Showing: 1 - 3 of 3 RESULTS

Surgery for benign breast conditions unlikely to harm breastfeeding ability

Having surgery for benign breast conditions won’t harm a woman’s future ability to breastfeed, new research suggests.

The study included 85 women, aged 18 to 45. Fifteen had a prior history of benign breast conditions, including cysts, benign tumors and enlarged breasts. Sixteen had had breast surgery, including breast augmentation, reduction mammoplasty and biopsy.

Whether they’d had surgery or not, 80% were able to breastfeed or obtain breast milk for bottle-feeding, according to findings presented Saturday at a virtual meeting of the American College of Surgeons. Research presented at meetings should be considered preliminary until published in a peer-reviewed journal.

Each year, nearly one million women in the United States are diagnosed with benign breast conditions. About half of women will have a benign breast lesion in their lifetime.

Many of these conditions are managed with surgery. Other common breast procedures include surgery to reduce enlarged breast tissue or augmentation for asymmetry or developmental breast conditions.

“Pediatricians and obstetrician-gynecologists who refer teenage patients for treatment of breast conditions, as well as parents, are concerned that surgery may impact breast development and eventual lactation,” said study co-author Laura Nuzzi, clinical research manager at Boston Children’s Hospital.

There is limited research on how surgery for benign breast conditions may affect later breastfeeding. The authors are continuing their research in this area, they noted in an ACS news release.

Study co-author Shannon Malloy is a clinical research associate in the hospital’s Adolescent Breast Clinic.

Malloy said, “We hope to augment the conclusions from this study that suggest plastic reconstructive surgeons, primary care practitioners, and any provider who comes in contact with women who have a benign breast condition can reassure them that an operation for a benign breast condition is safe and should not preclude them from enjoying the benefits of surgery for fear of impairing future breastfeeding satisfaction and lactation.”

More information

The American Academy of Pediatrics has more on breastfeeding.

Copyright 2020 HealthDay. All rights reserved.

Source Article

A virus and bacteria may ‘team up’ to harm babies’ brains

A newly discovered bacteria may be working with a common virus to cause a serious brain condition in infants in Uganda, according to a new study.

This brain disorder, called hydrocephalus, involves an abnormal buildup of fluid in the cavities of the brain and is the most common reason for brain surgery in young children, according to the National Institute of Neurological Disorders and Stroke (NINDS). Every year, about 400,000 new cases of hydrocephalus are diagnosed in children worldwide, and the condition remains a major burden in low- and middle-income countries, according to the study published today (Sept. 30) in the journal Science Translational Medicine

About half of those hydrocephalus cases happen after a prior infection and are known as “post-infectious hydrocephalus,” according to the study. But until now, scientists didn’t know what microbes were infecting infants, and identifying those pathogens is key to preventing the condition, according to the authors.

Related: The 12 deadliest viruses on Earth

For nearly 20 years, a small hospital in Uganda called the CURE Children’s hospital has been treating thousands of cases of hydrocephalus in children.

“Hydrocephalus is the most common childhood neurosurgical condition that we see in the population that we serve,” one of the lead authors Dr. Edith Mbabazi-Kabachelor, director of research, CURE Children’s Hospital of Uganda said in a statement. If left untreated in children younger than 2 years of age, hydrocephalus will increase head size, leading to brain damage; the majority of those children will die, and the others will be left with physical or cognitive disabilities, she added. 

So a group of international researchers set out to understand what could be causing this brain condition.

“Thirteen years ago, while visiting Uganda and seeing a stream of kids with hydrocephalus after infection I asked the doctors, ‘What is the biggest problem you have that you can’t solve?'” one of the senior authors Steven J. Schiff, Brush Chair professor of engineering and professor of engineering science and mechanics, neurosurgery and physics at Penn State, said in the statement. “‘Why don’t you figure out what makes these kids sick?’ was the reply.”

