Heterogeneity of Outcomes Reporting in Trials Evaluating Traditional Chinese Medicine Breast Massage for Stasis Acute Mastitis: A Methodological Review / 中国医学科学杂志(英文版)

Objective To systematically analyze the current status of outcomes reporting in clinical trials on treating stasis acute mastitis with Traditional Chinese Medicine breast massage.Methods We searched CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, Embase, Cochrane library, JBI, CINAHL, PsycINFO, Clinical Trials Registry Platform portal, Clinical Trials Registry, Australian New Zealand Clinical Trials Registry, Center Watch Registry from inception to May 15, 2022 to find randomized controlled trials, non-randomized controlled trials, case series and cohort studies which reported the outcomes of stasis acute mastitis managed with Traditional Chinese Medicine breast massage, with search terms of mastitis, acute mastitis, lactation mastitis, puerperal mastitis, breast problem, breast engorgement, milk stasis, blocked ducked, breast pain, breast massage, and acupoint massage. Outcomes and the measurement schemes (measurement methods, timing of assessing outcome, frequency of assessing outcome, measurers) were extracted from the included studies. We used the Management of Otitis Media with Effusion in Children with Cleft Palate (MOMENT) to assess the quality of each study, then categorized outcomes derived from the included studies into different domains according to the Outcome Measures in Rheumatology Arthritis Clinic Trials (OMERACT) Filter 2.1 framework.Results We identified 85 clinical trials, in which 54 different outcomes were reported. A total of 81.2% (69/85) of studies were assessed as medium quality with a mean score of 2.6, and 18.8% (16/85) as low quality with a mean score of 0.9. These outcomes were organized in three core areas. Lump size (89.4%, 76/85) was the most frequently reported outcome, followed by breast pain (69.4%, 59/85) and milk excretion (68.2%, 58/85). Five methods were used to assess lump size and four methods to assess breast pain.Conclusions The outcomes reported in clinical trials regarding stasis acute mastitis treated by Traditional Chinese Medicine breast massage are heterogeneous. Developing a core outcome set to achieve consistent standards for reporting outcomes and modalities for validation of the outcomes is clearly warranted.

Antimicrobial activity of propolis extract fractions against Staphylococcus spp. isolated from goat mastitis / Atividade antimicrobiana de frações do extrato de própolis frente à Staphylococcus spp. isolados de mastite caprina

The indiscriminate use of antibiotics in the treatment of caprine mastitis causes the appearance of resistant microorganisms, besides leaving residues in milk, putting at risk to human health. In this way, propolis is an alternative in the treatment of diseases because it has antimicrobial activity, mainly because of the presence of flavonoids in its composition. The aim of this study was to evaluate the antimicrobial potential of propolis to Staphylococcus spp. Isolated from cases of goat mastitis and qualify the crude ethanoic extract by high performance liquid chromatography (HPLC). In this study, the minimum bactericidal concentration values of propolis extracts in ethanol, ethyl acetate and hexane showed that the best concentrations capable of promoting the highest mortality of the isolates of Staphylococcus spp. from mastitis in goats, were 6250, 3125 and 1562.5µg/mL, respectively. By the microplate adherence test, it was found that 20.78% isolates were not able to form biofilm, 14.70% were classified as moderate and 64.70% were weak and none as a strong biofilm producer. Propolis in its different diluents was able to affect the formation of biofilm and showed a pronounced marked antimicrobial activity against Staphylococcus spp. strains and may be indicated for use in in vivo studies.(AU)

O uso indiscriminado de antibióticos no tratamento de mastite caprina leva ao desenvolvimento de micro-organismos resistentes que poderão estar presentes em alimentos, colocando em risco a saúde humana. Dessa forma, a própolis surge como uma alternativa para o tratamento de doenças por possuir uma ação antimicrobiana, principalmente pela presença de flavonoides em sua composição. O objetivo desse estudo foi avaliar o potencial antimicrobiano da própolis frente à Staphylococcus spp. isolados de casos de mastite caprina e qualificar o extrato etanoico bruto por cromatografia líquida de alta eficiência (CLAE-DAD). Neste estudo, os valores de concentração bactericida mínima (CBM) dos extratos de própolis em álcool etílico, acetato de etila e hexano nos isolados foram de 6250, 3125 e 1562,5µg/mL, respectivamente. Pelo teste de aderência à microplacas, observou-se que 20,78% dos microorganismos, não foram capazes de formar biofilme, 14,70% foram classificados como moderados, 64,70% em fracos e nenhum como forte produtor de biofilme. A própolis em seus diferentes diluentes foi capaz de afetar a formação de biofilme e apresentou significativa atividade antimicrobiana frente a cepas de Staphylococcus spp., podendo ser indicada para utilização em estudos "in vivo".(AU)

