Background: Patient reported outcomes (PROs) are an important addition to oncologic breast surgical care. The majority of BREAST-Q PRO literature has been focused on mastectomy with reconstruction (MR), with a paucity of information on more common surgical approaches in practice namely, breast conserving therapy (BCT) and mastectomy (M). This information will help inform patients around decision-making regarding surgical options.
Methods: 837 women underwent surgery between 2010 and 2012, and were later invited to complete the postoperative BREAST-Q module specific to their most recent surgery. Multivariate analysis was performed to compare BREAST-Q subscale scores between each of the three surgical cohorts.
Results: 257 women participated (161 BCT, 84 M, 12 MR). Patients undergoing BCT reported scores in the satisfaction with breasts domain 8 points higher than those undergoing mastectomy (p = 0.046). BCT also reported higher scores than mastectomy in the areas of psychosocial well being (12 points higher) as well as sexual well-being (17 points higher) (p = 0.0006).
Conclusions: BCT appears superior to mastectomy in terms of satisfaction with breasts, sexual well-being and now psychosocial well-being. Overall, BCT is associated with excellent patient reported outcomes.
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http://dx.doi.org/10.1016/j.amjsurg.2019.04.006 | DOI Listing |
Background: Traumatic anterior shoulder dislocation is the most common type of joint dislocation, with an incidence of 11 to 29 per 100 000 persons per year. Controversy still surrounds the recommendations for treatment and the available procedures for surgical stabilization.
Methods: This review is based on pertinent publications (2014-2024) that were retrieved by a selective search in the PubMed and Google Scholar databases.
AIDS Patient Care STDS
January 2025
Department of Obstetrics, Gynecology & Reproductive Sciences, University of California San Francisco, Oakland, California, USA.
Community health workers (CHWs) play a significant role in supporting health services delivery in communities with few trained health care providers. There has been limited research on ways to optimize the role of CHWs in HIV prevention service delivery. This study explored CHWs' experiences with offering HIV prevention services [HIV testing and HIV pre- and post-exposure prophylaxis (PrEP and PEP)] during three pilot studies in rural communities in Kenya and Uganda, which aimed to increase biomedical HIV prevention coverage via a structured patient-centered HIV prevention delivery model.
View Article and Find Full Text PDFJAMA Netw Open
January 2025
Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
Importance: During buprenorphine treatment for opioid use disorder (OUD), risk factors for opioid relapse or treatment dropout include comorbid substance use disorder, anxiety, or residual opioid craving. There is a need for a well-powered trial to evaluate virtually delivered groups, including both mindfulness and evidence-based approaches, to address these comorbidities during buprenorphine treatment.
Objective: To compare the effects of the Mindful Recovery Opioid Use Disorder Care Continuum (M-ROCC) vs active control among adults receiving buprenorphine for OUD.
JAMA Netw Open
January 2025
Department of Surgery, University of Washington, Seattle.
Importance: Timely access to care is a key metric for health care systems and is particularly important in conditions that acutely worsen with delays in care, including surgical emergencies. However, the association between travel time to emergency care and risk for complex presentation is poorly understood.
Objective: To evaluate the impact of travel time on disease complexity at presentation among people with emergency general surgery conditions and to evaluate whether travel time was associated with clinical outcomes and measures of increased health resource utilization.
JAMA Netw Open
January 2025
Institute of Medical Science, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
Importance: Secondary lymphedema is a common, harmful side effect of breast cancer treatment. Robust risk models that are externally validated are needed to facilitate clinical translation. A published risk model used 5 accessible clinical factors to predict the development of breast cancer-related lymphedema; this model included a patient's mammographic breast density as a novel predictive factor.
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