Radiotherapy treatment planning for prostate and nodes using variable planning ring

2019 ◽  
Vol 19 (4) ◽  
pp. 399-402
Author(s):  
Poonam Yadav ◽  
Yue Yan ◽  
Bhudatt R. Paliwal

AbstractBackground:Prostate cancer is one of the most common solid malignancies and has a high morbidity rate. The uncertainty of the prostate location compromises the overall treatment plan optimisation. To account for the location uncertainty, the radiation oncologist needs to expand the margin of the planning target volume (PTV), which may increase the radiation toxicity to organs in proximity.Materials and methods:In this study, we investigated the quality of treatment plans for a patient with different ring sizes (2 and 3 cm). A small ring-shaped structure circumferentially around the PTV helps in defining the location of PTV. Prostate and pelvic node plans were analysed with dose prescription to 99% of PTV.Results:Additional ring-shaped structures led to more conformal dose coverage for target with reduced radiation side effects to nearby organ at risk (OAR). Expected treatment time was slightly higher for 2 cm ring compared to 3 cm ring. In case of prostate, expected duration was 4% higher, while for node plan, expected duration for 2 cm ring was 16% higher compared to 3 cm ring plan.Conclusions:It was observed that using a smaller size ring can lead to improved dose sparing to OAR with same target coverage as with larger dimension ring. The composite plans do not show any clinically significant difference in dose to OARs.

2020 ◽  
pp. 000313482093355
Author(s):  
Tarik Wasfie ◽  
Adam Howell ◽  
N Cwalina ◽  
Raquel Yapchai ◽  
Jennifer Hille ◽  
...  

Background Elderly patients with rib fractures carry a high morbidity rate, particularly due to pulmonary complications as decreased respiratory efforts ensue secondary to pain. Risk of bleeds in the elderly on anticoagulant therapy is high. The effort to reduce narcotic use in patients is now a health care priority. We propose that the use of paravertebral analgesia (PVA) pumps is an alternative pain control method with less risk and easy placement. Methods Two hundred and seventy-nine patients were admitted with multiple fractured ribs to the Trauma Center of Community Hospital and treated with the application of continuous PVA via a pump (72 patients). Pain scores were recorded before and after the initiation of the pump. These patients were compared with a group of the remaining 207 patients who received intravenous narcotics only. Results The mean change from baseline in pain scores for all patients was 1.43 (SD = 2.75). The mean change in pain for the treatment group was 1.93 (SD = 2.60), and the change in pain for the control group was 1.24 (SD = 2.79). Change in pain differed between groups (1.3 vs 1.8; P = .01) although it was a small difference. After adjusting for age, gender, Injury Severity Score, Glasgow Coma Scale, number of fractures, and comorbid conditions, there was no significant difference in pain post-procedure (odds ratio = 0.75; P = 0.39) with an effect size of 30% and total sample size of 279. Conclusion The PVA pump using bupivacaine is an effective safe and alternative method for managing elderly patients with rib fractures eliminating the serious side effects associated with narcotics.


2012 ◽  
Vol 45 (5) ◽  
pp. 563-566 ◽  
Author(s):  
Sandra Baltazar Guatura ◽  
Aripuana Sakurada Aranha Watanabe ◽  
Clarice Neves Camargo ◽  
Ana Maria Passos ◽  
Sheila Negrini Parmezan ◽  
...  

INTRODUCTION: Influenza A H1N1 2009 is associated with a high morbidity rate among children around the world, including Brazil. This survey was conducted on samples of symptomatic children (< 12 years) to investigate the influenza virus as the etiological agent of respiratory infections in a day care school in a health facility during the first and second pandemic wave of H1N1 (2009-2010) in São Paulo, Brazil. METHODS: Influenza infections were determined by real-time PCR in 34% (47/137) of children with a median age of 5 years (8 months - 12 years), from June to October 2009 and in 16% (14/85) of those with median age of 6 years (1-12 years), from March to November 2010. RESULTS: In general, most positive cases (64%) occurred in children aged 5-12 years, this age group was significantly the most affected (39.8%, p = 0.001, OR = 8.3, CI 95% 1.9-36.9). Wheezing was reported by 31% (19/61) and dyspnea by 23% (14/61) of the studied patients. An outbreak of influenza H1N1 with an attack rate of 35.7% among children (median age 6 years) was documented in April 2010, before the vaccination campaign against the pandemic virus was extended for children up to 5 years in Brazil. CONCLUSIONS: Therefore, the study reinforces the recommendation to immunize school children to reduce the incidence of the disease.


