Bejegyzés

Relationships Between Symptoms and Changes in Breast Physiology During Lactation Mastitis

Catherine M. Fetherston, C.T. Lai, Peter E. Hartmann
Breastfeeding Medicine. 2006, 1(3): 136-145.

Abstract

Objective: The objective was to investigate changes in milk composition that reflect variations in breast permeability, milk synthesis, and immune response in women before, during, and after mastitis.

Methods: Mothers (n = 26) were followed prospectively from day 5 postpartum to the end of their lactation. Milk from each breast, blood, 24-hour urine samples, and data on breast and systemic pathologies were collected at reference intervals during the first 3 months postpartum, daily during the occurrence of any breast inflammation, and 7 days after resolution of symptoms, and was analyzed using mixed-model analysis (repeated measures).
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Vasospasm of the Nipple Presenting as Painful Lactation

Sarah M. Page, MD and David S. McKenna, MD

Obstetrics & Gynecology 2006;108:806-808

Case Report

Abstract

BACKGROUND: Breast pain is a common complaint among lactating women. Vasospasm of the nipple should be considered in the differential diagnosis of breast pain, particularly when no other signs of infection or trauma are encountered. This report demonstrates a case of vasospasm successfully treated with nifedipine.

CASE: A 26-year-old breastfeeding multipara presented with intermittent episodes of extreme pain associated with blanching of the nipple. The pain subsided upon return of normal color to the nipple. She was able to continue breastfeeding after successful treatment with nifedipine.
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Excretion of lactose in urine as a measure of increased permeability of the lactating breast during inflammation

Catherine M. Fetherston, Ching Tat Lai, Leon R. Mitoulas, Peter E. Hartmann

Acta Obstetricia et Gynecologica Scandinavica Volume 85, Number 1 / January 2006 pp20 – 25

Abstract:

Hypothesis. The increased excretion of lactose in urine will be an accurate predictor of increased breast permeability during inflammation of the breast and therefore could predict whether there is a relationship between the severity and type of symptoms suffered during mastitis and changes in breast permeability.

Methods. Twenty-six mothers were followed prospectively from Day 5 postpartum to the end of their lactation. Milk from each breast, blood, 24-hour urine samples, and data on breast and systemic pathologies were collected at reference intervals during the first three months postpartum, daily during the occurrence of any breast inflammation and 7 days after resolution of symptoms.
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Prevention of and Therapies for Nipple Pain: A Systematic Review

Kristine Morland-Schultz and Pamela D. Hill

JOGNN*, 34, 428-437; 2005

Objective: To review the literature on nipple pain and to delineate effective strategies for the prevention and treatment of nipple pain in breastfeeding mothers.

Data Sources: Computerized searches on MEDLINE, Pre-MEDLINE, CINAHL, and the Cochrane Library.

Study Selection: Articles from indexed journals relevant to the objective were reviewed from January 1983 to April 2004. Preference was given to research-based studies in English.

Data Extraction: Data were extracted and organized under two headings: prevention of nipple pain or trauma and treatment of nipple pain or trauma. The Critical Appraisal Form by J.
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A Heads Up for MRSA Mastitis

Notes from Dr. Hale

We are all hearing more and more about the new epidemic of Methicillin-Resistant Staph Aureus (MRSA). While the rate in the general public is still low, it is rising and it seems especially so in pediatric age patients where a higher prevalence seems to occur in settings that enable close contact between individuals, such as day-care centers.

S aureus can colonize the nasopharynx, perineum, or skin. The most common way to screen for colonization is culture of specimens from the nasopharynx. Although most colonized individuals remain asymptomatic, small disruptions of the skin can lead to local infections.
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Raynaud’s Phenomenon of the Nipple: A Treatable Cause of Painful Breastfeeding

Jane E. Anderson, MD, Nancy Held, RN, MS and Kara Wright, MD

Pediatrics 2004;113:e360–e364.

Maurice Raynaud first described the vasospasm of arterioles in 1862, and Raynaud’s phenomenon is now felt to be common, affecting up to 20% of women of childbearing age. Raynaud’s phenomenon has been reported to affect the nipples of breastfeeding mothers and is recognized by many lactation experts as a treatable cause of painful breastfeeding…

Because the breast pain associated with Raynaud’s phenomenon is so severe and throbbing, it is often mistaken for Candida albicans infection. It is not unusual for mothers who have Raynaud’s phenomenon of the nipple to be treated inappropriately and often repeatedly for C albicans infections with topical or systemic antifungal agents…

To diagnose Raynaud’s phenomenon accurately, additional symptoms such as precipitation by cold stimulus, occurrence of symptoms during pregnancy or when not breastfeeding, and biphasic or triphasic color changes must be present…

Treatment options include methods to prevent or decrease cold exposure, avoidance of vasoconstrictive drugs/nicotine that could precipitate symptoms, and pharmacologic measures.
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Mastitis – Causes and Management

A mastitis a mell gyulladásos állapota, amelyhez fertőzés társulhat. Általában a laktációval összefüggésben lép fel, ezért laktációs vagy puerperális mastitisnek is nevezik. Esetenként fatális lehet, amennyiben nem megfelelően kezelik. A mastitis súlyos szövődménye a melltályog, amely lokalizált gennygyülem a mell állományán belül. Ezek az állapotok számottevő nehézséget jelentenek, és jelentős költséggel járnak. A legújabb kutatások kimutatták, hogy a mastitis megnöveli a HIV szoptatás útján való átvitelének kockázatát.

Egyre nyilvánvalóbb, hogy a mell nem elég hatékony kiürítése, ami a nem megfelelő szoptatási technika eredménye, fontos hajlamosító tényező, mégis, a mastitis még mindig a mell-fertőzés szinonímája az egészségügyi szakemberek fejében. Ezek a szakemberek gyakran képtelenek a mastitisben szenvedő nőknek olyan segítséget nyújtani, ami lehetővé teszi a szoptatás folytatását, és javasolják szükségtelenül a szoptatás abbahagyását.
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Vasospasm of the nipple–a manifestation of Raynaud’s phenomenon: case reports

Laureen Lawlor-Smith, Carolyn Lawlor-Smith

BMJ 1997;314:644

Raynaud’s phenomenon was first described by Maurice Raynaud in 1862. It is defined as intermittent ischaemia affecting the acral parts of the body, most commonly the fingers or toes. It is much more prevalent in women, with a female to male ratio of 9:1. It is common in healthy women of childbearing age, affecting up to 22% of healthy women in the 21-50 year age group. Nipple pain is the most common symptom in breastfeeding women and is the second most common reason given for abandoning breastfeeding, exceeded only by perceived low milk supply. We report on five women with Raynaud’s phenomenon affecting their nipples.
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Galactocele: three distinctive radiographic appearances

A Gómez, J M Mata, L Donoso and A Rams
Radiology 1986; 158:43-44

Abstract

Three radiographic appearances of galactocele of the breast not, to our knowledge, described previously in the literature were studied in 11 patients.

Mammary nodules with distinct and separate hydro-fat levels were observed in five cases. A nodule containing mixed water and fat densities was seen in one patient, while in the five remaining patients, pneumocystograms revealed masses of a water density mixed with the injected air.

A cikk teljes szövege a Radiology oldalán olvasható.

Radiology főoldal
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