Pub Date : 2020-11-27DOI: 10.15406/ijrrt.2020.07.00286
B. Wong, D. Christie, J. Hellyer, Corinne Henningsen, Tania Brogmus, G. Fogarty
Skin field cancerisation arises from prolonged sun exposure and increases with age. Multiple areas of the skin can be involved resulting in poor quality of life and cosmesis and even death. The long-term efficacy of traditional treatments such as topical creams is disappointing. Volumetric modulated arc therapy (VMAT) is a relatively new radiation technique that allows the definitive treatment of large convex fields. Extra dose can also be delivered simultaneously using a boost technique to proven areas of macroscopic invasive disease. In what we believe is the first publication of its kind, we present a retrospective case series of 15 patients with 21 areas treated with VMAT to the back. Treatment is feasible but areas of skin cancerisation over 800 cm2 should not be treated in one course but broken into smaller fields separated by adequate breaks. Care should be taken when treating large areas of the spine as pancytopenia may result and routine blood counts between treatment courses should be considered. More research is warranted to confirm the dose and efficacy outcomes, but this technique may represent a new therapeutic option for patients with extensive skin field cancerisation of the back.
{"title":"Volumetric modulated arc therapy (VMAT) for extensive skin field cancerisation (ESFC) – exploring the limits of treatment volumes with a case series of backs","authors":"B. Wong, D. Christie, J. Hellyer, Corinne Henningsen, Tania Brogmus, G. Fogarty","doi":"10.15406/ijrrt.2020.07.00286","DOIUrl":"https://doi.org/10.15406/ijrrt.2020.07.00286","url":null,"abstract":"Skin field cancerisation arises from prolonged sun exposure and increases with age. Multiple areas of the skin can be involved resulting in poor quality of life and cosmesis and even death. The long-term efficacy of traditional treatments such as topical creams is disappointing. Volumetric modulated arc therapy (VMAT) is a relatively new radiation technique that allows the definitive treatment of large convex fields. Extra dose can also be delivered simultaneously using a boost technique to proven areas of macroscopic invasive disease. In what we believe is the first publication of its kind, we present a retrospective case series of 15 patients with 21 areas treated with VMAT to the back. Treatment is feasible but areas of skin cancerisation over 800 cm2 should not be treated in one course but broken into smaller fields separated by adequate breaks. Care should be taken when treating large areas of the spine as pancytopenia may result and routine blood counts between treatment courses should be considered. More research is warranted to confirm the dose and efficacy outcomes, but this technique may represent a new therapeutic option for patients with extensive skin field cancerisation of the back.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"93 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117340987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-19DOI: 10.15406/ijrrt.2020.07.00285
G. Fogarty, D. Christie, B. Wong, E. Sim, Evan Ng, I. Porter, Tuna Ha, A. Potter
The successful treatment of skin disease decreases morbidity and mortality. Radiation therapy (RT) can cure skin disease and conserves tissue, possibly delivering better quality of life post treatment and so a superior survivorship. Modern RT delivers better dose conformality and homogeneity, and more is known about the radiobiology of skin and its diseases, enabling treatment personalisation. Skin, however, can be viewed in RT departments as not a serious subspecialty, even in Australia where the incidence of skin cancer is highest. Radiation oncology leaders are needed to carve out a niche for RT amongst a crowded field of skin carers. This article based on the cumulative experience of a group of Australian skin radiation oncologists (ROs), details how this may be achieved. First, focus is placed on growing a high-quality service. The RO needs to understand how patient, tumour and treatment factors impact the skin RT prescription. The particular nuances around skin RT planning, including immobilisation, simulation, contouring and the advantages and disadvantages of each RT modality in skin, are important to know. How skin reacts to RT when the skin is the target and the importance of fractionation is essential knowledge. Second, the RO needs to understand the needs of the skin stakeholders. These include those in the department who look to them for leadership. It includes those outside the department, that is, patients and other skin carers who could be future colleagues and even referrers. Third, the RO needs to use much needed research as a way to bring the disparate skin caring community together through completing high-quality research to guide therapy and post-treatment care.
