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1.
Int Wound J ; 21(6): e14907, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38822706

ABSTRACT

Recent randomised controlled trials (RCTs) have investigated the analgesic activity of sesame oil among patients with limb trauma; nevertheless, their findings are inconsistent. Hence, this review aimed to clarify the impact of topical administration of sesame oil on acute pain of adult outpatients with minor limb trauma. The online databases (e.g., Scopus, PubMed, Web of Science) were searched up to 31 January 2024. The RCTs were included if they compared the effect of applying standard treatments plus topical sesame oil to administering standard treatments alone or with a placebo/sham treatment. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) and the Cochrane Collaboration's risk of bias tool were applied to address the evidence quality and the study's methodological rigour, respectively. Four RCTs had the inclusion criteria, and their findings were pooled in a meta-analysis employing a random-effects approach. According to the pooled analysis, the reduction in mean change of the pain score from baseline to the second/third intervention day was significantly higher in favour of clients who received standard care plus daily massage of the trauma site with sesame oil compared to those who received a control condition (weighted mean difference: -1.10; 95% confidence interval [-1.62, -0.57]; p < 0.001). However, the evidence quality was moderate, and only two studies had good methodological rigour. Hence, more high-quality studies are needed to make a solid evidence-based conclusion about the favourable consequence of topical sesame oil on alleviating acute traumatic limb pain.


Subject(s)
Administration, Topical , Randomized Controlled Trials as Topic , Sesame Oil , Humans , Sesame Oil/therapeutic use , Sesame Oil/administration & dosage , Pain Management/methods , Pain Management/standards , Adult , Female , Male , Analgesics/administration & dosage , Analgesics/therapeutic use , Pain Measurement/methods , Middle Aged , Extremities/injuries
2.
Yakugaku Zasshi ; 144(6): 685-690, 2024.
Article in English | MEDLINE | ID: mdl-38825477

ABSTRACT

Docetaxel (DTX) is a key drug used in perioperative chemotherapy for breast cancer. Edema is a known adverse effect of DTX, but its effect on health-related QOL (HRQOL) is unclear. In this study, we evaluated the effects of edema caused by administration of DTX on HRQOL in patients with early-stage breast cancer. We prospectively investigated patients diagnosed with early-stage breast cancer (stage I-III) who received 4 cycles of DTX as preoperative or postoperative chemotherapy between September 2021 and December 2022 at Yamanashi Prefectural Central Hospital. The circumference of each extremity was measured at each administration of DTX, and limb edema was evaluated by Common Terminology Criteria for Adverse Events version 5.0. HRQOL was evaluated using SF-12 version 2, which has a range of 0-100 (national standard, 50), and compared between the presence and absence of grade 2 or higher edema and between before and after administration of DTX. Twenty patients met the eligibility criteria and were included in the study. There was no difference in the HRQOL score according to whether grade 2 limb edema was present. The median HRQOL summary scores before and after administration of DTX were 51.1 and 50.8 (p=0.763), respectively, for mental health, 52.6 and 49.4 (p=0.005) for physical health, and 38.9 and 37.5 (p=1.000) for role/social health. We found no direct effect of DTX-induced limb edema on HRQOL in patients with early-stage breast cancer. However, HRQOL summary scores indicated that administration of DTX reduced physical health in these patients.


Subject(s)
Breast Neoplasms , Docetaxel , Edema , Quality of Life , Humans , Docetaxel/adverse effects , Docetaxel/administration & dosage , Breast Neoplasms/drug therapy , Female , Prospective Studies , Middle Aged , Edema/chemically induced , Edema/etiology , Aged , Neoplasm Staging , Adult , Extremities , Antineoplastic Agents/adverse effects , Perioperative Care
3.
Cell Mol Biol (Noisy-le-grand) ; 70(6): 61-65, 2024 Jun 05.
Article in English | MEDLINE | ID: mdl-38836683

