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A Comparison of breast surgeon and Nomogram-Generated Risk Predictions of Sentinel and Non-Sentinel Node Metastases

Journal of Cancer Therapy 2013年第7期4卷 1-6页

作者： Luisa Sugaya Paulo R. de Alcantara Filho Bruna Salani Mota Sujata Patil Kimberly J. Van Zee José Luiz B. Bevilacqua breast Service Department of Surgery Memorial Sloan-Kettering Cancer Center New York USA Department of Epidemiology and Biostatistics Memorial Sloan-KetteringCancer Center New York USA Hospital Sirio-Libanes Sao Paulo Brazil

Memorial Sloan-Kettering Cancer Center (MSKCC) has developed 2 nomograms: the Sentinel Lymph Node Nomogram (SLNN), which is used to predict the likelihood of sentinel lymph node (SLN) metastases in patients with invasive breast cancer, and the Non-Sentinel Lymph Node Nomogram (NSLNN), which is used to predict the likelihood of residual axillary disease after a positive SLN biopsy. Our purpose was to compare the accuracy of MSKCC nomogram predictions with those made by breast surgeons. Two questionnaires were built with characteristics of two sets of 33 randomly selected patients from the MSKCC Sentinel Node Database. The first included only patients with invasive breast cancer, and the second included only patients with invasive breast cancer and positive SLN biopsy. 26 randomly selected Brazilian breast surgeons were asked about the probability of each patient in the first set having SLN metastases and each patient in the second set having additional non-SLN metastases. The predictions of the nomograms and breast surgeons were compared. There was no correlation between nomogram risk predictions and breast surgeon risk prediction estimates for either the SLNN or the NSLNN. The area under the receiver operating characteristics curves (AUCs) were 0.871 and 0.657 for SLNN and breast surgeons, respectively (p 0.0001), and 0.889 and 0.575 for the NSLNN and breast surgeons, respectively (p 0.0001). The nomograms were significantly more accurate as prediction tools than the risk predictions of breast surgeons in Brazil. This study demonstrates the potential utility of both nomograms in the decision-making process for patients with invasive breast cancer.

关键词： Sentinel Lymph Node Biopsy Nomogram Predictions breast Cancer Completion Axillary Lymph Node Dissection

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Urological Complications of Female Genital Mutilation: A Case Report of 15 Patients

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Open Journal of Urology 2024年第9期14卷 499-506页

作者： Mamadou Tidiani Coulibaly Issa Amadou Maimouna Traore Falaye Sissoko Dramane Cisse Urological surgeon at the Urology Department of CHU Gabriel Tour Bamako Mali

Objective background: This was a retrospective study of the clinical and therapeutic aspects of urological complications of female genital mutilation in the urology department of Bamako’s Gabriel Touré University Hospital. Methods: Our study took place from 2002 to 2017 in the urology department of the Gabriel Touré University Hospital in Bamako and concerned cases of complications of female genital mutilation. Our study included all girls or women presenting with urinary disorders related to complications of genital mutilation and received in urological consultation and surgical management. Results: The average age of our patients was 2.5 years, with extremes ranging from 3 months to 35 years. The oldest patient had presented with dystocia during both deliveries. Acute urine retention (n = 7) was the most frequent reason for consultation. Other signs included urinary incontinence, pollakiuria and burning. Physical examination revealed clitoridectomy and abrasion of the labia minora in 13 patients. Type III of the WHO classification of female genital mutilation was the most frequent and corresponded to infibulation.

关键词： Acute Retention of Urine Clitoridectomy Female Genital Mutilation

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Anatomical steps in the conceptualisation of the urethral ligament plication(ULP),a tape-free operation for stress urinary incontinence(SUI)cure

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Gynecology and Obstetrics Clinical Medicine 2024年第2期4卷 122-125页

作者： Peter Petros Retired Pelvic surgeon SydneyNew South WalesAustralia

INTRODUCTION It is not sufficient to describe an anatomical *** answer is required to the question,‘what is it for'.Salvador Gil-Vernet(1892-1987)was a famous Spanish anatomist and urologist and Nobel Prize *** anatomical structure in question is the role of the pubourethral ligament(PUL)in the cure of stress urinary incontinence(SUI).The 1990 Integral Theory,on which the tension-free vaginal tape(TVT)operation is based,described two separate closure mechanisms for the urethra,both reliant on the PUL,distally and at the bladder neck,with the bladder neck the most important.

