scholarly journals Practice of radiation therapy for anal cancer in Austria—a survey on behalf of the Austrian radiation oncology society gastrointestinal tumor group (ÖGRO-GIT)

Author(s):  
S. Gerum ◽  
W. Iglseder ◽  
R. Schmid ◽  
K. Peterka ◽  
T. H. Knocke-Abulesz ◽  
...  

Abstract Purpose We conducted a patterns-of-care survey on chemoradiation for locoregionally confined anal cancer in Austria to evaluate areas of disagreement and to identify possible targets for further standardization. Methods An anonymous questionnaire comprising 38 questions was sent to all Austrian radiation oncology departments. Results were analyzed descriptively and compared to two international guidelines. Results The response rate was 93%. Work-up generally includes DRE, endoscopy, and cross-sectional imaging of chest/abdomen and pelvis. PET-CT is used by 38%. Screening for HIV and biopsies of suspicious lymph nodes are infrequently used. All centers perform IMRT, mainly with daily IGRT. Median doses to the primary are 54.7 Gy (T1–2) and 59.4 Gy (T3–4). Suspicious nodes receive a boost (median dose 54 Gy), while elective nodal areas are mainly treated with 45–50.4 Gy. Target delineation of elective nodal areas seems generally uniform, although disagreement exists regarding inclusion of the common iliac nodes. No agreement was found for OAR-delineation and dose constraints. Concurrent chemotherapy is mitomycin and 5‑FU/capecitabine. Supportive care beyond skin care is infrequently offered. Intensive follow-up is performed for at least 5 years. Treatment of T1N0 shows considerable disagreement. Conclusion We found a high rate of agreement between the centers and concordance with major guidelines. PET-CT, routine HIV testing, and biopsies of suspicious LN seem underrepresented. The largest controversy regarding target volumes concerns inclusion of the common iliac nodes. Prescribed doses are generally in line with the recommendations or higher. OAR delineation, dose constraints, supportive care, and treatment of early anal cancer represent areas for further standardization.

2005 ◽  
Vol 44 (S 01) ◽  
pp. S38-S40
Author(s):  
Th. Herrmann

Summary:PET/CT imaging is most likely to be of use in radiation oncology with patients who have poorly defined target volume areas, e.g. brain tumours, bronchogenic carcinoma, and cases of miscellaneous geographical miss. Other tumours that call for dose escalated radiotherapy, such as head and neck tumours, bronchogenic carcinoma, and prostate carcinomas may further benefit from an accurate delineation of the metabolically active tumour volume and its differentiation from surrounding healthy tissue, or tumour atelectasis.


2016 ◽  
Vol 2 (1) ◽  
pp. 62-78
Author(s):  
. Hemraj ◽  
Raj Kumar ◽  
Sourabh Kosey ◽  
Amit Sharma ◽  
Nalini Negi

To determine the most common physical side effects experienced by local chemotherapy patients. Their perceptions of these side effects and informational needs from clinical pharmacists were also evaluated. This was a single center, observational cross-sectional study conducted at department of General Surgery, Guru Gobind Singh Medical College and Hospital, Faridkot, Punjab. A face to face interview was conducted. Information collected included chemotherapy related side effects after last chemotherapy experience, the most worrisome side effects, overlooked by healthcare professionals and the preferred method, amount and source of receiving related information. In this study, hundred patients were enrolled out of them 48 were male and 52 were female. When differential calculations was done, common side effects or adverse effects of chemotherapy in the patients of breast, lung cancer, Ovarian Cancer, Colon cancer, Prostate cancer, Lymphoma Cancer, Cervix cancer where there is much irregular medicine intake 57.4% may be due to common problem of joint pain reported by all the patients under study, with the consecutive problem of nausea and vomiting. The high prevalence of chemotherapy related side effects among local patients is a major concern and findings of their perceptions and informational needs may serve as a valuable guide for clinical pharmacists and physicians to help in side effect management. This study shows the common problems reported by the patients when they are suffering from cancer condition, according to their incidence perceptions as experienced by the patient, this will allow the physician and clinical pharmacist to effectively counsel and manage the common symptoms as reported prior to its occurrence in the patient, so that withdrawal can be checked.


Author(s):  
Yasir. B. Elshambaty

Purpose this study aims to show the patterns and outcome of pediatric injury among those living in Albaha region in Saudi Arabia Methods this is a cross-sectional descriptive household-based study, included children between 0-17 years old both male and female. The data were collected with structured questionnaire between 20 Nov – 20 Dec 2018 and  analyzed with SPSS version 25 Results the total of participants was 257 injured child. 199(77.4%) are male and 58(22.6%) are female. About 44%of them were injured at pre-school level and 56% were traumatized at school age. The least incidence of injury occurred in those less than 2 yrs and higher incidence in those between 3-10 yrs old. The most common mechanism of injury was falling from height. The most affected group age by RTA accidents was 11-17 yrs old. Approximately 83% of the injured children required hospital management. Only one third of the injuries were  associated complications. The most common injured anatomic part was the upper limb and the least affected part was the spine. Only 5% of the injuries were associated with a disability and the common was loss of organ or part of it. Paralysis occurred in less than 1% and head injury resulted in disabilities more than 1%. Conclusion the vast majority of the injuries in our participants are not serious. The severe injuries were associated with RTA-related trauma. Most of injuries due to falling from height are not serious. We recommend not to allow the children to drive cars. Keywords: pediatric injuries; injury patterns; household.