ABSTRACT

This experiment aimed to explore the influence mechanism of external fixator on open fracture. A total of 128 patients with open tibiofibular fractures were included in this study. The patients were randomly divided into external fixator group (n=64) and control group (n=64) according to the order of admission. Double-blind controlled observation was used. The levels of osteocalcin (BGP), ß-CTX, P1 NP, BALP, including haptoglobin (Hp), ceruloplasmin (CER), serum adrenocorticotropic hormone (ACTH), cortisol (COR), C-reactive protein (CRP), white blood cell (WBC) and interleukin-6 (IL-6) were recorded in different groups. The postoperative VAS score and quality of life were recorded. Log-rank was used to analyze the difference in postoperative adverse reaction rates among different groups. External fixation stent treatment increased BGP, PINP, and BALP expression and decreased ß-CTX, Hp, CER, ACTH, COR, CRP, WBC, and IL-6 levels. Patients in the external fixation stent group had significantly lower VAS score quality of life scores and incidence of adverse events than the control group. External fixation stents protect open fracture patients by promoting bone metabolism.


Subject(s)
Bone and Bones , C-Reactive Protein , External Fixators , Osteocalcin , Quality of Life , Humans , Male , Female , Adult , Osteocalcin/blood , Osteocalcin/metabolism , Middle Aged , Bone and Bones/metabolism , C-Reactive Protein/metabolism , Fractures, Open/surgery , Fractures, Open/metabolism , Interleukin-6/blood , Interleukin-6/metabolism , Procollagen/blood , Procollagen/metabolism , Double-Blind Method , Collagen Type I/metabolism , Collagen Type I/blood , Adrenocorticotropic Hormone/blood , Adrenocorticotropic Hormone/metabolism , Peptide Fragments/blood , Extremities/surgery , Extremities/injuries , Peptides , Hydrocortisone/blood
4.
PLoS One ; 19(5): e0298959, 2024.
Article in English | MEDLINE | ID: mdl-38739667

ABSTRACT

Informal caregivers play a significant role in providing care for older, often vulnerable, patients, and supporting them as they live with chronic diseases. Due to the rising prevalence of older vascular patients and their use of healthcare, the role of their informal caregivers will become more important. However, little is known about the experiences of informal caregivers of patients with critical limb-threatening ischemia and the impact of informal care on different aspects of these caregivers' lives. In addition, literature does not describe the burden this role brings with it, or lack thereof. Therefore a qualitative study using a phenomenological approach, specifically interpretive phenomenological analysis, was used to gain insight into the experiences of the primary informal caregivers of patients with chronic limb-threatening ischemia. Data were collected via semi-structured interviews and focus groups discussions. Fifteen primary informal caregivers of patients with critical limb-threatening ischemia under the care of the vascular surgeon at a tertiary teaching hospital in the Netherlands were included. Data analysis yielded three themes: the perceived identity of this group of caregivers; the varying intensity of informal care; and the collaboration between informal carers, their care recipients and the professional care provider within the vascular surgery department. In contrast to carers of other chronic diseases, the shifting intensity of care that informal caregivers of critical limb-threatening ischemia patients experience seems to prevent long-term overload. Adapting to that fluctuating situation requires flexibility from healthcare providers within the vascular surgery department. In addition, professionals need to involve informal caregivers in the patient's decision-making process and recognize their role in that process.


Subject(s)
Caregivers , Ischemia , Qualitative Research , Humans , Caregivers/psychology , Male , Female , Ischemia/psychology , Aged , Middle Aged , Aged, 80 and over , Adult , Netherlands , Extremities/blood supply
5.
Radiat Oncol ; 19(1): 56, 2024 May 14.
Article in English | MEDLINE | ID: mdl-38745333

