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Psychosocial difficulties are defined as impairments in mental and body functions, activity limitations and participation restrictions, experienced in common across brain disorders. This cross-sectional study compared the psychosocial difficulties among people with Parkinson's disease (n = 61), schizophrenia (n = 84) and stroke (n = 70). The extent of difficulties was found to be similar across the three disorders in most of the domains studied. ABL001 in vivo Psychosocial difficulties were also found to be associated with sociodemographic and illness related factors. The results challenge the brain disorder-specific approach to psychosocial difficulties commonly carried out in neurological and psychiatric research. Implications to occupational therapy are presented.Lymphedema is a chronic edema that sometimes occurs after treatment of gynecologic cancer, and cellulitis often occurs concomitantly with lymphedema. On the other hand, necrotizing fasciitis (NF) is a relatively rare, but life-threatening disease. The symptoms in cellulitis and NF are very similar. In this case report, we describe a case in which the diagnosis of NF in a lymphedematous limb was difficult. A 70-year-old woman had secondary lymphedema in bilateral legs and consulted our department. On the first day of lymphedema therapy, the patient complained of vomiting, diarrhea, and fever (37.7 °C) without local fever in the legs. She was diagnosed with acute gastroenteritis. On the next day, swelling and pain in her left leg occurred and her blood pressure was 59/44 mmHg. She was diagnosed with cellulitis accompanied by lower limb lymphedema and septic shock. On the second day, blisters appeared on the left leg, and computed tomography showed NF. We performed debridement under general anesthesia and her vital signs improved postoperatively. Streptococcus agalactiae (B) was detected in blood culture, and we administered bixillin and clindamycin. Postoperatively, necrosis in the skin and fat around the left ankle gradually spread, and it took 5 months to complete epithelialization. The diagnosis was more difficult than usual NF because patients with lymphedema often experience cellulitis. Clinicians should always think of NF to avoid mortality due to delayed treatment. This case report was approved by the institutional ethics committee.
Data on pediatric HS presentation and response to treatment are limited. We investigated disease characteristics, prescribed treatments, and treatment responses in a pediatric HS cohort.
Pediatric HS patients were identified through an electronic medical record search using ICD9/10 codes for HS. Inclusion criteria included a diagnosis of HS before 18 years of age. Data on demographics, disease presentation, and treatment was collected.
73 patients (59 female, 14 male) were identified. Mean age of symptom onset was 12.6 +/- 2.9 years (range 6-17). Axillary involvement disproportionately affected males (92.9% v 62.7%, p = 0.029), while females had higher groin (59.3% v 28.6%, p = 0.038) involvement. Non-White patients trended toward disproportionately presenting with Hurley-2/3 disease (44.1% v 21.1%, p = 0.093), while females trended toward having a younger age of symptom onset (12.3 v 13.9, p = 0.063), and higher likelihood of HS treatment (93.2% v 78.6%, p = 0.094). The most frequently prescribed treatments were topical clindamycin (61.6%), doxycycline (35.6%), and benzoyl peroxide wash (31.5%).
Pediatric HS patients have varied presentations and response to treatment. Further studies are needed to characterize the disease and the most effective treatments.
Pediatric HS patients have varied presentations and response to treatment. Further studies are needed to characterize the disease and the most effective treatments.
Patients who received a kidney transplant (KT) are described in literature as a group with a higher incidence of malignant neoplasms compared to the general population. Cancer development after KT has become a major issue, as a remarkable percentage of patients are diagnosed with cancer. Treatment of prostate cancer (PCa) in renal transplant recipients (RTRs) is a challenging issue that has been discussed by many authors over the years, but evidence is sparse and often includes conflicting reports. Among the therapeutic options for PCa in these patients, prostate irradiation represents a valuable alternative to surgery or other systemic therapies, as RTRs are often ineligible for these treatments.
To report six cases treated at our institution between 1998 and 2017 and discuss the available literature.
Patients' characteristics were reported along with biochemical status at diagnosis, type of immunosuppressive treatment, radiation therapy technique, and dose to transplanted kidney.
Overall, prostate irradiation was delivered respecting the dose constraints and patients showed good tolerance with no reports of acute or late transplanted kidney injury.
Our experience confirms that prostate radiotherapy for RTRs is feasible and effective and represents a valid option that should be considered by the multidisciplinary team.
Our experience confirms that prostate radiotherapy for RTRs is feasible and effective and represents a valid option that should be considered by the multidisciplinary team.Interaural place-of-stimulation mismatch for bilateral cochlear-implant (BI-CI) listeners is often evaluated using pitch-comparison tasks that can be susceptible to procedural biases. Bias effects were compared for three sequential interaural pitch-comparison tasks in six BI-CI listeners using single-electrode direct stimulation. The reference (right ear) was a single basal, middle, or apical electrode. The comparison electrode (left ear) was chosen from one of three ranges basal half, full array, or apical half. In Experiment 1 (discrimination), interaural pairs were chosen randomly (method of constant stimuli). In Experiment 2 (ranking), an efficient adaptive procedure rank ordered 3 reference and 6 or 11 comparison electrodes. In Experiment 3 (matching), listeners adjusted the comparison electrode to pitch match the reference. Each experiment was evaluated for testing-range bias (point of subjective equality [PSE] vs. comparison-range midpoint) and reference-electrode slope bias (PSE vs. reference electrode).
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