Summaries: International Kidney Cancer Symposium
Conclusion: there is no increased risk of doing the lymph node dissection early on. Dr. Eggener-CON Basics Lymph node dissections rarely done, even for large tumors, because there is no proven therapeutic or staging benefit for low risk patients. A Mayo study revealed no data showing therapeutic benefit in high risk patients. For clinically node negative high risk patients, there is staging value but no proven therapeutic benefit. Rate of positive nodes is associated with stage and grade; the higher the stage and grade, the more likely there will be positive nodes. A tumor> 10 cm with sarcomatoid features and tumor necrosis is also associated with positive nodes. Looking at several studies, the percentage of patients that were found to have positive nodes at the time of surgery was relatively small in all but one study. The 5-year cancer specific survival for these patients was very consistent at 35-39%. According to the National Comprehensive Cancer Network guidelines for kidney cancer, “Regional lymph node dissection is optional but is recommended for patients with adenopathy on preoperative imaging or palpable/visible adenopathy at time of surgery.” Conclusions: Lymph node dissection for patients with clinical node negative T1-T2 disease is proven not to be necessary Lymph node dissection for patients with clinical node negative T3-T4 disease...
I was hoping to post this on the...forum that doesn't exist...but still awaiting access. If you don't feel comfortable posting a reply on the general forum I'd really appreciate a DM. Thanks in advance... So I have an offer to work with an ortho group and wonder if I can get some insight from all you wise folks on how to fairly counter what I think is a pretty poor offer... The good: Practice is in a part of town with an excellent payor mix. It's 3 orthos who have broken off from a... What do you all think of this offer to join an ortho group...
wanted to see groups timeline from MBB to RFA after its decided that its axial pain requiring RFA- how you guys do the follow ups after the procedures? does it take 6-8 weeks to go from first MBB to final RFA
Discussion Syphilis is caused by the spirochete Treponema pallidum. It is a very old disease that despite understanding the organism and readily available treatment, still causes disease. Syphilis is transmitted sexually. According to the Centers for Disease Control, “[i]n 2018, a total of 35,063 cases of [Primary and Secondary] syphilis were reported in the United States, yielding a rate of 10.8 cases per 100,000 population …. This rate represents a 14.9% increase compared with 2017 (9.4 cases per 100,000 population), and a 71.4% increase compared with 2014 (6.3 cases per 100,000 population).” The incre...
HEART attack symptoms include difficulty breathing, chest pain, and an overwhelming feeling of anxiety. But you could also be at risk of a deadly myocardial infarction and heart disease symptoms if you develop this sign on your skin. Has your skin changed colour?
Skeletal muscle atrophy is a major consequence of several pathophysiological conditions, including neuromuscular diseases, disuse (limb immobilization, space flight), aging (sarcopenia) and other wasting conditions (i.e. cancer cachexia). Basically, a disequilibrium between anabolic/catabolic pathways leads to progressive loss of muscle mass and functional impairment. The aim of translational research in this field is to identify anabolic compounds able to support protein synthesis and muscle mass, restoring muscle function and metabolism.
This study also aimed to understand the nutrition priorities for this patient population and their families.
Duchenne/Becker muscular dystrophy (DMD/BMD) is a progressive skeletal myopathy as well as a cardiomyopathy. Historically, it is reported that patients with DMD/BMD experience significant morbidity/mortality as a result of rhythm abnormalities. However, natural history data is limited regarding the specific mode of death, e.g. heart failure vs. sudden cardiac death vs. non-cardiac death. We identified 82 patients at our institution to analyze retrospectively (67 DMD/15 BMD). Average age was 21 (range 10-38) years.
In Becker muscular dystrophy (BMD), only partially functional dystrophin is present in skeletal muscle, leading to progressive muscle weakness, fat replacement, fibre size changes, and increased membrane permeability. Diffusion tensor imaging (DTI) shows promise for studying pathology noninvasively as membrane permeability and fibre diameter can be determined using long diffusion times. Here we compare muscle diffusion properties between BMD patients and controls. We scanned 13 BMD patients age 20-59 yrs — and 9 healthy, male controls age 23-65 yrs — on a 3T MRI system.
The use of oral corticosteroids and reduced weight bearing in Duchenne muscular dystrophy (DMD) increases risk of poor bone health, resulting in osteoporosis, bone pain, fractures and vertebral deformities. We carried out a retrospective study within Birmingham Heartlands Hospital's Paediatrics Department, one of our largest referral centres for Neuromuscular
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