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Breastfeeding Medicine : the Official... Oct 2023Breastfeeding has health benefits for both mothers and children. Nipple problems may result in the child being weaned prematurely before the recommended 6 months... (Randomized Controlled Trial)
Randomized Controlled Trial
Breastfeeding has health benefits for both mothers and children. Nipple problems may result in the child being weaned prematurely before the recommended 6 months minimum period of exclusive breastfeeding. The study aimed to compare the effectiveness of topically applying olive oil and breast milk in treating nipple pain and soreness in breastfeeding mothers during the early postpartum period. A quasi-randomized controlled trial was conducted in a maternity ward of a medical center in northern Taiwan. Eighty breastfeeding mothers were recruited, and randomly assigned to the olive oil or breast milk group. Visual analogue pain scale (intensity of nipple pain) and nipple soreness scores were collected at 24, 48, and 72 hours after delivery. Differences in postintervention outcomes between groups were examined using the Generalized Estimating Equation model. The results indicated that both olive oil and breast milk groups reported a significant increase in the intensity of nipple pain and nipple soreness at 24, 48, and 72 hours after delivery. However, differences in the outcome measurements between olive oil and breast milk groups were statistically insignificant at -value >0.05. This study found that olive oil had similar effects on nipple pain and soreness to breast milk. In addition, most breastfeeding mothers provided positive feedback on using olive oil. Olive oil can be a safe, accessible, and alternative choice for breastfeeding mothers in treating nipple pain and soreness, especially early in the breastfeeding period. The Clinical Trail Registration Number: NCT03568370.
Topics: Female; Humans; Pregnancy; Breast Diseases; Breast Feeding; Mastodynia; Milk, Human; Mothers; Nipples; Olive Oil; Infant
PubMed: 37797219
DOI: 10.1089/bfm.2023.0081 -
Annals of the Royal College of Surgeons... Apr 2024There has been an almost 100% increase in referrals to breast cancer diagnostic clinics in the past decade. Breaching of the two-week cancer referral target is now...
INTRODUCTION
There has been an almost 100% increase in referrals to breast cancer diagnostic clinics in the past decade. Breaching of the two-week cancer referral target is now commonplace, potentially delaying diagnoses of breast malignancy in many women. Almost one in five of these referrals are women with mastalgia, not a symptom linked to breast cancer. The objective of the study was the safe introduction of an advanced nurse practitioner-led telephone service for women with mastalgia to improve the service for women and create capacity for those with "red flag" breast symptoms.
METHODS
Referrals to clinic were triaged, women with mastalgia only were directed to a telephone-based assessment clinic and symptoms evaluated using a multidisciplinary created proforma.
RESULTS
Within 23 months, 1,427 women were assessed in the breast pain telephone assessment clinic: 863 (61%) were aged over 40 and 564 (39%) aged under 40. A total of 1,238 underwent telephone assessment. Reassurance and discharge only was needed for 365 (26%). The aetiology of pain was identified as musculoskeletal in 1,104/1,238 (89%) of patients, with only 39/1,238 (3.2%) identified as having true breast pain. Additional symptoms were mentioned by 264 women (18%) during the consultation; all immediately redirected back to a diagnostic clinic. Mammography was undertaken in 609 women (43%). Seven women (0.6%) were diagnosed with a breast malignancy. Patient survey indicated that 93% of patients were satisfied with the care received and 97% said they would recommend the service to a family member or friend.
CONCLUSIONS
Although face-to-face assessments for breast pain remain the standard practice in many breast units, data indicating the safety of a telephone assessment clinic, along with high levels of patient satisfaction, question whether services can be delivered differently.
Topics: Humans; Female; Adult; Middle Aged; Aged; Mastodynia; Breast Neoplasms; Referral and Consultation; Telephone; Nurse Practitioners
PubMed: 37642083
DOI: 10.1308/rcsann.2023.0056 -
Journal of the American College of... Oct 2023Despite rising popularity and performance, studies evaluating the use of large language models for clinical decision support are lacking. Here, we evaluate ChatGPT...
