Vaccinations and therapeutics have been developed for COVID-19, but vaccine uptake varies markedly among countries. Public health responses have also varied, in particular, with lockdown efforts and school closing. All over the world, the pandemic exposed healthcare and economic weaknesses. COVID-19 exacerbated mental health issues by exposing the population to prolonged periods of fear, anxiety, financial stress, psychological uncertainties, and sometimes isolation from even family and friends. Chronic pain patients have been disproportionately affected. The pandemic-associated stresses may have exacerbated their already painful symptoms while at the same time interrupting their access to care. The ramifications of the COVID-19 post-viral syndrome ("long are not yet known. COVID-19 viral infection has been associated with neuropathic pain symptoms. Tele-triage and telehealth applications can help manage chronic pain patients in the COVID-19 era, but many interventional procedures, injections, or other treatments have been delayed. The role of palliative care for patients with terminal cases of infection must be re-examined. Palliative care is a relatively new medical specialty and allows terminally ill patients to die in as much comfort and peace as can be afforded to them. More training in palliative care for all clinicians is urgently needed. COVID-19 exposed much that is wrong or weak or inadequate in our healthcare systems, but it also allowed us to embrace new technologies and develop better systems to manage the challenge of a pandemic.
The authors describe a case of bone-marrow necrosis which represented the initial clinical feature of a "small cell" lung carcinoma with bone metastases.
The authors describe a case of nodular-sclerosing Hodgkin's disease, originally observed in clinical stage III B and treated by systemic chemotherapy, with relapse after a 28-year disease-free interval. As far as we know, the length of remission in this case is second only to that of a case recently described by Hung and co-workers. Therefore, although according to data in the literature relapse after a very long disease-free interval is more frequently observed in patients with stage I A and II A disease, it may occur also in cases with symptomatic, widespread disease. This phenomenon, while reflecting the complexity of relations between the different factors (histologic subtype, clinical stage, host vs tumor defenses, therapy, etc.) that variously affect the clinical course and outcome, underlines the need for cautiousness when assessing the ultimate prognosis of individual cases of Hodgkin's disease.
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