Gastrointestinal Stromal Tumours treated before and after the advent of c-kit immunostaining

<p>Abstract</p> <p>Background</p> <p>Recently developed immunohistochemical markers have revolutionised the classification of gastrointestinal stromal tumours (GISTs) whilst tyrosine kinase inhibitors (imatinib) have had a significant impact on the treatment of advanced tumours. We review the clinicopathological features of previously resected mesenchymal tumours of the gastrointestinal tract in our institution to 1) reclassify the histological diagnosis of those stained prior to c-kit availability; 2) perform survival analysis to identify prognostic factors, and 3) to consider the implications for patients.</p> <p>Methods</p> <p>Clinicopathological records of patients with a diagnosis of mesenchymal tumours treated between May 1992 and April 2007 were reviewed.</p> <p>Results</p> <p>82 patients were reviewed. 26 (32%) were reclassified as GISTs following c-kit immunostaining and a further 14 patients were treated for GIST up to April 2007 (Total: 40 patients; 21 males and 19 females, mean age 67, range 30-92 years). 36 (90%) underwent complete resection. 5-year survival of patients with GIST alone was 80%. Females had a better median survival (M: F 43 months: 73 months).</p> <p>Conclusions</p> <p>The availability of c-kit staining allowed 32% of previously diagnosed mesenchymal tumours to be reclassified as GISTs. This may have implications for the follow-up of patients diagnosed prior to the availability of this method.</p

Field-based usability evaluation methodology for mobile geo-applications

An important aspect of a Dutch research project into usable (and well scaled) mobile maps for consumers is presented: the development of an appropriate field-based usability evaluation methodology for the prototype of a geo-mobile application that will be the result of a user centred design approach. Automatic generalisation, required for the user&apos;s orientation in space, but also for progressive data transfer, will be an important aspect of the prototype. What is reported here is an effective and technically unique user research methodology, based on a combination of video observation, thinking aloud and semi-structured interviewing. The experiments that have led to this outcome revealed some interesting usability issues that deserve further investigation

Location interoperability services for medical emergency operations during disasters

The organizational structure that deals with the Response phase in disaster and risk management is based on a strong co-operation between several organizations, such as the police, fire departments, the local government and the health services1 The size of the organization depends largely upon the scale of the disaster itself. Van Dijke 2003 identifies 31 processes, that concern information flows and coordination of forces, that are relevant in these cases. This paper concentrates on the information process at the first aid in hospitals, which is part of ‘somatic health care’. Research has been conducted on the information problems during emergency operations at first aid departments in Italy and The Netherlands. The results identify location information (location of patients, equipment, physicians and/or relatives, and so on) as a critical factor for improve quality and coordination of health services. In most cases the location has to be determined indoors, where the most common global 3D positioning (based on GPS) is not available. It is still a challenge to obtain accurate positions indoors. In general terms, one can distinguish between two broad classes of location technology: global (telecommunications) and local (WiFi, Bluetooth) network approaches, based on absolute (providing coordinates) or relative (providing speed and direction of movement) positioning. Currently, the most commonly used approaches for indoor positioning are based on WiFi and RFID. This paper presents a system for indoor positioning and LBS to support hospital teams in emergency management. The paper discusses current information problems, investigates the required functionality of a system for hospital services, and the added value of indoor location technology

Do High-Volume Injections Affect the Ultrasonographic Neovascularization in Chronic Achilles Tendinopathy? A Randomized Placebo-Controlled Clinical Trial

Objective:High-volume injections (HVIs) are thought to target neovascularization in chronic midportion Achilles tendinopathy (AT), yet the mechanism has not been clarified. Therefore, we aim to evaluate whether a HVI decreases ultrasonographic Doppler flow in patients with chronic midportion AT.Design:A double-blind, randomized, placebo-controlled clinical trial.Setting:Sports medicine department at a district general hospital.Patients:Sixty-two patients with clinically diagnosed chronic midportion AT were included and randomized into the intervention group (HVI-group, n = 30) and placebo group (n = 32).Intervention:A daily calf-muscle exercise program combined with either (1) a HVI (HVI-group: 50 mL) or (2) a placebo-injection (placebo-group: 2 mL) with a mixture of saline and lidocaine.Main Outcome Measures:Primary outcome was the surface area quantification (SAQ) score (%) of the Doppler flow during a 24-week follow-up period. Secondary outcome was the association between SAQ scores and symptoms [Victorian Institute of Sports Assessment-Achilles (VISA-A)]. Outcomes were measured before, directly after, and 1 hour after the injection and at 2, 6, 12, and 24 weeks of follow-up.Results:There was no significant between-group difference at 24 weeks [-0.1%; 95% confidence interval (CI), -4.9 to 4.7] or at any of the other time points. Change in SAQ score did not correlate with the change in VISA-A score (P = 0.93).Conclusion:A HVI does not affect Doppler flow in patients with chronic midportion AT. Also, changes in Doppler flow were not associated with the clinical outcome. These findings challenge the theoretical basis of a HVI.Trial registration:NCT02996409

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