RESUMEN
Farmers are using municipal wastewater either treated or untreated for irrigation because of limited fresh water resources. Wastewater extensively used for irrigation purposes is enriched with many nutrients. The reuse of wastewater is imposing a negative impact on human health and the ecosystem. It is a need of the day to identify and assess issues of the reuse of wastewater. In the current experiment, impact of organic/inorganic amendments was studied to mitigate the toxic effects of pollutants present in wastewater. Soil was brought from the site having consistent use of wastewater and different treatments were applied as per plan. The experiment has 28 treatments with 04 replications. Nine different amendments were used at 3 varying levels. Incubation time of 30 days was given after the addition of all treatments. The results of the study showed the application of FYM @ 5.0% w/w soil reduced soil pH (7.44), EC (2.16 dS m-1), SAR (8.14), lead (8.48 mg kg-1), cadmium (1.14 mg kg-1), nickel (10.55 mg kg-1) and arsenic (2.03 mg kg-1) when compared with control and other treatments. Usage of compost and horse waste followed FYM. On the basis of this study, it is recommended that wastewater can be used for irrigation purpose after treating with FYM preferably and compost in general.
Asunto(s)
Contaminantes del Suelo , Suelo , Aguas Residuales , Aguas Residuales/química , Aguas Residuales/toxicidad , Contaminantes del Suelo/análisis , Contaminantes del Suelo/química , Contaminantes del Suelo/toxicidad , Suelo/química , Riego Agrícola/métodos , Compostaje/métodos , Contaminantes Químicos del Agua/química , Contaminantes Químicos del Agua/análisis , Concentración de Iones de Hidrógeno , Arsénico/análisis , Arsénico/toxicidadRESUMEN
Staphylococcus aureus is a major source of bacteremia and develops several complications, causing high morbidity and mortality. Rapid identification and detection of these bacteria have become an important issue for biomedical applications. Herein, an optical method based on a modified fluorescence in situ hybridization (FISH) approach has been established using DNA hybridization technology for the swift detection of pathogenic S. aureus from clinical samples. The platform was constructed with single-stranded genomic DNA and microbial colony by directly immobilizing in agarose-polyvinyl alcohol (AG-PVA) hydrogel on the surface of a glass slide. The probe was based on an elongation factor encoding the tuf gene, which binds with equal affinity to single-stranded DNA targets as well as surface proteins on microbial cells. The probe was labeled with MFP488 fluorophore having excitation wavelength 501 nm. The hybridization of the labeled probe with the target DNA and surface proteins was carried out under optimal FISH conditions, and the detection of bacteria was based on temporary field excitation of the labeled probe under a fluorescence microscope. Positive hybridization signals were detected by high fluorescence intensity. In comparison to genomic DNA, robust signals were observed with microbial cells, perhaps due to the moonlighting effect of the elongation factor Tu (Ef-Tu) expressed on the surface of bacterial cells. The applicability of the developed platform was tested on pediatric nasal samples, and results were verified with real-time qPCR. The designed platform is stable and sensitive, and after detailed optimization, a portable structure for on-site detection of pathogenic bacteria from clinical samples can be produced.
