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Insights about low-dose rays, the particular misconceptions, truth and continuing to move forward.
At presentation, isolated metastasis from oropharyngeal squamous cell carcinoma is rare. Liver is a relatively uncommon first site of failure, especially in the absence of other distant metastases, particularly without diagnosis of lung metastases. We report on a case of HPV-related oropharyngeal squamous cell carcinoma with synchronous liver metastasis treated with radiation therapy. This condition, defined as "oligometastatic state," describes a subset of patients with limited volume metastatic disease in whom favorable outcomes were reported with the use of local ablative therapies on both the primary tumor and metastatic sites. As a definitive treatment, we offered the patient, ineligible for other therapeutic approaches, exclusive radiation treatment on the head and neck region and a stereotactic ablative approach targeted to the liver metastasis. © 2020 The Authors. Published by the British Institute of Radiology.Aberrant course of internal carotid arteries (ICA) is rarely seen. In patients who are asymptomatic, anomalies may be detected incidentally during head and neck examination. Symptomatic patients may present with hearing loss, pulsatile tinnitus, dysphagia or a foreign body sensation in the posterior pharynx. If the retropharyngeal course of ICA remains undiagnosed, accidental biopsy or surgical intervention can result in life threatening complications. The abnormal course of ICA results from a complex defect in embryological development and is unlikely to be an acquired process. Previously, bilateral and unilateral agenesis, hypoplastic, retropharyngeal tortuous ICA and kissing sellar ICA have been described in literature. We used various imaging techniques to describe this first case of fused ICA with an aberrant course through the clivus and dorsum sellae. The patient also presented with patulous Eustachian tubes on both the left and right side. © 2020 The Authors. Published by the British Institute of Radiology.Hepatocellular carcinoma (HCC) has become one of the leading causes of cancer death worldwide. There has been anecdotal report regarding the effectiveness of proton beam treatment for HCC. In this pre-clinical investigation, the woodchuck model of viral hepatitis infection-induced HCC was used for proton beam treatment experiment. The radiopaque fiducial markers that are biodegradable were injected around the tumor under ultrasound guidance to facilitate positioning in sequential treatments. An α cradle mode was used to ensure reproducibility of animal positioning on the treatment couch. A CT scan was performed first for contouring by a radiation oncologist. The CT data set with contours was then exported for dose planning. Three fractionations, each 750 CcGyE, were applied every other day with a Mevion S250 passive scattering proton therapy system. Multiphase contrast-enhanced CT scans were performed after the treatment and at later times for follow-ups. 3 weeks post-treatment, shrinking of the HCC nodule was detected and constituted to a partial response (30% reduction along the long axis). By week nine after treatment, the nodule disappeared during the arterial phase of multiphase contrast-enhanced CT scan. Pathological evaluation corroborated with this imaging response. A delayed, but complete imaging response to proton beam treatment applied to HCC was achieved with this unique and clinically relevant animal model of HCC. © 2020 The Authors. Published by the British Institute of Radiology.Objectives This work presents an ambient-assisted living application that encourages seniors during nocturnal wandering episodes to return to bed in calm and comfort reassurance. Methods Structuring knowledge by designing a software architecture capable of delivering high-level analysis and processing. A senior's home has been upgraded into a smart home enabling the gathering of habits for two weeks and set up for personalized assistance over four weeks. Home automation devices associated with Actigraph monitors and self-reported sleep were used for more accuracy. Results The architectural model can be used in ambient-assisted living applications for which data collection is permanent and continuous. Its layered organization facilitates the management of specific and general activities of daily life. The results of the home experience show that the system gave a notification whenever the need arose. On the other hand, it allowed the caregiver to get more information about the lifestyle of the senior. Conclusions Future work should focus on providing more services to contextualize assistance. Ontology is used to structure all the ambient knowledge of the smart home. We also plan to do more home experiments. © The Author(s) 2020.Objective Although SLE disproportionately affects minority racial groups, they are significantly under-represented in clinical trials in the USA. This may lead to misleading conclusions in race-based subgroup analyses. We conducted focus groups to evaluate the perceptions of diverse patients with lupus about clinical trial participation. Methods A qualitative research design employed three 90 min focus groups led by a trained moderator and guided by the Theory of Planned Behaviour. Open-ended questions about trial participation included advantages and disadvantages (behavioural beliefs), approving and disapproving significant others (normative beliefs), and participation enhancers and barriers (control beliefs). Discussions were recorded, transcribed and analysed to identify emerging themes. Results Patients with SLE (n=23) aged 21-72, with increased proportion of minority groups (65%), participated. Reported advantages of trial participation included altruism and personal benefit. Disadvantages included uncee rights and permissions. AOA hemihydrochloride Published by BMJ.Objective To evaluate the association of cigarette smoking and right ventricular (RV) systolic and diastolic functions in a population-based cohort of individuals at middle age. Methods This cross-sectional study included participants who answered the smoking questionnaire and underwent echocardiography at the Coronary Artery Risk Development in Young Adulthood year 25 examination. RV systolic function was assessed by echocardiographic-derived tricuspid annular plane systolic excursion (TAPSE) and by right ventricular peak systolic velocity (RVS'), while RV diastolic function was evaluated by early right ventricular tissue velocity (RVE'). Multivariable linear regression models assessed the relationship of smoking with RV function, adjusting for age, sex, race, body mass index, systolic blood pressure, total cholesterol, high-density lipoprotein (HDL) cholesterol, diabetes mellitus, alcohol consumption, pulmonary function, left ventricular systolic and diastolic function and coronary artery calcium score. Results A total of 3424 participants were included.
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