Micropapillary pattern in lung adenocarcinoma: aspect on 18F-fluorodeoxyglucose positron emission tomography/computed tomography imaging.

We diagnosed a non-small cell lung carcinoma in a 49-year-old female patient with the histopathological diagnosis of stage IIIB mixed bronchioloalveolar and papillary adenocarcinoma with extensive micropapillary feature, which was not visualized on the preoperative multimodality imaging with positron emission tomography (PET) and computed tomography (CT). The micropapillary component characterized by a unique growth pattern with particular morphological features can be observed in all subtypes of lung adenocarcinoma. Micropapillary component is increasingly recognized as a distinct entity associated with higher aggressiveness. Even the most modern multimodality PET/CT imaging technology may fail to adequately visualize this important component with highly relevant prognostic implications. Thus, the pathologist needs to consciously look for a micropapillary component in the surgical specimen or in preoperative biopsies or cytology. This may have potential future treatment implications, as adjuvant or neoadjuvant chemotherapy may be of relevance, even in the early stages of the disease.

Communication skills training in oncology: a position paper based on a consensus meeting among European experts in 2009.

BACKGROUND: Communication in cancer care has become a major topic of interest. Since there is evidence that ineffective communication affects both patients and oncology clinicians (physicians and nurses), so-called communication skills trainings (CSTs) have been developed over the last decade. While these trainings have been demonstrated to be effective, there is an important heterogeneity with regard to implementation and with regard to evidence of different aspects of CST. METHODS: In order to review and discuss the scientific literature on CST in oncology and to formulate recommendations, the Swiss Cancer League has organised a consensus meeting with European opinion leaders and experts in the field of CST, as well as oncology clinicians, representatives of oncology societies and patient organisations. On the basis of a systematic review and a meta-analysis, recommendations have been developed and agreed upon. RESULTS: Recommendations address (i) the setting, objectives and participants of CST, (ii) its content and pedagogic tools, (iii) organisational aspects, (iv) outcome and (v) future directions and research. CONCLUSION: This consensus meeting, on the basis of European expert opinions and a systematic review and meta-analysis, defines key elements for the current provision and future development and evaluation of CST in oncology.

Decision making and management of gliomas: practical considerations.

Over the last decade, diagnostic options and introduction of novel treatments have expanded the armamentarium in the management of malignant glioma. Combined chemoradiotherapy has become the standard of care in glioblastoma up to the age of 70 years, while treatment in elderly patients or with lower grade glioma is less well defined. Molecular markers define different disease subtypes and allow for adapted treatment selection. This review focuses on simple questions arising in the daily management of patients.

[Recueil].

Capitulare Haristallense (a. 779), Capitulare Mantuanum secundum, generale (a. 813) (Ar-v). - Admonitio generalis (1v). - Collectio capitularium Ansegisi (1bis-64v). - Lex salica (65v-92v). - Pactus Childeberti I et Chlotharii I (a. 511/558) (92v-94v). - Childeberti II decretio (a. 596) (94v-96). - Capitula legibus addenda (a. 818/819) [Ajout du XVIe s.] (96bis v-ter) Isidorus Hispalensis, De auctoribus legum [Etymologiae, liber V] (97-120v). - Lex Alamannorum (121v-144v). Les ff. 1-56 ont peut-être été copiés à Tours ou dans les environs. Les feuilles de papier contiennent des ajouts manuscrits, du XVIe s. Les mss. lat. 18237 et 18238 ont été consultés par Etienne Baluze (1630-1718), bibliothécaire de Colbert et canoniste, pour son édition des Capitularia regum francorum."

[Recueil].

Capitulare ecclesiasticum (1-7v). - Capitula legibus addenda (7v-14v). - Capitula per se scibenda (14v-16v). - Capitulare missorum (16v-20). "Domine Deus omnipotens propitius est omni peccatori..." [Ajout du Xe s.] (20v). - Collectio capitularium Ansegisi (21-40v). - Lex salica (41-83v). Les cahiers des ff. 1-20 et 41-83 faisaient partie du même ms. Ils ont été copiés durant le second quart ou vers le milieu du IXe s., et sont signés de QI à QVI, tandis que les ff. 21-40v ont été copiés plus tardivement, durant la seconde moitié du IXe s. ou la première moitié du Xe s. Les ff. 44-45 ont été rajoutés pour compléter une lacune du texte, mentionnée au f. 43v par une main du XIVe s.: "hic deficiunt II° folia". La portion manquante du texte a été recopiée par deux mains différentes, du XVIIe s. Les mss. lat. 18237 et 18238 ont été consultés par Etienne Baluze (1630-1718), bibliothécaire de Colbert et canoniste, pour son édition des Capitularia regum francorum."

