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Patient perspective: Is intensive screening of women at high risk of breast cancer evidence-based medicine or ?
Womens Health (Lond)
January 2025
Department of Pharmacy Practice, Midwestern University College of Pharmacy, Glendale Campus, Glendale, AZ, USA.
In 2023, a breast cancer risk assessment and a subsequent positive test for the BRCA-2 genetic mutation brought me to the uncomfortable intersection of a longstanding career as an advocate for high-quality medical evidence to support shared patient-provider decision making and a new role as a high-risk patient. My search for studies of available risk-management options revealed that the most commonly recommended approach for women with a ⩾20% lifetime breast cancer risk, intensive screening including annual mammography and/or magnetic resonance imaging beginning at age 25-40 years, was supported only by cancer-detection statistics, with almost no evidence on patient-centered outcomes-mortality, physical and psychological morbidity, or quality of life-compared with standard screening or a surgical alternative, bilateral risk-reducing mastectomy. In this commentary, I explore parallels between the use of the intensive screening protocol and another longstanding women's health recommendation based on limited evidence, the use of hormone therapy (HT) for postmenopausal chronic disease prevention, which was sharply curtailed after the publication of the groundbreaking Women's Health Initiative trial in 2002.
View Article and Find Full Text PDFSuccessful treatment of a C2 aneurysmal bone cyst with hydroxyapatite and calcium sulfate synthetic bone void filler injection: a case report.
J Spine Surg
December 2024
Department of Neurosurgery, The Gemelli University Hospital, Rome, Italy.
Background: Aneurysmal bone cysts (ABCs) are benign, blood-filled neoplasms causing bone destruction, often requiring resection. However, challenges arise, especially at the cranio-cervical junction, where proximity to critical structures limits removal. Non-surgical options include selective arterial embolization (SAE) as main treatment, while Denosumab and centrifugated bone marrow emerge as experimental alternatives.
View Article and Find Full Text PDFInvestigation of unfavorable prognostic factors for survival in Chinese patients with gastric gastrointestinal stromal tumors.
Transl Cancer Res
December 2024
Key Laboratory of Tropical Translational Medicine of Ministry of Education, the First Affiliated Hospital, Hainan Medical University, Haikou, China.
Background: Gastrointestinal stromal tumor (GIST) was very rare in the gastrointestinal (GI) tract. Most GISTs were asymptomatic at early stage. Therefore, it was of great significance to explore the prognostic factors of patients with GIST.
View Article and Find Full Text PDFUnraveling the uncommon: Pneumoperitoneum induced by emphysematous pyelonephritis.
Radiol Case Rep
March 2025
Emergency Radiology Department, Ibn Sina University Hospital, Faculty of Medicine and Pharmacy of Rabat, Mohamed V University, Rabat, Morocco.
Emphysematous pyelonephritis is a necrotizing infection of the renal parenchyma by gas-forming organisms, with a risk of the gas extending into peri-nephric or para-renal spaces and in advanced cases, the involvement may be extensive and bilateral. It is a common complication in patients with long-term diabetes, primarily caused by Gram-negative organisms or, in some cases, anaerobes. The diagnosis of emphysematous pyelonephritis is made by clinical features and confirmed by computed tomography.
View Article and Find Full Text PDFA case of emergency stent graft placement for subclavian artery injury during ventriculoperitoneal shunt placement.
Radiol Case Rep
March 2025
Department of Diagnostic and Interventional Radiology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki, Kanagawa 216-8511, Japan.
With advancements in medical devices and imaging techniques, endovascular treatment using stent grafts has emerged as a viable and aggressive therapeutic option for traumatic subclavian artery injuries, including iatrogenic cases. Existing literature suggests that endovascular treatment is less invasive and offers hemostatic success rates comparable to traditional surgical methods. However, there is a paucity of case reports, necessitating further investigation into treatment indications and procedural challenges.
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