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Vercruysse W, Muniz RR, Joos B, Hardy A, Hamed H, Desta D, Boyen HG, Schreurs S, Safari M, Marchal W, Vandamme D. Co-pyrolysis of chicken feathers and macadamia nut shells, a promising strategy to create nitrogen-enriched electrode materials for supercapacitor applications. Bioresour Technol 2024; 396:130417. [PMID: 38316229 DOI: 10.1016/j.biortech.2024.130417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/31/2024] [Accepted: 01/31/2024] [Indexed: 02/07/2024]
Abstract
Global food waste emits substantial quantities of nitrogen to the environment (6.3 Mtons annually), chicken feather (CF) waste is a major contributor to this. Pyrolysis, in particular co-pyrolysis of nitrogen-rich and lignocellulosic waste streams is a promising strategy to improve the extent of pyrolytic nitrogen retention by incorporating nitrogen in its solid biochar structure. As such, this biochar can serve as a precursor for nitrogen-enriched activated carbons for application in supercapacitors. Therefore, this study investigates the co-pyrolysis of CF with macadamia nut shells (MNS) to create nitrogen-rich activated carbons. Co-pyrolysis increased nitrogen retention during pyrolysis from 9 % to 18 % compared to CF mono-pyrolysis, while the porosity was maintained. After removing undesirable inorganic impurities by dilute acid washing, this led to a specific capacitance of 21F/g using a scan rate of 20 mV/s. Finally, cycling stability tests demonstrated good stability with 73 % capacitance retention after 10 000 cycles.
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Affiliation(s)
- W Vercruysse
- Analytical and Circular Chemistry, Institute for Materials Research (imo-imomec), Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium
| | - R R Muniz
- Analytical and Circular Chemistry, Institute for Materials Research (imo-imomec), Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium
| | - B Joos
- Design and Synthesis of Inorganic Nanomaterials, Institute for Materials Research (imo-imomec), Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium; IMEC vzw, Division Imomec Associated Laboratory, Wetenschapspark 1, 3590 Diepenbeek, Belgium; EnergyVille, Thor Park 8320, 3600 Genk, Belgium
| | - A Hardy
- Design and Synthesis of Inorganic Nanomaterials, Institute for Materials Research (imo-imomec), Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium; IMEC vzw, Division Imomec Associated Laboratory, Wetenschapspark 1, 3590 Diepenbeek, Belgium; EnergyVille, Thor Park 8320, 3600 Genk, Belgium
| | - H Hamed
- Electrochemical Engineering, Institute for Materials Research (imo-imomec), Hasselt University, Agoralaan, 3590 Diepenbeek, Belgium; IMEC vzw, Division Imomec Associated Laboratory, Wetenschapspark 1, 3590 Diepenbeek, Belgium
| | - D Desta
- Nano Structure Physics, Materials Physics, Institute for Materials Research (imo-imomec), Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium
| | - H-G Boyen
- Nano Structure Physics, Materials Physics, Institute for Materials Research (imo-imomec), Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium
| | - S Schreurs
- Nuclear Technology Centre (NuTeC), Centre for Environmental Sciences (CMK), Agoralaan, 3590 Diepenbeek, Belgium
| | - M Safari
- Electrochemical Engineering, Institute for Materials Research (imo-imomec), Hasselt University, Agoralaan, 3590 Diepenbeek, Belgium; IMEC vzw, Division Imomec Associated Laboratory, Wetenschapspark 1, 3590 Diepenbeek, Belgium
| | - W Marchal
- Analytical and Circular Chemistry, Institute for Materials Research (imo-imomec), Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium
| | - D Vandamme
- Analytical and Circular Chemistry, Institute for Materials Research (imo-imomec), Hasselt University, Agoralaan Gebouw D, 3590 Diepenbeek, Belgium.
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Jamil M, Sweed H, Abou-Hashem R, Hamed H, Ali K. 1283 MEDICATION-RELATED HARM (MRH) IN OLDER PEOPLE AFTER LEAVING HOSPITAL - AN UNDER-REPORTED EGYPTIAN CHALLENGE. Age Ageing 2023. [DOI: 10.1093/ageing/afac322.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Abstract
Introduction
Ageing is associated with multimorbidity, polypharmacy and medication-related harm (MRH). A 2013 systematic review reported only one study of medication errors (MEs) in older Egyptian patients. Our study investigated MRH (adverse drug reactions (ADR), drug errors, and non-adherence) in older Egyptian adults after hospital-discharge.
Methods
Between 2018 and 2020, we recruited 400 Egyptian patients, aged ≥60 years on discharge from Geriatrics and Internal Medicine wards from 3 hospitals, and followed them up for 8 weeks. Study procedures adopted a modified PRIME trial methodology (1).