ABSTRACT

BACKGROUND: Oncologic surgical resection is the standard of care for extremity and truncal soft tissue sarcoma (STS), often accompanied by the addition of pre- or postoperative radiation therapy (RT). Preoperative RT may decrease the risk of joint stiffness and fibrosis at the cost of higher rates of wound complications. Hypofractionated, preoperative RT has been shown to provide acceptable outcomes in prospective trials. Proton beam therapy (PBT) provides the means to decrease dose to surrounding organs at risk, such as the skin, bone, soft tissues, and adjacent joint(s), and has not yet been studied in patients with extremity and truncal sarcoma. METHODS: Our study titled "PROspective phase II trial of preoperative hypofractionated protoN therapy for extremity and Truncal soft tissue sarcOma (PRONTO)" is a non-randomized, prospective phase II trial evaluating the safety and efficacy of preoperative, hypofractionated PBT for patients with STS of the extremity and trunk planned for surgical resection. Adult patients with Eastern Cooperative Group Performance Status ≤ 2 with resectable extremity and truncal STS will be included, with the aim to accrue 40 patients. Treatment will consist of 30 Gy radiobiological equivalent of PBT in 5 fractions delivered every other day, followed by surgical resection 2-12 weeks later. The primary outcome is rate of major wound complications as defined according to the National Cancer Institute of Canada Sarcoma2 (NCIC-SR2) Multicenter Trial. Secondary objectives include rate of late grade ≥ 2 toxicity, local recurrence-free survival and distant metastasis-free survival at 1- and 2-years, functional outcomes, quality of life, and pathologic response. DISCUSSION: PRONTO represents the first trial evaluating the use of hypofractionated PBT for STS. We aim to prove the safety and efficacy of this approach and to compare our results to historical outcomes established by previous trials. Given the low number of proton centers and limited availability, the short course of PBT may provide the opportunity to treat patients who would otherwise be limited when treating with daily RT over several weeks. We hope that this trial will lead to increased referral patterns, offer benefits towards patient convenience and clinic workflow efficiency, and provide evidence supporting the use of PBT in this setting. TRIAL REGISTRATION: NCT05917301 (registered 23/6/2023).


Subject(s)
Extremities , Proton Therapy , Radiation Dose Hypofractionation , Sarcoma , Humans , Proton Therapy/methods , Sarcoma/radiotherapy , Sarcoma/pathology , Prospective Studies , Adult , Female , Male , Soft Tissue Neoplasms/radiotherapy , Soft Tissue Neoplasms/pathology , Soft Tissue Neoplasms/surgery , Preoperative Care , Torso
7.
Biol Lett ; 20(5): 20240097, 2024 May.
Article in English | MEDLINE | ID: mdl-38773927

ABSTRACT

Ostracod crustaceans originated at least 500 Ma ago. Their tiny bivalved shells represent the most species-abundant fossil arthropods, and ostracods are omnipresent in a wide array of freshwater and marine environments today and in the past. Derima paparme gen. et sp. nov. from the Herefordshire Silurian Lagerstätte (~430 Ma) in the Welsh Borderland, UK, is one of only a handful of exceptionally preserved ostracods (with soft parts as well as the shell) known from the Palaeozoic. A male specimen provides the first evidence of the appendages of Binodicopina, a major group of Palaeozoic ostracods comprising some 135 Ordovician to Permian genera. The appendage morphology of D. paparme, but not its shell, indicates that binodicopes belong to Podocopa. The discovery that the soft-part morphology of binodicopes allies them with podocopes affirms that using the shell alone is an unreliable basis for classifying certain fossil ostracods, and knowledge of soft-part morphology is critical for the task. Current assignment of many fossil ostracods to higher taxa, and therefore the evolutionary history of the group, may require reconsideration.


Subject(s)
Biological Evolution , Crustacea , Fossils , Animals , Crustacea/anatomy & histology , Crustacea/classification , Fossils/anatomy & histology , Male , Extremities/anatomy & histology , Animal Shells/anatomy & histology
9.
Am J Crit Care ; 33(3): 226-233, 2024 May 01.
Article in English | MEDLINE | ID: mdl-38688844

ABSTRACT

BACKGROUND: It remains poorly understood why only some hemodynamically unstable patients who receive aggressive treatment with vasopressor medications develop limb necrosis. OBJECTIVE: To determine the incidence of limb necrosis and the factors associated with it following high-dose vasopressor therapy. METHODS: A retrospective case-control medical records review was performed of patients aged 18 to 89 years who received vasopressor therapy between 2012 and 2021 in a single academic medical center. The study population was stratified by the development of limb necrosis following vasopressor use. Patients who experienced necrosis were compared with age- and sex-matched controls who did not experience necrosis. Demographic information, comorbidities, and medication details were recorded. RESULTS: The incidence of limb necrosis following vasopressor administration was 0.25%. Neither baseline demographics nor medical comorbidities differed significantly between groups. Necrosis was present in the same limb as the arterial catheter most often for femoral catheters. The vasopressor dose administered was significantly higher in the necrosis group than in the control group for ephedrine (P = .02) but not for the other agents. The duration of therapy was significantly longer in the necrosis group than in the control group for norepinephrine (P = .001), epinephrine (P = .04), and ephedrine (P = .01). The duration of vasopressin administration did not differ significantly between groups. CONCLUSION: The findings of this study suggest that medication-specific factors, rather than patient and disease characteristics, should guide clinical management of necrosis in the setting of vasopressor administration.