Author(s):  
Matthias G. Abah ◽  
Emem E. Bassey ◽  
Emmanuel B. Edu ◽  
Okupa D. Ovie

Background: Voluntary abortion for social reasons is illegal in Nigeria; however, the practice remains mostly clandestine and unsafe with varying consequences and determinants yet to be studied in all settings.Methods: A descriptive cross-sectional study design was used to assess the prevalence, practice and determinants of termination of pregnancy amongst 119 female Secondary School students in South-South Nigeria.Results: The prevalence of abortion was 57.1%. Most of the students were above 18years (58.8%), Christian (95.8%) and of rural residence (66.4%). While 58.8% had experienced an unwanted pregnancy, 61.4% had used some form of contraceptive with condom being the commonest (39.5%). Most (89.1%) have heard of abortions while 67.6% and 16.2% have had abortions once and twice respectively with the top reasons for abortion being that they were still in school (33.8%), too young (25.9%) and to avoid shame or stigma associated with the pregnancy (11.7%). Dilation and curettage was the predominant method employed (40.2%) mainly by medical doctors (34.1% and pharmacists (35.6%) while 51 (75%) had post-abortal complaints such as pain (41.2%) and bleeding (21.6%). There was a significant association between having an abortion and place of residence (rural more than urban), (p=0.04), being pregnant more than once (p<0.001), mothers` level of education (p=0.03), fathers` level of education (p=0.02) and mothers occupation (p=0.04).Conclusions: The prevalence of abortion is high and complicated by high morbidity rate despite a higher contraceptive prevalence rate whose major determinants were the socio-demographic characteristics of the parents. There is a need for early sex education from parents as this can influence abortion perception and practice in later years.


Biomedicines ◽  
2019 ◽  
Vol 7 (1) ◽  
pp. 20 ◽  
Author(s):  
Natalia Voge ◽  
Enrique Alvarez

The global incidence of multiple sclerosis (MS) appears to be increasing. Although it may not be associated with a high mortality rate, this disease has a high morbidity rate which affects the quality of life of patients and reduces their ability to do their activities of daily living. Thankfully, the development of novel disease modifying therapies continues to increase. Monoclonal antibodies (MABs) have become a mainstay of MS treatment and they are likely to continue to be developed for the treatment of this disease. Specifically, MABs have proven to be some of the most efficacious treatments at reducing relapses and the inflammation in MS patients, including the first treatment for primary progressive MS and are being explored as reparative/remyelinating agents as well. These relatively new treatments will be reviewed here to help evaluate their efficacy, adverse events, immunogenicity, and benefit-risk ratios in the treatment of the diverse spectrum of MS. The focus will be on MABs that are currently approved or may be approved in the near future.


Drug Research ◽  
2020 ◽  
Vol 70 (05) ◽  
pp. 199-205
Author(s):  
Takahiro Nishimura ◽  
Haruichi Kohno ◽  
Hideaki Nagai ◽  
Daisuke Maruoka ◽  
Yuichi Koike ◽  
...  

AbstractIn Japan, tuberculosis has been recognized as one of the major infections requiring urgent measures because of its high morbidity rate even now especially in elderly people suffering from tuberculosis during the past epidemic and its reactivation. Hence, many Japanese clinicians have made efforts to suppress the onset of tuberculosis and treat it effectively. The objectives of this study are to (1) identify covariate(s) that may explain the variation of rifampicin, which is the key antitubercular agent, under the steady-state by evaluating its population pharmacokinetics and (2) to propose an appropriate dosing method of rifampicin to Japanese patients. For this purpose, serum concentration–time data were obtained from 138 patients receiving rifampicin (300–450 mg) and isoniazid (300–400 mg) every day over 14 days, and analyzed using nonlinear mixed effects model. Thereby, population pharmacokinetic parameters were estimated followed by elucidating relations between the parameters and statistical factors. The analysis adopted one-compartment model including Lag-time by assuming that the absorption process is 0+1st order. The analyses demonstrate that meal affected the bioavailability, primary absorption rate constant, and zero order absorption time in the constructed model. A body weight calculated from the power model was selected as the covariate by the Stepwise Covariate Model method and found to highly affect the clearance in the range from −31.6% to 47.4%. We conclude that the dose in Japanese tuberculous patients can be well estimated by the power model formula and should be taken into consideration when rifampicin is administered.


1995 ◽  
Vol 82 (10) ◽  
pp. 1406-1408 ◽  
Author(s):  
K. Slim ◽  
D. Pezet ◽  
Y. Riff ◽  
E. Clark ◽  
J. Chipponi

2022 ◽  
Vol 67 (4) ◽  
pp. 203-213
Author(s):  
Suhaila N. Darogha ◽  
Sarhang H. Azeez ◽  
Zhian G. Abdullah

Urinary tract infection (UTI) is a major clinical problem in a wide age range that is associated with a high morbidity rate. Due to issues such as low specificity and the inability to differentiate between different types of infection in current diagnostic methods, there is a need to introduce novel UTI markers. The present study was conducted to evaluate the utility of Procalcitonin (PCT) and interleukin-6 (IL-6) as a marker of bacterial urinary tract infection. For this purpose, a cross-sectional study was conducted between November 2020 and February 2021 among 125 patients and 60 healthy volunteers (control) in Erbil Teaching Hospital. The concentration of PCT and IL-6 was quantified using the ELISA cloud immunoassay test. Between-group comparisons were assessed for the variables with analysis of variance. The results revealed that there was a significant difference between PCT levels in UTI patients (104.6±6.07) and control groups (54±2.24) (p <0.0001). The differences in IL-6 concentration in UTI patients (55.74±4.2) and control groups (24.56±2.4) were also significant (p <0.0001), implying that the level of both PCT and IL-6 increased due to bacterial infection in the urinary tract. As a whole, the findings of this study provide


