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Alternative Therapies in Health and... May 2024To explore the interrelations among self-tolerance, self-management, emotional states, and cancer-related bone metastatic pain and to understand how these factors...
OBJECTIVE
To explore the interrelations among self-tolerance, self-management, emotional states, and cancer-related bone metastatic pain and to understand how these factors collectively influence patient outcomes.
METHODS
We conducted a study with 160 inpatients suffering from cancer-related bone metastatic pain. The study spanned from June 2022 to June 2023. Using validated instruments, we collected comprehensive clinical data and assessed participants for self-tolerance, self-management, emotional states, and pain levels.
RESULTS
The study found no significant differences in self-tolerance, self-management, emotional state, and pain across different cancer types, genders, and stages (P > .05). Notably, self-tolerance showed a negative correlation with self-management (r = -0.51, P < .001) and a positive correlation with emotional state (r = 0.266, P = .001) and pain (r = 0.34, P < .001). The standardized path coefficient values from the chain relationship model were significant, such as the impact of emotional state on pain (0.166, P = .023) and self-management on pain (-0.291, P < .01).
CONCLUSION
The pain of cancer bone metastases is related to self-tolerance, negative emotion, and self-management. Self-tolerance can directly affect pain and can also affect pain through the chain relationship between negative emotion and self-management. The pain of cancer bone metastases is related to self-tolerance, negative emotion, and self-management. Self-tolerance can directly affect pain and can also affect pain through the chain relationship between negative emotion and self-management.
PubMed: 38758142
DOI: No ID Found -
Ear, Nose, & Throat Journal May 2024The parapharyngeal space has been described as an inverted pyramid shape with the base of the skull and the great cornu of the hyoid bone at the top. Tumors of the...
The parapharyngeal space has been described as an inverted pyramid shape with the base of the skull and the great cornu of the hyoid bone at the top. Tumors of the parapharyngeal space account for 0.5% of head and neck tumors and a wide range of tumor types can occur in this area, 80% of which are benign, the most common being pleomorphic adenomas of the salivary glands and neurogenic tumors. We present a 39-year-old woman who was hospitalized due to left-sided neck pain with a feeling of blockage in the left ear and hearing loss for 10 months. Imaging showed that the mass was not connected to the cranium and the patient underwent surgical resection via a transoral approach, where the contents of the mass were found to be cerebrospinal fluid, and meningocele in the parapharyngeal space is a rare occurrence. The patient presented mainly with painful symptoms, which were eventually relieved by nerve block therapy.
PubMed: 38757650
DOI: 10.1177/01455613241249094 -
Frontiers in Immunology 2024Pulmonary sarcomatoid carcinoma (PSC) is a rare subtype of non-small-cell lung cancer (NSCLC), which is resistant to chemotherapy and radiotherapy with a poor prognosis....
BACKGROUND
Pulmonary sarcomatoid carcinoma (PSC) is a rare subtype of non-small-cell lung cancer (NSCLC), which is resistant to chemotherapy and radiotherapy with a poor prognosis. PSC is highly malignant and is prone to recurrence even after surgery. The programmed death-ligand 1 (PD-L1) tumor cell proportion score (TPS) 5%, TERT and TP53 gene mutations were detected in this patient accompanied by multiple metastatic sites. The anlotinib is a novel multitarget tyrosine kinase inhibitor (TKI) that could be effective for advanced NSCLC and some sarcoma patients. Limited clinical trials and case reports have shown that PSC patients with gene mutations and PD-L1 expression have good responses to multitarget antiangiogenic drug and immune checkpoint inhibitors (ICIs). In this article, we reported a case with metastatic PSC diagnosed by Computed Tomography (CT)-guided needle biopsy treated with immunotherapy combined with antiangiogenic drugs as a neoadjuvant chemotherapy (NACT). PSC is controlled and the patient achieves successfully limb salvage treatment by surgical resection. Therefore, targeted therapy and immunotherapy can provide sufficient surgical opportunities for limb salvage in the treatment of metastatic PSC patients.
