Abstract：
BACKGROUND:Nipple discharge occurs in 2% to 5% of women. We evaluated the effectiveness of a previously proposed treatment algorithm for these patients. METHODS:Patients with pathologic nipple discharge and a negative mammogram and subareolar ultrasound were offered follow-up from 2005 to 2011 according to the algorithm. RESULTS:A total of 192 patients, mean age 56 years, were studied. Risk of carcinoma among the entire cohort was 5%. Breast surgeon was consulted for 142 (74%) patients: 48 (34%) underwent initial subareolar excision and 94 (66%) were clinically followed. The rate of carcinoma was 17% (8/48) after initial subareolar excision, 0% (0/13) for those without imaging abnormalities, 23% (8/35) with imaging abnormalities, and 1% (1/94) with clinical follow-up. Of patients who underwent follow-up, 21% (n = 20) underwent subareolar excision because of imaging abnormality (n = 1, 1%) or persistent discharge (n = 19, 20%). Most patients had ductal carcinoma in situ (n = 5, 56%). CONCLUSIONS:Patients with nipple discharge can be prospectively identified based on radiographic findings and clinical examination for safe clinical follow-up. Most will have resolution avoiding a surgical procedure.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Ashfaq A,Senior D,Pockaj BA,Wasif N,Pizzitola VJ,Giurescu ME,Gray RJdoi
10.1016/j.amjsurg.2013.12.035subject
Has Abstractpub_date
2014-08-01 00:00:00pages
222-7issue
2eissn
0002-9610issn
1879-1883pii
S0002-9610(14)00151-2journal_volume
208pub_type
杂志文章abstract：BACKGROUND:Fibroadenomas commonly found by palpation and routine mammography account for approximately 20% of open surgical breast biopsies. Alternatives to open surgery include tumor removal using an automated coring device and tumor ablation using heating or cooling elements. We report our initial experience with cry...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01010-3
更新日期：2002-11-01 00:00:00
abstract：:The satisfactory substitute for catgut suture, Vicryl (polyglactin 910) suture, was used in fifty-three patients who underwent general and thoracic surgical procedures. Theoretical advantages of increased strength, controlled absorption by slow depolymerization and dissolution, and superior handling characteristics we...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90367-1
更新日期：1977-08-01 00:00:00
abstract：:It is important that physicians participate in the debate and planning process that will ultimately guide how we reform the way health care is financed and delivered in the United States. Herein is offered a perspective on the problem, one which is not necessarily appreciated by health planners. While we deliver the b...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/0002-9610(94)90081-7
更新日期：1994-02-01 00:00:00
abstract：BACKGROUND:Aging of the population necessitates consideration of the increasing number of older adults requiring emergency care. The objective of this study was to compare outcomes and presentation of octogenarian and/or nonagenarian emergency general surgery (EGS) patients with younger adults. METHODS:Based on a stan...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.01.021
更新日期：2016-08-01 00:00:00
abstract：BACKGROUND:Obesity is a risk factor for many comorbid conditions that increase the cost of health care. We sought to examine the effect of obesity on surgical complications and cost in a group of patients undergoing intestinal surgery. METHODS:Using the Veterans Affairs Surgical Quality Improvement Program (VASQIP), w...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2012.01.013
更新日期：2012-10-01 00:00:00
abstract：BACKGROUND:The role of stereotactic fine-needle aspiration cytology (SFNAC) in the diagnosis of nonpalpable breast lesions is poorly defined. PATIENTS AND METHODS:Data were prospectively collected from 225 consecutive patients with nonpalpable breast lesions who had aspiration cytology followed by immediate surgical e...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1016/s0002-9610(05)80116-3
更新日期：1994-12-01 00:00:00
abstract：BACKGROUND:The relationship between hospital volume and patient outcomes remains controversial for rectal cancer. METHODS:This is a population-based database study. Patients treated with surgery for a stage I to III rectal adenocarcinoma from 2003 to 2009 were identified. High-volume hospitals (HVH) were those centers...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2016.07.007
更新日期：2017-02-01 00:00:00
abstract：:Though morbidity and mortality rates following pancreatic resection have improved in recent years, they are still around 35% and 5%, respectively. Typical complications, such as pancreatic fistula, abscess, and subsequent sepsis, are chiefly associated with exocrine pancreatic secretion. In order to clarify whether th...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1016/0002-9610(92)90264-r
