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Background: Papillary tumours of the breast are diagnostically challenging lesions and represent a wide spectrum of diseases from papilloma to invasive papillary carcinoma. A rare subtype of breast papillary tumour resembling the tall cell variant of thyroid papillary carcinoma (BTRTPC) has been described. The nomenclature of this entity, its relationship to other papillary tumours, and its nature, whether in situ or invasive, remain unclear. Methods: Seventy-five papillary carcinomas (PCs) of the breast previously diagnosed in routine practice were reviewed and the presence of features (n = 10) characteristic of BTRTPC were assessed to determine whether BTRTPC comprises a distinct entity or is part of the spectrum of the previously defined PC variants. Results: Nuclear overlapping and eosinophilic granular cytoplasm were seen in 81 and 75% of the cases, whereas nuclear grooves, nuclear clearing, and tall cells were noticed in 51, 42, and 38% of the cases, respectively; 27% of the cases showed macro- and micro-follicular architecture filled with colloid-like material. Five cases (7%) lacked oestrogen receptor (ER) expression. Co-existing invasive carcinoma was seen in 25 cases (33%). Two cases displayed several features characteristic of BTRTPC, and both were ER-negative. Conclusion: Features characteristic of BTRTPC overlap with other PCs of the breast. Molecular and immunohistochemical biomarkers are needed to provide objective diagnostic criteria for the characterisation of such lesions in routine practice.

Despite the significant biological, behavioural and management differences between ductal carcinoma in situ (DCIS) and invasive carcinoma of the breast, they share many morphological and molecular similarities. Differentiation of these two different lesions in breast pathological diagnosis is based typically on the presence of an intact barrier between the malignant epithelial cells and stroma; namely, the myoepithelial cell (MEC) layer and surrounding basement membrane (BM). Despite being robust diagnostic criteria, the identification of MECs and BM to differentiate in-situ from invasive carcinoma is not always straightforward. The MEC layer around DCIS may be interrupted and/or show an altered immunoprofile. MECs may be absent in some benign locally infiltrative lesions such as microglandular adenosis and infiltrating epitheliosis, and occasionally in non-infiltrative conditions such as apocrine lesions, and in these contexts this does not denote malignancy or invasive disease with metastatic potential. MECs may also be absent around some malignant lesions such as some forms of papillary carcinoma, yet these behave in an indolent fashion akin to some DCIS. In Paget's disease, malignant mammary epithelial cells extend anteriorly from the ducts to infiltrate the epidermis of the nipple but do not typically infiltrate through the BM into the dermis. Conversely, BM-like material can be seen around invasive carcinoma cells and around metastatic tumour cell deposits. Here, we review the role of MECs and BM in breast pathology and highlight potential clinical implications. We advise caution in interpretation of MEC features in breast pathology and mindfulness of the substantive evidence base in the literature associated with behaviour and clinical outcome of lesions classified as benign on conventional morphological examination before changing classification to an invasive lesion on the sole basis of MEC characteristics.

The study of the anthelmintic properties of plants rich in plant secondary metabolites can provide ecologically sound methods for the treatment of parasites on grazing animals. The purpose of the present study was to evaluate the anthelmintic effect of five tropical native Australian plant species rich in plant secondary metabolites on adult Haemonchus contortus and Trichostrongylus colubriformis in experimentally infected goats. Thirty young, nematode-free goats were infected with 2500 H. contortus and 5000 T. colubriformis infective larvae thrice weekly for a week (day 1-7 of the experiment). On day 27 after first infection, the goats were allocated into six groups of five animals per group. From day 28 to day 35, fresh leaves from Acacia salicina, Acacia nilotica, Eucalyptus corymbia, Casuarina cunninghamiana and Eucalyptus drepanophylla were included in the goats diet. Five groups were offered leaves from one of these plant species and one group, the untreated control, received only the basal diet formulated with 20% Medicago sativa and 80% Avena sativa. Following plant material administration, the goats were monitored daily until day 40 and then slaughtered on day 41. Total faecal worm egg output, total production of larvae recovered from faecal cultures, total post-mortem worm burdens and the per capita fecundity of female worms were estimated. The toxicity of the plant species for the goats was measured by histopathological analyses of liver and kidney samples. Results showed that goats feeding on the plant material rich in plant secondary metabolites had significantly lower egg output compared to the control goats (P0.05). A similar response was found for larval production in both H. contortus and T. colubriformis supporting that egg output was affected in both species. Although the total worm burdens were not affected by the plant material (P0.05), the per capita fecundity was significantly reduced by E. corymbia, A. nilotica and A. salicina (P0.05). No signs of toxicity were detected in the liver or kidney samples. It is concluded that goats can benefit from the short-term ingestion of plant secondary metabolites, which reduce the total faecal egg output and thus decrease the potential for re-infection from the pasture.