Subject(s)
Necrosis , Vasoconstrictor Agents , Humans , Vasoconstrictor Agents/adverse effects , Vasoconstrictor Agents/administration & dosage , Vasoconstrictor Agents/therapeutic use , Female , Male , Middle Aged , Retrospective Studies , Aged , Necrosis/chemically induced , Adult , Aged, 80 and over , Case-Control Studies , Adolescent , Norepinephrine/adverse effects , Norepinephrine/administration & dosage , Norepinephrine/therapeutic use , Young Adult , Extremities , Incidence , Epinephrine/administration & dosage , Epinephrine/adverse effects , Epinephrine/therapeutic use , Risk Factors
10.
Perfusion ; 39(1_suppl): 23S-38S, 2024 Apr.
Article in English | MEDLINE | ID: mdl-38651584

ABSTRACT

Limb ischaemia is a clinically relevant complication of venoarterial extracorporeal membrane oxygenation (VA ECMO) with femoral artery cannulation. No selective distal perfusion or other advanced techniques were used in the past to maintain adequate distal limb perfusion. A more recent trend is the shift from the reactive or emergency management to the pro-active or prophylactic placement of a distal perfusion cannula to avoid or reduce limb ischaemia-related complications. Multiple alternative cannulation techniques to the distal perfusion cannula have been developed to maintain distal limb perfusion, including end-to-side grafting, external or endovascular femoro-femoral bypass, retrograde limb perfusion (e.g., via the posterior tibial, dorsalis pedis or anterior tibial artery), and, more recently, use of a bidirectional cannula. Venous congestion has also been recognized as a potential contributing factor to limb ischaemia development and specific techniques have been described with facilitated venous drainage or bilateral cannulation being the most recent, to reduce or avoid venous stasis as a contributor to impaired limb perfusion. Advances in monitoring techniques, such as near-infrared spectroscopy and duplex ultrasound analysis, have been applied to improve decision-making regarding both the monitoring and management of limb ischaemia. This narrative review describes the evolution of techniques used for distal limb perfusion during peripheral VA ECMO.


Subject(s)
Extracorporeal Membrane Oxygenation , Femoral Artery , Humans , Extracorporeal Membrane Oxygenation/methods , Perfusion/methods , Catheterization/methods , Ischemia/prevention & control , Ischemia/etiology , Adult , Catheterization, Peripheral/methods , Catheterization, Peripheral/adverse effects , Extremities/blood supply
11.
Ann Med ; 56(1): 2338248, 2024 Dec.
Article in English | MEDLINE | ID: mdl-38590164

ABSTRACT

BACKGROUND/OBJECTIVE(S): Chronic obstructive pulmonary disease (COPD) can precipitate a deterioration of an individual's physical performance and overall health. Evidence suggests that, along with pulmonary functions, several other factors are related to the significant impairment of walking performance in individuals with COPD. This study compared the depressive symptoms, health status, upper and lower extremity functions, and peak oxygen uptake (VO2peak) in a group of individuals with COPD based on walking performance using a cutoff distance of 350 m in the six-minute walking test (6MWT). The study also investigated the associations between these factors and walking performance. MATERIALS AND METHODS: Participants performed the 6MWT according to the guidelines and were classified into high (>350 m; n = 40) or low (<350 m; n = 30) walking performance groups according to distance. The forced expiratory volume (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio were recorded. Participants completed the Patient Health Questionnaire-9 (PHQ-9), St. George's Respiratory Questionnaire (SGRQ), and the Upper and Lower Extremity Functional Index (UEFI/LEFI). Predicted VO2peak was measured using the Duke Activity Status Index (DASI). RESULTS: Seventy participants with a mean age of 63 ± 11 years (20% female) were enrolled in this study. Patients with high walking performance demonstrated significantly better health status than those with low walking performance (SGRQ: 49 ± 25 vs. 56 ± 21, p = 0.03). Participants with low walking performance had lower predicted VO2peak compared to their higher performing counterparts (p = 0.002). The overall model was significant (F(8, 61) = 7.48, p = 0.0006), with PHQ-9, SGRQ, UEFI/LEFI, VO2peak, and FEV1/FVC explaining approximately 49.5% of the variance in the 6MWT distance. CONCLUSION: This study shed light on the association of depressive symptoms, health status, extremity function, and VO2peak with walking performance, providing valuable insights that may impact the management and care of individuals with COPD.