{"title":"Experiences in growing a skin radiation therapy practice","authors":"G. Fogarty, D. Christie, B. Wong, E. Sim, Evan Ng, I. Porter, Tuna Ha, A. Potter","doi":"10.15406/ijrrt.2020.07.00285","DOIUrl":"https://doi.org/10.15406/ijrrt.2020.07.00285","url":null,"abstract":"The successful treatment of skin disease decreases morbidity and mortality. Radiation therapy (RT) can cure skin disease and conserves tissue, possibly delivering better quality of life post treatment and so a superior survivorship. Modern RT delivers better dose conformality and homogeneity, and more is known about the radiobiology of skin and its diseases, enabling treatment personalisation. Skin, however, can be viewed in RT departments as not a serious subspecialty, even in Australia where the incidence of skin cancer is highest. Radiation oncology leaders are needed to carve out a niche for RT amongst a crowded field of skin carers. This article based on the cumulative experience of a group of Australian skin radiation oncologists (ROs), details how this may be achieved. First, focus is placed on growing a high-quality service. The RO needs to understand how patient, tumour and treatment factors impact the skin RT prescription. The particular nuances around skin RT planning, including immobilisation, simulation, contouring and the advantages and disadvantages of each RT modality in skin, are important to know. How skin reacts to RT when the skin is the target and the importance of fractionation is essential knowledge. Second, the RO needs to understand the needs of the skin stakeholders. These include those in the department who look to them for leadership. It includes those outside the department, that is, patients and other skin carers who could be future colleagues and even referrers. Third, the RO needs to use much needed research as a way to bring the disparate skin caring community together through completing high-quality research to guide therapy and post-treatment care.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122255259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-09DOI: 10.15406/ijrrt.2020.07.00283
L. Kotsis, Kostic Sz, P. Vadasz
Objective: The reasons of delay and a more selective management of 7 unusually late esophageal disruptions is evaluated in this study. Material and methods: In case of a 13 day-old rupture, left transthoracic debribement, primary repair with hiatusplasty was done. In a 6 week-old postpneumonectomy leak, esophageal exclusion, fenestration, chemotherapy and Roux-en-Y bypass was performed. Closure with serratus anterior flap was used in a small esophageal leak with empyema which occured 4 months after pneumonectomy. In a iatrogenic, 9 day-old esophageal injury, suture, than Urchel type temporary exclusion was carried out. In a 6 week-old iatrogenic leak with localised empyema, Urchel-Ergin type exclusion with thoracostomy was used. As a first step esophageal exclusion and than decortication was performed in a 13 day-old rupture with empyema,followed by substenal colonic bypass 2 months later. In a 7 day-old transfixion esophgeal wound, suture with drainage was performed. The patient with closed esophagus was lost, for irreversibile sepsis. Results. Recovery time was 9 to 28 days. Conclusion: Even in such unique esophageal disruptions individual approach prove to useful.
{"title":"Surgery of very late intrathoracic esophgeal ruptures and perforations","authors":"L. Kotsis, Kostic Sz, P. Vadasz","doi":"10.15406/ijrrt.2020.07.00283","DOIUrl":"https://doi.org/10.15406/ijrrt.2020.07.00283","url":null,"abstract":"Objective: The reasons of delay and a more selective management of 7 unusually late esophageal disruptions is evaluated in this study. Material and methods: In case of a 13 day-old rupture, left transthoracic debribement, primary repair with hiatusplasty was done. In a 6 week-old postpneumonectomy leak, esophageal exclusion, fenestration, chemotherapy and Roux-en-Y bypass was performed. Closure with serratus anterior flap was used in a small esophageal leak with empyema which occured 4 months after pneumonectomy. In a iatrogenic, 9 day-old esophageal injury, suture, than Urchel type temporary exclusion was carried out. In a 6 week-old iatrogenic leak with localised empyema, Urchel-Ergin type exclusion with thoracostomy was used. As a first step esophageal exclusion and than decortication was performed in a 13 day-old rupture with empyema,followed by substenal colonic bypass 2 months later. In a 7 day-old transfixion esophgeal wound, suture with drainage was performed. The patient with closed esophagus was lost, for irreversibile sepsis. Results. Recovery time was 9 to 28 days. Conclusion: Even in such unique esophageal disruptions individual approach prove to useful.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128046834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-09DOI: 10.15406/ijrrt.2020.07.00284
S. Mohril, Mahipal Singh Sankhla, Swaroop S. Sonone, Kapil Parihar, Rajeev Kumar
These days mobile phones have become associated with elementary a part of our life, this is often one in every of the foremost necessary mediums for communication. Consequently, several portable towers are planted to hide additional areas, particularly in huddled cities and concrete areas. Now, the bottom stations made on these locations have transceivers that employ mistreatment frequency (RF) waves to determine communication among users within the mobile network. Because of the variety of base stations needed it will increase with bigger portable use with market competition, and with new technological capabilities. The microwave frequencies utilized in mobile communication cause thermal and non-thermal effects and leave a negative impact on the biological system. The quantity of RF-EMW radiation energy absorbed by human tissue depends on the frequency, intensity, polarization, and period of exposure. The EMR is recognized because of the major reason behind cancer. This review paper presents the potential biological and medicine health effects of high-intensity portable tower radiation.