With the purpose of studying the anthelmintic efficacy of some plant species presents in Queensland State, Australia, we tested in vitro the effect of plant extracts on infective larvae (L3) migration of Haemonchus placei, Cooperia sp., Haemonchus contortus and Trichostrongylus colubriformis. In general, plant extracts reduced the larval migration of Haemonchus placei and Cooperia sp. The most effective plants against Haemonchus placei and Cooperia sp. (P < 0.0001) were Allocasuarina torulosa, Neolitsea dealbata, Acacia holosericea, Acacia salicina, Callitris endlicheri and Casuarina cunninghamiana. Plants extracts were less effective on L3 migration of Haemonchus contortus and Trichostrongylus colubriformis. Callitris endlicheri, Casuarina cunninghamiana, Acacia farnesiana, Acacia holosericea and Acacia nilotica were the plant extracts that shown an important larval migration inhibition against H. contortus and Trichostrongylus colubriformis (P < 0.0001). Callitris endlicheri was the plant that consistently inhibited the larval migration of every nematode species under study. These in vitro results suggest anthelmintic properties associate with some of the plant species we studied. EEA Cerro Azul Fil: Moreno, Fabiana Carina. University Drive. CSIRO Davies Laboratory; Australia. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad Ciencias Veterinarias; Argentina. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Montecarlo; Argentina Fil: Gordon, Iain J. University Drive. CSIRO Davies Laboratory; Australia Fil: Wright, A.D. AIMS Australian Institute of Marine Science; Australia Fil: Benvenutti, Marcelo. University Drive. CSIRO Davies Laboratory; Australia. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Montecarlo; Argentina Fil: Saumell, Carlos A. Universidad Nacional del Centro de la Provincia de Buenos Aires. Facultad Ciencias Veterinarias; Argentina

To assess the effectiveness of erythropoietin (EPO) in a Clinical Oncohematology Unit within a general hospital, and to propose a therapeutic algorithm with EPO based on recommendations by ASCO.A descriptive, retrospective study was carried out on patients who required support treatment with EPO while in the Oncohematology Unit during the year 2001. Data were collected by reviewing patient medical records. An effective treatment was defined as an increase in baseline hemoglobin (Hb) equal to or higher than 2 g/dL over 4-8 weeks, with no transfusion requirements or decreased transfusion needs. Baseline Hb values, their distribution per diagnosis, and the involvement of platinum-containing chemotherapy regimens were analyzed.Of the 353 patients in chemotherapy, 87% corresponded to oncologic diagnoses while the rest had hematological neoplasms. A total of 54 patients were assessed, with 83% of these corresponding to the oncologic area. Oncologic diagnoses that most required the use of EPO included: head-neck 53%, genitourinary 39%, and lung 39%. Overall effectiveness was 57% (60% in oncology and 44% in hematology). The Hb value leading to initial prescription (baseline Hb) was always below 10 g/dL for the hematology area, whereas most oncology patients exhibited higher levels at therapy onset.1. Its percentage of failure: 40% for oncology and 56% for hematology patients, together with its high cost, shows that a further search for predictive factors is warranted in order to more precisely select individuals who may benefit from this therapy. 2. The percentage of oncology patients with baseline Hb10 is only 29%. Baseline Hb values for treatment onset and peak Hb values for therapy discontinuation should be agreed upon. Treatment initiation when Hb values fall below 10 g/dL would be a reasonable option, and a decision to use EPO above 10 g/dL should be made in patients with less severe anemia (10-12 g/dL) only if clinical circumstances render it advisable. 3. Use protocols must include clear concept definitions for treatment, and for primary and secondary prophylaxis, which will help in the establishment of therapeutic algorithms.

To discuss various aspects of drug prescription for first-year resident physicians (MIR-1) working in Emergency Departments in order to promote a rational use of drugs, and to assess the impact of such pharmaceutical intervention.During personal interviews MIR-1s were briefed (both orally and in written form) on prescription characteristics of their department. Both qualitative (compliance with the Pharmaco-therapeutic Guide, prescription of drugs with low intrinsic value) and quantitative (prescription profile for medicines with the same active principle but different price) parameters were discussed. Then the impact of these interviews was analysed by comparing outpatient prescriptions by MIR-1s during August-November 2000 versus those filled by their colleagues during this same period in 1998 and 1999.Outpatient prescriptions by the MIR-1 group conformed better to the qualitative and quantitative parameters studied. Despite such better results, greater savings may still be obtained by improving quinolone/macrolide, anti-ulcer drug, ACE inhibitor and NSAID prescriptions, since these amount to 93% of total potential savings.By conducting personal interviews with a pharmacist new MIR-1s encounter an additional information source contributing to more sensible drug prescriptions.