2017 ◽  
Vol 8 (1) ◽  
pp. 33
Author(s):  
Rajni Suri ◽  
Anshu Suri ◽  
Neelam Kumari ◽  
Amool R. Singh ◽  
Manisha Kiran

The role of women is very crucial in our society. She cares for her parents, partner, children and other relatives. She performs all types of duties in family and also in the society without any expectations. Because of playing many roles, women often face many challenges in their life including both physical and mental. Mental health problems affect women and men equally, but some problems are more common among women including both physical and mental health problems. Aim of the study - The present study is aimed to describe and compare the clinical and socio-demographic correlates of female mentally ill patients. Methods and Materials: The study includes 180 female mentally ill patients based on cross sectional design and the sample for the study was drawn purposively. A semi structured socio-demographic data sheet was prepared to collect relevant information as per the need of the study. Result: The present study reveals that the socio-demographic factors contribute a vital role in mental illness. Findings also showed that majority of patients had mental problems in the age range of 20-30 have high rate. Illiterate and primary level of education and daily wage working women as well as low and middle socio-economic status women are more prone to have mental illness. Other factors like marital status, type of family and religion etc also important factors for mental illness. Keywords: Socio demographic profile, female, psychiatric patient


2020 ◽  
Vol 22 (3) ◽  
pp. 141-145
Author(s):  
Krishna Chandra Devkota ◽  
S Hamal ◽  
PP Panta

Pleural effusion is present when there is >15ml of fluid is accumulated in the pleural space. It can be divided into two types; exudative and transudative pleural effusion. Tuberculosis and parapneumonic effusion are the common cause of exudative pleural effusion whereas heart failure accounts for most of the cases of transudative pleural effusion. This study was a hospital based cross sectional study performed at Nepal Medical College during the period of January 2016-December 2016. A total of 50 patients who fulfilled the inclusion criteria were enrolled. Pleural effusion was confirmed by clinical examination and radiology. After confirmation of pleural effusion, pleural fluid was aspirated and was analysed for protein, LDH, cholesterol. The Heffner criteria was compared with Light criteria to classify exudative or transudative pleural effusion. Among 50 patients, 30 were male and 20 were female. The mean age of patient was 45.4±21.85 years. The sensitivity and specificity of using Light criteria to detect the two type of pleural effusion was 100% and 90.9%, whereas using Heffner criteria was 94.87%, 100% respectively(P<0.01). There are variety of causes for development of pleural effusion and no one criteria is definite to differentiate between exudative or transudative effusion. In this study Light criteria was more sensitive whereas Heffner criteria was more specific to classify exudative pleural effusion. Hence a combination of criteria might be useful in case where there is difficulty to identify the cause of pleural effusion.


2018 ◽  
Vol 8 (4) ◽  
pp. 65-69
Author(s):  
Mao Nguyen Van ◽  
Dong Tran Nam

Background: Pigmented tumour of the skin is one of the common tumour in human including the benign pigmented tumours (more common) called Nevi tumours and the malignant one called melanoma which was less frequent but the most poor in prognosis. In addition, the others not belonging to these group had the same clinical appearance, so the application of histopathology and immunohistochemistry for the definitive diagnosis was indespensible. Objectives: 1. To describe the macroscopic features of the pigmented tumoral-like lesions; 2. To classify the histopathologic types of the pigmented cell tumours and the other pigmented tumours of the skin. Materials and Method: Cross-sectional research on 55 patients diagnosed as pigmented tumoral lesions by clinician, then all definitively diagnosed by histopathology combining the immunohistochemistry in difficult cases. Results: There was no difference in gender, the disease was discovered most common in adult, especially with the age over 51 years old (58.1%). the most region located was in the face accounting for 60%, following the trunk and limbs (14.6%, 12.8% respectively). All 3 malignant melanomas happened in foot. The most common color of the lesions was black (65.4%), the other ones were rose, grey and blue. Histopathology and immunohisthochemistry showed that the true pigmented cell tumours were 52.6% encompassing benign ones (Nevi tumour) (41.8%), melanoma (5.4%) and lentigo (5.4%). 47.4% was not the true pigmented cell tumour including pigmented basocellular carcinoma (36.4%) and the others less common as histiofibromas, acanthoma and papilloma. Conclusion: the pigmented tumoral-like lesions of the skin could be the true pigmented cell tumours and the others, so the application of the histopathology and the immunohistochemistry after the clinical discovery helps to determine and classify the disease definitely and for the best orientation of treatment as well. Key words: skin tumour, benign pigmented tumour (Nevi), malignant pigmented tumour (melanoma), pigmented basocellular carcinoma