Results
The average age of study participants was 71 (range 60 to 93, SD +/- 6.29) years with 53% females. In the cohort of 325 patients completing follow up, MRH occurred in 99 patients (incidence of 30.5%), with 5 patients (5.1%) experiencing a fatal MRH. Almost two thirds (65.7%) of MRH events were secondary to ADRs, 2 % related to non-adherence, 18.2 % due to both ADR and non-adherence, and 14% related to MEs. Multivariate logistic regression analysis showed that non-adherence (p-value 0.000, OR- 95% CI: 36.029), inappropriate prescription using Beer’s criteria (p 0.000, OR- 95% CI: 6.589), length of stay >7days (p 0.001, OR- 95% CI: 6.176), presence of Ischaemic Heart Disease (IHD) (p 0.000,OR- 95% CI: 5.695), Platelets count ≤ 245X 109/L (p 0.021, OR- 95% CI: 2.640), and dementia medications (p 0.017, OR- 95% CI: 4.616) were all significantly associated with MRH.
Conclusions
Medication-related harm in older Egyptian adults is common after hospital discharge. An integrated care pathway is required targeting high-risk older patients.
Reference
1. Stevenson J, Parekh N, Ali K et al. Protocol for a Prospective (P) study to develop a model to stratify the risk (RI) of medication (M) related harm in hospitalized elderly (E) patients in the UK (The PRIME study). BMC Geriatrics 2016; 16: 22. https://doi.org/10.1186/s12877-016-0191-8.
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Affiliation(s)
- M Jamil
- Ain Shams University Geriatrics and Gerontology Department, , Egypt
| | - H Sweed
- Ain Shams University Geriatrics and Gerontology Department, , Egypt
| | - R Abou-Hashem
- Ain Shams University Geriatrics and Gerontology Department, , Egypt
| | | | - K Ali
- Brighton and Sussex Medical School Academic Department of Geriatrics, , UK
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Jain U, Kothari A, Malhotra A, Hamed H, Purushotham A. The role of axillary staging in patients with Ductal Carcinoma In Situ (DCIS) on diagnostic tissue biopsy. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)01423-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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4
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Morgan C, Stringfellow TD, Rolph R, Kovacs T, Kothari A, Pinder SE, Hamed H, Sever AR. Neoadjuvant chemotherapy in patients with breast cancer: Does response in the breast predict axillary node response? Eur J Surg Oncol 2019; 46:522-526. [PMID: 31740186 DOI: 10.1016/j.ejso.2019.11.498] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 11/07/2019] [Accepted: 11/11/2019] [Indexed: 10/25/2022] Open
Abstract
INTRODUCTION Determining the extent of residual disease in the breast and axilla following neoadjuvant chemotherapy (NACT) is vital for surgical planning. Traditionally patients with incomplete radiological response in the breast after NACT undergo axillary node clearance, regardless of axillary clinical and radiological response. The aim of this study was to determine whether radiological and/or pathological response in the breast to NACT were predictive of axillary response. MATERIALS AND METHODS A retrospective cohort study of patients with operable breast cancer with histologically proven axillary lymph node involvement who received NACT and underwent definitive surgical treatment between 1/1/2016 and 31/12/2018 were included. All had MRI and/or US of the breast and axilla before, mid-treatment and at the end of NACT. RESULTS The 83 patients had a median age of 50 years (range 25-77). MRI had a positive predictive value (PPV) of 52.6% and negative predictive value (NPV) of 81.8% for breast pathological complete response (pCR). For axillary pCR, US had a PPV of 60.0% and NPV of 89.6%. Only 71% of patients had radiological concordance; 15.9% had radiological complete response (rCR) in breast and axilla whilst 55.1% had neither breast nor axillary rCR. 85.6% of patients had pathological concordance (20.5% with breast and axillary pCR: 65.1% with residual disease in both). CONCLUSION Radiological and pathological response in the breast to NACT does not accurately predict axillary response. The axilla and the breast should be viewed and assessed as two separate entities for treatment plans.
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Affiliation(s)
- C Morgan
- Department of Breast Surgery, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - T D Stringfellow
- Department of Breast Surgery, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - R Rolph
- Department of Breast Surgery, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - T Kovacs
- Department of Breast Surgery, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - A Kothari
- Department of Breast Surgery, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - S E Pinder
- Department of Pathology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - H Hamed
- Department of Breast Surgery, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - A R Sever
- Department of Radiology, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
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Kothari A, Smeeton B, Iwuchukwu O, in‘t Hout B, Kovacs T, Hamed H. A novel strategy for the immediate salvage of infected breast implants. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Hamed H, Elsawy E, Gaber A. Detection of β-Lactamase Enzymes using conventional and Molecular Methods. J Infect Public Health 2019. [DOI: 10.1016/j.jiph.2018.10.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Cook L, Massa M, Kothari A, Kovacs T, Hamed H, Douek M. 88. Outcomes of immediate implant-based breast reconstruction using an acellular dermal matrix. Eur J Surg Oncol 2014. [DOI: 10.1016/j.ejso.2014.08.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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8
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Fathy H, Hamed H, Fawzi H. EPA-0504 - Association between cognitive functions, cortisol release and symptoms severity in patients with schizophrenia. Eur Psychiatry 2014. [DOI: 10.1016/s0924-9338(14)77907-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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9
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Kontos M, Roy P, Rizos D, Petrou A, Hamed H. Contralateral relapse after surgery for breast cancer: evaluation of follow-up paradigms. Int J Clin Pract 2013; 67:1113-7. [PMID: 24165425 DOI: 10.1111/ijcp.12217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 05/22/2013] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Early treatment of breast cancer patients with loco-regional relapse or contralateral disease has been shown to improve survival. There is no current consensus on the optimal follow-up strategy. This study estimates the risk of isolated contralateral relapse (CR) after breast cancer surgery and its change over time, together with the efficacy of clinical examination, self-examination and mammography in the detection of CR. METHODS Data from patients treated for early breast cancer at Guy's Hospital between 1990 and 1997 were collected and those with isolated contralateral recurrences were analysed. Life table analysis was performed and CR, CR-free and cumulative CR rates were calculated. Correlations were evaluated using Pearson's correlation coefficient. RESULTS One thousand one hundred and forty-three women were included in the study and 23 patients had isolated CR. The median probability of CR was a constant 0.24% per year. Only one recurrence was found clinically at follow up, while the majority was detected through mammography and self-palpation. CONCLUSIONS The risk of CR is low and constant with time. Contralateral mammography is useful and can detect the vast majority of contralateral recurrences. These findings may have practical implications especially on the planning of postmastectomy follow up.
