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https://www.readbyqxmd.com/read/28651115/ten-year-results-of-applying-an-original-scoring-system-for-addressing-adjuvant-therapy-use-after-breast-conserving-surgery-for-ductal-carcinoma-in-situ-of-the-breast
#1
Massimiliano Gennaro, Maria Carmen De Santis, Luigi Mariani, Salvatore Lo Vullo, Vera Cappelletti, Roberto Agresti, Umberto Cortinovis, Biagio Paolini, Serena Di Cosimo, Maria Luisa Carcangiu, Maria Grazia Daidone, Laura Lozza
PURPOSE: Although large-scale randomised clinical trials have established that radiotherapy (RT) - alone or combined with hormonal therapy (HT) - is effective in reducing the risk of ipsilateral breast tumour recurrence (IBTR), overall survival does not seem to be improved by adjuvant therapies. We sought to ascertain whether specific criteria can be adopted to avoid RT with an acceptable rate of IBTR after breast-conserving surgery (BCS) achieving tumour-free margins. PATIENTS AND METHODS: This non-randomised prospective study concerned the outcome of patients who underwent BCS for ductal carcinoma in situ (DCIS) and were prospectively assessed by means of an established scoring system based on width of free margins in association with age <40, presence of comedonecrosis, high grade, ER negativity and HER2 positivity, to orient the use of any adjuvant therapies...
June 23, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28650898/retroperitoneal-hemorrhage-after-sacral-neurostimulator-placement-for-urgency-urinary-incontinence
#2
Casey L Kinman, Deslyn T G Hobson, Anubhav Agrawal, Martin S Vyleta, Sean L Francis
Sacral neuromodulation (SNM) is an effective therapy for patients who experience urinary incontinence, idiopathic urinary retention, and fecal incontinence. Although typically a low-risk procedure, rarely, it can be associated with significant hemorrhage. A 61-year-old woman on chronic anticoagulation underwent uncomplicated implantation of SNM for refractory urgency urinary incontinence. Anticoagulation was held on the day of surgery and resumed on postoperative day 1. On postoperative day 2, the patient developed an extensive retroperitoneal hemorrhage...
July 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28650749/comparative-effectiveness-of-radial-extracorporeal-shockwave-therapy-and-ultrasound-guided-local-corticosteroid-injection-treatment-for-plantar-fasciitis
#3
Sehriban Hocaoglu, Umit Erkan Vurdem, Mehtap Aykac Cebicci, Serap Tomruk Sutbeyaz, Zuhal Guldeste, Serap Gurek Yunsuroglu
BACKGROUND: We compared the long-term clinical and ultrasonographic effects of radial extracorporeal shockwave therapy (rESWT) versus ultrasound-guided corticosteroid injection treatment in patients with plantar fasciitis unresponsive to conservative therapy. METHODS: Seventy-two patients with unilateral plantar fasciitis were randomized to receive either rESWT (three times once per week) (n = 36) or corticosteroid treatment (a single 1-mL dose of betamethasone sodium plus 0...
May 2017: Journal of the American Podiatric Medical Association
https://www.readbyqxmd.com/read/28650355/axillary-dissection-and-nodal-irradiation-can-be-avoided-for-most-node-positive-z0011-eligible-breast-cancers-a-prospective-validation-study-of-793-patients
#4
Monica Morrow, Kimberly J Van Zee, Sujata Patil, Oriana Petruolo, Anita Mamtani, Andrea V Barrio, Deborah Capko, Mahmoud El-Tamer, Mary L Gemignani, Alexandra S Heerdt, Laurie Kirstein, Melissa Pilewskie, George Plitas, Virgilio S Sacchini, Lisa M Sclafani, Alice Ho, Hiram S Cody
OBJECTIVE: To determine rates of axillary dissection (ALND) and nodal recurrence in patients eligible for ACOSOG Z0011. BACKGROUND: Z0011 demonstrated that patients with cT1-2N0 breast cancers and 1 to 2 involved sentinel lymph nodes (SLNs) having breast-conserving therapy had no difference in locoregional recurrence or survival after SLN biopsy alone or ALND. The generalizability of the results and importance of nodal radiotherapy (RT) is unclear. METHODS: Patients eligible for Z0011 had SLN biopsy alone...
