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[PMID]: 27797159
[Au] Autor:Churilla TM; Egleston B; Bleicher R; Dong Y; Meyer J; Anderson P
[Ad] Address:Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, Pennsylvania. thomas.churilla@fccc.edu.
[Ti] Title:Disparities in the Local Management of Breast Cancer in the US according to Health Insurance Status.
[So] Source:Breast J;, 2016 Oct 31.
[Is] ISSN:1524-4741
[Cp] Country of publication:United States
[La] Language:ENG
[Ab] Abstract:Although standard practice guidelines for breast cancer are clear, the interplay between insurance and practice patterns for the US is poorly defined. This study was performed to test for associations between patient insurance status and presentation of breast cancer as well as local therapy patterns in the US, via a large national dataset. We queried the NCI Surveillance, Epidemiology, and End Results data base for breast cancer cases diagnosed from 2007 to 2011 in women aged 18-64 with nonmetastatic ductal/lobular cancers, treated surgically. We tested for associations between insurance status (insured/Medicaid/uninsured) and choice of surgical procedure (mastectomy/breast conserving surgery [BCS]), omission of radiotherapy (RT) following BCS, and administration of post-mastectomy radiation (PMRT). There were 129,565 patients with localized breast cancer analyzed. The health insurance classification included insured (84.5%), Medicaid (11.5%), uninsured (2.1%) and unknown (1.9%). Medicaid or uninsured status was associated with large, node positive tumors, black race, and low income. The BCS rate varied by insurance status: insured (52.2%), uninsured (47.7%), and Medicaid (45.2%), p < 0.001. In multivariable analysis, Medicaid insurance remained significantly associated with receipt of mastectomy (OR [95% CI] = 1.07 [1.03-1.11]), while RT was more frequently omitted after BCS in both Medicaid (OR [95% CI] = 1.14 [1.07-1.21]) and uninsured (OR [95% CI] = 1.29 [1.14-1.47]) patients. Insurance status was associated with significant variations in breast cancer care in the US. Although patient choice cannot be determined from this dataset, departure from standard of care is associated with specific types of insurance coverage. Further investigation into the reasons for these departures is strongly suggested.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1610
[Cu] Class update date: 161031
[Lr] Last revision date:161031
[St] Status:Publisher
[do] DOI:10.1111/tbj.12705

  2 / 1616937 MEDLINE  
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[PMID]: 27797126
[Au] Autor:Altundag K
[Ad] Address:Tria Residence, Ankara, Turkey. altundag66@yahoo.com.
[Ti] Title:Primary Surgery After or Before Systemic Treatment May Affect the Survival Results in Stage IV Breast Cancer Patients.
[So] Source:Breast J;, 2016 Oct 31.
[Is] ISSN:1524-4741
[Cp] Country of publication:United States
[La] Language:ENG
[Pt] Publication type:LETTER
[Em] Entry month:1610
[Cu] Class update date: 161031
[Lr] Last revision date:161031
[St] Status:Publisher
[do] DOI:10.1111/tbj.12700

  3 / 1616937 MEDLINE  
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[PMID]: 27797125
[Au] Autor:Al Johani B; Al Malik O; Anwar E; Tulbah A; Alshabanah M; AlSayed A; Ajarim D; Al-Tweigeri T
[Ad] Address:Department of General Surgery, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. badria_eid@eid-ott.com.
[Ti] Title:Reply to "Letter to the Editor Concerning the Article-Impact of Surgery on Survival in Stage IV Breast Cancer".
[So] Source:Breast J;, 2016 Oct 31.
[Is] ISSN:1524-4741
[Cp] Country of publication:United States
[La] Language:ENG
[Pt] Publication type:LETTER
[Em] Entry month:1610
[Cu] Class update date: 161031
[Lr] Last revision date:161031
[St] Status:Publisher
[do] DOI:10.1111/tbj.12701

