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Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the impact of nociceptive level (NOL) index on cellular immunity and HIF-1α in patients with radical breast cancer. Methods A total of 80 patients undergoing radical mastectomy between December 2022 and December 2023 were randomly assigned into an experimental group and a control group using a random number table method. The NOL index in the experimental group was maintained within the range of 30 to 50, with corresponding adjustments made to achieve the target concentration of remifentanil. In contrast, the control group initially received remifentanil at a target controlled infusion rate of 4 ng/mL, which was adjusted based on hemodynamics. The average target concentration of remifentanil was recorded for both groups. Venous blood samples were collected from all participants one day before and one day after surgery to measure CD4+, CD8+ cell counts, NK cell activity, as well as serum levels of HIF-1α. Results There were no significant differences observed in anesthesia time, operation time, intraoperative mean arterial pressure (MAP), heart rate (HR), and postoperative visual analog scale (VAS) scores between the two groups. The average target concentration of remifentanil in the experimental group was significantly lower than that in the control group (P < 0.05). Moreover, the experimental group exhibited higher values of CD4+, CD4+/CD8+ ratio, and NK cells compared to the control group, while demonstrating a lower level of HIF-1α expression (P < 0.05). In addition, within the experimental group, there was a decrease in CD4+ count and CD4+/CD8+ ratio one day after surgery compared to one day before surgery; meanwhile, HIF-1α expression increased significantly after surgery when compared to preoperative levels (P < 0.05). Similarly, within the control group, there was a decrease observed in CD4+, CD8+, CD4+/CD8+ ratio as well as NK cell values one day after surgery when compared to preoperative levels; additionally, HIF-1α expression showed a significant increase after surgery when compared to preoperative levels (P < 0.05). Conclusion The implementation of NOL monitoring during radical mastectomy under general anesthesia can effectively lower the required remifentanil concentration, thereby mitigating its suppressive effects on T lymphocytes, preserving NK cell activity, and reducing elevated levels of HIF-1α. Consequently, this approach exerts minimal impact on the tumor immune microenvironment (TIME) in patients. [ABSTRACT FROM AUTHOR]

This study aims to compare the anesthetic effects of remimazolam tosilate and propofol in patients undergoing radical mastectomy. The study group received remimazolam tosilate in combination with sufentanil and cisatracurium besilate for anesthesia induction, while the control group received propofol with sufentanil and cisatracurium besilate. In the study group, the eyelash reflex disappearance time was longer and the recovery time was shorter compared to the control group (p < 0.05). No significant differences were observed in Post-Anesthesia Care Unit (PACU) retention time and Visual Analogue Scale (VAS) scores at 24 hours post-operation between the groups (p > 0.05). Furthermore, the study group exhibited a lower decrease in Mean Arterial Pressure (MAP) at 1, 3 and 5 minutes after anesthesia induction (p<0.05). After losing consciousness, there was no statistically significant difference in HR decrease between both groups (p > 0.05). The study group also had higher respiratory rate (RR) and Tidal volume (VT) levels, with a lower incidence of apnea compared to the control group (p < 0.05). Thirty minutes before anesthesia, no significant differences were found in the five indicators between the groups (p>0.05). At 24 hours post-operation, the study group showed higher Cluster of Differentiation 3+ (CD3+), CD4+, natural killer (NK) cell levels and CD4+/CD8+ ratios compared to the control group (p < 0.05). However, at 72 hours post-operation, no statistically significant differences were observed in these five indicators between the groups (p > 0.05). Compared with propofol, remimazolam tosilate achieves rapid sedation, maintains adequate sedation, and reduces suppression of the respiratory and circulatory systems. [ABSTRACT FROM AUTHOR]

