Booneboll9655
On MRI, primary hepatic or splenic tumors (n = 3) also appeared as large heterogeneous masses. Seven patients (35.0%) had advanced-stage disease, and intraabdominal extranodal cases were more likely to have regional lymphadenopathy (n = 4) and distant metastases (n = 5). Hypervascularity was seen in 90.0% (18/20) of patients and progressive enhancement was seen in 11 (78.6%) of 14 tumors with multiphase imaging. CONCLUSION. FDCS is a rare, mostly solitary, well-delineated malignancy. A nodal-type FDCS typically presents as a small homogeneous mass, whereas an extranodal FDCS in the mediastinum or abdomen manifests as a large heterogeneous mass with internal necrosis and calcifications accompanied by regional lymphadenopathy. Hypervascularity and progressive enhancement can be seen in the majority of tumors.Background Extensive lymphatic malformations (LM) may cause substantial morbidity. The mTOR (mammalian target of rapamycin) inhibitor sirolimus shows promise for treating vascular anomalies, though response assessment is not standardized. Objective To retrospectively characterize changes on MRI in extensive LM in children treated with sirolimus. Methods Twenty-five children treated with sirolimus for extensive LM were included. Baseline MRI was defined as MRI closest to therapy initiation; follow-up MRI was defined as most recent MRI while on therapy. Two pediatric radiologists independently determined MRI lesion volume by tracing lesion contours on all slices (normalized to patient body mass index) and signal by placing an ROI on lesions' dominant portion (normalized to CSF signal), on baseline and follow-up T2-weighted sequences. Inter-reader agreement was determined, and values averaged for further analysis. Volume and signal changes were compared with patient, lesion, and therapy characteristics. Results Mean (±SD) interval between sirolimus initiation and follow-up MRI was 22.1±13.8 months. Mean lesion volume index on baseline and follow-up MRI was 728 mL/m2 ± 970 mL/m2 and 345 mL/m2±501 mL/m2, respectively (p.05). Inter-reader agreement for volume index change was excellent [intraclass correlation coefficient (ICC)=0.983] and for signal ratio change was moderate-good (ICC=0.764). Conclusion Sirolimus treatment for extensive LM in children is associated with significant reductions in volume and signal on T2-weighted MRI. The volume decrease is greater in younger children and craniocervical lesions. Clinical Impact The results may facilitate development of standardized MRI-based criteria for assessing pharmacotherapy response of vascular malformations.
The aim of this joint guideline is to provide evidence-based recommendations to practicing physicians and other healthcare providers on definitive-intent chemoradiotherapy for patients with stage II-IVA nasopharyngeal carcinoma (NPC).
The Chinese Society of Clinical Oncology (CSCO) and ASCO convened an expert panel of radiation oncology, medical oncology, surgery, and advocacy representatives. The literature search included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2020. Outcomes of interest included survival, distant and locoregional disease control, and quality of life. Expert panel members used this evidence and informal consensus to develop evidence-based guideline recommendations.
The literature search identified 108 relevant studies to inform the evidence base for this guideline. Five overarching clinical questions were addressed, which included subquestions on radiotherapy (RT), chemotherapy sequence, and concurrent, induction, and adjuvant chemotherapy options.
Evidence-based recommendations were developed to address aspects of care related to chemotherapy in combination with RT for the definitive-intent treatment of stage II to IVA NPC.Additional information is available at www.asco.org/head-neck-cancer-guidelines.
Evidence-based recommendations were developed to address aspects of care related to chemotherapy in combination with RT for the definitive-intent treatment of stage II to IVA NPC.Additional information is available at www.asco.org/head-neck-cancer-guidelines.
Patients presenting with lateral hip pain may pose a difficult diagnostic challenge, as pain can be due to various causes.
The purpose was to identify risk factors and predictors for symptomatic hip abductor tears in a cohort of patients undergoing primary hip arthroscopy for femoroacetabular impingement syndrome. We hypothesized that body mass index (BMI), female sex, age, and presence of chondral damage would be significant predictors of hip abductor pathologies.
Cohort study (diagnosis); Level of evidence, 3.
Data were prospectively collected and retrospectively reviewed. Patients were included if they underwent primary hip arthroscopy between March 2009 and December 2019. Patients with Tönnis grade >1, previous hip conditions, incomplete radiographic data, or open procedures were excluded. All demographic variables, intraoperative measurements, and radiographic measurements were assessed using a bivariate analysis. A stepwise logistic regression was used to determine predictive variables.
In oing hip arthroscopy for femoroacetabular impingement syndrome. This model can be used in support of physical examination and imaging suggestive of hip abductor pathology to preoperatively identify the probability of a symptomatic hip abductor tear in these patients.
This study successfully created a predictive model that identified female sex (OR, 7.41), increasing age (OR, 1.137 for each year), and increased BMI (OR, 1.034 for each unit of BMI) as significant independent predictors of the presence of hip abductor tears in patients undergoing hip arthroscopy for femoroacetabular impingement syndrome. This model can be used in support of physical examination and imaging suggestive of hip abductor pathology to preoperatively identify the probability of a symptomatic hip abductor tear in these patients.
The aging of society continues to progress in Japan. As aging is more pronounced in rural than in urban societies, rehabilitation can contribute to rural elderly patients' discharge to home after hospitalization for various causes. The relationship between rural elderly patients' improvement of motor and cognitive function in relation to activities of daily life (ADL) through rehabilitation and their discharge to home has not been clarified in rural communities. The purpose of this study was to clarify whether an improvement of ADL can enable elderly hospitalized patients to discharge to their homes in a rural community.
This retrospective cohort study included 783 consecutive patients aged over 65 years with frailty and multimorbidity who were admitted with acute diseases and underwent active rehabilitation at a rural community hospital. This study was conducted from April 2016 to March 2020. learn more The following patient data were collected from the electronic medical records age, sex, body mass index, serum albumin, diagnosis on admission, the Charlson Comorbidity Index, living with family or alone, duration of disease from the onset of symptoms to the start of rehabilitation, duration of rehabilitation, care level based on the Japanese insurance system, cognitive and motor components of the functional independence measure (FIM) as the measurement of the level of ADL at both admission and discharge, change in these components of the FIM, and the place to which patients were discharged (home or facility).
