Resectability and Ablatability Criteria for the Treatment of Liver Only Colorectal Metastases:Multidisciplinary Consensus Document from the COLLISION Trial Group

The guidelines for metastatic colorectal cancer crudely state that the best local treatment should be selected from a 'toolbox' of techniques according to patient- and treatment-related factors. We created an interdisciplinary, consensus-based algorithm with specific resectability and ablatability criteria for the treatment of colorectal liver metastases (CRLM). To pursue consensus, members of the multidisciplinary COLLISION and COLDFIRE trial expert panel employed the RAND appropriateness method (RAM). Statements regarding patient, disease, tumor and treatment characteristics were categorized as appropriate, equipoise or inappropriate. Patients with ECOG≤2, ASA≤3 and Charlson comorbidity index ≤8 should be considered fit for curative-intent local therapy. When easily resectable and/or ablatable (stage IVa), (neo)adjuvant systemic therapy is not indicated. When requiring major hepatectomy (stage IVb), neo-adjuvant systemic therapy is appropriate for early metachronous disease and to reduce procedural risk. To downstage patients (stage IVc), downsizing induction systemic therapy and/or future remnant augmentation is advised. Disease can only be deemed permanently unsuitable for local therapy if downstaging failed (stage IVd). Liver resection remains the gold standard. Thermal ablation is reserved for unresectable CRLM, deep-seated resectable CRLM and can be considered when patients are in poor health. Irreversible electroporation and stereotactic body radiotherapy can be considered for unresectable perihilar and perivascular CRLM 0-5cm. This consensus document provides per-patient and per-tumor resectability and ablatability criteria for the treatment of CRLM. These criteria are intended to aid tumor board discussions, improve consistency when designing prospective trials and advance intersociety communications. Areas where consensus is lacking warrant future comparative studies.</p

Coping with burns: the role of coping self-efficacy in the recovery from traumatic stress following burn injuries

We conducted a three-wave prospective study among patients with burns (N = 178) to examine the prospective influence of coping self-efficacy (CSE) perceptions on trajectories of posttraumatic stress symptoms in the first 12 months after burn injuries. Using linear growth curve modeling, we corrected for demographics, the number of surgeries during initial admittance, trait coping styles, and changing levels of health-related quality of life. CSE during initial admission was by far the strongest predictor of both initial PTSD symptoms and degree of symptom change with higher CSE levels associated with lower initial symptoms and a steeper decline of symptoms over time. Of the other variables only avoidant coping was associated with higher initial symptom levels, and only emotional expression associated with greater rate of recovery. Current findings suggest that CSE plays a pivotal role in recovery from posttraumatic stress after a burn injury, even when the role of burn-related impairments is taken into consideration. Implications of findings are discussed

Coping with burns : the role of coping self-efficacy in the recovery from traumatic stress following burn injuries

We conducted a three-wave prospective study among patients with burns (N = 178) to examine the prospective influence of coping self-efficacy (CSE) perceptions on trajectories of posttraumatic stress symptoms in the first 12 months after burn injuries. Using linear growth curve modeling, we corrected for demographics, the number of surgeries during initial admittance, trait coping styles, and changing levels of health-related quality of life. CSE during initial admission was by far the strongest predictor of both initial PTSD symptoms and degree of symptom change with higher CSE levels associated with lower initial symptoms and a steeper decline of symptoms over time. Of the other variables only avoidant coping was associated with higher initial symptom levels, and only emotional expression associated with greater rate of recovery. Current findings suggest that CSE plays a pivotal role in recovery from posttraumatic stress after a burn injury, even when the role of burn-related impairments is taken into consideration. Implications of findings are discussed

Pain in young children with burns : extent, course and influencing factors

Little evidence is available on the extent, course and influencing factors of pain in young children with burns. At present, reliable and valid measurement instruments to assess pain behavior in these children are available, implying that valuable insight into these questions can now be obtained. The aim of this study is to document the extent and course of pain behavior with the COMFORT-B, and to assess factors that may influence procedural pain. First, cutpoints for COMFORT-B scores were established by Rasch analysis to assess clinically relevant changes. Second, the extent of background and procedural pain behavior was assessed by descriptive statistics. Third, the course and factors that may influence procedural pain behavior were investigated by latent growth modeling. Trained nurses collected pain behavior data in 168 children (mean age 20 months, mean TBSA 6%, mean length of stay 10 days). Cutpoints of COMFORT-B scores were as follows: 6-13 (mild pain), 14-20 (moderate pain) and 21-30 (severe pain). This study suggests that background pain is more adequately treated than procedural pain. Factors that influenced baseline pain scores and/or the course over 8 days included TBSA, the number of surgical procedures, acetaminophen administration by the referring hospital, and the application of hydrofiber dressings. The implications of these findings are discussed

