RESUMO
BACKGROUND: The aim of this study was to compare the risk of complications and recurrence between oncoplastic and conventional breast surgery. METHODS: This is a retrospective analysis of a consecutive series of 436 patients with stage I-III breast cancer who underwent surgery at the University Hospital of Basel between 2011 and 2018. RESULTS: The nipple/skin-sparing mastectomy (NSM/SSM) group showed significantly more delayed wound healing (32.7 vs. 5.8%, p < 0.001) and skin necrosis (13.9 vs. 1.9%, p = 0.020) compared to conventional mastectomy (CM), which corresponded to significantly higher odds of short-term complications (OR 2.34, 95% CI 1.02-5.35, p = 0.044). The incidence rate of long-term morbidity in oncoplastic breast-conserving surgery (OBCS) was significantly higher compared to conventional breast-conserving surgery (CBCS; 25.5 vs. 11.3 per 100 patient years [PY], p < 0.001), in particular concerning chronic pain (13.3 vs. 6.6, p = 0.011) and lymphedema (4.1 vs. 0.4, p = 0.003). Seroma as a long-term morbidity occurred more often in the CM group compared to the NSM/SSM group (5.8 vs. 0.5 per 100 PY, p = 0.004). Patients received adjuvant treatment earlier after CM compared to NSM/SSM (HR 1.83, 95% CI 1.05-3.19, p = 0.034). There were no significant differences in the incidence of positive margins nor in the odds of recurrence after OBCS versus CBCS and after NSM/SSM versus CM. CONCLUSIONS: Even though the present study confirmed expected differences in complications and morbidity, it suggested that oncoplastic surgery is oncologically safe. Patients undergoing NSM/SSM should be followed closely to allow early detection and treatment of frequently associated complications and ensure timely start of adjuvant therapy.
RESUMO
Los pingüinos de Magallanes son entre las aves marinas, la especie más afectada por la contaminación con petróleo en Chubut y Santa Cruz. Una de las consecuencias adversas de la exposición a hidrocarburos y otros contaminantes es el aumento de los niveles celulares de especies reactivas del oxígeno o estrés oxidativo, considerados herramientas útiles como biomarcadores del impacto de la exposición a contaminantes químicos peligrosos. El objetivo de este trabajo fue evaluar parámetros hematológicos y marcadores de estrés oxidativo durante la rehabilitación de tres pingüinos empetrolados provenientes del Área Natural Protegida Punta Tombo, Chubut, Argentina. Se tomaron tres muestras de sangre por individuo: la primera muestra al arribo de los pingüinos al centro de rehabilitación, la segunda una semana después y una última muestra antes de ser liberados. Se obtuvieron la cantidad total de leucocitos, la razón heterófilos/linfocitos, el hematocrito y las concentraciones de glucosa y de proteínas totales. Se analizó la actividad de la enzima catalasa, responsable de la degradación del peróxido de hidrógeno, los niveles de tioles totales no proteicos y el daño a lípidos evaluando las especies reactivas al ácido tiobarbitúrico, como indicadores de estrés oxidativo. El estudio se complementó con la obtención del peso de los pingüinos. En general, los parámetros medidos, aumentaron o se mantuvieron constantes desde la primera toma de muestra hasta la última. Si bien algunas de las variables para cada pingüino se comportaron diferentes durante el tratamiento, en general se observó una tendencia a normalizarse hacia el momento de su liberación. Se concluye que los pingüinos se liberaron en buen estado físico luego de la rehabilitación.
Magellanic penguins are among the most affected seabirds by oil contamination in Patagonia. Hydrocarbons and other pollutants cause an increase in the cellular levels of reactive oxygen species that lead oxidative stress and in this way, the evaluation of oxidative stress parameters could be useful tools as biomarkers to evaluate the exposure to hazardous chemical contaminants. The aim of the present work was to evaluate hematological parameters and oxidative stress biomarkers during the rehabilitation of three oil-spill penguins from Punta Tombo Natural Protected Area in Chubut, Argentina. Three blood samples were taken from each individual, the first sample was obtained at arrival of penguin to the rehabilitation center, the second one was the following one week and last sample was taken before animals were freed. Hematocrit, white blood cell count, heterophil/ lymphocyte ratio as a measure of stress, and concentrations of glucose and total proteins were determined. The thiobarbituric acid reactive species, a well-established method for monitoring lipid peroxidation, the activity of catalase enzyme (involved in the catabolism of hydrogen peroxide) and the thiol levels were evaluated as oxidative stress indicators. In general, the measured parameters remained constant or increased their values from the first to the last blood sampling. While some of the variables for each penguin behaved differently during treatment, generally they tended to normalize when penguins were released. We conclude that penguins were released in good physical condition after rehabilitation.