tbuckley/cabot-search huggingface dataset:
Effect of Structured Physical Activity on Overall Burden and Transitions Between States of Major Mobility Disability in Older Persons
Authors: Thomas M. Gill, Jack M. Guralnik, Marco Pahor, Timothy Church, Roger A. Fielding, Abby C. King, Anthony P. Marsh, Anne B. Newman, Christine A. Pellegrini, Shyh-Huei Chen, Heather G. Allore, Michael E. Miller
Journal: Annals of Internal Medicine (2016)

Background: The total time a patient is disabled likely has a greater influence on his or her quality of life than the initial occurrence of disability alone. Objective: To compare the effect of a long-term, structured physical activity program with that of a health education intervention on the proportion of patient assessments indicating major mobility disability (MMD) (that is, MMD burden) and on the risk for transitions into and out of MMD. Design: Single-blinded, parallel-group, randomized trial. (ClinicalTrials.gov: NCT01072500) Setting: 8 U.S. centers between February 2010 and December 2013. Participants: 1635 sedentary persons, aged 70 to 89 years, who had functional limitations but could walk 400 m. Intervention: Physical activity (n = 818) and health education (n = 817). Measurements: MMD, defined as the inability to walk 400 m, was assessed every 6 months for up to 3.5 years. Results: During a median follow-up of 2.7 years, the proportion of assessments showing MMD was substantially lower in the physical activity (0.13 [95% CI, 0.11 to 0.15]) than the health education (0.17 [CI, 0.15 to 0.19]) group, yielding a risk ratio of 0.75 (CI, 0.64 to 0.89). In a multistate model, the hazard ratios for comparisons of physical activity with health education were 0.87 (CI, 0.73 to 1.03) for the transition from no MMD to MMD; 0.52 (CI, 0.10 to 2.67) for no MMD to death; 1.33 (CI, 0.99 to 1.77) for MMD to no MMD; and 1.92 (CI, 1.15 to 3.20) for MMD to death. Limitation: The intention-to-treat principle was maintained for MMD burden and first transition out of no MMD, but not for subsequent transitions. Conclusion: A structured physical activity program reduced the MMD burden for an extended period, in part through enhanced recovery after the onset of disability and diminished risk for subsequent disability episodes. Primary Funding Source: National Institute on Aging, National Institutes of Health.
<i>Sema6D</i>acts downstream of bone morphogenetic protein signalling to promote atrioventricular cushion development in mice
Authors: Yin Peng, Lanying Song, Ding Li, Robert Kesterson, Jianbo Wang, Lizhong Wang, Gregg Rokosh, Bingruo Wu, Qin Wang, Kai Jiao
Journal: Cardiovascular Research (2016)

Bone morphogenetic protein (BMP) signalling plays a key role in regulating the development of the atrioventricular (AV) septum and valves; however, the molecules that mediate the complex activities of BMP signalling are not fully understood. The major goal of this study is to identify the critical downstream regulatory targets of BMP signalling in AV cushions, which are precursors of the AV septum and valves. We established a conditional immortal AV cushion mesenchymal cell line, tsA58-AVM. Using this line, we observed that the expression of Sema6D is upregulated by BMP stimulation through microarray analysis. Sema6D is required for BMP-upregulated migration of tsA58-AVM cells. To reveal the in vivo role of Sema6D , we established the Sema6D loxp/loxp mouse line and specifically inactivated Sema6D in endocardial cells (by Nfatc1 Cre ) when cushion mesenchymal cells started to form. We observed a hypocellular AV cushion defect in mutant hearts at early stages (E9.25, E9.5). The defect was resolved at a later stage, most likely due to compensation by increased Sema6C in mutant AV cushions. Furthermore, our ex vivo culturing and in vivo transgenic studies collectively suggest that SEMA6D activates Rho through PLXNA1-FARP1 to promote cushion mesenchymal cell formation. We demonstrate for the first time that Sema6D is a target of BMP signalling and that Semaphorin signalling is essential for the initiation of cushion mesenchymal cell formation in the AV canal. Our study reveals a novel BMP- Sema6D -Rho axis regulating AV cushion development.
