IntroductionBreast cancer is a major health problem worldwide and the second most common cause of cancer-related deaths in women. Although population screening by mammography can ensure early detection of breast cancer and the rapid development of therapeutic options (i.e. surgery, radiotherapy, hormonal therapy, chemotherapy, more recently, targeted cancer drugs) provides the possibility of multidisciplinary treatment, the morbidity of breast cancer is still high [1]. Trends in mortality and morbidity did not show a decline in the United States between 2005 and 2009 [2]. Similarly, age-standardised incidence rates for breast cancer in females in Great Britain did not decrease in the past 7 to 8 years [3]. Long-term followup studies showed that the probability of relapse ranges from 30 to 85% depending on tumour stage [4] AbstractThere is increasing evidence that the heavy isotope of hydrogen, deuterium (D), has a pivotal role in cell signalling and that its depletion through the replacement of normal drinking water with deuterium-depleted water (DDW) results in tumour necrosis. The impact of D-depletion on breast cancer outcome was studied retrospectively. The normal daily water intake (150 ppm D) of 232 breast cancer patients was replaced with DDW (65-105 ppm D) for at least 91 days, without altering conventional treatment regimens. According to staging at initial diagnosis, patients with early stage breast cancer (n158) achieved a median survival time (MST) of 217 months (18.1 years), compared with 52 months (4.3 years) in patients with advanced disease (n74). The MST is pending in the subgroup of patients who were in remission at the start of DDW treatment; only one out of 48 patients died during the cumulative follow-up period of 221.1 years. Although single DDW treatment was effective, an outstandingly long MST of 24.4 years was attained in the subgroup of 53 patients who were treated with DDW at least twice. In comparison with published data, DDW treatment in combination with or as an extension of conventional therapies noticeably prolonged MST in certain subgroups of breast cancer patients. D-depletion may also be a highly effective therapy for preventing the recurrence of breast cancer. Furthermore, the method is safe and can be easily integrated into standard treatment regimens for breast cancer.Keywords: deuterium depletion; deuterium-depleted water; breast cancer; retrospective study; median survival time; early stage breast cancer; advanced disease and the goal in such cases is to maintain quality of life, ameliorate symptoms, and delay progression [5].A wide range of information is available regarding the differences in physicochemical properties of deuterium (D) and protium (H), the two stable isotopes of hydrogen Open AccessNobleResearch www.nobleresearch.org
(1) Introduction: Negative pressure wound therapy (NPWT) is a frequently applied open abdomen (OA) treatment. There are only a few experimental data supporting this method and describing the optimal settings and pressure distribution in the abdominal cavity during this procedure. The aim of our study was to evaluate pressure values at different points in the abdominal cavity during NPWT in experimental abdominal compartment syndrome (ACS) animal model; (2) Methods: In this study (permission Nr. 13/2014/UDCAW), 27 Hungahib pigs (15.4–20.2 kg) were operated on. ACS was generated by implanting a plastic bag in the abdomen through mini-laparotomy and filled with 2100–3300 mL saline solution (37 °C) to an intraabdominal pressure (IAP) of 30 mmHg. After 3 h, NPWT (Vivano Med® Abdominal Kit, Paul Hartmann AG, Germany) or a Bogota bag was applied. The NPWT group was divided into −50, −100 and −150 mmHg suction groups. Pressure distribution to the abdominal cavity was monitored at 6 different points of the abdomen via a multichannel pressure monitoring system; (3) Results: The absolute pressure levels were significantly higher above than below the protective layer. The values of the pressure were similar in the midline and laterally. Amongst the bowels, the pressure values changed periodically between 0 and −12 mmHg which might be caused by peristaltic movements; (4) Conclusions: The porcine model of the present study seems to be well applicable for investigating ACS and NPWT. It was possible to provide valuable information for clinicians. The pressure was well distributed by the protective layer to the lateral parts of the abdomen and this phenomenon did not change considerably during the therapy.
ACS resulted in impairment of macro- and micro-rheological parameters and abdominal organs' microcirculation. All of the used techniques improved the results, however, applying Bogota-bag or -150 mmHg vacuum set showed worse microcirculatory and micro-rheological data than the settings at -100 or -50 mmHg.
