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https://www.readbyqxmd.com/read/29439832/factors-associated-with-positive-margins-in-women-undergoing-breast-conservation-surgery
#1
Brittany L Murphy, Judy C Boughey, Michael G Keeney, Amy E Glasgow, Jennifer M Racz, Gary L Keeney, Elizabeth B Habermann
OBJECTIVE: To identify factors predicting positive margins at lumpectomy prompting intraoperative reexcision in patients with breast cancer treated at a large referral center. PATIENTS AND METHODS: We reviewed all breast cancer lumpectomy cases managed at our institution from January 1, 2012, through December 31, 2013. Associations between rates of positive margin and patient and tumor factors were assessed using χ 2 tests and univariate and adjusted multivariate logistic regression, stratified by ductal carcinoma in situ (DCIS) or invasive cancer...
February 10, 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29428232/evaluating-the-effect-of-margin-consensus-guideline-publication-on-operative-patterns-and-financial-impact-of-breast-cancer-surgery
#2
Neal Bhutiani, Megan K Mercer, Katelynn C Bachmann, Samantha R Heidrich, Robert Cg Martin, Charles R Scoggins, Kelly M McMasters, Nicolás Ajkay
BACKGROUND: This study sought to evaluate re-excision rates, patient satisfaction with their breasts, and health care costs before and after publication of 2014 Society of Surgical Oncology - American Society of Radiation Oncology consensus guideline on margins for breast conservation surgery with whole-breast irradiation for stage I-II breast cancer at an academic institution. STUDY DESIGN: Patients with stage I and II invasive carcinoma who underwent partial mastectomy were divided into two groups based on whether they were treated before (PRE) or after (POST) guideline publication in March 2014...
February 8, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29428039/rationale-for-mastectomy-after-neoadjuvant-chemotherapy
#3
Lejla Hadzikadic Gusic, Kendall Walsh, Teresa Flippo-Morton, Terry Sarantou, Danielle Boselli, Richard L White
Neoadjuvant chemotherapy (NAC) reduces tumor size, facilitating the use of breast conservation surgery (BCS). However, mastectomy remains the surgical outcome for certain women. The goal of this study was to determine the rationale for mastectomy after NAC, particularly in women eligible for BCS. Retrospective data were reviewed on patients who received NAC between February 2006 and August 2010 at our institution. Demographics and tumor characteristics were compared between patients who received BCS and mastectomy after NAC...
January 1, 2018: American Surgeon
https://www.readbyqxmd.com/read/29425553/invasive-treatment-of-nstemi-patients-in-german-chest-pain-units-evidence-for-a-treatment-paradox
#4
Frank P Schmidt, Claus Schmitt, Matthias Hochadel, Evangelos Giannitsis, Harald Darius, Lars S Maier, Claus Schmitt, Gerd Heusch, Thomas Voigtländer, Harald Mudra, Tommaso Gori, Jochen Senges, Thomas Münzel
BACKGROUND: Patients with non ST-segment elevation myocardial infarction (NSTEMI) represent the largest fraction of patients with acute coronary syndrome in German Chest Pain units. Recent evidence on early vs. selective percutaneous coronary intervention (PCI) is ambiguous with respect to effects on mortality, myocardial infarction (MI) and recurrent angina. With the present study we sought to investigate the prognostic impact of PCI and its timing in German Chest Pain Unit (CPU) NSTEMI patients...
March 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29409490/unilateral-pedal-lymphangiography-plus-computed-tomography-angiography-for-location-of-persistent-idiopathic-chyle-leakage-not-detectable-by-ordinary-contrast-computed-tomography
#5
Dingyi Liu, Boke Liu, Weimu Xia, Qi Tang, Haidong Wang, Jian Wang, Yanfeng Zhou, Jiashun Yu, Wenmin Li, Mingwei Wang, Wenlong Zhou, Sang Hu, Yuan Shao
BACKGROUND: To identify the value of unilateral pedal lymphangiography (LPG) plus computed tomography angiography (CTA) in accurate depiction of persistent idiopathic chyluria undetectable by ordinary contrast CT. METHODS: Eighteen patients 44-63 years of age with persistent idiopathic chyluria who failed conservative management were included. Ordinary CT had not revealed a chyle leak. Cystoscopy, unilateral LPG, and post-LPG CT angiography (CTA) were sequentially performed...