关键词： urinary bladder operation

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Kiran Nandivada’s Stuck Blade in a Grinder Jar Degenerative Cascade by LSTV at L5-S1

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Open Journal of Orthopedics 2024年第1期14卷 12-21页

作者： Venkata Satya Kumar Kiran Nandivada Nadavinamani Shivanand Raghavendra Nandivada Nikhil Bharadwaja Moola Sohith Mahadeva Reddy Ahmed Usama Rizvi Nandivada Ortho Spine surgeon & Rheumatologist Abu Dhabi United Arab Emirates Senior Orthopedic surgeon & Rheumatologist Abu Dhabi United Arab Emirates General Practitioner Visakhapatnam India Department of Medicine Kamineni Institute of Medical Sciences Telangana India Department of Medicine Tbilisi State Medical University Tbilisi Georgia

Background: Mario Bertolotti, (1917) described LSTV-Lumbar spinal transitional vertebra as Bertolotti Syndrome a century ago and associated low back pain with it. Yet, it needs to be given significance in general orthopaedic practice even now, and radiologists underreport it. LSTV is a congenital anatomical anomaly that Castellvi classified into four varying types. Purpose: I titled this phenomenon “Kiran Nandivada’s stuck blade in a grinder jar degenerative cascade by LSTV at L5-S1” to clearly explain how an abnormal mega-transverse apophysis with its various variations affects the weight-bearing mechanics as the L5-S1 which is a vital junction where the maximum body weight is directed into both the sacroiliac joints and if a transitional vertebra occurs it becomes detrimental and abnormally redirects the load-bearing forces and leads to a progressive degenerative cascade both proximally and distally. As the L5 vertebral rotations and other movements of flexion, extensions, lateral flexion are stuck like a bent grinder blade, the other areas of the region are damaged progressively as the pelvis, just like the grinder motor tries to move it, resulting in overheating and maybe even a burnout results in the form of facet arthritis, disc degeneration in the normal disc above, the transitional disc at L5-S1, foraminal osteophytes causing radiculopathy, sacroiliac joint arthritis. Material and Methods: Around 200 X-rays of children and adults with this congenital anomaly have been studied between 2020 and 2023. This is a retrospective study. Results: 1) Our study showed an Increased incidence of LSTV at 15%. 2) Patients ranged from asymptomatic, atypical lumbago to classical lumbago with sciatica and claudication. Findings supported facet and sacroiliac joint arthritis and the pain, relieved with physiotherapy, posture corrections, weight reduction, and lifestyle precautions, negating the need for local steroid injections, radiofrequency ablation or surgical excision as

关键词： LSTV Bertolotti Syndrome Transitional Vertebra Facet Tropism Congenital Dysplasia

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Comparison of Surgical Techniques Used in Treating Acromioclavicular Dislocation in Patients Participating in Sports: A Systematic Review

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Open Journal of Orthopedics 2024年第1期14卷 41-52页

作者： Walter Hugo Brandão Nascimento Paulo Renan Matos Sucupira Cunha João Pedro Pimentel Abreu Lethycia Pereira Rosa Kamilly Iêda Silva Veigas Rodrigo Martins Silva Caetano Orthopedic and Trauma surgeon Brazilian Army Rio de Janeiro Brazil Orthopedic and Trauma surgeon S&atildeo Luís Brazil Scholarship Holder National Council for Scientific and Technological Development (CNPq) S&atildeo Luís Brazil School of Medicine Federal University of Maranh&atildeo (UFMA) S&atildeo Luís Brazil Orthopedic and Trauma surgeon Shoulder and Elbow Surgery Specialist University Hospital of the Federal University of Maranh&atildeo (HUUFMA/EBSERH) S&atildeo Luís Brazil

Introduction: The acromioclavicular joint is a superficial diarthrodial joint that surrounds the medial articular facet of the acromion and the distal portion of the clavicle. Due to its anatomy and biomechanics, it is highly susceptible to trauma and in young men who play contact sports, acromioclavicular dislocation is common. This article aimed to systematically review the literature and compare the surgical techniques used in the treatment of acromioclavicular dislocation in patients who practice sports. Methods: This systematic review was conducted according to the International Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Eligible studies for this systematic review included articles in English or Spanish published between 2013 and 2023, which mention the occurrence of acromioclavicular dislocation during sports practices. Additionally, only studies that addressed the surgical treatment of acromion-clavicular dislocation and contained original data on the topic were included. Results: We found 144 eligible studies after searching the LILACS and PubMed databases. Based on the inclusion and exclusion criteria and the reviewers’ consensus, we selected four studies for the systematic review. 133 patients with AC joint displacement were evaluated. Mean Age: approximately 31.90 years. 81.92 of these injuries occurred during sports practice. Surgical Procedures Used: titanium plates fixation (49 patients), arthroscopy (24), single tunnel technique (30) and coracoid sling technique (30). The results of the visual analog scale and Constant-Murley scores varied between the techniques used. Twenty-two complications after surgical treatment were identified. Conclusion: A significant variability of operative techniques can be used in the surgical approach of acromioclavicular dislocation, such as arthroscopy, single tunnel, coracoid sling and titanium plates. Although it presented excellent functional results compared to the other three tech