COPD is a global health issue that significantly impairs physical performance, particularly walking.Depressive symptoms, health status, extremity function, and predicted peak oxygen uptake can predict walking performance in patients with COPD, offering insight into potential interventions.


Subject(s)
Depression , Pulmonary Disease, Chronic Obstructive , Humans , Female , Middle Aged , Aged , Male , Pulmonary Disease, Chronic Obstructive/diagnosis , Health Status , Forced Expiratory Volume , Extremities , Walking , Physical Functional Performance , Quality of Life
12.
Sci Rep ; 14(1): 8012, 2024 04 05.
Article in English | MEDLINE | ID: mdl-38580704

ABSTRACT

The objective of human pose estimation (HPE) derived from deep learning aims to accurately estimate and predict the human body posture in images or videos via the utilization of deep neural networks. However, the accuracy of real-time HPE tasks is still to be improved due to factors such as partial occlusion of body parts and limited receptive field of the model. To alleviate the accuracy loss caused by these issues, this paper proposes a real-time HPE model called CCAM - Person based on the YOLOv8 framework. Specifically, we have improved the backbone and neck of the YOLOv8x-pose real-time HPE model to alleviate the feature loss and receptive field constraints. Secondly, we introduce the context coordinate attention module (CCAM) to augment the model's focus on salient features, reduce background noise interference, alleviate key point regression failure caused by limb occlusion, and improve the accuracy of pose estimation. Our approach attains competitive results on multiple metrics of two open-source datasets, MS COCO 2017 and CrowdPose. Compared with the baseline model YOLOv8x-pose, CCAM-Person improves the average precision by 2.8% and 3.5% on the two datasets, respectively.


Subject(s)
Benchmarking , Extremities , Humans , Neural Networks, Computer , Posture , Videotape Recording
13.
World J Surg Oncol ; 22(1): 113, 2024 Apr 26.
Article in English | MEDLINE | ID: mdl-38664776

ABSTRACT

BACKGROUND: The standard curative treatments for extremity soft tissue sarcoma (ESTS) include surgical resection with negative margins and perioperative radiotherapy. However, the optimal resection margin remains controversial. This study aimed to evaluate the outcomes in ESTS between microscopically positive margin (R1) and microscopically negative margin (R0) according to the Union for International Cancer Control (UICC) (R + 1 mm) classification. METHODS: Medical records of patients with localized ESTS who underwent primary limb-sparing surgery and postoperative radiotherapy between 2004 and 2015 were retrospectively reviewed. Patients were followed for at least 5 years or till local or distant recurrence was diagnosed during follow-up. Outcomes were local and distal recurrences and survival. RESULTS: A total of 52 patients were included in this study, in which 17 underwent R0 resection and 35 underwent R1 resection. No significant differences were observed in rates of local recurrence (11.4% vs. 35.3%, p = 0.062) or distant recurrence (40.0% vs. 41.18%, p = 0.935) between R0 and R1 groups. Multivariate analysis showed that distant recurrences was associated with a Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grade (Grade III vs. I, adjusted hazard ratio (aHR): 12.53, 95% confidence interval (CI): 2.67-58.88, p = 0.001) and tumor location (lower vs. upper extremity, aHR: 0.23, 95% CI: 0.07-0.7, p = 0.01). Kaplan-Meier plots showed no significant differences in local (p = 0.444) or distant recurrent-free survival (p = 0.161) between R0 and R1 groups. CONCLUSIONS: R1 margins, when complemented by radiotherapy, did not significantly alter outcomes of ESTS as R0 margins. Further studies with more histopathological types and larger cohorts are necessary to highlight the path forward.


