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Hasan Karanlik, Ilker Ozgur, Berkay Kilic, Alisan Fathalizadeh, Yasemin Sanli, Semen Onder, Pinar Saip, Fatma Sen, Bahadir M Gulluoglu
BACKGROUND AND OBJECTIVES: It is not clear whether sentinel lymph node biopsy (SLNB) can be applied to patients with a second breast cancer or recurrence occurring at previously treated breast. The purpose of this study was to assess the feasibility of SLNB procedure in patients with recurrent breast cancer. METHODS: Patients with non-metastatic recurrent N0 breast cancer at ipsilateral breast were included. Patients were grouped according to their initial breast, axilla, and overall surgery...
October 25, 2016: Journal of Surgical Oncology
C Nos, K B Clough, P Bonnier, S Lasry, G Le Bouedec, B Flipo, J-M Classe, M-C Missana, V Doridot, S Giard, H Charitansky, A Charles-Nelson, A-S Bats, C Ngo
BACKGROUND: Two thirds of node-positive breast cancer patients have limited pN1 disease and could benefit from a less extensive axillary lymph node dissection (ALND). METHODS: 172 breast cancers patients requiring an ALND were prospectively enrolled in the Sentibras Protocol of Axillary Reverse Mapping (ARM). Radioisotope was injected in the ipsilateral hand the day before surgery. ALND was standard. Removed lymph nodes were classified into non radioactive nodes and radioactive nodes (ARM nodes)...
August 26, 2016: European Journal of Surgical Oncology
Pelin Üstüner, Ali Balevi, Mustafa Özdemir
INTRODUCTION: There is no satisfactory and efficient method for long-term removal of white-colored and thin hair. METHODS: We conducted a randomised clinical trial of hirsute patients with excessive white and/or thin hair on the face and/or axilla. In Group I (n: 16), the facial hair on one side of the face was painted with a black eyelash mascara immediately before Nd:YAG laser and the other half was only treated by Nd:YAG. In Group II (n: 20), the axillary hair on one side was painted with the mascara before the Alexandrite laser with the other side being only treated by Alexandrite...
October 20, 2016: Journal of Cosmetic and Laser Therapy: Official Publication of the European Society for Laser Dermatology
Margaret M Fleming, Anna I Holbrook, Mary S Newell
OBJECTIVE: The purpose of this article is to delineate the potential techniques for percutaneous ablation of breast cancer, discuss the advantages and disadvantages of each technique, and provide results from recent studies on these technologies. The techniques discussed are cryotherapy, laser irradiation, microwave irradiation, radiofrequency ablation, high-intensity focused ultrasound ablation, and irreversible electroporation. CONCLUSION: Although percutaneous ablation techniques have some promising potential for less-invasive treatment of breast cancer, larger multicenter trials are needed to confirm their efficacy, especially in comparison with the reference standard of lumpectomy...
October 20, 2016: AJR. American Journal of Roentgenology
Ryan P Cauley, Sean A Hickey, Charles Scott Hultman, Katie Mathews, Jeremy Goverman
BACKGROUND: Postburn axillary contractures are common and significantly impact quality of life. Simple release combined with split thickness skin grafting necessitates a donor site, requires immobilization, and may result in poor functional outcome. Common methods of adjacent tissue rearrangement are not well designed to treat broad linear contractures. Flaps from the back, flank, or arm can be used, but may come with significant donor site morbidity. We demonstrate the use of the STARplasty, a novel adjacent tissue rearrangement initially developed to treat neosyndactyly, as a useful reconstructive option for the release of Kurtzman type 1 posterior or anterior axillary contractures...
October 17, 2016: Annals of Plastic Surgery
Carolina Souza Neves da Costa, Sandra L Saavedra, Nelci Adriana Cicuto Ferreira Rocha, Marjorie H Woollacott
BACKGROUND: External support has been viewed as an important biomechanical constraint for children with deficits in postural control. Nonlinear analysis of head stability is necessary to confirm benefits of interaction between external trunk support and level of trunk control. OBJECTIVE: To compare the effect of biomechanical constraints (trunk support) on neural control of head stability during development of trunk control. DESIGN: Quasi-experimental repeated measure study...
