Fibrous Hamartoma of Infancy is a benign subdermal tumor most commonly presenting at the proximal appendages. Here we present a case of Fibrous Hamatoma of Infancy at the hand with discussion of its challenging excisi...Fibrous Hamartoma of Infancy is a benign subdermal tumor most commonly presenting at the proximal appendages. Here we present a case of Fibrous Hamatoma of Infancy at the hand with discussion of its challenging excision and post-operative complications. This case highlights the delicate and challenging nature of pediatric hand surgery.展开更多
Melanotic neuroectodermal tumor of infancy (MNTI) is a rare benign, locally invasive neoplasm afflicting the infant more often in the craniofacial region. The current understanding is that this tumor’s origin is neur...Melanotic neuroectodermal tumor of infancy (MNTI) is a rare benign, locally invasive neoplasm afflicting the infant more often in the craniofacial region. The current understanding is that this tumor’s origin is neural crest cells. The typical presentation is that a rapidly growing non-ulcerated anterior maxillary mass occurs in an infant usually less than six months old. This tumor may involve other areas including the ovaries, epididymis, femur, mandible, and brain. We present that an 8-month-old infant with a maxillary lesion of MNTI appeared encapsulated, which is a hitherto unreported feature. Investigations leading to the diagnosis and the management of the case are also presented. The need to report cases of this rare entity cannot be overemphasized as this will go a long way in adding new knowledge about its biological nature.展开更多
Acute lymphoblastic leukemia/lymphoma is a highly aggressive neoplasm of precursor lymphoid (blast) cells. There are 2 main subtypes based on lymphoid lineage;B lymphoblastic leukemia/lymphoma (B-ALL/LBL) and T lympho...Acute lymphoblastic leukemia/lymphoma is a highly aggressive neoplasm of precursor lymphoid (blast) cells. There are 2 main subtypes based on lymphoid lineage;B lymphoblastic leukemia/lymphoma (B-ALL/LBL) and T lymphoblastic leukemia/lymphoma (T-ALL/LBL). B-ALL/LBL commonly presents with fever, fatigue, bone or joint pain, bleeding or anorexia (signs of bone marrow infiltration), lymphadenopathy, hepatosplenomegaly, involvement of skin, soft tissue and testes, with a predilection for the central nervous system. Immature cell markers, such as CD34 and TdT, can help to differentiate lymphoblasts from Burkitt lymphoma which, is considered a mature high-grade B cell lymphoma that mimics lymphoblastic lymphoma/leukemia. Unfavorable prognostic factors include: infancy and adult age of diagnosis, high white blood cell count, slow response to initial therapy, central nervous system involvement at the time of diagnosis and Minimal residual disease after therapy. We present a case report of a 4 months old infant seen at a Tertiary Hospital with a rare presentation of CD34 Negative B-lymphoblastic leukemia/lymphoma presenting as cutaneous lesions in infancy.展开更多
ON October 1, 2019, the People’s Republic of China (PRC) ushers in the 70th anniversary of its founding. Over the past 70 diployears, the PRC has developed from the state of poverty and emptiness in 1949 to being the...ON October 1, 2019, the People’s Republic of China (PRC) ushers in the 70th anniversary of its founding. Over the past 70 diployears, the PRC has developed from the state of poverty and emptiness in 1949 to being the second largest economy in the world which is flourishing with a strong national identity.展开更多
Adolescence is the age of all disturbances both physiological and psychological.This internal and external insight conflicts is often hard to be managed.Thus,some teens will be subjected to act more than others.They u...Adolescence is the age of all disturbances both physiological and psychological.This internal and external insight conflicts is often hard to be managed.Thus,some teens will be subjected to act more than others.They use their bodies to show deep suffering as well as confusion.Numerous pathological behaviors can appear due to this significant sensitiveness like escaping difficulties.One of the ways solving this hardness of understanding and resolving these disorders is the disturbance in the nutritional behavior.This paper would allow us to understand the subjective dimensions that incite acting by mental anorexia.We suggest that a lack in the reflexive function might be the main cause of the attitude.Thereby,teen’s mental anorexia would show mistreatment at early care,that would make them feel unable to be good mothers in the future.展开更多
目的分析八珍汤联合调脾针刺治疗肿瘤相关性厌食患者的效果。方法纳入80例肿瘤相关性厌食患者,随机分为对照组与试验组各40例,在常规治疗基础上,对照组给予八珍汤治疗,试验组在对照组基础上联合治疗调脾针刺治疗,两组均治疗6周。比较两...目的分析八珍汤联合调脾针刺治疗肿瘤相关性厌食患者的效果。方法纳入80例肿瘤相关性厌食患者,随机分为对照组与试验组各40例,在常规治疗基础上,对照组给予八珍汤治疗,试验组在对照组基础上联合治疗调脾针刺治疗,两组均治疗6周。比较两组患者治疗前后中医证候积分、血清营养指标、营养状态水平、癌因性疲乏情况。记录两组患者不良反应发生情况。结果治疗6周后,两组患者神疲乏力、恶心呕吐、食欲不振中医证候积分和Piper疲乏调查量表评分均降低,且两组比较,试验组评分更低(P<0.05);两组患者前白蛋白(prealbumin,PA)、血红蛋白(hemoglobin,Hb)、转铁蛋白(transferrin,TRF)水平、体质量指数(body mass index,BMI)、上臂中点周径(mid-point arm circumference,MAC)、肱三头肌皮褶厚度(triceps skinfold thickness,TSF)、上臂肌肉周径(mid-arm muscle circumference,MAMC)水平均上升,且两组比较,试验组水平更高(P<0.05)。治疗期间,两组均未发生严重不良反应。结论八珍汤联合调脾针刺治疗肿瘤相关性厌食患者可明显缓解其食欲不振、疲乏等临床症状,有利于提高其营养水平,改善患者体质量等身体状态。展开更多