RESUMEN
The precise detection of pathogenic microorganisms is crucial for the reduction of water-borne diseases. Herein, a filter-paper-based florescent chemosensor was fabricated for the detection of Escherichia coli and Staphylococcus aureus contamination exploiting protein-DNA interaction between the target and a specific probe. The sensing mechanism involved the self-assembly of Rhodamine B (RhB) on silver nanoparticles (AgNPs) surface that was labeled with a single-stranded DNA probe. This causes the fluorescence quenching of RhB by a distant-dependant process. The hybridization between pathogen-specific probe and bacterial surface protein causes the release of fluorescence of RhB, which was observed under UV light. For paper-based bio-surface preparation, the mixture comprising RhB-AgNP-ssDNA was drop-casted on filter paper discs. The conditions were optimized using isolated genomic DNA of the microbes. The method was applied for E.coli detection using an eae gene-based probe targeting intimin protein and S. aureus detection using tuf gene-based probe targeting EF-tuf protein on the microbe's surface. The chemosensor had a notable specificity and selectivity for E.coli, and S. aureus, with detection limits of 0.6 × 108 and 0.37 × 103 CFU/mL respectively. Moreover, the sensor was tested on real water samples, which presented excellent reproducibility of results (RSD ≤ 0.24%). Furthermore, the gradient change of fluorescence was captured by a smartphone, which allows direct detection of pathogens in a sensitive semi-quantitative way without the need for expensive instruments. The designed chemosensor can serve as a simple, inexpensive, and rapid method for the on-site detection of microbial contamination in drinking water.
Asunto(s)
Técnicas Biosensibles , Agua Potable , Nanopartículas del Metal , Agua Potable/microbiología , Staphylococcus aureus/genética , Plata , Técnicas Biosensibles/métodos , Teléfono Inteligente , Reproducibilidad de los Resultados , Monitoreo del Ambiente , Escherichia coli/genética , ADNRESUMEN
Sugarcane is the world's largest cultivated crop by biomass and is the main source of sugar and biofuel. Sucrose phosphate synthase (SPS) enzymes are directly involved in the synthesis of sucrose. Here, we analyzed and compared one of the important gene families involved in sucrose metabolism in a high and low sucrose sugarcane cultivar. A comprehensive in silico analysis of the SoSPS family displayed their phylogenetic relationship, gene and protein structure, miRNA targets, protein interaction network (PPI), gene ontology and collinearity. This was followed by a spatial expression analysis in two different sugarcane varieties. The phylogenetic reconstruction distributed AtSPS, ZmSPS, OsSPS, SoSPS and SbSPS into three main groups (A, B, C). The regulatory region of SoSPS genes carries ABRE, ARE, G-box, and MYC as the most dominant cis-regulatory elements. The PPI analysis predicted a total of 14 unique proteins interacting with SPS. The predominant expression of SPS in chloroplast clearly indicates that they are the most active in the organelle which is the hub of photosynthesis. Similarly, gene ontology attributed SPS to sucrose phosphate synthase and glucosyl transferase molecular functions, as well as sucrose biosynthetic and disaccharide biological processes. Overall, the expression of SPS in CPF252 (high sucrose variety) was higher in leaf and culm as compared to that of CPF 251 (low sucrose variety). In brief, this study adds to the present literature about sugarcane, sucrose metabolism and role of SPS in sucrose metabolism thereby opening up further avenues of research in crop improvement.
Asunto(s)
Saccharum , Sacarosa , Saccharum/genética , Pakistán , Filogenia , Grano ComestibleRESUMEN
Background: Malaria has been identified as a crucial vector-borne disease around the globe. The primary aim of this study was to investigate the incidence of malaria in the district of Bannu and its relationship with climatic conditions such as temperature, rainfall, relative humidity, and topography. Methods: Secondary data were obtained from the metrological office and government hospitals across the district for 5 years (2013-2017). A Poisson regression model was applied for the statistical analysis. Results and discussion: The number of reported cases of malaria was 175,198. The regression analysis showed that temperature, relative humidity, and rainfall had a significant association (p < 0.05) with malaria incidence. In addition, the topographic variables were significantly associated (p < 0.05) with malaria incidence in the region. The percent variation in the odds ratio of incidence was 4% for every unit increase in temperature and 2% in humidity. In conclusion, this study indicated that the temperature, humidity, rainfall, and topographic variables were significantly associated with the incidence of malaria. Effective malaria control and interventions integrated with climatic factors must be considered to overcome the disease burden.