February 6, 2018: BMC Urology
https://www.readbyqxmd.com/read/29395710/an-invasive-vs-a-conservative-approach-in-elderly-patients-with-non-st-segment-elevation-myocardial-infarction-systematic-review-and-meta-analysis
#6
REVIEW
Avadhesh Saraswat, Atifur Rahman, Kuljit Singh
BACKGROUND: Elderly (≥ 75 years) patients form a large sub-group of non-ST-segment elevation myocardial infarction (NSTEMI) population but are vastly under-represented in trials. Thus, the benefits of an early angiography in the elderly remain unclear. In this systematic review, we compared outcomes of "invasive" and "conservative" strategies of NSTEMI management in elderly patients. METHODS: A comprehensive search of major databases was performed. We included comparative studies of any design that enrolled patients ≥ 75 years, and where outcomes of both strategies of NSTEMI management were available...
December 5, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29334604/breast-conservation-therapy-versus-mastectomy-in-patients-with-t1-2n1-triple-negative-breast-cancer-pooled-analysis-of-krog-14-18-and-14-23
#7
Kyubo Kim, Hae Jin Park, Kyung Hwan Shin, Jin Ho Kim, Doo Ho Choi, Won Park, Seung Do Ahn, Su Ssan Kim, Dae Yong Kim, Tae Hyun Kim, Jin Hee Kim, Jiyoung Kim
Purpose: The aim of this study is to compare the treatment outcomes of breast conserving surgery (BCS) plus radiotherapy (RT) vs. mastectomy for patients with pT1-2N1 triple negative breast cancer (TNBC). Methods: Using two multicenter retrospective studies on breast cancer, a pooled analysis was performed among 320 patients with pT1-2N1 TNBC. All patients who underwent BCS (n=212) received whole breast RT with or without regional nodal RT, while none who underwent mastectomy (n=108) received it...
January 8, 2018: Cancer Research and Treatment: Official Journal of Korean Cancer Association
https://www.readbyqxmd.com/read/29317757/human-mediated-and-natural-dispersal-of-an-invasive-fish-in-the-eastern-great-lakes
#8
Mattias L Johansson, Bradley A Dufour, Kyle W Wellband, Lynda D Corkum, Hugh J MacIsaac, Daniel D Heath
The globally invasive Round Goby (Neogobius melanostomus) was introduced to the Great Lakes around 1990, spreading widely and becoming the dominant benthic fish in many areas. The speed and scope of this invasion is remarkable and calls into question conventional secondary spread models and scenarios. We utilized nine microsatellites to identify large-scale genetic structure in Round Goby populations in the eastern Great Lakes, and assessed the role of colonization vs. secondary transport and dispersal in developing this structure...
January 10, 2018: Heredity
https://www.readbyqxmd.com/read/29302485/21-gene-recurrence-assay-in-patients-receiving-intraoperative-radiotherapy-are-favorable-characteristics-a-surrogate-for-low-recurrence
#9
Bridget A Oppong, Surupa Sen Gupta, Monique Gary, Patricia Wehner, Mihriye Mete, Danjing Zhao, Sulakshana Seevaratnam, Sonali Rudra, Shawna C Willey
Background: Intraoperative radiotherapy (IORT) has gained momentum for early stage and favorable breast cancers (BC). The 21-gene recurrence assay guides treatment of hormone positive and node-negative BC. Methods: Analysis of 82 invasive BC treated with breast conservation surgery (BCS) and IORT 2013-2015. Data collection included patient demographics, tumor characteristics, nodal status, recurrence test (RS) and adjuvant therapy. Results: The mean age was 68 years...
December 2017: Gland Surgery
https://www.readbyqxmd.com/read/29285036/selective-radiation-therapy-for-ductal-carcinoma-in-situ-following-breast-conserving-surgery-according-to-age-and-margin-width-korean-radiation-oncology-group-11-04-and-16-02-studies
#10
Kyubo Kim, Jin Hee Kim, Yong Bae Kim, Chang-Ok Suh, Kyung Hwan Shin, Jin Ho Kim, Tae Hyun Kim, So-Youn Jung, Doo Ho Choi, Won Park, Seung Do Ahn, Su Ssan Kim, Ji Woon Yea, Min Kyu Kang, Dong Won Kim, Yi-Jun Kim
Purpose: The optimal indications for omitting adjuvant radiation therapy (RT) after breast-conserving surgery are still controversial in ductal carcinoma in situ (DCIS) of the breast. The purpose of this study was to validate the role of postoperative RT in DCIS patients aged ≤50 years and with tumor margin widths of <1 cm, both of which have been proven to be high-risk features for recurrence in cohorts not receiving RT. Methods: Using two multicenter retrospective studies on DCIS, a pooled analysis was performed among patients aged ≤50 years and with margin widths <1 cm...