<i>APOE</i> Genotypes Associate With Cognitive Performance but Not Cerebral Structure: Diabetes Heart Study MIND
Authors: Nicholette D. (Palmer) Allred, Laura M. Raffield, Joycelyn C. Hardy, Fang-Chi Hsu, Jasmin Divers, Jianzhao Xu, S. Carrie Smith, Christina E. Hugenschmidt, Benjamin C. Wagner, Christopher T. Whitlow, Kaycee M. Sink, Joseph A. Maldjian, Jeff D. Williamson, Donald W. Bowden, Barry I. Freedman
Journal: Diabetes Care (2016)

OBJECTIVE Dementia is a debilitating illness with a disproportionate burden in patients with type 2 diabetes (T2D). Among the contributors, genetic variation at the apolipoprotein E locus (APOE) is posited to convey a strong effect. This study compared and contrasted the association of APOE with cognitive performance and cerebral structure in the setting of T2D. RESEARCH DESIGN AND METHODS European Americans from the Diabetes Heart Study (DHS) MIND (n = 754) and African Americans from the African American (AA)-DHS MIND (n = 517) were examined. The cognitive battery assessed executive function, memory, and global cognition, and brain MRI was performed. RESULTS In European Americans and African Americans, the APOE E4 risk haplotype group was associated with poorer performance on the modified Mini-Mental Status Examination (P &amp;lt; 0.017), a measure of global cognition. In contrast to the literature, the APOE E2 haplotype group, which was overrepresented in these participants with T2D, was associated with poorer Rey Auditory Verbal Learning Test performance (P &amp;lt; 0.032). Nominal associations between APOE haplotype groups and MRI-determined cerebral structure were observed. CONCLUSIONS Compared with APOE E3 carriers, E2 and E4 carriers performed worse in the cognitive domains of memory and global cognition. Identification of genetic contributors remains critical to understanding new pathways to prevent and treat dementia in the setting of T2D.
Phase 1 trial of rituximab, lenalidomide, and ibrutinib in previously untreated follicular lymphoma: Alliance A051103
Authors: Chaitra S. Ujjani, Sin-Ho Jung, Brandelyn Pitcher, Peter Martin, Steven I. Park, Kristie A. Blum, Sonali M. Smith, Myron Czuczman, Matthew S. Davids, Ellis Levine, Lionel D. Lewis, Scott E. Smith, Nancy L. Bartlett, John P. Leonard, Bruce D. Cheson
Journal: Blood (2016)
Prevalence of diabetes mellitus in rural Saudi Arabia
Authors: سراج ميره
Journal: Diabetes Care (1987)

Several studies have clearly shown the impact of modernization on the prevalence of diabetes mellitus in susceptible communities. Saudi Arabia has faced a rapid development program over the last two decades. In a recent study, we found a high prevalence of diabetes mellitus in urban Saudi Arabia. A total of 5222 rural subjects of both sexes were involved in a study of the prevalence of diabetes mellitus in the western region of Saudi Arabia. Random capillary blood glucose, body weight and height, and income were recorded. The results showed an overall prevalence of 4.3%. There was a rise of prevalence with age and higher-income groups. Prevalence