The number of people living with soft-tissue and bone sarcomas is increasing due to improved individual therapy and changes in demographics. At present, there are no recommendations for psychological ...co-treatment, occupational and social reintegration following the treatment of soft tissue and bone sarcomas.
Seventy-four patients, 42 males and 32 females, aged between 18 and 80 years (54.58 ± 16.99 yr.) with soft-tissue (62) and bone sarcomas (12) were included to answer five standardized and one personal questionnaire regarding quality of life, function, reintegration and participation after surgical treatment.
A number of tumour-specific and patient-specific factors were identified that affected the therapeutic outcome. Patients with sarcoma of the lower extremity described poorer mobility. Patients who underwent amputation reported a higher anxious preoccupation. Patients with a higher range of education were less fatalistic and avoiding. The size of tumours or additive radiation therapy did not affect the post-therapeutic quality of life, coping and function. There was a good correlation between anxiety and depression with occupational reintegration, function, quality of life and coping.
Patients with sarcomas of the lower limb have a higher demand for postoperative rehabilitation and need more help in the postoperative occupational reintegration. Furthermore patients that underwent limb-preserving operations reported better postoperative function and quality of life. Risk assessment using patient-specific factors and an intensive psychological co-treatment may have a large role in the co-treatment of patients from the beginning of their cancer therapy.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Desmoid tumors are fibroblastic neoplasms that have an intermediate behavior with a highly aggressive infiltrative growth arising from deep muscle or aponeurosis. We present the case of a 34-year-old ...woman that developed a painless mass in the right popliteal fossa during pregnancy after intracytoplasmic sperm injection and hormonal therapy. The MRI scan showed a hyperintense mass of 6,7 cm × 4,7 cm × 3,8 cm surrounding the lateral head of the gastrocnemius muscle. The open biopsy was done one week after delivery, and the histology showed a desmoid tumor. We performed the resection one week later and found the common peroneal nerve completely surrounded by the tumor. The close resection due to the neurolysis was the reason why an adjuvant radiation with 56 Gy was done. The last clinical examination, 18 month later, did not show any signs of recurrence and an excellent functional outcome. This case demonstrates the possible influences of pregnancy and hormonal therapy on the evolution of desmoid tumors.
Post-traumatic osteomyelitis attributed to metallo-β-lactamase (MBL)-producing Gram-negative bacteria presents a challenging clinical scenario. Cefiderocol emerges as a viable treatment option within ...the limited therapeutic options available.
In this brief report, we present a case of a Ukrainian patient with osteomyelitis caused by multi-drug resistant
, which was successfully treated with cefiderocol, facilitated in part by outpatient parenteral antibiotic therapy (OPAT).
Administration of Cefiderocol via OPAT can present a safe and effective option for treatment of post-traumatic osteomyelitis with multi-drug resistant
A possible effect on iron homeostasis of extended treatment duration with cefiderocol may be taken into consideration.
With the increasing use of next-generation sequencing, highly effective targeted therapies have been emerging as treatment options for several cancer types. Recurrent gene-fusions have been ...recognized in sarcomas; however, options for targeted therapy remain scarce. Here, we describe a case of a sarcoma, associated with a
RET::TRIM33
-fusion gene with an exceptional response to a neoadjuvant therapy with the selective RET inhibitor selpercatinib. Resected tumor revealed subtotal histopathologic response. This is the first report of successful targeted therapy with selpercatinib in
RET
-fusion-associated sarcomas. As new targeted therapies are under development, similar treatment options may become available for sarcoma patients.
An automated method for using unstructured grids to patch non- C0 interfaces between structured blocks has been developed in conjunction with a finite-volume method for solving chemically reacting ...flows on unstructured grids. Although the standalone unstructured solver, FVFLO-NCSU, is capable of resolving flows for high-speed aeropropulsion devices with complex geometries, unstructured-mesh algorithms are inherently inefficient when compared to their structured counterparts. However, the advantages of structured algorithms in developing a flow solution in a timely manner can be negated by the amount of time required to develop a mesh for complex geometries. The global domain can be split up into numerous smaller blocks during the grid-generation process to alleviate some of the difficulties in creating these complex meshes. An even greater abatement can be found by allowing the nodes on abutting block interfaces to be nonmatching or non-C 0 continuous. One code capable of solving chemically reacting flows on these multiblock grids is VULCAN, which uses a nonconservative approach for patching non-C0 block interfaces. The developed automated unstructured-grid patching algorithm has been installed within VULCAN to provide it the capability of a fully conservative approach for patching non-C0 block interfaces. Additionally, the FVFLO-NCSU solver algorithms have been deeply intertwined with the VULCAN source code to solve chemically reacting flows on these unstructured patches. Finally, the CGNS software library was added to the VULCAN postprocessor so structured and unstructured data can be stored in a single compact file. This final upgrade to VULCAN has been successfully installed and verified using test cases with particular interest towards those involving grids with non- C0 block interfaces.
