Toxicity and morbility after isolated lower limb perfusion in 242 chemo-hyperthermal treatments for cutaneous melanoma: The experience of the Tuscan Reference Centre

<p>Abstract</p> <p>Background</p> <p>The aim of this retrospective study was to assess the results concerning the regional and systemic toxicity and complications in 242 chemo-hyperthermal treatments (HILPs) for lower limb melanoma.</p> <p>Patients and methods</p> <p>60 HILPs (G-A) were performed with mild HT plus L-PAM (10 mg/lt) ± D-actimomycin; 74 HILPs (G-B) with true HT (40–41.8°C) plus L-PAM (10 mg/lt) ± D-act; 108 HILPs (G-C) with true HT plus L-PAM (10 mg/lt) ± D-act plus L-PAM (5 mg/lt) additional bolus.</p> <p>Results</p> <p>Limb toxicity was very low in G-A and in G-B; increasing toxicity (grade III = 37%) in G-C; no grade IV statistical difference was registered in all three groups, with percentage values among 1.6% and 2.7%. Systemic toxicity showed itself only in the haemopoietic parameters. No differences were registered in G-B vs G-A group. In G-C vs G-B a significative increase of systemic toxicity was seen in grade 3 (p < 0.05). Postoperative complications were acceptable. Local and systemic side-effects were transient; no permanent neurological limb deficit was registered. The postoperative mortality was recorded in 3/182 HILPs (1.6%) of the G-B and G-C groups.</p> <p>Conclusion</p> <p>These data suggested that the technical implementations reduced the occurrence and the severity of the side effects and complications. The essential requirement for HILP is the quality assurance of the procedures. Although higher regional and systemic toxicity were observed in the G-C group caused by L-PAM additional bolus, the safeness of the procedures under the true hyperthermal regimen and the time increase of the high L-PAM concentration have assured the treatment reliability along with the increased clinical efficacy expectations of the treatments.</p

Mitochondrial disease: Needs and problems of children, their parents and family. A systematic review and pilot study into the need for information of parents during the diagnostic phase

Contains fulltext : 51979.pdf (publisher's version ) (Closed access)OBJECTIVE: Firstly, this paper aims to systematically review the mitochondrial disease literature to identify studies assessing the needs and problems in the daily life of children with a mitochondrial disease and of their parents and family. The second aim is to provide more insight into the need for information by the parents of these children during the diagnostic process while in hospital. DESIGN: A systematic review and a pilot study, using a qualitative (focus group interviews; n = 7) and a quantitative (questionnaire; n = 37) design. RESULTS: Mothers reported great socioeconomic and psychoaffective strain and showed psychopathological symptoms in the two studies published with respect to this topic. The pilot study showed that parents considered an honest and interested attitude of the person who is giving the information as most important. Furthermore they wanted oral and written information and a central point where they could go with their questions at any time they felt the need. The need for information increased during the four phases of the diagnostic process and was highest in the fourth phase. CONCLUSIONS: The few studies found in the review, combined with expectations that having a mitochondrial disease must have a great impact on these children and their parents and family, call for more research in their needs and problems. Furthermore, there are gaps in the current information provision to parents of these children. A better understanding of the needs and problems of these children and their family is essential for effective care planning and might result in an improved quality of life

Feasibility test of a UK-scalable electronic system for regular collection of patient-reported outcome measures and linkage with clinical cancer registry data: The electronic Patient-reported Outcomes from Cancer Survivors (ePOCS) system

<p>Abstract</p> <p>Background</p> <p>Cancer survivors can face significant physical and psychosocial challenges; there is a need to identify and predict which survivors experience what sorts of difficulties. As highlighted in the UK National Cancer Survivorship Initiative, routine post-diagnostic collection of patient reported outcome measures (PROMs) is required; to be most informative, PROMs must be linked and analysed with patients' diagnostic and treatment information. We have designed and built a potentially cost-efficient UK-scalable electronic system for collecting PROMs via the internet, at regular post-diagnostic time-points, for linking these data with patients' clinical data in cancer registries, and for electronically managing the associated patient monitoring and communications; the electronic Patient-reported Outcomes from Cancer Survivors (ePOCS) system. This study aims to test the feasibility of the ePOCS system, by running it for 2 years in two Yorkshire NHS Trusts, and using the Northern and Yorkshire Cancer Registry and Information Service.</p> <p>Methods/Design</p> <p>Non-metastatic breast, colorectal and prostate cancer patients (largest survivor groups), within 6 months post-diagnosis, will be recruited from hospitals in the Yorkshire Cancer Network. Participants will be asked to complete PROMS, assessing a range of health-related quality-of-life outcomes, at three time-points up to 15 months post-diagnosis, and subsequently to provide opinion on the ePOCS system via a feedback questionnaire. Feasibility will be examined primarily in terms of patient recruitment and retention rates, the representativeness of participating patients, the quantity and quality of collected PROMs data, patients' feedback, the success and reliability of the underpinning informatics, and the system running costs. If sufficient data are generated during system testing, these will be analysed to assess the health-related quality-of-life outcomes reported by patients, and to explore if and how they relate to disease, treatment and/or individual differences characteristics.</p> <p>Discussion</p> <p>There is currently no system in the UK for collecting PROMs online and linking these with patients' clinical data in cancer registries. If feasible, ePOCS has potential to provide an affordable UK-scalable technical platform to facilitate and support longitudinal cohort research, and improve understanding of cancer survivors' experiences. Comprehensive understanding of survivorship difficulties is vital to inform the development and provision of supportive services and interventions.</p

