The planning of cancer screening programmes.

Positive screening tests require investigation, usually by specialists. Specialist services are known to be limited. The planning of screening programmes must first include a model of existing diagnostic and follow-up services of symptomatic patients so that the added impact of the extra referrals required for screening can be estimated. This is fundamental to the planning of screening programmes; inevitable diagnostic delay, impeded access to services for symptomatic patients, and resulting harm or increased mortality from disease can thus be avoided.

Influence of Deep Serratus Anterior Plane Block on Chronic Pain at 3 Months After Breast-Conserving Surgery: Prospective, Cohort Study.

OBJECTIVES: In 2015, we evaluated our practices regarding pain after breast-conserving surgery. Thereafter, we have adapted our practices by performing a systematic deep serratus plane block before the surgical incision. In 2019, we assessed the impact of these changes in terms of chronic pain. The main objective of this study was to evaluate the prevalence of chronic pain 3 months after this type of surgery. MATERIALS AND METHODS: All patients treated with breast-conserving surgery as outpatients were included in this prospective study between April and July 2019. After inducing general anesthesia, 20 mL of ropivacaine 3.75 mg/mL were injected under the serratus muscle. Morphine titration was performed in the recovery room according to pain scores. A pain and quality of life questionnaire was sent 3 months after surgery. A backward logistic regression model was applied to calculate the adjusted odds ratios. RESULTS: The final analysis involved 137 patients. Three months after surgery, 43 patients (31%) reported persistent pain related to the surgery. Maximum pain in the last 24 hours was moderate to severe in 60% of cases, 16 patients (35%) took painkillers. Morphine titration in the recovery room was required in 25 patients (18%). Younger age and the use of lidocaine to prevent after injection of propofol during general anesthesia induction appeared to be protective factors for the risk of pain at 3 months (secondary endpoints). DISCUSSION: No persistent pain at 3 months was reported in 69% of cases. Furthermore, the use of a deep serratus anterior plane block before the surgical incision has limited the need for morphine titration in the recovery room to <1 patient in 5. These evaluations of professional practices should be encouraged.

Familial hypersensitivity pneumonitis triggered by Cladosporium herbarum exposure during carpooling.

This series reports cases of Cladosporium herbarum-related HP due to an uncommon exposure source, illustrating the genetic background underlying HP, and highlighting the role of environmental home inquiry and serum precipitins in diagnosis and follow-up https://bit.ly/3hzvE4w.

Angle-resolved ellipsometry of scattering patterns from arbitrary surfaces and bulks.

Accurate angular phase data are extracted from angle-resolved scattering measurements made with polarized light using a technique developed in the laboratory. This Ellipsometry of Angle-Resolved Scattering (E.A.R.S.) technique makes it possible to distinguish surface scattering from bulk scattering independent of the scattering levels for different types of samples. Phase data are also investigated in the speckle pattern.

Elimination of polarized light scattered by surface roughness or bulk heterogeneity.

An interferential technique is described to eliminate polarized scattering from optical substrates and coatings. Conditions of annulment are respectively given for surface roughness and for bulk heterogeneity, at each direction of space. At low-level scattering, the method offers a complete discrimination of surface and bulk effects, whatever the micro-structural parameters. Arbitrary scattering levels can be treated in a similar way, but require the knowledge of microstructure.