更新日期：1992-01-01 00:00:00
abstract：BACKGROUND:Traumatic injuries during pregnancy are the leading cause of nonobstetric maternal mortality. We aimed to determine hospital charges for trauma activations during pregnancy. METHODS:We used the Illinois State Trauma Registry data from 1999 to 2003. Using STATA for bivariate and regression analyses, we compa...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.10.018
更新日期：2014-07-01 00:00:00
abstract：BACKGROUND:Metabolic syndrome (MetS) is defined by numerous comorbidities. We sought to assess MetS's effect on the 7 main emergency general surgery (EGS) procedures that constitute 80% of EGS procedures, mortalities, complications, and costs. METHODS:Data were acquired from the ACS-NSQIP database from 2005 to 2017. C...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.12.021
更新日期：2020-08-01 00:00:00
abstract：BACKGROUND:Injury epidemiology fluctuates with economic activity in many countries. These relationships remain unclear in Canada. METHODS:The annual risk of admission for major injury (Injury Severity Score ≥12) to a high-volume, level-1 Canadian trauma center was compared with indicators of economic activity over a 1...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.12.011
更新日期：2014-05-01 00:00:00
abstract：BACKGROUND:The aim of this study was to characterize patients readmitted following inpatient general surgery procedures. We hypothesized that a decreased length of stay would increase risk for readmission. METHODS:We utilized our institutional National Surgical Quality Improvement Project database from 2006 to 2011. T...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.10.022
更新日期：2014-04-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to describe the admission characteristics of trauma victims that are predictive of the development of delirium during hospitalization. METHODS:In this case-control study, data (demographics, injury type, medical histories, admission laboratory values, medications, and outcomes)...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2003.12.027
更新日期：2004-03-01 00:00:00
abstract：BACKGROUND:Thrombotic thrombocytopenic purpura (TTP) is a rare, life-threatening disorder of unknown pathophysiology. The role of splenectomy in the multimodality therapy of TTP is controversial. MATERIALS AND METHODS:All charts of patients with TTP at the University of Utah between 1984 and 1994 were reviewed to eval...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80015-4
更新日期：1995-12-01 00:00:00
abstract：:Mesenteric vascular disease continues to be associated with an extremely high mortality. It is not necessarily a disease of old age: 20 of the 75 patients in our series were less than 60 years of age. In retrospect, earlier diagnosis and a more aggressive approach could have improved the survival rate of 17.3 percent....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90251-2
更新日期：1980-02-01 00:00:00
abstract：BACKGROUND:This study was designed to investigate abnormalities in gene expression in ductal adenocarcinoma of the pancreas using cDNA arrays. METHODS:Gene expression in pancreatic ductal adenocarcinoma was compared with normal pancreatic tissue controls. Specimens from 5 patients with pancreatic adenocarcinoma were t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01105-4
更新日期：2002-12-01 00:00:00
abstract：:A prospective study designed specifically to analyze errors in management and iatrogenic complications was conducted on 234 consecutive patients with penetrating chest trauma. Eleven percent of penetrating pleural injuries were incorrectly diagnosed on initial physical and radiologic examination, but this led to wrong...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(89)90577-1
更新日期：1989-04-01 00:00:00
abstract：BACKGROUND:Percutaneous endoscopic gastrostomy and jejunostomy tube placement have long been considered the standard for supplying enteral nutrition when oral intake is not possible. Both have well-documented roles and limitations and are associated with a higher than generally appreciated incidence of aspiration. A di...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(98)00298-0
更新日期：1999-01-01 00:00:00
abstract：BACKGROUND:The severity of ischemia and reperfusion (I/R) injury is an important determinant of patient outcome in hepatic surgery. The aim of this study was to investigate the efficacy of a protease inhibitor in alleviating I/R injury to human liver in the setting of hepatectomy under intermittent Pringle maneuver. M...
