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Leah A Commander, David W Ollila, Siobhan M O'Connor, Johann D Hertel, Benjamin C Calhoun
Benign cystic epithelial inclusions with squamous, glandular, or Müllerian phenotypes are known to occur in the axillary lymph nodes of patients with benign and malignant breast disease. Careful evaluation of hematoxylin and eosin-stained slides and correlation with the histologic findings in the ipsilateral breast are paramount in evaluation of suspected benign inclusions. In this case of ductal carcinoma in situ (DCIS) of the breast in a 73-year-old woman, DCIS also involved epithelial inclusions in an ipsilateral axillary lymph node...
March 1, 2018: International Journal of Surgical Pathology
Susan Mayor
No abstract text is available yet for this article.
March 19, 2018: BMJ: British Medical Journal
Sandra J Lee, Xiaoxue Li, Hui Huang, Marvin Zelen
BACKGROUND: We present updated features to a model developed by Dana-Farber investigators within the Cancer Intervention and Surveillance Modeling Network (CISNET). The initial model was developed to evaluate the impact of mammography screening strategies. METHODS: This major update includes the incorporation of ductal carcinoma in situ (DCIS) as part of the natural history of breast cancer. The updated model allows DCIS in the pre-clinical state to regress to undetectable early-stage DCIS, or to transition to invasive breast cancer, or to clinical DCIS...
April 2018: Medical Decision Making: An International Journal of the Society for Medical Decision Making
Nicolien T van Ravesteyn, Jeroen J van den Broek, Xiaoxue Li, Harald Weedon-Fekjær, Clyde B Schechter, Oguzhan Alagoz, Xuelin Huang, Donald L Weaver, Elizabeth S Burnside, Rinaa S Punglia, Harry J de Koning, Sandra J Lee
BACKGROUND: Ductal carcinoma in situ (DCIS) can be a precursor to invasive breast cancer. Since the advent of screening mammography in the 1980's, the incidence of DCIS has increased dramatically. The value of screen detection and treatment of DCIS, however, is a matter of controversy, as it is unclear the extent to which detection and treatment of DCIS prevents invasive disease and reduces breast cancer mortality. The aim of this paper is to provide an overview of existing Cancer Intervention and Surveillance Modelling Network (CISNET) modeling approaches for the natural history of DCIS, and to compare these to other modeling approaches reported in the literature...
April 2018: Medical Decision Making: An International Journal of the Society for Medical Decision Making
Klim McPherson, Shaymaa Al Waheidi
BACKGROUND: There has been extensive debate about whether mammographic screening has done more good than harm. Recent reviews showed that women who undergo mammographic screening are more likely to have a tumour that was an overdiagnosis and therefore would not cause them problems. In the Gaza Strip, a strong forum of people advocate an increase in mammographic screening, and the aim of this study was to establish the evidence for this view. METHODS: Research papers that have focused on breast screening in the Gaza Strip or elsewhere in the occupied Palestinian territory were reviewed...
February 21, 2018: Lancet
Xin-Yu Tian, Chun-Hong Liu, De-Xiang Wang, Xiu-Li Ji, Hui Shi, Chun-Yan Zheng, Meng-Shuang Xie, Wei Xiao
Background: The interpretation of spirometry varies on different reference values. Older people are usually underrepresented in published predictive values. This study aimed at developing spirometric reference equations for elderly Chinese in Jinan aged 60-84 years and to compare them to previous equations. Methods: The project covered all of Jinan city, and the recruitment period lasted 9 months from January 1, 2017 to September 30, 2017, 434 healthy people aged 60-84 years who had never smoked (226 females and 208 males) were recruited to undergo spirometry...
March 19, 2018: Chinese Medical Journal
Ai Shimizu, Toshihiko Hoashi, Kasho Kataoka, Noriko Shirakawa, Nobuko Mayumi, Yoko Funasaka, Hidehisa Saeki
Verrucous carcinoma (VC) is an uncommon, distinct type of well-differentiated squamous cell carcinoma. Here we present two cases of VC, one arising from the lower leg and the other from genital skin. Case 1, a female patient, aged 95 years, had a brownish verrucous plaque on her right lower leg. Histopathologically, epithelial tumor cells grew pushing the stroma, while the basement membrane was intact. No prominent cellular atypia or hyperchromatin was found. Case 2, a male patient, aged 53 years, had a verrucous plaque at the border between his scrotum and inner aspect of his thigh...