CT brain scans of infants with hydrocephalus show differences in the brains of those with post-infectious hydrocephalus (PIH), non-postinfectious hydrocephalus (NPIH), infection with the bacteria Paenibacillus (Paeni) or infection with the virus cytomegalovirus (CMV).

CT brain scans of infants with hydrocephalus show differences in the brains of those with post-infectious hydrocephalus (PIH), non-post-infectious hydrocephalus (NPIH), infection with the bacteria Paenibacillus (Paeni) or infection with the virus cytomegalovirus (CMV). (Image credit: J.N. Paulson et al., Science Translational Medicine (2020))

Schiff and his team analyzed blood and cerebrospinal fluid from 100 infants under 3 months old being treated at the CURE Children’s hospital for hydrocephalus — 64 of them developed the condition after an infection (doctors knew they had been infected because the babies either had severe illness, seizures or brain imaging showed signs of a prior infection) and 36 without a prior infection (brain images and other tests showed another issue causing the condition such as tumors or cysts).

They sent these samples to two different labs for DNA and RNA sequencing to look for possible traces of genetic material from bacteria, viruses

Pandemic AVR: Making Patients Wait May Do More Harm Than Good

Recent cardiac events suffered by patients with symptomatic severe aortic stenosis (AS) could be tied to whether their hospitals expedited aortic valve replacement (AVR) in select cases or paused these procedures in response to COVID-19, two reports suggested.

In the first, a Swiss hospital showed success selecting patients for expedited AVR despite safety concerns during the pandemic, whereas a New York City center that pushed these procedures back for everyone had a substantial number of patients subsequently die or require urgent transcatheter AVR (TAVR) while waiting, the second found.

Both reports were published online in JAMA Network Open.

“Taken together, these studies provide useful guidance. First, as we have known for many years, symptomatic AS is a life-threatening condition, and its treatment cannot be considered elective in any way. Patients with the most echocardiographically severe stenosis, clinically advanced symptoms, or comorbid coronary artery disease or lung disease belong at the head of the line,” according to Thoralf Sundt, MD, of Massachusetts General Hospital and Harvard Medical School in Boston.

“Whether one chooses to interpret the current state of the pandemic as an ongoing first wave — perhaps with a nadir in some regions — or as the quiet before a second wave, there is a clear need for tools permitting precise triage of patients by the urgency with which procedures should be performed,” he emphasized in an accompanying editorial.

Selective AVR in Switzerland

Certain people with critical AS were good candidates for expedited AVR during a nationwide ban on elective procedures, according to the prospective AS DEFER study.

A cohort of 71 patients referred for AVR from March 20 to April 26, a period when Switzerland banned elective procedures in all hospitals, were divided into two treatment groups according to a prespecified algorithm:

  • Expedited (n=25): Patients with critical AS (i.e., aortic valve area ≤0.6 cm2, transvalvular mean gradient ≥60 mm Hg, cardiac decompensation during the previous 3 months, or exercise intolerance with clinical symptoms on minimal exertion) who underwent TAVR at a mean 10 days after referral
  • Deferred (n=46): Patients with a larger aortic valve area and stable symptoms

Adverse cardiac outcomes were not statistically more likely for either group at an average 31 days after treatment allocation: the composite endpoint of all-cause mortality, disabling and nondisabling stroke, and unplanned hospitalization for valve-related symptoms or worsening heart failure reached 4.0% of the expedited group versus 19.6% of those deferred (log rank P=0.08), reported Thomas Pilgrim, MD, MSc, of Inselspital, Bern University Hospital, and colleagues.

Hospitalizations were more likely in the deferred AVR arm than the expedited arm (19.6% vs 0.%, P=0.02) and accounted for all the primary outcome events in the former. No patient died.

Among deferred AVR patients, those who wound up requiring hospitalization for valve-related symptoms or worsening heart failure had more commonly presented with multivalvular disease (44.4% vs 8.6%, P=0.02), suggesting that this group in particular may benefit from expedited AVR, Pilgrim’s group said.

“I cannot tell if the authors considered