2017 ◽  
Vol 1 (2) ◽  
pp. 1-5
Author(s):  
Asnidar ◽  
Tenriwati

Hypertension is a disease that causes a high morbidity rate. The purpose of this study was to analyze the decrease in heart rate of hypertensive patients before and after doing massage on the carotid artery at the Bontobangun Public Health Center. design with population and sample that is all hypertension patients in Public Health Center of Bonto Public Health Center as many as 30 people. The sampling technique used was accidentaly sampling. The results of this study were in the pre-test there were 17 people (56.7%) who were in the category of moderate heart rate, 13 people (43.3%) high heart rate, in the post-test there were 25 people (83.3%) who had moderate heart rate , and 5 people (16.7%) had high heart rates. The conclusion of this study is that there is a decrease in heart rate of hypertension patients after carotid artery massage in public polyclinic public clinics at Bonto Wake with a value of p = 0.008 <α = 0.05. suggestions from this study are so that the results of this study can add a reference regarding carotid artery massage to decrease heart rate in patients with hypertension in the general poly bontobangun puskesmas.


2020 ◽  
Author(s):  
Gina Penachiotti ◽  
Fabio Valdez ◽  
Wilfredo A González-Arriagada ◽  
Hector F Montes ◽  
Judith Parra ◽  
...  

Abstract Background. The oral squamous cell carcinoma (OSCC) affects more than 300,000 patients annually worldwide with a high morbidity rate (37.8%). Several tumor biomarkers have been suggested to anticipate outcome but results were poor. Changes of SPINK7 and associated proteins in precancerous oral lesions could lead to genomic instability and promote oncogenesis. Our aim was to evaluate SPINK7as apotential molecular biomarkerpredictive of OSCC stages, compared with well-known molecules altered in cancer: HER2,TP53, RB1, NFKB and CYP4B1. Methods.Oral biopsies from patientswith dysplasia (n=33), less invasive(n=28) andhighly invasiveOSCC (n=18) were collected. 20 cases with a clinical suspicion but normal mucosa confirmedwere included ascontrol. Gene expression of SPINK7, P53,RB, NFKBand CYP4B1 were quantified by qPCR.SPINK7 levels were correlated with a cohort of 330 patients from the TCGA. Also,SPINK7, HER2, TP53, and RB1, were evaluated by immunohistofluorescence. One-way Kruskal-Wallis test and Dunn's post-hocwith a p<0.05 significance were used to data analyze.Results.In OSCC, SPINK7wasdown regulated andP53, RB, NFKB and CYP4B1were up regulatedrespect tothe others groups (p<0.001). Also,SPINK7 expressionwasdiminished in patients of TCGA(p=2.10e-6). In less invasive OSCC,SPINK7 and HER2 proteinswere decreasedandTP53 and RB1 significantly increasedrespect todysplasia and highly invasivegroups (p<0.05).Conclusion. Our results suggest that SPINK7changes accompanied of HER2, P53 and RB1 can be used to classify the molecular stage of epithelial oral lesion inthe OSCC, allowing a more accuratediagnosis to molecular and histopathological level.


2015 ◽  
Vol 70 (6) ◽  
pp. 748-755
Author(s):  
Marina Andreevna Snovskaya ◽  
Anna Sergeevna Batyrova ◽  
Leyla Seymurovna Namazova-Baranova ◽  
Anna Aleksandrovna Alekseeva ◽  
Elena Aleksandrovna Vishneva ◽  
...  

High morbidity rate of atopic diseases among children, including high importance of grass pollen as a sensitizing agent, determine the relevance of studies on diagnostic examination systems for appointment of adequate therapy. The research of the most relevant allergens for patients to exclude of duplicating and uninformative tests became urgent after development of a new type of diagnostic tests that does not require expensive equipment. The objective of this research was to evaluate the results of in vitro- and in vivo-diagnostic examinations of children with various forms of atopic disease caused by pollen of meadow grasses, and to choose the most significant prognostic parameters for the diagnosis. Methods: 277 children aged 4–16 years with various forms of atopic disease were included in the study. There were performed skin prick tests and determination of IgE-antibodies levels to allergen extracts of cocksfoot (g3), meadow fescue (g4), timothy grass (g6). Results: In the studied group of patients 32–50% of children have antibodies to grass allergens. There was a close correlation of antibody response on the investigated allergens, quantitative coincidence of IgE-antibodies to g3 and g4 allergens levels. IgE (g6) concentration was close to the IgE(g3) and IgE(g4) levels (85,0±21,6%). Analysis of the skin tests results showed that 44% of patients have a positive response to grass allergens, and in vivo-tests results coincide with serological tests results, mostly in a qualitative sense. The most significant relationship was noted between in vivo and in vitro-tests in the results of testing the response to meadow fescue pollen.Conclusion: Based on these data IgE concentration index to meadow fescue allergens can be used as a prognostic marker to determine the sensitization of patients with different nosology forms of allergy and can help to improve allergic diagnostics.


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