The Medical journal of Australia
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Fibroadenoma of the breast is a common cause of a benign breast lump in premenopausal women. The consensus view is that women with fibroadenomas are not at significant increased risk of developing breast cancer. Diagnosis is based on the combination of clinical examination, imaging and non-surgical tissue biopsy (the triple test). ⋯ Traditionally, symptomatic fibroadenomas were treated by surgical excision, and this option should always be offered. There is increasing evidence that a conservative approach is safe and acceptable, provided the result of an adequate triple test is both negative for cancer and consistent with a fibroadenoma. Patients who choose conservative management need to be informed of the limitation of the tests, and must be assessed promptly if there is symptomatic or clinical change.
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To assess the predictive value of cardiac troponin I levels in cardiac and all-cause mortality in patients presenting to an emergency department. ⋯ Compared with CK-MB, cardiac troponin I more accurately predicts 30-day mortality rates in patients presenting to the emergency department. Moreover, troponin I levels identify additional groups of patients at increased risk of death not so identified by measuring CK-MB values.
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(1) To determine the prevalence of cervical zygapophyseal joint pain in a specialist clinical setting; (2) to review the number of diagnostic blocks needed to identify the segmental level of the symptomatic joints; and (3) to determine the distribution of segmental levels of cervical zygapophyseal joint pain in a clinical setting. ⋯ The prevalence of cervical zygapophyseal joint pain estimated in this clinical study is lower than that found in previous research setting studies, but our requirement for confirmation by a repeat block (which many patients declined) makes our estimate conservative; it is likely that the true prevalence is higher. Zygapophyseal joints are clearly a common source of pain in patients presenting with chronic neck pain, with or without headache. Cervical zygapophyseal joint pain is readily diagnosable, enabling patients to seek further, targeted treatment.