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Affiliation(s)
- M Kontos
- Breast Unit, Guy's and St Thomas' NHS Foundation Trust, Great maze Pond, London, UK
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Pilgrim G, Savage L, Hamed H, Dani M. Intra-operative specimen microradiography in wide local excision of breast cancer. Eur J Surg Oncol 2011. [DOI: 10.1016/j.ejso.2011.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022] Open
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11
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Savage L, Pilgrim G, Hamed H. 5150 POSTER Intra-operative Specimen Microradiography in Wide Local Excision of Breast Cancer. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)71592-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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12
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Kontos M, Allen DS, Agbaje OF, Hamed H, Fentiman IS. Factors influencing loco-regional relapse in older breast cancer patients treated with tumour resection and tamoxifen. Eur J Surg Oncol 2011; 37:1051-8. [PMID: 21843919 DOI: 10.1016/j.ejso.2011.07.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Revised: 06/20/2011] [Accepted: 07/25/2011] [Indexed: 10/17/2022] Open
Abstract
BACKGROUND In breast cancer patients (≥70 years), tumour resection plus tamoxifen (T + T) has a higher loco-regional relapse (LR) rate than mastectomy. This study examines factors influencing local recurrence in these cases. METHODS Clinical records of 71 patients aged ≥70 years, randomised to the T + T arm of 2 randomised trials were reviewed. Cox Proportional Hazards model was used to determine the most significant variables. RESULTS After 15-years follow-up, LR relapse occurred in 29/71, of whom 5 had synchronous metastatic disease. Most tumours recurred in the index quadrant. Subsequently 21/24 patients with loco-regional recurrence only had salvage mastectomy. Three variables significantly predicted LR: lympho-vascular invasion (LVI) (HR [95% CI]: 11.18 [4.47, 27.95], p < 0.01), ER negative status (HR [95% CI]: 0.27 [0.10, 0.72] p = 0.01), and tumour necrosis (HR [95% CI]: 2.65 [1.10, 6.37], p = 0.03). Final margin status was not associated with LR. CONCLUSIONS Tumour resection + Tamoxifen in older patients results in long-term local control in the majority with most loco-regional failures being salvageable. Risk factors for LR are lympho-vascular invasion, ER status and tumour necrosis. Negative tumour excision margins did not significantly change local outcome in the absence of radiotherapy. In these older patients LVI significantly reduced survival time.
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Affiliation(s)
- M Kontos
- Hedley Atkins Breast Unit, Guy's Hospital, London, UK
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13
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Gherbal R, Hamed H, Foth H. The effect of zinc ions on expression of metallothionein and poly (ADP-ribose) polymerase-1 in human lung cells. Toxicol Lett 2011. [DOI: 10.1016/j.toxlet.2011.05.560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Pichert G, Jacobs C, Jacobs I, Menon U, Manchanda R, Johnson M, Hamed H, Firth C, Evison M, Tutt A, de Silva L, Langman C, Izatt L. Novel one-stop multidisciplinary follow-up clinic significantly improves cancer risk management in BRCA1/2 carriers. Fam Cancer 2010; 9:313-9. [PMID: 20300867 DOI: 10.1007/s10689-010-9333-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The purpose of this study is to measure the impact of a multidisciplinary one-stop follow-up clinic (MDOSC) on breast and ovarian surveillance, risk reducing surgery and enrolment in clinical trials in BRCA1/2 carriers. All BRCA1/2 carriers in our region were invited and chose which specialists to see in our MDOSC offering best practice using clinical protocols based on national guidelines and published data. Uptake was evaluated over 24 months recording numbers of individuals undergoing breast and ovarian surveillance, risk reducing surgery, newly diagnosed cancers, their method of detection and participation in clinical trials. 172 (60%) of invited BRCA1/2 carriers chose to attend the MDOSC. Breast surveillance was initiated in 88% and screening frequency altered in 14% of women to comply with national guidelines. Risk reducing salpingo-oophorectomy was chosen by 47% of women and an additional 39% were considering it. The rate of failure to remove fallopian tubes fell from 15 to 3% of procedures (P < 0.01) and peritoneal washings and serial sectioning of tubes and ovaries rose from 25% and 14% before, to 67% (P < 0.001) and 63% (P < 0.001) procedures, respectively, after initiation of our MDOSC. 24% of women considered and 18% decided to undergo risk reducing mastectomy during the follow-up period. Participation in clinical trials increased significantly from 51 to 229 enrolments (P < 0.001). Our novel MDOSC designed to devise an individually tailored cancer risk management strategy had a high uptake amongst our BRCA1/2 carriers. Attendance resulted in improved breast and ovarian cancer risk management.
