Chest wall pain following lung stereotactic body radiation therapy using 48 Gy in three fractions: A search for predictors

Purpose

Chest wall pain is an uncommon but bothersome late complication following lung stereotactic body radiation therapy. Despite numerous studies investigating predictors of chest wall pain, no clear consensus has been established for a chest wall constraint. The aim of our study was to investigate factors related to chest wall pain in a homogeneous group of patients treated at our institution.

Disparate exposure to physically demanding working conditions in France

BackgroundOur study was aimed at examining disparate exposure to physically demanding working conditions in France, a key objective being to identify the types of employees/jobs requiring high-priority preventive actions.MethodsWe analyzed the data from the 2017 French nationwide cross-sectional survey (SUMER) on occupational hazards to which French employees in various sectors were subjected. The prevalence of several types of physically demanding working conditions (lifting of heavy loads, awkward body postures, vibrations, noise, and extreme temperatures) was explored. Potential associations of individual and job characteristics with these factors of hardship at work were studied by multivariate logistic regression.ResultsIn total, 48% of employees were exposed to at least one physically demanding working condition and 24.8% were exposed to multiple constraints. While managers and intellectual professionals were exposed relatively infrequently to physical constraints, blue-collar workers experienced the highest frequency of exposure. On the one hand, the role of company size depended on the factor of hardship at work considered; on the other hand, employees in large-scale companies were generally less exposed. As expected, employees in the construction industry were the most exposed to physical constraints; that said, our results also show that some activities in the services sector (e.g., personal care, administrative and support services) were quite significantly affected by a wide array of physically demanding working conditions.ConclusionNotwithstanding the establishment in France of Plans de Santé au travail (preventive workplace health and safety plans), occupational risks were found to be high, and above all, they were unevenly distributed among the various socio-professional categories, and strongly contributed to social inequalities in health. Our results identify the types of publics to be designated as high-priority targets for preventive measures aimed at reducing the adverse impacts of physically demanding working conditions and the incidence of associated musculoskeletal disorders.     

絮凝剂产生菌Diaphorobacter Z-052的发酵研究

从污水处理厂活性污泥中筛选出1株有絮凝活性的细菌Z-052，经分子生物学鉴定为Di-aphorobacter属。对Z-052产絮凝剂的发酵条件进行了优化。研究结果表明，在优化培养基中，于30℃培养72h，其发酵液对4g／L高岭土悬液的絮凝活性可达93．2％。Z-052絮凝剂对活性炭、土壤、酵母等固体颗粒悬液的絮凝活性分别达到95．1％、80．4％和72．4％。     

乳腺癌新辅助化疗后动态增强MRI表现与病理反应性相关性研究

目的探讨乳腺癌新辅助化疗后动态增强MRI（DCE—MRI）表现的形态学和时间信号强度曲线（TIC）类型与病理学反应性的关系。方法45例乳腺癌患者经新辅助化疗结束后行乳腺DCE—MR检查及手术治疗。应用AW4．2图像工作站观察残余肿瘤强化的形态和TIC类型（共3型）。由病理科医师对乳腺癌化疗后手术标本的病理反应性进行评估，分为1～5级，5级为病理完全缓解，4级和5级为组织学显著反应。分析病理反应性级别与DCE—MRI残余强化的TIC类型、形态的关系，统计方法采用精确概率法。结果45例中病理反应性5级7例，4级16例，3级16例，1和2级共6例。20例I型曲线中组织学显著反应者占70．0％（14／20），而6例Ⅲ型曲线均为组织学反应不显著者。TIC类型在不同的病理反应级别分布差异有统计学意义（P=0．001）。组织学显著反应且有残余强化者共18例，其中非肿块性强化11例。残余强化的肿块（非肿块）形态表现在不同病理反应性分级中分布差异有统计学意义（P=0．012）。结论乳腺癌新辅助化疗后DCE—MRI的形态及血液动力学表现特点与化疗后病理反应性相关。非肿块性强化和I型TIC与组织学显著反应有关。     

Intubating conditions and onset of neuromuscular block of rocuronium (Org 9426); a comparison with suxamethonium

The intubating conditions and neuromuscular blocking profile following 600 micrograms.kg-1 rocuronium (Org 9426) have been investigated in patients under various experimental conditions. They were compared with conditions following 1.5 mg.kg-1 suxamethonium, preceded by a precurarising dose (10 mg) of gallamine, and with those in a control group in the absence of a muscle relaxant. Rocuronium produced good to excellent intubating conditions at 60 as well as at 90 s after administration, even though there was only a partial blockade of the adductor pollicis muscle. Intubating conditions following suxamethonium were comparable with those after rocuronium. Half of the control patients could be intubated. The clinical duration and the recovery time of 600 micrograms.kg-1 of rocuronium were 24(4) and 9(3) min (mean(s.d.)), respectively. Rocuronium may have a major advantage over existing non-depolarising muscle relaxants due to the early presence of excellent intubating conditions. The results indicate that rocuronium may replace suxamethonium in procedures in which rapid sequence induction is required.     

Seasonal covariation of the circadian phases of rectal temperature and slow wave sleep onset

There is a scarcity of well-controlled studies of the seasonal variation in circadian rhythmicity. In the present study, the circadian phase of rectal temperature and the onset of slow wave sleep were studied in a series of twelve 24-h experiments, one each month of the year, for six healthy subjects under controlled conditions in a climatic chamber. In winter, as compared with summer, the average circadian rhythm of rectal temperature was phase delayed by 45 min, and the average onset of slow wave sleep was phase delayed by 40 min. The temporal relationship between the circadian phase of rectal temperature and the timing of slow wave sleep was maintained throughout the year. Habitual rising and retiring times covaried as well. Furthermore, the circadian rhythm of rectal temperature followed the timing of the photoperiod across the year, but had a much smaller range of seasonal variation. Apparently, the seasonal variation in the photoperiodic zeitgeber is largely compensated for by the stabilizing influence of secondary zeitgebers. However, in healthy subjects some effect of photoperiodic variation can still be observed.     

Nitric oxide administration after the ventilator: evaluation of mixing conditions

Background: Because of the potential toxicity of nitric oxide (NO) and its oxidising product nitrogen dioxide (NO₂), any system for the delivery of inhaled NO must aim at stable and predictable levels of NO and as low concentrations as possible of NO₂.
Methods: In a laboratory set-up, we have evaluated mixing conditions in a system where NO is added after the ventilator with continuous flow. Mixing was studied by using carbon dioxide (CO₂) as a tracer gas since capnography has a short response time (360 ms) in comparison with measurements of NO with electrochemical fuel cells (response time of 18s). CO₂ (in volumes corresponding to an ideal mixture of 1,3 and 6%) was fed, after the ventilator, either into plain breathing tubing, into one or two soda lime absorbers, or into an empty and a soda lime-filled canister, at different ventilatory rates and different I: E ratios. Samples were drawn from the inspiratory limb close to the Y-piece. NO was added in the same way and in the same volume as the highest concentration of CO₂.
Results: CO₂ added to plain tubing resulted in peak levels up to five times the set levels, while addition to a mixing box with an empty and a soda lime-filled canister resulted in even mixing with gas concentrations close to the ideal. When NO was fed into plain tubing, low levels were measured at the Y-piece, indicating poor mixing. Gas supply to a mixing chamber resulted in even concentrations.
Conclusions: Even and predictable levels of NO can be obtained with continuous flow of NO to the inspiratory limb, after the ventilator, if a mixing chamber is used. To obtain adequate mixing, the volume of the mixing box should be greater than the tidal volume.