Consensus neuropathological diagnosis of common dementia syndromes: testing and standardising the use of multiple diagnostic criteria

The aim of this study was to assess the variation between neuropathologists in the diagnosis of common dementia syndromes when multiple published protocols are applied. Fourteen out of 18 Australian neuropathologists participated in diagnosing 20 cases (16 cases of dementia, 4 age-matched controls) using consensus diagnostic methods. Diagnostic criteria, clinical synopses and slides from multiple brain regions were sent to participants who were asked for case diagnoses. Diagnostic sensitivity, specificity, predictive value, accuracy and variability were determined using percentage agreement and kappa statistics. Using CERAD criteria, there was a high inter-rater agreement for cases with probable and definite Alzheimer's disease but low agreement for cases with possible Alzheimer's disease. Braak staging and the application of criteria for dementia with Lewy bodies also resulted in high inter-rater agreement. There was poor agreement for the diagnosis of frontotemporal dementia and for identifying small vessel disease. Participants rarely diagnosed more than one disease in any case. To improve efficiency when applying multiple diagnostic criteria, several simplifications were proposed and tested on 5 of the original 210 cases. Inter-rater reliability for the diagnosis of Alzheimer's disease and dementia with Lewy bodies significantly improved. Further development of simple and accurate methods to identify small vessel lesions and diagnose frontotemporal dementia is warranted.

Predicting the HER2 status of breast cancer from basic histopathology data: an analysis of 1500 breast cancers as part of the HER2000 International Study

The tests that are currently available for the measurement of overexpression of the human epidermal growth factor-2 (HER2) in breast cancer have shown considerable problems in accuracy and interlaboratory reproducibility. Although these problems are partly alleviated by the use of validated, standardised 'kits', there may be considerable cost involved in their use. Prior to testing it may therefore be an advantage to be able to predict from basic pathology data whether a cancer is likely to overexpress HER2. In this study, we have correlated pathology features of cancers with the frequency of HER2 overexpression assessed by immunohistochemistry (IHC) using HercepTest (Dako). In addition, fluorescence in situ hybridisation (FISH) has been used to re-test the equivocal cancers and interobserver variation in assessing HER2 overexpression has been examined by a slide circulation scheme. Of the 1536 cancers, 1144 (74.5%) did not overexpress HER2. Unequivocal overexpression (3+ by IHC) was seen in 186 cancers (12%) and an equivocal result (2+ by IHC) was seen in 206 cancers (13%). Of the 156 IHC 3+ cancers for which complete data was available, 149 (95.5%) were ductal NST and 152 (97%) were histological grade 2 or 3. Only 1 of 124 infiltrating lobular carcinomas (0.8%) showed HER2 overexpression. None of the 49 'special types' of carcinoma showed HER2 overexpression. Re-testing by FISH of a proportion of the IHC 2+ cancers showed that only 25 (23%) of those assessable exhibited HER2 gene amplification, but 46 of the 47 IHC 3+ cancers (98%) were confirmed as showing gene amplification. Circulating slides for the assessment of HER2 score showed a moderate level of agreement between pathologists (kappa 0.4). As a result of this study we would advocate consideration of a triage approach to HER-2 testing. Infiltrating lobular and special types of carcinoma may not need to be routinely tested at presentation nor may grade 1 NST carcinomas in which only 1.4% have been shown to overexpress HER2. Testing of these carcinomas may be performed when HER2 status is required to assist in therapeutic or other clinical/prognostic decision-making. The highest yield of HER2 overexpressing carcinomas is seen in the grade 3 NST subgroup in which 24% are positive by IHC. (C) 2003 Elsevier Science Ltd. All rights reserved.

Curso de pol??ticas p??blicas e desenvolvimento econ??mico

O curso apresentou os seguintes temas: pol??ticas p??blicas macroecon??micas, setoriais e sociais como instrumento de estabiliza????o e desenvolvimento econ??mico; fundamentos econ??micos para as pol??ticas p??blicas; pol??tica macroecon??mica: pol??tica monet??ria e o combate ?? infla????o, pol??tica fiscal e desenvolvimento, pol??tica de com??rcio exterior e o c??mbio; pol??ticas setoriais: industrial, agr??cola, infraestrutura; a estrat??gia atual de desenvolvimento econ??mico e o papel das pol??ticas sociais

Curso de ambienta????o para analista t??cnico de pol??ticas sociais

Apresenta????o do curso na abertura de cada uma das 4 turmas realizadas

??tica no servi??o p??blico

Apresenta????o sobre ??tica no Servi??o P??blico. Estado Democr??tico de Direito. P??blico versus Privado. A ??tica do servidor p??blico

Federalismo e territorialidade nas pol??ticas p??blicas brasileiras

Fundamentos do Federalismo no Brasil. As rela????es federativas nas a????es governamentais e os desafios dessa configura????o institucional para a viabiliza????o de pol??ticas sociais federais no territ??rio nacional

Pol??ticas p??blicas e pol??tica social no Brasil: pol??ticas p??blicas e gest??o participativa no Brasil

Conceito de pol??tica p??blica e sua fun????o nas rela????es entre Estado e sociedade. O ciclo de pol??ticas p??blicas e as rela????es entre suas fases. Conceito de arranjos institucionais de pol??ticas p??blicas e sua fun????o na capacidade de a????o do Estado

Pol??tica social no Brasil e o desenvolvimento: desafios e perspectivas

Pol??tica Social e Desenvolvimento. Panorama geral e comparado sobre as Pol??ticas Sociais Brasileiras (abrang??ncia, gest??o/organiza????o, financiamento e gasto)

Apresenta????o sobre a administra????o p??blica no Brasil e os desafios da gest??o p??blica contempor??nea

Administra????o P??blica Brasileira: transforma????es e desafios para a gest??o p??blica no Brasil contempor??neo: desempenho, governan??a, rela????es intersetoriais.

A administra????o p??blica no Brasil e os desafios da gest??o p??blica contempor??nea: o sistema de planejamento e or??amento federal

O Sistema de Planejamento e Or??amento Federal (PPA, LDO, LOA). O PPA 2012-2015. Ciclo do PPA: elabora????o, gest??o, monitoramento, avalia????o e revis??o

Semin??rio: o desafio da implementa????o das pol??ticas p??blicas

Debater sobre os desafios da incorpora????o dos temas transversais, relacionados a p??blicos espec??ficos, nos processos de implementa????o de pol??ticas p??blicas da Administra????o P??blica Federal

Brasil: territorialidade e pol??ticas p??blicas

Import??ncia, possibilidades e desafios para a produ????o de pol??ticas p??blicas baseadas em abordagem territorial e focadas em popula????es, tendo em vista heran??as hist??ricas e tend??ncias recentes de ocupa????o territorial e seus decorrentes impactos no contexto social

Aula gest??o de programas e projetos sociais

Ciclo de Projetos Governamentais e suas Caracter??sticas. Conceitos, fundamentos e abordagens metodol??gicas em gest??o de projetos. Referencial t??cnico do processo de gerenciamento: inicia????o, planejamento, execu????o, monitoramento e controle e encerramento de projetos. Gerenciamento do projeto no n??vel operacional

Brasil sem mis??ria

Apresenta????o sobre o Plano Brasil sem Mis??ria.

Instrumentos de monitoramento e avalia????o do plano Brasil sem mis??ria e de programas do MDS

Apresenta????o do tema Instrumentos de Monitoramento e Pesquisas de Avalia????o do Plano Brasil sem Mis??ria e de Programas do MDS