The APSY-SED study: protocol of an observational, longitudinal, mixed methods and multicenter study exploring the psychological adjustment of relatives and healthcare providers of patients with cancer with continuous deep sedation until death.

BACKGROUND: Since 2016, France is the only country in the World where continuous deep sedation until death (CDSUD) is regulated by law. CDSUD serves as a response to refractory suffering in palliative situations where the patients' death is expected to occur in the following hours or days. Little is known on the psychological adjustment surrounding a CDSUD procedure for healthcare providers (HCPs) and relatives. Our study aims to gather qualitative and quantitative data on the specific processes behind the psychological adjustment of both relatives and HCPs, after the administration of CDSUD for patients with cancer. METHODS: The APSY-SED study is a prospective, longitudinal, mixed-methods and multicenter study. Recruitment will involve any French-speaking adult cancer patient for who a CDSUD is discussed, their relatives and HCPs. We plan to include 150 patients, 150 relatives, and 50 HCPs. The evaluation criteria of this research are: 1/ Primary criterion: Psychological adjustment of relatives and HCPs 6 and 13 months after the death of the patient with cancer (psychological adjustment = intensity of anxiety, depression and grief reactions, CDSUD-related distress, job satisfaction, Professional Stress and Professional experience). Secondary criteria: a)occurrence of wish for a CDSUD in patients in palliative phase; b)occurrence of wish for hastened death in patients in palliative phase; c)potential predictors of adjustment assessed after the discussion concerning CDSUD as an option and before the setting of the CDSUD; d) Thematic analysis and narrative account of meaning-making process concerning the grief experience. DISCUSSION: The APSY-SED study will be the first to investigate the psychological adjustment of HCPs and relatives in the context of a CDSUD procedure implemented according to French law. Gathering data on the grief process for relatives can help understand bereavement after CDSUD, and participate in the elaboration of specific tailored interventions to support HCPs and relatives. Empirical findings on CDSUD among patients with cancer in France could be compared with existing data in other countries and with results related to other medical fields where CDSUD is also conducted. TRIAL REGISTRATION: This protocol received the National Registration Number: ID-RCB2021-A03042-39 on 14/12/2021.

Petersen's hernia as a complication of bariatric surgery: CT findings.

Referrals for bariatric surgery have currently increased due to the need for more effective interventions in the management of severely obese patients. The Roux-en-Y gastric bypass is currently one of the preferred procedures, and internal hernias are the main causes of late postoperative complication. Petersen's hernia is a less common finding in most published papers compared to transmesocolic hernia, however, it seems to be increasing in incidence (in our service, eight cases which have been tomographic diagnosed in 2 years, were confirmed by laparoscopic surgery). The clinical findings are not specific, usually with abdominal pain, associated or not with abdominal distention and vomiting. In this context, imaging exams have an important role in the early diagnosis and surgery of this condition, with multislice computed tomography being the most accurate method. The aim of this pictorial essay is to the demonstrate the main CT findings associated with Petersen's hernia in patients who underwent Roux-en-Y gastric bypass.

Circadian variation of methyleugenol anesthesia in albino rats

In Wistar rats synchronized to a 12-h light/12-h dark cycle (lights on from 08:00 to 20:h), the ip injection of methyleugenol (200 mg/Kg) at 08:00, 12:00 and 16:00 h significantly increased the sleeping time (time between loss and recovery of righting reflex) when compared to animals anesthetized at 20:00, 24:00 and 04:00h. These data provide another example of the importance of circadian rhythms in biological systems and their practical relevance to pharmacology

Neoplasia trofoblastica gestacional: I. Imagem ultra-sonografica na neoplasia trofoblastica maligna. / Gestational trophoblastic neoplasm. I.Ultrasonographic image in malignant trophoblastic neoplasm

O exame ultra-sonografico no diagnostico da mola hidatiforme esta bem estabelecido, entretanto, e incipiente o estudo na neoplasia trofoblastica maligna. Dez pacientes foram avaliadas pela ultra-sonografia e encontramos imagem caracteristica que foi correlacionada com a arteriografia, mostrando ser um exame fiel, seguro e facilmente repetido, tanto no diagnostico como na avaliacao da resposta a quimioterapia durante e apos o tratamento

Hemangioendothelioma of the lung and pleura: report of three cases.

Three patients with hemangioendothelioma of the lung and pleura are reported. Two patients underwent removal of the pulmonary lesion: both recovered and were alive one year and eight years later. The patient with pleural involvement had a radical excision of the pleura with the vascular tumor. He died almost two years later. The main histologic feature of this lesion is the presence of neoplastic cells within the endothelium, evidenced by reticulin silver stain.

Correlacao radiologico-patologica na pielonefrite cronica. / Pathologic and radiographic correlation in chronic phylonephritis

Os autores fazem uma correlacao entre os aspectos anatomo-patologicos e os achados radiologicos da pielonefrite cronica, alem de tecerem comentarios acerca da incidencia, etiopatogenia e quadro clinico desta entidade