CASE SUMMARY
A 69-year-old male diagnosed with malignant bone tumor in the proximal femur was admitted to our hospital in June 2022 with recurrent fever as well as swelling and pain in the left thigh for twenty days. The initial computed tomography (CT) scan of the chest showed a pulmonary cavity (20 mm × 30 mm) and scattered lung masses. Subsequently, he underwent a CT-guided needle biopsy to distinguish the essence of osteolytic bone destruction and soft tissue mass in the left proximal femur which showed metastatic sarcomatoid carcinoma histology. Genetic testing revealed TERT c.-124C mutation (abundance 8.81%), TP53 p.R342 mutation (abundance 11.35%), tumor mutational burden (TMB) 7.09 muts/Mb, microsatellite stability (MSS), and PD-L1 (SP263) TPS 5% were also detected. The patient was tentatively treated with a combination of antiangiogenic drug and PD-1 inhibitor. After one course, the tumor volume significantly reduced in magnetic resonance imaging (MRI) and pathological fracture occurred in the femur after combined treatment. The patient received proximal femoral tumor resection and prosthesis replacement after defervescence. Sequentially sintilimab with anlotinib were administered for over 1 year. Finally, the local tumor was well controlled, and no obvious drug-related adverse reactions were observed. The lesions in the lung remained in partial response (PR) for more than 16 months and complete response (CR) of metastatic tumor in the proximal femur was observed through imaging examinations.
CONCLUSION
This is the first reported case of a metastatic PSC in femur showing a favorable response to the treatment consisting of anlotinib combined with sintilimab. This case suggests that antiangiogenic therapy combined with immunotherapy may benefit patients with metastatic PSC in the preoperative adjuvant therapy for limb salvage.
Topics: Humans; Antibodies, Monoclonal, Humanized; Bone Neoplasms; Lung Neoplasms; Quinolines; Neoadjuvant Therapy; Male; Indoles; Antineoplastic Combined Chemotherapy Protocols; Carcinoma, Non-Small-Cell Lung; Aged; Treatment Outcome; Immune Checkpoint Inhibitors
PubMed: 38756778
DOI: 10.3389/fimmu.2024.1372279 -
International Journal of Dentistry 2024The authors of this study proposed an innovative approach involving the use of Biodentine™ material as an intraorifice barrier in cracked teeth with root extension to...
PURPOSE
The authors of this study proposed an innovative approach involving the use of Biodentine™ material as an intraorifice barrier in cracked teeth with root extension to promote internal crack sealing, preventing the possibility of microinfiltration and apical crack propagation.
MATERIALS AND METHODS
The dental records of 11 patients with 12 posterior cracked teeth with root extension were included with a precise protocol performed by a senior endodontist. The treatment protocol included pulp diagnosis, crack identification using a dental operating microscope (DOM), endodontic treatment, placing a Biodentine™ as an intraorifice barrier, and immediate full-coverage restoration. The effectiveness of the treatment was assessed at two intervals, 6 months, and 1-3 years posttreatment, evaluating clinical, radiographic, and tomographic aspects. The treatment was deemed successful if there were no indications of radiolucency, sinus tracts, edema, or periodontal pockets associated with the crack line.
RESULTS
The study observed remarkably positive outcomes during the follow-up period, which spanned from 1 to 3 years. All the cracked teeth (100%) remained asymptomatic, meaning they were free of pain or discomfort. Furthermore, these teeth were in occlusal function. Both radiographic and tomographic assessments revealed the absence of bone loss along the crack line. This outcome signifies that the treatment effectively prevented further deterioration of the surrounding bone.
CONCLUSIONS
Integrating advanced biomaterials and conservative restorative techniques has paved the way for innovative approaches in dental care. This protocol suggests a proactive step for managing cracked teeth with root extension. It addresses both biological aspects by sealing internal cracks and mechanical aspects by preventing crack progression, thereby improving these teeth' prognosis and long-term survival.
PubMed: 38756384
DOI: 10.1155/2024/2234648 -
Frontiers in Surgery 2024Delayed union and non-union of fractures continue to be a major problem in trauma and orthopedic surgery. These cases are challenging for the surgeon. In addition, these... (Review)
Review
Delayed union and non-union of fractures continue to be a major problem in trauma and orthopedic surgery. These cases are challenging for the surgeon. In addition, these patients suffer from multiple surgeries, pain and disability. Furthermore, these cases are a major burden on healthcare systems. The scientific community widely agrees that the stability of fixation plays a crucial role in determining the outcome of osteosynthesis. The extent of stabilization affects factors like fracture gap strain and fluid flow, which, in turn, influence the regenerative processes positively or negatively. Nonetheless, a growing body of literature suggests that during the fracture healing process, there exists a critical time frame where intervention can stimulate the bone's return to its original form and function. This article provides a summary of existing evidence in the literature regarding the impact of different levels of fixation stability on the strain experienced by newly forming tissues. We will also discuss the timing and nature of this "window of opportunity" and explore how current knowledge is driving the development of new technologies with design enhancements rooted in mechanobiological principles.
