Survival of premenopausal breast cancer patients in relation to menstrual timing of surgery with peritumoral estrogen receptor status and angiogenesis

To define the prognostic significance of menstrual timing of breast cancer [BRCA] surgery, its interaction with estrogen receptor [ER] and angiogenesis. Prospective randomized involving 40 premenopausal BRCA patents with accurate triangulation of surgery [no multistage] in objectively defined menstrual cycle side [transvaginal ultrasound-serum progesterone], immunocytochemical stain for estrogen receptors and factor VIII, 5 years follow up with well proved finite end points./ /[ disease free survival [DFS]and disease free time [DFT]/ /]. Resected Tumors in the follicular phase had more angiogenic score [P, 0.001] plus higher micro vessel count [P, 0.001]. Patients who underwent surgery in the luteal phase had better [DFS] [P, 0.02]. On univariant analysis the menstrual timing [P, 0.01] and angiogenic score [P, 0.01] predicted the DFS, their bivariant analysis found luteal phase subset with low angiogenic score had the best prognosis [P, 0.04], but on multivariate analysis the menstrual timing was the discriminant factor [P, 0.04], the predictors for DFT were menstrual timing [P, 0.02], and ER status [P, 0.04] with insignificant difference on subset analysis. Menstrual timing represented grade II prognostic factor, with better DFS, DFT for patients operated in the luteal phase. It acts through angiogenesis modulation

Fournier's gangrene: clinical, biochemical, bacteriologic, immunologic study and treatment outcome

Identify Fournier's disease associations, outcome and survival factors. Fournier's gangrene patients [34] were treated between 2003 to 2006. Data were collected about medical history, physical findings, metabolic test, bacteriologic typing, immunologic screening for T cell function, serum IL-2, ICAM-I and gamma IFN with their management. The disease had age range 3-67 years, polymicrobial nature, and low serum albumin [3.3 +/- 0.6mg/dl]. Inadequate T-cell function [18255.3 +/- 1641 CPM] and high ICAM-I, IL-2, gamma IFN [10.5 +/- 0.7, 93.3 +/- 1.6, 131 +/- 2 pg/ml] were detected in Fournier's disease but serum IL-2 was relevant to outcome [P=0.0001]. The survival factors were patients' age [P=0.0001], presentation timing [P=0.001], both disease extent [P=0.0001], septic shock [P=0.01], severe SIRS [P=0.001], serum albumin [P=0.0001] and IL-2. Fournier's disease is consistent with deviated metabolic status and immunologic dissonance, inciting local gangrenous process, these parameters are significant for disease outcome

Early oral feeding versus delayed oral feeding in patients undergoing intestinal resection

Aim: This study was conducted to evaluate early oral feeding versus delayed feeding after intestinal resection

Methods: In the period from June 2005 to September 2006 this study included 240 patients who underwent intestinal resection either elective or emergency, they were randomized into two groups. Group [A] included 120 patients with early oral feeding and group [B] with delayed oral feeding. Patients were followed lip for a period of 3-12 months

Results: Twenty four [20%] patients in group [A] had leakage versus 28 [23.3%] in [B], [p0.531]. Sixteen [13.3%] patients were explored in group [A] versus 18 [15%] in [B], [p= 0.711]. In group [A] 15 [12.5%] patients had local complications versus 14 [11.3%] in [B], this was not of statistical significance. Hospital stay was significantly shorter in group A than [B] with mean stay of [2.5 + 1.7] versus [9.93 + 2.60] days respectively. General complications were less frequent in group [A] versus [B] with more patient satisfaction and early return to work, but readmissions were more frequent among group [A] [5 versus 2]. Regarding mortality 9 [7.5%] patients died in group [A] versus 8 [6.6%] in [B], [p= 0.333]

Conclusion: Early oral feeding after intestinal resection is well tolerated and safe with better outcome