Multi-institutional feasibility study of intensity-modulated radiotherapy with chemotherapy for locally advanced non-small cell lung cancer

International Journal of Clinical Oncology - This multi-institutional clinical trial evaluated the feasibility of intensity-modulated radiotherapy (IMRT) for patients with locally advanced...     

A case of diaphragmatic hernia incarceration after a heart transplant operation

We report a case of a diaphragmatic hernia after a heart transplant operation. A 43-year-old woman, who underwent orthotropic heart transplantation for hypertrophic cadiomyopathy two year earlier, presented with vomiting and epigastric pain. A computed tomography scan showed that the stomach and transverse colon were dislocated in the left thoracic cavity. We diagnosed left diaphragmatic hernia incarceration and performed laparoscopic repair of the diaphragmatic hernia. A 12 × 8 cm diaphragmatic defect was found intraoperatively on the ventrolateral aspect of the left diaphragm, and the stomach with volvulus had herniated into the thorax through the defect. The hernia was considered to be iatrogenic. The diaphragmatic defect was large, and the diaphragm was thinning. We closed the defect by mesh repair. Laparoscopic mesh repair of the diaphragmatic hernia could be performed safely and with minimal invasiveness.     

What Factors Affect the Evolution of the Wife’s Mental Health After the Husband’s Retirement? Evidence From a Population-Based Nationwide Survey in Japan

BackgroundThe “retired husband syndrome” refers to the negative impact of the husband’s retirement on the wife’s health. This study provided new insights by examining whether and to what extent the wife’s social participation, interactions with her husband, and job status prior to her husband’s retirement affected the evolution of her mental health after her husband’s retirement.MethodsWe collected data from a 12-wave nationwide panel survey conducted from 2005 to 2016, starting with individuals aged 50–59 years. Focusing on 3,794 female respondents whose husbands retired during the survey period, we applied random-effects linear regression models to investigate the evolution of their mental health as measured by the Kessler 6 (K6) score (range, 0–24; Mean, 3.41; standard deviation, 4.11) during the 5 years after their husbands’ retirement.ResultsOn average, the wife’s K6 score rose by 0.18 (95% confidence interval [CI], 0.08–0.28), 0.18 (95% CI, 0.03–0.34), and 0.19 (95% CI, −0.02 to 0.43) in the first 3 years, respectively, after the husband’s retirement, before declining toward the baseline level. However, the wife’s active social participation, intense interactions with her husband, and absence of paid employment before her husband’s retirement prevented her mental health from deteriorating.ConclusionThe results suggest the limited relevance of the “retired husband syndrome” among middle-aged Japanese couples. The effects of a husband’s retirement on the wife’s mental health depended heavily on her prior behavior.Key words: marital quality, mental health, random-effects model, retired husband syndrome, social participation