Surgical Improvement of Breast Abscess in Lactating Mothers

Objective: To examine the overall diagnostic and the surgical outcomes among lactating females of breast abscesses who were treated using minimally invasive procedures. Methods: This descriptive case series study was conducted during the seven months from May 2019 to November 2019. At the general surgery department of Liaquat University of Medical & Health Sciences, Jamshoro, treated 60 lactating female patients with probable breast abscesses, with an age of more than 18 years. Percutaneous drainage insertion and ultrasound guided fine needle aspiration (FNA) were used in the treatment of breast abscesses in a minimally invasive manner. Ultrasound-guided fine needle aspiration was performed during drainage installation, followed by the insertion percutaneously of the ordinary drainage catheter through a prick incision. Data was collected by study proforma and SPSS version 20 was used for the analysis of data. Results: Average age of the females was 40 years. Clinical inflammation like puerperal mastitis was in 24(40%) patients, non-puerperal mastitis was in 27(45%) of the cases and other inflammation like as folliculinids and infected seroma were in 9(15%) patients. Fibrocystic variation was seen in 58 percent of the participants. 67 percent of non-puerperal mastitis patients had fibrocystic variations, 17 percent of puerperal mastitis patients had fibrocystic variations, and 56 percent of the other patients with other inflammatory forms had fibrocystic variations. Early problems occurred in 12 of every 60 patients (20%) whose are treated using minimally invasive procedures. Conclusion: As per study conclusion, fine needle aspiration (FNA) as per ultrasound guidance minimally invasive therapy combined with antibiotic treatment was observed to be the effective treatment approach for breast abscesses, and it is also a feasible and safe in terms of less post-operative recovery duration, complications, and hospital stay. Keywords: lactating mothers, Abscess, breast, surgery

Preliminary study on the construction of animal model for non-puerperal mastitis

Objection: This qualitative study explored the key factors affecting the occurrence of non-puerperal mast (NPM） and the construction of an animal model which is closer to the characteristics of the disease.Background: The etiological factors and pathogenesis of NPM are unknown, and the incidence, misdiagnosis rate and recurrence rate are high. Previously reported modeling methods vary, reproducibility is poor, and disease characteristics cannot be well characterized, so new animal models are urgently needed for research.Methods: In this study, using female Wistar rats to construct a non-puerperal mastitis animal model by intraperitoneal injection of metoclopramide to simulate hyperprolactinemia + autologous milk injected into the mammary gland to simulate ductal secretions. Results: Pathological results showed that 2 weeks after injection in group C (intraperitoneal injection of metoclopramide for 2 weeks + breast injection of maternal milk mixture twice) and group D (intraperitoneal injection of metoclopramide for 2 weeks + breast injection of maternal milk mixture three times), lipid stasis, periductal inflammation, and massive plasma cell and lymphocyte infiltration were observed,similar to the lesions in patients with human plasma cell mastitis. Conclusions: We believe that we can can establish a non-puerperal mastitis model by altering prolactin levels and ductal secretion stasis in rats.

Pregnancy-lactation cycle: how to use imaging methods for breast evaluation

Pregnancy and lactation constitute states of intense hormonal variation with secretory and structural changes in the breast parenchyma. These changes translate into important features on breast imaging, as well as the emergence of specific benign and malignant lesions. This literature review aims to discuss the safety of the use of breast imaging methods (mammography, ultrasound, and magnetic resonance imaging) during the pregnancy-lactation cycle, and to present the expected physiological changes and imaging appearance of the main breast diseases that may occur in this period, such as galactocele, lactating adenoma, fibroadenoma, puerperal mastitis, and pregnancy-associated breast cancer.

Bilateral Cystic Neutrophilic Granulomatous Mastitis Due to Corynebacterium tuberculostearicum

