164 research outputs found
Lipofilling in Post-Treatment Oral Dysfunction in Head and Neck Cancer Patients
Lipofilling is a new treatment option for head- and neck cancer patients who suffer from chronic and severe (chemo-) radiation or surgery-related swallowing problems. Lipofilling is a technique of autologous grafting in which living fat cells are transplanted from one location to another in the same patient. In the case of head and neck cancer patients, volume loss or muscle atrophy of the tongue or pharyngeal musculature caused by the treatment may result in oropharyngeal dysfunction. Firstly, intensive swallowing therapy will be given, but if that offers no further improvement and the functional problems persist, lipofilling can be considered. By transplantation of autologous adipose tissue, the functional outcomes might improve by compensating the existing tissue defects or tissue loss. Only a few studies have been published which evaluated the effectiveness of this new treatment option. The results of those studies show that the lipofilling technique seems safe and of potential value for improving swallowing function in some of the included patients with chronic and severe dysphagia after surgery and/or (chemo-) radiation therapy for head and neck cancer. The lipofilling procedure will be described in detail as well as the clinical implications
Feasibility of a subcutaneous gluteal turnover flap without donor site scar for perineal closure after abdominoperineal resection for rectal cancer
Background: Abdominoperineal resection (APR) carries a high risk of perineal wound morbidity. Perineal wound closure using autologous tissue flaps has been shown to be advantageous, but there is no consensus as to the optimal method. The aim of this study was to evaluate the feasibility of a novel gluteal turnover flap (GT-flap) without donor site scar for perineal closure after APR. Methods: Consecutive patients who underwent APR for primary or recurrent
Congenital epulis of the jaw: a series of five cases and review of literature
This article describes five cases of congenital epulis, a rare and benign swelling in the mouth of a newborn, which is not widely known. We present five cases: four cases presented as single pedunculated nodules of the gingiva and in one case two nodules were present. Of all, 50% were located at the maxilla. Excision was performed in four of the five cases and in one case, spontaneous regression was awaited. No recurrence was reported. The characteristic features of congenital epulis are a pedunculated, flesh-pink coloured tumour with a predominant occurrence on the anterior maxillary alveolar ridge in a female newborn. Although the aetiology is unknown, most authors suggest a mesenchymal, rather than an odontogenic, origin. Endogenous hormonal factors might influence growth prenatally. Histological findings include granular cells with eosinophilic cytoplasm and small, eccentric nuclei. Despite the fact that the lesion can be a striking sight, spontaneous regression is possible and can be awaited. Indications for non-radical excision under local anaesthesia are severe upper airway obstruction and interference with feeding technique. In conclusion, we provide clinical and histological information about congenital epulis, so that this entity will be more easily recognised and relevant information given to parent
Spontaneous regression of congenital epulis: a case report and review of the literature
<p>Abstract</p> <p>Introduction</p> <p>Congenital epulis is a rare lesion found on the alveolar process of a newborn child, diagnosed soon after birth. The lesion has a site predilection for the anterior maxillary alveolar process and a 9:1 sex predilection for females. Once diagnosed the traditional management of the lesion has been surgical excision under general anesthesia.</p> <p>Case presentation</p> <p>The purpose of this case report is to describe spontaneous regression of congenital epulis in a three week old healthy African American female child. She presented with a 1.5 cm bilobed sessile nodular lesion in the region of the right maxillary cuspid. The clinical impression was congenital epulis. Since the lesion was not interfering with feeding and respiration, a conservative approach was taken. The child was followed-up for 18 months, during which the lesion progressively regressed.</p> <p>Conclusions</p> <p>Conservative management prevented unnecessary surgery and anesthesia exposure in a neonate.</p
The detection rate of early UV emission from supernovae: A dedicated GALEX/PTF survey and calibrated theoretical estimates
The radius and surface composition of an exploding massive star,as well as
the explosion energy per unit mass, can be measured using early UV observations
of core collapse supernovae (SNe). We present the first results from a
simultaneous GALEX/PTF search for early UV emission from SNe. Six Type II SNe
and one Type II superluminous SN (SLSN-II) are clearly detected in the GALEX
NUV data. We compare our detection rate with theoretical estimates based on
early, shock-cooling UV light curves calculated from models that fit existing
Swift and GALEX observations well, combined with volumetric SN rates. We find
that our observations are in good agreement with calculated rates assuming that
red supergiants (RSGs) explode with fiducial radii of 500 solar, explosion
energies of 10^51 erg, and ejecta masses of 10 solar masses. Exploding blue
supergiants and Wolf-Rayet stars are poorly constrained. We describe how such
observations can be used to derive the progenitor radius, surface composition
and explosion energy per unit mass of such SN events, and we demonstrate why UV
observations are critical for such measurements. We use the fiducial RSG
parameters to estimate the detection rate of SNe during the shock-cooling phase
(<1d after explosion) for several ground-based surveys (PTF, ZTF, and LSST). We
show that the proposed wide-field UV explorer ULTRASAT mission, is expected to
find >100 SNe per year (~0.5 SN per deg^2), independent of host galaxy
extinction, down to an NUV detection limit of 21.5 mag AB. Our pilot GALEX/PTF
project thus convincingly demonstrates that a dedicated, systematic SN survey
at the NUV band is a compelling method to study how massive stars end their
life.Comment: See additional information including animations on
http://www.weizmann.ac.il/astrophysics/ultrasa
Subjective outcome related to donor site morbidity after sural nerve graft harvesting: a survey in 41 patients
Predicting change in quality of life from age 79 to 90 in the Lothian Birth Cohort 1921
Purpose: Quality of life (QoL) decreases in very old age, and is strongly related to health outcomes and mortality. Understanding the predictors of QoL and change in QoL amongst the oldest old may suggest potential targets for intervention. This study investigated change in QoL from age 79 to 90 years in a group of older adults in Scotland, and identified potential predictors of that change.
