Talk:Mastitis

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if[edit]

if antibiotics don't work, the doctor should rule out cancer? this seems counterintuitive, anyone care to expound on this?


i think it is trying to say that:

the physician should then go on to test and rule out breast cancer


Mastitis[edit]

I think there is an error and that the word "not" has been missed out otherwise the sentence is nonsensical.

La Leche League[edit]

Whether or not an average breast feeding enthusiast from LLL is more adept than an average obstetrician is an opinion for forum discussions, not a fact for encyclopedias. 207.172.172.221 03:49, 11 November 2006 (UTC)

Treatment[edit]

I'm surprised cabbage leaves haven't been mentioned as the most popular and effective treat -(although that might be only outside the US). [1] --Aspro 16:26, 14 December 2006 (UTC)

That article mentions cabbage leaves but does not give any
details, do you know of some better reference? Btw, yes there

are huge differences are across countries and US is certainly not reknowned to be #1 breastfeeding nation. I did also read of some Philipine plant used for treatment of brest problems - Sambong -- Richiez 17:45, 1 January 2007 (UTC)

It was for want of having a good solid reference that I refrained from adding this item to the article in the hope that someone else might know of one. There are some studies on Pubmed ( www.pubmedcentral.nih.gov/ ) but I don't feel inclined to find the time to read though them at the moment. Those that I have glanced at seemed as though they have be done by students -mindlessly 'going through the motions'. For instance, non mentioned when stating the 'preposition' what they defined as 'cabbage'. My point being: that popping into the local supermarket for a one of to-days modern cultivars, developed for its mildness and sweetness would -I guess- probably not be as effective. Country dwellers know to use the more bitter varieties for reducing swellings and inflammation. Nicholas Culpeper would use Cabbage Brassica capitata or Colewort Brassica oleracea or even better Sea Colewort (Sea Kale) Brassica marina. The later became a popular garden plant 'maybe' for this reason.
Cabbages And Coleworts:
http://www.bibliomania.com/2/1/66/113/frameset.html
The Sea Coleworts
http://www.bibliomania.com/2/1/66/113/frameset.html
I don't know about the far east plant you mention but there are possibly quite a few around the world.
Here is an animal study: Treatment Trial of Subclinical Mastitis with the Herb Persicaria senegalense (Polygonaceae)
http://www.springerlink.com/content/xl127562608357v8/
Any addition to the article on this topic I think would benefit greatly from the input of a qualified herbalist. --Aspro 19:09, 15 January 2007 (UTC)
Whatever PubMed citations you find are good enough to justify an entry here. This is not really a treatment manual but may certainly help someone to expand his horizon.
Richiez 21:05, 8 February 2007 (UTC)
Think I will beg to differ with you here, listing a badly designed trial (even if it is on Pubmed) not only reduces the chances that someone will look for a better one but also allows the opportunity for ridiculing WP for citing just any study no matter how poor the quality and a bad trial might mislead.--Aspro 18:36, 9 February 2007 (UTC)
Badly designed trial? How many randomized, double blind, placebo controlled trials wrt Mastitis are you aware off? Zero is a huge overestimate afaics. I think it is ok to cite anythying as long it is useful and appropriately commented (Class IV or V evidence, eventually extra cautions). It would be usefull to sketch what it is used to treat, which countries and if available approximate method. Richiez 16:05, 11 February 2007 (UTC)

Fibrocystic Disease redirecting here - splitup or handle more topics?[edit]

Noticed that Fibrocystic Disease and a few other more or less related keywords for benign breast conditions link to the Mastitis page. Should this page handle more benign breast conditions (and perhaps get renamed accordingly) or should every topic get own entry?

Points in favor of common page:

  • Fibrocystic condition and nonpuerperal mastitis are strongly related, perhaps more than puerperal and nonpuerperal mastitis
  • Terminology of benign breast conditions is fairly confused and makes it hard to search for literature - explaining it in a single page may be better overseeable than having separate entries for every subject

Points aginst a common page:

  • The page would probably get a container for all thinkable benign breast conditions, perhaps unnecessary large and complex to navigate?

