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Long-term clinical results of early-stage lung cancer patients treated with risk-adapted stereotactic body radiotherapy using LINAC or CyberKnife : A single-institution analysis of more than 400 cases.

PURPOSE: The aim of the study was to evaluate the clinical efficacy and side effects of stereotactic body radiotherapy (SBRT) using a gantry-based linear accelerator (LINAC) or robotic technique in a large cohort of consecutively treated medically inoperable early-stage lung cancer patients. METHODS: Between March 2015 and February 2023, 401 early-stage (T1-2 N0 M0) primary lung cancer patients were treated using either LINACs (Varian VitalBeam® and TrueBeam®; Varian, Palo Alto, CA, USA) or CyberKnife® (Accuray, Madison, WI, USA). Median age was 70 years (range 44-90). Diagnosis was based on

Dosimetric Factors and Toxicity in Highly Conformal Thoracic Reirradiation.

PURPOSE: We determined cumulative dose to critical structures, rates of toxicity, and outcomes following thoracic reirradiation. METHODS AND MATERIALS: We retrospectively reviewed our institutional database for patients treated between 2008 and 2014, who received thoracic reirradiation with overlap of 25% prescribed isodose lines. Patients received courses of hyperfractionated (n=5), hypofractionated (n=5), conventionally fractionated (n=21), or stereotactic ablative radiation therapy (n=51). Doses to critical structures were converted to biologically effective dose, expressed as 2 Gy per fra

Outcomes of scapulothoracic fusion in patients with facioscapulohumeral dystrophy: a comparison of allograft versus autograft bone grafting.

BACKGROUND: Scapulothoracic (ST) fusion for facioscapulohumeral muscular dystrophy (FSHD) is an established treatment that corrects scapular instability, although it has high reported complication rates. The purpose of our study was to characterize the outcomes of ST fusion for FSHD in a large patient cohort and compare the outcomes based on bone graft type and fixation technique. Our hypothesis was that union rates would not differ by bone graft type during ST fusion. METHODS: A retrospective chart review was undertaken to identify patients who underwent ST fusion at multiple institutions pe

Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomised trials.

BACKGROUND: The standard of care for operable, stage I, non-small-cell lung cancer (NSCLC) is lobectomy with mediastinal lymph node dissection or sampling. Stereotactic ablative radiotherapy (SABR) for inoperable stage I NSCLC has shown promising results, but two independent, randomised, phase 3 trials of SABR in patients with operable stage I NSCLC (STARS and ROSEL) closed early due to slow accrual. We aimed to assess overall survival for SABR versus surgery by pooling data from these trials. METHODS: Eligible patients in the STARS and ROSEL studies were those with clinical T1-2a (<4 cm), N0

[The significance of a 4,183 Da peptide of dermcidin protein in the early diagnosis and differential diagnosis of acute coronary syndrome].

OBJECTIVE: To investigate the predictive value of 4,183 Da peptide of dermcidin protein in the early diagnosis and differential diagnosis of ischemic heart disease. METHODS: A prospective controlled study was conducted. Serum samples were drawn from 161 patients with acute coronary'syndrome [ACS, including 46 patients with unstable angina (UA), 23 with acute non-ST elevation myocardial infarction, and 92 with acute ST segment elevation myocardial infarction], 111 subjects for routine physical examination, including 45 patients with hypertension history, 42 with coronary heart disease, 22 with

Stereotactic hypofractionated radiation therapy for stage I non-small cell lung cancer.

We reviewed our initial institutional experience with the use of stereotactic hypofractionated radiation therapy (SFRT) in patients with stage I non-small cell lung cancer (NSCLC). Thirty patients with inoperable stage I non-small cell lung cancer due to a severe chronic obstructive pulmonary disease (COPD) and/or chronic heart disease (Eastern Cooperative Oncology Group (ECOG) performance status of 0-2) were treated between December 2000 and October 2003 with SFRT in curative intent. Infiltration of locoregional lymph nodes and distant metastases were ruled out by computerized tomography (CT)

[Congenital pseudarthrosis of the clavicle: 25 childhood cases].