also differed with sex. The overall prevalence in women (5.9%) was twice that for men (2.9%; P less than .001). Obesity occurred in 41.2% of our diabetic subjects compared to 29.3% in nondiabetic subjects (P less than .001). Multiple logistic regression analysis with body mass index (BMI) as the dependent variable showed that sex and income status were significant factors (P less than .0001 and P less than .04, respectively). When blood glucose was fixed as the dependent variable, the analysis showed that age, income, and BMI were significant factors (P less than .004, P less than .0001, and P less than .045, respectively)
Abstract 19925: Novel Pre-implant Characteristics Associated With 12 Month Risk of Gastrointestinal Bleeding Among Patients Supported With Continuous Flow Left Ventricular Assist Device Therapy
Authors: Yang Shi, Matthew Rappelt, Rayan Yousefzai, Nasir Sulemanjee, Dianne Zwicke, Thomas Hastings, Omar Cheema, Francis Downey, John Crouch, Vinay Thohan
Journal: Circulation (2015)

Introduction: Continuous-flow Left Ventricular Assisted Device (CF-LVAD) therapy is increasingly utilized for patients with end stage heart failure. Among the most common and unpredictable complications after CF-LVAD is gastrointestinal bleeding (GIB). Hypothesis: We hypothesize that pre-implant characteristics are associated with GIB post-implant of a CF-LVAD. The aim of this analysis is to identify novel pre-implant factors that influence risk of post-implant GIB. Methods: All CF-LVAD implants between January 2006 and December 2014 among patients who survived more than 15 days were included and followed for 12 months. Primary event was GIB and patients were censored at time of re-implant, heart transplant, or death. Student’s t-test was used to compare continuous variables and chi-square test for categorical variables. Cox Proportional Hazards model was used to identify univariate and multivariable models predicting GIB. Results: Among the total 257 patients included, 65 (25.3%) were identified as having a GIB. Baseline differences and their independent univariate hazard ratio (HR) are noted in Table 1. Using stepwise selection and developing a multivariable model, prior GI abnormalities (HR=2.12, p&lt;0.01), prior percutaneous coronary intervention (PCI: HR=2.65, P&lt;0.01) and chronic obstructive pulmonary disease (COPD: HR=1.73, P&lt;0.01) remained statistically significant predictors of GIB (Table 2). Conclusions: We describe novel risk factors (history of GI abnormalities, prior PCI, COPD) as predictors for developing GIB post CF-LVAD implantation. We advocate a closer examination of these risk factors when evaluating patients for CF-LVAD therapy.
포스터 발표 : 한약재 및 건강식품에 의한 약인성 간 손상의 두가지 원인산정 척도의 적용
Authors: 이수정, 이승환, 박창환, 이완식, 주영은, 최성규, 유종선, 김세종
Journal: Clinical and Molecular Hepatology (2003)