Subject(s)
Extremities , Margins of Excision , Neoplasm Recurrence, Local , Sarcoma , Humans , Male , Female , Middle Aged , Sarcoma/surgery , Sarcoma/pathology , Sarcoma/radiotherapy , Sarcoma/mortality , Retrospective Studies , Neoplasm Recurrence, Local/pathology , Neoplasm Recurrence, Local/epidemiology , Neoplasm Recurrence, Local/surgery , Extremities/pathology , Extremities/surgery , Adult , Follow-Up Studies , Survival Rate , Aged , Prognosis , Radiotherapy, Adjuvant/methods , Radiotherapy, Adjuvant/statistics & numerical data , Organ Sparing Treatments/methods , Organ Sparing Treatments/statistics & numerical data , Young Adult , Soft Tissue Neoplasms/surgery , Soft Tissue Neoplasms/pathology , Soft Tissue Neoplasms/radiotherapy , Soft Tissue Neoplasms/mortality , Adolescent
14.
J Biomech ; 166: 112063, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38564846

ABSTRACT

Force-sensing insoles are wearable technology that offer an innovative way to measure loading outside of laboratory settings. Few studies, however, have utilized insoles to measure daily loading in real-world settings. This is an ancillary study of a randomized controlled trial examining the effect of weight loss alone, weight loss plus weighted vest, or weight loss plus resistance training on bone health in older adults. The purpose of this ancillary study was to determine the feasibility of using force-sensing insoles to collect daily limb loading metrics, including peak force, impulse, and loading rate. Forty-four participants completed a baseline visit of three, 2-minute walking trials while wearing force-sensing insoles. During month two of the intervention, 37 participants wore insoles for 4 days for 8 waking hours each day. At 6-month follow-up, participants completed three, two-minute walking trials and a satisfaction questionnaire. Criteria for success in feasibility was defined as: a) > 60 % recruitment rate; b) > 80 % adherence rate; c) > 75 % of usable data, and d) > 75 % participant satisfaction. A 77.3 % recruitment rate was achieved, with 44 participants enrolled. Participants wore their insoles an average of 7.4 hours per day, and insoles recorded an average of 5.5 hours per day. Peak force, impulse, and loading rate collected at baseline and follow-up were 100 % usable. During the real-world settings, 87.8 % of data was deemed usable with an average of 1200 min/participant. Lastly, average satisfaction was 80.5 %. These results suggest that force-sensing insoles appears to be feasible to capture real-world limb loading in older adults.


Subject(s)
Mechanical Phenomena , Walking , Humans , Aged , Feasibility Studies , Extremities , Weight Loss , Shoes
15.
J Foot Ankle Res ; 17(2): e12013, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38613833

ABSTRACT

BACKGROUND: This study examined the efficacy of an interdisciplinary limb preservation service (LPS) in improving surgical outcomes for diabetic foot ulcer (DFU) patients compared to traditional care. METHODS: Data from January 1, 2017 to September 30, 2020 were retrospectively reviewed. An interdisciplinary LPS clinic began on August 1, 2018, coexisting with a preexisting single specialty service. Primary outcomes were major/minor amputation rates and ratios and hospital length of stay. Surgical endpoints pre- and post-LPS launch were compared. RESULTS: Among 976 procedures for 731 unique DFU patients, most were male (80.4%) and Hispanic (89.3%). Patient demographics were consistent before and after LPS initiation. Major amputation rates decreased by 45.5% (15.4%-8.4%, p = 0.001), with outpatient procedures increasing over 5-fold (3.3% pre-LPS to 18.7% post-LPS, p < 0.001). Hospital stay reduced from 10.1 to 8.5 days post-LPS (p < 0.001). The major to minor amputation ratio declined from 22.4% to 12.7%. CONCLUSIONS: The interdisciplinary LPS improved patient outcomes, marked by fewer major amputations and reduced hospital stays, suggesting the model's potential for broader application.


Subject(s)
Diabetic Foot , Lipopolysaccharides , Humans , Male , Female , Retrospective Studies , Amputation, Surgical , Diabetic Foot/surgery , Extremities
16.
Radiol Phys Technol ; 17(2): 569-577, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38668937

ABSTRACT

This study aimed to assess the feasibility of a skin marker-less patient setup using a surface-guided radiotherapy (SGRT) system for extremity radiotherapy. Twenty-five patients who underwent radiotherapy to the extremities were included in this retrospective study. The first group consisted of 10 patients and underwent a traditional setup procedure using skin marks and lasers. The second group comprised 15 patients and had a skin marker-less setup procedure that used an SGRT system only. To compare the two setup procedures for setup accuracy, the mean 3D vector shift magnitude was 0.9 mm for the traditional setup procedure and 0.5 mm for the skin marker-less setup procedure (p < 0.01). In addition, SGRT systems have been suggested to improve the accuracy and reproducibility of patient setups and consistently reduce interfractional setup errors. These results indicate that a skin marker-less patient setup procedure using an SGRT system is useful for extremity irradiation.


