99 research outputs found
diagnostical test of the prostate cancer
No full textguided prostate biopsy, its technique conditions and the process of performing a biopsy. Every author proposes the use of preoperative antibiotics based prophylaxis. Differences may be found in the type, dosage and the time span of preoperative application. For anaesthesia mostly lidocaine was proposed, which may be a gel applied in the rectum or used in the form a prostate infiltrate. The widest debate goes on in respect of defining the number of biopsies needed. Recently 8 or rather 10 samples are proposed to be taken. Twelve biopsies do offer an advantage compared to 6 although in case of 8 this isn’t so. According to the site of sample taking the apex, the base and the middle part are proposed. In case of a palpable nodule or any lesion, made visible by TRUS an additional, targeted, biopsy has to be performed. Certain new techniques like the 3D Doppler, contrast, intermittent and others shall also be presented. A repeated biopsy shall be necessary in case of PIN atypia, beyond that the author also discusses other indications for a repeated biopsy. We may expect the occurrence of direct postoperative complications and it is necessary to know how to treat these
Abstract P4-13-09: Immediate breast reconstruction versus delayed breast reconstruction: An analysis of oncological outcomes
No full textAbstract
Introduction
Breast reconstruction is an important option for patients who undergo mastectomy for breast cancer. Several studies have investigated outcomes for patients who undergo either immediate or delayed reconstruction versus mastectomy alone but few have evaluated the relationship of the timing of reconstruction to oncological outcome.
Aim
To determine if there is a difference in oncological outcomes for patients who undergo delayed versus immediate breast reconstruction following mastectomy for breast cancer.
Methods
Patients who underwent immediate or delayed breast reconstruction between 2005 and 2006 were identified from a database maintained prospectively at the regional plastic surgery unit. Tumour pathology details were obtained retrospectively from the electronic patient record and from local electronic laboratory systems. Details of treatment, and recurrence and mortality data were obtained by review of each patient's electronic record. In the delayed reconstruction cohort, patients who underwent reconstruction 6-60 months after initial cancer surgery were included. In the immediate reconstruction group, patients who had recurrence or died within the first 6 months after surgery were excluded. Logistic regression survival analysis was carried out for the two cohorts and compared using Chi square test.
Results
193 patients who underwent immediate reconstruction and 116 patients who underwent delayed reconstruction were identified. Patients who had immediate reconstruction were more likely to have DCIS only, compared to those who had delayed reconstruction, but otherwise there was no significant difference between the two groups in terms of pathological characteristics or type of reconstruction performed (autologous or implant-based). Of those who had delayed reconstruction, median time from initial cancer surgery to reconstructive surgery was 27 months (6-58 months). There were 49 breast cancer deaths, 13 deaths from other causes and 65 recurrences. Median follow up time from reconstruction, of those who survived, was 111 months (29-134 months). Median follow up from initial cancer surgery was 116 months (46-185 months). There was no difference in breast cancer specific survival between the two groups when measured from time of cancer surgery (delayed reconstruction HR 1.05, 95% CI 0.59-1.89, p=0.861) or from time of reconstruction (delayed reconstruction HR 1.33, 95% CI 0.75-2.40, p=0.334). There was no difference in recurrence rates between the two groups when measured from time of cancer surgery (delayed reconstruction HR 0.94, 95% CI 0.56-1.60, p=0.822) or from time of reconstruction (delayed reconstruction HR 1.23, 95% CI 0.73-2.07, p=0.433).
Conclusion
Our data has demonstrated no difference in cancer specific survival or recurrence rates in patients who underwent mastectomy with immediate breast reconstruction compared to patients who had delayed reconstruction.
Citation Format: Morrow ES, Dolan RD, Blackhall V, Romics L. Immediate breast reconstruction versus delayed breast reconstruction: An analysis of oncological outcomes [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-13-09.</jats:p
A benignus prostata-hyperplasia gyógyszeres kezelése = Conservative treatment of benign prostatic hyperplasia
No full textA szerző összefoglalja a benignus prostata-hyperplasiában jelenleg alkalmazott gyógyszereket. A növényi kivonatokkal szerzett tapasztalatok két évtizedes múltra tekintenek vissza, alkalmazásuk a benignus prostata-hyperplasia iniciális fázisában javasolt. A hormonális hatású 5-alfa-reduktáz finasterid jelentős, bár csak több év-hónap alatt kialakuló prostatavolumen-redukció a vizelési zavarok mechanikus komponensét befolyásolja kedvezően. Indikációja főleg a 40 g feletti prostatavolumen esetén áll fenn. Az alfa-receptor-gátlók a hólyagnyakra ható, rövid terápiás idejű relaxáns hatásokkal a prostata-hyperplasia dinamikus komponensére hatnak, alkalmazásuk indokolt minden benignus prostata-hyperplasia esetében, függetlenül a prostatavolumentől. Több-kevesebb hypotoniás mellékhatással számolni kell. Az utóbbi időben az 5-foszfodiészteráz-gátlók kedvező hatását is leírták, illetve az is nyilvánvalóvá vált, hogy az alfa-blokkolókkal kezelt beteg szexuális aktivitása is fokozódik.
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Medical treatment of benign prostatic hyperplasia is reviewed by the author. Experiences with herbal extracts have been known for more than 2 decades. Treating benign prostatic hyperplasia with these extracts is recommended in initial phase. Prostate volume is decreased and mechanical component of dysuria is improved by treating for a long time (months, years) with 5-alfa-reductase finasterid which contains hormone. This drug is indicated when volume of the prostate is over 40 g. Dynamical component of benign prostatic hyperplasia is treated with α-receptor blockers which act on the bladder neck. These medicines have effects earlier and are recommended for all patients with benign prostatic hyperplasia independently of prostate volume. These might have some side effects like hypotension. The improving effects of 5-phosphodiestherase inhibitors on BPH have been discovered recently. The same effect has been described of alpha-blockers on sexual activity
Changes in Prostate-Specific Antigen and Prostatic Acid Phosphatase Concentration following Prostatic Examination in Benign Prostatic Hypertrophy and Prostate Cancer Patients
No full text
Oncological safety and cosmetic outcomes in oncoplastic breast conservation surgery, a review of the best level of evidence literature
No full textEsther Jennifer Campbell,1 Laszlo Romics2,3 1Department of Plastic Surgery, Glasgow Royal Infirmary, 2Department of Surgery, New Victoria Hospital Glasgow, 3Department of Academic Surgery, Glasgow Royal Infirmary, Glasgow, Scotland, UK Abstract: Oncoplastic breast conservation surgery (OBCS) is increasingly becoming part of routine breast cancer surgical management. OBCS may be viewed as an extension of standard breast conservation surgery for resecting tumors of larger sizes without compromising on cosmetic outcome, or as an alternative to mastectomy. High quality evidence to support the oncological safety and benefits of OBCS is lacking. This review will focus on the best available level of evidence and address key issues regarding oncological safety in OBCS, such as tumor resection margins and re-excision rates, local recurrence and patient outcome, postoperative complications and adjuvant therapy delivery, and briefly discuss cosmetic outcome in OBCS. Comparative observational studies and systematic review report no poorer outcomes compared with standard breast conservation surgery. More evidence needs to be generated to support the oncological safety and improved aesthetic outcome. Prospective data collection will significantly contribute to the generation of stronger evidence. Keywords: oncoplastic breast conservation surgery, oncological safety, cosmetic outcomes, therapeutic mammoplasty, recurrence, surviva
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