Objective:To observe the clinical effect difference between abdominal acupuncture combined with megestrol acetate and megestrol acetate for advanced cancer-related anorexia.Methods:A total of 60 patients with advanced...Objective:To observe the clinical effect difference between abdominal acupuncture combined with megestrol acetate and megestrol acetate for advanced cancer-related anorexia.Methods:A total of 60 patients with advanced cancer-related anorexia were randomly divided into an abdominal acupuncture combined with oral megestrol acetate treatment group(group A)and oral megestrol acetate treatment group(group B),with 30 cases in each group.Both groups were given nutritional assessment,nutritional supplementation,improvement of constipation,correction of electrolyte disturbance and other general treatments.In addition,group B was given another 160 mg megestrol acetate dispersible tablet once a day.Group A was treated with abdominal acupuncture on the basis of group B treatment,5 times a week,and both the groups were treated for 2 weeks.The appetite visual analog scale(VAS),Karnofsky(KPS)score,and body weight of the two groups were observed before and after treatment,and the clinical efficacy was evaluated.Results:After treatment,the appetite VAS in the both groups were lower than those before treatment,the Karnofsky(KPS)scores were higher than those before treatment,and the differences were statistically significant(both P<0.05).The differences of appetite VAS and KPS score before and after treatment in group A were higher than those of group B,and the differences were statistically significant(both P<0.05).After treatment,the body weights of the two groups were higher than those before treatment,and the difference of group A before and after treatment was higher than that of group B,but the difference was not statistically significant(P>0.05).The effective rate of group A was 76.7%and that of group B was 50%,the difference was statistically significant(P<0.05).Conclusion:Abdominal acupuncture combined with oral megestrol acetate and oral megestrol acetate both can effectively improve the appetite and functional status of patients with advanced cancer-related anorexia.Abdominal acupuncture can improve the curative effect,which is better than that of western medication alone,providing a new idea for the treatment of advanced cancer-related anorexia in the future.展开更多
OBJECTIVE:To use evidence-based medicine to systematically evaluate the effectiveness and safety of acupuncture therapy for improving anorexia in tumor patients.METHODS:We queried the China National Knowledge Infrastr...OBJECTIVE:To use evidence-based medicine to systematically evaluate the effectiveness and safety of acupuncture therapy for improving anorexia in tumor patients.METHODS:We queried the China National Knowledge Infrastructure Database(CNKI),China Science and Technology Journal Database(VIP),Wanfang Data,Pub Med,Cochrane Library,and Embase databases to identify reports of randomized controlled trials(RCTs)that applied acupuncture therapy to improve anorexia in tumor patients,and used Rev Man 5.3 software to conduct a Meta-analysis of the effective rate,appetite score,Karnofsky Performance Status(KPS)score,Functional Assessment of Anorexia/Cachexia Therapy(FAACT)appetite scale,and body weight in each study.Subgroup analysis was conducted based on whether radiotherapy or chemotherapy were also administered.RESULTS:A total of 10 RCTs were included with a total of 648 patients,including 343 patients in the treatment group and 305 patients in the control group.The Meta-analysis results showed that the clinical efficacy,appetite score,KPS score,and FAACT score of the treatment group(which received acupuncture to improve appetite)were better than those of the control group,and the difference was statistically significant(P<0.05);however,there was no statistically significant difference in body weight between the treatment group and the control group(P>0.05).The results of the subgroup analysis showed that the effective rate and appetite score for patients with long-term and chronic loss of appetite who underwent acupuncture were better than those of the control group,and the difference was statistically significant(P<0.05).CONCLUSIONS:Acupuncture therapy has good efficacy and safety in the treatment of anorexia in tumor patients,and it also has good efficacy and safety for long-term and chronic loss of appetite.The reliability and stability of the above results need to be confirmed by high-quality RCTs with larger sample sizes.展开更多