关键词： Acromioclavicular Joint Shoulder Dislocation Surgical Procedure Postoperative Complications Postoperative Care

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Colorectal resections for malignancy: A pilot study comparing conventional vs freehand robot-assisted laparoscopic colectomy

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World Journal of Clinical Cases 2024年第3期12卷 488-494页

作者： Shamir O Cawich Joseph Martin Plummer Sahle Griffith Vijay Naraynsingh Department of Surgery University of the West IndiesSt AugustineTrinidad and Tobago Department of General Surgery and Consultant General and Colorectal surgeon Department of SurgeryUniversity of the West IndiesKingstonKIN7Jamaica Department of Surgery Queen Elizabeth HospitalBridgetownBarbados Department of Surgery Port of Spain General HospitalPort of SpainTrinidad and Tobago

BACKGROUND Laparoscopic colectomy is widely accepted as a safe operation for colorectal cancer,but we have experienced resistance to the introduction of the FreeHandffrobotic camera holder to augment laparoscopic colorectal *** To compare the initial results between conventional and FreeHandffrobot-assisted laparoscopic colectomy in Trinidad and *** This was a prospective study of outcomes from all laparoscopic colectomies per-formed for colorectal carcinoma from November 29,2021 to May 30,*** following data were recorded:Operating time,conversions,estimated blood loss,hospitalization,morbidity,surgical resection margins and number of nodes *** data were entered into an excel database and the data were analyzed using SPSS ver *** There were 23 patients undergoing colectomies for malignant disease:8(35%)FreeHandff-assisted and 15(65%)conventional laparoscopic *** were no *** time was significantly lower in patients under-going robot-assisted laparoscopic colectomy(95.13±9.22 vs 105.67±11.48 min;P=0.045).Otherwise,there was no difference in estimated blood loss,nodal harvest,hospitalization,morbidity or *** The FreeHandffrobot for colectomies is safe,provides some advantages over conventional laparoscopy and does not compromise oncologic standards in the resource-poor Caribbean setting.

关键词： Laparoscopic Colectomy Robot Surgery Minimally invasive

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Role of diaphragm in pancreaticopleural fistula

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World Journal of Gastroenterology 2011年第32期17卷 3759-3760页

作者： Anestis P Ninos Stephanos K Pierrakakis Consultant General surgeon Department of Surgery Thriassio General Hospital Consultant General and Thoracic surgeon Head of the Department of Surgery Thriassio General Hospital

A pancreatic pleural effusion may result from a pancreatopleural fistula. We herein discuss two interesting issues in a similar case report of a pleural effusion caused after splenectomy, which was recently published in the World Journal of Gastroenterology . Pancreatic exudate passes directly through a natural hiatus in the diaphragm or by direct penetration through the dome of the diaphragm from a neighboring subdiaphragmatic collection. The diaphragmatic lymphatic "stomata" does not contribute to the formation of such a pleural effusion, as it is inaccurately mentioned in that report. A strictly conservative approach is recommended in that article as the management of choice. Although this may be an option in selected frail patients, there has been enough accumulative evidence that a pancreaticopleural fistula may be best managed by early endoscopy in order to avoid complications causing prolonged hospitalization.

关键词： Fistula Pleural effusion Pancreatic surgery

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Small Cell Neuroendocrine Carcinoma of the Vulva: Case Report and Literature Review

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Open Journal of Obstetrics and Gynecology 2024年第2期14卷 295-300页

作者： Gabriela Françóes Rostirolla Alessandra Guerra Maria Carolina Rey Alt Luiza Tesser Dalla Libera Maria Eduarda Appel Binda Márcia Appel Fernando De Marco dos Santos Department of Obstetrics and Gynecology Caxias do Sul University Caxias do Sul Brazil Department of Pathology UNIVATES Lajeado RS Medical Student Caxias do Sul University Caxias do Sul Brazil Department of Obstetric and Gynecology Federal University of Rio Grande do Sul Porto Alegre Brazil Department of Oncology surgeon Caxias do Sul University Caxias do Sul Brazil

Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. When present, these neoplasms often manifest with nonspecific signs and symptoms such as pain, itching, swelling, single-focus lesions, bleeding, and enlargement of inguinal lymph nodes, in addition to the presence of progressively enlarging vulvar nodules. Consequently, the diagnostic investigation involves histopathological examination and confirmation through immunohistochemistry. Objective: To present a comprehensive understanding of this rarely studied pathology. The primary objective is to provide valuable insights that could aid in the future development of universally applicable treatment guidelines. Case Presentation: A 57-year-old female, with no prior comorbidities, menopause at 36, who presented with a left vulvar nodule accompanied by intense pain and swelling, later diagnosed with small cell neuroendocrine carcinoma in the vulva. Conclusion: This case report highlights the importance of enhancing our knowledge regarding small cell neuroendocrine carcinoma in the vulva, given its scarcity in medical literature. The information presented here underscores the need for standardized diagnostic and treatment approaches, paving the way for future consensus on managing this uncommon but challenging neoplasm.

关键词： Vulvar Neoplasms Carcinoma Small Cell Carcinoma Neuroendocrine Genital Neoplasms Female Vulvar Diseases

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Morphometric Analysis of Maxillary Central Incisor to Determine its Crown Form: A Model‑based Cross‑sectional Study

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Journal of Forensic Science and Medicine 2016年第4期2卷 213-218页

作者： Jayasankar Purushothaman Pillai Riddhi Patel Alka Banker Rajarajeswari J Sukhdev Mishra Department of Oral Pathology Government Dental College and HospitalNational Institute of Occupational HealthAhmedabad1Consultant Dental SurgeonBharuch Department of Orthodontia Goenka Research Institute of Dental ScienceGandhinagarGujaratIndia Consultant Dental surgeon National Institute of Occupational HealthAhmedabad1Consultant Dental SurgeonBharuch Department of Biostatistics National Institute of Occupational HealthAhmedabad1Consultant Dental SurgeonBharuch

The size and shape of tooth crowns are morphogenetically predetermined during *** maxillary central incisors have contributed to sexual dimorphism,and several classifications of the form of maxillary central incisors are available in the ***,in the present study,aimed to analyze the mesiodistal(MD)measurements at two levels of maxillary central incisor,to determine its crown *** study was conducted on 100 dental plaster models(50 males and 50 females).The MD dimensions at the contact area level MD_incisal(MD_I)and at the gingival papilla level(MD_G)and the gingivo‑incisal height of the crown were measured in the dental models using digital Vernier *** data were analyzed using SPSS version 16 statistical *** mean values of all the three parameters measured were slightly greater for males and also for the left central *** were no significant differences in all the three variables when the right and left incisors were *** differences were noted when the parameters are compared between *** height/width ratio of crown showed a significant difference between male and *** value of the ratio between the two MD dimensions(MD_I and MD_G)was used to determine the crown *** ratio between the MD dimensions at incisal and gingival area showed a significant difference between genders and no such significance was found between right and left central *** is a significant difference in the form of maxillary central incisors between male and female samples and not between right and *** MD dimensions at incisal and gingival thirds decide the form of crown.

关键词： Crown form maxillary central incisor morphometric ratio sexual dimorphism

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Patients with Crohn’s disease have longer post-operative in-hospital stay than patients with colon cancer but no difference in complications’ rate

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World Journal of Gastrointestinal Surgery 2019年第5期11卷 261-270页

作者： 2015 European Society of Coloproctology(ESCP)collaborating group Alaa El-Hussuna 不详 Academic Research Consultant SurgeonDepartment of SurgeryAalborg University HospitalHobrovej 18-22Aalborg 9100Denmark

BACKGROUND Right hemicolectomy or ileocecal resection are used to treat benign conditions like Crohn’s disease(CD)and malignant ones like colon cancer(CC).AIM To investigate differences in pre-and peri-operative factors and their impact on post-operative outcome in patients with CC and *** This is a sub-group analysis of the European Society of Coloproctology’s prospective,multi-centre snapshot *** patients with CC and CD undergoing right hemicolectomy or ileocecal resection were *** outcome measure was 30-d post-operative *** outcome measures were post-operative length of stay(LOS)at and *** Three hundred and seventy-five patients with CD and 2,515 patients with CC were *** with CD were younger(median=37 years for CD and 71 years for CC(Psurgeons(Psurgeons and underwent less radical resection but had a longer LOS than patients with CC although complications'rate was not different between the two groups.

关键词： Crohn’s disease Colon cancer Complications Length of stay Bowel resection Right hemicolectomy

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