Efficacy and safety of rifampicin-based triple therapy for non-puerperal mastitis: A single-arm, open-label, prospective clinical trial

Efficacy of red ointment in wound cavity repair following non-puerperal mastitis debridement

BACKGROUND

The objective of this study is to evaluate the efficacy of red ointment, a widely used topical agent in traditional Chinese medicine, in promoting wound cavity repair following debridement for non-puerperal mastitis (NPM).

METHODS

A prospective, randomized controlled trial was conducted, including 88 patients diagnosed with NPM. Patients were randomly assigned to either the treatment group or the control group. All patients underwent debridement during the acute inflammatory phase. Postoperatively, the treatment group received daily dressing changes using sterile gauze strips infused with red ointment, whereas the control group received sterile gauze strips soaked in rivanol. The effectiveness of treatment was assessed after two weeks by evaluating the total effective rate, wound cavity score, symptom and sign score, laboratory parameters, and adverse events.

RESULTS

In the intention to treat analysis, the total effective rate was 90.9% in the red ointment group, which was higher than the 86.4% observed in the rivanol group. In the per protocol analysis, the total effective rate was 97.6% in the red ointment group, exceeding the 92.7% in the rivanol group. Compared with rivanol-treated gauze strips, the use of red ointment gauze strips resulted in a significantly greater reduction in wound cavity volume (p < 0.05), improved local breast symptoms (p < 0.05), and a lower wound cavity score (p < 0.001). Granulation tissue in the red ointment group exhibited a significantly fresher color compared to the rivanol group (p < 0.05). No significant differences were observed between the two groups regarding adverse effects on hepatic and renal function following treatment.

CONCLUSION

The use of red ointment gauze strips for wound cavity filling following NPM debridement demonstrated favorable clinical efficacy and safety, providing a viable option for postoperative drainage management.

Analysis of three treatment methods for granulomatous lobular mastitis: a retrospective study in a single center

Background

Granulomatous lobular mastitis (GLM) is a rare, benign inflammatory condition of the breast that is difficult to distinguish from breast cancer on the basis of clinical and imaging findings. GLM typically has a long disease course, and is difficult to treat and prone to recurrence. Furthermore, there is currently no standard treatment for GLM. The aim of this study was to compare the therapeutic effects and patient satisfaction scores of surgery, triple anti-tuberculosis drug therapy, and combination treatment against GLM.

Methods

The medical records and follow-up data of GLM patients who underwent treatment at our center were retrospectively analyzed. Patients were divided into the treatment groups of surgery (group A), triple anti-tuberculosis drug therapy (group B), and combination therapy (group C). The demographic and clinical data, treatment outcomes, and patient satisfaction scores were compared among the three groups.

Results

Median follow-up duration of the patients was 35.43 months (range, 13.27-67.90 months). There were 106, 109, and 88 patients in groups A, B, and C respectively. The cure rates were similar among the groups (P = 0.220), although treatment duration was longest for group B, followed by group C and group A (P < 0.001). Group B had the highest patient satisfaction scores (P < 0.001),whereas the recurrence rate was highest in Group A (P < 0.001). Furthermore, no severe adverse drug reactions or major postoperative complications were observed in any of the patients.

Conclusions

Triple anti-tuberculosis drug therapy can effectively treat GLM patients with high patient satisfaction scores for potential application in clinical practice. The combination of surgery and triple anti-tuberculosis drug therapy is a suitable option for patients seeking rapid relief.

Trial registration

The study was registered at the Us Clinical Trial Registration Center (registration number: NCT06565845;date: 08/21/2024).

Clinical Characteristics of Non-Puerperal Mastitis: A Retrospective Analysis of 724 Patients

Objective

The aim of this study is to retrospectively analyze the clinical characteristics of non-puerperal mastitis.

Methods

A retrospective study was undertaken to investigate 724 cases of non-puerperal mastitis in patients hospitalized from April 2004 to December 2021 at the Mammary Gland Department of Shuguang Hospital, which is affiliated with Shanghai University of Traditional Chinese Medicine. Employing statistical methodologies including mean ± standard deviation, median, and one-sample t-test, the study sought to analyze and delineate factors associated with morbidity, such as age, childbirth, lactation, and body mass index (BMI).