2018: Journal of Nippon Medical School, Nippon Ika Daigaku Zasshi
Leonard Berlin
For the first 180 years following the founding of the US, physicians occasionally were sued for medical malpractice. Allegations of negligence were errors of commission - i.e. the physician made a mistake by doing something wrong, usually mistreatment of a fracture or dislocation, a complication or death following a surgical procedure, prescribing the wrong medication, and after the discovery of the X-ray by Roentgen in 1895, causing radiation burns. In the mid twentieth century malpractice allegations slowly changed from errors of commission to errors of omission - i...
September 26, 2017: Diagnosis
Maura Massimino, Douglas B Evans, Marta Podda, Claudio Spinelli, Paola Collini, Natalia Pizzi, Archie Bleyer
In adolescents and young adults, thyroid cancer accounts for 13% of all invasive neoplasms, being three times more frequent in females, but overdiagnosis and overtreatment are common. There are two therapeutic approaches, one radical and no longer preferred in all instances, and the other conservative. Permanent complications of surgery and metabolic irradiation can affect quality of life and carry an economic burden. The overall survival rate approaches 100% for patients with differentiated thyroid cancer regardless of the extent of treatment...
March 12, 2018: Pediatric Blood & Cancer
Daniel D Sjoberg, Andrew J Vickers, Melissa Assel, Anders Dahlin, Bing Ying Poon, David Ulmert, Hans Lilja
BACKGROUND: Prostate-specific antigen (PSA) screening reduces prostate cancer deaths but leads to harm from overdiagnosis and overtreatment. OBJECTIVE: To determine the long-term risk of prostate cancer mortality using kallikrein blood markers measured at baseline in a large population of healthy men to identify men with low risk for prostate cancer death. DESIGN, SETTING, PARTICIPANTS: Study based on the Malmö Diet and Cancer cohort enrolling 11 506 unscreened men aged 45-73 yr during 1991-1996, providing cryopreserved blood at enrollment and followed without PSA screening to December 31, 2014...
March 5, 2018: European Urology
Tomasz Nowikiewicz, Wojciech Zegarski, Iwona Głowacka-Mrotek
Overtreatment means treatment that goes beyond current standards, and patients with any disease can be overtreated. Overtreatment is also given to patients with cancer, including those who need surgery. Overtreatment is closely related to the problem of overdiagnosis. In patients with cancer, unnecessary surgery may cause complications and generates unnecessary costs. The size of the problem of unnecessary surgery in patients with cancer can best be shown among patients with the most common cancers, which dedicated screening programs...
February 28, 2018: Polski Przeglad Chirurgiczny
Yoshinobu Saitoh, Takao Setoguchi, Takako Yoshioka, Junichiro Nishi, Akihide Tanimoto, Setsuro Komiya
OBJECTIVE: The aim of this study was to evaluate whether intraoperative histopathological examination could predict the risk of relapse of infection in periprosthetic joint infections (PJI). METHODS: The study included 25 patients (14 women and 11 men, with a mean age of 67.0 years (range, 37-83 years)), who had two-staged revision surgery for a PJI. Following prosthetic removal in the first stage, all patient underwent an intraoperative histopathological examination during the second stage...
March 1, 2018: Acta Orthopaedica et Traumatologica Turcica
Luigino Dal Maso, Chiara Panato, Silvia Franceschi, Diego Serraino, Carlotta Buzzoni, Susanna Busco, Stefano Ferretti, Antonietta Torrisi, Fabio Falcini, Manuel Zorzi, Claudia Cirilli, Walter Mazzucco, Michele Magoni, Paolo Collarile, Fabio Pannozzo, Anna Luisa Caiazzo, Antonio Giampiero Russo, Alessio Gili, Adele Caldarella, Roberto Zanetti, Maria Michiara, Lucia Mangone, Rosa Angela Filiberti, Mario Fusco, Francesca Gasparini, Giovanna Tagliabue, Rosaria Cesaraccio, Rosario Tumino, Luciana Gatti, Francesco Tisano, Silvano Piffer, Giovanna Maria Sini, Guido Mazzoleni, Stefano Rosso, Anna Clara Fanetti, Salvatore Vaccarella
AIMS: In Italy, incidence rates of thyroid cancer (TC) are among the highest worldwide with substantial intracountry heterogeneity. The aim of the study was to examine time trends of TC incidence in Italy and to estimate the proportion of TC cases potentially attributable to overdiagnosis. METHODS: Data on TC cases reported to Italian cancer registries during 1998-2012 aged <85 years were included. Age-standardised incidence rates (ASR) were computed by sex, period, and histology...
