Background: Breast cancer is the most common malignancy affecting the Iraqi population and the leading cause of cancer related mortality among Iraqi women. It has been well documented that prognosis of patients depends largely upon the hormone receptor contents and HER-2 over expression of their neoplasm. Recent studies suggest that Triple Positive (TP) tumors, bearing the three markers, tend to exhibit a relatively favorable clinical behavior in which overtreatment is not recommended. Aim: To document the different frequencies of ER/PR/HER2 breast cancer molecular subtypes focusing on the Triple Positive pattern; correlating those with the corresponding clinico-pathological characteristics among a sample of Iraqi patients diagnosed with the disease. Patients and Methods: This retrospective study involved 570 female patients diagnosed with breast cancer who visited the Main Referral Center for Early Detection of Breast Cancer and the National Cancer Research Center. The requested data was mainly extracted from an established information system database, developed by the principal author over a 4-years period from 2012 to 2016. The registered information comprised data related to clinical presentation, diagnostic and pathologic findings. ER, PR and HER2 status were analyzed immunohistochemically and the detected profiles were correlated with the corresponding clinico-pathological characteristics. Results: The rates of ER (+), PR (+) and HER-2 (+) tumors were 66.8%, 64% and 29.3% respectively. The tumor marker expression status was documented in eight subtypes; 83 cases (14.6%) of the examined breast carcinomas were categorized as ER+/PR+/HER2+ (Triple Positive/Luminal B), 89 cases (15.6%) were ER-/PR-/HER2- (Triple Negative), 241 (42.2%) were ER+/PR-/HER2- (Luminal A) while 67 (11.8%) showed ER-/PR-/HER2+ expression (HER-2 variant). No significant variations were noted when comparing age, menopausal status and tumor grade of Luminal B pattern to Luminal A and the rest of the studied subtypes. Although our data revealed a statistical difference with respect to the distribution of tumor types; where infiltrative ductal carcinoma constituted the major histology among patients with Triple Positive/Luminal B subtype (86.7% as compared to 67.6% in Luminal A), nevertheless, more than two third of those patients (67.4%) were diagnosed at earlier stages (I and II) compared to 55.2% of those in the remaining groups. Conclusions and Recommendations: Our findings support the hypothesis that the Triple Positive subtype might be driven primarily by the hormone receptor status. Further comprehensive surveys are recommended to focus on the intrinsic interactions and tumor cell heterogeneity of that pattern to avoid overtreatment and predict accurate response to therapy.
In most recent studies, long-term retention after orthodontic treatment has been hypothesized that may be necessary to maintain the stability of the dentition and avoid post-treatment changes. The bonded fixed retainer is characterized by its clinical effectiveness, patient acceptance, and lack of patient complaints as compared with a removable retainer. An electronic database (such as PubMed, PubMed Central, Web of Science, Science Direct, Cochrane Library, Scopus, and ResearchGate) has been collected using specific keywords. Of the 152 articles, only randomized clinical trials that investigated different types of fixed retainers or compared fixed with removable retainers were illustrated in tables and included in this review. The
... Show MoreThe research aims to design an electronic program that allows users to assess the possibility of different practices for projects management professional according to the PMBOK methodology)) and using the requirements Data mentioned in the "knowledge and experience in project management Evaluation guide" issued by the professional Institute of project management According to the results of this program will be electronic The possible classification of project management in terms of both (proficiency_ perform tasks) as less than the desired level or within or above average in terms of best practices, and finally a number of recommendations to overcome the possible shortcomings. The most important is the need to enrich the service
... Show MoreA series of experiments were conducted for the first time in Iraq to evaluate the efficiency of five plant leaves extracts (Ibicella lutea, Nerium oleander, Clerodendron inerme, Allium cepa and Eucalyptus spp.) in treating the common carp (Cyprinus carpio) infected with monogenetic trematodes of genera Dactylogyrus. Five different concentrations of such extracts were used to bathe fishes for 5,10,15,20 and 25 minutes. A concentration of 15% A. cepa for 25 minutes of bath exposure was affective in trematode eradication. Extracts of both Eucalyptus and N. oleander at a concentration of 10% each were also affective for ten minutes exposure. Extracts of C. inerme had no any effect on such parasites. On the otherhand, extracts of 1. hitea caused
... Show MoreThe construction project is a very complicated work by its nature and requires specialized knowledge to lead it to success. The construction project is complicated socially, technically and economically in its planning, management and implementation aspects due to the fact that it has many variables and multiple stakeholders in addition to being affected by the surrounding environment. Successful projects depend on three fundamental points which are cost-time, performance and specifications. The project stakeholder's objective to achieve best specifications and the cost-time frame stipulated in the contract.
