Volumetric variations and the effects of these differences on dosimetry during the course of volumetric modulated arc therapy for head and neck cancer

Introduction To observe the changes in the patients anatomy and the effects of these differences on dose distribution throughout the treatment in order to design an optimal adaptive plan and to find the optimal time for replanning in head and neck cancer patients who receive primary radiotherapy or chemoradiotherapy. Materials and Methods Fifteen head and neck cancer patients were evaluated prospectively. VMAT plan with simultaneous integrated boost or sequential technique was performed. The last CBCT of the 3th and 5th week were fusioned deformably with planning CT. Initial plans were adapted to these CBCT images. An adaptive plan was generated during the week when normal tissues overdosed more than 5% or the target volume underdosed more than 5%. The volumetric changes and dosimetric differences in target volumes, parotid glands and spinal cord were compared between planning CT and CBCT images. Also adaptive plan doses were compared with delivered doses in terms of target volumes, parotid glands and spinal cord. Results While there was no significance at the comparison of the volumes in GTV and PTV70 between the planning CT and 3rd week CBCT, it became significant at the 5th week. Primary and lymph node GTVs reduced by 44.8% and 70.9% respectively. Parotid glands and spinal cord doses increased in the 3rd week as well as; it rose a significant level for the ipsilateral parotid and spinal cord in the 5th week. Adaptive plan was needed in 10 patients. Adaptive plan provided a 1 Gy dose reduction in contralateral parotid glands, 1.4 Gy in ipsilateral parotid glands and 1 Gy in the spinal cord. Conclusion Significant changes were observed in the volume of target and parotid glands despite it not being reflected much in dosimetry. A new CT scan can be recommended to evaluate for an adaptive plan in 5th week in the absence of clinically usable online correction methods

The interaction between current smoking and hemoglobin on the risk of advanced fibrosis in patients with biopsy-proven nonalcoholic fatty liver disease

Backgroun

Fate of abstracts presented at the annual scientific meeting of the Undersea and Hyperbaric Medical Society

Introduction: The full-text publication of abstracts presented at any given scientific meeting in peer-reviewed journals is accepted as a measure of scientific quality of that particular meeting. The aim of this study is to determine the full-text publication rate of abstracts presented at the 2005 Scientific Meeting of the Undersea and Hyperbaric Medical Society (UHMS)

Diagnostic Accuracy of Tru-Cut Biopsy for Soft Tissue Tumors

Objective: Biopsy is an essential step in the diagnosis of patients with soft tissue tumors. Tru-cut biopsy is a simple procedure that could be performed in the outpatient setting under local anesthesia. It is cost-effective and less time consuming compared with the open biopsy. The aim of the present retrospective study is to assess this biopsy technique with regard to the diagnostic accuracy for soft tissue tumors

The diagnostic utility of fibrosis-4 or nonalcoholic fatty liver disease fibrosis score combined with liver stiffness measurement by fibroscan in assessment of advanced liver fibrosis: a biopsy-proven nonalcoholic fatty liver disease study

Background/aim

The Charlson Comorbidity Index: can it predict the outcome in acute kidney injury?

Purpose Comorbidity has a significant impact on the health status and treatment outcome of a patient. The Charlson comorbidity index (CCI) is a frequently used scoring system, which evaluates the prognosis based on the patient's comorbid conditions. The aim of this study was to evaluate the usefulness of CCI in predicting the mortality and renal recovery in non-critically ill patients with severe AKI. Methods A total of 530 adult patients who were referred from the emergency department and underwent intermittent urgent hemodialysis (uHD) were enrolled in the study. Personal history for comorbidities were recorded and then assessed using the CCI. Results The mean CCI score was 3.3 +/- 2.6. In our multivariate analysis, higher white blood cell count was associated with mortality (p = 0.023). The other parameters including CCI score were not found to be significantly associated with mortality excluding patients with sepsis. Moreover, the CCI was not significantly useful in the discrimination of patients with complete recovery from patients who remained dependent to dialysis. Conclusions We could not find significant association between CCI and short-term hospital mortality and renal outcome. Whereas, malnutrition, inflammation and general aging may have impact on short-term mortality among patients