Objectives: To evaluate the long-term outcome of adolescents with anorexia nervosa and attempt to define prognostic factors for outcome. Methods: Transversal, descriptive epidemiological study with a strict methodolog...Objectives: To evaluate the long-term outcome of adolescents with anorexia nervosa and attempt to define prognostic factors for outcome. Methods: Transversal, descriptive epidemiological study with a strict methodology: minimum interval of 4 years since first admission, evaluation using clearly defined diagnostic criteria (EAT-40 self-evaluation, HSCL, global patient-driven self-evaluation and hetero evaluation: clinical interview and LECE). The 198 subjects are former adolescent anorexics treated at the Hôpital d’Enfants (Children’s Hospital) in Nancy (France). Results: Clinical evaluation of the 144 subjects traced showed positive outcome for 68.1%, intermediate outcome for 23.2% and poor outcome for 8.7%. 5 factors for a good prognosis were found (middle socioeconomic class of parents, no prior treatment, hospitalization > 1 month,展开更多
The question of the link between pregnancy and eating disorders is an important question. At the moment, there are few concrete answers for these patients. Despite common fertility challenges, patients who suffer from...The question of the link between pregnancy and eating disorders is an important question. At the moment, there are few concrete answers for these patients. Despite common fertility challenges, patients who suffer from ED are able to access maternity. ED and pregnancy can either have an easy evolution or experience a lot of trouble. Many studies describe obstetrical and foetal complications (low birthweight, inadequate intra-uterine growth, small head circumference, miscarriage, caesarean section). Those patients are frequently reluctant to address their disease with their specialist, who also often doesn’t know how to screen the signs. The lack of official data to train the specialists further increases these difficulties. However, ED are frequent in the general population and young patients are likely to eventually want to become mothers. It is thus essential to know how to screen those patients early and accurately to improve their treatment and care. Eating disorders impact the pregnancy, the delivery and the postpartum as well as the growth of the baby. It is an important public health problem. The evolution from being a woman to becoming a mother is a difficult one, and even more so when the women is suffering from ED. Those patients must handle their nutritional fears, the anxiety about their body changing with pregnancy and the daily challenges. The early interactions with their baby have consequences on their development. It seems necessary to evaluate how to improve the screening and the patient care in ED patients. Screening should begin from the pregnancy desire to the postpartum. This patient care should be based on a multidisciplinary care team.展开更多
AIM: To compare outcomes in anorexia nervosa(AN) in different treatment settings: inpatient, partial hospitalization and outpatient. METHODS: Completed and published in the English language, randomized controlled tria...AIM: To compare outcomes in anorexia nervosa(AN) in different treatment settings: inpatient, partial hospitalization and outpatient. METHODS: Completed and published in the English language, randomized controlled trials comparing treatment in two or more settings or comparing different lengths of inpatient stay, were identified by database searches using terms "anorexia nervosa" and "treatment" dated to July 2014. Trials were assessed for risk of bias and quality according to the Cochrane handbook by two authors(Madden S and Hay P) Data were extracted on trial quality, participant features and setting, main outcomes and attrition. RESULTS: Five studies were identified, two comparing inpatient treatment to outpatient treatment, one study comparing different lengths of inpatient treatment, one comparing inpatient treatment to day patient treatment and one comparing day patient treatment with outpatient treatment. There was no difference in treatment outcomes between the different treatment settings and different lengths of inpatient treatment. Both outpatient treatment and day patient treatment were significantly cheaper than inpatient treatment. Brief inpatient treatment followed by evidence based outpatient care was also cheaper than prolonged inpatient care for weight normalization also followed by evidence based outpatient care. CONCLUSION: There is preliminary support for AN treatment in less restrictive settings but more research is needed to identify the optimum treatment setting for anorexia nervosa.展开更多
文摘Fibrous Hamartoma of Infancy is a benign subdermal tumor most commonly presenting at the proximal appendages. Here we present a case of Fibrous Hamatoma of Infancy at the hand with discussion of its challenging excision and post-operative complications. This case highlights the delicate and challenging nature of pediatric hand surgery.
