Linear accelerator-based stereotactic radiosurgery in recurrent glioblastoma: A single center experience

Background/Aim. Management of patients with recurrent glioblastoma (GB) comprises a therapeutic challenge in neurooncology owing to the aggressive nature of the disease with poor local control despite a combined modality treatment. The majority of cases recur within the highdose radiotherapy field limiting the use of conventional techniques for re-irradiation due to potential toxicity. Stereotactic radiosurgery (SRS) offers a viable noninvasive therapeutic option in palliative treatment of recurrent GB as a sophisticated modality with improved setup accuracy allowing the administration of high-dose, precise radiotherapy. The aim of the study was to, we report our experience with single-dose linear accelerator (LINAC) based SRS in the management of patients with recurrent GB. Methods. Between 1998 and 2010 a total of 19 patients with recurrent GB were treated using single-dose LINAC-based SRS. The median age was 47 (23-65) years at primary diagnosis. Karnofsky Performance Score was ≥ 70 for all the patients. The median planning target volume (PTV) was 13 (7-19) cc. The median marginal dose was 16 (10-19) Gy prescribed to the 80%-95% isodose line encompassing the planning target volume. The median follow-up time was 13 (2-59) months. Results. The median survival was 21 months and 9.3 months from the initial GB diagnosis and from SRS, respectively. The median progression-free survival from SRS was 5.7 months. All the patients tolerated radiosurgical treatment well without any Common Toxicity Criteria (CTC) grade > 2 acute side effects. Conclusion. Single-dose LINAC-based SRS is a safe and well- tolerated palliative therapeutic option in the management of patients with recurrent GB

An exploratory study into the effects of a 20 minute crushed ice application on knee joint position sense during a small knee bend.

Objectives The effect of cryotherapy on joint positioning presents conflicting debates as to whether individuals are at an increased risk of injury when returning to play or activity immediately following cryotherapy application at the knee. The aim of this study was to investigate whether a 20 minute application of crushed ice at the knee immediately affects knee joint position sense during a small knee bend. Design Pre and post-intervention. Setting University movement analysis laboratory. Participants Eleven healthy male participants. Main Outcome Measures Kinematics of the knee were measured during a weight bearing functional task pre and post cryotherapy intervention using three-dimensional motion analysis (Qualisys Medical AB Gothenburg, Sweden). Tissue cooling was measured via a digital thermometer at the knee. Results Results demonstrated significant reductions in the ability to accurately replicate knee joint positioning in both sagittal (P=.035) and coronal (P=.011) planes during the descent phase of a small knee bend following cryotherapy. Conclusion In conclusion a twenty minute application of crushed ice to the knee has an adverse effect on knee joint repositioning. Team doctors, clinicians, therapists and athletes should consider these findings when deciding to return an athlete to functional weight bearing tasks immediately following ice application at the knee, due to the potential increase risk of injury

How Does Cryotherapy Effect Ankle Proprioception in Healthy Individuals?

Objectives: To investigate how a 15 minute Cryotherapy intervention effects proprioception by measuring Joint positional Sense (JPS) and static single legged balance. Design: Repeated measures design. Setting: Laboratory. Participants: Eighteen healthy university sports team students (11 males, 7 females) aged between 20-21 years. Main Outcome Measures: Participants were treated with 15 minutes Aircast Cryo-cuff. The subject’s skin temperature was measured before and immediately after 15 minutes Cryotherapy treatment. Ankle active joint positional sense (A-JPS) and passive joint positional sense (P-JPS) was measured at pre-test, immediately post-test and 5 minutes post-test. Static balance was measured by Centre of Pressure (CoP) mean path length, medial-lateral (ML) CoP mean Deviation and anterior-posterior (AP) CoP mean Deviation and mean time-to-boundary (TtB) Minima for AP and ML directions. Results: No significant differences found for the variables of JPS and static single balance testing after 15 minutes Cryotherapy treatment. However, mean differences for CoP mean path length and ML mean deviation were shown to improve following Cryotherapy treatment, results not previously found in the literature. Conclusion: Results suggest that 15 minute Cryo-cuff treatment doesn’t significantly affect proprioception. Although the effect of Cryotherapy on proprioception depends on cooling modality used, time frame applied and joint applied to

The Warmth of You, The Warmth in Me: The effect of partner presence and absence on the perception of physical warmth