Surgical site infections (SSIs) following radical mastectomy in breast cancer patients can significantly affect patient recovery and healthcare resources. Identifying and understanding the risk factors for postoperative wound infections (PWIs) are crucial for improving surgical outcomes. This retrospective study was conducted from June 2020 to June 2023, including 23 breast cancer patients who developed PWIs post‐radical mastectomy and a control group of 46 patients without such infections. Comprehensive patient data, including variables such as intraoperative blood loss, hospital stay duration, body mass index (BMI), operation time, anaemia, drainage time, diabetes mellitus, cancer stage, white blood cell (WBC) count, serum albumin levels and preoperative neoadjuvant chemotherapy, were meticulously gathered. Statistical analyses, including univariate and multivariate logistic regression, were performed using SPSS software (Version 27.0). The univariate analysis identified several factors significantly associated with an increased risk of PWIs, including preoperative neoadjuvant chemotherapy, low serum albumin levels, advanced cancer stage, diabetes mellitus and reduced WBC count. Multivariate logistic regression highlighted anaemia, prolonged drainage time, diabetes mellitus, advanced cancer stage, reduced WBC count, hypoalbuminemia and preoperative neoadjuvant chemotherapy as significant contributors to the increased risk of PWIs. Anaemia, extended drainage time, diabetes mellitus, advanced cancer stage, low WBC count, hypoalbuminemia and preoperative neoadjuvant chemotherapy are key risk factors for SSIs post‐radical mastectomy. Early identification and proactive management of these factors are imperative to reduce the incidence of postoperative infections and enhance recovery outcomes in breast cancer patients. [ABSTRACT FROM AUTHOR]

The article provides an overview of the ConSIBreC randomized controlled trial, which aims to evaluate the effectiveness of conserving surgery in patients with inflammatory breast cancer (IBC) who have achieved a clinical complete response after neoadjuvant chemotherapy. IBC is a rare and aggressive subtype of breast cancer, and the standard treatment is radical mastectomy. However, with the increasing rate of complete response to chemotherapy, there is a question of whether breast conserving surgery could be a viable option. The trial will involve 329 patients per arm and will assess local recurrence rates, survival rates, and other outcomes. The study is expected to offer valuable evidence on the potential of conserving surgery in IBC patients. [Extracted from the article]

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Emergency agitation is a common postoperative complication in patients under general anesthesia, which can lead to unpredictable damages such as shedding of drainage tube and bleeding from the wound. The purpose of the study is to investigate whether intraoperative infusion of Magnesium Sulfate reduces the incidence of emergency agitation (EA) in patients undergoing radical mastectomy, and to evaluate its safety and efficacy. Methods: A total of 70 patients were randomly assigned to two groups: the Magnesium group (M group) and the control group (C group). After a routine intravenous anesthetic induction, patients in the M group received a 30 mg/kg bolus of intravenous magnesium during the first hour and then a continuous infusion of 10 mg/kg ×h until the end of the surgery, patients in the C group received 0.9% saline at the same volume and rate. The sedation-agitation scale (SAS) and the visual analogue scale were used to assess agitation and pain, respectively. Results: Compared to the C group, the M group reduced the incidence of EA significantly (odds ratio 0.26, 95% confidence interval 0.09–0.71, P = 0.009). The postoperative pain score of the magnesium sulfate group(0(0,1)) was lower than that of the control group(2(0,3)) at T0 (P = 0.011). Additionally, the M group required a lower dosage of remifentanil during surgery compared to the C group(300.4 ± 84 versus 559.3 ± 184 µg, respectively, P<0.001). Conclusions: the intraoperative infusion of magnesium sulfate is a safe and effective method for reducing the incidence of emergency agitation in patients undergoing radical mastectomy. Trail registration: The study was registered in Chictr.org with the identifier: ChiCTR2300070595 on 18/04/2023. [ABSTRACT FROM AUTHOR]

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Medical Equipment Journal is the property of Chinese Medical Equipment Journal Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

