Alstrupbaker8504
Breast symmetry was not associated with high patient satisfaction (
= 0.55).
Despite the fact that OS was performed in patients with worse tumour conditions and in more demanding patients, OS allowed similar cosmetic results to classical BCT.
Despite the fact that OS was performed in patients with worse tumour conditions and in more demanding patients, OS allowed similar cosmetic results to classical BCT.
A large proportion of breast cancer patients who undergo adjuvant radiotherapy suffer from radiotherapy-induced fatigue. The possible causative factors of this specific side effect are diverse.
Prevalence, duration, and severity of radiotherapy-induced fatigue are dependent on the type of radiotherapy, as well as on the irradiated volume, dose scheme, on the number of radiation fields, the combination with other treatments, diurnal rhythm, smoking, and time-to-hospitalization. Recommended treatments include non-pharmacologic interventions, such as physical and psychosocial interventions. Pharmacologic therapies include treatment with methylphenidate and modafinil. In addition to its early detection with standardized instruments, adequate education to breast cancer patients about risks and predisposing factors of radiotherapy-induced fatigue is essential. Multidimensional strategies help to maintain the patients' quality of life and therefore guarantee treatment adherence and efficacy.
Radiotherapy-induced fatigue is an underreported, underdiagnosed, and undertreated side effect. This review provides an overview of radiotherapy-induced fatigue in breast cancer patients receiving adjuvant radiotherapy.
Radiotherapy-induced fatigue is an underreported, underdiagnosed, and undertreated side effect. This review provides an overview of radiotherapy-induced fatigue in breast cancer patients receiving adjuvant radiotherapy.
There has been huge progress over the last 30 years in identifying the familial component of breast cancer.
Currently around 20% is explained by the high-risk genes
and
, a further 2% by other high-penetrance genes, and around 5% by the moderate risk genes
and
. In contrast, the more than 300 low-penetrance single-nucleotide polymorphisms (SNP) now account for around 28% and they are predicted to account for most of the remaining 45% yet to be found. Even for high-risk genes which confer a 40-90% risk of breast cancer, these SNP can substantially affect the level of breast cancer risk. Indeed, the strength of family history and hormonal and reproductive factors is very important in assessing risk even for a BRCA carrier. The risks of contralateral breast cancer are also affected by SNP as well as by the presence of high or moderate risk genes. Genetic testing using gene panels is now commonplace.
There is a need for a more parsimonious approach to panels only testing those genes with a definite 2-fold increased risk and only testing those genes with challenging management implications, such as
and
, when there is strong clinical indication to do so. Testing of SNP alongside genes is likely to provide a more accurate risk assessment.
There is a need for a more parsimonious approach to panels only testing those genes with a definite 2-fold increased risk and only testing those genes with challenging management implications, such as CDH1 and TP53, when there is strong clinical indication to do so. Testing of SNP alongside genes is likely to provide a more accurate risk assessment.
About 30% of all women with breast or ovarian cancer exhibit a family history of the disease. So far, the genetic cause could be deciphered in about 30% of these cases. The results demonstrate a high genetic heterogeneity, with high-risk and moderate-risk genes and low-risk variants contributing alone or in concert to the development of cancer. Furthermore, it has been shown that the genotype significantly determines the phenotype and that knowledge of the phenotype is as important as the genotype to offer adequate and risk-adapted prevention to persons at risk. For newly identified risk genes, however, the phenotype is not sufficiently characterized at first, and thus prevention measures are not sufficiently evaluated.
The German Consortium for Hereditary Breast and Ovarian Cancer has developed a concept for collecting the missing data in the context of knowledge-generating care and at the same time ensuring care based on the best available knowledge. Core elements of this concept are structured and standardized care, an outcome-oriented evaluation based on a comprehensive registry, networking with certified breast and gynecological cancer centers combined with regular training on state-of-the-art care for doctors, and compilation of comprehensible patient information. This comprehensive concept has been incorporated into contracts for specialized care with health insurers and thus ensures nationwide care at the highest scientific and clinical levels.
This article describes how to implement a concept of evidence-generating care for risk-adjusted prevention in a nationwide health care system.
