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Klippel–Trenaunay syndrome and complex venous malformations: Should multimodality approach be standard of care?
Published in Byung-Boong Lee, Peter Gloviczki, Francine Blei, Jovan N. Markovic, Vascular Malformations, 2019
Dermal VMs are best treated with foam sclerotherapy (Figure 85.7). We prefer using polidocanol (POL) 0.5% foam for this purpose. POL foam is injected into the target vessels either under ultrasound guidance or by direct visualization. POL is less likely to cause pigmentation or ulceration when used to treat intradermal vessels. The treatment can be optimized and potentiated when tumescent fluid is infiltrated in the perivenous space.6 This provides an internal compression that helps with better closure of target veins. Vascular lasers cannot achieve resolution of dermal VMs and should only be reserved for CMs.
Hormonal Regulation of Gene Transcription
Published in Gerald M. Kolodny, Eukaryotic Gene Regulation, 2018
In chick oviduct, both estrogens and progesterone (P) elevate endogenous Pol activities.72–76 Results using the former class of steroids are discussed later. While Ρ apparently enhances Pol II activity in immature chick oviduct,72 it does not have clear-cut effects when given to chicks pretreated with, and then withdrawn from, estrogen.76 In other systems, steroids activate both Pol I and II; for example, these effects are achieved by Ε in chick liver,77 by C and cortisone in rat liver,78–80 by testosterone (T) in rat prostate,81,82 by la,25-dihydroxyvitamin D3 in chick intestine,83 and by dexa-methasone (Dex) in rat thymus cells.84,85 In the latter two cases, no effect on Pol I is seen, and in thymus cells, the Pol II response is rapid (ten minutes after hormone). Growth hormone,56,86 thyroid hormones87,88 and insulin89 also modulate RNA polymerases.
Venous anatomy and pathophysiology
Published in Helane S Fronek, The Fundamentals of Phlebology: Venous Disease for Clinicians, 2007
Forty-four percent of combination-treated areas completely resolved. There appeared to be little difference in efficacy and adverse sequelae with concentrations of POL between 0.25% and 0.75%. There did appear to be greater improvement with laser energies of 7.5-7.75 J/cm2. As with the FLPDL alone, treatment site did not appear to significantly affect outcome, except for an increased incidence of complications in the ankle and knee areas.
Pembrolizumab as a single agent for patients with MSI-H advanced endometrial carcinoma
Published in Expert Review of Anticancer Therapy, 2022
Margherita Turinetto, Valentina Lombardo, Carmela Pisano, Lucia Musacchio, Sandro Pignata
Over the next few years, the treatment of EC will shift away from the exclusive use of CT to more modern therapy, including targeted therapy and immunotherapy, both in the early and advanced settings of the disease. While histology and staging still play a major role in defining the therapeutic algorithm in the early phase of the disease, a molecular-driven treatment based on the genetic alterations found in the specimen promises to be more effective. Trials are ongoing in the adjuvant setting (RAINBO trials), in which high-risk EC patients are assigned to adjuvant treatment according to their mutational status. POL-E mutated patients will be randomized to receive either external beam radiation therapy (RT) or active surveillance; P53 mutated patients will receive CT-RT followed by a PARP inhibitor (olaparib) or placebo; MSI-H patients will be randomized into receiving external beam RT with or without ICI (durvalumab). NSMP-copy number low patients will receive either CT-RT or RT followed by progestogens.
Discovery of caisson disease: a dive into the history of decompression sickness
Published in Baylor University Medical Center Proceedings, 2022
Scott Ninokawa, Kristen Nordham
Triger’s caisson was adopted throughout France for various mining projects, and Triger himself continued to use the system to complete other small projects throughout the region. He was unique among employers of his time, as he paid close attention to the safety and well-being of his workers, as is demonstrated by his personal testing of working conditions before each shift. As such, he hired two physicians, B. Pol and T. J. J. Watelle, to oversee the medical needs of his future projects utilizing the caisson. In addition to performing preemployment physicals, Pol and Watelle would monitor and care for the 64 laborers at one of Triger’s next projects in Northern France. The Douchy project was reportedly conducted at pressures 3.5 times the normal atmospheric pressure, and Pol and Watelle noted dyspnea, arthralgia, pruritus, and myalgias in many of the workers upon exiting the caisson.6 Pol himself was stricken with caisson disease and only recovered after a night of severe chest pain, paralysis, emesis, and dyspnea.7
Does Self-Change Occur Among Severely Dependent Substance Users?
Published in Journal of Psychoactive Drugs, 2020
Gila Chen, Keren Gueta, Natti Ronel
The relationship between severity of substance dependence, younger age, and using cannabis, raises concerns about the potential adverse effects associated with cannabis use, which researchers tend to treat as a normative phenomenon. Second, the severity of psychiatric problems among the TC group with a history of child abuse requires treatment intervention. The present findings suggest a challenge to the traditional belief that it is generally the severity of substance dependence that determines the need for treatment intervention (Carballo et al. 2007). In our case, this did not seem to be the case. Severity of substance dependence did not differentiate between the groups, but the severity of psychiatric problems and a history of CAN did. Indeed, previous research has confirmed a strong association of child abuse with adolescent mental health problems and SU dependence (Oshri et al. 2011). Furthermore, previous studies have suggested that treatment-seeking facilitators include, among others, early onset of cannabis use and comorbid mental disorders (Arendt and Munk-Jorgensen 2004; Gates et al. 2012). Thus, in similar research studies, van der Pol and her associates found that (a) the mental health conditions of dependent frequent cannabis patients were worse, and (b) comorbid mental disorders were more prevalent among the treatment-seeking patients than the non-treatment seeking cannabis users (van der Pol et al. 2013a, 2013b). To conclude, treatment intervention targeting all three issues of childhood trauma, SUDs, and psychiatric problems is required.