Method: Participants were members of the Lothian Birth Cohort 1921 who attended clinic visits at age 79 (n = 554) and 90 (n = 129). Measures at both time points included QoL (WHOQOL-BREF: four domains and two single items), anxiety and depression, objective health, functional ability, self-rated health, loneliness, and personality.
Results: Mean QoL declined from age 79 to 90. Participants returning at 90 had scored significantly higher at 79 on most QoL measures, and exhibited better objective health and functional ability, and lower anxiety and depression than non-returners. Hierarchical multiple regression models accounted for 20.3ā56.3% of the variance in QoL at age 90. Baseline QoL was the strongest predictor of domain scores (20.3ā35.6% variance explained), suggesting that individual differences in QoL judgements remain largely stable. Additional predictors varied by the QoL domain and included self-rated health, loneliness, and functional and mood decline between age 79 and 90 years.
Conclusions: This study has identified potential targets for interventions to improve QoL in the oldest old. Further research should address causal pathways between QoL and functional and mood decline, perceived health and loneliness
Sense of coherence and quality of life in older in-hospital patients without cognitive impairment- a 12Ā month follow-up study
The effect of regular walks on various health aspects in older people with dementia: protocol of a randomized-controlled trial
<p>Abstract</p> <p>Background</p> <p>Physical activity has proven to be beneficial for physical functioning, cognition, depression, anxiety, rest-activity rhythm, quality of life (QoL), activities of daily living (ADL) and pain in older people. The aim of this study is to investigate the effect of walking regularly on physical functioning, the progressive cognitive decline, level of depression, anxiety, rest-activity rhythm, QoL, ADL and pain in older people with dementia.</p> <p>Methods/design</p> <p>This study is a longitudinal randomized controlled, single blind study. Ambulatory older people with dementia, who are regular visitors of daily care or living in a home for the elderly or nursing home in the Netherlands, will be randomly allocated to the experimental or control condition. Participants of the experimental group make supervised walks of 30 minutes a day, 5 days a week, as part of their daily nursing care. Participants of the control group will come together three times a week for tea or other sedentary activities to control for possible positive effects of social interaction. All dependent variables will be assessed at baseline and after 6 weeks, and 3, 6, 9, 12 and 18 months of intervention.</p> <p>The dependent variables include neuropsychological tests to assess cognition, physical tests to determine physical functioning, questionnaires to assess ADL, QoL, level of depression and anxiety, actigraphy to assess rest-activity rhythm and pain scales to determine pain levels. Potential moderating variables at baseline are: socio-demographic characteristics, body mass index, subtype of dementia, apolipoprotein E (ApoE) genotype, medication use and comorbidities.</p> <p>Discussion</p> <p>This study evaluates the effect of regular walking as a treatment for older people with dementia. The strength of this study is that 1) it has a longitudinal design with multiple repeated measurements, 2) we assess many different health aspects, 3) the intervention is not performed by research staff, but by nursing staff which enables it to become a routine in usual care. Possible limitations of the study are that 1) only active minded institutions are willing to participate creating a selection bias, 2) the drop-out rate will be high in this population, 3) not all participants will be able to perform/understand all tests.</p> <p>Trial registration</p> <p><a href="http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=1482">NTR1482</a></p
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