Oncoplastic Surgical Techniques for Personalized Breast Conserving Surgery in Breast Cancer Patient with Small to Moderate Sized Breast

Oncoplastic surgery has revolutionized the field of breast conserving surgery (BCS). The final aims of this technique are to obtain an adequate resection margin that will reduce the rate of local recurrence while simultaneously improving cosmetic outcomes. To obtain successful results after oncoplastic surgery, it is imperative that patients be risk-stratified based on risk factors associated with positive margins, that relevant imaging studies be reviewed, and that the confirmation of negative margins be confirmed during the initial operation. Patients who had small- to moderate-sized breasts are the most likely to be dissatisfied with the cosmetic outcome of surgery, even if the defect is small; therefore, oncoplastic surgery in this population is warranted. Reconstruction of the remaining breast tissue is divided into volume displacement and volume replacement techniques. The use of the various oncoplastic surgeries is based on tumor location and excised breast volume. If the excised volume is less than 100 g, the tumor location is used to determine which technique should be used, with the most commonly used technique being volume displacement. However, if the excised volume is greater than 100 g, the volume replacement method is generally used, and in cases where more than 150 g is excised, the latissimus dorsi myocutaneous flap may be used to obtain a pleasing cosmetic result. The local recurrence rate after oncoplastic surgery was lower than that of conventional BCS, as oncoplastic surgery reduced the rate of positive resection margins by resecting a wider section of glandular tissue. If the surgeon understands the advantages and disadvantages of oncoplastic surgery, and the multidisciplinary breast team is able to successfully collaborate, then the success rate of BCS with partial breast reconstruction can be increased while also yielding a cosmetically appealing outcome

Diskrepanz zwischen den gesellschaftlichen Ansprüchen und der Praxis im ASD

Die Bachelorarbeit befasst sich mit dem Allgemeinen Sozialdienst in Deutschland als Instanz der Kinder und Jugendhilfe sowie als Spannungsfeld in der Sozialen Arbeit. Der Schwerpunkt der Arbeit liegt auf der Frage , welche Spannungsverhältnisse es zwischen der ASD Arbeit in der Praxis und den gesellschaftlichen Erwartungen gibt. Betrachtet werden dabei die unterschiedlichen Einflussfaktoren, die die Arbeit des ASD erschweren und zu Diskrepanzen zwischen dem ASD und seinen KlientInnen führen. Die Arbeit stützt sich auf eine intensive Literaturrecherche mit Einbezug einer Studie der Hochschule Koblenz und meiner persönliche n Erfahrungen , die ich während mein es Praktikums im Jahr 2019 beim Allgemeinen Sozialdienst in Leipzig gesammelt habe

Long-term outcome of simple inversion of the appendix as an alternative to incidental appendectomy

Background: Inversion of the appendix is an alternative to incidental appendectomy to prevent future ap--pendicitis. This study investigated outcome and complications in a group of patients who underwent simple inversion of the appendix. Patients and Methods: Inversion of the appendix was performed in 41 patients, including 21 women (51%) and 20 men (49%) (mean age, 48.7 years; range, 12-85 years). A simple inversion technique was used in 65% of patients. Twenty-nine patients had colonoscopy between 3 to 44 months after surgery (mean, 8 months), none for the sake of the study. Results: During the follow up, none of patients developed intussusception or rectal bleeding. Colonoscopy demonstrated an absent appendix in 9 patients (31%). In the remaining 20 patients (69%), the inverted appendix persisted with no obvious change on visualized mucosa. Conclusion: Neither intussusception nor hemorrhage was observed after simple inversion. In our view, persistence of the appendix is a welcome event since the presence of the appendix may carry several benefits as it continues to work as a specialized organ, exerting an important physiological role in facilitating forward passage of colon contents, providing antibacterial functions and possibly playing a preventive role against development of colon and other cancers