Occult disease in reduction mammoplasties and prophylactic mastectomies

2019 ◽  
Vol 26 (4) ◽  
pp. 691-696 ◽  
Author(s):  
Angheliki Nomikos ◽  
Ehab A. Husain ◽  
Ashley D. Graham
Keyword(s):  
Occult Disease

scholarly journals Selective treatment and monitoring of disseminated cancer micrometastases in vivo using dual-function, activatable immunoconjugates

2014 ◽  
Vol 111 (10) ◽  
pp. E933-E942 ◽  
Author(s):  
Bryan Q. Spring ◽  
Adnan O. Abu-Yousif ◽  
Akilan Palanisami ◽  
Imran Rizvi ◽  
Xiang Zheng ◽  
...  
Keyword(s):  
Cancer Cell ◽  
Near Infrared ◽  
Dual Function ◽  
Imaging Method ◽  
Drug Resistant ◽  
Micrometastatic Disease ◽  
Selective Treatment ◽  
Cell Internalization ◽  
Occult Disease

Drug-resistant micrometastases that escape standard therapies often go undetected until the emergence of lethal recurrent disease. Here, we show that it is possible to treat microscopic tumors selectively using an activatable immunoconjugate. The immunoconjugate is composed of self-quenching, near-infrared chromophores loaded onto a cancer cell-targeting antibody. Chromophore phototoxicity and fluorescence are activated by lysosomal proteolysis, and light, after cancer cell internalization, enabling tumor-confined photocytotoxicity and resolution of individual micrometastases. This unique approach not only introduces a therapeutic strategy to help destroy residual drug-resistant cells but also provides a sensitive imaging method to monitor micrometastatic disease in common sites of recurrence. Using fluorescence microendoscopy to monitor immunoconjugate activation and micrometastatic disease, we demonstrate these concepts of “tumor-targeted, activatable photoimmunotherapy” in a mouse model of peritoneal carcinomatosis. By introducing targeted activation to enhance tumor selectively in complex anatomical sites, this study offers prospects for catching early recurrent micrometastases and for treating occult disease.

scholarly journals Opportunistic Discovery of Occult Disease by Use of Test Panels in New, Symptomatic Primary Care Outpatients: Yield and Cost of Case Finding

2000 ◽  
Vol 46 (8) ◽  
pp. 1091-1098 ◽  
Author(s):  
Yuzuru Takemura ◽  
Haku Ishida ◽  
Yuji Inoue ◽  
Hiroyuki Kobayashi ◽  
J Robert Beck
Keyword(s):  
Primary Care ◽  
Uric Acid ◽  
Cost Effectiveness ◽  
Disease Patient ◽  
Fecal Occult Blood ◽  
X Rays ◽  
Clinical Efficiency ◽  
National Defense Medical College ◽  
Occult Disease ◽  
The Cost

Abstract Background: Diagnostic test panels have been advocated by the Japan Society of Clinical Pathology for evaluation of presenting complaints of new outpatients in primary care medicine. The tests have additional potential utility for opportunistic finding of asymptomatic diseases, but data are lacking on the number of new conditions identified by the test panels and on the cost per identified case. Methods: We studied 540 new, symptomatic patients at the Comprehensive Medicine Clinics of National Defense Medical College during 1991–1997. All underwent testing with the “Essential Laboratory Tests” panel (2) [ELT(2) panel]. This panel includes hematologic tests, urinalysis, total protein, C-reactive protein, albumin, cholesterol, triglycerides, glucose, urea nitrogen, creatinine, uric acid, serum protein fractionation, six enzymes, and optional tests, including x-rays, electrocardiogram, and fecal occult blood. Results: The ELT(2) panel uncovered 276 additional diagnoses of asymptomatic disease or abnormal health status. The most frequent occult condition was hyperlipidemia (100 cases) followed by liver dysfunction (53 cases). Clinical efficiency of the panel (occult diseases/patient) varied depending on the category of tentative initial diagnosis, with the highest efficiency in patients with cardiovascular disease. We created smaller panels by combining 11 basic tests [called the ELT(1) baseline panel] with one or more additional tests from the ELT(2) and analyzed their cost-effectiveness. Addition of four tests (total cholesterol, alanine aminotransferase, glucose, and uric acid) improved both clinical efficiency (0.41 occult disease/patient) and economic efficiency [¥2372 (∼$22.50 US)/occult disease] at a cost-effectiveness of ¥177 per incremental case of occult disease. Addition of further tests decreased cost-effectiveness. Conclusions: Although the ELT(2) panel has supplemental utility for opportunistic screening of some significant, occult diseases and conditions, universal utilization of the full panel is not supported by the cost-effectiveness found in this study.

Sinonasal Posttransplant Lymphoproliferative Disorder in Pediatric Lung Transplant Patients

2005 ◽  
Vol 133 (1) ◽  
pp. 38-41 ◽  
Author(s):  
Brian W. Herrmann ◽  
Stuart C. Sweet ◽  
David W. Molter
Keyword(s):  
Cystic Fibrosis ◽  
Head And Neck ◽  
Lymphoproliferative Disorder ◽  
Lung Transplant ◽  
Nasal Polyposis ◽  
Case Series ◽  
Posttransplant Lymphoproliferative Disorder ◽  
Transplant Patients ◽  
Occult Disease ◽  
Lung Transplants

OBJECTIVE: To evaluate sinonasal manifestations of posttransplant lymphoproliferative disorder (PTLD) in the pediatric lung transplant population. STUDY DESIGN AND METHODS: Case series of children less than 18 years presenting with PTLD after pulmonary transplantation at St Louis Children's Hospital between Jan 1, 1990 and Dec 31, 2003. RESULTS: Two hundred eighty-two lung transplants were performed in 246 children. Thirty-two cases of histopathologically confirmed PTLD were identified with 8 (25%) presenting in the head and neck. Sinonasal PTLD was the most common site of head and neck involvement (63%), with 40% of patients presenting with occult disease. All patients with sinonasal PTLD had longstanding nasal polyposis related to cystic fibrosis ( P = 0.07). CONCLUSIONS: This is, to our knowledge, the first report identifying an increased frequency of sinonasal PTLD after pediatric pulmonary transplantation, particularly in children with cystic fibrosis and associated nasal polyposis. Because sinonasal PTLD may be asymptomatic, this region should receive close scrutiny on surveillance evaluations.