December 2017: Journal of Breast Cancer
https://www.readbyqxmd.com/read/29283905/efficacy-and-safety-of-flexible-endoscopic-management-of-zenker-s-diverticulum
#11
Deepanshu Jain, Abhinav Sharma, Manan Shah, Upen Patel, Nirav Thosani, Shashideep Singhal
Zenker's diverticulum (ZD), a pulsion diverticulum of hypopharynx is a rare but treatable cause of morbidity in geriatric population. Traditionally a surgical disease but due to its associated high morbidity, flexible endoscopy has become a lucrative option. We reviewed 997 patients from 23 original studies who underwent flexible endoscopic diverticulotomy (FED) of ZD. Composite technical and clinical success rate for the study cohort was 99.4% and 87.9%, respectively. Composite failure rate was 10.0% but close to half of them (45...
December 27, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/29230119/a-potential-additional-variable-to-consider-in-the-surgical-treatment-of-ductal-carcinoma-in-situ
#12
Katherine Chaisson, Amy Rivere, Ralph Corsetti, Tova Weiss, George M Fuhrman
Background: HER2/neu is a potentially interesting variable that has been demonstrated to have a profound impact on the management of invasive breast carcinoma, and we performed this study to evaluate the differences between HER2-positive and HER2-negative ductal carcinoma in situ. The impetus for this study was our poor recruitment to the National Surgical Adjuvant Breast and Bowel Project Protocol B-43 trial that was designed to evaluate the potential role of trastuzumab in breast conservation therapy for patients with HER2-positive ductal carcinoma in situ...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29228053/traditional-scientific-data-vs-uncoordinated-citizen-science-effort-a-review-of-the-current-status-and-comparison-of-data-on-avifauna-in-southern-brazil
#13
Louri Klemann-Junior, Marcelo Alejandro Villegas Vallejos, Pedro Scherer-Neto, Jean Ricardo Simões Vitule
Data generated by citizen science is particularly valuable in ecological research. If used discerningly with data from traditional scientific references, citizen science can directly contribute to biogeography knowledge and conservation policies by increasing the number of species records in large geographic areas. Considering the current level of knowledge on south Brazilian avifauna, the large volume of data produced by uncoordinated citizen science effort (CS), and the growing need for information on changes in abundance and species composition, we have compiled an updated, general list of bird species occurrence within the state of Paraná...
2017: PloS One
https://www.readbyqxmd.com/read/29190666/movement-to-outpatient-hysterectomy-for-benign-indications-in-the-united-states-2008-2014
#14
Gaby Moawad, Emelline Liu, Chao Song, Alex Z Fu
INTRODUCTION: The past decade has witnessed adoption of conservative gynecologic treatments, including minimally invasive surgery (MIS), alongside steady declines in inpatient hysterectomies. It remains unclear what factors have contributed to trends in outpatient benign hysterectomy (BH), as well as whether these trends exacerbate disparities. MATERIALS AND METHODS: Retrospective cohort of 527,964 women ≥18 years old who underwent BH from 2008 to 2014. BH surgical approaches included: open/abdominal hysterectomy (AH), vaginal hysterectomy (VH), laparoscopic hysterectomy (LH), and robotic-assisted hysterectomy (RH)...
2017: PloS One
https://www.readbyqxmd.com/read/29182482/endoscopic-plantar-fasciotomy-vs-open-radiofrequency-microtenotomy-for-recalcitrant-plantar-fasciitis
#15
Weining Wang, Inderjeet Singh Rikhraj, Andrew Chen Chou Chia, Hwei Chi Chong, Kevin Oon Thien Koo
BACKGROUND: Although usually self-limiting, around 10% of patients develop recalcitrant plantar fasciitis despite conservative treatment. In such cases, operative intervention can be offered. Traditionally, plantar fasciotomy has been the treatment of choice, but recently, there has been a push for more minimally invasive approaches. Radiofrequency microtenotomy has also been increasingly used as a treatment option. In this study, we compare the outcomes of endoscopic plantar fasciotomy and open radiofrequency microtenotomy...