배경/목적: 최근 B형 간염 바이러스에 의한 간염의 빈도는 감소하는 반면 한약재 및 식물성 건강식품에 의한 약인성 간손상이 차지하는 비율이 증가하는 실정이다. 약인성 간손상의 진단은 특이표지자가 없어 RUCAM(Roussel Uclaf Causality Assessment Method) 척도와 M&V(Maria and Victorino) 척도를 사용하고 있으나, 이 두 척도는 일반약제에 의한 약인성 간손상을 평가하기 위해 고안된 방법으로, 한약재나 건강식품에 의한 간손상을 평가하는데 있어서는 유용성이 알려져 있지 않다. 따라서 한약재 및 건강식품에 의한 약인성 간손상에서 두 척도를 비교분석하고 일치도를 알아보고자 하였다. 대상과 방법: 1998년 5월부터 2002년 12월까지 한약재 및 건강식품에 의한 급성 간손상으로 입원한 99명의 환자를 대상으로 하였다. 대상 환자들은 AST, ALT, alk-P, total bilirubin, direct bilirubin 검사 중 한가지 이상의 항목이 정상범위의 상한의 2배 이상 증가한 경우만을 포함하였다. 각 환자에 대하여 후향적으로 RUCAM 척도 및 M&V 척도를 사용하여 평가한 후, 두 척도를 사용하여 얻어진 각 등급간의 일치도를 조사하였다. 또한 한약과 건강식품에 의한 간손상군 59예(A군)와 후향적으로 다른 원인에 의한 간손상으로 증명된 40예(B군)간에 RUCAM 척도와 M&V 척도를 사용하여 얻어진 총점과 등급의 분포를 비교평가하였다. 결과: 1) RUCAM 척도의 경우 약제에 의한 간손상 환자의 76.3%가 확정적과 가능성 높음에 포함된 반면, M&V 척도의 경우에는 약제에 의한 간손상 환자의 3.4% 만이 가능성 높음에 포함되었다. 2) 약인성 간손상군(A군)과 다른 원인에 의한 간손상군(B군) 간의 RUCAM 척도를 이용한 총점은 A군 6.9±2.0점, B군 4.1±2.6이었으며, M&V 척도를 이용한 총점은 A군 9.8±2.7점, B군 3.1±3.5점으로 두 척도 모두 A군에서 유의하게 높았다.(p＜0.05) 3) 약인성 간손상군(A군)에서 두 척도 간의 등급이 일치하는 경우는 6예(10.2%)로 일치도는 낮았으며 1등급의 불일치를 보이는 경우는 31예(52.5 %), 2등급의 불일치를 보이는 경우는 16예(27.1%), 3등급의 불일치를 보이는 경우는 6예(10.2%)였다. 결론: 약인성 간손상의 평가에 사용되는 RUCAM 척도와 M&V 척도는 다른 원인에 의한 간손상과 약인성 간손상을 구별하는데 한계가 있고 두 척도간의 일치도가 낮아 한약 및 건강식품 등을 포함하는 약인성 간손상 평가에 유용한 새로운 척도개발이 필요하다.
Residential radon,<i>EGFR</i>mutations and<i>ALK</i>alterations in never-smoking lung cancer cases
Authors: Alberto Ruano-Ravina, María Torres-Durán, Karl T. Kelsey, Isaura Parente-Lamelas, Virginia Leiro-Fernández, Ihab Abdulkader, José Abal-Arca, Carmen Montero-Martínez, Iria Vidal-García, Margarita Amenedo, Olalla Castro-Añón, Antonio Golpe-Gómez, Javier González-Barcala, Cristina Martínez, Rosirys Guzmán-Taveras, Mariano Provencio, María José Mejuto-Martí, Alberto Fernández-Villar, Juan Miguel Barros-Dios
Journal: European Respiratory Journal (2016)

The aim of this study was to assess if residential radon exposure might cause EGFR mutations or ALK rearrangements in never-smokers. We designed a multicentre case–control study in a radon-prone area (Galicia, Spain); only lung cancer cases were included in the study. We obtained residential radon measurements and clinical information for all the participants. We compared the median values of residential radon between patients with EGFR mutations or ALK rearrangements versus those without them. 323 patients were included. Median age was 70 years and 19.5% were males. 42 and 15% of patients were EGFR - and ALK -positive, respectively. The most frequent EGFR alterations were exon 19 deletions and exon 21 (L858R) single-point substitution mutations. ALK -positive patients were 10 years younger than ALK -negative patients. Residential radon levels were two-fold higher in patients with exon 19 deletions compared with patients with exon 21 (L858R) single-point substitution mutations (216 versus 118 Bq·m −3 ; p=0.057). There were no differences in residential radon levels by EGFR mutation status. ALK -positive patients (n=12) essentially had two-fold residential radon levels compared with ALK -negative patients (290 versus 164 Bq·m −3 , respectively). Residential radon may have a role in the molecular signature of lung cancer in never-smokers, although more studies with larger sample sizes are needed to support this hypothesis.
