Drewbarefoot3773

To compare robotic mastectomy with open classical technique outcomes in breast cancer patients.

As the use of robotic nipple sparing mastectomy continues to rise, improved understanding of the surgical, oncologic and quality of life outcomes is imperative for appropriate patient selection as well as to better understand indications, limits, advantages and dangers.

In a phase III, open label, single center, randomized controlled trial involving 80 women with breast cancer (69) or with BRCA mutation (11), we compared the outcome of robotic and open nipple sparing mastectomy. Primary outcomes were surgical complications and quality of life using specific validated questionnaires. Secondary objective included oncologic outcomes.

Robotic procedure was 1 hour and 18 minutes longer than open (P < 0.001). No differences in the number or type of complications (P = 0.11) were observed. Breast-Q scores in satisfaction with breasts, psychosocial, physical and sexual well-being were significantly higher after robotic mastectomy vs open procedure. Respect to baseline, physical and sexual well-being domains remained stable after robotic mastectomy while they significantly decreased after open procedure (P<= 0.02). The overall Body Image Scale questionnaire score was 20.7 +/- 13.8 vs. 9.9 +/- 5.1 in the robotic vs open groups respectively, P < 0.0001. At median follow-up 28.6 months (range 3.7-43.3), no local events were observed.

Complications were similar among groups upholding the robotic technique to be safe. Quality of life was maintained after robotic mastectomy while significantly decrease after open surgery. Early follow up confirm no premature local failure. ClinicalTrials.gov NCT03440398.

Complications were similar among groups upholding the robotic technique to be safe. Quality of life was maintained after robotic mastectomy while significantly decrease after open surgery. Early follow up confirm no premature local failure. ClinicalTrials.gov NCT03440398.

Trimethylaminuria is a rare disorder characterised by foul odour from bodily fluids and breath. The condition is caused by a homozygous mutation in the FMO3 (flavin monooxygenase 3) gene coding for the enzyme that converts TMA (trimethylamine) to trimethylamine N-oxide. The result is elevated levels of secreted trimethylamine, which has a strong odour. The condition is likely to affect mental, emotional and social health. The diagnosis is reached by testing of free TMA (trimethylamine) and percentage N-oxidation in urine samples or by genetic testing.

A man in his fifties had from childhood occasionally been told that his breath resembled rotten fish. He had searched for a diagnosis on the internet and was referred to testing for trimethylaminuria, and the diagnosis was confirmed.

Urine test samples with high levels of free TMA and subnormal percentage of trimethylamine N-oxide revealed the diagnosis of trimethylaminuria. There is no causal treatment. Patients are advised to avoid choline-rich foods and take hygienic measures.

Urine test samples with high levels of free TMA and subnormal percentage of trimethylamine N-oxide revealed the diagnosis of trimethylaminuria. There is no causal treatment. Patients are advised to avoid choline-rich foods and take hygienic measures.

Children and adolescents with Down syndrome have a comprehensive need for follow-up in the primary and specialist healthcare services.

In June 2019, we published a questionnaire on the Facebook group of the Norwegian Network for Down syndrome. The purpose was to investigate user experiences among parents of children and adolescents with Down syndrome in the age group 0-20years, in their encounter with the healthcare services.

We received 174responses. Those most satisfied were parents of children who received follow-up for secondary diagnoses such as vision problems, heart defects and endocrine disorders. Those least satisfied were parents of children with problems associated with behaviour, sleep and puberty. Approximately 6out of 10parents reported no negative experiences in their encounter with the healthcare services, but 29/161 (18%) reported that the diagnosis of Down syndrome had contributed to treatment failure by the paediatrician or in the child rehabilitation service.

The study indicates a need for improved follow-up of children and adolescents with Down syndrome, both in the primary and specialist healthcare services.

The study indicates a need for improved follow-up of children and adolescents with Down syndrome, both in the primary and specialist healthcare services.

Dural arteriovenous fistulae are among the most common causes of pulsatile tinnitus. Selective angiography can be necessary for a definitive diagnosis, but in rare cases has been reported to cause sudden cortical blindness.

We present a woman in her seventies for whom cerebral angiography revealed a dural arteriovenous fistula. Two hours after the angiography she experienced sudden bilateral blindness. A local cause of sudden visual loss was excluded by clinical examination, cerebral bleeding was excluded by CT scan, vascular spasms and occlusions were excluded by CT angiography and acute infarction over the bilateral parieto-occipital cortex was excluded by MRI. The CT scan did, however, show contrast enhancement in the visual cortex from the contrast given during the previously performed cerebral angiography. The patient's vision spontaneously recovered within six days after the angiography, with no residual neurological deficits in her subsequent clinical follow up. Surgery was later performed on her dural arteriovenous fistula, which successfully treated the pulsatile tinnitus.