This article describes how to implement a concept of evidence-generating care for risk-adjusted prevention in a nationwide health care system.Technology-based education of children with special needs has become the focus of many research works in recent years. The wide range of different disabilities that are encompassed by the term "special needs", together with the educational requirements of the children affected, represent an enormous multidisciplinary challenge for the research community. In this article, we present a systematic literature review of technology-enhanced and game-based learning systems and methods applied on children with special needs. The article analyzes the state-of-the-art of the research in this field by selecting a group of primary studies and answering a set of research questions. Although there are some previous systematic reviews, it is still not clear what the best tools, games or academic subjects (with technology-enhanced, game-based learning) are, out of those that have obtained good results with children with special needs. The 18 articles selected (carefully filtered out of 614 contributions) have been used to reveal the most frequent disabilities, the different technologies used in the prototypes, the number of learning subjects, and the kind of learning games used. The article also summarizes research opportunities identified in the primary studies.The identity and institutional image of universities are presented to the world through their websites. On their websites, universities publish their academic offerings, their mission, their vision, their academic objectives, their achievements, their regulations, their news and all their university work. Hence, the importance of university websites is accessible. The accessibility of university websites has been evaluated several times in the past, but there is no work that has summarized all the evaluations performed to provide a general overview of the situation. Therefore, in this research we have performed a systematic literature review (SLR) to consolidate, analyze, synthesize and interpret the accessibility results of university websites published in 42 papers that have been selected for this study. The methodology used in this SLR was that proposed in Kitchenham's guidelines, which includes three stages planning the review, conducting the review and reporting the review. The results present the analysis and synthesis of the evaluations of 9,140 universities in 67 countries. Of these, 38,416 web pages, 91,421 YouTube videos and 28,395 PDF documents were evaluated. Manual methods, methods with automatic tools and the combination of both methods were used for the evaluation. Most websites were evaluated using the ISO/IEC 405002012 and Section 508 standards. The accessibility guidelines most commonly violated in the evaluations were adaptable, compatible, distinguishable, input assistance, keyboard accessible, navigable, predictable, readable and text alternatives. PF-06873600 In conclusion, the university websites, YouTube videos and PDF documents analyzed in the 42 papers present important accessibility problems. The main contribution of this SLR is the consolidation of the results of the 42 studies selected to determine the findings and trends in the accessibility of university websites around the world.Using data from the COVID-19 questionnaire of the Survey of Health, Ageing and Retirement in Europe (SHARE), we investigate the time patterns of precautionary health behaviours of individuals aged 50 years and above during the summer of 2020, an easing phase of the COVID-19 pandemic in Europe. We also examine how these health behaviours differ by the presence of chronic conditions such as hypertension, high cholesterol level, heart disease, diabetes or chronic bronchitis, which can be considered as risk factors for COVID-19. Our results suggest that while on average, people became less precautious during the analysed time period, this is less so for those who are at higher risk. We also document large regional differences in precautionary health behaviours and show that higher-risk individuals are on average more cautious in all regions. We conclude that people adjusted their health behaviours in line with the generally understood risk of the COVID-19 disease. At the same time, our results also point out divergences in the level of willingness to take different precautionary steps.The conventional X‑ray image is the method of choice for suspected pneumonia. Computed tomography (CT) is indicated for treatment refractory or recurrent infiltrates, difficult differential diagnostics, suspected complications and in immunocompromised patients. Thoracic sonography can be used as an alternative method for initial diagnostics and in the intensive care unit to monitor progress. In addition to the detection of infiltrates the radiological classification can help to limit the pathogen spectrum. Radiologically, three forms of pneumonia can principally be differentiated lobar pneumonia, bronchopneumonia and interstitial pneumonia. Furthermore, there are special forms of pneumonia with certain pathogens, such as aspergilloma, invasive mycosis, postprimary tuberculosis and nontuberculous mycobacteriosis or in a specific clinical context, such as aspiration pneumonia, postinfarction pneumonia, retention pneumonia and septic emboli. The most frequent complications of pneumonia are lung abscesses and pleural empyema. Both can sometimes but not always be seen in the X‑ray image. If clinically suspected the indications for CT should be generously applied. Certain pre-existing diseases, such as immunodeficiency or structural alterations of the lungs can predispose to pulmonary infections, frequently with unusual pathogens or manifestation forms and must be taken into account in the diagnostics.Because rats are commensal organisms that depend on human activities for food, shifts in human behavior will have pronounced effects on local rat populations. In the spring of 2020, social distancing measures were implemented globally to curtail the spread of SARS-CoV-2. This presented a unique opportunity to obtain information regarding the immediate effects of shifts in human behavior on rat populations in a variety of countries. In response to increased sightings of rats in the USA that were reported in American media, we analyzed the changes in the number of public service calls in Tokyo, Japan. We found that the number of calls increased after the implementation of social distancing measures, suggesting that rat sightings had also increased in Tokyo. We then surveyed the changes in the business activities of pest management professionals in the USA, Canada, and Tokyo. We found that the activities were increased in 50 to 60% of the respondents from the USA and Canada. In contrast, 60 to 70% of the respondents from Tokyo answered that their activities were not changed.