What are the opinions, where should we draw the line? Richiez 21:32, 8 February 2007 (UTC)

I see your reasoning. In cases like this, it sometimes needs a bit of lateral thinking... eg. Searching for articles related to the affected organ.
This article brings together Breast#Disorders. It then links rather confusingly back to this Mastitis article. Also the article on breasts does not gives some of the other common names for Fibrocystic Breast Condition which is the same thing as fibrocystic breast disease, chronic cystic mastitis, diffuse cystic mastopathy, mammary dysplasia and so on. I suppose the key consideration here is the word inflamed and there can sometimes be inflammation present with cystic fibrosis.
So I think the guidance at the start of this article is OK but both articles need to be made clearer that the 'itis' refers to inflammation being present. Now, returning to your original question –the other conditions linking here then might be easier to reconsider, and possible redirect to the article on the breast OR if the condition is described else where on WP: then the alternative names be redirected to the most commonly used name. Does that seem to make as much sense as it dose to me? --Aspro 18:36, 9 February 2007 (UTC)
So I count that as a vote to handle Fibrocystic here? It would be impractical to handle only the 'itis' part of it. Regarding the other names, a glossary of terms related to mastitis and fibrocystic is on my todo list. Thought that it would be practical to have all related things in one place, otoh such lists tend to run out of scope quite easilly hence my original query. Richiez 16:14, 11 February 2007 (UTC)
My apologies, I wasn't being as clear as I thought. My thinking is: if the 'Breast' article is worked on first and all the conditions placed on there and sorted out. Then it would be easier to (1) place them into their proper groups and from there (2) Decide which conditions merit their own article. (3) Then, (3) it should prove easier --I think-- to see how best to have all the other necessary links and redirects. I think that Fibrocystic Breast Condition ought be mentioned in passing on this article, but it should be both with (a) a qualifier (i.e.,. it is a benign condition) and (b) to direct the reader to its own article which has yet to be created. So in other words: I think trying to fill in all the possible details at this stage before asking if there are enough of the right sort of boxes to put it in, is a harder way to go about things.--Aspro 18:34, 11 February 2007 (UTC)
The concept seems fine, but since the breast page is allready overburdened with cultural stuff it might be better to create breast_health as something a container for health related stuff that does not fit elsewhere or does not have an own entry yet? Hm.. breast_health might be a bad name for an entry dealing with all kinds of diseases. -- Richiez 23:35, 12 February 2007 (UTC)
Not withstanding the internal contradiction of an article called Breast Health to list breast diseases, that suggestion of yours does never the less, seem to hold the promise of bringing about more order upon this area. When one takes into consideration breast hygiene and other things, then yes: it is a subject in itself, and worthy of having an article dedicated to it along the lines you suggest.(Fear I will be tide up for the next few days. Do go along with Breast Health. Just click on it and add some info. Hopefully it will attract others to add their tuppence worth).--Aspro 00:56, 13 February 2007 (UTC)
Have created the 'Breast Health' article for you and added a template and some bits and pieces to get it going. However, I have just noticed that the second word of the title should have been in lower case, to conform to WP policy. Will have to do that later.--Aspro 11:18, 13 February 2007 (UTC)
Thinking a bit more about the name, I think Breast medical would make more sense? -- Richiez 23:38, 13 February 2007 (UTC)
Yet another possible name, Breast physiology and medical issues. Breast Health is quite ok though. -- Richiez 12:42, 14 February 2007 (UTC)

Bigger changes ahead[edit]

I am working on several sections of this article and want to upload the changes in one go, if anyone is planning bigger changes would be better to mention it here so we don't waste too much effort. My changes will probably include

  • update introduction
  • expand and improve puerperal mastitis
  • more extensive classification in nonpuerperal part
  • subsections about duct ectasia, subareolar abscess/smold and maybe more
Richiez (talk) 13:08, 28 December 2007 (UTC)

Uploaded my version new version.. sorry for the mixed reference styles but inline references are a lot of pain for me to work with. Ideally I would just write {{{{PMID 1234567}}}}.. does that exist??

On my TODO list now

  • little fixes
  • some more details in the breast cancer & mastitis section
  • more on iaotrogenic causes in aetiology and treatment
  • subsection about infections in nonpueperal mastitis

Since the basic structure of the article is now more or less in place I will work in smaller chunks

Richiez (talk) 16:14, 11 January 2008 (UTC)

?Hyponatraemic shock[edit]

Rises in sodium levels are found during mastitis. This is well reported. However, could you please supply references for hyponatraemic shock in the breastfeeding child - a condition which I have never seen in 15 years of work with breastfeeding women with mastitis. Mummy61 (talk) 05:48, 14 July 2008 (UTC)

The formulation in the text is wrong (oversimplified). It was meant to say that an osmotic imbalance can result from sudden weaning resembling the symptoms of hyponatremic shock, not a real hyponatremic shock. I am looking at usable references for this. Richiez (talk) 09:39, 22 July 2008 (UTC)

Mastitis, Antibiotics and MRSA[edit]

This has been on my radar for some time but do not currently have the time to finish up the changes to commit them into the article.

