198 research outputs found
Optimising the treatment of patients with long bone metastases
Bone metastases of the long
bones can cause pain and pathologic fractures. Local treatment consists of
radiotherapy or surgical stabilisation. The most appropriate treatment depends
on many factors, including the symptoms, the location and extent of the lesion,
the wishes and expectations of the patient, and the expected remaining
survival. Survival estimation of patients with symptomatic long bone metastases
is crucial to prevent over- and undertreatment. This thesis aimed to develop a
prognostic model for estimating survival in patients with cancer and
symptomatic metastases of the long bones, evaluate current (surgical) treatment
modalities and trends, and provide rationale for future prospective randomized
trials. As a result, the OPTIModel was developed: an easy-to-use prognostic
model that categorises patients into four clinically relevant survival
categories based on only three variables (tumour type, Karnofsky Performance
Score, visceral/brain metastases). To enable easy use of the model, an app was
created (OPTIModel). Futhermore, this thesis shows that almost all treatments
of pathologic fractures are based on expert opinion and small, retrospective
cohorts, as opposed to large, prospective (randomized) trials, which is
interesting in an era of evidence based medicine. This confirms the need of a
prospective, multicenter cohort, which was designed and implemented
accordingly. KWF KankerbestrijdingLUMC / Geneeskund
Regional Cerebral Blood Flow Patterns in Children vs. Adults with ADHD Combined and Inattentive Types: A SPECT Study
Objective: The current study sought to determine whether ADHD Combined Type (ADHD-C) and ADHD Primarily Inattentive Type (ADHD-PI) showed differential regional cerebral blood flow (rCBF) patterns in children vs. adults. Participants and Methods: The overall sample (N=1484) was effectively split into four groups: adults with ADHD-PI (n=519), adults with ADHD-C (n=405), children with ADHD-PI (n=192), children with ADHD-C (n=368). All participants were void of bipolar, schizophrenia, autism, neurocognitive disorders, and TBI. The data were collected from a de-identified archival database of individuals who underwent SPECT scans at rest. Results: Using αConclusions: Overall, the current study suggested that children may show rCBF differences between different ADHD subtypes, but adults may not. The current study did not find significance in any of the 17 brain regions examined when comparing adults with ADHD-C to adults with ADHD-PI. All significant findings were attributed to the children with ADHD-C group showing aberrant blood flow rate than at least one other group. Previous research has supported that the differentiation of these subtypes as distinctive disorders is difficult to make in adults (Sobanski et al., 2006). Other research has indicated the potential of imaging techniques to differentiate the two in children (Al-Amin, Zinchenko, & Geyer, 2018). The current findings support nuanced ways in which rCBF patterns of ADHD-C and ADHD-PI differ between children and adults
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