Subject(s)
Extremities , Lasers , Radiotherapy, Image-Guided , Humans , Female , Male , Aged , Middle Aged , Radiotherapy, Image-Guided/methods , Retrospective Studies , Adult , Skin/radiation effects , Aged, 80 and over , Radiotherapy Planning, Computer-Assisted/methods , Radiotherapy Setup Errors/prevention & control
17.
Int J Mol Sci ; 25(7)2024 Apr 03.
Article in English | MEDLINE | ID: mdl-38612818

ABSTRACT

Many genomic, anatomical and functional differences exist between the medullary (MTAL) and the cortical thick ascending limb of the loop of Henle (CTAL), including a higher expression of claudin-10 (CLDN10) in the MTAL than in the CTAL. Therefore, we assessed to what extent the Cldn10 gene expression is a determinant of differential gene expression between MTAL and CTAL. RNAs extracted from CTAL and MTAL microdissected from wild type (WT) and Cldn10 knock out mice (cKO) were analyzed by RNAseq. Differential and enrichment analyses (GSEA) were performed with interactive R Shiny software. Between WT and cKO MTAL, 637 genes were differentially expressed, whereas only 76 were differentially expressed between WT and cKO CTAL. Gene expression patterns and GSEA analyses in all replicates showed that WT MTAL did not cluster with the other replicates; no hierarchical clustering could be found between WT CTAL, cKO CTAL and cKO MTAL. Compared to WT replicates, cKO replicates were enriched in Cldn16, Cldn19, Pth1r, (parathyroid hormone receptor type 1), Casr (calcium sensing receptor) and Vdr (Vitamin D Receptor) mRNA in both the cortex and medulla. Cldn10 is associated with gene expression patterns, including genes specifically involved in divalent cations reabsorption in the TAL.


Subject(s)
Adrenal Medulla , Extremities , Animals , Mice , Claudins/genetics , Mice, Knockout , Gene Expression
18.
Curr Biol ; 34(10): 2066-2076.e3, 2024 05 20.
Article in English | MEDLINE | ID: mdl-38657610

ABSTRACT

Flies groom in response to competing mechanosensory cues in an anterior-to-posterior order using specific legs. From behavior screens, we identified a pair of cholinergic command-like neurons, Mago-no-Te (MGT), whose optogenetic activation elicits thoracic grooming by the back legs. Thoracic grooming is typically composed of body sweeps and leg rubs in alternation, but clonal analysis coupled with amputation experiments revealed that MGT activation only commands the body sweeps: initiation of leg rubbing requires contact between the leg and thorax. With new electron microscopy (EM) connectome data for the ventral nerve cord (VNC), we uncovered a circuit-based explanation for why stimulation of posterior thoracic mechanosensory bristles initiates cleaning by the back legs. Our previous work showed that flies weigh mechanosensory inputs across the body to select which part to groom, but we did not know why the thorax was always cleaned last. Here, the connectome for the VNC enabled us to identify a pair of GABAergic inhibitory neurons, UMGT1, that receives diverse sensory inputs and synapses onto both MGT and components of its downstream circuits. Optogenetic activation of UMGT1 suppresses thoracic cleaning, representing a mechanism by which mechanosensory stimuli on other body parts could take precedence in the grooming hierarchy. We also anatomically mapped the pre-motor circuit downstream of MGT, including inhibitory feedback connections that may enable rhythmicity and coordination of limb movement during thoracic grooming. The combination of behavioral screens and connectome analysis allowed us to identify a neural circuit connecting sensory-to-motor neurons that contributes to thoracic grooming.


