Combination of Reverse Shoulder Prosthesis, Elbow Prosthesis, and Polyetheretherketone: A Modified Total Humeral Replacement for Osteosarcoma Humerus Treatment.

Total humeral replacement is a complex surgery that requires many challenges to overcome such as the weight of the implant material and the shoulder function due to extensive resection of the rotator cuff. Improvements in implants material that is lighter than usual can lead to higher surgery success rates. We present a patient who was diagnosed with osteosarcoma of the right humerus. The patient received 2 cycles of MAP chemotherapy (included: doxorubicin, cisplatin, and methotrexate) before surgery. He underwent radical resection of osteosarcoma and total humerus replacement with a modified total humeral material. The purpose of this improvement was to reduce the implant's weight and to improve postoperative recovery. Six months after the surgery, the weight-bearing ability of the patient's shoulder within a wide range of movement has restored; the shoulder, elbow, and hand can move in a controlled way. Despite the short postoperative follow-up time, the improvement in the modified technique has brought many positive results. Total humerus replacement, which combines the reverse shoulder prosthesis, elbow prosthesis, and polyetheretherketone, is an appropriate solution for patients with osteosarcoma of the humerus instead of custom-made humerus megaprosthesis.

Characteristics of Agencies Providing Support Services for Children with Autism Spectrum Disorders in Vietnam.

As in virtually all countries, in Vietnam there has been a general trend towards apparent increased rates of Autism Spectrum Disorder (ASD). To address the needs of families and children with ASD, many agencies providing support services have been opened throughout Vietnam over the last two decades. Although agencies in general appear to strive to provide good quality service, the actual quality of operations is unknown. The present article collected and analyzed secondary data from 68 agencies across Vietnam from different information sources, using the nine criteria published by Tran, Weiss, and Pham (in press) [1] and Nguyen, Hoang, Nguyen, Pham, and Tran (2017) [2] to evaluate agency quality. Results of this review suggest that a significant number of centers do not have appropriate legal status, are not following basic ethical standards, are using non-evidence based intervention methods, and are unclear in regards to the intervention procedures or intervention plans they use. Although the current study has a number of limitations, it provides important initial information regarding the current status of ASD services in Vietnam.