Introduction Cystic neutrophilic granulomatous mastitis (CNGM) is a form of breast lobulocentric granulomatous inflammation characterized by cystic spaces of dissolved lipid, surrounded by neutrophils. Corynebacterium is frequently the etiological agent, specially C kroppenstedtii. It is often painful and can simulate malignancy by clinical and imaging features. Clinical Case A 36-year-old woman, three pregnancies with puerperal mastitis in all. Consults by increase in left breast volume, painful, 1-month evolution, with erythema and not quantified fever. With antibiotherapy, erythema resolved, but the mass persisted. Ultrasound showed a 28-mm right nodule and extensive left architecture distortion, hypoechogenic, poorly delimited, which compromised superior quadrants, both BIRADS 4. Bilateral core biopsies had typical findings of CNGM, with bacteria inside cysts, identified with HE, which were Gram positive. The cultures gave Corynebacterium, typified as tuberculostearicum by MALDI-TOF methodology, with antibiotic multisensitivity. After 6 weeks of evolution, the last two with ciprofloxacin, on the left the mass had decreased, with 3-cm periareolar collection. Right lesion fistulized on the biopsy path. Conclusions We present a case of bilateral cystic neutrophilic granulomatous mastitis with clinical and imaging features suspected of malignancy. After 6 weeks of evolution, the last two with ciprofloxacin therapy, she had reduction of volume of the larger lesion and fistulization contralateral. She would probably require in its management, in addition to surgery to resolve the fistula, use of lipophilic antibiotics and corticosteroids.

CARACTERIZAÇÃO CLÍNICA E EPIDEMIOLÓGICA DA MASTITE PUERPERAL EM UMA MATERNIDADE DE REFERÊNCIA

Objetivo: analisar o perfil sociodemográfico e epidemiológico da mastite em mulheres internadas em uma maternidade pública no período de 2005 a 2011. Metodologia: estudo descritivo, documental e retrospectivo com abordagem quantitativa, abrangendo todos os casos de mulheres com mastite de 2005 a 2011 em uma maternidade de referência no Piauí. Resultados: as mulheres, em sua maioria, eram adolescentes e adultas jovens (61,5%), solteiras (36,4%), oriundas da capital (61,5%), com ensino fundamental completo (34,6%) e do lar (36,5%). Todas fizeram uso de antibioticoterapia, a maioria não apresentou recidiva (94,2%) e a principal complicação clínica foi o ingurgitamento mamário (67,3%). Conclusão: trata-se de uma patologia frequente que interfere significativamente no sucesso ou não da amamentação, tornando-se imperativo uma assistência de enfermagem com ênfase na educação em saúde por meio de orientações sobre boas técnicas de amamentação e prevenção da mastite.Descritores: Aleitamento Materno, Período Pós-Parto, Saúde da Mulher, Enfermagem.CLINICAL AND EPIDEMIOLOGICAL CHARACTERIZATION OF PUERPERAL MASTITIS IN A REFERENCE MATERNITYObjective: to analyze the sociodemographic and epidemiological profile of mastitis in women hospitalized in a public maternity hospital from 2005 to 2011. Methodology: descriptive, documental and retrospective study with a quantitative approach, covering all cases of women with mastitis from 2005 to 2011 in Reference Maternity in Piauí. Results: most of women were teenagers and young adults (61.5%), single (36.4%), from the capital city (61.5%), with complete elementary education (34.6%), and housewives (36.5%). They all used antibiotic therapy. The majority did not present recurrence (94.2%), and the main clinical complication was breast engorgement (67.3%). Conclusion: mastitis is a frequent pathology that significantly interferes with the success or failure in breastfeeding. Nursing assistance with an emphasis on health education through guidelines on good breastfeeding techniques and prevention of mastitis becomes imperative.Descriptors: Breastfeeding, Postpartum Period, Women’s health, Nursing.CARACTERIZACIÓN CLÍNICA Y EPIDEMIOLÓGICA DE LA MASTITE PUERPERAL EN UNA MATERNIDAD DE REFERENCIAObjetivo: analizar el perfil sociodemográfico y epidemiológico de la mastitis en mujeres ingresadas en una maternidad publica en el periodo de 2005 a 2011. Metodología: estudio descriptivo, documental y retrospectivo con abordaje cuantitativo, que abarca todos los casos de mujeres con mastitis de 2005 hasta 2011 en maternidad de referencia en el Piauí. Resultados: las mujeres, en su mayoría, eran adolescentes y adultas jóvenes (61,5%), solteras (36,4%), oriundas de la capital (61,5%), con educación fundamental completa (34,6%) y que eran dueñas de casa (36,5%). Todas hicieron terapia con antibióticos, la mayoría no presentó recidiva (94,2%) y la principal complicación clínica fue la congestión mamaria (67,3%). Conclusión: se trata de una patología frecuente y que interfiere significativamente en el suceso o no de la lactancia materna, se vuelve imperativo una asistencia de enfermería con enfoque en la educación en salud por medio de orientaciones sobre buenas técnicas de lactancia materna y prevención de la mastitis.Descriptores: Lactancia Materna, Periodo Posparto, Salud de la Mujer, Enfermería.