{"title":"Adverse impacts of mobile phone tower radiation on human health","authors":"S. Mohril, Mahipal Singh Sankhla, Swaroop S. Sonone, Kapil Parihar, Rajeev Kumar","doi":"10.15406/ijrrt.2020.07.00284","DOIUrl":"https://doi.org/10.15406/ijrrt.2020.07.00284","url":null,"abstract":"These days mobile phones have become associated with elementary a part of our life, this is often one in every of the foremost necessary mediums for communication. Consequently, several portable towers are planted to hide additional areas, particularly in huddled cities and concrete areas. Now, the bottom stations made on these locations have transceivers that employ mistreatment frequency (RF) waves to determine communication among users within the mobile network. Because of the variety of base stations needed it will increase with bigger portable use with market competition, and with new technological capabilities. The microwave frequencies utilized in mobile communication cause thermal and non-thermal effects and leave a negative impact on the biological system. The quantity of RF-EMW radiation energy absorbed by human tissue depends on the frequency, intensity, polarization, and period of exposure. The EMR is recognized because of the major reason behind cancer. This review paper presents the potential biological and medicine health effects of high-intensity portable tower radiation.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122144693","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-28DOI: 10.15406/ijrrt.2020.07.00282
Shimon Prasad, Nicole Dougheney, A. Hong, J. Flood, E. Paton, David Wong, Gerald B Fobarty
Introduction: Hair colour is determined by varying ratios of black-brown eumelanin and reddish-brown/reddish-yellow pheomelanin. Hair colour change has been reported with cancer therapies. Radiotherapy (RT) usually causes temporary epilation to permanent alopecia. A change in hair colour following radiation is rare and usually results in depigmentation. There has only been one other case reported of repigmentation after RT. Cases: We present five cases of changes to scalp hair pigmentation in the penumbral region in patients treated with volumetric modulated arc therapy (VMAT) for skin cancer. Five treated areas across four patients involved repigmentation from grey to black, and there was one case of depigmentation from brown to grey. The latter occurred during immunotherapy administration. For the two cases where recalculation of the dosimetry was possible for three areas, repigmentation changes happened at an average mean dose of 16 Gy (9.3 – 26 Gy) in an average of 26 (25 - 27) fractions; that is, 0.6 Gy per fraction at five fractions per week. Discussion: This series of six areas in five patients of hair colour change in the penumbral region of VMAT to the scalp for skin cancer is the first report of this phenomenon. Repigmentation of scalp hair with RT is rare. Even though rare, the potential for hair colour change may need to be part of the informed consent discussion in patients contemplating this treatment.