2017 ◽  
pp. 22-24
Author(s):  
Thi Thao Nhi Tran ◽  
Dinh Toan Nguyen

Background and Purpose: Stroke is the second cause of mortality and the leading cause of disability. Using the clinical scale to predict the outcome of the patient play an important role in clinical practice. The Totaled Health Risks in Vascular Events (THRIVE) score has shown broad utility, allowing prediction of clinical outcome and death. Methods: A cross-sectional study conducting on 102 patients with acute ischemic stroke using THRIVE score. The outcome of patient was assessed by mRankin in the day of 30 after stroke. Statistic analysis using SPSS 15.0. Results: There was 60.4% patient in the group with THRIVE score 0 – 2 points having a good outcome (mRS 0 - 2), patient group with THRIVE score 6 - 9 having a high rate of bad outcome and mortality. Having a positive correlation between THRIVE score on admission and mRankin score at the day 30 after stroke with r = 0.712. THRIVE score strongly predicts clinical outcome with ROC-AUC was 0.814 (95% CI 0.735 - 0.893, p<0.001), Se 69%, Sp 84% and the cut-off was 2. THRIVE score strongly predicts mortality with ROC-AUC was 0.856 (95% CI 0.756 - 0.956, p<0.01), Se 86%, Sp 77% and the cut-off was 3. Analysis of prognostic factors by multivariate regression models showed that THRIVE score was only independent prognostic factor for the outcome of post stroke patients. Conclusions: The THRIVE score is a simple-to-use tool to predict clinical outcome, mortality in patients with ischemic stroke. Despite its simplicity, the THRIVE score performs better than several other outcome prediction tools. Key words: Ischemic stroke, THRIVE, prognosis, outcome, mortality


2017 ◽  
pp. 46-52
Author(s):  
Thanh Thai Le ◽  
Phuong Nam Tran ◽  
Thi Ngan An Nguyen

Aims: To study outcomes of septoplasty and partial inferior turbinectomy (PIT) method, expecting leastsurgical equipment, good result, price rationalization. Methods: Prospective, cross-sectional study. Including 40 patients treated by septoplasty and PIT method. Assessment had been made after 3 months post-op. Results: The common symptoms were nasal obstruction (100%), headache (40%). The deformities of nasal septalwere deviation (42.5%), crest (30%). There were 67.5% of patients with severe bilateral hypertrophic inferior turbinate, mostly over grade II, enlargement both soft and bone parts (60%). After 3 months, the nasal obstruction and headache presented good or great results in 90% of patients, 93.7% of patients had straight nasal septaland 90% hadsmall inferior turbinate.VAS: patients’s contentment was 100%. Conclusions: The study showed that septoplasty and partial inferior turbinectomy presented good results with 87.5% after surgery and 90% after 3 months. Key words: septal deformity, hypertrophy inferior turbinate, septoplasty, partial inferior turbinectomy


2019 ◽  
Vol 16 (3) ◽  
pp. 215-223 ◽  
Author(s):  
Dejan Jakimovski ◽  
Matthew Topolski ◽  
Kana Kimura ◽  
Virja Pandya ◽  
Bianca Weinstock-Guttman ◽  
...  

Background: Studies have previously shown greater arterial and venous extracranial vascular changes in persons with multiple sclerosis (PwMS) when compared to healthy controls (HCs). Objectives: To determine the change in the number and size of secondary neck vessels in PwMS and HCs over a 5-year follow-up period. Methods: Both at baseline and follow-up, 83 PwMS and 25 HCs underwent magnetic resonance angiography (MRA) imaging and analysis. The number and cross-sectional area (CSA) of all secondary neck vessels (excluding the common/internal carotid, vertebral artery, and internal jugular vein) measured at levels from C2-T1 were determined by semi-automated edge detection/ contouring software. The longitudinal change in the number and CSA of the secondary neck vessels from the PwMS and HCs were analyzed by non-parametric Wilcoxon repeated measure. Benjamini-Hochberg procedure adjusted for false discovery rate (FDR). Results: For over 5 years, PwMS demonstrated a consistent longitudinal decrease in both the number of secondary neck vessels (Z-change between -3.3 and -5.4, q=0.001) and their CSA (Zchange between -2.9 and -5.2, q=0.004). On the contrary, the HCs did not demonstrate a significant longitudinal change in secondary neck vessels over the follow-up period. Due to the longitudinal decrease, the PwMS showed a lower number of secondary neck vessels when compared to HCs measured at follow-up (p<0.029, except for C4 with trending p=0.071). The PwMS changes were also corroborated within each MS phenotype. Conclusion: PwMS demonstrate a significant mid-term decrease in the number and the size of the secondary neck vessels. The clinical relevance of these findings and the effect on intracranial blood flow are currently unknown.


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