OBJECTIVE
Despite rising popularity and performance, studies evaluating the use of large language models for clinical decision support are lacking. Here, we evaluate ChatGPT (Generative Pre-trained Transformer)-3.5 and GPT-4's (OpenAI, San Francisco, California) capacity for clinical decision support in radiology via the identification of appropriate imaging services for two important clinical presentations: breast cancer screening and breast pain.
METHODS
We compared ChatGPT's responses to the ACR Appropriateness Criteria for breast pain and breast cancer screening. Our prompt formats included an open-ended (OE) and a select all that apply (SATA) format. Scoring criteria evaluated whether proposed imaging modalities were in accordance with ACR guidelines. Three replicate entries were conducted for each prompt, and the average of these was used to determine final scores.
RESULTS
Both ChatGPT-3.5 and ChatGPT-4 achieved an average OE score of 1.830 (out of 2) for breast cancer screening prompts. ChatGPT-3.5 achieved a SATA average percentage correct of 88.9%, compared with ChatGPT-4's average percentage correct of 98.4% for breast cancer screening prompts. For breast pain, ChatGPT-3.5 achieved an average OE score of 1.125 (out of 2) and a SATA average percentage correct of 58.3%, as compared with an average OE score of 1.666 (out of 2) and a SATA average percentage correct of 77.7%.
DISCUSSION
Our results demonstrate the eventual feasibility of using large language models like ChatGPT for radiologic decision making, with the potential to improve clinical workflow and responsible use of radiology services. More use cases and greater accuracy are necessary to evaluate and implement such tools.
Topics: Humans; Female; Mastodynia; Radiology; Breast Neoplasms; Decision Making
PubMed: 37356806
DOI: 10.1016/j.jacr.2023.05.003 -
Breastfeeding Medicine : the Official... Jun 2023Nipple vasospasm is a painful cutaneous vasoconstriction that nursing mothers experience after breastfeeding. In this case series, we present the common features and...
Nipple vasospasm is a painful cutaneous vasoconstriction that nursing mothers experience after breastfeeding. In this case series, we present the common features and management of nipple vasospasm in nursing mothers. The diagnosis of vasospasm relies on the doubt of physician or the breastfeeding consultant and observation of the color change of the nipple. Persistent nipple and breast pain in breastfeeding is often attributed to thus, many mothers receive antifungal therapy before the diagnosis. Timely diagnosis also prevents unnecessary antimicrobial treatments. Precise and rapid diagnosis is crucial, as pain is a risk factor for cessation of breastfeeding and its exclusivity.
Topics: Female; Humans; Mothers; Breast Feeding; Nipples; Risk Factors; Mastodynia
PubMed: 37335330
DOI: 10.1089/bfm.2023.0024 -
Chinese Medical Sciences Journal =... Jun 2023Objective To systematically analyze the current status of outcomes reporting in clinical trials on treating stasis acute mastitis with Traditional Chinese Medicine... (Review)
Review
Objective To systematically analyze the current status of outcomes reporting in clinical trials on treating stasis acute mastitis with Traditional Chinese Medicine breast massage.Methods We searched CNKI, Wanfang, VIP, SinoMed, PubMed, Web of Science, Embase, Cochrane library, JBI, CINAHL, PsycINFO, Clinical Trials Registry Platform portal, Clinical Trials Registry, Australian New Zealand Clinical Trials Registry, Center Watch Registry from inception to May 15, 2022 to find randomized controlled trials, non-randomized controlled trials, case series and cohort studies which reported the outcomes of stasis acute mastitis managed with Traditional Chinese Medicine breast massage, with search terms of mastitis, acute mastitis, lactation mastitis, puerperal mastitis, breast problem, breast engorgement, milk stasis, blocked ducked, breast pain, breast massage, and acupoint massage. Outcomes and the measurement schemes (measurement methods, timing of assessing outcome, frequency of assessing outcome, measurers) were extracted from the included studies. We used the Management of Otitis Media with Effusion in Children with Cleft Palate (MOMENT) to assess the quality of each study, then categorized outcomes derived from the included studies into different domains according to the Outcome Measures in Rheumatology Arthritis Clinic Trials (OMERACT) Filter 2.1 framework.Results We identified 85 clinical trials, in which 54 different outcomes were reported. A total of 81.2% (69/85) of studies were assessed as medium quality with a mean score of 2.6, and 18.8% (16/85) as low quality with a mean score of 0.9. These outcomes were organized in three core areas. Lump size (89.4%, 76/85) was the most frequently reported outcome, followed by breast pain (69.4%, 59/85) and milk excretion (68.2%, 58/85). Five methods were used to assess lump size and four methods to assess breast pain.Conclusions The outcomes reported in clinical trials regarding stasis acute mastitis treated by Traditional Chinese Medicine breast massage are heterogeneous. Developing a core outcome set to achieve consistent standards for reporting outcomes and modalities for validation of the outcomes is clearly warranted.