25or Bogota bag was applied. NPWT group was divided into -50, -100 and 150 mmHg suction group. 26Pressure distribution to the abdominal cavity was monitored at 6 different points of the abdomen via
A súlyos akut pancreatitis késői szövődménye a demarkált necrosis, amely valamilyen intervenciós kezelést igényel. Jelen közlemény célja a különböző kezelési módok indikációinak, technikai kérdéseinek, korlátainak elemzése. A sú-lyos akut pancreatitis kezdetétől 4-6 hét kell ahhoz, hogy a demarkált necrosis kialakuljon. A necrectomiát ez után javasolt tervezni. A transluminalis endoszkópos necrectomia a gyomor és a nyombél mögött elhelyezkedő demarkált necrosisok esetén kecsegtet jó eredménnyel. A kiterjedt hasnyálmirigy-elhalások kezelésére napjainkban is a sebészi kezelés a leggyakrabban alkalmazott eljárás. A nyitott necrectomia a ligamentum gastrocolicumon vagy a mesocolonon keresztül végezhető, amelyet nyitott vagy zárt bursaomentalis-öblítéssel vagy -tamponálással lehet kiegészíteni. A másik alternatíva a transgastricus necrosectomia, amely nem igényel külső drenázskezelést. Mindkét sebészi kezelést lehet laparoszkóp segítségével végezni. Emellett lokalizált necrosisok esetén egyéb minimálisan invazív módsze-rek is alkalmazhatók. A demarkált necrosisok kezelésében a különböző sebészi kezelések mellett a transluminalis endoszkópos és a minimálisan invazív sebészi módszerek jó eredménnyel alkalmazhatók. Orv. Hetil., 2016, 157(47), 1866-1870. Kulcsszavak: demarkált necrosis, sebészet, endoluminalis endoszkópos necrectomiaThe treatment of walled-off pancreatic necrosis ReviewWalled-off pancreatic necrosis is a late complication of severe acute pancreatitis that generally needs some interventions. The aim of this review is to analyse the indications, technical aspects and limits of these therapeutic options. The development of the walled-off pancreatic necrosis needs 4-6 weeks from the onset of the disease. The necrosectomy is recommended after this time. Endoscopic necrosectomy offers good results if the necrosis is in retrogastric or retroduodenal localisations. Open necrosectomy can be performed through the gastrocolic ligament or the mesocolon. It is suggested to complete necrosectomy with open or closed omental bursa drainage or packing. The transgastric necrosectomy does not need external drainage. Surgical procedures can be performed with laparoscopy either. In localized necrosis other minimal invasive approaches can be used. Conclusions: In addition to the transluminal endoscopic or minimal invasive necrosectomies different types of surgical procedures has an important role in the treatment of walled-off pancreatic necrosis.Keywords: walled-off pancreatic necrosis, surgical treatment, endoluminal endoscopic necrectomy Szentkereszty, Zs., Balog, K., Balázs, L., Csiszkó, A. [The treatment of walled-off pancreatic necrosis. Review]. Orv. Hetil., 2016, 157(47) Rövidítések endo-VAC = endoscopic vacuum-assisted closure; MOF = multiple organ failure; SAP = severe acute pancreatitis; WOPN = walled-off pancreatic necrosis A walled-off pancreatic necrosis (WOPN) egy fallal kö-rülvett, környezetétől elhatárolt, folyadékot és/vagy gennyet, necroticus pancreast és peripancreaticus zsírt tartalmazó üreg. A módosítot...
Background Breast cancer is the leading cancer in women globally. Despite decreasing mortality rates, largely due to early detection and modern treatment, the effectiveness of screening on long-term survival outcomes remains unclear. Aims This study evaluates the 15-year survival outcomes of a national breast cancer screening program initiated in Hungary in 2002. Methods Using a prospectively maintained patient database, the study included individuals from the first 6 years of the program who underwent surgery for histologically confirmed breast cancer and had available follow-up information. Patients were categorized based on the method of breast cancer detection into two groups: those diagnosed during or 2 years after the population-based screening exam (Group A), and those who self-detected or sought medical attention for symptoms (Group B). Results Of the 309 patients who underwent breast cancer surgery, 208 were screen-detected (Group A) and 101 were symptomatic (Group B). The 15-year overall survival was 75.0% for Group A and 76.2% for Group B (p = 0.927). The 15-year disease-specific survival was 85.6% and 81.2% (p = 0.249), respectively. A statistically not significant positive trend in disease-free survival was observed in Group A (81.7% vs. 75.2%; p = 0.144). Conclusions The study underscores the importance of extended follow-up periods in evaluating the outcomes of breast cancer screening programs. While the screening program may not significantly enhance overall survival rates, it has demonstrated a reduction in the mastectomy rate and could potentially extend periods of disease-free survival. These findings contribute to the ongoing discourse about the long-term benefits of breast cancer screening programs.
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