October 6, 2016: Physical Therapy
A Hennigs, F Riedel, F Marmé, P Sinn, K Lindel, A Gondos, K Smetanay, M Golatta, C Sohn, F Schuetz, J Heil, A Schneeweiss
BACKGROUND: During the last decade, neoadjuvant chemotherapy (NACT) of early breast cancer (EBC) evolved from a therapy intended to enable operability to a standard treatment option aiming for increasing cure rates equivalent to adjuvant chemotherapy (ACT). In parallel, improvements in the quality control of breast cancer care have been established in specialized breast care units. PATIENTS AND METHODS: This study analyzed chemotherapy usage in patients with EBC treated at the Heidelberg University Breast Unit between January 2003 and December 2014...
October 15, 2016: Breast Cancer Research and Treatment
Tiffany Y Loh, Philip R Cohen
BACKGROUND: Tumor necrosis factor-α (TNF-α) inhibitors, such as infliximab, adalimumab, and certolizumab pegol are effective agents in the treatment of inflammatory bowel disease. Some individuals undergoing anti-TNF-α therapy for Crohn's disease or ulcerative colitis develop psoriasiform lesions. This is a paradoxical finding, as classical psoriasis is known to respond to these agents. PURPOSE: The clinical features of anti-TNF-α-induced psoriatic dermatitis are described...
September 9, 2016: Curēus
Wedad Abdelrahman, Maureen Y Walsh, Susannah E Hoey, Donal O'Kane
Pyoderma gangrenosum (PG) is a rare inflammatory neutrophilic dermatosis often misdiagnosed. It is uncommon in infants and children accounting for 4% of cases. A one-year-old male in paediatric ICU ventilated for bronchopneumonia was referred with ulcerated areas on his neck and axilla corresponding to sites of recent removal of central and arterial lines. Examination revealed areas of deep ulceration with violaceous undermined borders in keeping with PG. This was supported by a skin biopsy showing a neutrophilic infiltrate in the deeper dermis...
2016: Case Reports in Pediatrics
Sean McIntire, Lee Boujie, John Leasiolagi
Injuries involving rupture of the pectoralis major are relatively rare. When they do occur, it is mostly frequently in a young, athletic man. The most common cause is weight lifting that results in eccentric muscle contraction (muscle contraction against an overbearing force, leading to muscle lengthening)-specifically, the bench press. Other mechanisms for this injury include forceful abduction and external rotation of the arm. Injury can occur anywhere along the pectoralis major from its medial origin on the sternum and clavicle to its lateral tendinous insertion on the humerus...
2016: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
Andrew Gratzon, Jerette Schultz, Kristine Secrest, Kenneth Lee, Jeffrey Feiner, Richard D Klein
ABSTARCT: BACKGROUND: Secondary lymphedema following breast cancer therapy remains a major problem. Vascularized lymph node transfer (VLNT) is a surgical treatment for lymphedema that has shown promising results, but limited studies in the United States have investigated outcomes for single-stage VLNT to the axilla. The goal of this prospective, ongoing study was to investigate the clinical, psychosocial, and functional outcomes of patients who underwent VLNT for the treatment of upper extremity lymphedema after breast cancer therapy...
October 12, 2016: Annals of Surgical Oncology
Ismail Jatoi, John R Benson, Masakazu Toi
With the advent of sentinel lymph node biopsy, surgical methods for accurately staging the axilla in patients with early-stage breast cancer have become progressively less extensive, with formal axillary lymph node dissection confined to a dwindling group of patients. Although details of methods for sentinel lymph node biopsy have yet to be standardised, this technique is now widely practised and accepted as standard of care worldwide. In the past 5 years, attention has focused on minimisation of surgical morbidity by restricting further axillary surgery or considering radiotherapy in patients with a small tumour burden in their sentinel nodes...
October 2016: Lancet Oncology
Marco Gipponi, Piero Fregatti, Alessandro Garlaschi, Federica Murelli, Cecilia Margarino, Francesca Depaoli, Paola Baccini, Maurizio Gallo, Daniele Friedman
OBJECTIVE: A prospective observational clinical study was undertaken to assess the accuracy of preoperative Axillary Ultrasound (AUS) plus Fine-Needle Aspiration Cytology (FNAC) as well as and its clinical utility, that is the capacity of the information supplied by the test to guide the clinical decision-making. MATERIALS AND METHODS: from January 2013 to August 2015, 400 female patients with pT1-3 cN0 operable breast cancer underwent AUS with FNAC at the Breast Unit of the "IRCCS San Martino-IST" in Genoa (Italy)...
