Outcomes of outpatient breast cancer surgery at a private breast clinic

Advances in surgical and anesthetic techniques have allowed for outpatient treatment of breast cancer. We evaluated the feasibility, safety, efficacy, and surgical outcomes of outpatient surgery in 370 patients with breast cancer who underwent breast‐conserving surgery (BCS)/axillar lymph node (ALN) management. There were no deaths or severe intraoperative complications, but 41 complications were observed and disease recurrence occurred in 18 patients. The cumulative overall survival rate was 95.2%. Outpatient surgery was well tolerated, feasible, and safe in patients receiving BCS/ALN management.     

Impact of oral potentially malignant disorders on quality of life

Background

Oral potentially malignant disorders (OPMDs) could have a significant psychological impact on patients, principally because of the unknown risk of malignant transformation, while the physical and functional impairments could differ. This study aimed to assess the impact of three different OPMDs and their disease stages on the quality of life (QoL) of affected patients.

Methods

Oral leukoplakia (OL), oral lichen planus (OLP) and oral submucous fibrosis (OSF) patients who were undergoing treatment at an oral medicine clinic of a dental teaching hospital in India were the study population. All subjects completed the recently developed OPMDQoL questionnaire and a short form 12 item (version 2) health survey questionnaire (SF‐12v2). OPMDQoL questionnaire consists of 20 items over four dimensions. A higher score denotes poor OHRQoL. SF‐12v2 has two components, a Physical Component Summary (PCS) and Mental Component Summary (MCS).

Results

A total of 150 subjects (50 each of OL, OLP and OSF) participated. OL patients (37.7 ± 7.9) reported significantly better OPMDQoL scores than OLP (47.3 ± 5.8) and OSF (45.4 ± 9.2) patients. OLP patients reported significant problems in obtaining a clear diagnosis for their condition, more so than the other OPMDs. OL patients reported fewer problems for the dimension, “physical impairment and functional limitations” than the OLP and OSF patients. A significant trend was observed with the overall OPMDQoL and MCS, deteriorating as the disease stage increased.

Conclusions

OLP and OSF have a significant impact on the QoL of affected individuals: OL less so. Increasing stage of the disease is associated with worsening QoL.     

Supplemental maxillomandibular fixation with miniplate osteosynthesis��required or not?

Aim

To compare outcomes of open reduction and internal fixation of mandible fractures followed by either immediate mobilization or 5?days of maxillomandibular fixation.

Material and methods

We analyzed our use of supplemental maxillomandibular fixation with miniplate osteosynthesis during a 2.5-year period in 118 patients with 180 mandible fractures. A retrospective, matched pairing of identical fractures fixated with identical plating schemes was carried out. Thirty-five pairs of patients undergoing monocortical plating were identified. Patients in group 1 were treated with supplemental maxillomandibular fixation after surgery, whereas patients in group 2 (immediate release group) were treated without postoperative maxillomandibular fixation.

Results

The total rate of complications was 17% with supplemental maxillomandibular fixation and 14% without supplemental maxillomandibular fixation (p?>?0.05). No statistically significant outcome advantage could be attributed to the use of maxillomandibular fixation.

Conclusion

The current retrospective study shows no significant differences in treating isolated mandible fractures with open reduction and internal fixation and immediate release versus open reduction and internal fixation with 5?C7?days of MMF.     

A heterozygous effect for PINK1 mutations in Parkinson's disease?

OBJECTIVE: To investigate the significance of PINK1 mutations in sporadic Parkinson's disease (PD). METHODS: We determined the frequency of PINK1 mutations by direct sequencing in a large series of PD patients with apparently sporadic disease (n = 768). RESULTS: Twelve heterozygous mutations were identified, nine in PD patients and three in control subjects. INTERPRETATION: Given the difficulty in interpreting the pathogenic significance of the heterozygous mutations that have already been reported in parkin and DJ-1, we first determined the frequency of heterozygous PINK1 mutations in the general population by sequencing a large number of control subjects (n = 768), then subsequently assessed their functional significance by examining their effects on stress-induced alterations to the mitochondrial membrane potential (DeltaPsim). We demonstrate an enrichment of heterozygous mutations in sporadic PD patients compared with matched control subjects (1.2% in PD vs 0.4% in control subjects). Furthermore, we show that they adversely affect DeltaPsim in a similar way to the familial G309D mutation. Although it remains difficult to conclusively demonstrate the pathogenicity of heterozygous mutations, the results of this study and the previously reported subclinical nigrostriatal dysfunction in carriers of heterozygous PINK1 mutations suggest the possibility that these heterozygous mutations are a significant risk factor in the development of later onset PD.     

Insecticidal and larvicidal activities of medicinal plant extracts against mosquitoes

In recent years, use of environment friendly and biodegradable natural insecticides of plant origin have received renewed attention as agents for vector control because they are rich in bioactive chemicals, active against a limited number of species including specific target insects, and biodegradable. The present study was carried out to evaluate the adulticidal, repellent, and larvicidal activity of crude hexane, ethyl acetate, and methanol extracts of eight plants, viz. Aristolochia indica L., Cassia angustifolia Vahl, Diospyros melanoxylon Roxb., Dolichos biflorus L., Gymnema sylvestre (Retz) Schult, Justicia procumbens L., Mimosa pudica L., and Zingiber zerumbet L., were tested against adult and early fourth instar larvae of Culex gelidus Theobald and Culex quinquefasciatus Say (Diptera: Culicidae). The effective adult mortality was observed in methanol extract of A. indica, ethyl acetate extract of D. biflorus, and ethyl acetate and hexane extract of Z. zerumbet against C. gelidus and C. quinquefasciatus (LD₅₀ = 37.75, 78.56, 129.44, 86.13, 80.06, 112.42, 53.83, and 46.61; LD₉₀ = 166.83, 379.14, 521.50, 289.83, 328.18, 455.72, 181.15, and 354.50 ppm, respectively). Complete protections for 150 min were found in hexane and methanol extract of A. indica and Z. zerumbet at 1,000 ppm against mosquito bites. The highest larval mortality was found in the hexane extract of Z. zerumbet, ethyl acetate extract of D. biflorus, and methanol extracts of A. indica against C. gelidus (LC₅₀ = 26.48, 33.02, and 12.47 ppm; LC₉₀ = 127.73, 128.79, and 62.33 ppm) and against C. quinquefasciatus (LC₅₀ = 69.18, 34.76, and 25.60 ppm; LC₉₀ = 324.40, 172.78, and 105.52 ppm), respectively, after 24 h. The plant extracts are potential to be used as an ideal eco-friendly approach for the control of the Japanese encephalitis vector, C. gelidus, and lymphatic filariasis vector, C. quinquefasciatus.