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Affiliation(s)
- G Pichert
- Clinical Genetics Department, Guy's and St Thomas NHS Foundation Trust, Guys Hospital, 7th Floor Borough Wing, Great Maze Pond Road, SE1 9RT, London, UK.
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Kontos M, Lewis R, Lüchtenborg M, Holmberg L, Hamed H. Does immediate breast reconstruction using free flaps lead to delay in the administration of adjuvant chemotherapy for breast cancer? Eur J Surg Oncol 2010; 36:745-9. [DOI: 10.1016/j.ejso.2010.06.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2010] [Revised: 05/24/2010] [Accepted: 06/07/2010] [Indexed: 10/19/2022] Open
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Hamed H, Gherbal R, Torky A, Foth H. Aberrant promoter methylation of RASSF1A, P16, DAPK, and Metallothionein-IA in human lung exposed to metals and cigarette smoke condensate (CSC). Toxicol Lett 2010. [DOI: 10.1016/j.toxlet.2010.03.618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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17
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Gherbal R, Hamed H, Sacher B, Torky A, Foth H. Methylation–unmethylation response of the promoter of DNA repair gene poly(ADP-ribose)polymerases (PARP-1) to inflammatory mediators and anti-inflammatory drugs in human lung. Toxicol Lett 2010. [DOI: 10.1016/j.toxlet.2010.03.619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kontos M, Allen D, Trafalis DT, Jones G, Garmo H, Holmberg L, Hamed H. Follow-up may not be beneficial after treatment of grade 1 breast cancer. Br J Surg 2009; 96:999-1004. [PMID: 19644972 PMCID: PMC7970719 DOI: 10.1002/bjs.6669] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2009] [Indexed: 11/12/2022]
Abstract
BACKGROUND Identification of women treated for breast cancer who have a low risk of locoregional recurrence or contralateral breast cancer, and who can be discharged safely from follow-up, would lower costs without compromising prognosis. This study investigated the risk of locoregional recurrence and contralateral breast cancer in women treated for grade 1 breast cancer. METHODS Some 1143 women who had surgery for breast cancer were followed, and the rate of locoregional recurrence or contralateral breast cancer was determined. The risk was compared to the tumour grade. RESULTS At a mean follow-up of 9.1 years, 10-year estimates of the cumulative risk of locoregional recurrence or contralateral breast cancer for grade 1, 2 and 3 breast cancer were 0.03 (95 per cent confidence interval (c.i.) 0.01 to 0.08), 0.12 (0.09 to 0.15) and 0.16 (0.13 to 0.20) respectively. Grade 1 tumours had a risk of locoregional recurrence or contralateral breast cancer of 285 (95 per cent c.i. 93 to 670) per 100,000 person-years. CONCLUSION Women treated for grade 1 breast cancer could be discharged from follow-up after completion of the primary treatment, without compromising their quality of care.
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Affiliation(s)
- M Kontos
- Breast Unit, Guy's Hospital, London, UK.
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Abstract
Abstract
Background
The prognosis of patients with synchronous bilateral breast cancer (SBBC) is usually based on the tumour with the worst pathological features. There is little evidence in the literature for this assumption, potentially impairing reasoned decisions on optimal adjuvant therapy.
Methods
This was a case–control study in which 68 women with SBBC were matched with 128 women with unilateral breast cancer. Both the GuysRisk prognostic model and the Nottingham Prognostic Index were used to determine the bilateral tumour with the poorer prognosis. Controls were matched for age, menopausal status, date of diagnosis, histological type and grade, and oestrogen receptor and axillary node status.
Results
Both prognostic models indicated the same side tumour with the worst prognosis. Kaplan–Meier survival curves for both disease-free and overall survival showed no significant difference in outcome between the two groups.
Conclusion
Prognosis was determined by the tumour with the worst prognosis, with no additional worsening of outcome incurred from the second tumour.