The power of the small press: Entrepreneurial publishing and disruption of the industry

Due to the conglomeration of media and publishing companies in the twentieth century (McCleery, 2007), the size of publishing companies has become more polarized, with a majority of small publishers comprising a small percent of revenue and market share compared to the few, but powerful, larger publishing houses (Publishers Association, ‘UK Book Publishing Industry in Statistics’ 2014). In economics, the polarizing principle asserts that ‘developments at one pole of the corporate/cultural spectrum are often counterbalanced by antithetical innovations at the other’ which has, in the publishing industry, led to ‘the emergence of tiny publishing houses’ at the other end of the spectrum in opposition to the conglomerates (Brown et al 2006). This article examines the distribution and disruption of power in the publishing industry by emphasising the role of the small press. Through interview data with small publishers in the United Kingdom, this article considers the power of the small press. Ultimately this article argues that small publishing companies disrupt the power of the conglomerates in the publishing industry by innovation—a characteristic of the entrepreneurially-oriented small firm. By using Johannessen’s six categories of newness (2001), this article illustrates the ways in which small publishers are using innovation to disrupt power in the book industry

Zuidhorn, Jellemaweg, Gemeente Westerkwartier (Gr.). Een archeologische begeleiding.

De Steekproef heeft in opdracht van A. Hak Noord-Oost BV tussen september en december 2020 een archeologische begeleiding uitgevoerd aan de Jellemaweg te Zuidhorn (gemeente Westerkwartier). De aanleiding voor de archeologische begeleiding waren de graafwerkzaamheden ten behoeve van de aanleg van nieuwe gas-, water- en elektriciteitsleidingen. Omdat de graafwerkzaamheden bij de aanleg mogelijke aanwezige archeologische waarden konden vernietigen, zijn deze werkzaamheden uitgevoerd onder archeologische opgraving conform BRL SIKB 4000, protocol 4004 variant Archeologische Begeleiding. De maximale ontgravingsdiepte voor deze werkzaamheden bedroeg 110 centimeter beneden maaiveld met een sleufbreedte van maximaal 80 centimeter. Tijdens het documenteren van de profielkolommen is besloten om op enkele locaties dieper te ontgraven om zo een meer volledig bodemprofiel te krijgen. In de directe omgeving van het plangebied zijn in het verleden meerdere archeologische onderzoeken uitgevoerd. Tijdens deze onderzoeken zijn een ophogingspakket van klei aangetroffen met meerdere fragmenten laat middeleeuws aardewerk en bot, en enkele (laat middeleeuwse) waterkuilen/-putten en een mestkuil. De archeologische resten in het plangebied duiden op een bewoningsfase en uitbreiding van de dorpskern van Zuidhorn vanaf de late middeleeuwen. Het is duidelijk dat het gebied sinds de late middeleeuwen veelvuldig is opgehoogd, waarschijnlijk ten behoeve van de dorpsuitbreiding. Tijdens het onderzoek zijn vondsten gedaan in de categorieën aardewerk, natuursteen, dierlijk bot, metaal en slakmateriaal Er zijn 230 scherven aardewerk gevonden die deel hebben uitgemaakt van minimaal 68 potten. Het overgrote deel van het aardewerk dateert tot de dertiende en veertiende eeuw (late middeleeuwen B). Het materiaal is afkomstig uit ophogingslagen. Deze lagen werden veelal gevormd door afval, mest en/of plaggen uit de nederzetting en omgeving. Een kleinere groep aardewerk dateert van na de veertiende eeuw, tot in de achttiende eeuw. Ook in dit geval gaat het om 'regulier' afval. Vanwege de kleine hoeveelheid zal in deze periode echter minder met huisafval zijn opgehoogd. De resultaten en de vondsten geven informatie over de datering en totstandkoming van het dorp Zuidhorn en kunnen in de toekomst dienen voor verder wetenschappelijk onderzoek