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[PMID]: 27797116
[Au] Autor:Moggia E; Rouse B; Simillis C; Li T; Vaughan J; Davidson BR; Gurusamy KS
[Ad] Address:Department of General and Digestive Surgery, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Rozzano, Milan, Italy, Italy, 20089.
[Ti] Title:Methods to decrease blood loss during liver resection: a network meta-analysis.
[So] Source:Cochrane Database Syst Rev;10:CD010683, 2016 Oct 31.
[Is] ISSN:1469-493X
[Cp] Country of publication:England
[La] Language:ENG
[Ab] Abstract:BACKGROUND: Liver resection is a major surgery with significant mortality and morbidity. Specialists have tested various methods in attempts to limit blood loss, transfusion requirements, and morbidity during elective liver resection. These methods include different approaches (anterior versus conventional approach), use of autologous blood donation, cardiopulmonary interventions such as hypoventilation, low central venous pressure, different methods of parenchymal transection, different methods of management of the raw surface of the liver, different methods of vascular occlusion, and different pharmacological interventions. A surgeon typically uses only one of the methods from each of these seven categories. The optimal method to decrease blood loss and transfusion requirements in people undergoing liver resection is unknown. OBJECTIVES: To assess the effects of different interventions for decreasing blood loss and blood transfusion requirements during elective liver resection. SEARCH METHODS: We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and Science Citation Index Expanded to September 2015 to identify randomised clinical trials. We also searched trial registers and handsearched the references lists of identified trials. SELECTION CRITERIA: We included only randomised clinical trials (irrespective of language, blinding, or publication status) comparing different methods of decreasing blood loss and blood transfusion requirements in people undergoing liver resection. DATA COLLECTION AND ANALYSIS: Two review authors independently identified trials and collected data. We assessed the risk of bias using Cochrane domains. We conducted a Bayesian network meta-analysis using the Markov chain Monte Carlo method in WinBUGS 1.4, following the guidelines of the National Institute for Health and Care Excellence Decision Support Unit guidance documents. We calculated the odds ratios (OR) with 95% credible intervals (CrI) for the binary outcomes, mean differences (MD) with 95% CrI for continuous outcomes, and rate ratios with 95% CrI for count outcomes, using a fixed-effect model or random-effects model according to model-fit. We assessed the evidence with GRADE. MAIN RESULTS: We identified 67 randomised clinical trials involving a total of 6197 participants. All the trials were at high risk of bias. A total of 5771 participants from 64 trials provided data for one or more outcomes included in this review. There was no evidence of differences in most of the comparisons, and where there was, these differences were in single trials, mostly of small sample size. We summarise only the evidence that was available in more than one trial below. Of the primary outcomes, the only one with evidence of a difference from more than one trial under the pair-wise comparison was in the number of adverse events (complications), which was higher with radiofrequency dissecting sealer than with the clamp-crush method (rate ratio 1.85, 95% CrI 1.07 to 3.26; 250 participants; 3 studies; very low-quality evidence). Among the secondary outcomes, the only differences we found from more than one trial under the pair-wise comparison were the following: blood transfusion (proportion) was higher in the low central venous pressure group than in the acute normovolemic haemodilution plus low central venous pressure group (OR 3.19, 95% CrI 1.56 to 6.95; 208 participants; 2 studies; low-quality evidence); blood transfusion quantity (red blood cells) was lower in the fibrin sealant group than in the control (MD -0.53 units, 95% CrI -1.00 to -0.07; 122 participants; 2; very low-quality evidence); blood transfusion quantity (fresh frozen plasma) was higher in the oxidised cellulose group than in the fibrin sealant group (MD 0.53 units, 95% CrI 0.36 to 0.71; 80 participants; 2 studies; very low-quality evidence); blood loss (MD -0.34 L, 95% CrI -0.46 to -0.22; 237 participants; 4 studies; very low-quality evidence), total hospital stay (MD -2.42 days, 95% CrI -3.91 to -0.94; 197 participants; 3 studies; very low-quality evidence), and operating time (MD -15.32 minutes, 95% CrI -29.03 to -1.69; 192 participants; 4 studies; very low-quality evidence) were lower with low central venous pressure than with control. For the other comparisons, the evidence for difference was either based on single small trials or there was no evidence of differences. None of the trials reported health-related quality of life or time needed to return to work. AUTHORS' CONCLUSIONS: Paucity of data meant that we could not assess transitivity assumptions and inconsistency for most analyses. When direct and indirect comparisons were available, network meta-analysis provided additional effect estimates for comparisons where there were no direct comparisons. However, the paucity of data decreases the confidence in the results of the network meta-analysis. Low-quality evidence suggests that liver resection using a radiofrequency dissecting sealer may be associated with more adverse events than with the clamp-crush method. Low-quality evidence also suggests that the proportion of people requiring a blood transfusion is higher with low central venous pressure than with acute normovolemic haemodilution plus low central venous pressure; very low-quality evidence suggests that blood transfusion quantity (red blood cells) was lower with fibrin sealant than control; blood transfusion quantity (fresh frozen plasma) was higher with oxidised cellulose than with fibrin sealant; and blood loss, total hospital stay, and operating time were lower with low central venous pressure than with control. There is no evidence to suggest that using special equipment for liver resection is of any benefit in decreasing the mortality, morbidity, or blood transfusion requirements (very low-quality evidence). Radiofrequency dissecting sealer should not be used outside the clinical trial setting since there is low-quality evidence for increased harm without any evidence of benefits. In addition, it should be noted that the sample size was small and the credible intervals were wide, and we cannot rule out considerable benefit or harm with a specific method of liver resection.
[Pt] Publication type:REVIEW; JOURNAL ARTICLE
[Em] Entry month:1610
[Cu] Class update date: 161031
[Lr] Last revision date:161031
[St] Status:Publisher