{"title":"Scalp hair repigmentation in the penumbral region of radiotherapy– a case series","authors":"Shimon Prasad, Nicole Dougheney, A. Hong, J. Flood, E. Paton, David Wong, Gerald B Fobarty","doi":"10.15406/ijrrt.2020.07.00282","DOIUrl":"https://doi.org/10.15406/ijrrt.2020.07.00282","url":null,"abstract":"Introduction: Hair colour is determined by varying ratios of black-brown eumelanin and reddish-brown/reddish-yellow pheomelanin. Hair colour change has been reported with cancer therapies. Radiotherapy (RT) usually causes temporary epilation to permanent alopecia. A change in hair colour following radiation is rare and usually results in depigmentation. There has only been one other case reported of repigmentation after RT. Cases: We present five cases of changes to scalp hair pigmentation in the penumbral region in patients treated with volumetric modulated arc therapy (VMAT) for skin cancer. Five treated areas across four patients involved repigmentation from grey to black, and there was one case of depigmentation from brown to grey. The latter occurred during immunotherapy administration. For the two cases where recalculation of the dosimetry was possible for three areas, repigmentation changes happened at an average mean dose of 16 Gy (9.3 – 26 Gy) in an average of 26 (25 - 27) fractions; that is, 0.6 Gy per fraction at five fractions per week. Discussion: This series of six areas in five patients of hair colour change in the penumbral region of VMAT to the scalp for skin cancer is the first report of this phenomenon. Repigmentation of scalp hair with RT is rare. Even though rare, the potential for hair colour change may need to be part of the informed consent discussion in patients contemplating this treatment.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"1085 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116036047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-15DOI: 10.15406/ijrrt.2020.07.00281
F. Fokoue, S. E. Mselmi, N. Alaoui
We report here the case of a young patient victim of a road accident and having benefited from osteosynthesis by double screwing, in whom the clinical course was marked two years later by the occurrence of osteonecrosis of the femoral head (ONFH) therefore the diagnosis was confirmed by a SPECT CT centered on the pelvis, supplementing a three-phase bone scintigraphy.
{"title":"SPECT-CT imaging in the early diagnosis of osteonecrosis of femoral head after osteosynthesis by percutane screwing in the young adult: a case report","authors":"F. Fokoue, S. E. Mselmi, N. Alaoui","doi":"10.15406/ijrrt.2020.07.00281","DOIUrl":"https://doi.org/10.15406/ijrrt.2020.07.00281","url":null,"abstract":"We report here the case of a young patient victim of a road accident and having benefited from osteosynthesis by double screwing, in whom the clinical course was marked two years later by the occurrence of osteonecrosis of the femoral head (ONFH) therefore the diagnosis was confirmed by a SPECT CT centered on the pelvis, supplementing a three-phase bone scintigraphy.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117010114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-14DOI: 10.15406/ijrrt.2020.07.00280
G. Fogarty, A. Hong, L. Rocha, RE Vilain, P. Ferguson, P. Guitera
Introduction: Atypical intraepidermal melanocytic proliferation (AIMP) is an early form of lentigo maligna (LM) which itself is a precursor to melanoma. It presents commonly on the head and neck where tissue conserving therapies are attractive. When treating LM with imiquimod, dermatologists treat until a certain level of skin inflammation is achieved. Radiation oncologists treat to a set dose of radiation irrespective of the skin reaction at completion. The dose of radiotherapy for AIMP is unknown and these lesions are currently treated in the same manner as LM. Case series: Five immunocompetent patients (average age 80 years) with AIMP or early LM (ELM) on the head and neck region were treated with RADICAL radiotherapy (RT) protocols. All treatment sites were mapped with in vivo reflectance confocal microscopy (RCM) and measured on average 4.0 cm in diameter (range 2.0–6.0 cm). The median RT dose administered was 50 Gray (Gy) [45-54 Gy] in 1.8-2Gy per fraction to the planning target volume (PTV), usually by megavoltage electrons. All patients completed RT. The peak radiation acute skin toxicity observed at any time in all patients was only dry desquamation, equivalent to a grade 2 acute radiation dermatitis reaction by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. At a median of follow up of 10 months, all patients had biopsy proven recurrence of AIMP (n=3) or LM (n=2). All recurrences were within the RT field. Patients were followed for an average total of five years post salvage treatment (range: 26 - 124 months). Discussion: This series raises questions. First, what radiation dose is required to cure AIMP and ELM? This series suggests that the same dose, if not higher, used in established in-situ disease, is required. Second, should radiation oncologists treat to a grade 3 skin reaction? It may be then advisable to use standard fractionation (2Gy or less) so that the peak RT reaction coincides with the end of treatment and allows for titration and extra dose to be added.