The question is, was the optimum implementation accomplished? The provision for the success of the project
... Show MoreThis paper presents an investigation to the effect of the forming speed on healing voids that inhabit at various size in an ingot. The study was performed by using finite element method with bilinear isotropic material option, circular type voids were considered. The closure index was able to predict the minimum press force necessary to consolidate voids and the reduction. The simulation was carried out, on circular cross-section lead specials containing a central void of different size. At a time with a flat die, different ratio of inside to outside radius was taken with different speed to find the best result of void closure.
Roller Compacted Concrete is a type of concrete that is environmentally friendly and more economical than traditional concrete. Roller Compacted Concrete is typically used for heavy-duty and specialist constructions, such as hydraulic structures and pavements, because of its coarse surface. The main difference between RCC and conventional concrete mixtures is that RCC has a more significant proportion of fine aggregates that allow compaction and tight packing. In recent years, it has been estimated that several million tons of waste demolished material (WDM) produced each year are directed to landfills worldwide without being recycled for disposal. This review aimed to study the literature about creating a Roller-Comp
... Show MoreSurface drip irrigation is one of the most conservative irrigation techniques that help control providing water directly on the soil through the emitters. It can supply fertilizer and providing water directly to plant roots by drippers. One of the essential needs for trickle irrigation nowadays is to obtain more knowledge about the moisture pattern under the trickling source for various types of soil with various discharge levels with trickle irrigation. Simulation numerical using HYDRUS-2D software, version 2.04 was used to estimate an equation for the wetted area from a single surface drip irrigation in unsaturated soil is taking into account water uptake by roots. In this paper, using two soil types were used, namely
... Show MoreThis research aims at to identify the extent to which creative thinking skills Impact the change &development of Administrative Leadership styles In Administrative Leadership of the Medical City Department. Identify the nature of the relationship between them, determine the prevailing leadership style, &measure the level of creative thinking skills they have. In order to achieve the objectives of the research, the descriptive analytical method was adopted.
The research tool consisted of a questionnaire consisting of (61) paragraphs, in addition to the interview & observation. The research sample consisted of (170) administrative leaders in the upper &middle organizational levels. The
... Show MoreIn this research, the covariance estimates were used to estimate the population mean in the stratified random sampling and combined regression estimates. were compared by employing the robust variance-covariance matrices estimates with combined regression estimates by employing the traditional variance-covariance matrices estimates when estimating the regression parameter, through the two efficiency criteria (RE) and mean squared error (MSE). We found that robust estimates significantly improved the quality of combined regression estimates by reducing the effect of outliers using robust covariance and covariance matrices estimates (MCD, MVE) when estimating the regression parameter. In addition, the results of the simulation study proved
... Show MoreHypothyroidism has been associated with disorders of glucose and insulin metabolism..The present study was designed to evaluate the possible change in some hormones (free testosterone, estradiol, prolactin, insulin), glucose and homeostasis model assessment of insulin resistance (HOMA-IR) in women with primary hypothyroidism under thyroid hormone replacement therapy .This cross-sectional study was carried on 62 hypothyroid patients׳ women and 22 healthy women as control group at the specialized center for endocrinology and diabetes, AL-Rasafa Directorate of Health Baghdad, with age range(15-60 years), diagnosed as having primary hypothyroidism on thyroxine replacement therapy with duration not less than four months.
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