RESUMEN
INTRODUCTION: Shared learning is imperative in the assessment and safe implementation of new healthcare interventions. Magnetic seeds (Magseed®) potentially offer logistical benefit over wire localisation for non-palpable breast lesions but few data exist on outcomes comparing these techniques. A national registration study (iBRA-NET) was conducted to collate device outcomes. In order to share learning, thematic analysis was conducted to ascertain early clinical experiences of Magseed® and wire guided localisation and explore how learning events may be applied to improve clinical outcomes. METHODS: A qualitative study of 27 oncoplastic surgeons, radiologists and physicians was conducted in January 2020 to ascertain the feasibility and challenges associated with Magseed® versus wire breast localisation surgery. Four focus groups were asked to discuss experiences, concerns and shared learning outcomes which were tabulated and analysed thematically. RESULTS: Three key themes were identified comparing Magseed® and wire localisation of breast lesions relating to preoperative, intraoperative and postoperative learning outcomes. Percutaneous Magseed® detection, instrument interference and potential seed or wire dislodgement were the most common issues identified. Clinician experience suggested Magseed® index lesion identification was non-inferior to wire placement and improved the patient pathway in terms of scheduling and multi-site insertion. CONCLUSIONS: Prospective shared learning suggested Magseed® offered additional non-clinical benefits over wire localisation, improving the efficiency of the patient pathway. Recommendations for improving breast localisation technique, appropriate patient selection and clinical practice through shared learning are discussed that may aid other surgeons in the adoption of this relatively new technique.
Asunto(s)
Neoplasias de la Mama , Prácticas Interdisciplinarias , Humanos , Femenino , Neoplasias de la Mama/cirugía , Neoplasias de la Mama/diagnóstico , Estudios Prospectivos , Fenómenos Magnéticos , Reino UnidoRESUMEN
Herein, an electrochemical biosensor has been prepared to assess the sensitivity of an organophosphate insecticide, malathion, to acetylcholinesterase (AChE) enzyme of three insects including Apis mellifera (honeybee), Tribolium castaneum (red flour beetle), and Zootermopsis nevadensis (dampwood termite). A composite of nickel chromite (NiCr2O4) and graphitic carbon nitride (g-C3N4) was prepared and characterized for its morphological, chemical and electrical properties. The NiCr2O4/g-C3N4 composite integrated pencil graphite electrodes were used to covalently immobilize insect AChE enzymes and amperometric response of bioelectrodes was determined through cyclic voltammetry. The prepared bioelectrodes exhibited high enzyme immobilization efficiency and electro-catalytic performance. The integrated bioelectrodes could efficiently detect malathion induced inhibition of insects' AChEs. The linear ranges for malathion were found to be 0.1-1.6 µM, 1-40 nM and 2-100 nM, and LODs were 2 nM, 0.86 nM and 2.3 nM for A. mellifera, T. castaneum, and Z. nevadensis, respectively. Additionally, the biosensing platform developed using A. mellifera AChE was found highly sensitive and effective for malathion recoveries from spiked wheat flour samples with high recovery rates. Moreover, the proposed method was adequately reproducible and selective. The results revealed that A. mellifera AChE is less sensitive to inhibition by malathion as compared to T. castaneum, and Z. nevadensis AChE. The experimental results were validated through computational docking of malathion with insect AChEs and the results were in correspondence to experimental outcomes. The proposed method can be a plausible alternate to conventional analytical methods to assess the pesticide sensitivity and toxicity of various compounds against insect enzymes.
RESUMEN
One of the common viral pathogens in infectious diarrhea is Rotavirus; in developing countries, it is a primary cause of deaths in children less than five years of age. This study was planned to find out the etiologic agents of acute watery diarrhea. In this study, 1465 stool samples were analyzed with the symptoms of acute diarrhea. Demographic data analysis showed no. of episodes of diarrhea, vomiting, and fever. All samples were checked by ELISA technique for the presence of Rotavirus circulating strains. More than 6% patients were found to be positive with Rotavirus. Common Rotavirus genotypes, including G2P4, G2P6, G3P4, G8P4, G8P6, G9P4, and G10P4, were detected in patients through RT-PCR. This study concluded that detection of rotavirus strain diversity and management of diarrheal patients may identify assortment of emerging strains and reduce emergence of antimicrobial resistance and repeated episodes of diarrhea, which may also help to avoid and manage the essential nutrients lost leading to malnutrition and stunted growth, as well as to reduce high mortality rate in young children less than five years.
