Feasibility of oncoplastic techniques in the surgical management of locally advanced breast cancer

Background: Locally advanced breast cancer (LABC) is still common in developing countries. The association between neoadjuvant chemotherapy (NC) and oncoplastic surgery (OS) might provide an oncological treatment with satisfactory aesthetic results.Purpose: The goal was to demonstrate if oncoplastic surgical techniques can be utilized to treat LABC which was submitted to neoadjuvant chemotherapy.Methods: This prospective clinical trial included breast cancer patients, clinical stage III, who underwent established NC regimen. All patients underwent preoperative planning to control the tumor size and to define the surgical technique. A detailed analysis of the pathological specimen was performed.Results: 50 patients were assessed and surgically treated. Tumor size ranged from 3.0 to 14.0 cm (median 6.5 cm). Pathologic response was rated as stable, progressive, partial response, and complete response in 10%, 8%, 80% and 2% of the cases, respectively. Seventeen (34%) patients were submitted to OS. No patient had positive margins. Skin involvement was presented in 36% of pathologic specimen.Conclusions: Oncoplastic surgical techniques for selected patients decrease the rates of radical surgery despite large tumors. (www.clinicaltrials.gov, NCT00820690). (C) 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.

A combination of clinical and microbiological management of generalized aggressive periodontitis in primary teeth. A case report

International Journal of Paediatric Dentistry 2012; 22: 310316 Background. Generalized aggressive periodontitis (GAP) in primary teeth is a rare periodontal disease that occurs during or soon after eruption of the primary teeth. An association with systemic diseases is a possibility. Case Report. A 4-year-old Brazilian girl presented with GAP involving the entire primary dentition. The patient and her parents and sister were subjected to microbiological testing to identify the microorganisms involved in the disease. The patient underwent tooth extraction to eradicate the disease and received a prosthesis for the restoration of masticatory function. After the permanent teeth erupted, fixed orthodontic appliances were place to restore dental arch form and occlusion. Conclusions. The results show the importance of an early diagnosis of GAP and of a multidisciplinary approach involving laboratory and clinical management to treat the disease and to restore masticatory function, providing a better quality of life for patients.

Management of an Unusual Presentation of Ascher Syndrome

Ascher syndrome is defined by the association between double lip, blepharochalasis, and nontoxic goiter. Because it is a rare disease, it is most often misdiagnosed, despite its implications for quality of life. We report a variation of an incomplete type of Ascher syndrome affecting the upper lip, upper eyelids, and lateral canthi of a young male patient. The surgical management, follow-up, and a brief overview of the syndrome are described. The results presented show an aesthetic and functional improvement of the facial deformities.

Interdisciplinary approach to the management of Ewing sarcoma: A case report

Ewing sarcoma is a common primary bone malignancy occurring in childhood and adolescence. This case report describes a 4-year-old female patient who had Ewing sarcoma in the left clavicular region. The patient underwent total excision of the left clavicle and subsequently developed periodontitis and multiple carious lesions after chemotherapy. Caries risk and salivary flow rate tests were performed, followed by periodontal treatment, topical fluoride application, restoration of caries, and oral hygiene instruction. The care of this patient demonstrates that an interdisciplinary approach is essential to eliminate all foci of infection, minimize morbidity, and improve the patient's general health before, during, and after oncological treatment. © 2012 Special Care Dentistry Association and Wiley Periodicals, Inc.

Influence of Agroforestry and Traditional Management of Maize (Zea mays L.) on Soil Fertility

The aim of the work was to evaluate soil nutrient concentration at 0-5, 5-10, and 10-20 cm in maize (Zea mays L.) grown in sequence with black oats (Avena strigosa Schreb.) under Leucaena diversifolia alley cropping agroforestry system (AFS) and traditional management system/sole crop (without trees-TS), following a randomized block design. The experiment was carried out at the Brazilian Association of Biodynamic Agriculture, in Botucatu, São Paulo, Brazil. The treatments were: control (C), chemical fertilizer (F), biomass of L. diversifolia alley cropping (B), and biomass of L. diversifolia alley cropping + chemical fertilizer (B+F). After 2 yr, it was observed that pH, organic matter, and nutrient content had a tendency to show higher values in the treatments biomass+fertilizer, biomass, and fertilizer application, in both systems. Higher values in pH, organic matter, phosphorus, potassium, calcium, magnesium, sum of bases, cation exchange capacity, percentage base saturation, boron, copper, and manganese tended to occur in the agroforestry system. © 2013 Copyright Taylor and Francis Group, LLC.

Productivity, Leaf Nutrient Content and Soil Carbon Stocked in Agroforestry and Traditional Management of Maize (Zea mays L.)

The aim of the work was to evaluate the productivity, leaf nutrient content and soil nutrient concentration in maize (Zea mays L.) grown in sequence with black oats (Avena strigosa Schreb.) under Leucaena diversifolia alley cropping agroforestry system (AFS) and traditional management system/sole crop (without trees-TS), after two years of cultivation following a randomized block design. The experiment was carried out in the Brazilian Association of Biodynamic Agriculture, in Botucatu—S?o Paulo, Brazil. Treatments were: control (C), chemical fertilizer application (F), biomass of L. diversifolia alley cropping application (B), biomass of L. diversifolia alley cropping + chemical fertilizer application (B + F). In the second year of management it was observed that black oat yield was higher in treatments B + F and F with significant difference in relation to the others treatments in both systems, followed by treatment B. Between systems, only treatment B showed significant difference, with higher yield value corresponding to AFS, reflecting the efficiency of AFS to promote soil fertility. Maize production presented the second year of cultivation an increasing trend in all treatments in both production systems. This result may be due to the cumulative effect of mineralization and maize straw and oats, along the experiment. How productivity was higher in the AFS system, could also be occurring effect of biological nitrogen fixation, water retention and reduction of extreme microclimate through the rows of L. diversifolia. Comparing the AFS and TS, it was observed that the concentration of N in leaf tissue was higher in the AFS treatments, probably due to nitrogen fixation performed through the rows of L. diversifolia, that is a nitrogen fixing tree species. After two years, carbon stocked in soil show higher values in the treatments biomass + fertilizer and biomass application, in both systems, AFS and TS.