Objective: The aim of this study was to evaluate outcomes after breast-conserving surgery (BCS) and intraoperative radiotherapy (IORT), and to identify risk factors associated with complications.
Materials/methods: We evaluated patients with early-stage breast cancer treated from January 1, 2011 to January 31, 2014 with BCS and IORT at a single institution. The presence of breast cancer recurrences, complications, or fat necrosis were assessed at subsequent follow-up visits using physical examination and breast imaging.
Results: Overall, 113 patients, of whom three were undergoing bilateral treatments, were identified. The median length of time for IORT was 29 min and 36 s (range 15:50-59:00). Fifteen patients received additional external beam radiotherapy (EBRT), and the median follow-up was 40.3 months (range 1.6-58.3) for all patients. To date, one biopsy-proven ipsilateral recurrence has been noted (0.9%), for which the patient elected to undergo a mastectomy. Nine patients were found to have wound complications (7.7%) and two had fat necrosis (1.7%) on follow-up. Of all the evaluated risk factors, only applicator size (p < 0.01) had a statistically significant association with an increase in complications.
Conclusions: With a short follow-up, IORT appears to be a safe treatment modality for a select group of patients, leading to a reasonable increase in operating room time and complication rates following BCS. The utilization of larger applicators at the time of IORT was associated with an increase in wound complications and fat necrosis.
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http://dx.doi.org/10.1245/s10434-016-5679-0 | DOI Listing |
JAMA Neurol
December 2024
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Importance: Gestational hypertension, preeclampsia, and eclampsia are established risk factors for stroke and dementia later in life. Whether these pregnancy complications are associated with an increased risk of new-onset neurological disorders within months to years after giving birth is not known.
Objective: To explore whether gestational hypertension, preeclampsia, and eclampsia are associated with new-onset migraine, headache, epilepsy, sleep disorder, or mental fatigue within months to years after giving birth.
JAMA Netw Open
December 2024
Department of Behavioural Science and Health, Institute of Epidemiology and Health Care, University College London, London, United Kingdom.
Importance: Issues related to social connection are increasingly recognized as a global public health priority. However, there is a lack of a holistic understanding of social connection and its health impacts given that most empirical research focuses on a single or few individual concepts of social connection.
Objective: To explore patterns of social connection and their associations with health and well-being outcomes.
JAMA Netw Open
December 2024
Hypertension Laboratory, Cardiovascular Disease Center of Guangdong Province, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China.
Importance: Although cumulative evidence suggests that higher blood pressure (BP) and a greater burden of social determinants of health (SDOH) are associated with an increased risk of stroke, few studies have examined whether SDOH burden modifies the association between BP and stroke risk.
Objective: To evaluate whether the association between BP classification and stroke risk differs by SDOH burden among Chinese adults.
Design, Setting, And Participants: In this cohort study, analyses were conducted among 90 850 participants in the prospective subcohort of the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project, with recruitment from January 1, 2016, to December 31, 2020.
Graefes Arch Clin Exp Ophthalmol
December 2024
Department of Ophthalmology and Laboratory of Eye Research, Rabin Medical Center - Beilinson Hospital, Felsenstein Medical Research Center, 39 Jabotinski St., Petach Tikva, 49100, Israel.
Background: Diabetes poses a risk to diabetic keratopathy in up to two-thirds of patients. Insulin-degrading enzyme (IDE) is a protease that can break down insulin and several growth factors and may impair wound healing. Increased IDE levels have been found in fluid from diabetic skin ulcers.
View Article and Find Full Text PDFCardiol Ther
December 2024
Cardio-Oncology Program, Division of Cardiovascular Medicine, Department of Medicine, Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA, 01805, USA.
In addition to traditional risk factors, patients with breast cancer are at an increased risk of atrial fibrillation due to cancer itself and certain cancer therapies. Atrial fibrillation in these patients adds to their morbidity and mortality. The precise mechanisms leading to the increased atrial fibrillation in patients with breast cancer are not well understood.
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