Hypertension at the Workplace - An Occult Disease? The Need for Work Site Surveillance

2001 ◽  
pp. 116-138 ◽  
Author(s):  
K.L. Belkic ◽  
P.L. Schnall ◽  
P.A. Landsbergis ◽  
J.E. Schwartz ◽  
L.M. Gerber ◽  
...  
Keyword(s):  
Work Site ◽  
Occult Disease

scholarly journals The SENIORLAB study in the quest for healthy elderly patients

2018 ◽  
Vol 42 (4) ◽  
pp. 109-120 ◽  
Author(s):  
Martin Risch ◽  
Benjamin Sakem ◽  
Lorenz Risch ◽  
Urs E. Nydegger
Keyword(s):  
Reference Intervals ◽  
Serum Folate ◽  
Glucose Turnover ◽  
Total Serum ◽  
Healthy Elderly ◽  
Observational Prospective Cohort Study ◽  
Occult Disease ◽  
Metabolic Performance ◽  
25 Oh Vitamin D ◽  
Definition Of

Abstract Reference intervals (RIs) for laboratory analyses by and large, are provided by analytical platform providers – the provenience and preanalytics of materials for the calculation of intervals often remain arcane particularly relating to the age group of donors. In an observational, prospective cohort study on 1467 healthy uniracial Caucasian residents >60 years of age, 105 frequently used lab tests were done on one blood sample. With a nonrestrictive definition of health, several pathological lab results pointing to occult disease have been found and published from SENIORLAB so far. The RIs found for hemoglobin in women went from 117.9 to 152.4 g/L (80–84 years) and in men from 124.9 to 170.6 g/L (90% confidence interval [CI]). This article lists RIs computed with SENIORLAB data for such frequently ordered analyses as platelet counts, vitamin B12 and folate, ferritin and analytes measured to estimate metabolic performance in glucose turnover. In fact, 64.5% of the cohort showed prediabetic fasting plasma glucose (FPG) and/or glycated hemoglobin (HbA1c); total serum folate levels but not red blood cell folate decreased with progressing age. As much as 66% of evaluable study participants had insufficient levels of 25(OH) vitamin D. Published reports from SENIORLAB are referenced in this article.

Oligometastasis as a predictor for occult disease

2014 ◽  
Vol 251 ◽  
pp. 1-10 ◽  
Author(s):  
Wayne S. Kendal
Keyword(s):  
Occult Disease

Bleeding From Occult Disease During Anticoagulant Therapy

Angiology ◽  
1957 ◽  
Vol 8 (4) ◽  
pp. 337-340 ◽  
Author(s):  
Shmuel Stern ◽  
O. Herman Dreskin
Keyword(s):  
Anticoagulant Therapy ◽  
Occult Disease

Distribution of FDG-avid nodes in esophageal cancer: Implications for radiotherapy target delineation.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 151-151 ◽  
Author(s):  
Brandon Garcia ◽  
Karyn A. Goodman ◽  
Lajhem Cambridge ◽  
Mark Dunphy ◽  
Abraham Jing-Ching Wu
Keyword(s):  
Esophageal Cancer ◽  
Primary Tumor ◽  
Tumor Location ◽  
Volume Data ◽  
Target Delineation ◽  
Esophageal Tumors ◽  
Occult Disease ◽  
Target Volumes ◽  
Individualized Approach ◽  
Pre Treatment

151 Background: Clinical target volumes (CTV) for radiation therapy (RT) in esophageal cancer (EC) are based on standard expansions of the primary tumor volume. Data is needed to better define the regions at highest risk for occult disease, based on histology and location of the primary tumor. We therefore reviewed PET scans in EC patients to characterize the frequency and location of FDG-avid lymph node metastases (LNM). Methods: We identified 474 EC patients with reviewable pre-treatment PET-CT scans who received RT. Tumors were classified by histology and location: upper esophageal (above carina, 15%), or lower/GE junction (85%). Locations of suspicious LNM were classified using standard radiographic nodal atlases, and distances from primary tumor to paraesophageal LNM were also measured. Results: FDG-avid LNM were identified and characterized in 204 patients. The most common LNM in upper EC were supraclavicular (1), retrotracheal (3P) and paratracheal (4). The most common LNM in lower EC were paraesophageal (8), and those in the gastrohepatic space (abdominal stations 1, 3 and 7). Overall, 55% of paraesophageal LNM were adjacent to the primary tumor. Of upper esophageal tumors with paraesophageal LNM, 87% were adjacent to the tumor and none were >6cm from tumor. However, 57% of lower esophageal tumors with paraesophageal LNM had non-adjacent paraesophageal nodes, half of which were >5cm from the tumor. Conclusions: A more data-driven and individualized approach to CTV delineation could improve the therapeutic ratio of RT in esophageal cancer. These results can guide CTV delineation by indicating the potential distribution of nodal involvement in esophageal cancer according to tumor location and histology. Because most paraesophageal LNM are adjacent to primary tumor, the necessity for uniformly large, longitudinal CTV expansions along the esophagus is unclear. [Table: see text]

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