Contralateral Prophylactic Mastectomy is Associated with a Survival Advantage in High-Risk Women with a Personal History of Breast Cancer

Background  

The aim of this study was to investigate whether contralateral prophylactic mastectomy (CPM) in addition to therapeutic mastectomy (TM) is associated with a survival advantage in high-risk women with breast cancer.     

Development and Psychometric Evaluation of the Treatment-Emergent Activation and Suicidality Assessment Profile

Although effective in treating a range of childhood psychiatric conditions, selective serotonin reuptake inhibitors (SSRI) have been implicated in the induction of an “activation syndrome” (characterized by symptoms of irritability, restlessness, emotional labiality, etc.) that may represent an intermediary state change that fosters suicidality. SSRI-induced activation syndrome is well-accepted by many clinicians and thought to be relatively common, particularly in children and teens. However, gaps exist in empirical data on phenomenology and tools for early detection. With this in mind, we report on a recently funded National Institutes of Health grant to develop a measure of behavioral activation to be completed in a clinical setting. We discuss the development of this measure—the Treatment-Emergent Activation and Suicidality Assessment Profile (TE-ASAP)—as well as psychometric results from a sample of youth with internalizing disorders who were at varying stages of SSRI treatment. Overall, psychometric data were quite promising, with the TE-ASAP demonstrating excellent reliability (i.e., internal consistency, inter-rater, short-term test–retest stability) and strong validity properties. Through further evaluation of the TE-ASAP in the context of a controlled multimodal trial in youth with obsessive–compulsive disorder, we hope to augment understanding of activation syndrome and, in turn, mitigate risks through early detection of this potentially lifethreatening adverse effect.     

Awareness about Oral Cancer among Dental Postgraduate Students in the State of Andhra Pradesh,India

The aim of the study was to evaluate the knowledge and awareness of dental postgraduate students regarding risk factors, signs of oral cancer, and treatment plan and post treatment complications. A questionnaire was given to the 450 dental postgraduate students of all specialties to various dental colleges in Andhra Pradesh. The questionnaire included 10 questions pertaining to knowledge about oral cancer, its risk factors, key symptoms, and treatment plan and post treatment complications. Majority of postgraduate students were aware that habits (94 %) were the main risk factor for most of oral cancer whereas 50 % of students were aware of clinical presentation of oral cancer and 67 % were confident about the proper treatment protocol. Majority of the postgraduate students were aware of the main risk factors. On the other hand, several aspects like clinical signs of oral cancer, treatment protocol, referrals, and post treatment complications need to be improved. Continuing dental education programs and workshops on oral cancer should be carried out to enhance the knowledge and awareness of the postgraduate students.     

Immune response to the third COVID-19 vaccine dose is related to lymphocyte count in multiple sclerosis patients treated with fingolimod

Journal of Neurology - The majority of multiple sclerosis [MS] patients treated with fingolimod fail to develop a protective level of IgG humoral and adaptive cellular immune responses following...     

Diagnostic interest of whole-body MRI in early- and late-onset LAMA2 muscular dystrophies: a large international cohort

Journal of Neurology - LAMA2-related muscular dystrophy (LAMA2-RD) encompasses a group of recessive muscular dystrophies caused by mutations in the LAMA2 gene, which codes for the alpha-2 chain of...     

SARS wars: an examination of the quantity and construction of health information in the news media

The media have the power to sway public perception of health issues by choosing what to publish and the context in which to present information. The media may influence an individual's tendency to overestimate the risk of some health issues while underestimating the risk of others, ultimately influencing health choices. Although some research has been conducted to examine the number of articles on selected health topics, little research has examined how the messages are constructed. The purpose of this article is to describe an examination of the construction of news reports on health topics using aspects of the social amplification of risk model and the elaboration likelihood model of persuasion for theoretical direction. One hundred news media reports (print, radio, television, and Internet) were analyzed in terms of message repetition, context, source, and grammar. Results showed that health topics were more often discussed in terms of risk, by credible sources using strong language. This content analysis provides an empirical starting point for future research into how such health news may influence consumer's perceptions of health topics.     

Challenges Faced by New Mothers in the Early Postpartum Period: An Analysis of Comment Data from the 2000 Pregnancy Risk Assessment Monitoring System (PRAMS) Survey

Objective To identify challenges that women face 2–9 months postpartum using qualitative data gathered by the Pregnancy Risk Assessment Monitoring System (PRAMS). Methods PRAMS is an on-going population-based surveillance system that collects self-reported information on maternal behaviors and experiences before, during, and after the birth of a live infant. We analyzed free text comment data from women in 10 states who answered the PRAMS survey in 2000. Preliminary analysis included a review of the comment data to identify major themes and a demographic comparison of women who commented (n = 3,417) versus women who did not (n = 12,497). Subsequent analysis included systematic coding of the data from 324 women that commented about postpartum concerns and evaluation to ensure acceptable levels of reliability among coders. Results We identified the following major themes, listed in order of frequency: (1) need for social support, (2) breastfeeding issues, (3) lack of education about newborn care after discharge, (4) need for help with postpartum depression, (5) perceived need for extended postpartum hospital stay, and (6) need for maternal insurance coverage beyond delivery. Conclusion The themes identified indicate that new mothers want more social support and education and that some of their concerns relate to policies regarding breastfeeding and medical care. These results can be used to inform programs and policies designed to address education and continuity of postpartum care for new mothers.     

Nodal Pathologic Complete Response Rates in Luminal Breast Cancer Vary by Genomic Risk

Background

Although an advantage of neoadjuvant chemotherapy (NAC) is eradication of axillary disease, nodal pCR rates are much lower for ER+/HER2? breast cancer than other subtypes. We sought to evaluate the association of genomic risk with nodal pCR in ER+/HER2? disease.

Methods

Patients with ER+/HER2? clinically-node-positive (cT0-cT4d/cN1-cN3/cM0) breast cancer treated with NAC and surgery 2010–2018 in the National Cancer Database were identified. Low genomic risk was classified as Oncotype Dx Recurrence Score (RS) 0–25, or Mammaprint 70-gene or RS coded as “Low.” High genomic risk included RS >25, or 70-gene or RS coded as “High.” Nodal pCR was compared between patients with high versus low genomic risk by using chi-square tests and multivariable logistic regression.

Results

Of 15,698 patients, genomic risk was available for 692 of 15,698 (4.4%). High genomic risk was similar between patients aged <50 years versus 50+ (50.8% vs. 57.3%, p = 0.10). Nodal pCR was higher in high genomic risk (25.0%) than low genomic risk (10.4%, p < 0.001). This difference was observed both for patients aged <50 years (29.9% vs. 9.8%) and aged ≥50 years (22.7% vs. 10.8%). On multivariable analysis adjusted for potential confounding variables, including age, grade, and PR status, genomic risk was independently associated with decreased odds of residual nodal disease (odds ratio 0.49, p = 0.002).

Conclusions

For patients with node-positive ER+/HER2? breast cancer treated with NAC, nodal pCR was highest in patients aged <50 years with high genomic risk tumors. In contrast, nodal pCR rates were low in patients with low genomic risk tumors, regardless of age. This information may help when counseling patients regarding axillary management.