Management of Breast Abscess during Breastfeeding.

(1) Background: Breast abscess (BA) is a condition leading in the majority of cases to breastfeeding interruption. Abscesses are commonly treated with antibiotics, needle aspiration or incision and drainage (I&D), but there is still no consensus on the optimal treatment. Since there are no well-defined clinical guidelines for abscess management, we conducted a retrospective, observational study with the aim of assessing ultrasound (US)-guided management of BA without surgery, regardless of the BA size.

The Role of in Mastitis : A Multidisciplinary Working Group Experience.

Background: Breastfeeding women are at risk of developing mastitis during the lactation period. has emerged as the community-acquired pathogen responsible for virulence (methicillin resistance and Panton-Valentine leukocidin toxin producing).

Research Aim: The aim was to compare the microorganisms responsible for mastitis and breast abscesses during breastfeeding.

Radio-guided and clip-guided preoperative localization for malignant microcalcifications offer similar performances in breast-conserving surgery.

Obtaining a tailored breast resection is challenging in microcalcifications detected on screening mammography, and an accurate localization is required. The aim of this study was to compare the efficacy of radio-guided localization (ROLL) versus ultrasound localization of a titanium clip with collagen (TCC) in terms of clear margins, re-intervention rates, excess of resected breast tissue, and operative times in pure malignant microcalcifications detected on screening mammography. Two hundred and twenty-one consecutive patients with malignant microcalcifications detected on screening mammography from a tertiary breast unit were reviewed: 177 patients were localized by TCC and 44 patients by stereotactic ROLL.

A Novel Indocyanine Green Fluorescence-Guided Video-Assisted Technique for Sentinel Node Biopsy in Breast Cancer.

Background: The equipment to detect indocyanine green (ICG) fluorescence for sentinel lymph node (SLN) biopsy in breast cancer is not widely accessible nor optimal. The fluorescence appears as a poorly defined white shine on a black background, and dimmed lighting is required. The aim of this study was to assess the feasibility, accuracy and healthcare costs of a novel approach for SLN biopsy by a video-assisted ICG-guided technique.

Sentinel node biopsy in ductal carcinoma in situ of the breast: Never justified?

Sentinel lymph node biopsy for ductal carcinoma in situ (DCIS) of the breast is not standard of care. However, nodal involvement for DCIS patients is reported. Aim of our study was to identify preoperative features predictive of nodal involvement in DCIS patients.

Is there a role for homeopathy in breast cancer surgery? A first randomized clinical trial on treatment with to reduce post-operative seroma and bleeding in patients undergoing total mastectomy.

Aim: This study aimed to evaluate the benefits of on post-operative blood loss and seroma production in women undergoing unilateral total mastectomy by administering 1000 Korsakovian dilution (1000 K).

Materials And Methods: From 2012 to 2014, 53 women were randomly assigned to or placebo and were followed up for 5 days. The main end point was the reduction in blood and serum volumes collected in drainages.

Localization of nonpalpable breast lesions with sonographically visible clip: optimizing tailored resection and clear margins.

Background: Achieving clear margins with adequate resection volumes is one of the principal goals of breast-conserving surgery. The aim of our study was to compare preoperative localization using 2 different clips, radiopaque or sonographically visible, to reach this goal.

Methods: We reviewed 209 consecutive nonpalpable breast cancers that were treated with lumpectomy: 59 with radiopaque and 150 with sonographically visible clip positioned during biopsy procedure.

Preoperative localization and surgical margins in conservative breast surgery.

Breast-conserving surgery (BCS) is the treatment of choice for early breast cancer. The adequacy of surgical margins (SM) is a crucial issue for adjusting the volume of excision and for avoiding local recurrences, although the precise definition of an adequate margins width remains controversial. Moreover, other factors such as the biological behaviour of the tumor and subsequent proper systemic therapies may influence the local recurrence rate (LRR).

Usefulness of Preoperative Diagnosis with Magnetic Resonance Imaging for Conservative Surgery in Paget's Disease of the Breast.

BACKGROUND: Paget's disease (PD) of the breast is a relatively rare condition (incidence 1-3%) among primary breast cancers [6]. It presents with suggestive symptoms like erythema, nipple bleeding and ulceration. PATIENT AND METHODS: A 76-year-old woman was followed up for cancer of the left breast that had been operated 10 years before.

[Vacuum-assisted breast biopsy for diagnosis of non-palpable lesions: experience with 226 cases].

Vacuum-assisted breast biopsy (VABB) is now available for non-palpable lesions. The present study describes the results obtained from 226 consecutive VABBs performed at "L. Sacco" Hospital, Milan, from November 2005 to July 2007 (198 stereotactic and 28 ultrasonographic procedures).

Primary carcinoma of ectopic breast tissue.

We describe a case of a 37-year-old woman with a left axillary mass. Often, the initial differential diagnosis of an axillary mass is not easy to make. We performed fine-needle aspiration of the axillary mass that revealed the presence of numerous epithelial neoplastic cells.

Incarcerated massive incisional hernia: extensive necrosis of the colon in a very obese patient. Surgical treatment and vacuum-assisted closure therapy: a case report.

We discuss a diabetic obese patient with an extensive necrosis of the ascending and transverse colon plus segmental necrosis of the small bowel incarcerated in a massive median incisional hernia below the umbilicus. After a blood test and an abdominal CT scan (without contrast dial), the patient underwent an urgent operation. We performed an extended right hemicolectomy, multiple segmental small bowel resections and a terminal ileostomy.

Bowel ultrasound in Crohn's disease: surgical perspective.

Background: Bowel ultrasound has been proven to be a useful tool in the management of Crohn's disease, particularly in the assessment of intra-abdominal complications, most of which require surgery.