Subject(s)
Drosophila melanogaster , Grooming , Animals , Grooming/physiology , Drosophila melanogaster/physiology , Extremities/physiology , Connectome , Optogenetics , Mechanoreceptors/physiology , Mechanotransduction, Cellular
19.
Acta Trop ; 255: 107219, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38649106

ABSTRACT

In triatomines, vectors of Chagas disease, active dispersal takes place by walking and flying. Flight has received more attention than walking although the last is the dispersal modality used by nymphs due to their lack of wings and also used by adults, which would facilitate the colonization and reinfestation of houses after vector control actions. The present work studied the morphometrical variation of Triatoma infestans legs, the main vector of Chagas disease the Southern Cone of South America. We described morphometric traits and the natural variation of each leg segment. Different linear, size and shape variables of each component of the three right legs of fifth instar nymphs of T. infestans were analyzed using morphometric tools. We analyzed differentiation, variation and correlation for each segment across the fore-, mid and hind legs using different statistical approaches such as general linear model, canonical variates analysis, test of equality of coefficient of variation and partial least square analysis. We also analyzed variation and correlation between segments within each leg with partial least square and morphometric disparity analyses. Our results showed that the segments differed between legs, as general trends, the dimensions (length, width and/or size) were greater in the hind legs, smaller in the forelegs and intermediate in the mid ones. The femur and tibia (length and/or width) showed differences in morphometric variation between legs and the femur and tibia showed the highest levels of correlation between legs. On the other hand, in the fore- and mid legs, the femur (length or width) showed similar variation with tibia and tarsus lengths, but in the hind legs, the femur showed similar variation with all segments and not with the tibia length, and there were strong correlations between linear measurement within each leg. Our results suggest that the femur and tibia could play a determining role in the coordination between the legs that determines the walking pattern. Considering that these segments would also be linked to the specific function that each leg has, this study suggests a preponderant role of the femur and tibia in the walking locomotion of T. infestans.


Subject(s)
Insect Vectors , Nymph , Triatoma , Animals , Triatoma/anatomy & histology , Triatoma/growth & development , Triatoma/physiology , Insect Vectors/anatomy & histology , Insect Vectors/physiology , Nymph/anatomy & histology , Nymph/physiology , Nymph/growth & development , Chagas Disease/transmission , Extremities/anatomy & histology
20.
Curr Oncol ; 31(4): 1725-1738, 2024 03 26.
Article in English | MEDLINE | ID: mdl-38668034

ABSTRACT

Introduction: Soft tissue sarcomas (STS) are low-incidence tumors whose clinical and histopathological factors are associated with adverse oncological outcomes. This study evaluated prognostic factors (PF) associated with tumor recurrence and overall survival (OS) in patients diagnosed with STS of the extremities, treated at the Instituto Nacional de Cancerología (INC), Bogotá, Colombia. Materials and Methods: An analytical observational study of a historical cohort was carried out, including patients diagnosed with STS and managed surgically in the Functional Unit for Breast and Soft Tissue Tumors of the INC from January 2008 to December 2018. Results: A total of 227 patients were included; 74.5% had tumors greater than 5 cm. Most patients (29.1%) were in stage IIIB at diagnosis. Age was associated with higher mortality (HR = 1.01; CI95%: 1-1.02; p = 0.048). Tumor persistence at admission to the INC (HR = 2.34; CI95%: 1.25-4.35; p = 0.007) and histologic grade III (HR = 5.36; CI95%: 2.29-12.56; p = <0.001) showed statistical significance in the multivariate analysis for recurrence of any type, as did the PFs associated with a higher risk of local recurrence (HR = 2.85; CI95%: 1.23-6.57; p = 0.014 and HR = 6.09; CI95%: 2.03-18.2; p = 0.001), respectively. Tumor size (HR = 1.03; CI95%: 1-1.06; p = 0.015) and histologic grade III (HR = 4.53; CI95%: 1.42-14.49; p = 0.011) were associated with a higher risk of distant recurrence. Conclusions: This cohort showed that in addition to histologic grade and tumor size, tumor persistence at the time of admission has an impact on disease recurrence, so STS should be managed by a multidisciplinary team with experience in this pathology in high-volume reference centers.


Subject(s)
Extremities , Neoplasm Recurrence, Local , Sarcoma , Humans , Female , Male , Sarcoma/mortality , Colombia/epidemiology , Middle Aged , Extremities/pathology , Prognosis , Adult , Aged , Soft Tissue Neoplasms/mortality , Soft Tissue Neoplasms/pathology , Aged, 80 and over
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