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Affiliation(s)
- T Irvine
- Hedley Atkins Breast Unit, Guy's Hospital, London, UK
| | - D S Allen
- Hedley Atkins Breast Unit, Guy's Hospital, London, UK
| | - C Gillett
- Hedley Atkins Breast Unit, Guy's Hospital, London, UK
| | - H Hamed
- Hedley Atkins Breast Unit, Guy's Hospital, London, UK
| | - I S Fentiman
- Hedley Atkins Breast Unit, Guy's Hospital, London, UK
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Evans DGR, Baildam AD, Anderson E, Brain A, Shenton A, Vasen HFA, Eccles D, Lucassen A, Pichert G, Hamed H, Moller P, Maehle L, Morrison PJ, Stoppat-Lyonnet D, Gregory H, Smyth E, Niederacher D, Nestle-Kramling C, Campbell J, Hopwood P, Lalloo F, Howell A. Risk reducing mastectomy: outcomes in 10 European centres. J Med Genet 2008; 46:254-8. [DOI: 10.1136/jmg.2008.062232] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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21
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Mohamed O, Bennett C, Mahran A, Helmy T, Hamed H, Farid M. T09-P-09 Artery size hypothesis, does it exist? Sexologies 2008. [DOI: 10.1016/s1158-1360(08)72890-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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22
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Mohamed O, Bennett C, Hamed H, Farid M. T09-O-33 Vascular risk factors as predictors for the sexual function following coronary artery bypass surgery. Sexologies 2008. [DOI: 10.1016/s1158-1360(08)72866-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kontos M, Kothari A, Hamed H. Effect of harmonic scalpel on seroma formation following surgery for breast cancer: a prospective randomized study. J BUON 2008; 13:223-230. [PMID: 18555469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
PURPOSE With the escalating cost of healthcare provision, surgical techniques that could lead to shorter postoperative stay and reducing cost of health provision are welcomed. We report the results of a prospective randomized trial to investigate the role of harmonic scalpel (HS) in reducing postsurgical seroma formation, complications, pain and consequent cost in breast surgery. PATIENTS AND METHODS Thirty-three procedures were carried out on 32 women. Patients were prospectively randomized to either HS or electrocautery (EC). The two cohorts were accordingly matched and postsurgical seroma volumes, complications and pain scores were documented. RESULTS There were 16 procedures in the HS and 17 in the EC group. First 48 h drainage, total drained volume, aspirated volume, operative time, pain score, number of patients that developed seromas, number of clinic visits for aspiration, complications and required analgesia were comparable in the two groups. Multivariate analysis showed no significant correlation between the total amount of seroma drainage and the known risk factors (body mass index/BMI, size of the invasive tumor and number of positive nodes). CONCLUSION No significant reduction in seroma formation or wound complications and pain could be found with the use of HS. We were unable to demonstrate any significant clinical advantages with the use of HS or cost benefit.
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Affiliation(s)
- M Kontos
- Hedley Atkins Breast Unit, Guy's Hospital, London, UK.
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Mohamed O, Bennett C, Farid M, Hamed H. T09-O-32 Does EuroSCORE predict sexual function after cardiac surgery? Sexologies 2008. [DOI: 10.1016/s1158-1360(08)72865-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kontos M, Hamed H. Why individualize breast cancer survivors' follow-up? J BUON 2007; 12:553-554. [PMID: 18067218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- M Kontos
- Academic Oncology, Breast Unit, Guy's Hospital, London, UK.
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Burgess CC, Potts HWW, Hamed H, Bish AM, Hunter MS, Richards MA, Ramirez AJ. Why do older women delay presentation with breast cancer symptoms? Psychooncology 2007; 15:962-8. [PMID: 16511900 DOI: 10.1002/pon.1030] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Women who delay their presentation with breast cancer for three months or longer are more likely to be diagnosed with later stage disease and have poorer survival. Older women, who are at greater risk of developing breast cancer, are also more likely to delay their presentation. Factors associated with delayed presentation were assessed in 69 women (>65 years) with breast cancer. Previous factors identified for women of all ages were confirmed (having a non-lump symptom p=0.003) or strengthened (non-disclosure of symptom discovery to a relative or close friend p=0.001). Additional factors for delay in this older group included reservations about seeing their GP (p=0.02) and fear of the consequences of cancer (p=0.04). These factors should inform the design of interventions to reduce delays.
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Affiliation(s)
- C C Burgess
- Cancer Research UK London Psychosocial Group, Adamson Centre, St Thomas' Hospital, London SE1 7EH, UK.
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Abstract
The majority of women who are undergoing mastectomy can also have breast reconstruction. In most breast units, implants and latissimus dorsi flaps can be performed. The more sophisticated transverse rectus abdominis myocutaneous (TRAM) flap-based reconstructions are generally performed by plastic surgeons so that there may be logistic problems in using these techniques for immediate reconstruction. Decisions on technique will also depend on the patient's build and co-existing medical conditions together with the likelihood of need for postoperative radiotherapy as part of the primary local treatment.
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Affiliation(s)
- I S Fentiman
- Hedley Atkins Breast Unit, Guy's Hospital, London, UK.
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Kulkarni D, Beechey-Newman N, Kothari A, Hamed H, D'Arrigo C, Ryder K, Fentiman I. The epidemiology of HER-2 positive tumours. EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)80102-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Eastwood T, Hamed H, Beechey-Newman N, Fentiman I. Screen detected breast cancer: is preoperative staging necessary? EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)80363-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Kulkarni D, Beechey-Newman N, Hamed H, Kothari A, Ryder K, Fentiman I. Occult primary breast cancer. EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)80107-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Hamed H, Eastwood T, Springall R, Beechey-Newman N, Fentiman I. Should full axillary clearance be the standard procedure in node positive axilla? EJC Suppl 2006. [DOI: 10.1016/s1359-6349(06)80124-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Abstract
Gigantomastia by definition means bilateral benign progressive breast enlargement to a degree that requires breast reduction surgery to remove more than 1800 g of tissue on each side. It is seen at puberty or during pregnancy. The etiology for this condition is still not clear, but surgery remains the mainstay of treatment. We present a unique case of Gigantomastia, which was neither related to puberty nor pregnancy and has undergone three operations so far for recurrence.