{"title":"Is more dose and skin reaction required when treating early lentigo maligna definitively with radiotherapy? A case series","authors":"G. Fogarty, A. Hong, L. Rocha, RE Vilain, P. Ferguson, P. Guitera","doi":"10.15406/ijrrt.2020.07.00280","DOIUrl":"https://doi.org/10.15406/ijrrt.2020.07.00280","url":null,"abstract":"Introduction: Atypical intraepidermal melanocytic proliferation (AIMP) is an early form of lentigo maligna (LM) which itself is a precursor to melanoma. It presents commonly on the head and neck where tissue conserving therapies are attractive. When treating LM with imiquimod, dermatologists treat until a certain level of skin inflammation is achieved. Radiation oncologists treat to a set dose of radiation irrespective of the skin reaction at completion. The dose of radiotherapy for AIMP is unknown and these lesions are currently treated in the same manner as LM. Case series: Five immunocompetent patients (average age 80 years) with AIMP or early LM (ELM) on the head and neck region were treated with RADICAL radiotherapy (RT) protocols. All treatment sites were mapped with in vivo reflectance confocal microscopy (RCM) and measured on average 4.0 cm in diameter (range 2.0–6.0 cm). The median RT dose administered was 50 Gray (Gy) [45-54 Gy] in 1.8-2Gy per fraction to the planning target volume (PTV), usually by megavoltage electrons. All patients completed RT. The peak radiation acute skin toxicity observed at any time in all patients was only dry desquamation, equivalent to a grade 2 acute radiation dermatitis reaction by Common Terminology Criteria for Adverse Events (CTCAE) Version 5.0. At a median of follow up of 10 months, all patients had biopsy proven recurrence of AIMP (n=3) or LM (n=2). All recurrences were within the RT field. Patients were followed for an average total of five years post salvage treatment (range: 26 - 124 months). Discussion: This series raises questions. First, what radiation dose is required to cure AIMP and ELM? This series suggests that the same dose, if not higher, used in established in-situ disease, is required. Second, should radiation oncologists treat to a grade 3 skin reaction? It may be then advisable to use standard fractionation (2Gy or less) so that the peak RT reaction coincides with the end of treatment and allows for titration and extra dose to be added.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134221283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-07DOI: 10.15406/ijrrt.2020.07.00278
Y. Urmanova, Shakhnoza Mukhtarova, Tursunkulov Ortikali, M. Mukhtarova, Kholikov Farkhod Jamoliddin Ugli
In 2017-2019, 40 patients were examined (16 of them men, 24 women) with type 2 diabetes mellitus in combination with IHD, of which 38 patients had a favorable course and 8 with an unfavorable course. For an unfavorable profile, the presence of strokes, mycocardial infarction (fatal, nonfatal), repeated hospitalizations for worsening chronic heart failure (decrease in ejection fraction), repeated surgical interventions (percutaneous coronary intervention, coronary artery bypass grafting) for the current 3 years was taken into account. The average age of patients was 65.5 years. In total, 119 signs recorded in the first three days from the moment of patient's arrival were analyzed as possible predictors of an unfavorable prognosis. From this whole set, a number of parameters with corresponding values were selected as markers of coronary heart disease, which showed the highest incidence rate in the group of patients with adverse course (NBT) and the highest in the group of patients with favorable course (BT). the most pathognomonic predictors of IHD progression in patients with type 2 diabetes were systolic LV dysfunction (fv <40%), SBP> 160 mm Hg and/or DBP above 100 mm Hg. Art., severe angina pectoris, LVH and ECG signs of myocardial ischemia, persisting upon discharge from the hospital, history of ACVA comorbidity plus DM-2.