Scientists Against War: A Plea to World Leaders for Better Governance

The current Russian war against Ukraine is of global concern. It builds on the annexation of Crimea in 2014 and subsequently the war in the Donbas region of Ukraine, and has become a large-scale Russian invasion of Ukraine from three directions, Crimea in the south, Russia in the east, and Belarus in the north. Despite the geopolitical background that, in the eyes of Russia, justifies its annexation of regions in and around Ukraine, we cannot turn a blind eye towards the untold miseries of the citizens of the invaded country. Although it is unclear as to how the situation will unfold, what is clear is that lives are being lost, many civilians are being injured, traumatized, and valuable assets destroyed. Taking into consideration that the population of the countries involved in this conflict totals nearly 200 million citizens, many lives on both sides will be sacrificed, millions of people displaced, Europe will be overrun with new refugees, and global world economics will be disrupted by the war itself and by the sanctions imposed on Russia. The current global governance mechanisms are likely to be forever changed, with other players with malevolent intentions becoming emboldened to embark on expansionist ventures.Fil: Pandi Perumal, Seithikurippu R.. Somnogen Canada Inc.; Canadá. Saveetha University; IndiaFil: Kumar, Velayudhan Mohan. National Academy of Medical Sciences; IndiaFil: Pandian, Namasivayam Ganesh. Kyoto University; JapónFil: de Jong, Joop T.. Amsterdam UMC; Países Bajos. University of Boston. School of Medicine; Estados UnidosFil: Andiappan, Sudalaikannu. Madurai Kamaraj University; IndiaFil: Corlateanu, Alexandru. Nicolae Testemitanu State University Of Medicine And Pharmacy; MoldaviaFil: Mahalaksmi, Arehally Marappa. JSS Academy of Higher Education and Research; IndiaFil: Chidambaram, Saravana Babu. JSS Academy of Higher Education and Research; IndiaFil: Kumar, Ramasamy Rajesh. Global Community Educational Foundation; AustraliaFil: Ramasubramanian, Chellamuthu. M. S. Chellamuthu Trust and Research Foundation; IndiaFil: Sivasubramaniam, Sudhakar. Manonmaniam Sundaranar University; IndiaFil: Bjørkum, Alvhild Alette. Western Norway University Of Applied Sciences; NoruegaFil: Cutajar, JosAnn. University of Malta; MaltaFil: Berk, Michael. Deakin University; AustraliaFil: Trakht, Ilya. Columbia University; Estados UnidosFil: Vrdoljak, Anton. University Of Mostar; Bosnia y HerzegovinaFil: Meira e Cruz, Miguel. Universidad de Lisboa; PortugalFil: Eyre, Harris A.. Deakin University; Australia. University of California; Estados Unidos. Baylor College of Medicine; Estados Unidos. University of Texas Health Science Center at Houston; Estados UnidosFil: Grønli, Janne. University of Bergen; NoruegaFil: Cardinali, Daniel Pedro. Pontificia Universidad Católica Argentina "Santa María de los Buenos Aires". Instituto de Investigaciones Biomédicas. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Investigaciones Biomédicas; ArgentinaFil: Maercker, Andreas. Universitat Zurich; SuizaFil: van de Put, Willem A. C. M.. Institute for Tropical Medicine Antwerp; Países Bajos. Fordham University; Estados UnidosFil: Guzder, Jaswant. Sir Mortimer B. Davis Jewish General Hospital; Canadá. Jewish General Hospital; CanadáFil: Bjorvatn, Bjørn. University of Bergen; Noruega. Haukeland University Hospital; NoruegaFil: Tol, Wietse A.. Universidad de Copenhagen; Dinamarca. Vrije Universiteit Amsterdam; Países Bajos. ARQ National Psychotrauma Centre-International; Países BajosFil: Acuña Castroviejo, Darío. Universidad de Granada; EspañaFil: Meudec, Marie. Institute of Tropical Medicine; BélgicaFil: Morin, Charles M.. Laval University; CanadáFil: Partinen, Markku. Terveystalo Healthcare; Finlandia. University of Helsinki; FinlandiaFil: Golombek, Diego Andres. Universidad Nacional de Quilmes. Departamento de Ciencia y Tecnología. Laboratorio de Cronobiología; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Scientists Against War:A Plea to World Leaders for Better Governance

© The Author(s), under exclusive licence to Springer Nature Singapore Pte Ltd.The current Russian war against Ukraine is of global concern. It builds on the annexation of Crimea in 2014 and subsequently the war in the Donbas region of Ukraine, and has become a large-scale Russian invasion of Ukraine from three directions, Crimea in the south, Russia in the east, and Belarus in the north. Despite the geopolitical background that, in the eyes of Russia, justifes its annexation of regions in and around Ukraine, we cannot turn a blind eye towards the untold miseries of the citizens of the invaded country. Although it is unclear as to how the situation will unfold, what is clear is that lives are being lost, many civilians are being injured, traumatized, and valuable assets destroyed. Taking into consideration that the population of the countries involved in this conflict totals nearly 200 million citizens, many lives on both sides will be sacrifced, millions of people displaced, Europe will be overrun with new refugees, and global world economics will be disrupted by the war itself and by the sanctions imposed on Russia.info:eu-repo/semantics/publishedVersio