Granulomatous lobular mastitis(GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patien...Granulomatous lobular mastitis(GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patients with inflammatory disorders of the breast. This consensus is summarized to establish evidence-based recommendations for the management of GLM. Literature was reviewed using PubMed from January 1, 1971 to July 31, 2020. Sixty-six international experienced multidisciplinary experts from 11 countries or regions were invited to review the evidence.Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus. Experts discussed and concluded 30 recommendations on historical definitions,etiology and predisposing factors, diagnosis criteria, treatment, clinical stages, relapse and recurrence of GLM. GLM was recommended as a widely accepted definition. In addition, this consensus introduced a new clinical stages and management algorithm for GLM to provide individual treatment strategies. In conclusion, diagnosis of GLM depends on a combination of history, clinical manifestations, imaging examinations, laboratory examinations and pathology.The approach to treatment of GLM should be applied according to the different clinical stage of GLM. This evidencebased consensus would be valuable to assist front-line surgeons and medical specialists in the optimal management of GLM.展开更多
Ignoring the importance of receiving booster doses of vaccines in vast majority of adults could result in their lack of immunity against tetanus and diphtheria. In this prospective cohort study all immunocompetent adu...Ignoring the importance of receiving booster doses of vaccines in vast majority of adults could result in their lack of immunity against tetanus and diphtheria. In this prospective cohort study all immunocompetent adults ≥ 40 years old who were admitted for any reason during the time period of the survey were enrolled and antibody levels against tetanus and diphtheria were measured. 84 patients (48%) were 40 - 60 years old and 93 (52%) subjects aged older than 60 years. In general, anti-tetanus antibody titer was <0.1 IU/mL (non-immune range) in 83 people (46.9%). For anti-diphtheria antibody, 74 (41.8%) were considered non-immune. Of all people whose tetanus antibody level was <0.1, 19 had a complete history of childhood diphtheria and tetanus immunization and 64 had unknown vaccination history. Among people with diphtheria antibody levels < 0.1, 18 (24.3%) had complete history of childhood vaccination and 56 (75.6%) had unknown history.展开更多
基金supported by Improving the Ability of Diagnosis and Treatment of Difficult Diseases (ZLYNXM202009)。
文摘Granulomatous lobular mastitis(GLM) is a rare and chronic benign inflammatory disease of the breast. Difficulties exist in the management of GLM for many front-line surgeons and medical specialists who care for patients with inflammatory disorders of the breast. This consensus is summarized to establish evidence-based recommendations for the management of GLM. Literature was reviewed using PubMed from January 1, 1971 to July 31, 2020. Sixty-six international experienced multidisciplinary experts from 11 countries or regions were invited to review the evidence.Levels of evidence were determined using the American College of Physicians grading system, and recommendations were discussed until consensus. Experts discussed and concluded 30 recommendations on historical definitions,etiology and predisposing factors, diagnosis criteria, treatment, clinical stages, relapse and recurrence of GLM. GLM was recommended as a widely accepted definition. In addition, this consensus introduced a new clinical stages and management algorithm for GLM to provide individual treatment strategies. In conclusion, diagnosis of GLM depends on a combination of history, clinical manifestations, imaging examinations, laboratory examinations and pathology.The approach to treatment of GLM should be applied according to the different clinical stage of GLM. This evidencebased consensus would be valuable to assist front-line surgeons and medical specialists in the optimal management of GLM.
文摘Ignoring the importance of receiving booster doses of vaccines in vast majority of adults could result in their lack of immunity against tetanus and diphtheria. In this prospective cohort study all immunocompetent adults ≥ 40 years old who were admitted for any reason during the time period of the survey were enrolled and antibody levels against tetanus and diphtheria were measured. 84 patients (48%) were 40 - 60 years old and 93 (52%) subjects aged older than 60 years. In general, anti-tetanus antibody titer was <0.1 IU/mL (non-immune range) in 83 people (46.9%). For anti-diphtheria antibody, 74 (41.8%) were considered non-immune. Of all people whose tetanus antibody level was <0.1, 19 had a complete history of childhood diphtheria and tetanus immunization and 64 had unknown vaccination history. Among people with diphtheria antibody levels < 0.1, 18 (24.3%) had complete history of childhood vaccination and 56 (75.6%) had unknown history.
