Bloody nipple discharge in infants
ABSTRACT Though milky nipple discharge is frequently seen in neonates, blood stained discharge from the nipple is an exceptionally rare phenomenon. We noted a case of a three-month-old baby girl who presented with bilateral blood stained nipple discharge without signs of inflammation; engorgement or hypertrophy and which subsided without any intervention. This case is reported along with literature review about managing this rare condition.
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ABSTRACT: Bloody nipple discharge occurs rarely in infancy and may be secondary to mammary ductal ectasia. Discharge commonly resolves spontaneously, and ultrasonography is a useful diagnostic technique to detect the cause of discharge. We report a 28-month-old boy who presented with unilateral bloody nipple discharge for one month without signs of infection or mass. Ultrasound examination showed a dilated duct in the retroareolar region. No atypical cells were present on cytologic evaluation of the discharge. Further diagnostic studies were avoided and the discharge ceased completely one month later. We conclude that bloody nipple discharge is usually a benign and self-limited process in infancy and that it is advisable to avoid unnecessary invasive investigations initially. Invasive diagnostic studies or surgery should be reserved for cases with a palpable mass, persistent discharge or equivocal ultrasonographic findings.The Turkish journal of pediatrics 47(4):379-81. · 0.56 Impact Factor
Conference Paper: Using an enhanced genetic algorithm to solve the unit commitment problem[Show abstract] [Hide abstract]
ABSTRACT: The genetic algorithm (GA) is a general purpose optimization technique based on mechanisms inspired from natural genetics and natural selection. It is very suitable for solving nonlinear, multi-constraint, combinatorial optimization problems which are tough for conventional methods, However, the simple genetic algorithm (SGA) may have a slow convergence or even cannot reach the global optimum. Therefore, an enhanced GA is proposed in this paper to solve the unit commitment problem in power systems. The new features of the enhanced GA include chromosome mapping, problem specific operators and local search technique. As expected, it has a significantly improved performance of finding the optimum solution to the unit commitment problemIntelligent Processing Systems, 1997. ICIPS '97. 1997 IEEE International Conference on; 11/1997
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ABSTRACT: An understanding of underlying causes of bloody nipple discharge (BND) is necessary to be able to advise treatment guidelines of this rare symptom in the pediatric age group. Of 11 patients with 14 breasts that had BND, data regarding age, sex, side and duration of BND, physical examination findings, laboratory values, culture reports, ultrasonography (US) findings, treatment approach, histopathologic details, and outcomes were obtained, and also, literature was reviewed. The patients were between 3 months and 12 years of age. There were six males and five females. The BND was located in the right breast in six patients, in the left in two, and it was bilateral in three. On physical examinations, seven patients had palpable cystic nodules located at the areolar area and three had a diffuse breast enlargement without skin findings. Laboratory investigations showed normal hormone levels in all patients. At US examinations, seven breasts had cystic lesions, three had hypoechoic tissue in the subareolar region, and others had normal US findings. In a girl with positive culture for Staphylococcus aureus, BND resolved after oral antibiotics. Two cases resolved spontaneously, with 6 months and 4 months follow-up periods, respectively. Surgical intervention was performed for the remaining eight patients, and mean time to operation after onset of symptoms was 10 months (range = 1-34 months). Histopathologic findings showed that the underlying cause of BND was duct ectasia in five breasts, gynecomastia in three, and fibrocystic change in two. Their follow-up periods ranged between 3 months and 6 years, and no recurrences were observed. Classification of breasts with BND for selecting appropriate therapy on the basis of results of careful physical examination, with an US evaluation in selected cases, is effective, and prevents unnecessary investigations.Pediatric Surgery International 03/2006; 22(2):158-63. DOI:10.1007/s00383-005-1559-6 · 1.06 Impact Factor