  5 / 1616937 MEDLINE  
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[PMID]: 27797093
[Au] Autor:Daszkiewicz A; Janik A; Sliwczynska M; Karpe J; Misiolek H
[Ti] Title:A comparison of selective and conventional spinal anaesthesia for ambulatory surgery.
[So] Source:Anaesthesiol Intensive Ther;48(4):220-227, 2016.
[Is] ISSN:1731-2515
[Cp] Country of publication:Poland
[La] Language:ENG
[Ab] Abstract:BACKGROUND: Selective spinal anaesthesia is the practice of employing minimal doses of intrathecal agents so that only the nerve roots supplying a specific area and only the modalities that require to be anaesthetised are affected. The study is based on the hypothesis that small dose lidocaine spinal anaesthesia may be adequate for elective surgical procedures, providing limited motor and sensory block, and thus enabling earlier patient's discharge. The aim of this study was the comparison of the low and the conventional dose of lidocaine spinal anaesthesia discharge time. METHODS: The study was a prospective, randomized controlled single-blind trial, with 84 patients enrolled. Patients in study group (SS-L, Selective Spinal Lidocaine) were administered 3 mL of a 0.8% lidocaine solution containing 24 mg of lidocaine and 15 µg of fentanyl for spinal anaesthesia. Patients in the control group (CD-L, Conventional Dose Lidocaine) received 5 mL of a 1% lidocaine solution containing 50 mg of lidocaine and 25 µg of fentanyl for spinal anaesthesia. Discharge time was evaluated. RESULTS: In the SS-L group time to discharge were shorter (P < 0.01) compared to the CD-L group. CONCLUSION: Selective spinal anaesthesia with low dose of lidocaine decreases the time of patient discharge compared with conventional lidocaine dose spinal anaesthesia.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1610
[Cu] Class update date: 161031
[Lr] Last revision date:161031
[St] Status:In-Data-Review
[do] DOI:10.5603/AIT.2016.0046