PMID 18757649 recently hit the headlines, some comments:

  • their observed rate of abscesses (39% of mastitis cases) could be regarded extraordinary high. On average something like 5-15% would be expected but a higher rate is not very surprising in the context of a teaching hospital where they likely deal with more difficult cases.
  • the MRSA rates in simple mastitis versus mastitis with abscess indeed suggest that MRSA can be a very important factor in the pathogenesis of puerperal breast abscess.
  • the treatment success with conservative treatment and unspecific antibiotics once again raises the question if, how and when antibiotics ever help cure mastitis.

Latter question is not hypothetical. It should be well known (but maybe is not) since at least PMID 15112132 that excellent treatment success is possible without antibiotics. In fact the reported results of Peters are so outstanding that one might wonder if antibiotics actually make things worse. It has been indeed asserted in literature that early use of antibiotics does increase risk of abscessation. Btw Universitätsklinik Frankfurt is an university hospital where a bias towards lighter cases appears very unlikely.

I would be surprised if we ever see any double blinded randomized trial of mastitis treatment methods. The question antibiotics or not and at which stage is difficult to decide, particularly because severity of symptoms on presentation is not a reliable predictor for neither outcome nor an indication of pathogenesis. In my opinion it seems clear that indiscriminate use of antibiotics (especially by insufficiently trained staff) should be minimized.

Richiez (talk) 15:27, 8 September 2008 (UTC)

Some interesting material on mostly non-puerperal breast abscess and MRSA is here http://archsurg.ama-assn.org/cgi/content/abstract/142/9/881. Nonpuerperal breast abscess usually have long history of recurrent inflammation so in this case the occurence of MRSA may be partially explained by long pretreatment with common antibiotics. Only around 60% of abscesses showed any bacterial yield.


Richiez (talk) 18:14, 10 September 2008 (UTC)

Acute Mastitis and treatment.[edit]

I've just redirected Acute mastitis here. That article had very little information, and no sources. It did say that acute puerperal and nonpuerperal mastitis are treated by antibiotics and surgical draining. Can someone with a medical textbook handy write about treatment? --SV Resolution(Talk) 12:50, 5 May 2009 (UTC)

Thanks for killing that article. The term "acute mastitis" is sometimes used but the only useful definition of it is that is acute in contrast to "chronic mastitis". Chronic mastitis is the less frequent one so by default everything you find refers to acute mastitis. Treatment differs by region, abscessation status and puerperal/nonpuerperal variant. Richiez (talk) 23:16, 7 June 2009 (UTC)

Probiotics vs. Antibiotics for puerperal mastitis[edit]

PMID 20455694 is out. Seems like a very valuable addition to a nonexistent (PMID 19160255) body of evidence - they did even bacteria counts, almost unheard off in mastitis research. I am not sure I would wholeheartedly endorse the lactobacili now but it shows once again that antibiotics have extraordinary poor efficiacy in mastitis. Richiez (talk) 15:13, 25 June 2010 (UTC)

Merger proposal[edit]

Suggesting the merge because for most readers and many editors mastitis is identical to puerperal mastitis, leading to confusion, duplicated effort and readers looking at suboptimal articles. Long time ago it was intended to have mastitis as an overview for all inflammatory breast lesions but as of now the articles did grow to cover largely the same content.

Propose to merge puerperal mastitis into mastitis and provide a link to a disambiguation page on top of mastitis, make puerperal mastitis redirect to mastitis. The section about breast cancer&mastitis will be split and moved to respective subpages. Richiez (talk) 16:01, 13 August 2010 (UTC)

Also think I will create Inflammatory breast conditions and reuse most of nonpuerperal mastitis for that. Nonpuerperal mastitis will remain as redirect to the new overview page. Richiez (talk)

Merge in progress[edit]

Substantial rewrite and reshuffle of this and related articles, doing it here: User:Richiez/Drafts. Richiez (talk) 11:42, 19 January 2013 (UTC)