journal_title：American journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.amjsurg.2005.04.018
更新日期：2006-01-01 00:00:00
abstract：BACKGROUND:Many women with breast cancer recurrence previously treated with breast-conservation therapy desire repeat lumpectomies. We hypothesized that women undergoing mastectomy for breast cancer recurrence would show superior survival. METHODS:Patients who previously received breast-conservation therapy diagnosed ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.06.018
更新日期：2008-10-01 00:00:00
abstract：:This laboratory study compared the biomechanical and biochemical healing of microvascular free skin flaps in irradiated and nonirradiated recipient areas. In the adult rat, the skin of the right groin region was exposed to a single fraction dose of 20 Gy, using a linear megavoltage accelerator. The left groin was shie...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(05)80730-5
更新日期：1992-12-01 00:00:00
abstract：:A review of 143 patients with 144 feeding jejunostomies was carried out. In the 129 patients in whom catheters were utilized, only 48 (45 percent) had no complications. Seventy-one patients (55 percent) suffered one or more catheter-related complications. Ten of these complications were life-threatening or fatal, incl...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80267-8
更新日期：1988-01-01 00:00:00
abstract：:A 54-year-old man on palliative treatment for disseminated cutaneous malignant melanoma presented with abdominal pain and abdominal distention. A computed tomography scan showed an area in the distal ileum suggesting intussusceptions. In an exploratory laparotomy, a 10-cm mass was found comprised of the distal ileum t...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2008.09.018
更新日期：2009-07-01 00:00:00
abstract：BACKGROUND:Endoscopic retrograde cholangiopancreatography is a challenging procedure performed by surgeons and gastroenterologists. We employed cognitive task analysis to identify steps and decision points for this procedure. METHODS:Standardized interviews were conducted with expert gastroenterologists (7) and surgeo...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.05.006
更新日期：2015-10-01 00:00:00
abstract：BACKGROUND:Few studies have evaluated the role of computed tomography-guided percutaneous drainage (PD) in the management of gastrointestinal (GI) anastomotic leaks. METHODS:Ten-year review of an interventional radiology database identified patients with symptomatic GI anastomotic leaks. Clinical, laboratory, radiogra...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.08.050
更新日期：2014-07-01 00:00:00
abstract：BACKGROUND:Michigan repealed a 35-year mandatory helmet law on April 13, 2012. We examined the early clinical impacts at a level 1 trauma center in West Michigan. METHODS:Retrospective cohort study comparing outcomes among motorcycle crash victims in a 7-month period before and after the helmet law repeal. RESULTS:On...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.12.001
更新日期：2014-03-01 00:00:00
abstract：:In addition to its own inherent morbidity, the pain associated with chronic wounds presents a primary obstacle to healing. To initiate safe and effective therapy, we used a multidisciplinary approach that required the wound-healing clinician and pain-management practitioner to work together to diagnose and treat the p...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(03)00289-7
更新日期：2004-07-01 00:00:00
abstract：:An adaptable on-line computer system for entry, retrieval, and analysis of medical discharge summaries has been developed and applied in the Trauma Service of a busy city hospital. Each summary occupied 5 to 10 minutes of the physician's time and compared favorably in cost to the standard dictated summary. While the a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90049-0
更新日期：1976-08-01 00:00:00
abstract：BACKGROUND:Portal vein embolization (PVE), proposed to induce contralateral hepatic hypertrophy before major hepatectomy, carries some negative side effects since growth rate of metastases in the future remnant liver (RL) can be more rapid than that of nontumoral liver parenchyma. Therefore, metastases in the RL should...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01373-9
更新日期：2003-03-01 00:00:00
abstract：BACKGROUND:We hypothesized that mandatory multidisciplinary team (MDT) participation improves process evaluation, outcomes, and technical aspects of surgery for rectal cancer in a stable practice of colorectal surgery. METHODS:A retrospective review of MDT data was conducted of all patients with colorectal cancer sinc...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.08.015
更新日期：2016-01-01 00:00:00