PubMed: 38756355
DOI: 10.3389/fsurg.2024.1376441 -
Zhong Nan Da Xue Xue Bao. Yi Xue Ban =... Feb 2024Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease that is prevalent in middle-aged and elderly women, characterized by dry mouth, dry eyes, fatigue, and... (Review)
Review
Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease that is prevalent in middle-aged and elderly women, characterized by dry mouth, dry eyes, fatigue, and joint pain. Nearly one-third pSS patients have been suffering with osteoporosis (OP), displaying symptoms of lumbago, back pain, and even fracture, all of which severely affect their life quality. Common risk factors for pSS and OP include gender and age, persistent state of inflammation, immune disorders, intestinal flora imbalance, vitamin D deficiency, dyslipidemia and sarcopenia. Meanwhile, the comorbidities of pSS, such as renal tubular acidosis, primary biliary cholangitis, autoimmune thyroid diseases, and drugs (glucocorticoids, methotrexate, and cyclophosphamide) are unique risk factors for pSS complicated with OP. Education, guidance of healthy lifestyle, and OP screening are recommended for bone management of pSS patients. Early detection and intervention are crucial for keeping bone health and life quality in pSS patients.
Topics: Humans; Sjogren's Syndrome; Osteoporosis; Risk Factors; Female; Comorbidity; Vitamin D Deficiency; Quality of Life
PubMed: 38755728
DOI: 10.11817/j.issn.1672-7347.2024.230295 -
BMC Surgery May 2024Fractures involving the posterior acetabulum with its rich vascular and neural supply present challenges in trauma orthopedics. This study evaluates the effectiveness of...
Surgical treatment outcomes of acetabular posterior wall and posterior column fractures using 3D printing technology and individualized custom-made metal plates: a retrospective study.
BACKGROUND
Fractures involving the posterior acetabulum with its rich vascular and neural supply present challenges in trauma orthopedics. This study evaluates the effectiveness of 3D printing technology with the use of custom-made metal plates in the treatment of posterior wall and column acetabular fractures.
METHODS
A retrospective analysis included 31 patients undergoing surgical fixation for posterior wall and column fractures of the acetabulum (16 in the 3D printing group, utilizing 3D printing for a 1:1 pelvic model and custom-made plates based on preoperative simulation; 15 in the traditional group, using conventional methods). Surgical and instrument operation times, intraoperative fluoroscopy frequency, intraoperative blood loss, fracture reduction quality, fracture healing time, preoperative and 12-month postoperative pain scores (Numeric Rating Scale, NRS), hip joint function at 6 and 12 months (Harris scores), and complications were compared.
RESULTS
The surgical and instrument operation times were significantly shorter in the 3D printing group (p < 0.001). The 3D printing group exhibited significantly lower intraoperative fluoroscopy frequency and blood loss (p = 0.001 and p < 0.001, respectively). No significant differences were observed between the two groups in terms of fracture reduction quality, fracture healing time, preoperative pain scores (NRS scores), and 6-month hip joint function (Harris scores) (p > 0.05). However, at 12 months, hip joint function and pain scores were significantly better in the 3D printing group (p < 0.05). Although the incidence of complications was lower in the 3D printing group (18.8% vs. 33.3%), the difference did not reach statistical significance (p = 0.433).
CONCLUSION
Combining 3D printing with individualized custom-made metal plates for acetabular posterior wall and column fractures reduces surgery and instrument time, minimizes intraoperative procedures and blood loss, enhancing long-term hip joint function recovery.
CLINICAL TRIAL REGISTRATION
12/04/2023;Trial Registration No. ChiCTR2300070438; http://www.chictr.org.cn .
Topics: Humans; Printing, Three-Dimensional; Retrospective Studies; Acetabulum; Male; Female; Bone Plates; Adult; Middle Aged; Fracture Fixation, Internal; Treatment Outcome; Fractures, Bone; Operative Time; Young Adult; Prosthesis Design; Aged
PubMed: 38755649
DOI: 10.1186/s12893-024-02451-x -
BMJ Open May 2024The objective of this study is to determine research priorities for the management of major trauma, representing the shared priorities of patients, their families,...
OBJECTIVE
The objective of this study is to determine research priorities for the management of major trauma, representing the shared priorities of patients, their families, carers and healthcare professionals.
DESIGN/SETTING
An international research priority-setting partnership.
PARTICIPANTS
People who have experienced major trauma, their carers and relatives, and healthcare professionals involved in treating patients after major trauma. The scope included chest, abdominal and pelvic injuries as well as major bleeding, multiple injuries and those that threaten life or limb.
METHODS
A multiphase priority-setting exercise was conducted in partnership with the James Lind Alliance over 24 months (November 2021-October 2023). An international survey asked respondents to submit their research uncertainties which were then combined into several indicative questions. The existing evidence was searched to ensure that the questions had not already been sufficiently answered. A second international survey asked respondents to prioritise the research questions. A final shortlist of 19 questions was taken to a stakeholder workshop, where consensus was reached on the top 10 priorities.