Asunto(s)
Disentería , Infecciones por Rotavirus , Rotavirus , Niño , Preescolar , Diarrea/epidemiología , Humanos , Pakistán/epidemiología , Rotavirus/genética , Infecciones por Rotavirus/epidemiologíaRESUMEN
Rhinitis and rhinosinusitis are common conditions which have a significant burden on healthcare services and can lead to reduced productivity in patients across the entire age spectrum. Three disease-specific quality of life tools were analysed in hospital and community settings to explore prevalence, disease characteristics and financial costs to sufferers, and to compare these aspects between cohorts (young children, young adult and adults). These tools were Modified Sino-Nasal Outcome Test-20 (MSNOT-20) questionnaire for adults, MSNOT-20 Young Persons Questionnaire (MSYPQ) for 11-16-year-olds and Sami's Rhinosinusitis Diagnosis and Impact questionnaire for 5-10-year-olds. One of the top three symptoms in children aged 5-10 years was cough, which is a much less common symptom in adults. These validated, disease-specific, quality of life questionnaires provide a fuller illustration of the patient experience, allowing comprehensive comparative analysis across the ages.
Asunto(s)
Calidad de Vida , Sinusitis , Niño , Preescolar , Tos , Hospitales , Humanos , Sinusitis/epidemiología , Adulto JovenRESUMEN
BACKGROUND: Wire localization is historically the most common method for guiding excision of non-palpable breast lesions, but there are limitations to the technique. Newer technologies such as magnetic seeds may allow some of these challenges to be overcome. The aim was to compare safety and effectiveness of wire and magnetic seed localization techniques. METHODS: Women undergoing standard wire or magnetic seed localization for non-palpable lesions between August 2018 and August 2020 were recruited prospectively to this IDEAL stage 2a/2b platform cohort study. The primary outcome was effectiveness defined as accurate localization and removal of the index lesion. Secondary endpoints included safety, specimen weight and reoperation rate for positive margins. RESULTS: Data were accrued from 2300 patients in 35 units; 2116 having unifocal, unilateral breast lesion localization. Identification of the index lesion in magnetic-seed-guided (946 patients) and wire-guided excisions (1170 patients) was 99.8 versus 99.1 per cent (P = 0.048). There was no difference in overall complication rate. For a subset of patients having a single lumpectomy only for lesions less than 50â mm (1746 patients), there was no difference in median closest margin (2â mm versus 2â mm, P = 0.342), re-excision rate (12 versus 13 per cent, P = 0.574) and specimen weight in relation to lesion size (0.15â g/mm2versus 0.138â g/mm2, P = 0.453). CONCLUSION: Magnetic seed localization demonstrated similar safety and effectiveness to those of wire localization. This study has established a robust platform for the comparative evaluation of new localization devices.
