The impact of immediate breast reconstruction on the time to delivery of adjuvant therapy: the iBRA-2 study

Background: Immediate breast reconstruction (IBR) is routinely offered to improve quality-of-life for women requiring mastectomy, but there are concerns that more complex surgery may delay adjuvant oncological treatments and compromise long-term outcomes. High-quality evidence is lacking. The iBRA-2 study aimed to investigate the impact of IBR on time to adjuvant therapy. Methods: Consecutive women undergoing mastectomy ± IBR for breast cancer July–December, 2016 were included. Patient demographics, operative, oncological and complication data were collected. Time from last definitive cancer surgery to first adjuvant treatment for patients undergoing mastectomy ± IBR were compared and risk factors associated with delays explored. Results: A total of 2540 patients were recruited from 76 centres; 1008 (39.7%) underwent IBR (implant-only [n = 675, 26.6%]; pedicled flaps [n = 105,4.1%] and free-flaps [n = 228, 8.9%]). Complications requiring re-admission or re-operation were significantly more common in patients undergoing IBR than those receiving mastectomy. Adjuvant chemotherapy or radiotherapy was required by 1235 (48.6%) patients. No clinically significant differences were seen in time to adjuvant therapy between patient groups but major complications irrespective of surgery received were significantly associated with treatment delays. Conclusions: IBR does not result in clinically significant delays to adjuvant therapy, but post-operative complications are associated with treatment delays. Strategies to minimise complications, including careful patient selection, are required to improve outcomes for patients

Inhomogeneity in optical properties of rat brain: a study for LLLT dosimetry

Over the last few years, low-level light therapy (LLLT) has shown an incredible suitability for a wide\ud range of applications for central nervous system (CNS) related diseases. In this therapeutic modality light\ud dosimetry is extremely critical so the study of light propagation through the CNS organs is of great\ud importance. To better understand how light intensity is delivered to the most relevant neural sites we\ud evaluated optical transmission through slices of rat brain point by point. We experimented red\ud (λ = 660 nm) and near infrared (λ = 808 nm) diode laser light analyzing the light penetration and\ud distribution in the whole brain. A fresh Wistar rat (Rattus novergicus) brain was cut in sagittal slices and\ud illuminated with a broad light beam. A high-resolution digital camera was employed to acquire data of\ud transmitted light. Spatial profiles of the light transmitted through the sample were obtained from the\ud images. Peaks and valleys in the profiles show sites where light was less or more attenuated. The peak\ud intensities provide information about total attenuation and the peak widths are correlated to the scattering\ud coefficient at that individual portion of the sample. The outcomes of this study provide remarkable\ud information for LLLT dose-dependent studies involving CNS and highlight the importance of LLLT\ud dosimetry in CNS organs for large range of applications in animal and human diseases.CNP

Analysis of Outcomes in Ischemic vs Nonischemic Cardiomyopathy in Patients With Atrial Fibrillation A Report From the GARFIELD-AF Registry

IMPORTANCE Congestive heart failure (CHF) is commonly associated with nonvalvular atrial fibrillation (AF), and their combination may affect treatment strategies and outcomes