Obstetrics and Gynecology
James M. Rippe in Manual of Lifestyle Medicine, 2021
Human breast milk is a physiological form of nutrition for infants and young children. Even though formula feeding is widespread worldwide, a significant body of literature and research strongly supports infant and maternal benefits from breastfeeding. Both ACOG and AAP state that breastfeeding ensures the best possible health outcomes for the child. Both of these organizations recommend exclusive breastfeeding for at least the first six months of life and continue breastfeeding as complementary foods are introduced to the infant’s first year of life or longer if mutually desired by the women and her infant. The World Health Organization (WHO) endorses breastfeeding for the first two years of life. Healthy People 2020 guidelines establish a goal of 82% of babies to have been breastfed and a continuation rate of 61% at six months and 34% at one year.
History-taking model
Kaji Sritharan, Vivian A Elwell, Sachi Sivananthan in Essential OSCE Topics for Medical and Surgical Finals, 2007
(see Topic 40) Position: ask the patient to lie down on the bed, with their hands behind their head.Ask them whether they are experiencing any pain.Palpate both breasts, starting with the normal breast.Perform a systemic review of all four quadrants.If a lump is found, assess size, shape, surface, edges, consistency, mobility and site. Also assess the fixity of the lump (with the arms pressed in at the sides).
Psychosocial Aspects of Women’s Sexual and Reproductive Well-Being After Cancer
Jane M. Ussher, Joan C. Chrisler, Janette Perz in Routledge International Handbook of Women’s Sexual and Reproductive Health, 2019
Common surgical treatments for breast cancer include breast conserving treatment (lumpectomy and radiation treatment) and mastectomy with or without reconstruction. Breasts are positioned as such a significant part of women’s sense of self that having one breast is associated with being ‘half a woman’ (Manderson & Stirling, 2007, p. 82). This is reflected in findings that women who have had a mastectomy report greater body dissatisfaction than do those who have had breast conserving surgery, both immediately after surgery (Markopoulos et al., 2009) and at longer term follow-up (Lee, Sunu, & Pignone, 2009). Some women report body satisfaction following breast reconstruction (Nicholson, Leinster, & Sassoon, 2007; Rubino, Figus, Lorettu, & Sechi, 2007), whereas other women who experience reconstruction are not more satisfied than those who have had mastectomy alone (Avis et al., 2004). Breast reconstruction can assist in creating a physical appearance that appears ‘normal’ under clothing (Lee et al., 2009); however, it does not remove the psychological perception of having ‘abnormal’ breasts. For example, the absence of sensation, cold skin, and coming to terms with a new ‘artificial’ part of the body can be difficult for women (Snell et al., 2010).
Breast cancer glycan biomarkers: their link to tumour cell metabolism and their perspectives in clinical practice
Published in Expert Review of Proteomics, 2021
Tomas Bertok, Veronika Pinkova Gajdosova, Aniko Bertokova, Natalia Svecova, Peter Kasak, Jan Tkac
Breast, in both females and males, is a glandular organ made up of a fatty tissue (an adipose tissue) and a glandular tissue – usually more abundant in females. Breasts contain 12–20 lobes, which further divide into smaller lobules – these are connected via milk ducts (Figure 1) [10]. Epidermis of nipple and areola contain more pigments and, by their stimulation, the production of prolactin is enhanced. Based on the location/origin, the BCa is divided primarily into lobular or ductal (non-invasive in situ or invasive; ductal and lobular invasive BCa being the most common cancer types) [11], medullary, mucinous (colloid), tubular and inflammatory BCa/carcinoma. Less common types include Paget’s disease, angiosarcoma or phyllodes tumour [2,10]. Invasive ductal carcinoma (IDC) accounts for 60–75% of all BCa cases [12]. Triple negative BCa (TNBCa, one of the most aggressive tumours) is described by a deficiency of three surface receptors – progesterone (PR), estrogen (ER) and human epidermal growths factor 2 (HER2) [13]. An efficient drug treatment to increase the overall survival rate for TNBCa patients has long been lacking [14,15].
Current and emerging treatments for neonatal sepsis
Published in Expert Opinion on Pharmacotherapy, 2020
Federico Carbone, Fabrizio Montecucco, Amirhossein Sahebkar
As mentioned above, breast milk provides nutrients and microelements for the neonate’s proper growth and development [59]. Their concentration is widely dependent on the mother’s environment and diet [60]. Among them, Zinc (Zn) participates in ∼100 catalytic enzyme sites involved in cell membrane composition and nucleic acid metabolism. Breastfeed intake of Zn prevents defects in the nervous system and growth. In pre-clinical models and septic neonates, a tight link between low Zn levels and sepsis severity has been reported [61,62]. Neutrophil chemotaxis and phagocytosis are suppressed by free Zn chelation in vitro [63] and restored by Zn supplementation in vivo [64]. Similarly, Zn actively contributes to macrophage function (e.g. phagocyte activity and cytokine release) [65] and NK cell cytotoxicity [66]. Data from literature would also support a role of Zn in regulating gut microbiome, though caution is needed [67]. In light of this, low Zn concentrations have been frequently found in PICUs, whereas Zn supplementation has been reported to improve clinical response to antibiotic treatment [68] and reduce morbidity and mortality for late-onset sepsis and necrotizing enterocolitis in both preterm and term neonates [69–71]. A recent meta-analysis has substantially confirmed a role of Zn supplementation in reducing mortality for neonatal sepsis [38] (Table 1).
The risk of induced cancer and ischemic heart disease following low dose lung irradiation for COVID-19: estimation based on a virtual case
Published in International Journal of Radiation Biology, 2021
Gustavo Viani Arruda, Raissa Renata dos Santos Weber, Alexandre Colello Bruno, Juliana Fernandes Pavoni
The LAR results for men and women were evaluated as a function of the age at exposure (Figure 2(a,b)). For both sexes, the exposure of young persons may lead to a higher incidence of cancer, and the highest risk of cancer incidence was for lung cancer. Irradiation of the lung with doses ranging between 0.5 Gy and 1.5 Gy presents an absolute LAR below 5200 cases/100,000 for women and 2250 cases/100,000 for men. For women, the breast presents the second-highest LAR, especially for exposures of young women. The liver and esophagus presented LARs below 700/100,000 for both sexes, with a higher incidence of esophageal RIC for women and liver RIC for men. These values were also stratified in groups related to age at exposure (Figure 2(c,d)) and evaluated in a percentage form (Table 1). Regarding the LAR cutoff, we observed an unacceptable and cautionary LAR for lung cancer in all women and men between 20–60 years of age, with RT dose >1 Gy (Table 1). LAR for lung cancer with an RT dose of 1 Gy was cautionary for women aged >60 years and men aged <40 years. No LAR estimation was unacceptable for the RT dose below <0.7 Gy in all groups irrespective of sex or age at exposure (Table 1). The REID for 1.5, 1.0, 0.7, and 0.5 Gy was 2.5% (CI95% 1.1–3.9%), 1.6% (CI95% 0.7–2.6%), 1.1% (CI95% 0.5–1.8%), and 0.8% (CI95% 0.3–1.3%), Table 1.
Related Knowledge Centers
- Mammary Gland
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