Cost-Effectiveness of Clinical Breast Assessment-Based Screening in Rural Egypt

Introduction  

Breast cancer is the most common cancer in Egyptian women. However, the mean tumor size at diagnosis is 4.5 cm, and the median age is approximately 46 years. Both of these factors decrease the utility and cost-effectiveness of a mammography-based screening program typically designed for developed countries. We report the first clinical breast assessment-based screening project in an entirely rural Egyptian community.     

Health seeking behavior among cancer patients attending Ocean Road Cancer Institute, Tanzania

OBJECTIVES: To characterize cancer patients and to determine the associated health seeking behaviours. METHODS: Between September 2005 and February 2006, we collected data using structured and semi-structured interviews among new cancer patients attending the ORCI. Findings are summarized using univarite and bivariate analyses. RESULTS: There were 330 cancer patients during the study period. The mean age was 48 (SD = 13.5) years ranging between 21 and 84 years. The majority, 205 (62.1%), were females. More than two thirds of all patients, that is 225 (68.2%), presented at the ORCI at advanced stages of disease. Many patients reported to have neither heard, 193 (58.5%), nor to know cancer symptoms, 203 (61.5%). Only 185 (56.1%) of all patients reported their willingness to disclose and a freedom to talk about the disease. Risk factors for cancer staging were sex, patient's education status, awareness and knowledge of disease symptoms. CONCLUSIONS: Interventions targeted to improve health care seeking behaviour among cancer patients need to include health education and sensitization specifically of cancer disease, establish a strong referral mechanisms at primary health level and to start a population cancer registry for monitoring and evaluation purposes.     

Artificial intelligence strategy integrating morphologic and architectural biomarkers provides robust diagnostic accuracy for disease progression in chronic lymphocytic leukemia

Artificial intelligence-based tools designed to assist in the diagnosis of lymphoid neoplasms remain limited. The development of such tools can add value as a diagnostic aid in the evaluation of tissue samples involved by lymphoma. A common diagnostic question is the determination of chronic lymphocytic leukemia (CLL) progression to accelerated CLL (aCLL) or transformation to diffuse large B-cell lymphoma (Richter transformation; RT) in patients who develop progressive disease. The morphologic assessment of CLL, aCLL, and RT can be diagnostically challenging. Using established diagnostic criteria of CLL progression/transformation, we designed four artificial intelligence-constructed biomarkers based on cytologic (nuclear size and nuclear intensity) and architectural (cellular density and cell to nearest-neighbor distance) features. We analyzed the predictive value of implementing these biomarkers individually and then in an iterative sequential manner to distinguish tissue samples with CLL, aCLL, and RT. Our model, based on these four morphologic biomarker attributes, achieved a robust analytic accuracy. This study suggests that biomarkers identified using artificial intelligence-based tools can be used to assist in the diagnostic evaluation of tissue samples from patients with CLL who develop aggressive disease features. © 2021 The Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

Molluscicidal properties of Acacia nilotica subspecies tomentosa and astringens II

A screening programme of plants rich in plant phenolic tannins for molluscicidal activity against the snail species Bulinus truncatus and Biomphalaria pfeifferi is now under way. The spray-dried powders of the pods and stem bark of Acacia nilotica subspp. nilotica, tomentosa and astringens prove to be promising vegetable molluscicides.     

Apico-aortic shunts. Indications, results

Seven children or adolescents aged 8 to 20 years (average 13.5 years) underwent implantation of an apico-aortic conduit from 1980 to June 1989. Eleven previous operations under cardiopulmonary bypass had been performed. The indications were recurrence of muscular subaortic stenosis and/or congenital valvular stenosis in 3 cases, and stenotic, previously implanted aortic valve prosthesis of small calibre in 4 cases. The preoperative left ventricular-aortic systolic pressure gradient was between 70 and 130 mmHg. The first two patients had a bioprosthetic valvulation and the 5 succeeding patients a St Jude Medical mechanical prosthesis. The early and late mortality was nil. The average follow-up period is 5, 6 years at present (range 6 months to 9 years). One patient had to undergo repeat valve replacement after 5 years for degenerescence of the porcine bioprosthesis implanted in the conduit. No other complications related to the conduit or valve were observed. At the endpoint of the study all patients were asymptomatic without treatment. Control echocardiographic data showed normalisation of the indices of left ventricular function. Apico-aortic conduits would seem to be a safe and effective technique for the treatment of recurrent severe obstruction of the left ventricular outflow tract.