Breast implant illness: a step forward in understanding this complex entity and the impact of social media

Introduction. The number of implant-related complaints is constantly rising, a phenomenon probably accentuated by the extensive use of social media by patients. Material and method. A group of signs and symptoms considered to be caused by mammary implants is known as “Breast Implant Illness”. This paper analyzes the increased number of posts by patients on social media in which they describe their symptoms, their disappointment with the decision of using breast implants, and the beneficial effects of explantation. The case of a patient with breast implants who visited our clinic is reported here. The patient complained of two palpable masses, located in the left axilla and in the superolateral quadrant of the left breast. The pathophysiological mechanism by which lymphadenopathy occurred after a long period of time remains uncertain. Discussion. A review of the literature was conducted to identify the underlying causes of implant-related complaints, allowing evaluation of the presence of local complications, cancer with large anaplastic cells, and autoimmune diseases. The possibility of a somatization effect has also been considered. Conclusions. Plastic surgeons must remain the best source of information, taking on the role of educating the patient in order to better understand this condition

Breast implant illness: a step forward in understanding this complex entity and the impact of social media

Introduction. The number of implant-related complaints is constantly rising, a phenomenon probably accentuated by the extensive use of social media by patients. Material and method. A group of signs and symptoms considered to be caused by mammary implants is known as “Breast Implant Illness”. This paper analyzes the increased number of posts by patients on social media in which they describe their symptoms, their disappointment with the decision of using breast implants, and the beneficial effects of explantation. The case of a patient with breast implants who visited our clinic is reported here. The patient complained of two palpable masses, located in the left axilla and in the superolateral quadrant of the left breast. The pathophysiological mechanism by which lymphadenopathy occurred after a long period of time remains uncertain. Discussion. A review of the literature was conducted to identify the underlying causes of implant-related complaints, allowing evaluation of the presence of local complications, cancer with large anaplastic cells, and autoimmune diseases. The possibility of a somatization effect has also been considered. Conclusions. Plastic surgeons must remain the best source of information, taking on the role of educating the patient in order to better understand this condition

The incidence of haemorrhagic and thromboembolic events after breast cancer surgery in patients treated with pharmacological thromboprophylaxis

Background. Hemorrhagic events and venous thromboembolic disease, including pulmonary embolism and deep venous thrombosis, are the most important complications after breast cancer surgery. Although hemorrhagic complications are not usually severe and do not have a high mortality risk, venous thromboembolic disease is often associated with high morbidity and mortality rates. Under such circumstances, it is highly important to evaluate the need for systemic antithrombotic prophylaxis as opposed to mechanical interventions and the optimal duration of chemoprophylaxis in patients undergoing breast cancer surgery. Methods. Using the database of the General Surgery Department of “Colţea” Clinical Hospital, we analyzed the data from 2015 to 2018. During this period, pharmacological prophylaxis was used in all patients undergoing breast cancer surgery. Mechanical prophylaxis (intermittent pneumatic compression or graduated compression) has also been recommended, but there was no record of patient compliance. The primary outcome was the occurrence of venous thromboembolic or hemorrhagic events within 30 days after surgery. Results. In our institution, the venous thromboembolic disease rate for breast cancer surgery was 4/540 (0.7%; 95% CI: 0.02-1.9%), being similar to that of other studies. Hemorrhagic events occurred in 29 (5.4%; 95% CI 3.6-7.6%) patients, most commonly as hematoma in 3.3% of the patients. The incidence of hematoma requiring operation was 1.1% (95% CI: 0.4-2.4%), while hematoma treated conservatively was 2.2% (95% CI:1.2-3.8%). Other forms of hemorrhagic events include hemorrhagic drainage and bleeding wound, occurring in 2.0% of the cases. Conclusions. The occurrence of venous thromboembolic events is reduced among patients undergoing primary breast cancer surgery. A current issue is decreasing venous thromboembolic disease rates without increasing the hemorrhagic event rate. Standard guidelines on the antithrombotic prophylaxis of these patients are not well established since studies show contradictory data. Further investigations are needed to determine exactly which type of thromboprophylaxis is more effective

