RESUMO
The recurrence-free survival rates (RFS) after one-stage mastectomy and partial axillary dissection in 1242 low risk breast cancer patients with invasive ductal carcinoma with or without residual cancer tissue (RCT) in the wall of the biopsy cavity were compared. RFS was significantly lower in patients with RCT (RCT-positive) whether premenopausal (n = 416) or postmenopausal (n = 826). By applying the Cox multivariate analysis on RCT and various known prognostic criteria, the incidence rates for RCT-positive patients relative to RCT-negative patients were estimated. The relative risk by RCT-positivity was in the order of 1.45, indicating that RCT is an independent risk factor contributing an increased risk of recurrence of about 45%.
Assuntos
Biópsia/métodos , Neoplasias da Mama/cirurgia , Carcinoma Intraductal não Infiltrante/cirurgia , Excisão de Linfonodo , Mastectomia/métodos , Axila , Neoplasias da Mama/patologia , Carcinoma Intraductal não Infiltrante/patologia , Feminino , Humanos , Menopausa , Invasividade Neoplásica , Metástase Neoplásica , Recidiva Local de Neoplasia , Prognóstico , Fatores de RiscoRESUMO
The estimated probability of relapse of primary periareolar abscess of the nonlactating breast was 38 percent (95 percent confidence interval 18 to 58 percent) 8 years after simple incision and healing by granulation. Relapses were mainly fistulas in the line of incision. An attempt to identify relapses early was unsuccessful. This finding, in combination with the unsatisfactory results of simple incision and healing by granulation and the character of relapses, suggests improper initial operation and multifactorial causes. Initial incision followed by a search for a possible sinus tract and extensive excision in all patients with primary abscesses has been described and is recommended.
Assuntos
Abscesso/cirurgia , Doenças Mamárias/cirurgia , Doença Aguda , Feminino , Seguimentos , Humanos , Mamilos , Recidiva , Fatores de TempoRESUMO
The prophylactic treatment of the application of fibrin glue to the pulmonary surface during thoracoscopy in idiopathic spontaneous pneumothorax resulted in rapid and total pulmonary expansion in 33 of 35 patients. The 2 failures were due to apical cysts larger than 2 cm. The successfully treated patients were hospitalized for a median of 4 days (range 2-12). No complications were observed. All regained full working capacity within 1 month of discharge. Post-treatment X-ray examination of the chest was uniformly normal. During an observation time ranging from 7-24 months (median 12 months), 3 recurrences (9%) were seen at 7, 12, and 16 months, respectively. The treatment seems (1) to reduce the need for thoracotomy (2) to be associated with a high success rate, short and long-term, (3) to minimize the duration of hospital stay and (4) not to disturb the normal pleuro-pulmonary anatomy.
Assuntos
Adesivo Tecidual de Fibrina/uso terapêutico , Pneumotórax/terapia , Toracoscopia , Administração por Inalação , Adulto , Tubos Torácicos , Protocolos Clínicos/normas , Adesivo Tecidual de Fibrina/administração & dosagem , Seguimentos , Humanos , Tempo de Internação , Pessoa de Meia-Idade , Pneumotórax/diagnóstico por imagem , Pneumotórax/etiologia , Radiografia , RecidivaRESUMO
Classification of gynaecomastia as physiological/idiopathic is traditionally carried out by exclusion on the basis of the case history and results of the clinical examination. Out of 138 consecutive patients with gynaecomastia referred by general practitioners to the Surgical Gastroenterological Department K in Odense Hospital during the period 1978-1981 for treatment, 98 patients (71%) were classified in this manner. Following a period of observation ranging from four months to ten years, average 7.5 years, diseases were demonstrated in five of the physiological/idiopathic cases which were perhaps the causes of gynaecomastia. Employment of an extensive paraclinical programme of investigation would probably have resulted in demonstration of the underlying disease in three cases but would scarcely have improved the prognosis despite the possibility for earlier institution of treatment. Routine employment of extensive paraclinical investigations of selected patients with gynaecomastia of this type cannot be recommended on account of the limited diagnostic and therapeutic results. Classification of gynaecomastia based on the case history and clinical examination appears to be sufficiently exact in patients referred by general practitioners for treatment to a surgical department.
Assuntos
Ginecomastia/diagnóstico , Adolescente , Adulto , Idoso , Criança , Seguimentos , Ginecomastia/etiologia , Ginecomastia/cirurgia , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Mama , Dor/etiologia , Prolactina/metabolismo , Adulto , Antidepressivos Tricíclicos/farmacologia , Neoplasias da Mama/tratamento farmacológico , Butirofenonas/farmacologia , Anticoncepcionais Orais/farmacologia , Estrogênios/farmacologia , Feminino , Humanos , Menstruação , Fenotiazinas/farmacologiaAssuntos
Motilidade Gastrointestinal/efeitos dos fármacos , Complicações Pós-Operatórias/tratamento farmacológico , Vasopressinas/uso terapêutico , Adulto , Idoso , Ensaios Clínicos como Assunto , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Distribuição Aleatória , Fatores de TempoRESUMO
In a retrospective study of all post-mortem examinations and all celiotomies carried out at Glostrup Hospital in the period 1959-76, 81 patients with non-mechanical intestinal infarction were identified. Of these patients, 23 had suffered non-occlusive intestinal infarction. In 15 of the 23 patients the infarction was associated with cardiac disease and its treatment, in 2 patients it was associated with septic and haemorrhagic shock, and in 4 patients with still other diseases. Two patients were completely healthy, when struck by intestinal infarction. The course was fatal in 20 patients. It is concluded that non-occlusive intestinal infarction occurs often enough to be taken into consideration, whenever non-mechanical intestinal infarction is suspected. The treatment should be directed towards the conditions causing intestinal ischaemia.
Assuntos
Infarto/etiologia , Enteropatias/etiologia , Intestinos/irrigação sanguínea , Adulto , Idoso , Colo/irrigação sanguínea , Duodeno/irrigação sanguínea , Feminino , Humanos , Íleo/irrigação sanguínea , Infarto/cirurgia , Enteropatias/cirurgia , Jejuno/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Estudos RetrospectivosRESUMO
Histologic examination of mammary tissue from 39 patients with cyclical mastalgia and 68 with no mastalgia disclosed that fibrocystic disease was not in itself the cause of the cyclical condition. Nor did the study support the traditional concept of a relationship between major dysfunction of the internal genital organs and cyclical mastalgia. Although the organic basis for cyclical mastalgia is unknown, several observations strongly suggest that it is located in the mammary stroma. Future investigations of the organic basis for cyclical mastalgia should include the mammary stroma.
Assuntos
Mama/patologia , Dor/etiologia , Síndrome Pré-Menstrual/patologia , Adulto , Feminino , Doença da Mama Fibrocística/complicações , Doença da Mama Fibrocística/patologia , Humanos , Ciclo Menstrual , Pessoa de Meia-Idade , ParidadeRESUMO
Two hundred and eighty-six patients were exposed to puncture and irrigation of 468 maxillary sinuses after completion of radiological examination. The radiological interpretations were made by the same radiologist and related to the clinical rate of demonstrable antral fluid in fully and not fully developed sinuses. Radiologically normal sinuses contained fluid in patients over the age of twelve in 15.3% and when under that age in 39%. The radiological findings should not override one's clinical judgment, and the age of the patient should be considered when conclusions are to be drawn from the radiological findings.