2017-2019年共检查2型糖尿病合并IHD患者40例(男16例，女24例)，其中病程有利38例，病程不利8例。对于不利的情况，考虑到目前3年内中风、真菌性梗死(致命性和非致命性)、因慢性心力衰竭恶化(射血分数下降)而多次住院、多次手术干预(经皮冠状动脉介入治疗、冠状动脉旁路移植术)的存在。患者平均年龄65.5岁。总的来说，从患者到达的那一刻起的前三天记录的119个体征被分析为不良预后的可能预测因素。从这一集合中，选择了多个具有相应值的参数作为冠心病的标志物，其中不良病程组(NBT)的发病率最高，良好病程组(BT)的发病率最高。2型糖尿病患者IHD进展的最病理特征预测因子是收缩期左室功能障碍(血压160 mm Hg和/或舒张压高于100 mm Hg)。严重心绞痛、左室肥厚、心电图心肌缺血征像，出院后仍持续存在，有ACVA合并DM-2病史。
{"title":"Questions of the mathematical modeling of the progression of coronary heart disease in patients with type 2 diabetes mellitus","authors":"Y. Urmanova, Shakhnoza Mukhtarova, Tursunkulov Ortikali, M. Mukhtarova, Kholikov Farkhod Jamoliddin Ugli","doi":"10.15406/ijrrt.2020.07.00278","DOIUrl":"https://doi.org/10.15406/ijrrt.2020.07.00278","url":null,"abstract":"In 2017-2019, 40 patients were examined (16 of them men, 24 women) with type 2 diabetes mellitus in combination with IHD, of which 38 patients had a favorable course and 8 with an unfavorable course. For an unfavorable profile, the presence of strokes, mycocardial infarction (fatal, nonfatal), repeated hospitalizations for worsening chronic heart failure (decrease in ejection fraction), repeated surgical interventions (percutaneous coronary intervention, coronary artery bypass grafting) for the current 3 years was taken into account. The average age of patients was 65.5 years. In total, 119 signs recorded in the first three days from the moment of patient's arrival were analyzed as possible predictors of an unfavorable prognosis. From this whole set, a number of parameters with corresponding values were selected as markers of coronary heart disease, which showed the highest incidence rate in the group of patients with adverse course (NBT) and the highest in the group of patients with favorable course (BT). the most pathognomonic predictors of IHD progression in patients with type 2 diabetes were systolic LV dysfunction (fv <40%), SBP> 160 mm Hg and/or DBP above 100 mm Hg. Art., severe angina pectoris, LVH and ECG signs of myocardial ischemia, persisting upon discharge from the hospital, history of ACVA comorbidity plus DM-2.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114780669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-09-07DOI: 10.15406/ijrrt.2020.07.00279
T. Mathew, M. Chao, C. Lapuz, Jonathan M Tomaszewski, Bob Zhang, Megan Hall, M. Tacey, F. Foroudi
Introduction: Adjuvant radiotherapy (RT), including regional lymph node (RLN) irradiation is an important treatment in early stage breast cancer patients after breast-conserving surgery both the Radiation Therapy Oncology Group (RTOG) and European Society for Radiotherapy and Oncology (ESTRO). Our primary aim was to quantitatively compare target volumes delineated by ROs, to assess if either guideline has superior contouring reproducibility. Methods: Three ROs contoured breast clinical target volumes (CTVs), axillary lymph node levels 1-3, supraclavicular and internal mammary nodal (CTVn_IMN) volumes for 8 post-operative patients using the ESTRO and RTOG guidelines for each patient. The inter-observer variability in contouring was measured by the generalized Dice Similarity Coefficient (DSC). Mean DSC values were calculated to compare the common volume accuracy between observers.ss Results: The breast CTV contours showed the highest level of agreement between the ROs within each guideline (ESTRO DSC mean 0.92±0.04 and RTOG DSC mean 0.90±0.03). Due to the small standard deviation in DSC values, this difference of 0.02 was found to be statistically significant (p=0.031). The mean DSC for CTVn_IMN was 0.63 (±0.10) for ESTRO and 0.62 (±0.20) for RTOG guidelines, showing the least level of agreement for both guidelines. Within the axillary nodal volumes, level 1 showed the greatest agreement among the ROs for both ESTRO and RTOG guidelines with a mean DSC of 0.81 (±0.08) & 0.82 (±0.06) respectively. The range of mean DSC values for ESTRO and RTOG guidelines was 0.66-0.92 and 0.62-0.90 respectively. Conclusion: Overall, neither guideline showed a notable improvement in reproducibility between ROs.