文摘Melanotic neuroectodermal tumor of infancy (MNTI) is a rare benign, locally invasive neoplasm afflicting the infant more often in the craniofacial region. The current understanding is that this tumor’s origin is neural crest cells. The typical presentation is that a rapidly growing non-ulcerated anterior maxillary mass occurs in an infant usually less than six months old. This tumor may involve other areas including the ovaries, epididymis, femur, mandible, and brain. We present that an 8-month-old infant with a maxillary lesion of MNTI appeared encapsulated, which is a hitherto unreported feature. Investigations leading to the diagnosis and the management of the case are also presented. The need to report cases of this rare entity cannot be overemphasized as this will go a long way in adding new knowledge about its biological nature.
文摘Acute lymphoblastic leukemia/lymphoma is a highly aggressive neoplasm of precursor lymphoid (blast) cells. There are 2 main subtypes based on lymphoid lineage;B lymphoblastic leukemia/lymphoma (B-ALL/LBL) and T lymphoblastic leukemia/lymphoma (T-ALL/LBL). B-ALL/LBL commonly presents with fever, fatigue, bone or joint pain, bleeding or anorexia (signs of bone marrow infiltration), lymphadenopathy, hepatosplenomegaly, involvement of skin, soft tissue and testes, with a predilection for the central nervous system. Immature cell markers, such as CD34 and TdT, can help to differentiate lymphoblasts from Burkitt lymphoma which, is considered a mature high-grade B cell lymphoma that mimics lymphoblastic lymphoma/leukemia. Unfavorable prognostic factors include: infancy and adult age of diagnosis, high white blood cell count, slow response to initial therapy, central nervous system involvement at the time of diagnosis and Minimal residual disease after therapy. We present a case report of a 4 months old infant seen at a Tertiary Hospital with a rare presentation of CD34 Negative B-lymphoblastic leukemia/lymphoma presenting as cutaneous lesions in infancy.
文摘ON October 1, 2019, the People’s Republic of China (PRC) ushers in the 70th anniversary of its founding. Over the past 70 diployears, the PRC has developed from the state of poverty and emptiness in 1949 to being the second largest economy in the world which is flourishing with a strong national identity.
文摘Adolescence is the age of all disturbances both physiological and psychological.This internal and external insight conflicts is often hard to be managed.Thus,some teens will be subjected to act more than others.They use their bodies to show deep suffering as well as confusion.Numerous pathological behaviors can appear due to this significant sensitiveness like escaping difficulties.One of the ways solving this hardness of understanding and resolving these disorders is the disturbance in the nutritional behavior.This paper would allow us to understand the subjective dimensions that incite acting by mental anorexia.We suggest that a lack in the reflexive function might be the main cause of the attitude.Thereby,teen’s mental anorexia would show mistreatment at early care,that would make them feel unable to be good mothers in the future.