Topics: Child; Female; Humans; Australia; Massage; Mastitis; Mastodynia; Medicine, Chinese Traditional
PubMed: 37280723
DOI: 10.24920/004164 -
Acta Bio-medica : Atenei Parmensis Mar 2023One of the most common complications of free silicone injection at multiple sites is its leakage and more rarely its migration through the lymphatic system with a...
One of the most common complications of free silicone injection at multiple sites is its leakage and more rarely its migration through the lymphatic system with a resulting local inflammatory reaction of granulomatous type, known as "siliconoma". This report describes the case of a young woman who came to our attention for bilateral mastodynia and palpable tumefactions in breast and gluteal region, a few years after percutaneous injections of free liquid silicone for breast augmentation.
Topics: Female; Humans; Breast; Causality; Inflammation; Mammaplasty; Silicones
PubMed: 36883664
DOI: 10.23750/abm.v94iS1.13859 -
Breastfeeding Medicine : the Official... Mar 2023The aim of the study was to determine the effect of tea tree oil and coconut oil applied to the nipples during the early postpartum period on nipple crack formation.... (Randomized Controlled Trial)
Randomized Controlled Trial
The aim of the study was to determine the effect of tea tree oil and coconut oil applied to the nipples during the early postpartum period on nipple crack formation. This randomized controlled experimental research included a total of 90 women in the research sample abiding by the research criteria, with 30 each in the intervention groups (coconut oil or tea tree oil application) and 30 in the control group. Women in the intervention groups applied coconut oil or tea tree oil to the nipples on the 3rd, 7th, and 10th days postpartum, whereas the control group did not have any intervention. Data in the research were collected with the Descriptive Information Form for Mothers, Early Postpartum Period Breast Problem Assessment Form, and Visual Analog Scale (VAS). Analysis of data used the chi-square test, Kruskal-Wallis test, and Friedman's test. Mean age of women participating in the research was 28.23 ± 5.21 years. The differences between the groups applying coconut oil and tea tree oil on the 3rd, 7th, and 10th days postpartum and the control group were significant in terms of incidence of nipple cracks. In addition, the difference in mean VAS points for nipple pain in the groups using coconut oil and tea tree oil and the control group was found to be statistically significant ( < 0.05). According to the research findings, coconut oil and tea tree oil were determined to reduce nipple crack formation and nipple pain. It is recommended to increase the use of coconut oil and tea tree oil related to breast problems in nursing care during the postpartum period. NCT05456438.
Topics: Adult; Female; Humans; Young Adult; Breast Feeding; Coconut Oil; Mastodynia; Nipples; Postpartum Period; Tea Tree Oil
PubMed: 36763614
DOI: 10.1089/bfm.2022.0260 -
Clinical Breast Cancer Apr 2023Post-treatment mastalgia is a common complaint in up to 68% of patients after treatment. This symptom is worrisome to patients as many believe it is a sign of...
