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Frey M.N.,Federal University of Health Sciences, Porto Alegre | Luzzatto L.,European Institute of Oncology | Seidel G.B.,General Hospital of Caxias do Sul | Bonamigo R.R.,Federal University of Health Sciences, Porto Alegre | And 2 more authors.
Anais Brasileiros de Dermatologia

Lichen nitidus is a rare dermatosis, characterized by round, skin-colored papules whose size varies between 1-2 mm and are generally asymptomatic. It does not have predilection for gender or race, affecting mainly children and young adults. Its clinical course is unpredictable, but most cases tend to spontaneously regress years after the onset of the disease. Lesions are often localized, but rare reports of disseminated disease exist. ©2010 by Anais Brasileiros de Dermatologia. Source

Payne S.,St. Bartholomews Hospital | Burke D.,European Institute of Oncology | Mansi J.,Guys Hospital | Jones A.,Royal Free Hospital | And 5 more authors.
Clinical Medicine, Journal of the Royal College of Physicians of London

The impact of cancer on healthcare is increasing. Therefore, it is key that all doctors receive oncology training. This study surveyed UK undergraduate medical schools to determine the extent of oncology training provided by their curricula. Data on foundation year (FY) and core medical training (CMT) programmes were obtained and analysed for the proportion of oncology posts. Of the responding medical schools, five (36%) had a defined period dedicated to oncology (mean 2 weeks). Four foundation schools were in London, with 10,094 FY posts in 1699 programmes. Of these, 1.5% of post and 8.7% of programmes were in oncology. For CMT offered by the London deanery specialty schools, 11% of CMT post and 48% of programmes included oncology. Oncology was included in 11% posts and 48% programmes offered by the London Deanery specialty schools. Our results show that >50% of junior doctors receive dedicated undergraduate or postgraduate oncology training. An increase in oncology training is therefore urgently required. © Royal College of Physicians, 2013. Source

Fattori G.,Polytechnic of Milan | Riboldi M.,Polytechnic of Milan | Riboldi M.,Cnao Centro Nazionale Of Adroterapia Oncologica | Scifoni E.,Helmholtz Center for Heavy Ion Research | And 11 more authors.
Radiotherapy and Oncology

Purpose: To investigate dose distribution variations due to setup errors and range uncertainties in image-guided carbon ion radiotherapy of head chordoma. Materials and methods: Ten treatment plans were retrospectively tested with TRiP98 against ±1.0 mm and ±1.0- setup errors, as observed in clinical routine, and 2.6% range uncertainty when 2 mm CTV-to- PTV margins were applied. Single-fraction simulations were compared with the total treatment dose in terms of DVH bands, conformity and inhomogeneity. The contribution of image processing artifacts on reported results was also discussed, as a function of the imaging dataset resolution. Results: Results showed that safety margins grant the conformal target coverage in presence of setup errors with D95CTV variations below 10% in 7 patients out of 10. Instead, the inclusion of range uncertainty yielded to appreciable dose degradation, reporting larger effects for CTV and dose conformity, whereas reduced impact is found on the organ-at-risk. The fractionation scheme positively affects dose conformity and inhomogeneity; conversely its influence on DVH bands is strongly related to the patient anatomy. Conclusion: Besides safety margins, setup and range uncertainties lead to non-negligible combined contribution. Systematical treatment plan robustness assessment against expected uncertainties is thus encouraged, selecting beam settings and fractionation schemes where homogeneity is preserved. © 2014 Elsevier Ireland Ltd. All rights reserved. Source

Phillips K.-A.,University of Melbourne | Ribi K.,International Breast Cancer Study Group Coordinating Center | Sun Z.,Dana-Farber Cancer Institute | Thompson A.,University of Dundee | And 11 more authors.

Cognitive function in postmenopausal women receiving letrozole or tamoxifen as adjuvant endocrine treatment was compared during the fifth year of treatment in a substudy of the BIG 1-98 trial. In BIG 1-98 patients were randomized to receive adjuvant (A) 5-years tamoxifen, (B) 5-years letrozole, (C) 2-years tamoxifen followed by 3-years letrozole, or (D) 2-years letrozole followed by 3-years tamoxifen. The primary comparison was the difference in composite score for patients taking letrozole (B + C; N=65) vs. tamoxifen (A + D; N=55). The patients taking letrozole had better overall cognitive function than those taking tamoxifen (difference in mean composite z-scores=0.28, P=0.04, 95% CI: 0.02, 0.54, Cohen's D=0.40 indicating small to moderate effect). In this substudy, breast cancer patients taking adjuvant letrozole during the fifth year of treatment had better cognitive function than those taking tamoxifen, suggesting aromatase inhibitors do not adversely impact cognition compared with tamoxifen. © 2010 Elsevier Ltd. Source

Vogl T.J.,University Hospital of Frankfurt | Zangos S.,University Hospital of Frankfurt | Scholtz J.E.,University Hospital of Frankfurt | Schmitt F.,University Hospital of Frankfurt | And 5 more authors.
RöFo : Fortschritte auf dem Gebiete der Röntgenstrahlen und der Nuklearmedizin

Chemosaturation with percutaneous hepatic perfusion (PHP; Hepatic CHEMOSAT(®) Delivery System; Delcath Systems Inc, USA) is a minimally invasive, repeatable regional therapy for unresectable hepatic metastases. It uses a system of catheters and filters to isolate hepatic venous blood from the systemic circulation, allowing delivery of high-dose chemotherapy to the hepatic artery. Effluent hepatic venous blood is filtered before being returned to the systemic circulation, thereby reducing exposure to chemotherapy. We describe our experiences with chemosaturation-PHP at 2 European centers. 14 patients presented unresectable hepatic metastases from solid tumors; 13 received 1 - 3 sessions of chemosaturation-PHP. Melphalan 2.0 (n = 1) or 3.0 (n = 12) mg/kg was given as a 30-minute infusion into the hepatic artery. 12 patients were evaluable for tumor response. One complete (cholangiocarcinoma, n = 1) and 6 partial responses (ocular, n = 3 or cutaneous melanoma, n = 3) were observed, 5 patients had stable disease (ocular melanoma, n = 3; breast cancer, n = 1; gastric cancer, n = 1). Mild to moderate filter-related toxicity (i. e. thrombocytopenia, anemia) was observed immediately post-procedure. Grade 3/4 melphalan-related pancytopenia developed after 1 - 2 weeks. All hematological events were managed effectively with transfusions and/or other supportive measures. The new high-efficiency filter showed milder toxicity and faster recovery. In one case, chemosaturation-PHP was abandoned prematurely due to heparin-induced vaginal bleeding, and one patient died due to retroperitoneal hemorrhage from heparin anti-coagulation. Chemosaturation-PHP for non-resectable liver metastases is a feasible treatment option when performed by an experienced multi-disciplinary team. It may be a promising regional therapy for patients with no effective treatment options. © Georg Thieme Verlag KG Stuttgart · New York. Source

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