Rectal stump cancer has a low incidence rate, with patients with a history of colonic neoplasia carrying the highest risk of developing this severe complication. We observed no significant differences in quality of life between rectal stump and postproctectomy patients, but proctectomy surgery is associated with sexual and urinary complications.
The occurrence of primary melanoma of the small intestine is rare. We describe the case of a 25-year-old man found to have a primary melanoma of the ileum. The patient presented with gradual onset of abdominal pain, fever, diarrhea, weight loss and fatigue. A preoperative diagnosis of a small intestinal tumor was based on the findings of computed tomography scanning. This diagnosis was confirmed at laparotomy and a partial small bowel resection was performed. Histopathological examination of the resected specimen clarified the exact nature of the lesion, confirming the diagnosis of melanoma. Thorough postoperative investigation did not reveal a primary lesion in the skin, gastrointestinal tract, oculus or brain. Thus, we diagnosed this tumor as a primary lesion. One year after his operation, the patient remains well without any evidence of recurrence. Thus, we diagnosed this small bowel tumor as a primary melanoma of the small intestine.
ObjectiveCOVID-19 has put a strain on regular healthcare worldwide. For inflammatory bowel disease (IBD), gastrointestinal surgeries were postponed and changes in treatment and diagnostic procedures were made. As abrupt changes in treatment regimens may result in an increased morbidity and consequent well-being of patients with IBD, the aim of this study was to determine the effect of the COVID-19 pandemic on health-related quality of life (HRQoL) in patients with IBD.DesignAll patients with IBD who completed both Inflammatory Bowel Disease Questionnaire (IBDQ) and 36-Item Short Form Health Survey (SF-36) questionnaire between 31 August and 13 September 2020 were included in our cohort study. The primary end point was to determine the HRQoL in patients with IBD, measured by the IBDQ and SF-36 questionnaire. The secondary end point was determining which factors influence the HRQoL in patients with IBD.Results582 patients with IBD filled in the IBDQ and SF-36 questionnaire. The HRQoL in our study population was low according to the questionnaires on both physical and mental subscales. In addition, multivariate analysis showed that increased age, female sex and patients who underwent surgery had a significantly lower HRQoL, most frequently on the physical domains in both questionnaires.ConclusionPatients with IBD had an overall low HRQoL during the COVID-19 pandemic. Furthermore, older patients, women and patients who underwent surgical procedures had the lowest physical HRQoL.
Context. A significant fraction (10–20%) of the most massive stars move through space with a high (v ≳ 30 km s−1) velocity. One of the possible physical explanations is that a supernova in a compact binary system results in a high recoil velocity of the system. If the system remains bound, it can be subsequently observed as a spectroscopic binary (SB1), a high-mass X-ray binary, a compact binary, and finally a gravitational-wave event. Aims. If such a system is traced back to its parent cluster, binary evolution models can be tested in great detail. Methods. The Gaia proper motions and parallaxes are used to demonstrate that the high-mass X-ray binary HD 153919/4U 1700-37 originates from NGC 6231, the nucleus of the OB association Sco OB1. Results. The O supergiant and its compact companion, of which the physical nature (a neutron star or a black hole) is unknown, move with a space velocity of 63 ± 5 km s−1 with respect to NGC 6231. The kinematical age of the system is 2.2 ± 0.1 Myr. The parallaxes and accurate proper motions in Gaia DR2 were used to perform a membership analysis of NGC 6231; 273 members are identified, of which 268 have good quality photometry. The distance to NGC 6231 is 1.63 ± 0.15 kpc. Isochrone fitting results in an age of 4.7 ± 0.4 Myr and an extinction AV to the cluster of 1.7 ± 0.1. With the identification of NGC 6231 as the parent cluster, the upper limit on the age of the progenitor of 4U1700-37 at the moment of the supernova explosion is 3.0 ± 0.5 Myr. Conclusions. With these constraints, the evolutionary history of the system can be reconstructed with an initial mass of the progenitor of the compact object > 60 M⊙. The high mass, the extreme mass ratio, and short orbital separation of the system make it difficult to produce possible progenitor systems through population synthesis. We propose that the system experienced a Case A mass transfer phase before the supernova, which typically widens a binary. In order to create a progenitor system that does not merge, a lot of angular momentum must be lost from the system during the phase of mass transfer and/or an asymmetry in the supernova explosion provides a kick resulting in the observed orbital parameters. Given its current high space velocity and the derived evolutionary history, the compact object in the system is more likely to have received a large natal kick, which suggests that it is more likely a neutron star than a black hole. HD 153919/4U1700-37 might be a prototype in the Milky Way for the progenitor of gravitational wave events such as GW190412.
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