July 22, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28649650/vitamin-d-ointment-for-prevention-of-radiation-dermatitis-in-breast-cancer-patients
#5
Nicola J Nasser, Shlomit Fenig, Amiram Ravid, Ariella Nouriel, Naama Ozery, Sara Gardyn, Ruth Koren, Eyal Fenig
Radiation dermatitis occurs frequently during adjuvant radiation therapy for breast cancer. Prevention of radiation dermatitis by applying various creams and ointments has a limited success, and Aqua cream which has urea as one of its active ingredients is used in many institutions as a preventive treatment. The primary goal of this study is to assess the effect of vitamin D (calcipotriol) ointment in prevention of radiodermatitis in breast cancer patients compared to Aqua cream. Twenty-three women with localized breast cancer who underwent breast-conserving surgery and opted to receive adjuvant radiotherapy to breast only were enrolled in this study...
2017: NPJ Breast Cancer
https://www.readbyqxmd.com/read/28649094/current-management-of-pregnancy-associated-breast-cancer
#6
H Hy Yu, P Sy Cheung, R Cy Leung, T N Leung, W H Kwan
Pregnancy-associated breast cancer is the most common malignancy during pregnancy with an expected rise in incidence. The belief in the need for termination of pregnancy and that chemotherapy is contra-indicated during pregnancy is challenged by recent evidence. Patients can consider breast-conserving surgery and sentinel lymph node biopsy with acceptably low fetal risk from radiation exposure. A range of chemotherapeutics is possible in the second trimester in terms of drug class and frequency. Hormone therapy and monoclonal antibody therapy are contra-indicated during pregnancy and lactation...
June 26, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28649032/a-standard-mastectomy-should-not-be-the-only-recommended-breast-surgical-treatment-for-non-metastatic-inflammatory-breast-cancer-a-large-population-based-study-in-the-surveillance-epidemiology-and-end-results-database-18
#7
Hongliang Chen, Kejin Wu, Maoli Wang, Fuwen Wang, Mingdi Zhang, Peng Zhang
BACKGROUND: Standard mastectomy has long been the recommended breast surgical treatment for non-metastatic inflammatory breast cancer (IBC). The objective of this population-based study was to evaluate the significance of various breast surgical treatments for this highly aggressive subtype. METHODS: The Surveillance, Epidemiology, and End Results program registry was searched to identify women with non-metastatic IBC receiving standard treatment including breast surgery, radiation therapy and chemotherapy diagnosed between 1998 and 2013...
June 22, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28646722/radiation-therapy-utilization-and-outcomes-for-older-women-with-breast-cancer-impact-of-molecular-subtype-and-tumor-grade
#8
Waqar Haque, Denley Ming Kee Yuan, Vivek Verma, E Brian Butler, Bin S Teh, Lee Wiederhold, Sandra Hatch
BACKGROUND: Radiation therapy (RT) utilization for elderly women with respect to human epidermal growth factor receptor 2 (HER2) receptor status has not been evaluated. Our purpose was to determine differences in RT utilization and breast cancer specific survival (BCSS) for elderly breast cancer patients with distinct molecular biomarkers. METHODS: The Surveillance, Epidemiology, and End Results database was queried for women ≥70 years of age diagnosed with T1N0M0 breast cancer between 2010 and 2013 receiving breast conservation...
June 21, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28645784/the-effect-of-antimicrobial-photodynamic-therapy-on-the-expression-of-novel-methicillin-resistance-markers-determined-using-cdna-aflp-approach-in-staphylococcus-aureus
#9
Mohammad Neshvan Hoorijani, Hosein Rostami, Maryam Pourhajibagher, Nasim Chiniforush, Mansour Heidari, Babak Pourakbari, Hossein Kazemian, Kambiz Davari, Vahid Amini, Reza Raoofian, Abbas Bahador
BACKGROUND: Widespread methicillin resistant Staphylococcus aureus (MRSA) and absence of effective antimicrobial agents has led to limited therapeutic options for treating MRSA infection. We aimed to evaluate the effect of antimicrobial photodynamic therapy (aPDT) on the expression of novel identified methicillin resistance markers (NIMRMs) in S. aureus using complementary DNA-Amplified Fragment Length Polymorphism (cDNA-AFLP) approaches to address the therapeutic alternatives for MRSA infections...