Materials And Methods: The National Library of Medicine has been searched for articles on the use of bowel ultrasound in Crohn's disease focusing on aspects of interest to the surgeon.

Results And Conclusions: Several studies have demonstrated that bowel ultrasound may be useful to reduce the risk of unnecessary laparotomy in patients presenting acute abdomen with suspected chronic inflammatory bowel disease.

A prospective, longitudinal study of nonconventional strictureplasty in Crohn's disease.

Background: Bowel-sparing techniques have been proposed to avoid extended or repeated resections in patients with Crohn'rsquo;s disease (CD), but without precise indications, prospective evaluation, and with a technically limited repertoire.

Study Design: A prospective longitudinal study of new nonconventional strictureplasties (NCSP) in order to evaluate the safety, type and site of recurrence, and longterm clinical and surgical efficacy.

Results: Between January 1993 and December 2002, 102 among 305 consecutive patients underwent at least one NCSP for complicated CD.

[Strictureplasty in the surgical treatment of complicated Crohn's disease].

Introduction: Crohns disease is a panintestinal chronic inflammatory condition. Its remitting-relapsing behaviour may require in the single patient repeated surgeries, with the aim of resolving the complications of the disease. The awereness that surgery cannot resolve the disease has led, in the last years, to the development of new "conservative surgical techniques", which preserve as much of the intestinal tissue as possible.

[Bowel ultrasound in Crohn's disease. Surgical importance].

The use of ultrasound in Crohns disease has a recent history. This method is useful in various situations like: the diagnosis of the disease, the diagnosis of intra-abdominal complications and the follow-up of the operated patient. Moreover, thanks to its practicality of use, ripetibility and accuracy, ultrasounds can represent a first line diagnostic instrument for Crohns disease both in elective and emergency conditions.

[Surgical options in the treatment of perianal Crohn's disease].

Introduction: About 40% of patients with Crohns disease (CD) have a perianal involvement. Despite the recent introduction of anti-TNF antibody, this therapy has uncertain long-term results and surgery still remains a major treatment option.

Aims & Methods: This study relates our experience in surgical management of perianal CD without anti-TNF treatment.

The new calcium antagonist lercanidipine and its enantiomers affect major processes of atherogenesis in vitro: is calcium entry involved?

Atherosclerosis results from multiple factors and involves several mechanisms, including endothelial monocyte and smooth muscle cell (SMC) changes, cholesterol accumulation, plaque rupture and thromboembolism. Calcium ions play a role in the initial and chronic development of atherosclerotic lesions. Several studies in experimental animal models have demonstrated the potential direct antiatherosclerotic effects of calcium antagonists.

Lercanidipine: short plasma half-life, long duration of action and high cholesterol tolerance. Updated molecular model to rationalize its pharmacokinetic properties.

Calcium-channel antagonist drugs of the 1,4-dihydropyridine type have been shown to bind to the L-type calcium channel. These drugs are not only amphiphilic, but new molecular designs have become increasingly lipophilic and can readily transport across cell membranes, accessing both hydrophilic and hydrophobic environments, despite becoming more soluble in the membrane bilayer. This biophysical understanding appears not only to define the molecular pathways for drug binding to the calcium-channel receptor, but also to explain differences in the overall clinical pharmacokinetics observed for different drugs in this class.

Effect of the new calcium antagonist lercanidipine and its enantiomers on the migration and proliferation of arterial myocytes.

The in vitro effects were investigated of the new dihydropyridine calcium antagonist (CA) lercanidipine and its enantiomers on arterial myocyte (smooth muscle cell; SMC) migration and proliferation as related to L-type calcium channel inhibition. Lercanidipine and its enantiomers inhibited the replication and migration of arterial myocytes in concentration ranging from 10 to 50 microM. The antiproliferative effect of lercanidipine, evaluated as cell number, was dose dependent, with a potency similar to that of lacidipine and nifedipine, and was unrelated to the stereoselectivity of enantiomers to bind L-type calcium channels.

Functional antagonistic activity of Rec 15/2739, a novel alpha-1 antagonist selective for the lower urinary tract, on noradrenaline-induced contraction of human prostate and mesenteric artery.

The aim of this study was to compare with known reference standards the functional in vitro alpha-1 antagonistic activity of Rec 15/2739 on noradrenaline-induced contractions of human prostate and mesenteric artery. We also characterized these tissues with regard to the alpha-1 adrenoceptor subtypes present. Comparing the apparent pKB values revealed Rec 15/2739 to be one of the most potent compounds action on the prostate.

A double-blind clinical trial of fenticonazole (2%) spray versus naftifine (1%) spray in patients with cutaneous mycoses.

A multi-centre, double-blind trial was carried out in 100 patients with cutaneous mycotic infections, confirmed by direct microscopy and/or culture, to compare the efficacy and tolerability of spray formulations of 2% fenticonazole and 1% naftifine. On entry, patients were allocated at random to receive once daily topical applications of one or other drug over a period of 2 to 4 weeks, treatment being stopped when patients had recovered or substantially improved. Clinical and mycological assessments were made before (baseline), at weekly intervals during treatment and, if possible, 2 to 3 weeks after the end of treatment (drug-free period).

Fenticonazole tissue levels after the application of 3 different dosage forms of vaginal ovules.

Fenticonazole vaginal ovules of 200 mg, 600 mg and 1,000 mg were administered to 42 women prior to gynecological surgery. Tissue concentrations in the vaginal mucosa were determined after 3 h and 12 h in biopsy specimens taken from the same position in the posterior fornix. Tissue concentrations were higher at 3 h in comparison to 12 h with all 3 doses.