  6 / 1616937 MEDLINE  
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[PMID]: 27797069
[Au] Autor:Abe A; Manabe T; Takizawa N; Ueki T; Yamada D; Nagayoshi K; Sadakari Y; Fujita H; Nagai S; Yamamoto H; Oda Y; Nakamura M
[Ad] Address:Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Maidashi 3-1-1, Higashi-ku, Fukuoka, 812-8582, Japan. a-abe@surg1.med.kyushu-u.ac.jp.
[Ti] Title:IgG4-related sclerosing mesenteritis causing bowel obstruction: a case report.
[So] Source:Surg Case Rep;2(1):120, 2016 Dec.
[Cp] Country of publication:Germany
[La] Language:ENG
[Ab] Abstract:Sclerosing mesenteritis (SM) is a rare inflammatory and fibrosing disease primarily involving the small-bowel mesentery. Recently, SM was reported to be closely related to IgG4-related disease (IgG4-RD). This report describes a patient with SM associated with IgG4-RD. A 77-year-old woman with a history of surgery for ectopic pregnancy and wound dehiscence presented with intestinal obstruction. Abdominal enhanced computed tomography (CT) revealed an enhanced, radially shaped, oval mass, 3 cm in diameter, with an unclear rim in the mesentery of the distal ileum, which may have involved the distal ileum. To remove the cause of bowel obstruction, the SM was resected completely and the ileum was resected partially. Histologic examination showed that the mass was composed of spindle cells arranged in a fascicular or storiform pattern; moreover, fibrous stroma was observed, with dense lymphoplasmacytic infiltration and lymphoid follicles. Immunohistochemically, numerous IgG4-positive plasma cells were observed, at a density of 253 per high-powered field, and the IgG4/IgG ratio was about 50 %. Elastica van Gieson (EVG) staining also showed obstructive phlebitis. These findings indicated IgG4-related SM. Although the accurate diagnosis of SM remains difficult without histological analysis, IgG4-RD should be included in the differential diagnosis of unknown mesenteric tumors. Identification of IgG4-RD may prevent unnecessary surgery because corticosteroids may be effective in these patients.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1610
[Cu] Class update date: 161031
[Lr] Last revision date:161031
[St] Status:In-Data-Review

  7 / 1616937 MEDLINE  
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[PMID]: 27797068
[Au] Autor:Inoue Y; Gunji S; Obama K; Okabe H; Sakai Y
[Ad] Address:Department of Surgery, Kyoto University Graduate School of Medicine, Yoshida Konoecho, Sakyo-ku, Kyoto-shi, Kyoto, Japan.
[Ti] Title:Laparoscopy endoscopy cooperative surgery for gastric plexiform fibromyxoma: a case report.
[So] Source:Surg Case Rep;2(1):119, 2016 Dec.
[Cp] Country of publication:Germany
[La] Language:ENG
[Ab] Abstract:BACKGROUND: Gastric submucosal tumors are commonly treated by partial resection under laparoscopy. However, the surgical resection of gastric submucosal tumors sometimes causes deformation of the stomach, especially in the case of intraluminal tumors located near the pylorus or esophagogastric junction. Such deformations can result in impaired diet intake and reduced quality of life. Laparoscopic endoscopic cooperative surgery has been developed to overcome these problems. This is the first report to describe a case of gastric plexiform fibromyxoma, a rare gastric submucosal tumor, that was successfully resected by laparoscopic endoscopic cooperative surgery. CASE PRESENTATION: A 36-year-old Japanese woman presented with epigastric pain and anemia. Gastrointestinal endoscopy revealed a submucosal tumor in the gastric antrum. Because a definitive diagnosis could not be obtained and the tumor was located near the pylorus, we performed laparoscopic endoscopic cooperative surgery as diagnostic therapy. The postoperative course was favorable with no complications, such as delayed gastric emptying or outlet obstruction. The tumor was pathologically diagnosed as gastric plexiform fibromyxoma. CONCLUSIONS: Laparoscopic endoscopic cooperative surgery is a useful approach for diagnostic therapy for rare submucosal tumors to avoid the deformation of the stomach, especially when the tumor is located near the pylorus.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1610
[Cu] Class update date: 161031
[Lr] Last revision date:161031
[St] Status:In-Data-Review