An important construct that has long been associated with feelings of social connectedness, interpersonal closeness, and security is warmth. In everyday language, phrases such as "warm embrace" are often utilized in situations where social connections are of interest, and words of similar nature are also used to describe personality traits. Although a growing body of empirical research has consistently demonstrated that physical warmth is closely linked to social intimacy and proximity, extant research has not examined whether the presence of romantic partners is similarly associated with physical warmth. The studies presented in this dissertation were the first ones to investigate the link between romantic partner presence and perception of physical warmth and reveal that imagining romantic partner presence or absence altered thermal perceptions. Across five studies, it was consistently found that simply imagining being together with the partner was associated with feelings of warmth, whereas imagining being separated from the partner was associated with feelings of coldness. Moreover, thinking about partner absence (vs. partner presence or a control scenario) was associated with a greater desire for warm activities potentially to compensate for the feelings of coldness. Together, these findings extend the consistent findings on the link between social and physical warmth to romantic relationships and provide further evidence for the regulatory role of romantic relationships and the robust link between physical warmth and interpersonal affection

Stand By Me: The Presence Of A Close Friend Helps Against The Negative Effects Of Social Exclusion

Individuals are highly attuned to cues of exclusion, even when it is not caused by an actual social threat. To date there is little evidence identifying the situational factors that could buffer individuals from the detrimental consequences of exclusion. Our study investigated how the presence of a close friend, a potential attachment figure, affects the perception and experience of one-person exclusion. Participants played Cyberball either in the presence of a friend or alone. They were either included by both players or excluded by one player while the other remained fair. Although all excluded participants detected, participants who were excluded in the presence of their friends reported significantly better mood-and-need levels compared to those who participated alone. Individual differences did not moderate the effects. These findings suggest that although it does not affect the perception of social exclusion, the presence of a friend could buffer against the negative effects of exclusion

Mitigating the affective and cognitive consequences of social exclusion: An integrative data analysis of seven social disconnection interventions

Background: Being socially excluded has detrimental effects, with prolonged exclusion linked to loneliness and social isolation. Social disconnection interventions that do not require direct support actions (e.g., “how can I help?”) offer promise in mitigating the affective and cognitive consequences of social exclusion. We examine how various social disconnection interventions involving friends and unknown peers might mitigate social exclusion by either buffering (intervening before) and by promoting recovery (intervening after). Methods: We present an integrative data analysis (IDA) of five studies (N=664) that systematically exposed participants to exclusion (vs. inclusion) social dynamics. Using a well-validated paradigm, participants had a virtual interaction with two other people. Unbeknownst to participants, the other people’s behavior was programmed to either behave inclusively toward the participant or for one to behave exclusively. Critically, we experimentally manipulated the social context in which the exclusion occurred. Our social disconnection interventions manipulated whether a friend was present (vs. an unknown peer vs. being alone), the intensity of the social interaction (having a face-to-face conversation vs. being reminded of an upcoming interaction vs. mere presence), and the timing of the intervention in relation to the social dynamic (before vs. during vs. following exclusion). We then assessed participants’ in-the-moment affective and cognitive responses, which include mood, feelings of belonging, sense of control, and social comfort. Results: Experiencing exclusion (vs. inclusion) led to negative affective and cognitive consequences. However, engaging in a face-to-face conversation with a friend before the exclusion lessened its impact (p<.001). Moreover, a face-to-face conversation with a friend after exclusion, and even a reminder of an upcoming interaction with a friend, sped-up recovery (ps<.001). There was less conclusive evidence that a face-to-face conversation with an unknown peer, or the mere presence of a friend or unknown peer, conferred protective benefits. Conclusions: The findings provide support for the effectiveness of social disconnection interventions that involve actual (i.e., face-to-face) or symbolic (i.e., reminders) interactions with friends. These interventions target momentary vulnerabilities by promptly addressing negative affect and cognitions as they emerge. As such, they offer a promising approach to primary prevention prior to the onset of loneliness and social isolation

EFFECTS OF SUBSCAPULARIS MUSCLE SOFT TISSUE MOBILIZATION ON PAIN AND FUNCTIONALITY IN SHOULDER DYSFUNCTION

Purpose: Tightness of the subscapularis muscle causes glenohumeral external rotation limitation and difficulties in over-head activities. This study aimed to determine the effects of soft tissue mobilization applied to the subscapularis muscle on pain and functionality in shoulder dysfunctions