Asunto(s)
Neoplasias de la Mama/cirugía , Imanes , Mastectomía Segmentaria/métodos , Anciano , Neoplasias de la Mama/patología , Femenino , Marcadores Fiduciales , Humanos , Imanes/efectos adversos , Márgenes de Escisión , Mastectomía Segmentaria/efectos adversos , Mastectomía Segmentaria/instrumentación , Persona de Mediana Edad , Estadificación de Neoplasias , Complicaciones Posoperatorias , Estudios ProspectivosRESUMEN
This work describes the development and optimization of an electrochemical method to evaluate pesticide induced inhibition of honey bee (Apis mellifera) acetylcholinesterase (AChE) by means of acetylcholinesterase biosensor. The inhibition assay was based on the detection of changes in electrochemical activity of the enzyme caused by pesticide. As transducer, nitrogen doped carbon dots BSA (N-CD/BSA) nanocomposite electrodeposited on pencil graphite electrode was used to covalently immobilize AChE. The as-synthesized nanocomposite and fabricated electrodes were characterized for the structural, functional and electrochemical properties. Nanocomposite promoted the electron transfer reaction to catalyze the electro-oxidation of thiocholine and a large current response was obtained by cyclic voltammetry at 0.77 V, indicating successful immobilization of AChE. The sensitivity of Diazinon, an OP insecticide, for honeybee AChE was tested under optimal conditions and a linear response ranging 10-250 nM was obtained with a detection limit of 8.9 nM, and sensitivity 9 uA/nM/cm2. The method showed a good operational reproducibility and selectivity of biosensor. Further, the molecular docking provided additional support to the experimental data suggesting irreversible nature and contact toxicity of the pesticide for honey bee AChE. The developed biosensor has proved useful for the diazinon detection in wheat samples with 99% recovery rate.
Asunto(s)
AcetilcolinesterasaRESUMEN
INTRODUCTION: New medical devices must have adequate research, such that outcomes are known, enabling patients to be consented with knowledge of the safety and efficacy of the device to be implanted. Device trials are challenging due to the learning curve and iterative assessment of best practice. This study is designed to pilot a national collaborative approach to medical device introduction by breast surgeons in the UK, using breast localisation devices as an exemplar. The aim is to develop an effective and transferable surgical device platform protocol design, with embedded shared learning. METHODS AND ANALYSIS: The iBRA-net localisation study is a UK based prospective, multi-centre platform study, comparing the safety and efficacy of novel localisation devices with wire-guided breast lesion localisation for wide local excision, using Magseed® as the pilot intervention group. Centres performing breast lesion localisation for wide local excision or excision biopsy will be eligible to participate if using one of the included devices. Further intervention arms will be added as new devices are CE marked. Outcomes will be collected via an online database. The primary outcome measure will be identification of the index lesion. Participating surgeons will be asked to record shared learning events via online questionnaires and focus group interviews to inform future study arms. ETHICS AND DISSEMINATION: The study will aim to collect data on 950 procedures for each intervention (Magseed® and wire localisation) from UK breast centres over an 18-month period. Shared learning will be prospectively evaluated via thematic analysis to refine breast localisation technique and to promote early identification of potential pitfalls and problems. Results will be presented at national and international conferences and published in peer reviewed journals. REGISTRATION: This is a UK national audit registered with Manchester University NHS Foundation Trust. HIGHLIGHTS: This protocol outlines a novel methodology for a collaborative national platform study to collate safety and efficacy data on new medical devices. Improved registration and audit of new medical devices is a major theme of the Cumberlege report of the Independent Medicines and Medical Devices Safety Review.We outline a protocol for a UK based multi-centre prospective audit to investigate the safety and efficacy of new surgical devices for breast lesion localisation. The study will run as a platform study using wire localisation as a control group and Magseed® as the first intervention arm.The protocol is designed for additional bolt-on intervention arms for other localisation devices, such as Hologic Localizer™ and Savi Scout®, when they become available to the European market. This will enable comparison of these devices to datasets already collected on wire and Magseed® localisation.The study includes a novel shared learning methodology using iterative online database reporting and surgical interviews to centrally distribute information on learning events, critical governance issues and recommended protocols for future use.