Results

The average age of the 724 patients was 33.4 ± 5.5 years. Among them 54.94% were aged 30-39 years, 65.16% were within five years after delivery, and 62.56% were breastfeeding for less than 6 months. The BMI of patients aged 30-39 years was higher than that of the general Chinese population (P < 0.05). There was no significant correlation between smoking, oral contraceptives, trauma, and the incidence of the disease in this group.

Conclusion

Non-puerperal mastitis is more prevalent among women of childbearing age, specifically those aged 30-39 years, who breastfed for less than 6 months within the first five years after childbirth. In this age group, higher BMI is linked to increased morbidity.

Corynebacterium parakroppenstedtii secretes a novel glycolipid to promote the development of granulomatous lobular mastitis

Granulomatous lobular mastitis (GLM) is a chronic idiopathic granulomatous mastitis of the mammary gland characterized by significant pain and a high propensity for recurrence, the incidence rate has gradually increased, and has become a serious breast disease that should not be ignored. GLM is highly suspected relative to microbial infections, especially those of Corynebacterium species; however, the mechanisms involved are unclear, and prevention and treatment are difficult. In this study, we demonstrated the pathogenicity of Corynebacterium parakroppenstedtii in GLM using Koch's postulates. Based on the drug sensitization results of C. parakroppenstedtii, and utilizing a retrospective study in conjunction with a comprehensive literature review, we suggested an efficacious, targeted antibiotic treatment strategy for GLM. Subsequently, we identified the pathogenic factor as a new type of glycolipid (named corynekropbactins) secreted by C. parakroppenstedtii. Corynekropbactins may chelate iron, cause the death of mammary cells and other mammary -gland-colonizing bacteria, and increase the levels of inflammatory cytokines. We further analyzed the prevalence of C. parakroppenstedtii infection in patients with GLM. Finally, we suggested that the lipophilicity of C. parakroppenstedtii may be associated with its infection route and proposed a possible model for the development of GLM. This research holds significant implications for the clinical diagnosis and therapeutic management of GLM, offering new insights into targeted treatment approaches.

Treatment modalities for granulomatous mastitis, seeking the most appropriate treatment with the least recurrence rate: a systematic review and meta-analysis

BACKGROUND

Granulomatous mastitis (GM) is a rare, benign, inflammatory breast disease with an unknown etiology that predominantly affects women of reproductive age. The definitive treatment of GM is currently controversial; an appropriate therapeutic strategy has yet to be identified, and the disease's high recurrence rate remains. This study aims to determine the recurrence rate for each GM treatment strategy to identify the most appropriate treatment modality.

METHODS

The search for relevant articles was undertaken using three international databases, including Medline, Scopus, and Web of Science. Articles published in English until the end of 2021 evaluating the recurrence rate of GM were included. Using Stata 13.0, the pooled incidence and 95% confidence interval (CI) for the recurrence rate were determined.

RESULTS

Sixty-five eligible studies were included in our study. The recurrence rates of systemic steroid use, topical steroid use, antibiotic use, methotrexate use, observation, drainage, excision, antibiotic use and surgery, steroid use and surgery, antibiotic and steroid use, methotrexate and steroid use were 24% (95% CI: 21-27%), 11% (95% CI: 6-21%), 18% (95% CI: 14-22%), 13% (95% CI: 7-22%), 11% (95% CI: 7-17%), 65% (95% CI: 50-78%), 13% (95% CI: 10-16%), 23% (95% CI: 14-36%), 7% (95% CI: 5-11%), 11% (95% CI: 6-18%), and 4% (95% CI: 2-8%), respectively. Drainage had the highest recurrence rate, while combined methotrexate and steroid treatment had the lowest rate.

CONCLUSION

The optimal treatment strategy for GM depends on the disease's severity, consequences, and the patient's features. The study results indicate that combination therapy is preferable for minimizing the risk of relapse and reducing treatment complications.