OBJECTIVE: To investigate clinical utility of a new immobilization method in image-guided intensity-modulated radiotherapy (IMRT) for breast cancer patients after radical mastectomy. MATERIALS AND METHODS: Forty patients with breast cancer who underwent radical mastectomy and postoperative IMRT were prospectively enrolled. The patients were randomly and equally divided into two groups using both a carbon-fiber support board and a hollowed-out cervicothoracic thermoplastic mask (Group A) and using only the board (Group B). An iSCOUT image-guided system was used for acquiring and correcting pretreatment setup errors for each treatment fraction. Initial setup errors and residual errors were obtained by aligning iSCOUT images with digitally reconstructed radiograph (DRR) images generated from planning CT. Totally 600 initial and residual errors were compared and analyzed between two groups, and the planning target volume (PTV) margins before and after the image-guided correction were calculated. RESULTS: The initial setup errors of Group A and Group B were (3.14±3.07), (2.21±1.92), (2.45±1.92) mm and (3.14±2.97), (2.94±3.35), (2.80±2.47) mm in the left-right (LAT), superior-inferior (LONG), anterior-posterior (VERT) directions, respectively. The initial errors in Group A were smaller than those in Group B in the LONG direction (P < 0.05). No significant difference was found in the distribution of three initial error ranges (≤3 mm, 3–5 mm and > 5 mm) in each of the three translational directions for the two groups (P > 0.05). The residual errors of Group A and Group B were (1.74±1.03), (1.62±0.92), (1.66±0.91) mm and (1.70±0.97), (1.68±1.18), (1.58±0.98) mm in the three translational directions, respectively. No significant difference was found in the residual errors between two groups (P > 0.05). With the image-guided correction, PTV margins were reduced from 8.01, 5.44, 5.45 mm to 3.54, 2.99, 2.89 mm in three translational directions of Group A, respectively, and from 8.14, 10.89, 6.29 mm to 2.67, 3.64, 2.74 mm in those of Group B, respectively. CONCLUSION: The use of hollowed-out cervicothoracic thermoplastic masks combined with a carbon-fiber support board showed better inter-fraction immobilization than the single use of the board in reducing longitudinal setup errors for breast cancer patients after radical mastectomy during IMRT treatment course, which has potential to reduce setup errors and improve the pretreatment immobilization accuracy for breast cancer IMRT after radical mastectomy. [ABSTRACT FROM AUTHOR]

Keywords: Erector spinae plane block; Dexmedetomidine; Postoperative analgesia; Radical mastectomy EN Erector spinae plane block Dexmedetomidine Postoperative analgesia Radical mastectomy 731 734 4 05/16/22 20220601 NES 220601 This letter to the editor refers to article available at https://doi.org/10.1007/s40122-020-00234-9. Erector spinae plane block, Dexmedetomidine, Postoperative analgesia, Radical mastectomy. [Extracted from the article]

Background and Purpose: The low rate of internal mammary node (IMN) recurrence was attributed to systemic therapy and internal mammary chain (IMC) coverage by the tangential fields of irradiation. This study aimed to evaluate the incidental irradiation dose to the IMC in breast cancer patients after surgery and to estimate the clinical predictive parameters affecting the magnitude of the IMC. Materials and Methods: A total of 138 patients treated with postmastectomy radiotherapy and 210 patients undergoing radiotherapy after breast-conserving surgery (BCS) in our hospital were retrospectively analyzed. The mean dose (Dmean) to the IMC and the first to third intercostal spaces of IMC levels (ICS1–3) were evaluated. We evaluated the IMC coverage according to the type of surgery and whether the ipsilateral supraclavicular fossa (SCF) was included in the irradiation field. Results: The incidental radiation dose to the IMC was 29.69 Gy, and the dose delivered to the IMC, ICS1, and ICS2 showed a greater coverage in the modified radical mastectomy (MRM) group when compared with the BCS group (32.85 vs. 27.1 Gy, 26.6 vs. 12.5 Gy, 34.63 vs. 30.42 Gy). The dose delivered to ICS3 showed no difference between the MRM and BCS groups (37.41 vs. 36.24 Gy). Furthermore, 131 patients (37.64%) received radiotherapy to the chest wall and ipsilateral SCF. In the univariate analysis, both surgery type and SCF irradiation were parameters affecting the Dmean of incidental radiation to the IMC (r = −0.179, P = 0.001; r = −0.175, P = 0.001). In the multivariate analysis, surgery type was the only correlative factor that affected incidental radiation dose to the IMC (r = –3.534, P = 0.000). Conclusion: The real influencing factor of incidental dose to the IMC was the surgery form rather than the accession of SCF irradiation. [ABSTRACT FROM AUTHOR]