PURPOSE OF THE STUDY: Congenital pseudarthrosis of the clavicle is rare, only 200 cases having been reported. Based on 25 personal cases and an overview of the literature, we try to explain the etiology of this condition and the different kinds of treatment. MATERIAL AND METHODS: A retrospective analysis was performed on twenty-five children (16 females, 9 males, mean age at the end of the follow up - 11.5 yrs) from three different centers. We assessed the outcome of surgical and nonsurgical procedures, based on pain, functional ability, cosmetic results, and x-ray examination. RESULTS: A fa

Flail chest injuries: a review of outcomes and treatment practices from the National Trauma Data Bank.

BACKGROUND: Flail chest injuries are associated with severe pulmonary restriction, a requirement for intubation and mechanical ventilation, and high rates of morbidity and mortality. Our goals were to investigate the prevalence, current treatment practices, and outcomes of flail chest injuries in polytrauma patients. METHODS: The National Trauma Data Bank was used for a retrospective analysis of the injury patterns, management, and clinical outcomes associated with flail chest injuries. Patients with a flail chest injury admitted from 2007 to 2009 were included in the analysis. Outcomes inclu

Triaging Interventional Pain Procedures During COVID-19 or Related Elective Surgery Restrictions: Evidence-Informed Guidance from the American Society of Interventional Pain Physicians (ASIPP).

BACKGROUND: The COVID-19 pandemic has worsened the pain and suffering of chronic pain patients due to stoppage of "elective" interventional … in impaired mobility and inability to perform activities of daily living. Examples include painful rib fractures affecting oxygenation and post-dural puncture headaches limiting the ability to sit upright, stand and walk. In addition, emergency procedures include procedures to treat any severe or debilitating disease that prevents the patient from carrying out …

Efficacy and Safety of Asfotase Alfa in Infants and Young Children With Hypophosphatasia: A Phase 2 Open-Label Study.

CONTEXT: Long-term data on enzyme replacement treatment of hypophosphatasia (HPP) are limited. OBJECTIVE: To evaluate efficacy and safety of asfotase alfa in patients aged ≤5 years with HPP followed for up to 6 years. DESIGN: Phase 2 open-label study (July 2010 to September 2016). SETTING: Twenty-two sites; 12 countries. PARTICIPANTS: Sixty-nine patients [median (range) age: 16.0 (0.02 to 72) months] with severe HPP and sign/symptom onset before age 6 months. INTERVENTION: Asfotase alfa 2 mg/kg three times/week or 1 mg/kg six times/week subcutaneously. MAIN OUTCOME MEASURES: Primary effi

One Approach Anterior Decompression and Fixation with Posterior Unilateral Pedicle Screw Fixation for Thoracolumbar Osteoporotic Vertebral Compression Fractures.

OBJECTIVE: The objective of the present paper was to explore the clinical effect of one approach anterior decompression and fixation with posterior unilateral pedicle screw fixation for thoracolumbar osteoporosis vertebral compression fractures (OVCF). METHODS: This is a single-center retrospective analysis. A total of six thoracolumbar OVCF patients (four women and two men) with an average age of 65.2 years (58-72 years) who were treated between June 2016 and May 2018 were enrolled in the present study. The lesion segments included: 1 case at T11, 1 case at T12, 3 cases at L1, and 1 case at

Transcutaneous electrical nerve stimulation for acute pain.

BACKGROUND: This is a second update of a Cochrane Review originally published in Issue 2, 2009. Transcutaneous Electrical Nerve Stimulation … screening flexible sigmoidoscopy and non-procedural pain, e.g. postpartum uterine contractions and rib fractures. We pooled data for pain intensity for six trials (seven comparisons) comparing TENS with placebo but the I(2) statistic suggested substantial heterogeneity. Mean difference (MD) with 95% confidence intervals (CIs) on a visual analogue scale (VAS, 1 …

Locoregional irradiation for inflammatory breast cancer: effectiveness of dose escalation in decreasing recurrence.

