Medical Bulletin 19/November/2022

Ultrasound guided surgery for patients with ductal carcinoma in situ (DCIS) gives better results than the standard technique of using a wire inserted into the breast, according to research presented at the 13th European Breast Cancer Conference.

The technique, known as intraoperative ultrasound, or IOUS, enables surgeons to remove a smaller quantity of breast tissue, while still removing all the of ductal carcinoma in situ tissue. Using intraoperative ultrasound improves the chance of having no cancer cells at the outer edge of the tissue that was removed, thereby reducing the risk of patients needing a second operation.

The research involved 108 people who were diagnosed with ductal carcinoma in situ. Forty-one were treated with IOUS-guided surgery while 67 were treated with the routine surgery guided by wire localisation (WL).

Reference:

Ultrasound-guided surgery is quicker, less painful and more effective for treating early form of breast cancer; EUROPEAN ORGANISATION FOR RESEARCH AND TREATMENT OF CANCER, 13th European Breast Cancer Conference (EBCC13).

Study yields clues to why Alzheimer's disease damages certain parts of the brain

Memory loss is the first sign of Alzheimer's disease, followed by confusion and difficulty thinking. These symptoms reflect the typical pattern of worsening damage to brain tissues. Toxic clusters of proteins are concentrated in the temporal lobes the memory area of the brain before spreading to parts of the brain that is important for thinking and planning.

The findings, published in Science Translational Medicine, help explain why symptoms of Alzheimer's disease sometimes vary, and highlights an understudied aspect of Alzheimer's disease that suggests yet-to-be discovered biological mechanisms may play an important role in the disease.

Reference:

Study yields clues to why Alzheimer's disease damages certain parts of the brain; Science Translational Medicine, DOI: 10.1126/scitranslmed.abl7646.

Studies provide latest 'real world' evidence on effectiveness of covid-19 treatments

There are several ongoing discussion about the effectiveness of different antibody and antiviral treatments for covid-19 with recent World Health Organization guidance recommending against use of sotrovimab.

Two studies published by The BMJ provide up to date evidence on the effectiveness of both currently licensed and possible covid-19 treatments under everyday ('real world') conditions, helping to shed more light on whether these drugs can prevent people from becoming seriously ill.

The first is an observational study carried out in England. The researchers used hospital records and death certificates for high-risk adults with covid-19 (average age 52) to compare the effectiveness of the antibody treatment sotrovimab with the antiviral drug molnupiravir.

Reference:

Studies provide latest 'real world' evidence on effectiveness of covid-19 treatments; BMJ Journal, DOI: 10.1136/bmj-2022-071932.