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: The primary goal of modified radical mastectomy is to remove cancerous cells and reduce the risk of breast cancer spreading. This operation is associated with considerable acute postoperative pain and restricted shoulder movement. If this acute pain is neglected most patients will develop chronic post-mastectomy pain, which reduces the quality of life. Regional anesthesia using ultrasound-guided paravertebral nerve block or pectoral nerve block has become an ideal addition to general anesthesia for providing analgesia after breast cancer surgery. This was a randomized clinical trial conducted between February 2018 and February 2019. This study compared between the two nerve blocks regarding the efficacy in terms of analgesic consumption. Results: The study included 30 female patients who were undergoing modified radical mastectomy under general anesthesia and randomly divided into 2 groups of 15 patients in each. This study showed there was a statistically significant increase in the amount of total fentanyl used intraoperatively in TPVB group than PECs group with p value = 0.008. Less VAS score in PECS group with statistically significant difference between groups at 4 h, 5 h, 6 h, and 8 h. More time needed for 1st requested rescue analgesia in PECS group with P value = 0.013. Patients in PECS group received a less total dose of fentanyl in the first 24 h postoperative with P value = 0.040. There was no statistically significant difference found between groups regarding postoperative complications. Conclusions: In female patients undergoing breast surgeries, the PECs block can be used efficiently and safely, providing better pain relief than the TPVB and reducing intraoperative and postoperative opioids use. [ABSTRACT FROM AUTHOR]

Breast cancer is the most common cancer in women and the most common cause of death in working-age women. According to the results of immunohistochemical studies, 10-20% of cases revealed a triple-negative type of breast cancer. This subtype is characterized by significant proliferative activity and growth rate, aggressive clinical course, and early metastasis. This leads to a suspicious prognosis and, accordingly, encourages an increase of surgical treatment radicalism and aggressive systemic treatment. This review briefly analyzes existing treatment strategies for triple-negative breast cancer with a focus on surgical treatment. Surgical treatment is an integral part of complex therapy. Currently, the attention of researchers is focused not only on the radicalism of the operation, ensuring long-term survival, but also on achieving a good cosmetic result that determines the quality of life of patients. In this aspect, organ-preserving and prosthetic methods of operations are promising, the feasibility and effectiveness of which are being discussed. The relevance of choosing the optimal method of operation is evidenced by the lack of generally accepted approaches based on informative markers for the prognosis of the course of the disease. Therefore, the choice of the optimal method of surgical treatment taking into account the individual characteristics of the patient and the tumor, indications for chemotherapy, and radiation therapy remains an unresolved issue and requires further research. [ABSTRACT FROM AUTHOR]

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Female dogs, especially intact or neutered lately, are at increased risk for reproductive disorders including mammary tumors (MTs). This retrospective study evaluated the prevalence of reproductive pathology and associated mortality in a cohort of female dogs presented at a single veterinary clinic. The medical records of female dogs born in 2000-2003 were reviewed. The study included 599 cases, of which 293 were followed up until death. Causes of death were analyzed according to the spaying status. Among the 599 female dogs, 306 were intact (51%), 50 (8%) had been spayed before 2 years of age (ES, early spaying), and 243 (41%) after 2 years (LS, late spaying). During their lifetime, 79 dogs (13.2%) developed pyometra, and 160 (26.7%) a mammary tumor. Among the 293 dogs with complete follow-up, 103 (35.1%) had at least one MT during their lifetime, of which 53 (51.5%) died of their mammary cancer. Spayed (ES + LS) female dogs had a 4-fold decreased risk of dying from mammary cancer (OR = 0.23, 95% CI 0.11-0.47, p < 0.0001) compared to intact females. In this low-sterilization rate population, MTs developed in 35.1% of female dogs over their lifetime and was the cause of death in half of them. [ABSTRACT FROM AUTHOR]