Uterine artery embolization angiography and fertility related aspects

Purpose. Uterine artery embolization is a minimally invasive technique. It applies the principle of targeted anatomical structure devascularisation with utility in fibroid conservative therapy, including for future fertility preserving status. The objective of our paper represents a description and evaluation of angiography utility as a predictive method for fertility maintenance. Material and Methods. The angiography and ultrasound aspects obtained from a prospective study in which selected patients have undergone uterine artery embolization for fertility preservation are detailed. Results. The following angiography aspects have been detected: left- right shunt and utero-ovarian collaterals; these have been compared with the ultrasound aspects related to the fibroid evolution form a volumetric and Doppler ultrasound point of view. The angiographical description predicts the impact on post embolization fibroid evolution and upon fertility. An analysis is made in order to assess the way in which angiography can contribute to fertility alteration. Conclusions. The angiography aspects during embolization and the following ultrasound aspects can represent predictive factors as to fertility evolution after uterine artery embolization

Cyanotic Congenital Heart Defects – literature review

Congenital heart defects are one of the most interesting and important chapters regarding abnormal fetal growth pathology. The objective of this article is to present a literature review for the main cyanotic congenital heart defects. The ones presented in the article are: tetralogy of Fallot, transposition of the great vessels, double outlet right ventricle, truncus arteriosus, total anomalous pulmonary venous circulation and additional information regarding very rare malformations such as pentalogy of Cantrell and Uhl anomaly. An early and precise identification of congenital heart defects is an important step in an accurate follow-up of a potential problematic pregnancy. Knowing the sonographic aspect, associated pathology and the current available treatment procedures are vital for the fetal outcome and for the physician to adapt the right management in every situation that might appear during the pregnancy and in the neonatal period

The combined use of senometry and ultrasonography for breast cancer surgical planning

Ultrasound exerts an important role in breast cancer diagnosis protocol, but the use of eco-senometry can also improve therapeutic options, surgical planning and technique. We describe various measurement formulas and techniques that are applied in order to acquire important information regarding the breast and its lesions. Senometry and ultrasonography have been proven to be very effective, reaching up to reliability levels as high as 0.997 and accuracy levels as high as 99.6%. Senometry and ultrasonography have clearly demonstrated their value in breast cancer diagnosis and treatment. These methods are reliable, inexpensive and can be easily performed by the surgeon. More advances in the domain are expected in the future

Breast sarcoma surgical management: a five-year multicentric study

Background. Breast sarcomas are a heterogeneous group of breast neoplasms with a low incidence and a reserved prognosis. No treatment protocol has been yet established, a guideline similar to soft tissue sarcomas is used. Materials and Methods. Our study analyzed all the patients admitted with the diagnosis of malignant breast disease in two specialized centers on a five-year time frame. We compared long term results for the patients who underwent conservative treatment and mastectomy. Results. A total of 76 cases received surgical treatment with curative intent, 24 conservative procedures and 52 mastectomies. Incidence of local recurrence does not appear to be closely related to the type of surgical procedure. There were a number of five local recurrences for patients who received conservative treatment and 7 local recurrences where we used mastectomy. Kaplan-Meier analysis conducted shows no differences statistically significant (sig = 0.459) between the results of conservative treatment and mastectomy. Basically conservative surgery seems to get similar results, provided that R0 resection objective can be met. Conclusions. Treatment options are more limited for breast sarcomas than carcinomas, the role of surgery being more important to therapeutic success. The biological characteristic of the tumor including histological type and sub-type, play an important role in determining the results and the treatment should be tailored and adapted for each case

Management of pharynx fistula after upper digestive tract instrumentation

Pharynx fistula is a pathological state that can pose serious problems for both physician and patient and can lead up to the death of the patient in complicated cases. The authors describe a series of guidelines for the management of the pharynx fistula regarding the complications of the instrumentation of the upper digestive tract. Most of the cases that are addressed to our clinic can be treated with a conservative approach and a nutrition therapy plan tailored to each case. In selected cases surgery is the method of choice for therapy. The management of the pharynx fistula can be well managed in a multidisciplinary approach using resources from the E.N.T. and H.N.S. department and more important from the ICU department