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Affiliation(s)
- Dhananjay Kulkarni
- Breast Unit, Department of Academic Oncology, 3rd floor, Thomas Guy House, Guy's Hospital, London, SE1 9RT.
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Abstract
This study was designed to assess the efficacy and long-term outcome of fistulectomy and saucerization for treatment of mammary duct fistulae. Mammary fistula is a chronic condition that represents the final step in what has been termed "mammary duct associated inflammatory disease sequence." The treatment is primarily surgical and may include healing by secondary intention or primary closure with or without antibiotics. Reported series are small and often include variable surgical strategies applied without consistency. A consecutive series of 53 patients who had 59 mammary duct fistulae were treated by fistulectomy with saucerization. The median age was 32 years. Wounds were allowed to heal by secondary intention and antibiotics were not used. We reviewed the case records to establish the incidence of recurrent fistula and the time to complete healing. The long-term cosmetic outcome was determined by a postal survey. After a median follow-up of 6 years there had been no relapse in 92%. There was significant delay in healing in six cases (range: 10 to 30 weeks). Thirty-eight patients (83%) gave a definite history of regularly smoking between 10 and 20 cigarettes a day. Two thirds of the patients were either pleased or satisfied with the final cosmetic result of the surgery, but more than 90% said that it left them with some distortion of the nipple. Fistulectomy and saucerization achieves long-term cure in the majority of patients with mammary duct fistula, but it results in some degree of distortion of the nipple. The strong relationship between smoking and the occurrence of mammary duct fistulae is again demonstrated.
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Affiliation(s)
- N Beechey-Newman
- Hedley Atkins Breast Unit, Guy's Hospital London SE1 9RT, London, United Kingdom.
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Affiliation(s)
- E C Nwosu
- Department of Obstetrics and Gynaecology, Whiston Hospital, Prescot, UK.
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Beechey-Newman N, Kulkarni D, Kothari A, D'Arrlgo C, Culora G, Hamed H, Fentiman I. Breast duct microendoscopy in nipple discharge: microbrush improves cytology. Surg Endosc 2005; 19:1648-51. [PMID: 16222469 DOI: 10.1007/s00464-005-0124-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2005] [Accepted: 05/22/2005] [Indexed: 10/25/2022]
Abstract
BACKGROUND Breast duct microendoscopy is a new technique that allows direct visualization of the mammary ductal epithelia and has the potential to provide greater accuracy in the diagnosis of benign and malignant breast conditions. We have already established the feasibility of BDME on mastectomy specimens and in patients both under general and local anesthesia. It was the aim of this study to investigate the use of BDME in patients with pathological nipple discharge and to explore the feasibility of using an endoluminal microbrush to take cytology samples from specific lesions. MATERIALS AND METHODS Breast duct microendoscopy was offered to all patients undergoing surgery for nipple discharge. Surgery included microdochectomy (younger women) and total duct excision (especially in postmenopausal women). The microbrush was used to collect samples whenever an endoluminal papilloma was seen on endoscopy. The results of microbrush cytology samples were compared to ductal lavage samples. RESULTS Fifty consecutive patients undergoing microdochectomy or total duct excision for nipple discharge had breast microendoscopy (28 general, and 22 under local anesthesia). Thirty-one patients had microdochectomy and nineteen had total duct excision. Visualiza- tion of discharging ducts was accomplished in 100% cases. Endoluminal abnormalities were seen in 33 (66%) patients and dilated ducts were seen in 17 patients. Among the 33 patients, 15 had single papilloma, 3 multiple papilloma and 15 inflammation (erythema, fronds, adhesions). Seven out of eight patients with an intraductal papillorna who had microbrush cytology showed papillary cells whereas only 2 out of 11 patients who had ductal lavage were positive for papillary cells. Thus the sensitivity of the brush cytology technique for the diagnosis of papilloma was 87.5% and the sensitivity of ductal lavage 18% (p = 0.0055). CONCLUSION Breast duct microendoscopy is an effective way of establishing the etiology of nipple discharge. The microbrush increases the sensitivity of cytology significantly.
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Affiliation(s)
- N Beechey-Newman
- Department of Academic Oncology, Breast Unit, 3rd Floor, Thomas Guy House, Guy's Hospital, London, SE1 9RT, United Kingdom
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Abstract
The hypothesis was that smokers might have more aggressive types of breast cancer because of either delayed diagnosis or higher grade and hence have a worse prognosis. A cohort of breast cancer patients completed a lifestyle questionnaire at the time of diagnosis, including whether they were current smokers, ex-smokers or lifelong non-smokers. Ex-smokers were asked when they had stopped. The participants were 166 women with stage I/II invasive breast cancer diagnosed between October 1984 and March 1987. Participants were divided into three groups: current smokers, ex-smokers and non-smokers. Survival curves were produced by using Cox proportional hazards analysis, with outcome variables for overall and breast cancer-specific survival together with distant relapse-free survival. Smoking was the third most important predictor of distant relapse-free, breast cancer-specific and overall survival after stage and age at diagnosis. These results suggest that smokers are not only more likely to die of other diseases, but also have a higher mortality from breast cancer, compared with those with the disease who have never smoked. The best prognosis, however, was found in those who had given up smoking.