June 20, 2017: Photodiagnosis and Photodynamic Therapy
https://www.readbyqxmd.com/read/28644995/less-is-more-breast-conservation-might-be-even-better-than-mastectomy-in-early-breast-cancer-patients
#10
Oreste D Gentilini, Maria-Joao Cardoso, Philip Poortmans
During the recent years an increase of mastectomy rates in early breast cancer patients has been observed. Nevertheless, several large population-based studies reported a possible improved outcome after breast conserving therapy compared to radical surgery, after all the adjustments. We hereby summarize our opinion on this topic suggesting that these robust and consistent data might challenge the statement that breast conserving therapy is merely not inferior to radical surgery.
June 20, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/28644261/is-intravenous-thrombolysis-safe-and-effective-in-central-retinal-artery-occlusion-a-critically-appraised-topic
#11
Oana M Dumitrascu, Joanne F Shen, Madhavi Kurli, Maria I Aguilar, Lisa A Marks, Bart M Demaerschalk, Dean M Wingerchuk, Cumara B O'Carroll
BACKGROUND: Central retinal artery occlusion (CRAO) is a neurological and ophthalmologic emergency associated with poor visual recovery. There is a dilemma regarding the appropriate treatment, as formal guidelines are lacking. Despite being considered an ocular equivalent of cerebral infarction, the time window of intravenous (IV) thrombolysis administration for maximum efficacy and safety in CRAO remains uncertain. OBJECTIVE: To critically assess the current evidence regarding the safety and effectiveness of IV thrombolysis in the treatment of patients with CRAO...
July 2017: Neurologist
https://www.readbyqxmd.com/read/28643967/-place-of-interdisciplinary-treatments-in-chronic-low-back-pain
#12
Michael Iohn Norberg, Melissa Riat, Charles Benaïm
The treatment of chronic lumbar pain patients needs a global interdisciplinary approach when traditional conservative treatments do not fulfil their aims. One of the most efficient ways to proceed is using an interdisciplinary treatment program, including physiotherapeutic measures, occupational therapy and psychological support for 3 weeks. It is important that people in conflicts with insurances companies should be excluded from these treatments. It is also important that the reconditioning should continue over a long term to have a sustainable result...
June 21, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28643745/adjuvant-hypofractionated-radiation-in-carcinoma-breast-photon-versus-electron-comparison-of-treatment-outcome
#13
G Prameela Chelakkot, Rahul Ravind, K Sruthi, Namrata Chigurupati, Sanketh Kotne, Raghavendra Holla, Ram Madhavan, M Dinesh
BACKGROUND: Breast cancer tissue is sensitive to hypofractionation. This is an analysis of patients treated with hypofractionated protocols since 2009, at our tertiary cancer center. METHODS: Details of breast cancer patients treated with adjuvant hypofractionated external beam radiation therapy (EBRT) from January 2009 to December 2014 were retrieved and analyzed. RESULTS: One thousand seven hundred and eighty patients received adjuvant EBRT during this period...
April 2017: Journal of Cancer Research and Therapeutics
https://www.readbyqxmd.com/read/28643112/a-retrospective-study-of-antibiotic-de-escalation-in-patients-with-ventilator-associated-pneumonia-in-malaysia
#14
Rahela Ambaras Khan, Zoriah Aziz
Background Antibiotic de-escalation is an important strategy to conserve the effectiveness of broad-spectrum antibiotics. However, the outcome of this strategy for the treatment of ventilator-associated pneumonia (VAP) has not been widely studied in developing countries. Objectives To evaluate the outcome on intensive care unit (ICU) mortality, 28 days mortality, and length of ICU stay among VAP patients who receive de-escalation therapy. Setting This study was conducted in an ICU of a Malaysian public hospital...
June 22, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28640590/chlorin-e6-functionalized-theranostic-multistage-nanovectors-transported-by-stem-cells-for-effective-photodynamic-therapy
#15
Simo Näkki, Jonathan Martinez, Michael Evangelopoulos, Wujun Xu, Vesa-Pekka Lehto, Ennio Tasciotti
Approaches to achieve site-specific and targeted delivery that provide an effective solution to reduce negative, off target side-effects are urgently needed for cancer therapy. Here, we utilized a Trojan horse-like strategy to carry photosensitizer Chlorin e6 conjugated porous silicon multistage nanovectors with tumor homing mesenchymal stem cells for targeted photodynamic therapy and diagnosis. The inherent versatility of multistage nanovectors permitted the conjugation of photosensitizers to enable precise cell death induction (60%) upon photodynamic therapy, while simultaneously retaining the loading capacity to load various payloads, such as antitumor drugs and diagnostic nanoparticles...