October 8, 2016: Breast: Official Journal of the European Society of Mastology
Kyungmin Shin, Abigail S Caudle, Henry M Kuerer, Lumarie Santiago, Rosalind P Candelaria, Basak Dogan, Jessica Leung, Savitri Krishnamurthy, Wei Yang
OBJECTIVE: The purpose of this article is to describe the feasibility and safety of a multidisciplinary approach to imaging-guided axillary staging that facilitates personalized, less invasive surgical management of the axilla through targeted axillary dissection in patients with biopsy-proven nodal metastasis undergoing neoadjuvant chemotherapy. CONCLUSION: Axillary nodal status, critical in breast cancer staging, affects prognosis and treatment. As the paradigm shifts toward minimally invasive therapy, a clip marker is placed in the biopsied metastatic node for patients with N1-N2 disease undergoing neoadjuvant chemotherapy to facilitate targeted axillary dissection of the clipped node...
October 11, 2016: AJR. American Journal of Roentgenology
Julia Landin, Walter P Weber
Axillary lymph node dissection (ALND) has been standard of care for all patients with breast cancer until the 1990s. The stepwise retreat of breast surgeons from the axilla began after the introduction of the sentinel lymph node procedure. The evidence based clinical trend toward the omission of ALND has advanced to include patients with affected nodes, and several ongoing randomized controlled trials are evaluating the remaining indications for ALND. Conflicting with this trend toward less axillary surgery, indication and extent of regional nodal irradiation are currently broadened, equally supported by evidence from randomized trials...
August 2016: Breast Care
Christophe Van Berckelaer, Manon Huizing, Mireille Van Goethem, Andrew Vervaecke, Konstantinos Papadimitriou, Inge Verslegers, Bich X Trinh, Peter Van Dam, Sevilay Altintas, Tim Van den Wyngaert, Ivan Huyghe, Vasiliki Siozopoulou, Wiebren A A Tjalma
OBJECTIVE: To evaluate the role of preoperative axillary staging with ultrasound (US) and fine needle aspiration cytology (FNAC). Can we avoid intraoperative sentinel lymph node (SLN) examination, with an acceptable revision rate by preoperative staging? DESIGN: This study is based on the retrospective data of 336 patients that underwent US evaluation of the axilla as part of their staging. A FNAC biopsy was performed when abnormal lymph nodes were visualized. Patients with normal appearing nodes on US or a benign diagnostic biopsy had removal of the SLNs without intraoperative pathological examination...
September 20, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Conor F Hynes, M Blair Marshall
Endoscopic thoracic sympathectomy (ETS) is an effective treatment of primary hyperhidrosis of the face, upper extremities, and axillae. The major limitation is the side effect of compensatory sweating severe enough that patients request reversal in up to 10% of cases. When ETS is performed by cutting the sympathetic chain, reversal requires nerve grafting. However, for ETS done with clips, reversal is a simple thoracoscopic outpatient procedure of removing the clips. Subsequent reversal of the sympathectomy, ie, nerve regeneration, is successful in many cases...
November 2016: Thoracic Surgery Clinics
Aparajita Ghosh, Arijit Coondoo
A pigmented variant of lichen planus (LP) was first reported from India in 1974 by Bhutani et al. who coined the term LP pigmentosus (LPP) to give a descriptive nomenclature to it. LP has a number of variants, one of which is LPP. This disease has also later been reported from the Middle East, Latin America, Korea, and Japan, especially in people with darker skin. It has an insidious onset. Initially, small, black or brown macules appear on sun-exposed areas. They later merge to form large hyperpigmented patches...
September 2016: Indian Journal of Dermatology
Marisa Gilstrop, Matthew K Hoffman
Shoulder dystocia continues to challenge obstetrical providers and therefore the management must evolve. The available literature demonstrates clear value in both simulation training and having a clear algorithmic approach. Similarly, the available literature suggests that delivery of the posterior arm should be prioritized. Several new techniques such as the Menticoglou maneuver, Gaskin's maneuver, and the posterior axilla sling traction technique offer obstetrical choices after more traditional techniques have failed...
December 2016: Clinical Obstetrics and Gynecology
Jean Claude De Mauroy, Sophie Pourret, Frédéric Barral
OBJECTIVE: ART is the acronym for Asymmetry, Rigid, Torsion. The realization of this brace is based on new concepts (circled helicoid, global detorsion, Soft Contact, Mayonnaise tube effect, axilla baby lift, wrench & bolt…). The excellent in-brace correction has been proved on a consecutive series of 141 AIS selected according to the SRS criteria in a prospective database. Results at six months and a year were compared with those of the former Lyon brace and confirm that these good results remain constant...
September 2016: Annals of Physical and Rehabilitation Medicine
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