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Affiliation(s)
- I S Fentiman
- Department of Academic Oncology, Guy's Hospital, London, UK.
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Hamed H, Kotheri A, Beechey-Newman N, Fentiman IS. Toremifene, a new agent for treatment of mastalgia: an open study. Int J Fertil Womens Med 2004; 49:278-80. [PMID: 15751267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
OBJECTIVE Endocrine agents have been widely used in the treatment of mastalgia. Toremifene is an agent that predominantly has antiestrogenic properties with minimal estrogenic activities. This study was aimed at investigating this drug in the treatment of mastalgia and to evaluate its tolerability and efficacy. METHODS Seventeen premenopuasal women with a mean age of 37.7 years complaining of moderate to severe mastalgia received toremifene 60 mg daily. The treatment period was 12 weeks. 70% of patients had cyclical and 30% had noncyclical mastalgia. RESULTS All women with cyclical mastalgia responded to toremifene compared with only 75% of those with non-cyclical mastalgia. Four patients withdrew from the study after 4 weeks because of side effects, accounting for 23.5% of patients in the study. CONCLUSION This small study has shown that toremifene is an effective agent in the treatment of mastalgia, but a high incidence of side effects makes it ineligible as an agent of choice for treatment of mastalgia.
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Affiliation(s)
- H Hamed
- Department of Academic Oncology, Breast Unit, Guy's and St Thomas' Hospital Trust, London, UK
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El-Meteini M, Fayez A, Fathy M, Abdalaal A, Safaan H, Mostafa I, Abdalaal M, Syam M, Refay R, Abou-Alfetouh F, Khedr H, El-Halafawy Y, Taher Y, Hamed H, Badawy S, Ryad A, Awad H, Abdallah A, Ghafar TA, El-Monayeri M, Hoballah A, El-Dorry A, Adham M, Boillot O. Living related liver transplantation in Egypt: an emerging program. Transplant Proc 2004; 35:2783-6. [PMID: 14612119 DOI: 10.1016/j.transproceed.2003.09.052] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- M El-Meteini
- Department of Surgery, Ain-Shams University, Cairo, Egypt.
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Hamed H, Kothari A, Ibrahim S, Beechey-Newman N, Fentiman I. Routine mammograms in symptomatic women <50 yrs with normal physical examination: Is it justified? EJC Suppl 2004. [DOI: 10.1016/s1359-6349(04)90737-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Skillman J, Beechey-Newman N, Hamed H. Gigantomastia unrelated to pregnancy or puberty: a case report. Breast 2002; 11:179-80. [PMID: 14965666 DOI: 10.1054/brst.2001.0406] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2001] [Accepted: 11/08/2001] [Indexed: 11/18/2022] Open
Abstract
Idiopathic gigantomastia occurs during puberty and pregnancy but a spontaneous case has not been reported in the literature. An unusual case is described, which required urgent bilateral mastectomy to control systemic sepsis and extreme discomfort.
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Affiliation(s)
- J Skillman
- Hedley Atkins Breast Unit, Guy's Hospital, London, SE1 9TN, UK
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Beechey-Newman N, Hamed H, Thakur K, D'Ariggo C, Clark S, Fentiman I. Breast 04. Br J Surg 2002. [DOI: 10.1046/j.1365-2168.89.s.1.30_4.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Fentiman IS, Hamed H. Assessment of breast problems. Int J Clin Pract 2001; 55:458-60. [PMID: 11594255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
Patients with discrete breast lumps, irrespective of age, should be referred for assessment. Premenopausal women with equivocal lumps can be re-checked two weeks later and, if still present or dubious, sent to a breast clinic. Almost all women with breast pain do not need referral unless the symptoms are severe or prolonged. Careful examination will detect those individuals with underlying rib cage pain who can be reassured and given analgesics, if necessary, but not referred. Blood-containing nipple discharge is an indication for referral but such cases can be reassured that, in the absence of a lump, it is unlikely they have breast cancer. Most women who suspect their family history of breast cancer places them at increased risk can be safely reassured and do not need to be kept under surveillance. All those women who are eligible for the NHS screening programme should be encouraged to attend when invited.
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Affiliation(s)
- I S Fentiman
- Hedley Atkins Breast Unit, Guy's Hospital, London SE1 9RT, UK
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Hamed H, Fentiman IS. Benign breast disease. Int J Clin Pract 2001; 55:461-4. [PMID: 11594256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
Benign breast disorders (BBD), classified by the ANDI system (aberrations of normal development and involution), constitute the major workload in breast clinics. Breast pain (mastalgia) is classified as cyclical, and non-cyclical extramammary causes such as ribircage pain have to be identified. Most patients need reassurance alone but those with moderate/severe pain present for > 6 months may need treatment: randomised trials have shown danazol, bromocriptine and tamoxifen to be effective. Fibroadenoma is the commonest benign solid lump in women aged 15-30 years. The diagnosis must be confirmed by triple assessment. Cysts occur usually in women of middle to late reproductive life. After ultrasound has confirmed the lump as cystic, it can be aspirated. Nipple discharge should be tested for the presence of haemoglobin (Hb). Those with HB+ discharge may require microdochectomy for treatment and diagnosis, common causes being duct papilloma and duct ectasia. Breast abscesses may occur during lactation or in women with duct ectasia and are treated by incision or aspiration together with antibiotics.