VIH/SIDA

A presente dissertação de mestrado visa apresentar, divulgar e implementar informação básica sobre o VIH/SIDA num contexto social, pedagógico e médico para os utentes e profissionais de saúde. Uma das formas encontradas para fazer esta divulgação foi através da língua crioula, língua essa que tem a necessidade de entrar em contacto com estes termos e trabalha-los como forma de veicular esta informação. O melhor meio encontrado para se fazer a referida divulgação foi a construção de um Glossário de termos que vem no sentido de dar a conhecer aos profissionais de saúde e ao público em geral, a terminologia inerente ao VIH/SIDA, como forma de ajudar na consolidação e harmonização da língua específica, da área em causa, e na divulgação do ALUPEC (Alfabeto Unificado Para a Escrita da língua Cabo-verdiana). Os aspectos essências desta dissertação prendem-se à apresentação e transposição dos termos em estudo pelas três línguas de trabalho, em campos que melhor interagem com a linguagem de especialidade, num contexto social que inclui a vulgarização do termo. Muitos foram os obstáculos encontrados ao longo da elaboração da dissertação, devido à especificidade do tema e por ser o único realizado até então em Crioulo e na área de saúde. É apresentada uma contextualização do domínio de estudo e do local de aplicação que visa facilitar a integração do leitor na história e língua de Cabo Verde, como forma de encaminha-lo de forma simples e directa para os termos em estudo. Assim sendo, apresentamos um glossário com campos como o da definição, sinónimos, informação linguística, contexto em português (por este ser a língua oficial e de trabalho em Cabo Verde) a que segue uma sequenciação directa para fazer o leitor chegar ao termo em Crioulo, passando pelo campo do equivalente deste mesmo termo em inglês, para que se possa identificar as similaridades entres os termos, quando existem.

Computational fluid dynamics of the right ventricular outflow tract and of the pulmonary artery: a bench model of flow dynamics.

OBJECTIVES: The reconstruction of the right ventricular outflow tract (RVOT) with valved conduits remains a challenge. The reoperation rate at 5 years can be as high as 25% and depends on age, type of conduit, conduit diameter and principal heart malformation. The aim of this study is to provide a bench model with computer fluid dynamics to analyse the haemodynamics of the RVOT, pulmonary artery, its bifurcation, and left and right pulmonary arteries that in the future may serve as a tool for analysis and prediction of outcome following RVOT reconstruction. METHODS: Pressure, flow and diameter at the RVOT, pulmonary artery, bifurcation of the pulmonary artery, and left and right pulmonary arteries were measured in five normal pigs with a mean weight of 24.6 ± 0.89 kg. Data obtained were used for a 3D computer fluid-dynamics simulation of flow conditions, focusing on the pressure, flow and shear stress profile of the pulmonary trunk to the level of the left and right pulmonary arteries. RESULTS: Three inlet steady flow profiles were obtained at 0.2, 0.29 and 0.36 m/s that correspond to the flow rates of 1.5, 2.0 and 2.5 l/min flow at the RVOT. The flow velocity profile was constant at the RVOT down to the bifurcation and decreased at the left and right pulmonary arteries. In all three inlet velocity profiles, low sheer stress and low-velocity areas were detected along the left wall of the pulmonary artery, at the pulmonary artery bifurcation and at the ostia of both pulmonary arteries. CONCLUSIONS: This computed fluid real-time model provides us with a realistic picture of fluid dynamics in the pulmonary tract area. Deep shear stress areas correspond to a turbulent flow profile that is a predictive factor for the development of vessel wall arteriosclerosis. We believe that this bench model may be a useful tool for further evaluation of RVOT pathology following surgical reconstructions.