Primary Pleural Angiosarcoma Treated with Nivolumab and Ipilimumab: A Case Report.

Primary pleural angiosarcoma (PPA) is a rare and clinically fatal pleural tumor originating from vascular endothelial cells. Herein, we presented the case of a 73-year-old man who was referred to our emergency room with complaints of right chest and back pain for a few days. Chest computed tomography revealed massive pleural effusion and a large mass in the right chest cavity. Thoracoscopic examination demonstrated a large hemorrhagic tumor on the parietal pleura whose pathological analysis indicated PPA. The patient received immunotherapy combined with nivolumab and ipilimumab. A cycle of nivolumab and ipilimumab improved his hemorrhagic anemia and reduced the pleural effusion and tumor size. This treatment outcome suggests that nivolumab and ipilimumab comprise a vital treatment option for PPA.

Effectiveness of acute in-hospital occupational therapy for older patients with hip fracture.

AIM: To test the hypothesis that hip fracture patients who receive occupational therapy (OT) have better functional ability than those who do not. METHODS: This retrospective observational study utilized data from the Japan Rehabilitation Database spanning 2005-2015. In-hospital hip fracture patients admitted to acute hospitals were identified. In total, 1266 patients were eligible based on the exclusion criteria. The primary outcome was motor Functional Independence Measure (FIM) efficiency. RESULTS: Patients who received OT were 50.9% of hip fracture patients. Patients who received OT had significantly higher scores in motor FIM efficiency (mean 0.79 vs 0.70; P = 0.02) and FIM effectiveness (mean 0.49 vs 0.41; P < 0.01) than the patients who did not receive OT. From multivariate linear regression analysis, OT was identified as a significant factor in motor FIM efficiency (coefficient 1.29, 95% confidence interval 1.14-1.47; P < 0.01) and FIM effectiveness (coefficient 1.07, 95% confidence interval 1.02-1.12; P < 0.01). CONCLUSIONS: The present cohort analysis showed that OT for hip fracture patients in the acute phase likely contributes to improved functional ability. Geriatr Gerontol Int 2019; 19: 611-615.

Effect of early versus delayed mobilization by physical therapists on oral intake in patients with sarcopenic dysphagia after pneumonia.

BACKGROUND AND PURPOSE: Older pneumonia patients with sarcopenic dysphagia have difficulty with oral intake. Physical rehabilitation might be beneficial in the treatment of sarcopenic dysphagia. This study aimed to test the hypothesis that early mobilization by physical therapists enhances oral intake after pneumonia in sarcopenic dysphagia. METHODS: This retrospective observational study used data on consecutive pneumonia patients with sarcopenic dysphagia aged over 65 years hospitalized in the acute care ward from May 2017 to October 2017. We compared characteristics and outcomes between the early mobilization group and the delayed mobilization group. The outcomes were total oral intake and functional oral intake scale score at discharge. RESULTS: Applying the exclusion criteria, 125 patients were eligible. Patients with early mobilization were 33.6% of all pneumonia patients. There were no significant differences in baseline characteristics between both groups. Total oral intake rates at discharge were higher in the early mobilization group compared with the delayed mobilization group (75.6% vs 51.8%; p = 0.012). Functional oral intake scale scores were higher in the early mobilization group than the delayed mobilization group (p = 0.001). On multiple logistic regression analysis, early mobilization was significantly associated with total oral intake at discharge (odds ratio, 3.06; p = 0.01). Multiple linear regression analysis revealed that early mobilization was a significant factor affecting functional oral intake scale score at discharge (coefficient, 0.25; p = 0.01). CONCLUSION: Our cohort analysis demonstrated that early mobilization by a physical therapist is associated with improved total oral intake in patients with sarcopenic dysphagia after pneumonia.

Impact of oral health status on oral intake ability prognosis after pneumonia in older patients: a retrospective cohort study.

