.9%) pts in the high-risk group had a positive SLNB, 11 having a mastectomy and 4 having BCS. IPC: The provisional diagnosis of encysted papillary carcinoma is upgraded to an invasive carcinoma on final histology in around a third of cases. This has may have implications when deciding whether to offer sentinel node removal at the time of therapeutic surgery. Conclusions: We have defined a ‘high risk’ group of pts with pre-op diagnosis of non-invasive cancer undergoing BCS, who would benefit from SLNB at the time of the surgery. In patients with high-risk features; the risk of invasive disease is up to 40% but the risk of nodal involvement is approximately 8%. The risk of morbidity from SLN is up to about 5% especially the risk of lymphedema.Keywords: breast ductal carcinoma in Situ (DCIS), intracystic papillary carcinoma (IPC), sentinel node biopsy (SLNB), high-risk, non-invasive, cancer disease
Procedia PDF Downloads 1058708 Evaluation of Salivary Nickel Level During Orthodontic Treatment
Authors: Mudafara S. Bengleil, Juma M. Orfi, Iman Abdelgader
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Since nickel is a known toxic and carcinogenic metal, the present study was designed to evaluate the level of nickel released into the saliva of orthodontic patients. Non-stimulated saliva was collected from 18 patients attending The Orthodontic Clinic of Dental Faculty of Benghazi University. Patients were divided into two groups and level of nickel was determined by atomic absorption spectrophotometry. Nickel concentration values (mg/L) in first group prior to starting treatment was 0.097± 0.071. An increase in level of nickel was followed by decrease 4 and 8 weeks after applying the arch wire (0.208± 0.112) and (0.077±0.056 mg/L) respectively. Nickel levels in saliva of the second group were showed minimal variation and ranged from 0.061± 0.044mg/L to 0.083±0.054 throughout period of study. It may be concluded that there could be a release of nickel from the appliance used in first group but it doesn't reach toxic level in saliva.Keywords: atomic absorption spectrophotometry, nickel, orthodontic treatment, saliva, toxicity
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