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[PMID]: 27797004
[Au] Autor:Chernock RD; Jackson RS
[Ad] Address:Department of Pathology and Immunology, Washington University School of Medicine, 660 S. Euclid Ave., Campus Box 8118, St. Louis, MO, USA. rchernock@path.wustl.edu.
[Ti] Title:Novel Cause of 'Black Thyroid': Intraoperative Use of Indocyanine Green.
[So] Source:Endocr Pathol;, 2016 Oct 28.
[Is] ISSN:1559-0097
[Cp] Country of publication:United States
[La] Language:ENG
[Ab] Abstract:The antibiotic minocycline is virtually pathognomonic for brown-black discoloration of the thyroid gland referred to as 'black thyroid'. Black thyroid' is an incidental finding in patients taking the drug who undergo thyroid surgery for another indication and is not of known clinical significance. However, its recognition is important so as not to raise concern for a disease process. Here, we present the first case of 'black thyroid' attributable to the iodine-containing compound indocyanine green. Intraoperative indocyanine green was administered as part of a research protocol transoral robotic-assisted surgery for a base of tongue cancer in a 44-year-old man. Hemithyroidectomy was subsequently performed during the same operation for further evaluation of an indeterminate thyroid nodule. The resected thyroid lobe was dark, nearly black in color, and histologically showed extensive brown pigment deposition in the follicular epithelial cells and colloid, mimicking minocycline-induced 'black thyroid'. In this case, however, the patient was not taking minocycline; instead the 'black thyroid' was attributed to the iodine-containing compound indocyanine green. Indocyanine green is a hereto unreported cause of 'black thyroid' with histopathologic features that are remarkably similar to that induced by minocycline. Indocyanine green should be included the differential diagnosis of 'black thyroid'. Clinical history is important so as not to raise concern for a disease process.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1610
[Cu] Class update date: 161031
[Lr] Last revision date:161031
[St] Status:Publisher

  9 / 1616937 MEDLINE  
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[PMID]: 27796959
[Au] Autor:Smith GH; Boulanger CA
[Ad] Address:Mammary Stem Cell Section, Basic Research Laboratory, National Cancer Institute, National Institutes of Health, Building 37 Rm 1112, 37 Convent Drive, Bethesda, MD, 20892, USA. smithg@mail.nih.gov.
[Ti] Title:Techniques for the Reprogramming of Exogenous Stem/Progenitor Cell Populations Towards a Mammary Epithelial Cell Fate.
[So] Source:Methods Mol Biol;1501:277-289, 2017.
[Is] ISSN:1940-6029
[Cp] Country of publication:United States
[La] Language:ENG
[Ab] Abstract:This chapter considers the techniques necessary and required for the reprogramming of exogenous stem/progenitor cell populations towards a mammary epithelial cell fate. The protocols describe how to isolate cells from alternate mouse organs such as testicles of male mice and mix them with mammary cells to generate chimeric glands comprised of male and female epithelial cells that are fully competent. During the reformation of mammary stem cell niches by dispersed epithelial cells, in the context of the intact epithelium-free mammary stroma, non-mammary cells are sequestered and reprogrammed to perform mammary epithelial cell functions including those ascribed to mammary stem/progenitor cells. This therefore is a powerful technique for the redirection of cells from other organs/cancer cells to a normal mammary phenotype.
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1610
[Cu] Class update date: 161031
[Lr] Last revision date:161031
[St] Status:In-Data-Review

  10 / 1616937 MEDLINE  
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[PMID]: 27796918
[Au] Autor:Shimizu K; Nagashima T; Ohtaki Y; Takahashi T; Mogi A; Kuwano H
[Ad] Address:Division of General Thoracic Surgery, Integrative Center of General Surgery, Gunma University Hospital, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan. kmshimizu@gmail.com.
[Ti] Title:Pulmonary artery reconstruction with a tailor-made bovine pericardial conduit following sleeve resection of a long segmental pulmonary artery for the treatment of lung cancer: technical details of the dog-ear method for adjusting diameter during vascular anastomosis.
[So] Source:Gen Thorac Cardiovasc Surg;, 2016 Oct 31.
[Is] ISSN:1863-6713
[Cp] Country of publication:Japan
[La] Language:ENG
[Ab] Abstract:Sleeve resection of the pulmonary artery (PA) is always required for lung-sparing operations in which half or more of the vessel circumference is infiltrated by the primary tumor or metastatic hilar nodes. Following sleeve resection, conduit reconstruction may be indicated if there is excessive distance between the two vascular stumps, because there is a high degree of tension when repaired by direct anastomosis. We herein present a case of PA reconstruction using a tailor-made bovine pericardial conduit after sleeve resection of PA during lung cancer surgery. The length of resection was longer than 3 cm, and the difference in diameter between the conduit and peripheral PA stump was larger than 0.5 cm. We describe the surgical and oncological merits of a bovine pericardial conduit, and provide details of our reconstruction technique, focusing on adjustment of diameter between the conduit and peripheral PA (dog-ear method).
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1610
[Cu] Class update date: 161031
[Lr] Last revision date:161031
[St] Status:Publisher


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