BACKGROUND
Post-treatment mastalgia is a common complaint in up to 68% of patients after treatment. This symptom is worrisome to patients as many believe it is a sign of recurrence. The current study was performed to evaluate if post-treatment mastalgia is associated with a second breast cancer diagnosis.
MATERIALS AND METHODS
Patients included were seen from January 1, 2000 to December 31, 2020. All patients who were treated for breast cancer and then presented with breast pain during follow up were considered to have post-treatment mastalgia. All patients who were diagnosed with a second breast cancer but did not experience post-treatment mastalagia were also evaluated.
RESULTS
1799 patients had a mean age 52.9 years. 36% of patients experienced post-treatment mastalgia. Of patients who complained of post-treatment mastalgia, 19 were diagnosed with a chest wall recurrence (CW), ipsilateral breast tumor recurrence (IBTR), or contralateral breast cancer (CBC). 17 of the 19 patients had breast pain after the second diagnosis and treatment were completed. The average duration between their second diagnosis and initial complaint of breast pain was 6.2 years. The two patients who complained of breast pain prior to their second diagnosis did not have mastalgia at the time of their second diagnosis. Local recurrence or contralateral breast cancer were more common in patients without post treatment mastalgia (10.1% vs 0.3%, p < 0.0001) during follow up.
CONCLUSION
Post treatment mastalgia is not associated with recurrence. Interval or repeat imaging does not appear necessary and instead patient education and reassurance are important in its management.
Topics: Humans; Middle Aged; Female; Mastodynia; Breast Neoplasms; Neoplasm Recurrence, Local; Breast; Breast Diseases; Neoplasms, Second Primary
PubMed: 36641323
DOI: 10.1016/j.clbc.2022.12.004 -
Breastfeeding Medicine : the Official... Jan 2023Nipple fissure is a prevalent problem for breastfeeding mothers. Virgin coconut oil (VCO) is an herbal medicine that can heal microbial infections and wounds. This... (Randomized Controlled Trial)
Randomized Controlled Trial
Nipple fissure is a prevalent problem for breastfeeding mothers. Virgin coconut oil (VCO) is an herbal medicine that can heal microbial infections and wounds. This study aims to evaluate the efficacy of VCO and breast milk on nipple fissures in primiparous mothers. A single-blind clinical trial was conducted with 106 breastfeeding primiparous mothers suffering from nipple fissures in health centers of Zarand, Kerman, from August 2020 to November 2020. The participants were selected randomly and allocated to two 60-member groups using block randomization. Mothers in the first group were asked to apply 0.5 mL of coconut oil on their nipples three times a day. Mothers in the second group were trained to apply three to four drops of their milk on their nipples after every breastfeeding session. The level of nipple fissures and pain intensity were examined using Storr's scale and visual analog scale, respectively. The results were analyzed using the chi-square test, repeated measures analysis of variance, and the independent samples -test in SPSS 22. In this study, the significance level was set at < 0.05. Within-group comparisons revealed a significant difference between baseline scores and the scores on the 7th and 14th days ( < 0.001). Between-group comparison indicated no significant difference in nipple fissure ( = 0.419) and pain intensity ( = 0.405) at baseline. Nonetheless, there was a significant difference on the 7th day ( = 0.002, <0.001) and on the 14th day ( <0.001, = 0.036). Given its effect on nipple fissures, VCO may be used as a complementary substance to treat nipple fissures. This trial is registered with the Iranian Registry of Clinical Trials with the identifier: IRCT20190724044318N1.
Topics: Female; Humans; Milk, Human; Nipples; Coconut Oil; Breast Feeding; Pain Measurement; Single-Blind Method; Iran; Mastodynia; Mothers
PubMed: 36638195
DOI: 10.1089/bfm.2022.0120