In order to clarify the factors that mainly influence arm morbidity following treatment of breast cancer with the full axillary dissection protocol, we evaluated, in a model of multiple regression analysis, parameters such as the type of breast surgery, adjuvant radiotherapy, time of irradiation, age, number of dissected nodes and axillary nodal status. A total of 104 women were studied. Late arm edema was observed in 17% of the patients and was more frequent when (1) irradiation was given immediately after the operation than if it was given 6 months later (p = 0.009) and (2) the number of removed nodes exceeded 40 (p = 0.037). Upper limb pain was reported by 16% of the patients and was reported more frequently from patients over 60 years of age (p = 0.036), as well as from patients who underwent modified radical mastectomy (p = 0.044) and those in whom 30–40 nodes were dissected (p = 0.025). Shoulder joint mobility was impaired in 17% of the patients, and it was not affected by any of the examined factors. It seems that conservative breast surgery or adjuvant breast radiotherapy 6 months after the operation might reduce independently the likelihood of arm morbidity by 25%.
The present study was undertaken to examine the reliability of the sonographic diagnosis in 705 gynecological patients. The determination of the lesions was defined according to the operative diagnosis. The sensitivity, specificity and positive predictive value of the ultrasound technique were evaluated using the surgical findings as ‘gold standard’. In 631 patients (89.5%) the ultrasound examination established a correct diagnosis. The sensitivity and specificity of the ultrasound examination varied between 75–95.3% and 93.3–100%, respectively. The positive predictive value was found between 89.7 and 100%, while the false sonographic results were 10.4%, which included those of ectopic pregnancies. It is thus concluded that ultrasonography as compared to the surgical findings has proved to be of great value in establishing a gynecological diagnosis.
A case controlled study among 361 women with surgically treated ectopic pregnancy and 420 women delivered at term was designed, aiming at characterization of the association among previous pelvic operations, selected reproductive factors and ectopic pregnancy. All types of previous pelvic operations increase the risk of ectopic pregnancy from a 2-fold increase for appendectomy to a 9-fold increase for ectopic pregnancy, if maternal age, parity, history of spontaneous and induced abortions and history of infertility is controlled. This study suggests that a previous pelvic operation may increase the risk of ectopic pregnancy.
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