Evaluación del efecto antimicrobiano de Aloe barbadensis Miller asociado a ceftiofur sobre cepas de Escherichia coli / Evaluation of the antimicrobial effect of Aloe barbadensis Miller associated with ceftiofur on strains of Escherichia coli

El uso indiscriminado de antimicrobianos en animales de producción es la principal causa del aumento de la resistencia bacteriana, por lo que organizaciones intergubernamentales solicitan disminuir el uso excesivo de estos fármacos. La mastitis es causada principalmente por Escherichia coli en la zona central de Chile y, debido a que su tratamiento se concentra en el uso de antimicrobianos, se ha estudiado Aloe barbadensis Miller (Aloe vera) como una alternativa terapéutica por su efecto antimicrobiano. El objetivo de este trabajo fue evaluar el efecto inhibitorio "in vitro" de A. vera asociado a Ceftiofur en concentraciones menores a su Concentración Mínima Inhibitoria (CMI), frente a E. coli ATCC 25922 y en cepas aisladas de vacas con mastitis clínica. Se utilizó el Método de Macrodilución en Caldo. La CMI fue determinada mediante turbidez y confirmada por recuento de UFC/mL y por espectrofotometría UV-visible. Las cepas de campo fueron sometidas a un estudio de sensibilidad (Kirby Bauer) frente a un panel de antimicrobianos antes de analizar el efecto inhibitorio de A. vera. La CMI de A. vera se determinó en 60 mg/mL. La asociación de A. vera/Ceftiofur no inhibió el crecimiento de E. coli ATCC 25922. Todas las cepas de campo presentaron sensibilidad intermedia o resistencia a al menos un antimicrobiano, pero fueron inhibidas por A. vera. Esto sugiere que A. vera es más efectiva en la inhibición del crecimiento de E. coli en comparación a la asociación y podría presentarse como una alternativa terapéutica frente a mastitis clínicas causadas por E. coli.

Processos inflamatórios da mama: caracterização e manejo terapêutico / Inflammatory processes of breast: characterization and therapeutic management

Hiperemia, calor e dor na mama podem relacionar-se a um grande número de causas. Processos inflamatórios da mama geralmente estão relacionados ao ciclo grávido-puerperal e suas modificaçöes, principalmente as formas agudas. Este trabalho tem por objetivo a caracterização dos diferentes processos inflamatórios da mama e seu adequado manejo.

Redness, heat, and breast pain may be related to a number of causes. Inflammatory conditions of the breast are usually related to the pregnancy-puerperal cycle and its modifications, mainly acute forms. This work aims to characterize the different inflammatory breast conditions and its adequate management.

Estudo dos métodos de rotina diagnóstica de mastite no leite de éguas / Study of routine diagnosis methods of mastitis in mares

Routine diagnosis methods used in bovine mastitis were studied in 55 mares in lactation. The findings of strip cup test, California Mastitis Test-CMT, electronic somatic cell count-CCS, microbiological culture, and in vitro antimicrobial susceptibility profile of isolates were discussed. Streptococcus spp., Staphylococcus spp, and enterobacteria were the most common microorganisms isolated in health and CMT-positive mammary glands. Staphylococcus aureus and Arcanobacterium pyogenes were identified in two mares presenting clinical mastitis. Mean somatic cell count of eight mares without presence of microorganisms in milk was 247.57x10³/mL and 1.621,86x10³/mL in 47 mares with positive microbiological culture. Moderate concordance (63.8 percent) between positive reactions in CMT (1 to 3+) and microbiological culture was observed. Amicacin (78.9 percent), ceftiofur (74.7 percent), sulpha-trimetoprim (69,0 percent) and norfloxacin (69.0 percent), were the most effective drugs, while resistance of isolates was mainly observed against penicillin (64.8 percent), gentamycin (35.2 percent), azithromycin (35.2 percent), enrofloxacin (28.2 percent), and florfenicol (28.2 percent).