{"title":"Consistency of ESTRO and RTOG contouring guidelines for target volume delineation in early stage breast cancer","authors":"T. Mathew, M. Chao, C. Lapuz, Jonathan M Tomaszewski, Bob Zhang, Megan Hall, M. Tacey, F. Foroudi","doi":"10.15406/ijrrt.2020.07.00279","DOIUrl":"https://doi.org/10.15406/ijrrt.2020.07.00279","url":null,"abstract":"Introduction: Adjuvant radiotherapy (RT), including regional lymph node (RLN) irradiation is an important treatment in early stage breast cancer patients after breast-conserving surgery both the Radiation Therapy Oncology Group (RTOG) and European Society for Radiotherapy and Oncology (ESTRO). Our primary aim was to quantitatively compare target volumes delineated by ROs, to assess if either guideline has superior contouring reproducibility. Methods: Three ROs contoured breast clinical target volumes (CTVs), axillary lymph node levels 1-3, supraclavicular and internal mammary nodal (CTVn_IMN) volumes for 8 post-operative patients using the ESTRO and RTOG guidelines for each patient. The inter-observer variability in contouring was measured by the generalized Dice Similarity Coefficient (DSC). Mean DSC values were calculated to compare the common volume accuracy between observers.ss Results: The breast CTV contours showed the highest level of agreement between the ROs within each guideline (ESTRO DSC mean 0.92±0.04 and RTOG DSC mean 0.90±0.03). Due to the small standard deviation in DSC values, this difference of 0.02 was found to be statistically significant (p=0.031). The mean DSC for CTVn_IMN was 0.63 (±0.10) for ESTRO and 0.62 (±0.20) for RTOG guidelines, showing the least level of agreement for both guidelines. Within the axillary nodal volumes, level 1 showed the greatest agreement among the ROs for both ESTRO and RTOG guidelines with a mean DSC of 0.81 (±0.08) & 0.82 (±0.06) respectively. The range of mean DSC values for ESTRO and RTOG guidelines was 0.66-0.92 and 0.62-0.90 respectively. Conclusion: Overall, neither guideline showed a notable improvement in reproducibility between ROs.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"71 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129348907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-20DOI: 10.15406/ijrrt.2020.07.00277
Matheus Levy Almeida Taveira de Souzaa, Hugo Bertani Dressler, B. J. Pádua, A. H. Gomes, J. Magalhães, Rogério de Andrade Gomes, Rodrigo Simões Castilho, Wagner Vieira da Fonseca, R. A. Almeida Pinto
Ankle fractures are common and represent approximately a quarter of all lower limb fractures. The general concepts for osteosynthesis techniques for deviated and unstable fractures have undergone little change since the 1960s. The presence of comorbidities and poor soft tissue conditions, especially in elderly patients, is associated with a higher rate of postoperative complications. Intramedullary implants have the advantage of using smaller incisions, which minimizes skin damage allowing for early loading. The present technical note describes the use of the fibular intramedullary nail with a minimally invasive approach to deviated and unstable ankle fractures.
{"title":"Osteosynthesis of ankle fractures with an intramedullary nail of the fibula: surgical technique","authors":"Matheus Levy Almeida Taveira de Souzaa, Hugo Bertani Dressler, B. J. Pádua, A. H. Gomes, J. Magalhães, Rogério de Andrade Gomes, Rodrigo Simões Castilho, Wagner Vieira da Fonseca, R. A. Almeida Pinto","doi":"10.15406/ijrrt.2020.07.00277","DOIUrl":"https://doi.org/10.15406/ijrrt.2020.07.00277","url":null,"abstract":"Ankle fractures are common and represent approximately a quarter of all lower limb fractures. The general concepts for osteosynthesis techniques for deviated and unstable fractures have undergone little change since the 1960s. The presence of comorbidities and poor soft tissue conditions, especially in elderly patients, is associated with a higher rate of postoperative complications. Intramedullary implants have the advantage of using smaller incisions, which minimizes skin damage allowing for early loading. The present technical note describes the use of the fibular intramedullary nail with a minimally invasive approach to deviated and unstable ankle fractures.","PeriodicalId":214028,"journal":{"name":"International Journal of Radiology & Radiation Therapy","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129502203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：