Demographic and Clinical Features of Patients with Metastatic Breast Cancer: A Retrospective Multicenter Registry Study of the Turkish Oncology Group.

This multicenter registry study aims to analyze time-related changes in the treatment patterns and outcome of patients with metastatic breast cancer (MBC) over a ten-year period. Correlations between demographic, prognostic variables and survival outcomes were carried out in database aggregates consisting of cohorts based on disease presentation (recurrent vs. de novo) and the diagnosis date of MBC (Cohort I: patient diagnosed between January 2010 and December 2014; and Cohort II: between January 2015 and December 2019). Out of 1382 patients analyzed, 52.3% patients had recurrent disease, with an increased frequency over time (47.9% in Cohort I vs. 56.1% in Cohort II, p < 0.001). In recurrent patients, 38.4% (n = 277) relapsed within two years from initial diagnosis, among which triple-negative BC (TNBC) was the most frequent (51.7%). Median overall survival (OS) was 51.0 (48.0-55.0) months for all patients, which was similar across both cohorts. HER2+ subtype had the highest OS among subgroups (HER2+ vs. HR+ vs. TNBC; 57 vs. 52 vs. 27 months, p < 0.001), and the dnMBC group showed a better outcome than recMBC (53 vs. 47 months, p = 0.013). Despite the lack of CDK inhibitors, luminal A patients receiving endocrine therapy had a favorable outcome (70 months), constituting an appealing approach with limited resources. The only survival improvement during the timeframe was observed in HER2+ dnMBC patients (3-year OS Cohort I: 62% vs. Cohort II: 84.7%, p = 0.009). The incorporation of targeted agents within standard treatment has improved the outcome in HER2+ MBC patients over time. Nevertheless, despite advances in early diagnosis and treatment, the prognosis of patients with TNBC remains poor, highlighting the need for more effective treatment options.

Assessment of combined local anesthesia and ketamine for pain, swelling, and trismus after surgical extraction of third molars.

PURPOSE: The aim of this study was to assess the clinical efficacy of combined treatment with local anesthetic and subanesthetic ketamine for the relief or prevention of postoperative pain, swelling, and trismus after the surgical extraction of third molars. PATIENTS AND METHODS: Fifty patients undergoing the extraction of impacted mandibular third molars were included in the study. The patients were randomly divided into 2 groups: local anesthetic alone (LAA) and local anesthetic plus ketamine (LAK). The patients in the LAA group received 5 mL of a local anesthetic and saline combination comprising 2 mL of local anesthetic and 3 mL of saline. The patients in the LAK group received 5 mL of a local anesthetic, ketamine, and saline combination comprising 2 mL of local anesthetic and 0.3 mg/kg ketamine and saline. RESULTS: Facial swelling on postoperative days was significantly lower in the LAK group than in the LAA group (P = .0001). The mouth opening on the postoperative days was significantly greater in the LAK group than in the LAA group (P = .0001). The pain scores on the VAS at 30 minutes and 1, 4, 12, and 24 hours after surgery were significantly higher in the LAA group than in the LAK group (P = .0001, P = .005). CONCLUSION: The combination of a local anesthetic and subanesthetic doses of ketamine during surgical extraction of third molars can produce good local anesthesia while affording a comfortable procedure for the surgeon and patient and providing good postoperative analgesia with less swelling and significantly less trismus.

Oral Pyogenic Granuloma Associated With a Dental Implant Treated With an Er:YAG Laser: A Case Report.

A pyogenic granuloma is a tumorlike proliferation that occurs slightly more often in females, frequently involving the gingiva in the maxillary region. Clinically, it presents as a sessile or pedunculated exophytic mass with a smooth or lobulated surface, which tends to bleed easily. Its color can range from pink to dark red. The most common treatment is surgical excision. This case report presents a pyogenic granuloma that formed around an implant 7 years after its insertion. Pyogenic granulomas associated with dental implants are extremely rare; this is the fourth reported case and the first case of pyogenic granuloma to be treated with an Er:YAG laser.

Evaluation of dental anxiety in patients undergoing dentoalveolar surgery with laser treatment.

OBJECTIVE: The purpose of this study was to evaluate dental anxiety in patients undergoing apicectomy procedures performed with conventional instruments or an erbium-doped yttrium aluminum garnet (Er:YAG) laser. METHODS: Twenty-eight patients undergoing apicectomy were divided into two groups; roots were removed with an Er:YAG laser in group A (n=14) and with conventional instruments in group B (n=14). All patients completed preoperative State-Trait Anxiety Inventories (STAI) and postoperative questionnaires. RESULTS: Although state anxiety, trait anxiety, and postoperative questionnaire scores were lower in patients undergoing Er:YAG laser treatment than in those treated with conventional instruments, the differences were not statistically significant. CONCLUSIONS: Surgical instruments affect the anxiety levels of dental patients. Even with the STAI scores being lower for patients treated with Er:YAG, use of the Er:YAG laser alone cannot contribute to the resolution of dental anxiety. A patient's individual condition is the major factor influencing that patient's anxiety level.

Factors affecting the antibacterial effects of Nd:YAG laser in vivo.

BACKGROUND AND OBJECTIVES: One of the main advantages of laser surgery is it's bactericidal effect which reduces the risk of postoperative infections. Several study designs have been set to investigate this effect. Aim of this study was to research if the bactericidal effect of laser tool was affected from several factors in vitro studies. STUDY DESIGN/MATERIALS AND METHODS: To determinate and investigate the bactericidal effect of laser in an original model, alpha-hemolytic streptococcus, Bacterioides fragilis, Neisseria, Streptococcus salivarius, Staphylococcus aureus, and Candida albicans were prepared in 10(4), 10(6) and 10(8) inoculum and placed in Mueller-Hinton Broth which have five different proportions of sheep blood. Samples which exposed with various energy levels of Nd:YAG laser were spread on agar plates, and at the end of an incubation time the colonization counted comparatively. The lowest energy level without colonization was accepted as minimal bactericidal energy level. RESULTS: Highest minimum bactericidal energy level is used for alpha-hemolytic streptococcus and lowest values for neisseria. Bactericidal effect decreased on suspensions, of which population of microorganisms are high and hemoglobin concentration was high in the broth. CONCLUSIONS: These findings suggest that the Nd:YAG laser has a higher bactericidal effect when sheep blood is added to the media. Factors like population and type of bacteria in the irradiated suspension affect minimum bactericidal energy level.