AbstractIn this article, the authors present evidence regarding a dissociative subtype of PTSD, with clinical and neurobiological features that can be distinguished from nondissociative PTSD. The ...dissociative subtype is characterized by overmodulation of affect, while the more common undermodulated type involves the predominance of reexperiencing and hyperarousal symptoms. This article focuses on the neural manifestations of the dissociative subtype in PTSD and compares it to those underlying the reexperiencing/hyperaroused subtype. A model that includes these two types of emotion dysregulation in PTSD is described. In this model, reexperiencing/hyperarousal reactivity is viewed as a form of emotion dysregulation that involves emotional undermodulation, mediated by failure of prefrontal inhibition of limbic regions. In contrast, the dissociative subtype of PTSD is described as a form of emotion dysregulation that involves emotional overmodulation mediated by midline prefrontal inhibition of the same limbic regions. Both types of modulation are involved in a dynamic interplay and lead to alternating symptom profiles in PTSD. These findings have important implications for treatment of PTSD, including the need to assess patients with PTSD for dissociative symptoms and to incorporate the treatment of dissociative symptoms into stage-oriented trauma treatment.
Several chemical properties which influence the printability for fused filament fabrication 3D‐printing are derived from analyses of commercially available filaments. In preliminary experiments, ...polymerization conditions are optimized and suitable monomers and selectivity control agents (donors) are selected. An experimental series in which propene is copolymerized with the comonomers 1‐butene and 1‐hexene with an industrial Ziegler–Natta catalyst will be discussed here. The experiments are planned using design of experiments. Based on a split‐plot design, the design is adapted for mixtures and the combination of homo‐ and copolymerization. The observed factors, besides the mixture composition, are hydrogen partial pressure and the amount of donor. The obtained polymers are analyzed by means of high‐temperature size exclusion chromatography, differential scanning calorimetry, and rheology. 1‐Butene copolymers show good printing results and promising properties almost matching the desired ones. The targeted polymer properties are achieved within certain limits. 1‐Hexene copolymers result in lower molecular masses while crystallinity remains slightly higher, which does not match with the desired profile. Beneficial properties are likely to be achieved within a wider factor range, for example, higher comonomer amount and lower hydrogen partial pressure.
Material development of polypropylene copolymers for 3D‐printing application is done using design of experiments. Two types of comonomers and further polymerization influencing factors are screened for their impact on the polymer. The obtained materials with the most promising properties are produced into filaments and used for printing specimen.
Summary Background A better understanding of the effect of malaria control interventions on vector and parasite populations, acquired immunity, and burden of the disease is needed to guide strategies ...to eliminate malaria from highly endemic areas. We monitored and analysed the changes in malaria epidemiology in a village community in Senegal, west Africa, over 22 years. Methods Between 1990 and 2012, we did a prospective longitudinal study of the inhabitants of Dielmo, Senegal, to identify all episodes of fever and investigate the relation between malaria host, vector, and parasite. Our study included daily medical surveillance with systematic parasite detection in individuals with fever. We measured parasite prevalence four times a year with cross-sectional surveys. We monitored malaria transmission monthly with night collection of mosquitoes. Malaria treatment changed over the years, from quinine (1990–94), to chloroquine (1995–2003), amodiaquine plus sulfadoxine-pyrimethamine (2003–06), and finally artesunate plus amodiaquine (2006–12). Insecticide-treated nets (ITNs) were introduced in 2008. Findings We monitored 776 villagers aged 0–101 years for 2 378 150 person-days of follow-up. Entomological inoculation rate ranged from 142·5 infected bites per person per year in 1990 to 482·6 in 2000, and 7·6 in 2012. Parasite prevalence in children declined from 87% in 1990 to 0·3 % in 2012. In adults, it declined from 58% to 0·3%. We recorded 23 546 fever episodes during the study, including 8243 clinical attacks caused by Plasmodium falciparum , 290 by Plasmodium malariae , and 219 by Plasmodium ovale . Three deaths were directly attributable to malaria, and two to severe adverse events of antimalarial drugs. The incidence of malaria attacks ranged from 1·50 attacks per person-year in 1990 to 2·63 in 2000, and to only 0·046 in 2012. The greatest changes were associated with the replacement of chloroquine and the introduction of ITNs. Interpretation Malaria control policies combining prompt treatment of clinical attacks and deployment of ITNs can nearly eliminate parasite carriage and greatly reduce the burden of malaria in populations exposed to intense perennial malaria transmission. The choice of drugs seems crucial. Rapid decline of clinical immunity allows rapid detection and treatment of novel infections and thus has a key role in sustaining effectiveness of combining artemisinin-based combination therapy and ITNs despite increasing pyrethroid resistance. Funding Pasteur Institutes of Dakar and Paris, Institut de Recherche pour le Développement, and French Ministry of Cooperation.
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