Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy

Purpose Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. Methods The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. Results Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. Conclusions In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques

Turkish validity and reliability of a pediatric quality of life cancer module for children aged 8-12 and parents

This descriptive study was conducted to determine the validity and reliability in Turkey of the Pediatric Quality of Life Inventory Cancer Module (PedsQL 3.0) for children aged 8-12 in the hematology-oncology polyclinics of two university hospitals in Istanbul during the period 2006-2007. The data collection instruments were the Pediatric Quality of Life Inventory (PedsQL 4.0), the Pediatric Quality of Life Inventory Cancer Module (PedsQL 3.0) and a socio-demographic questionnaire, applied for 146 children diagnosed with cancer and 146 parents. Cronbach's alpha coefficients for the PedsQL 3.0 were found to be 0.602-0.982 for sub-groups with the children's form, 0.644-0.966 with the parents' form. The scale was found to give a significantly high level of reliability (0.60? ± ? <0.80). Significant and directly proportional correlations were demonstrated between the forms for children and parents. It was concluded that the PedsQL 3.0 cancer module is a valid and reliable tool for assessing the quality of life of Turkish children, aged 8-12, diagnosed with cancer

Impact of exercise on lower activity levels in children with acute lymphoblastic leukemia: A randomized controlled trial from Turkey

This randomized, controlled experimental study was carried out to determine the effects of an exercise program on both physical parameters and the quality of life of children with acute lymphoblastic leukemia (ALL). A total of 41 children with ALL (20 trial and 21 control cases) at two university hospitals were accepted into the study. Due to the demise of one of the children in the trial group, the study was completed with 19 trial and 21 control patients, a total of 40 children and their parents. Regular and systematic exercise regimens implemented by children with ALL have resulted in improved testing results, enhanced physical performance, and better laboratory results compared with a control group and to children's scores before the initiation of such a program. © 2012 Association of Rehabilitation Nurses

Organochlorine pesticide level in breast milk [Anne sütünde organoklorlu pestisid (OKP) düzeyi]

Objective: Mother's milk is the primary nutrition source for healthy development and growth of infants. Nutrients are transmitted to the infant through the breast milk along with other substances. The objective of this study was to determine the level of certain organochlorine pesticides (OCP's) in the milk of the mothers who have recently given birth and residing in Adana. Material and Methods: Between July and September 2006, milk was taken from 59 mothers who are within 1 to 30 postpartum days. These samples were analyzed with gas chromatography mass spectrometry (EI) and gas chromatography (ECD) in the Toxicology Laboratory of the Department of Forensic Medicine. The collected data were evaluated by the SPSS 10 statistical program. Results: Out of these 59 women included in the study, mean age was 26.8 ± 5.9. In 62.7% (37 samples) of the milk samples, OCP's were determined. There was no statistically significant relation between OCP positivity and residential place, profession, education level, agricultural activity and age groups. In the milk of 59 mothers, 13 types of OCP's were found. The most frequently observed types were alpha hexachlorocyclohexane (?-HCH) with 14 women, dichlorophenyl dichloroethylene (DDE) in 9 women, ?-Chlordane in 8 women, gamma hexachlorocyclohexane (?-HCH) in 7 women, beta hexachlorocyclohexane (ß-HCH) in 6 women. Conclusion: The finding that OCP was found in breast milk in 62.7% of the women included in the study, is very important from the perspective of public health. Our result that the OPC existence does not differ with age, profession and place of residency, shows that the whole population is under the risk. More comprehensive studies should be undertaken in this subject. © Türkiye Klinikleri

Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy

Purpose Indications for nipple-sparing mastectomy (NSM) have broadened to include the risk reducing setting and locally advanced tumors, which resulted in a dramatic increase in the use of NSM. The Oncoplastic Breast Consortium consensus conference on NSM and immediate reconstruction was held to address a variety of questions in clinical practice and research based on published evidence and expert panel opinion. Methods The panel consisted of 44 breast surgeons from 14 countries across four continents with a background in gynecology, general or reconstructive surgery and a practice dedicated to breast cancer, as well as a patient advocate. Panelists presented evidence summaries relating to each topic for debate during the in-person consensus conference. The iterative process in question development, voting, and wording of the recommendations followed the modified Delphi methodology. Results Consensus recommendations were reached in 35, majority recommendations in 24, and no recommendations in the remaining 12 questions. The panel acknowledged the need for standardization of various aspects of NSM and immediate reconstruction. It endorsed several oncological contraindications to the preservation of the skin and nipple. Furthermore, it recommended inclusion of patients in prospective registries and routine assessment of patient-reported outcomes. Considerable heterogeneity in breast reconstruction practice became obvious during the conference. Conclusions In case of conflicting or missing evidence to guide treatment, the consensus conference revealed substantial disagreement in expert panel opinion, which, among others, supports the need for a randomized trial to evaluate the safest and most efficacious reconstruction techniques