文摘目的分析八珍汤联合调脾针刺治疗肿瘤相关性厌食患者的效果。方法纳入80例肿瘤相关性厌食患者,随机分为对照组与试验组各40例,在常规治疗基础上,对照组给予八珍汤治疗,试验组在对照组基础上联合治疗调脾针刺治疗,两组均治疗6周。比较两组患者治疗前后中医证候积分、血清营养指标、营养状态水平、癌因性疲乏情况。记录两组患者不良反应发生情况。结果治疗6周后,两组患者神疲乏力、恶心呕吐、食欲不振中医证候积分和Piper疲乏调查量表评分均降低,且两组比较,试验组评分更低(P<0.05);两组患者前白蛋白(prealbumin,PA)、血红蛋白(hemoglobin,Hb)、转铁蛋白(transferrin,TRF)水平、体质量指数(body mass index,BMI)、上臂中点周径(mid-point arm circumference,MAC)、肱三头肌皮褶厚度(triceps skinfold thickness,TSF)、上臂肌肉周径(mid-arm muscle circumference,MAMC)水平均上升,且两组比较,试验组水平更高(P<0.05)。治疗期间,两组均未发生严重不良反应。结论八珍汤联合调脾针刺治疗肿瘤相关性厌食患者可明显缓解其食欲不振、疲乏等临床症状,有利于提高其营养水平,改善患者体质量等身体状态。
基金Supported by Huguo Temple Hospital of Traditional Chinese Medicine Affiliated to Beijing University of Traditional Chinese Medicine:2017-3
文摘Objective:To observe the clinical effect difference between abdominal acupuncture combined with megestrol acetate and megestrol acetate for advanced cancer-related anorexia.Methods:A total of 60 patients with advanced cancer-related anorexia were randomly divided into an abdominal acupuncture combined with oral megestrol acetate treatment group(group A)and oral megestrol acetate treatment group(group B),with 30 cases in each group.Both groups were given nutritional assessment,nutritional supplementation,improvement of constipation,correction of electrolyte disturbance and other general treatments.In addition,group B was given another 160 mg megestrol acetate dispersible tablet once a day.Group A was treated with abdominal acupuncture on the basis of group B treatment,5 times a week,and both the groups were treated for 2 weeks.The appetite visual analog scale(VAS),Karnofsky(KPS)score,and body weight of the two groups were observed before and after treatment,and the clinical efficacy was evaluated.Results:After treatment,the appetite VAS in the both groups were lower than those before treatment,the Karnofsky(KPS)scores were higher than those before treatment,and the differences were statistically significant(both P<0.05).The differences of appetite VAS and KPS score before and after treatment in group A were higher than those of group B,and the differences were statistically significant(both P<0.05).After treatment,the body weights of the two groups were higher than those before treatment,and the difference of group A before and after treatment was higher than that of group B,but the difference was not statistically significant(P>0.05).The effective rate of group A was 76.7%and that of group B was 50%,the difference was statistically significant(P<0.05).Conclusion:Abdominal acupuncture combined with oral megestrol acetate and oral megestrol acetate both can effectively improve the appetite and functional status of patients with advanced cancer-related anorexia.Abdominal acupuncture can improve the curative effect,which is better than that of western medication alone,providing a new idea for the treatment of advanced cancer-related anorexia in the future.
基金Supported by National Natural Science Foundation of China(No.82074545)Hebei Provincial Administration of Traditional Chinese Medicine Research Project on Traditional Chinese Medicine(No.2019132)。
文摘OBJECTIVE:To use evidence-based medicine to systematically evaluate the effectiveness and safety of acupuncture therapy for improving anorexia in tumor patients.METHODS:We queried the China National Knowledge Infrastructure Database(CNKI),China Science and Technology Journal Database(VIP),Wanfang Data,Pub Med,Cochrane Library,and Embase databases to identify reports of randomized controlled trials(RCTs)that applied acupuncture therapy to improve anorexia in tumor patients,and used Rev Man 5.3 software to conduct a Meta-analysis of the effective rate,appetite score,Karnofsky Performance Status(KPS)score,Functional Assessment of Anorexia/Cachexia Therapy(FAACT)appetite scale,and body weight in each study.Subgroup analysis was conducted based on whether radiotherapy or chemotherapy were also administered.RESULTS:A total of 10 RCTs were included with a total of 648 patients,including 343 patients in the treatment group and 305 patients in the control group.The Meta-analysis results showed that the clinical efficacy,appetite score,KPS score,and FAACT score of the treatment group(which received acupuncture to improve appetite)were better than those of the control group,and the difference was statistically significant(P<0.05);however,there was no statistically significant difference in body weight between the treatment group and the control group(P>0.05).The results of the subgroup analysis showed that the effective rate and appetite score for patients with long-term and chronic loss of appetite who underwent acupuncture were better than those of the control group,and the difference was statistically significant(P<0.05).CONCLUSIONS:Acupuncture therapy has good efficacy and safety in the treatment of anorexia in tumor patients,and it also has good efficacy and safety for long-term and chronic loss of appetite.The reliability and stability of the above results need to be confirmed by high-quality RCTs with larger sample sizes.