Effect Of Detecting and Isolating Asymptomatic<i>Clostridium difficile</i>Carriers—Reply
Authors: Yves Longtin, Rodica Gilca, Vivian G. Loo
Journal: JAMA Internal Medicine (2016)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Internal Medicine HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Internal Medicine journal
Radiation Therapy Deviations in Trial of Locally Advanced Pancreatic Cancer
Authors: Ashish Jani, David P. Horowitz
Journal: JAMA (2016)

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA HomeNew OnlineCurrent IssueFor Authors Podcasts Clinical Reviews Editors' Summary Medical News Author Interviews More Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA journal
P0064 : Ribavirin pre-treatment in liver transplant patients with hcv recurrence: Results from pearl multicentre randomized trial
Authors: V. Giannelli, A. Zanetto, P. Burra, P.R. Francesca, A. Gasbarrini, U.V. Comandini, G.M. Ettorre, M. Giusto, E. Biliotti, M. Merli, G. Taliani
Journal: Journal of Hepatology (2015)
Outcomes Following Hematopoietic Stem Cell Transplantation for Hematologic Malignancies in Patients with or without Advanced Care Planning.
Authors: Apar Kishor Ganti, Stephanie J. Lee, James O. Armitage, Philip J. Bierman, Gregory Bociek, Marcel P. Devetten, Lori J. Maness, Elizabeth C. Reed, Julie M. Vose, Fausto Loberiza
Journal: Blood (2005)
Pulmonary Complications after T-Cell Depleted Allogeneic Stem Cell Transplantation: Low Incidence and Strong Association with Acute GVHD.
Authors: Cynthia Huisman, Hanneke M. van der Straaten, Marijke R. Canninga-van Dijk, Rob Fijnheer, Leo F. Verdonck
Journal: Blood (2005)
Safety and pharmacokinetic (PK) study of perifosine plus capecitabine (P-CAP) in patients (pts) with refractory metastatic colorectal cancer (mCRC).
Authors: F. A. Greco, J. R. Infante, H. A. Burris, S. F. Jones, J. Kolesar, L. R. Gardner, P. Sportelli, J. C. Bendell
Journal: Journal of Clinical Oncology (2010)

e14086 Background: Perifosine (P), a synthetic alkylphospholipid, inhibits or modifies multiple signal transduction pathways, including AKT, MAPK and JNK. A small randomized phase II study of P 50 mg PO QD d1-21 + CAP 825 mg/m2 PO BID d1-14 (P-CAP) vs. placebo + CAP 825 mg/m2 PO BID d1-14 in pts with advanced mCRC showed improved TTP and OS of P-CAP vs. placebo + CAP. A more commonly used dose of CAP in the U.S. is 1,000 mg/m2 PO BID. This study evaluated the safety and PK of P 50 mg PO QD d1-21 + CAP 1,000 mg/m2 BID d1-14. Methods: Pts with refractory mCRC received P 50 mg PO QD d 1-21 + CAP 1,000 mg/m2 BID d1- 14. Pts were enrolled in a 3+3 fashion, with a total of 9 patients treated if the dose was tolerated for further safety and PK data. PK of P and CAP were evaluated C1D1 and C1D11 (steady-state). Plasma concentrations were evaluated by a validated LCMS assay with PK parameters determined with Win Non Lin version 5.2. Results: 10 pts were enrolled. Median age 65 (54-72); 70% female. Median prior Rx = 3 (2-4). Prior Rx: FOLFOX (100%); FOLFIRI (100%); bevacizumab (100%); EGFR antibody (60%); progressed on prior 5-FU-based Rx (100%). 9 pts were evaluable for DLT; no DLTs were observed. 