MR-DWIBS may be used to evaluate localisation of parenchymal neoplasms but is less efficacious in characterising lymph-node and skeletal lesions. [(18)F]-FDG-PET/CT remains the best whole-body technique to identify lymph-node and skeletal lesions, but its limitation is identifying tumours with low glucose metabolism as in mucinous neoplasms. MR-DWIBS evaluation must be integrated with morphological images to increase MR diagnostic accuracy.
Recent advances in tumor immunotherapy have made it possible to efficiently unleash immune effectors, reacting against neoplastic cells. Although these approaches primarily aim to eradicate malignancy, immune-related adverse events (irAEs) often influence patients’ prognosis, constituting a new spectrum of side effects. Taking into account the typical microenvironment and the intricate equilibrium between the anti-tumor response and the immune cells, the thymoma constitutes a unicum in the immune-oncology field. We report a fatal immune-mediated adverse events’ storm in a thymoma patient treated with Pembrolizumab, leading to hepatotoxicity accompanied by lymphocytosis, thrombocytopenia, and thyroid dysfunction, unveiling a novel potential pathophysiological effect of immunotherapy. The clinical proficiency of the immune checkpoint inhibitors in thymoma patients warrants timely prevention and management of off-target consequences in order to optimize this promising therapeutic option. This case report describes a unique consequence of irAEs, emerging as a red flag warranting a multidisciplinary approach.
Subjects affected by schizophrenia present significant deficits in various aspects of social cognition, such as emotion processing, social perception and theory of mind (ToM). These deficits have a greater impact than symptoms on occupational and social functioning. Therefore, social cognition represents an important therapeutic target in people with schizophrenia. Recent meta-analyses showed that social cognition training (SCT) is effective in improving social cognition in subjects with schizophrenia; however, real-life functioning is not always ameliorated. Integration of SCT with an intervention targeting metacognitive abilities might improve the integration of social cognitive skills to daily life functioning. Our research group has implemented a new individualized rehabilitation program: the Social Cognition Individualized Activities Lab, SoCIAL, which integrates SCT with a module for narrative enhancement, an intervention targeting metacognitive abilities. The present multi-center randomized controlled study will compare the efficacy of SoCIAL and treatment as usual (TAU) in subjects diagnosed with a schizophrenia-spectrum disorder. The primary outcome will be the improvement of social cognition and real-life functioning; while the secondary outcome will be the improvement of symptoms, functional capacity and neurocognition. The results of this study will add empirical evidence to the benefits and feasibility of SCT and narrative enhancement in people with schizophrenia-spectrum disorders.
Our work is in accordance with the literature. Using this technique MoBI-trak has been shown to be a reliable technique for the detection of peripheral vascular disease up to the trifurcation, although it underlines the necessity for more diagnostic investigation and improvements in the technique.
Se realizó el monitoreo y evaluación fisicoquímica de aguas residuales en las áreas críticas de drenaje correspondientes a la PTAR Puente Piedra, Lima. Para ello, se consideró la posición geográfica, el número de Usuarios No Domésticos (UND) y la identificación de UND cuyas descargas de aguas residuales presentaban elevado caudal. En las áreas críticas se establecieron puntos de monitoreo de aguas residuales, correspondientes a buzones de desagüe, en los que se evaluó la calidad a través del cumplimiento de los Valores Máximos Admisibles (VMA) del D.S. 021-2009- VIVIENDA. El plan de monitoreo abarcó un periodo de control de 8 horas con monitorios puntuales realizados cada 2 horas. En los puntos de monitoreo BZ-70651 y BZ-59124 se encontró exceso en los VMA para pH (>14), DBO5, DQO, SST, aceites y grasas a causa de presencia de industrias textiles y de fabricación de papel; en el punto BZ-212339 se encontró exceso DBO5, DQO, SST, aceites y grasas, sólidos sedimentables como resultado de material orgánico liberado por comercios, restaurantes y usuarios domésticos; en el punto BZ-46847 no se registró exceso en los VMA; y en el punto BZ-212344 se excedió DBO5 a causa de descargas de comercios, usuarios domésticos e industrias. Se recomienda extender la aplicación de la normativa, considerando los parámetros de análisis biológico, mejorar la fiscalización de los UND en el área de drenaje, establecimiento de estaciones de monitoreo continuo y replicar el procedimiento descrito a otras áreas de drenaje de PTAR para la optimización de los procesos de tratamiento de aguas residuales.
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