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Palliative Care for Adults
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Christopher M. Wilson, Amy J. Litterini
In order to best synthesize these abstract and arbitrary stages, they will be detailed utilizing a patient case and discussing his physical, psychosocial, functional, and emotional states. Although specific therapist interventions and procedures will not be detailed in order to focus on the progressive disease stages, readers are encouraged to consider how, where, and which of the therapist’s skills would be beneficial in each of the stages. See Figure 1.4 for the depiction and overview of these stages.
Cancer as a Chronic Disease
Published in Paloma Tejero, Hernán Pinto, Aesthetic Treatments for the Oncology Patient, 2020
Advances in oncology have managed to turn cancer into a chronic condition, increasing survival and quality of life, but it also often remains an incurable disease. We must bear in mind that many, even most, patients will present a progressive disease despite the treatments, especially in the final stages, where most therapies will be ineffective and only worsen the patient's situation. They may also have uncontrolled symptoms or intolerable side effects that may need attention. Patients could also reject continuation of therapy, as an informed choice, and doctors need to be able to accept and allow these decisions. For these reasons, palliative care and symptom control must be an integral part of the disease from the early stages.
Choroid Plexus Tumors and Meningiomas
Published in David A. Walker, Giorgio Perilongo, Roger E. Taylor, Ian F. Pollack, Brain and Spinal Tumors of Childhood, 2020
Kenneth K. Wong, Elwira Szychot, Jennifer A. Cotter, Mark Krieger
When progesterone receptors were described in meningiomas, mifepristone, an antiprogesterone agent, was evaluated in adults and showed modest positive response in a minority of patients in several single-arm trials.192,193 In contrast, tamoxifen, an antiestrogen agent, did not demonstrate efficacy in phase II trials. Most patients developed progressive disease.194,195 Finally, a phase III randomized controlled trial assessed the impact of mifepristone on overall and progression-free survival in progressive or recurrent meningioma.196 However, the trial showed no statistical differences between the two treatment arms.
Predictors of early progression after curative resection followed by platinum-based adjuvant chemoradiotherapy in oral cavity squamous cell carcinoma
Published in Postgraduate Medicine, 2021
Hsueh-Ju Lu, Szu-Wen Tseng, Chih-Yu Peng, Hsien-Chun Tseng, Chung-Han Hsin, Hsin-Lin Chen, Wei-Shiou Huang, Ming-Fang Wu, Muh-Hwa Yang, Peter Mu-Hsin Chang
To avoid the challenge of differentiating between locoregional recurrence and secondary primary tumors [26], only patients with newly diagnosed OCSCC were enrolled. Patients who were previously diagnosed with or treated for HNSCC, and those who had a combination of secondary primary malignancies were excluded. Additionally, all patients had undergone curative surgical resection and platinum-based adjuvant CRT after diagnosis. When given uniform treatment courses, treatment recommendations for progressive disease may be instituted, especially for patients with early progression, who require prompt treatment [8]. The tumor biology of patients with early progression may be aggressive [27,28]; therefore, only immune checkpoint therapy was recommended in these cases after disease progression [7,8]. Alternatively, next-generation sequencing may provide detailed genetic information to optimize the prediction rate of this model. However, given the easy accessibility of the scoring system in clinical practice, we were prompted to enhance it.
The assessment of serum ACE activity in COVID-19 and its association with clinical features and severity of the disease
Published in Scandinavian Journal of Clinical and Laboratory Investigation, 2021
Aslihan Avanoglu Guler, Nezrin Tombul, Pınar Aysert Yıldız, Hasan Selçuk Özger, Kenan Hızel, Ozlem Gulbahar, Abdurrahman Tufan, Gonca Erbaş, Gülbin Aygencel, Ozlem Guzel Tunçcan, Murat Dizbay, Mehmet Akif Öztürk
Several studies and reports have revealed that COVID-19 is characterized by the dysregulation of immune cell subsets, exaggerated inflammation, and hypercytokinemia, all of which have been correlated with disease severity and lung injury [18]. The specific factors that drive progressive disease have not been clarified yet. A previous study has demonstrated that the downregulated ACE2 expression and increased Ang II production by SARS-CoV infection resulted in severe lung injury [17]. This result might be associated with disequilibrium between ACE and ACE2 activity. However, this condition yet to be demonstrated for SARS-CoV-2 considering similarities and dissimilarities between two viruses [37,38]. Another finding from an acute lung injury model is the enhanced disease progression with ACE mediated Ang II production [22]. Besides, ACE deletion (D) polymorphism, which is associated with a higher ACE activity, is frequently observed in ARDS [39]. Moreover, a considerably higher frequency of D allele polymorphism was observed in SARS patients who require oxygen treatment compared to non-hypoxemic counterparts [40].
Comparison between surgery and thermal ablation for adrenal metastases: a retrospective study
Published in International Journal of Hyperthermia, 2021
Lin Xie, Han Qi, Fei Cao, Lujun Shen, Shuanggang Chen, Ying Wu, Tao Huang, Ze Song, Weijun Fan
The median follow-up was 29.0 months (range, 20.4 − 37.6 months). During follow-up, local progression occurred in 14 patients in the ablation group and 20 patients in the SR group. The 1-, 3- and 5-year LPFS rates were 74.0%, 62.8%, and 31.4% in the SR group, and 72.8%, 68.7%, and 51.5% in the ablation group, with the median LPFS of 41.5 months (95% CI 9.3–23.4 months) vs. 47.9 months (95% CI 20.6–75.8 months), respectively (p = 0.784) (Figure 3). The LTP rate in the ablation group was similar to that in the SR group (24.6% vs. 26.3%, p = 0.819) (Figure 4). Distant metastases occurred in 31 patients after ablation and in 49 patients after surgery. The distant metastasis occurrence rate in the ablation group was similar to that in the SR group (54.4% vs. 64.5%, p = 0.240). For patients with recurrent or progressive disease, various types of treatments, including chemotherapy, targeted drug therapy, and best supportive care, were performed. Univariate analysis revealed that age <65 years (p = 0.097) and tumor size ≥3 cm (p = 0.027) were associated with LPFS. Multivariate analysis showed that tumor size ≥3 cm was an independent prognostic factor for LPFS with a significant difference (p = 0.031) (Table 2). There was no significant difference in LPFS between MWA, RFA, and CA (p = 0.725).