Copyright of Progress in Modern Biomedicine is the property of Publishing House of Progress in Modern Biomedicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. Breast cancer related upper limb lymphedema (BCRL) is a common complication in post-mastectomy patients. It is known to cause upper limb disability, which subsequently may affect the grip strength and hand function. There is little evidence on the objective assessment of functional activities particularly hand function in women with BCRL. Therefore, this study objectively assesses the handgrip strength and hand functions in women with BCRL. Method. A cross-sectional study design was conducted on a sample of women with (nD31) and without (nD31) BCRL. The Handgrip strength and hand functions were measured using a dynamometer and Jebsen-Taylor hand function test, respectively. Results. The results showed a significantly reduced handgrip strength in women with BCRL as compared to age-matched healthy adult women for both right and left hands (p<0:05). Similarly, hand functions were significantly impaired in women with BCRL as compared to healthy adult women (p < 0:05). Reduction in handgrip strength and hand function in women with BCRL were clinically meaningful as indicated by moderate to large effect sizes (Cohen's d D 0.61 to 0.99 and 0.54 to 3.02, respectively) in all outcomes except power handgrip strength in left hand (Cohen's d D 0.38). Conclusion. The results of this study indicate a significant reduction of hand grip strength and hand function in women with BCRL. Our findings suggest that objective measures of grip strength and function be included in the assessment of women with BCRL to better guide clinical decision making and patient care, which may include management of impairment associated with hand strength and function. Future studies that evaluate hand grip strength and function in a larger sample which includes a more diverse age group of women with BCRL are warranted to confirm the current findings. [ABSTRACT FROM AUTHOR]

The five-year survival rate among breast cancer patients in Poland between 2010 and 2014 was 76.5%. It is approximately 10% lower than in Western Europe (United Kingdom 85.6%, Austria 84.8%, Germany 86%). The reason for this situation is complex. One of the factors is the fact that patients seek medical advice in very advanced stages of cancer, often requiring toilet mastectomy. We present the surgical treatment of five female advanced locoregional breast cancer patients admitted to the General, Vascular, and Oncological Surgery Department of the Multidisciplinary Hospital Warsaw-Międzylesie between 2017 and 2020. Two patients were treated with toilet mastectomy with skin flap transposition while three of them underwent a simple toilet mastectomy. We present the technical aspects of flap sliding to cover large skin defects after palliative breast resection. According to our observation the quality of life among these patients improved significantly, however, we have no evidence of extension of the length of life. In the most advanced breast cancer patients, toilet mastectomy is suitable even if this procedure requires skin flap transposition. We assess it as a recommended surgical treatment to improve the life quality of such patients, however, further research is required. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Clinical Nursing in Practice is the property of Journal of Clinical Nursing in Practice (Editorial Board, Shanghai Jiao Tong University Press) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The axillary lymph nodes are the primary group responsible for lymphatic drainage in the breast and, consequently, are the most common location for breast cancer metastasis. However, lymphatic pathways running from the breast, via intercostal spaces, to parasternal lymph vessels have also been identified. According to the American Joint Committee on Cancer eighth edition manual, regional lymph node metastasis normally travels to the ipsilateral axillary, supraclavicular, subclavicular, and internal mammary lymph nodes. The presence of intercostal metastasis is out the range of these regional lymph nodes. It is very rare for intercostal lymph nodes to be the extra-axillary site of metastasis in breast cancer, and it has been little reported on in the literature. Despite its rarity, it has the capacity to adversely affect the prognosis of breast cancer and drastically influence treatment choice. Here, we analyze such a case, with a patient receiving a radical mastectomy and metastatic intercostal lymph node dissection due to the presence of intercostal lymph node metastasis indicated via MRI. Furthermore, the potential application of preoperative 3-dimensional (3D) visualization and surgical planning is also discussed. [ABSTRACT FROM AUTHOR]