In the last decades there has been a growing interest towards the concept of "Quality of Life" (QoL), not only in the bio-medical field, but also in other areas, such as sociology, psychology, economics, philosophy, architecture, journalism, politics, environment, sports, recreation, advertisements. Nevertheless QoL does turn out to be an ambiguous and elusive concept -a precise, clear and shared definition appears to be a long way off. In this article an analysis of how QoL is interpreted and defined in various scientific articles published in the last two decades, is offered. In addition, an illustration of how widespread the use of this concept is in different fields of knowledge, the difficulties in reaching a shared understanding of QoL, the problems involved in stating clearly the construct, and a presentation of some of its conceptualizations, are provided. The importance of subjectivity in the definition of what QoL is, emerges as a key aspect. This personal and subjective dimension could be the starting point for a more thorough and holistic understanding of this concept, in which standardized sets of valid, reliable and evidence-based measures of, e.g., psychological and spiritual dimensions, are encompassed in the person's quality of life evaluation.

ObjectiveCurative surgery is not an option for many patients with clinical stage I non-small-cell lung carcinoma (NSCLC), but radical radiosurgery may be effective.MethodsInoperable patients with small peripheral clinical stage I NSCLC were enrolled in this study. Three-to-five fiducial markers were implanted in or near tumors under CT guidance. Gross tumor volumes (GTVs) were contoured using lung windows. The GTV margin was expanded by 5 mm to establish the planning treatment volume (PTV). A dose of 42–60 Gy was delivered to the PTV in 3 equal fractions in less than 2 weeks using the CyberKnife radiosurgery system. The 30-Gy isodose contour extended at least 1 cm from the GTV. Physical examination, CT imaging and pulmonary function testing were completed at 6 months intervals for three years following treatment.ResultsTwenty patients with an average maximum tumor diameter of 2.2 cm (range, 1.1 – 3.5 cm) and a mean FEV1 of 1.08 liters (range, 0.53 – 1.71 L) were treated. Pneumothorax requiring tube thoracostomy occurred following CT-guided fiducial placement in 25% of the patients. All patients completed treatment with few acute side effects and no procedure-related mortality. Transient chest wall discomfort developed in 8 of the 12 patients with lesions within 5 mm of the pleura. The mean percentage of the total lung volume receiving a minimum of 15 Gy was 7.3% (range, 2.4% to 11.3%). One patient who received concurrent gefitinib developed short-lived, grade III radiation pneumonitis. The mean percent predicted DLCO decreased by 9% and 11% at 6 and 12 months, respectively. There were no local failures, regional lymph node recurrences or distant metastases. With a median follow-up of 25 months for the surviving patients, Kaplan-Meier overall survival estimate at 2 years was 87%, with deaths due to COPD progression.ConclusionRadical CyberKnife radiosurgery is a well-tolerated treatment option for inoperable patients with small, peripheral stage I NSCLC. Effective doses and adequate margins are likely to have contributed to the optimal early local control seen in this study.

In severe sepsis, an increase in S100B does not allow the physicians to distinguish patients with severe impairment of consciousness from those with milder derangements or to prognosticate neurological recovery.

† Breast cancer, colon cancer, lung cancer, lymphoma, melanoma, sarcoma, and head and neck cancer.‡ Patient management includes diagnostic management and treatment management. § Patient clinical outcomes include overall survival, event-free survival, progression-free survival, disease-specific survival, disease-free survival, skeletal-related events, or change in outcome.

Human immunodeficiency virus (HIV)–associated neurocognitive disorder (HAND) is found in 30%–50% of individuals with HIV infection. To date, no HIV+ individual has been reported to have a positive amyloid PET scan. We report a 71-year-old HIV+ individual with HAND. Clinical and neuropsychologic evaluations confirmed a progressive mild dementia. A routine brain MRI was normal for age. [18F]Fluorodeoxyglucose–PET revealed mild hypermetabolism in bilateral basal ganglia and hypometabolism of bilateral parietal cortex including the posterior cingulate/precuneus. Resting state functional MRI revealed altered connectivity as found with individuals with mild AD. CSF examination revealed a low Aβ42/tau index but a low phospho-tau. An amyloid PET/CT with [18F]florbetaben revealed pronounced cortical radiotracer deposition. This case report suggests that progressive dementia in older HIV+ individuals may be due to HAND, AD, or both. HIV infection does not preclude CNS Aβ/amyloid deposition. Amyloid PET imaging may be of value in distinguishing HAND from AD pathologies.