RESULTS
A total of 1572 uncertainties, submitted by 417 respondents (including 132 patients and carers), were received during the initial survey. These were refined into 53 unique indicative questions, of which all 53 were judged to be true uncertainties after reviewing the existing evidence. 373 people (including 115 patients and carers) responded to the interim prioritisation survey and 19 questions were taken to a final consensus workshop between patients, carers and healthcare professionals. At the final workshop, a consensus was reached for the ranking of the top 10 questions.
CONCLUSIONS
The top 10 research priorities for major trauma include patient-centred questions regarding pain relief and prehospital management, multidisciplinary working, novel technologies, rehabilitation and holistic support. These shared priorities will now be used to guide funders and teams wishing to research major trauma around the globe.
Topics: Humans; Health Priorities; Surveys and Questionnaires; Research; Multiple Trauma; Wounds and Injuries; Caregivers; Health Personnel; Female; Male
PubMed: 38754886
DOI: 10.1136/bmjopen-2023-083450 -
PloS One 2024Trapeziometacarpal osteoarthritis (TMC-OA) reduces the range of motion (ROM) of the thumb. However, the kinematic change achieved through surgical treatment remains... (Comparative Study)
Comparative Study
Three-dimensional motion analysis of pre- and postoperative thumb movement in trapeziometacarpal joint osteoarthritis-Comparison of arthrodesis and trapeziectomy with suspensionplasty.
Trapeziometacarpal osteoarthritis (TMC-OA) reduces the range of motion (ROM) of the thumb. However, the kinematic change achieved through surgical treatment remains unclear. Therefore, to quantify the kinematic change following TMC-OA surgery, we performed a three-dimensional motion analysis of the thumb using an optical motion capture system preoperatively and 1 year postoperatively in 23 patients with TMC-OA scheduled for arthrodesis (AD) or trapeziectomy with suspensionplasty (TS). Eighteen hands of nine healthy volunteers were also included as controls. Both procedures improved postoperative pain and Disability of the Arm, Shoulder and Hand scores, and AD increased pinch strength. The ROM of the base of the thumb was preserved in AD, which was thought to be due to the appearance of compensatory movements of adjacent joints even if the ROM of the TMC joint was lost. TS did not improve ROM. Quantifying thumb kinematic changes following TMC-OA surgery can improve our understanding of TMC-OA treatment and help select surgical procedures and postoperative assessment.
Topics: Humans; Osteoarthritis; Female; Thumb; Male; Middle Aged; Arthrodesis; Range of Motion, Articular; Aged; Trapezium Bone; Biomechanical Phenomena; Carpometacarpal Joints; Movement; Adult; Postoperative Period
PubMed: 38753715
DOI: 10.1371/journal.pone.0302898 -
Clinical Interventions in Aging 2024To study the related factors of frailty and quality of life in elderly patients after spinal surgery.
BACKGROUND
To study the related factors of frailty and quality of life in elderly patients after spinal surgery.
METHODS
The anxiety, depression, frailty, and quality of life of all patients were assessed by the Anxiety screening scale (GAD-7), Depression screening scale (PHQ-9), Frailty screening scale (FRAIL), and European five-dimensional health scale (EQ-5D-5L) 1 day before surgery (DAY-0). A numeric rating scale (NRS) was used to evaluate patients' pain during activities on the 1st day (POD-1), 3rd day (POD-3), and 30th day (POD-30) after operation. FRAIL scale and EQ-5D-5L were used to evaluate patients' frailty and quality of life on POD-30 and 90th day (POD-90) after the operation.
RESULTS
There were significant differences in age, body mass index (BMI), preoperative serum albumin level (ALB), and NRS score on POD-1 between the two groups (P<0.05). Age and PHQ-9 score were positively correlated with EQ-5D-5L score (P<0.05, r =0.245, r=0.217), and preoperative ALB level was negatively correlated with EQ-5D-5L score (P<0.05, r =-0.274).
CONCLUSION
The older the age, the larger the BMI and the higher the NRS score on the first day after surgery, the more prone to frailty in elderly patients after spinal surgery; The older age and the lower the preoperative ALB level, the worse the quality of life in elderly patients after spinal surgery.
Topics: Humans; Quality of Life; Aged; Male; Female; Frailty; Depression; Anxiety; Aged, 80 and over; Frail Elderly; Body Mass Index; Geriatric Assessment; Spine; Middle Aged
PubMed: 38751856
DOI: 10.2147/CIA.S453830