1 pt was inevaluable after stopping study drug after 2d for non-related AE. G 3/4 AE's ≥ 10%: dyspnea (10%), rash (10%), hyperkalemia (10%) and abdominal pain (10%). Perifosine PK results show a mean half-life of 5.66 ± 4.06 hours, Cmax of 2.66 ug/mL, AUC(0- 8) (C1D1) of 9.73 hr*ug/mL, CL of 5.66 mL/hr and a V of 26.5 L. Steady state AUC(0-8) was 21.8 hr*ug/mL. These data are consistent with single agent perifosine PK data, suggesting no perifosine PK change with the addition of capecitabine. Capecitabine PK evaluation is underway. As of Jan 2010, 3/10 pts have had one response assessment (9 wk scan). One pt had a 13% decrease in disease, and 1 pt had SD. 7/10 pts remain on study treatment. Conclusions: P 50 mg PO QD d1-21 + CAP 1,000 mg/m2 PO BID d 1-14 is a well-tolerated regimen for pts with mCRC. Updated PK, safety and efficacy results will be presented. A randomized phase III trial of P-CAP vs. placebo + CAP is planned for refractory colorectal cancer pts. Author Disclosure Employment or Leadership Position Consultant or Advisory Role Stock Ownership Honoraria Research Funding Expert Testimony Other Remuneration Keryx Biopharmaceuticals Keryx Biopharmaceuticals
Camelid single-domain antibodies: A versatile tool for in vivo imaging of extracellular and intracellular brain targets
Authors: Tengfei Li, Matthias Vandesquille, Fani Koukouli, Clémence Dudeffant, Ihsen Youssef, Pascal Lenormand, Christelle Ganneau, Uwe Maskos, Christian Czech, Fiona Grueninger, Charles Duyckaerts, Marc Dhenain, Sylvie Bay, Benoît Delatour, Pierre Lafaye
Journal: Journal of Controlled Release (2016)
Correlation of 18FDG PET-CT with SPET-CT lymphoscintigraphy to guide surgical management of the axilla in patients with T2 or T3 breast cancer.
Authors: C. Soler, E. Gremillet, C. Bouteille, A. Steiner, B. Geissler
Journal: Journal of Clinical Oncology (2010)

623 Background: The aim of this study was to assess the impact of 18 FDG PET-CT (FDG-PET) and sentinel lymph node (SLN) localization by lymphoSPET-CT for the surgical management of the axilla in patients with T2,T3 breast cancer. Methods: 69 patients with T2 or T3 breast cancer (20-40 mm) were enrolled. Both FDG-PET and lymphoSPET-CT were performed for all 69 patients. FDG-PET was performed first to analyze breast and axillary area. Two to 4 days after, SLN SPET-CT was performed. When a focal accumulation of FDG was noted and related to one or more possible axillary metastases, it was compared with SLN as identified by SPECT-CT lymphoscintigraphy. Concordance and discordance of node localization were noted. Results: a focal axillary FDG uptake was found in 30 patients (43.4%). For these 30 patients, preoperative lymphoSPET-CT revealed SLN in 26. All the 26 SLNs were in the same CT location as the focal FDG uptake. SLN biopsy procedure was done in these 26 patients and revealed node metastases in 16 cases (61.5%). Axillary lymph node dissection (ALND) was performed when SLN was metastatic. For the 4 patients with focal axillary FDG uptake but no SLN detected by lymphoSPET-CT, ALND was performed and revealed axillary metastases in all cases. For the 39 patients (56.6%) for whom no focal FDG uptake around axillary region was found, lymphoSPET-CT always identified SLN which was when biopsied and followed by ALND only when metastatic. 3/39 (7.5%) SLN were metastatic, 36/39 (92.5%) SLN were healthy. So correlating 18FDG PET-CT with lymphoSPET-CT seems to be very important in cases of T2 and T3 breast cancer: (1) when a focal FDG uptake is found and no SLN is found by lymphoSPET-CT, ALND is indicated; (2) when a focal FDG uptake is found and is anatomically correlated with SLN as identified by lymphoSPET-CT, SLN biopsy procedure seems to be allowed and safe because node biopsy is related certainly with PET suspect node; and (3) in case of no focal FDG uptake in axillary area, SLN biopsy procedure is probably as safe as for T1 patient. Conclusions: if these preliminary results were to be confirmed, correlating 18FDG PET-CT with SPET-CT lymphoscintigraphy will allow avoiding systematic ALND in patients with T2 or T3 breast cancer. No significant financial relationships to disclose.