RESUMEN
This study was undertaken to assess the potential of Tribolium castaneum (Red flour beetle) acetylcholinesterase (Tc-AChE) based electrochemical biosensor integrating WO3/g-C3N4 nanocomposite modified Pencil graphite electrode to detect an organophosphate insecticide, Phosmet. The WO3/g-C3N4 nanocomposite provides a non-toxic, biocompatible surface for binding the enzyme on the electrode surface, attributed to its large surface area, high conductivity, and low ohmic resistance. The proposed biosensor shows a very good analytical performance with LOD 3.6 nM for Phosmet and effectively determined Phosmet in wheat with a 99% recovery rate. Furthermore, molecular docking deciphers the binding interactions of Phosmet with Tc-AChE using a modified AutoDock LGA algorithm and an AMBER03 force field in YASARA. The kinetic parameters strongly suggest the high potency of inhibitor with the enzyme. This study presents an adaptable, rapid, and straightforward approach that opens ways towards real progress in developing commercial biosensors for pesticide detection.
Asunto(s)
Acetilcolinesterasa/metabolismo , Técnicas Biosensibles/instrumentación , Grano Comestible/química , Grafito/química , Nitrilos/química , Óxidos/química , Fosmet/análisis , Tungsteno/química , Animales , Escarabajos/enzimología , Electrodos , Almacenamiento de Alimentos , Simulación del Acoplamiento Molecular , Nanocompuestos/química , Plaguicidas/análisis , Plaguicidas/metabolismo , Fosmet/metabolismoRESUMEN
INTRODUCTION: Breast conserving surgery of impalpable breast lesions requires safe and effective localisation techniques. Wire localisation has traditionally been used, but has limitations. Newer techniques are now being introduced to mitigate this. The iBRA-NET group aims to robustly evaluate these new techniques in well-designed prospective studies. We report the first phase of this evaluation, a survey to establish current practice and service provision of breast localisation techniques in the UK. METHODS: A national practice questionnaire was designed using 'SurveyMonkey®' and was circulated to UK breast surgeons via the Association of Breast Surgery and the Mammary Fold. The questionnaire was live from 6th October 2018 to 6th April 2019. Only one response per unit was requested to reflect the unit's practice. RESULTS: Complete responses were received from 98 breast units across the UK. Wires were the mostly commonly used localisation technique (n = 82) with fewer units using Magseed® (n = 9), Radioguided Occult Lesion Localisation (n = 5) and Radioiodine Seed Localisation (n = 2). There was significant variation in practice and logistics involved. Frequent delays and theatre overruns were reported in 39 and 16 units, respectively. The median satisfaction score of the current technique was 7 out of 10. The main perceived limitation of existing localisation methods was logistics affecting theatre scheduling and the main barrier to introducing a new technique was cost. CONCLUSION: Wires are currently the most commonly used localisation technique but are associated with significant logistical issues. Newer techniques may offer a better solution but will need robust evaluation before they are adopted to ensure safety and efficacy.
Asunto(s)
Neoplasias de la Mama , Radioisótopos de Yodo , Neoplasias de la Mama/diagnóstico por imagen , Neoplasias de la Mama/cirugía , Femenino , Humanos , Estudios Prospectivos , Encuestas y Cuestionarios , Reino UnidoRESUMEN
The report presents the formulation of hydrogel based on biopolymers chitosan and guar gum after cross-linking for sustained release of a commonly used orally prescribed analgesic Paracetamol. The oral ingestion of Paracetamol is associated with complications of the gastric tract and liver metabolism that can be effectually avoided by using transdermal drug delivery systems. The formulated transdermal patch was characterized for physicochemical properties including swelling, bonding pattern (using FTIR Fourier Transform Infra-Red and Scanning Electron Microscopy SEM) and antimicrobial activity. Biocompatibility and cytotoxicity was examined in vitro using cell culture in HeLa cell lines. After characterizing the novel formulated hydrogel were employed for the preparation of drug encapsulated in alginate beads as a transdermal patch. After formulation of the transdermal patch, the drug release was studied using an avian skin model. The results followed zero order kinetics and Non-Fickian law for diffusion. Paracetamol due to its small molecular mass (151.163g/mol) released in a sustained manner. The released drug successfully retained its biological effects including anti-inflammatory and anti-protease activity, indicating no interaction between the drug and the formulated hydrogel. It was shown that the formulated hydrogels could be safely used as a dermal patch for the sustained drug release of Paracetamol.