BACKGROUND AND PURPOSE: Older dysphagic patients with pneumonia are frequently managed with a nil per os regimen on admission. This practice could lead to worse oral health and outcomes after pneumonia. The aim of this study is to examine the hypothesis that oral health status has an effect on oral intake prognosis after pneumonia in older adults. METHODS: This retrospective observational study evaluated data on consecutive in-patients with pneumonia aged > 65 years in an acute care ward. We compared baseline characteristics and outcomes between two groups with or without oral health problems assessed using the Oral Health Assessment Tool. Primary outcome was attaining total oral intake (Functional Oral Intake Scale) at discharge. Secondary outcome was length of hospital stay. RESULTS: After applying exclusion criteria, 162 patients were eligible for analysis; 113 (70.0%) had oral health problems. Patients without oral health problems had higher rates of total oral intake at discharge than patients with oral health problems (69.4% vs. 49.6%; p = 0.03). Patients without oral health problems had shorter length of hospital stay than patients with oral health problems (mean, 30.6 days vs. 41.3 days; p = 0.03). Multiple logistic regression analysis identified oral health problems as a significant factor for total oral intake at discharge (odds ratio, 0.45; 95% confidence interval, 0.21-0.98). Multiple linear regression analysis revealed that oral health problems significantly affected length of hospital stay (coefficient, 11.0; 95% confidence interval, 1.2-20.7). CONCLUSION: Our data demonstrated that poor oral health status was associated with poor oral intake ability prognosis in patients with pneumonia in acute care.

Factors Associated with Difficulty in Returning to School in Students After Traumatic Brain Injury.

Traumatic brain injury (TBI) often causes behavioral problems and difficulties with school work, but the specific factors associated with difficulty in returning to school after TBI still remain unclear. The purpose of this study was to investigate factors associated with difficulty in returning to school within 1 year of injury in students with traumatic brain injury. This study is a secondary analysis of existing data sets. We recruited patients aged 16 years in the United States with a primary rehabilitation diagnosis of TBI registered in the Traumatic Brain Injury Model Systems National Database. We compared variables between the students who returned to school and those who did not return to school. In addition, subgroup analyses were performed focused on traumatic brain injury severity. We excluded those were received <10 years of schooling, and 309 eligible students were identified for the analysis. Of these, 246 (80%) did not return to school within 1 year of injury. There were fewer cases of severe TBI in the group of students who returned to school than in the group who did not return to school (29% vs 44%, P = 0.03). The duration of rehabilitation was significantly longer in the group who returned to school than in the group who did not return to school (mean days 40 vs 29, P = 0.001), and a subgroup analysis showed in the severe traumatic brain injury group (mean days 46 vs 29; P = 0.02) and the non-severe traumatic brain injury group (mean days 37 vs 26; P = 0.02) similar results. Insufficient amount of rehabilitation was associated with difficulty in returning to school in students after TBI, regardless of the severity of the injury.

Loss of ribosomal RNA modification causes developmental defects in zebrafish.

Non-coding RNAs (ncRNAs) play key roles in diverse cellular activities, and efficient ncRNA function requires extensive posttranscriptional nucleotide modifications. Small nucleolar RNAs (snoRNAs) are a group of ncRNAs that guide the modification of specific nucleotides in ribosomal RNAs (rRNAs) and small nuclear RNAs. To investigate the physiological relevance of rRNA modification in vertebrates, we suppressed the expression of three snoRNAs (U26, U44 and U78), either by disrupting the host gene splicing or by inhibiting the snoRNA precursor processing, and analyzed the consequences of snoRNA loss-of-function in zebrafish. Using a highly sensitive mass spectrometric analysis, we found that decreased snoRNA expression reduces the snoRNA-guided methylation of the target nucleotides. Impaired rRNA modification, even at a single site, led to severe morphological defects and embryonic lethality in zebrafish, which suggests that rRNA modifications play an essential role in vertebrate development. This study highlights the importance of posttranscriptional modifications and their role in ncRNA function in higher eukaryotes.

[An investigation of the effect of gamma rays emitted by patients undergoing radionuclide bone scintigraphy in computed radiography during X-ray mammography examination].

For convenience of outpatients, mammographies of outpatients are often taken after the injection of a radionuclide. In this study, we investigated the effects of gamma rays emitted by a patient onto imaging plates (IPs). We used a flat container filled with (99m)Tc solution as a planar source to irradiate gamma rays onto IPs. We changed irradiation times on each IP, and took radiographies of an ACR-specified 156 model phantom and AGH-D210F phantom. We evaluated radiography images, using visual evaluation, and profile curves, histograms, and CNR and RMS granularities analyses. The results indicated that the depiction ability of a fibrous part began to fall when the irradiation time exceeded 3 minutes. With an increase in irradiation time, an increase in pixel value and RMS granularity value and a decrease in CNR value were observed. In conclusion, IP exposed by gamma rays influenced the evaluation of phantom images.