November 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/29165886/pre-operative-features-of-non-invasive-follicular-thyroid-neoplasms-with-papillary-like-nuclear-features-an-analysis-of-their-cytological-gene-expression-classifier-and-sonographic-findings
#16
S J Song, V A LiVolsi, K Montone, Z Baloch
OBJECTIVE: To investigate the corresponding cytological diagnoses, Gene Expression Classifier (GEC) results and ultrasound features of thyroid nodules diagnosed as non-invasive follicular thyroid neoplasms with papillary-like nuclear features (NIFTP), as well as any coexisting pathology. METHODS: We performed a retrospective review of thyroid nodules histologically diagnosed as NIFTP at our institution between 1st April 2016 and 1st April 2017. The following data points were collected: demographics, nodule size, ultrasound features, cytological diagnosis, GEC results, origin of sample (in-house vs outside hospital) and any additional pathology identified in the resection specimen...
December 2017: Cytopathology: Official Journal of the British Society for Clinical Cytology
https://www.readbyqxmd.com/read/29153618/advantages-of-a-prospective-multidisciplinary-approach-in-transcatheter-aortic-valve-implantation-eight-years-of-experience
#17
Cátia Costa, Rui Campante Teles, João Brito, José Pedro Neves, Henrique Mesquita Gabriel, Miguel Abecassis, Regina Ribeiras, João Abecasis, Tiago Nolasco, Maria da Conceição Furstenau, Nélson Vale, António Tralhão, Sérgio Madeira, João Mesquita, Carla Saraiva, Rita Calé, Manuel Almeida, Ana Aleixo, Miguel Mendes
INTRODUCTION: Aortic stenosis is the most prevalent type of valvular disease in Europe. Surgical aortic valve replacement (SAVR) is the standard therapy, while transcatheter aortic valve implantation (TAVI) is an alternative in patients at unacceptably high surgical risk. Assessment by a heart team is recommended by the guidelines but there is little published evidence on this subject. The purpose of this paper is to describe the experience of a multidisciplinary TAVI program that began in 2008...
November 15, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29113294/therapeutic-management-and-one-year-outcomes-in-elderly-patients-with-acute-coronary-syndrome
#18
Esteban Orenes-Piñero, Juan M Ruiz-Nodar, María Asunción Esteve-Pastor, Miriam Quintana-Giner, José Miguel Rivera-Caravaca, Andrea Veliz, Mariano Valdés, Manuel Macías, Vicente Pernias-Escrig, Nuria Vicente-Ibarra, Luna Carrillo, Miriam Sandín-Rollán, Elena Candela, Teresa Lozano, Francisco Marín
Background: Elderly represents a subgroup of high-risk ACS patients due to their advanced age and other comorbidities. Unfortunately, they are also often under-represented in many studies and clinical trials. Furthermore, cardiologists commonly find difficulties in the choice of the antiplatelet treatment and even on whether invasive revascularization should be used. In this study, the management of elderly ACS patients regarding antiplatelet therapy and revascularization procedures will be analyzed...
October 6, 2017: Oncotarget
https://www.readbyqxmd.com/read/29109852/mortality-and-morbidity-in-necrotizing-pancreatitis-managed-on-principles-of-step-up-approach-7-years-experience-from-a-single-surgical-unit
#19
Deshpande Aparna, Sunil Kumar, Shukla Kamalkumar
AIM: To determine percentage of patients of necrotizing pancreatitis (NP) requiring intervention and the types of interventions performed. Outcomes of patients of step up necrosectomy to those of direct necrosectomy were compared. Operative mortality, overall mortality, morbidity and overall length of stay were determined. METHODS: After institutional ethics committee clearance and waiver of consent, records of patients of pancreatitis were reviewed. After excluding patients as per criteria, epidemiologic and clinical data of patients of NP was noted...
October 27, 2017: World Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29108379/postoperative-adjuvant-radiotherapy-is-associated-with-improved-survival-in-hepatocellular-carcinoma-with-microvascular-invasion
#20
Liming Wang, Weihu Wang, Xuesong Yao, Weiqi Rong, Fan Wu, Bo Chen, Mei Liu, Shengtao Lin, Yunhe Liu, Jianxiong Wu
Purpose: Limited studies have compared the efficacy of postoperative adjuvant therapies in HCC patients with microvascular invasion (MVI). In this study we assess the efficacy of postoperative adjuvant conservative therapy (CT), trans-catheter arterial chemoembolization (TACE) and radiotherapy (RT) in HCC patients with MVI. Results: Kaplan-Meier survival analysis revealed that patients in the RT group have significantly improved RFS (RT vs TACE: p = 0.011; RT vs CT: p < 0...
October 3, 2017: Oncotarget
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