PURPOSE: To evaluate the effect of radiation dose escalation on locoregional control, overall survival, and long-term complication in patients with inflammatory breast cancer. PATIENTS AND METHODS: From September 1977 to December 1993, 115 patients with nonmetastatic inflammatory breast cancer were treated with curative intent at The University of Texas M. D. Anderson Cancer Center. The usual sequence of multimodal treatment consisted of induction FAC or FACVP chemotherapy, mastectomy (if the tumor was operable), further chemotherapy, and radiation therapy to the chest wall and draining lymph

The effects of sequence and type of chemotherapy and radiation therapy on cosmesis and complications after breast conservation therapy.

PURPOSE: Chemotherapy plays an increasingly important role in the treatment of both node-negative and node-positive breast cancer patients, but the optimal sequencing of chemotherapy and radiation therapy is not well established. The purpose of this study is to evaluate the interaction of sequence and type of chemotherapy and hormonal therapy given with radiation therapy on the cosmetic outcome and the incidence of complications of Stage I and II breast cancer patients treated with breast-conserving therapy. METHODS AND MATERIALS: The records of 1053 Stage I and II breast cancer patients trea

THE INFLUENCE OF CHANGES IN CARBOHYDRATE METABOLISM INDICATORS IN PATIENTS WITH POLYTRAUMA COMPLICATED BY ALCOHOLIC DELIRIUM ON THE CHOICE OF THE SEDATION METHOD.

UNLABELLED: Topicality: Providing assistance to patients with polytrauma, in a state of alcohol intoxication, complicated by alcoholic delir … . Meschaninov» KhMR. All patients were diagnosed with polytrauma (thoracic and/or abdominal trauma: rib fractures, hemo-, pneumothorax, hematomas of the liver or spleen, fracture of the bones of the waist, and/or upper and/or lower limbs, fracture of the pelvis). In the course of the research, to achieve the goal, the main indicators of carbohydrate metabolism …

Proximal Scaphoid Pole Reconstruction Utilizing Ipsilateral Proximal Hamate Autograft.

BACKGROUND: Proximal pole scaphoid fractures complicated by nonunion and osteonecrosis present a challenging scenario with few good reconstructive options, especially when the proximal fragment is small or fragmented1-4. The use of an ipsilateral proximal hamate osteochondral autograft has emerged as a promising technique for reconstructing the proximal scaphoid pole, with the potential to restore carpal mechanics while avoiding the morbidity associated with free vascularized bone grafts or distant autograft sites. DESCRIPTION: The procedure involves replacing the diseased proximal scaphoid w

Широкие метастазы грудной клетки и стенки грудной клетки в качестве первоначального представления о раке молочной железы: доклад по делу и обзор литературы.

Метастатическое участие костей остается наиболее распространенной формой дальнего метастаза в раке груди, главным образом из-за анатомических и функциональных характеристик грудного позвоночника, ребер и грудины. Эти структуры примечательны высоким содержанием красного костного мозга, богатой сосудистой системы и их связью с венозным сплексом Бэтсона, что способствует их раннему участию в онкологическом распространении. В некоторых случаях многочисленные метастазы в грудном скелете могут представлять собой первое и единственное клиническое проявление недиагностированного злокачественного проце

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… Follow-up and outcomes On postoperative day two, a CT scan of the chest was performed, confirming multiple osseous lesions, pathological rib fractures, and signs of a chronic bronchopulmonary process ( Figure 2 ). …

Axial Multicentric Osteosarcoma in an English Cocker Spaniel.

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Chest pain without a clue-ultrasound to rescue occult multiple myeloma: A case report.

BackgroundChest pain is one of the most common symptoms with which a patient presents to a doctor. Differentials include, but are not limited to, cardiac pulmonary, gastrointestinal, psychosomatic and musculoskeletal causes. In our case, ultrasound of the chest wall paved the way for the diagnosis of multiple myeloma, which occultly presented with chronic chest pain.Case summaryHere we report a case of 50-year-old man with chronic chest pain without anemia or renal failure who was diagnosed with multiple myeloma, despite negative bence jones protein and M band electrophoresis. An ultrasound of