Asunto(s)
Acetaminofén/administración & dosificación , Acetaminofén/química , Quitosano/química , Portadores de Fármacos/química , Galactanos/química , Hidrogeles/química , Mananos/química , Gomas de Plantas/química , Acetaminofén/farmacocinética , Animales , Antiinfecciosos/química , Antiinfecciosos/farmacología , Línea Celular , Supervivencia Celular/efectos de los fármacos , Pollos , Preparaciones de Acción Retardada , Difusión , Composición de Medicamentos , Liberación de Fármacos , Humanos , Espectroscopía Infrarroja por Transformada de FourierRESUMEN
INTRODUCTION: Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. A literature review has revealed that there is no specific questionnaire available to assess well-being within the community. METHODS: Fifty South Asian women were randomly selected to complete the "Your Health: Quality of Life and Well-being Questionnaire" assessing diet, lifestyle, and mental health among others. Data from the questionnaires was extracted and participants were categorised based on these findings. RESULTS: This tool has positively identified a number of key risk factors for poor health, symptoms associated with mental illness, and the burden of comorbidities within the assessed cohort. Sixty-three percent of the women had an unhealthy body mass index (BMI), over half did not know the maximum limit of salt per day, and almost one-fourth had multiple health conditions. CONCLUSIONS: This questionnaire is an effective tool to use within the community. There is a significant burden of obesity, complicated by poor lifestyle habits and significant mood and anxiety symptoms within the studied South Asian population.
Asunto(s)
Pueblo Asiatico/estadística & datos numéricos , Depresión/epidemiología , Indicadores de Salud , Estilo de Vida Saludable , Salud Mental , Obesidad/epidemiología , Calidad de Vida/psicología , Mujeres/psicología , Adolescente , Adulto , Anciano , Pueblo Asiatico/psicología , Índice de Masa Corporal , Enfermedad Crónica , Depresión/psicología , Dieta/estadística & datos numéricos , Ejercicio Físico , Femenino , Humanos , Persona de Mediana Edad , Sobrepeso/epidemiología , Factores de Riesgo , Sueño , Fumar/epidemiología , Conducta Social , Cloruro de Sodio Dietético , Encuestas y Cuestionarios , Reino Unido , Adulto JovenRESUMEN
INTRODUCTION: There is variation in margin policy for breast conserving therapy (BCT) in the UK and Ireland. In response to the Society of Surgical Oncology and American Society for Radiation Oncology (SSO-ASTRO) margin consensus ('no ink on tumour' for invasive and 2 mm for ductal carcinoma in situ [DCIS]) and the Association of Breast Surgery (ABS) consensus (1 mm for invasive and DCIS), we report on current margin practice and unit infrastructure in the UK and Ireland and describe how these factors impact on re-excision rates. METHODS: A trainee collaborative-led multicentre prospective study was conducted in the UK and Ireland between 1st February and 31st May 2016. Data were collected on consecutive BCT patients and on local infrastructure and policies. RESULTS: A total of 79 sites participated in the data collection (75% screening units; average 372 cancers annually, range 70-900). For DCIS, 53.2% of units accept 1 mm and 38% accept 2-mm margins. For invasive disease 77.2% accept 1 mm and 13.9% accept 'no ink on tumour'. A total of 2858 patients underwent BCT with a mean re-excision rate of 17.2% across units (range 0-41%). The re-excision rate would be reduced to 15% if all units applied SSO-ASTRO guidelines and to 14.8% if all units followed ABS guidelines. Of those who required re-operation, 65% had disease present at margin. CONCLUSION: There continues to be large variation in margin policy and re-excision rates across units. Altering margin policies to follow either SSO-ASTRO or ABS guidelines would result in a modest reduction in the national re-excision rate. Most re-excisions are for involved margins rather than close margins.