文摘Objectives: To evaluate the long-term outcome of adolescents with anorexia nervosa and attempt to define prognostic factors for outcome. Methods: Transversal, descriptive epidemiological study with a strict methodology: minimum interval of 4 years since first admission, evaluation using clearly defined diagnostic criteria (EAT-40 self-evaluation, HSCL, global patient-driven self-evaluation and hetero evaluation: clinical interview and LECE). The 198 subjects are former adolescent anorexics treated at the Hôpital d’Enfants (Children’s Hospital) in Nancy (France). Results: Clinical evaluation of the 144 subjects traced showed positive outcome for 68.1%, intermediate outcome for 23.2% and poor outcome for 8.7%. 5 factors for a good prognosis were found (middle socioeconomic class of parents, no prior treatment, hospitalization > 1 month,
文摘The question of the link between pregnancy and eating disorders is an important question. At the moment, there are few concrete answers for these patients. Despite common fertility challenges, patients who suffer from ED are able to access maternity. ED and pregnancy can either have an easy evolution or experience a lot of trouble. Many studies describe obstetrical and foetal complications (low birthweight, inadequate intra-uterine growth, small head circumference, miscarriage, caesarean section). Those patients are frequently reluctant to address their disease with their specialist, who also often doesn’t know how to screen the signs. The lack of official data to train the specialists further increases these difficulties. However, ED are frequent in the general population and young patients are likely to eventually want to become mothers. It is thus essential to know how to screen those patients early and accurately to improve their treatment and care. Eating disorders impact the pregnancy, the delivery and the postpartum as well as the growth of the baby. It is an important public health problem. The evolution from being a woman to becoming a mother is a difficult one, and even more so when the women is suffering from ED. Those patients must handle their nutritional fears, the anxiety about their body changing with pregnancy and the daily challenges. The early interactions with their baby have consequences on their development. It seems necessary to evaluate how to improve the screening and the patient care in ED patients. Screening should begin from the pregnancy desire to the postpartum. This patient care should be based on a multidisciplinary care team.
基金Madden S and Touyz S have received consultancy fees from Shire Pharmaceuticals
文摘AIM: To compare outcomes in anorexia nervosa(AN) in different treatment settings: inpatient, partial hospitalization and outpatient. METHODS: Completed and published in the English language, randomized controlled trials comparing treatment in two or more settings or comparing different lengths of inpatient stay, were identified by database searches using terms "anorexia nervosa" and "treatment" dated to July 2014. Trials were assessed for risk of bias and quality according to the Cochrane handbook by two authors(Madden S and Hay P) Data were extracted on trial quality, participant features and setting, main outcomes and attrition. RESULTS: Five studies were identified, two comparing inpatient treatment to outpatient treatment, one study comparing different lengths of inpatient treatment, one comparing inpatient treatment to day patient treatment and one comparing day patient treatment with outpatient treatment. There was no difference in treatment outcomes between the different treatment settings and different lengths of inpatient treatment. Both outpatient treatment and day patient treatment were significantly cheaper than inpatient treatment. Brief inpatient treatment followed by evidence based outpatient care was also cheaper than prolonged inpatient care for weight normalization also followed by evidence based outpatient care. CONCLUSION: There is preliminary support for AN treatment in less restrictive settings but more research is needed to identify the optimum treatment setting for anorexia nervosa.