March 1, 2018: European Journal of Cancer
Brooke Nickel, Juan P Brito, Ray Moynihan, Alexandra Barratt, Susan Jordan, Kirsten McCaffery
BACKGROUND: In recent years management practices in relation to low-risk papillary microcarcinoma (PMC) have been evolving with increased awareness of the potential overdiagnosis and overtreatment of PMCs, and guidelines recommendations for non-surgical management options such as active surveillance. This study aimed to develop an in-depth understanding of patients' experiences of the communication of their PMC diagnosis, their treatment preferences and decision making. METHODS: Semi-structured qualitative interviews with 25 patients diagnosed pre-operatively with PMC < 1 year since their diagnosis and treatment...
March 2, 2018: BMC Cancer
Benjamin L Mazer, H Gilbert Welch
No abstract text is available yet for this article.
March 2018: Archives of Pathology & Laboratory Medicine
Jean Liew, James Lundblad, Adam Obley
The overdiagnosis of thyroid malignancies may be contributing to the increased incidence of these cancers with a relatively stable mortality rate. We present the case of a man with known malignancies, who underwent biopsy of a suspicious thyroid nodule. This procedure was complicated by local anesthetic systemic toxicity (LAST). It is important to address goals of diagnostic testing and treatment with patients, particularly if further evaluation is unlikely to change management or outcomes.
December 16, 2017: Curēus
Weng Khong Lim, Sonia Davila, Jing Xian Teo, Chengxi Yang, Chee Jian Pua, Christopher Blöcker, Jing Quan Lim, Jianhong Ching, Jonathan Jiunn Liang Yap, Swee Yaw Tan, Anders Sahlén, Calvin Woon-Loong Chin, Bin Tean Teh, Steven G Rozen, Stuart Alexander Cook, Khung Keong Yeo, Patrick Tan
The use of consumer-grade wearables for purposes beyond fitness tracking has not been comprehensively explored. We generated and analyzed multidimensional data from 233 normal volunteers, integrating wearable data, lifestyle questionnaires, cardiac imaging, sphingolipid profiling, and multiple clinical-grade cardiovascular and metabolic disease markers. We show that subjects can be stratified into distinct clusters based on daily activity patterns and that these clusters are marked by distinct demographic and behavioral patterns...
February 2018: PLoS Biology
Mina Rydell, Sebastian Lundström, Christopher Gillberg, Paul Lichtenstein, Henrik Larsson
BACKGROUND: Studies have reported increases in clinically diagnosed and treated attention deficit hyperactivity disorder (ADHD) during the last decade, but it is unclear if this reflects an increase in the underlying ADHD phenotype. We aimed to clarify if there has been an increase in the prevalence of ADHD-like traits in the general population from 2004 to 2014. METHOD: Data were collected from 9-year-old twins (19,271), participating in the population-based Child and Adolescent Twin Study in Sweden between 2004 and 2014...
February 27, 2018: Journal of Child Psychology and Psychiatry, and Allied Disciplines
Sara Loureiro-Vieira, Vera Marisa Costa, José Alberto Duarte, Margarida Duarte-Araújo, Salomé Gonçalves-Monteiro, Bastos Maria de Lourdes, Félix Carvalho, João Paulo Capela
Methylphenidate (MPH) is a first-line stimulant drug to treat attention deficit hyperactivity disorder (ADHD). Overdiagnosis of ADHD and MPH abuse lead to serious concerns about the possible long-term adverse consequences of MPH in healthy children and adolescents. We aimed to evaluate MPH effects in adolescent male Wistar rats (postnatal day 40) using an oral dose scheme (2 daily MPH doses 5 mg/kg in a 5% sucrose solution, 5 h apart, for 7 days) that mimics the therapeutic doses given to human adolescents...
February 23, 2018: Biomedicine & Pharmacotherapy, Biomédecine & Pharmacothérapie
Eric R Coon, Jacob Wilkes, Susan L Bratton, Rajendu Srivastava
OBJECTIVE: Compare trends in coronary artery (CA) abnormality diagnoses to trends in adverse cardiac outcomes among American children with Kawasaki disease (KD) to assess the fit of detection of CA abnormalities to an established model of overdiagnosis. DESIGN: Multicenter retrospective cohort. SETTING: 48 US children's hospitals in the Paediatric Health Information System database. PARTICIPANTS: Children <18 years receiving care for KD between 2000 and 2014...
February 22, 2018: Archives of Disease in Childhood
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