Transient cortical blindness is a rare but dramatic complication after cerebral angiography, thought to be caused by the transient neurotoxic effects of iodine-containing contrast agents. When other causes of sudden blindness are excluded, the patient can be reassured about the excellent prognosis for this condition.

Transient cortical blindness is a rare but dramatic complication after cerebral angiography, thought to be caused by the transient neurotoxic effects of iodine-containing contrast agents. When other causes of sudden blindness are excluded, the patient can be reassured about the excellent prognosis for this condition.

Previous caesarean section is considered the main risk factor for uterine rupture. However, other surgical procedures performed on the uterus can also lead to rupture in future pregnancies.

The patient was a nulliparous woman, induced at gestational age of 41+6 with misoprostol. She developed severe persistent abdominal pain. Due to fetal bradycardia, an acute caesarean section was performed. Peroperatively a large rupture was identified in the uterine fundus and the placenta was detached into the abdomen. STA-4783 chemical structure Medical history included a previous rightsided salpingectomy due to an extrauterine pregnancy located in the interstitial part of the right Fallopian tube.

Interstitial extrauterine pregnancy is rare, and recommendations for mode of delivery for subsequent pregnancies remain unclear. The current case illustrates the importance of being aware of the risk of rupture when the patient has undergone previous gynaecological surgery other than caesarean section, and of ensuring awareness of the placenta's location.

Interstitial extrauterine pregnancy is rare, and recommendations for mode of delivery for subsequent pregnancies remain unclear. The current case illustrates the importance of being aware of the risk of rupture when the patient has undergone previous gynaecological surgery other than caesarean section, and of ensuring awareness of the placenta's location.Monoclonal gammopathy is a frequent finding and may be associated with severe cancer such as myelomatosis and other B-cell lymphoproliferative disorders. However, the monoclonal component can also be the direct cause of serious disease, namely monoclonal gammopathy of clinical significance (MGCS). MGCS is most likely significantly underdiagnosed and is consequently also undertreated. In order to achieve a good therapeutic outcome, it is crucial that the condition is recognised at an early stage, so that treatment can be initiated before the patient has developed irreversible organ damage. Increased awareness of MCGS is therefore essential.

We have obtained knowledge of how the COVID-19pandemic affected the lives of adolescents immediately after the pandemic arrived in Norway. However, we know little about adolescents' experiences from the pandemic over time, and whether sociodemographic factors and infection rates at the municipality level play a role.

We used questionnaire data from 106448lower and upper secondary school pupils who took part in the Ungdata survey in 167municipalities in the spring of 2021 (response rate 76%). The adolescents' responses regarding their experiences during the pandemic were collated with statistics on infection rates at the municipality level. We performed a Chi-square test and multilevel analyses to investigate predictors of adolescents' experiences.

A total of 49% responded that the COVID-19pandemic affected their lives in a partly or very negative direction. Many reported negative changes in peer relationships, family relationships and mental health, but some also reported positive changes. Girls, older adolescents, those with a low socioeconomic background and those living in municipalities with a higher prevalence of infection reported more negative consequences.

Most adolescents reported that the pandemic has had more negative than positive consequences. Girls, older adolescents, those with a low socioeconomic background and those living in municipalities with a higher rate of infection may be especially affected by the negative effects of the pandemic.

Most adolescents reported that the pandemic has had more negative than positive consequences. Girls, older adolescents, those with a low socioeconomic background and those living in municipalities with a higher rate of infection may be especially affected by the negative effects of the pandemic.

Few studies have addressed the functional impact after transanal total mesorectal excision.

To evaluate function and health-related quality of life among patients with rectal cancer treated with transanal total mesorectal excision.

Consecutive patients treated between 2016 and 2018 were selected. Their function and quality of life was studied preoperatively, at 3 and 12 months after surgery.

Prospective case series.

Patients were eligible if they had primary anastomosis, the diverting stoma had been reversed, and in the absence of anastomotic leakage. Forty-five patients were finally included. A total of 31 (68.8%) and 32 patients (71.1%) completed the 3- and 12-months surveys, respectively.

Standard transanal total mesorectal excision.

The primary endpoint was functional and quality of life outcomes using validated questionnaires. Secondary endpoints included values obtained with endoanal ultrasounds, anorectal manometries, and rectal sensation testing.

Wexner and Low Anterior Resection Syndrdeo Abstract at http//links.lww.com/DCR/B541.

Patients undergoing transanal total mesorectal excision report acceptable quality of life and functional outcomes 12 months after surgery. See Video Abstract at http//links.lww.com/DCR/B541.