June 22, 2017: ACS Applied Materials & Interfaces
https://www.readbyqxmd.com/read/28639852/osteochondritis-dissecans-etiology-pathology-and-imaging-with-a-special-focus-on-the-knee-joint
#16
Juergen Bruns, Mathias Werner, Christian Habermann
This article is a review of the current understanding of the etiology, pathogenesis, and how to diagnose and treat knee osteochondritis dissecans (OCD) followed by an analysis of and outcomes of the treatments available. OCD is seen in children and adolescents with open growth plates (juvenile OCD) and adults with closed growth plates (adult OCD). The etiology of OCD lesions remains unclear and is characterized by an aseptic necrosis in the subchondral bone area. Mechanical factors seem to play an important role...
June 1, 2017: Cartilage
https://www.readbyqxmd.com/read/28639076/conservative-treatment-for-lumbar-compartment-syndrome-shows-efficacy-over-2-year-follow-up-a-case-report-and-literature-review
#17
Haruhisa Kanaya, Makoto Enokida, Shinji Tanishima, Ikuta Hayashi, Atsushi Tanida, Hideki Nagashima
BACKGROUND: Since in all studies of conservative treatment of lumbar compartment syndrome the follow-up duration was less than 6 months, it is difficult to draw firm conclusions. PURPOSE: To report a patient with lumbar paraspinal compartment syndrome who was treated conservatively over a follow-up period of 2 years. STUDY DESIGN: This is a case report of a 23-year-old male college student with lumbar paraspinal compartment syndrome who was treated conservatively...
June 20, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28639030/utilization-of-hypofractionated-whole-breast-radiation-therapy-in-patients-receiving-chemotherapy-a-national-cancer-database-analysis
#18
Tejan P Diwanji, Jason K Molitoris, Arpit M Chhabra, James W Snider, Soren M Bentzen, Katherine H Tkaczuk, Paula Y Rosenblatt, Susan B Kesmodel, Emily C Bellavance, Randi J Cohen, Sally B Cheston, Elizabeth M Nichols, Steven J Feigenberg
PURPOSE: Results from four major hypofractionated whole-breast radiotherapy (HF-WBRT) trials have demonstrated equivalence in select patients with early-stage breast cancer when compared with conventionally fractionated WBRT (CF-WBRT). Because relatively little data were available on patients receiving neoadjuvant or adjuvant chemotherapy, consensus guidelines published in 2011 did not endorse the use of HF-WBRT in this population. Our goal is to evaluate trends in utilization of HF-WBRT in patients receiving chemotherapy...
June 21, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28638953/-chronic-leg-ulcers
#19
REVIEW
J Dissemond
Chronic wounds often manifest as ulcers on the lower legs. The main causes of chronic leg ulcers are chronic venous insufficiency and/or peripheral arterial occlusive disease in approximately 80% of all patients. However, there are also numerous other potentially relevant factors which can cause or almost impede the healing of chronic leg ulcers. Therefore, disease such as vasculitis, livedo vasculopathy, pyoderma gangrenosum, necrobiosis lipoidica, Martorell hypertensive leg ulcer, calciphylaxis, infectious diseases, neoplasms, drugs, cutaneous artefacts and genetic defects are exemplarily presented...
June 21, 2017: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
https://www.readbyqxmd.com/read/28638315/acute-abdomen-a-rare-case-of-ruptured-hepatocellular-carcinoma
#20
Severin Gloor, Kai Oliver Jensen, Stefan Breitenstein, Christoph A Binkert, Eliane Angst, Franc Heinrich Hetzer
Spontaneous ruptures of hepatocellular carcinoma (HCC) are rare. Nevertheless they may lead to difficult decisions in the emergency situation. The acute therapies include conservative treatment, transarterial embolization and surgery. Curative treatment of HCC can be achieved by liver resection solely. The decision-making depends on prognostic patient's factors, such as hepatic viral infection status, Child-Pugh grade, liver cirrhosis and number of tumors. In this case transarterial embolization was preferable as a bridging therapy prior to further diagnostics and therapy, to lower the perioperative morbidity and mortality...
January 2017: Case Reports in Gastroenterology
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