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Affiliation(s)
- H Hamed
- Headley Atkins Breast Unit, Guy's Hospital, London SE1 9RT, UK
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Nwosu E, Saijad J, Hamed H, Ramsden G. Assessment of pregnant women's preference for the method of delivery. Int J Gynaecol Obstet 2000. [DOI: 10.1016/s0020-7292(00)83248-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Nwosu E, Saijad J, Hamed H, Ramsden G. Do pregnant women's request for delivery influence cesarean section rates? Int J Gynaecol Obstet 2000. [DOI: 10.1016/s0020-7292(00)86155-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abdel-Aleem H, Ahmed A, Sabra AM, Zakhari M, Soliman M, Hamed H. Serum alpha L-fucosidase enzyme activity in ovarian and other female genital tract tumors. Int J Gynaecol Obstet 1996; 55:273-9. [PMID: 9003953 DOI: 10.1016/s0020-7292(96)02770-1] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To assess the value of serum alpha-L-fucosidase as a tumor marker in the diagnosis of ovarian and other female genital tract tumors. METHODS One-hundred fifty-one patients were studied; 101 had different genital tract tumors (malignant ovarian tumors (48), carcinoma of the cervix (13), endometrial carcinoma (6), carcinoma of the vulva (6) and benign tumors (28)). A control group of 50 healthy female patients was included. Serum alpha-L-fucosidase activity was determined in all patients and controls. Serum CA 125 level was also determined in patients with malignant ovarian tumors. RESULTS patients with malignant ovarian tumors showed the lowest level of alpha-L-fucosidase activity in comparison to other malignant and benign tumors of the female genital tract and also in comparison to malignant ovarian tumors. RESULTS Patients with malignant ovarian tumors showed the lowest level of alpha-L-fucosidase activity in comparison to other malignant and benign tumors of the female genital tract and also in comparison to control group. The majority of ovarian carcinoma patients (90%) had a serum level of < 275 u/ml of alpha-L-fucosidase activity, while more than 90% of the control group and other genital tumors had a serum level of > 275 u/ml. The sensitivity and specificity of serum alpha-L-fucosidase activity in diagnosing epithelial ovarian tumors were 88.5% and 98%, respectively (using a cut-off level of < 275 u/ml). The corresponding figures for CA 125 were 96.2% and 100% (using a cut-off level of > 35 u/ml). CONCLUSIONS Serum alpha-L-fucosidase enzyme activity can be useful as a tumor marker in diagnosing advanced malignant epithelial ovarian tumors. Its sensitivity and specificity are comparable to CA 125. However, there is a lack of data to support its usefulness in the diagnosis of early stage disease (Stage 1). The cost of doing the test is one-third that of CA 125 and the test can be more widely applied in developing countries.
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Affiliation(s)
- H Abdel-Aleem
- Department of Obstetrics and Gynecology, Faculty of Medicine, Assiut University, Egypt
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Reyes RJ, Zicchi S, Hamed H, Chaudary MA, Fentiman IS. Surgical correction of gynaecomastia in bodybuilders. Br J Clin Pract 1995; 49:177-9. [PMID: 7547155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Gynaecomastia is a common and well-recognised side-effect of anabolic steroid abuse in athletes. A staging system is proposed and a technique of excision under local anaesthetic described. Careful selection of cases and the use of meticulous technique can achieve good cosmetic results, without risk of recurrence of gynaecomastia.
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Affiliation(s)
- R J Reyes
- Oncology Unit, Guy's Hospital, London
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Fentiman IS, Howell A, Hamed H, Lee SM, Ranson M, Wall J, Chaudary MA, Ash CM, Gregory WM, Sellwood RA. A controlled trial of adjuvant tamoxifen, with or without prednisolone, in post-menopausal women with operable breast cancer. Br J Cancer 1994; 70:729-31. [PMID: 7917929 PMCID: PMC2033384 DOI: 10.1038/bjc.1994.384] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
A randomised clinical trial has been conducted to compare adjuvant tamoxifen, 20 mg daily, with tamoxifen and prednisolone, 7.5 mg daily, in post-menopausal women with operable breast cancer. There were 254 evaluable patients, of whom 128 were given tamoxifen alone and 126 received tamoxifen and prednisolone. After a median follow-up of 48 months there was no significant difference in relapse-free or overall survival of the two groups. Furthermore, with survival slightly favouring tamoxifen, confidence intervals on the hazard ratio established that a difference in favour of tamoxifen plus prednisolone of even 5% at 5 years was very unlikely (P < 0.02). Thus, despite the relatively small number of patients in this trial, the data clearly establish that prednisolone is not of value as an additional adjuvant agent.
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Affiliation(s)
- I S Fentiman
- ICRF Clinical Oncology Unit, Guy's Hospital, London, UK
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Affiliation(s)
- I Fogelman
- Division of Radiological Sciences, Guy's and St Thomas' Hospital Trust, London, UK
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