Tuberculosis of the breast

Tuberculosis of the breast is an uncommon disease even in countries where the incidence of pulmonary and extrapulmonary tuberculosis is high. Clinical presentation is usually of a solitary, ill-defined, unilateral hard lump situated in the upper outer quadrant of the breast. This disease can present a diagnostic problem on radiological and microbiological investigations, and thus a high index of suspicion is needed. Incorporating a highly sensitive technique like polymerase chain reaction [PCR] may be helpful in establishing the usefulness of such technology and can aid in conforming the diagnosis early. The disease is curable with antitubercular drugs, and surgery is rarely required

Acute mastitis and breast abscesses among lactating women: occurrence and risk factors

This is a prospective study designed to assess the contributing factors for puerperal breast abscesses and mastitis as well as to evaluate treatment options. The study was conducted over a 2-year period, during which 176 nursing women with breast infection were followed. Of these, 140 had mast itis [79.6%] and 36 had breast abscesses [20.4%]. Ultrasono graphic examination was performed in selected cases. Patient age, parity, localization of infection, cracked nipples, duration of lactation, duration of symptoms, treatment options and healing time were all recorded. All patients with mastitis were treated with antibiotics and anti-inflammatory drugs. Abscesses were treated by incision and drainage. No significant difference was observed between the mastitis and the abscesses groups in relation to age, parity, localization of breast infection, cracked nipples or lactation time. Duration of symptoms and healing were longer in cases of abscesses. However, multivari ate analysis showed that the duration of symptoms was the only independent variable for abscess development. Delayed treatment of mastitis can lead to abscess formation and it can be prevented by early antibiotic therapy. Ultrasonography was observed to be helpful in detecting abscess formation in selected cases

Mastitis granulomatosa idiopática y mastitis de células plasmáticas: experiencia de tres años / Granulomatous mastitis and plasmatic cell mastitis: three-year experience

Se evaluó el manejo de 13 pacientes con mastitis granulomatosa idiopática y mastitis de células plasmáticas, tratadas en el Hospital Félix Bulnes, por un período de tres años. Se estudió la relación con la edad, anticoncepción, embarazo, lactancia y la atopia. Se evaluaron las limitaciones de la mamografía y de la ecotomografía mamaria y el uso de la biopsia trucut. Se compararon los resultados del tratamiento médico y quirúrgico.

Procesos inflamatorios benignos de la mama / Benign inflammatory disorders of the breast

Los procesos inflamatorios benignos de la mama representan un capítulo importante en la patología de esta glándula. Afectan preferentemente a mujeres en edad fértil y el diagnóstico de algunas de estas lesiones puede resultar sencillo y su tratamiento no ofrecer dificultades, sin embargo en otros casos existen serios problemas, tanto para identificar el tipo de lesión como para determinar su adecuada conducta terapéutica. Afortunadamente, la mayoría de las lesiones inflamatorias mamarias finalmente demostrarán ser benignas. No obstante, el médico debe estar vigilante excluyendo en cualquier lesión la posibilidad de cáncer mamario. Cuando se enfrenta clínicamente una lesión sospechosa y su estudio no resulta totalmente clarificador, no debe postergarse la realización de una biopsia. En este artículo se revisan algunos conceptos sobre los procesos inflamatorios benignos más habituales de la mama, con especial énfasis en las bases del diagnóstico y las principales tendencias en su manejo y tratamiento

Processos inflamatórios da mama / Breast inflammatory process

Os processos inflamatórios da mama (PIM) constituem situaçöes clínicas muito importantes na prática do ginecologista e mastologista, tanto pela sua alta freqüência, como pela diversidade de etiologias, que geralmente necessitam tratamento específico e diagnóstico diferencial com câncer. Os PIM geralmente estäo relacionados ao ciclo grávido-puerperal e suas modificaçöes, principalmente as formas agudas. No entanto, o tecido mamário pode hospedar qualquer agente infeccioso e manifestar formas clínicas de evoluçäo lenta e recorrente. Classificamos os processos inflamatórios da mama em agudos e crônicos, de acordo com suas histórias naturais. As mastites crônicas foram divididas em infecciosas ou näo-infecciosas, dependendo da existência de um agente infeccioso específico em sua etiopatogenia.

Mastitis periductal: a propósito de 20 observaciones / Periductal mastitis: apropos of 20 cases

La mastitis periductal (MP) es una afección benigna de la mama, que adopta formas clínicas variadas: secreción por el pezón, tumefacción subareolar con o sin componente inflamatorio, abscesos y fistulización.Estos diversos aspectos se intrincan entre sí y, en su marcha crónica, tienden a agravarse progresivamente, evolucionando por crisis recidivantes.A propósito de una serie de 20 observaciones, revisamos la patología y formulamos consideraciones clínicas y terapéuticas.Destacamos la posibilidad cierta de una semejanza clínica con el cáncer mamario y la necesidad de estar advertido para prevenir el error diagnóstico.En su tratamiento nos inclinamos por la cirugía de resección total de los galactóforos, para evitar las recidivas, y describimos la técnica aplicada a tal fin