Background: Cancer is a chronic condition that induces significant emotional and physical stress, which may increase the risk for developing Takotsubo cardiomyopathy (TCM). Main body: Takotsubo cardiomyopathy, also known as stress cardiomyopathy, is a clinical syndrome that generally presents as chest pain mimicking acute coronary syndrome or as an acute heart failure characterized by severe left ventricular systolic dysfunction in response to emotional, physical, or medical stress. The potential triggers for Takotsubo syndrome in cancer patients include the emotional turmoil of a cancer diagnosis, the inflammatory state of the cancer itself, and the physical stress of cancer surgery, systemic anti-neoplastic therapy, and radiation treatment. TCM is becoming increasingly recognized among patients with cancer and has been associated with adverse outcomes in this patient population. In this study, we searched the Pubmed database using keywords "Takotsubo cardiomyopathy", "cancer", and "anti-neoplastic therapy" to review case reports of Takotsubo syndrome occurring in oncologic patients after systemic anti-neoplastic therapy. Clinical presentation, electrocardiogram, laboratory data, transthoracic echocardiogram and coronary angiogram results, and patient outcomes were collected and analyzed. Conclusion: Patients with cancer are at an elevated risk for developing stress cardiomyopathy, and it is important to know which cancer drugs have been associated with the development of the Takotsubo syndrome.
Peroneus tertius (PT) muscle is peculiar to man, and man is the only member among the primates in whom this muscle occurs. The muscle is variable in its development and attachment. Because of functional demands of bipedal gait and plantigrade foot, part of extensor digitorum brevis (EDB) has migrated upwards into the leg from the dorsum of foot. PT is a muscle that evolution is rendering more important. In a total of 110 cadavers, extensor compartment of leg and dorsum of foot were dissected in both the lower limbs and extensor digitorum longus (EDL), and PT muscles were dissected and displayed. PT was found to be absent in 10.5% limbs, the incidence being greater on the right side. The remaining limbs in which the PT muscle was present had a very extensive origin from lower 3/4th of extensor surface of fibula (20% on right and in 17% on left), and the EDL was very much reduced in size. In approximately 12%, the tendon of PT was thick or even thicker than the tendon of EDL. In 4%, the tendon extended beyond fifth metatarsal up to metatarsophalangeal joint of fifth toe, and in 1.5%, it extended up to the proximal phalanx of little toe. In two cases (both on the right side), where PT was absent, it was replaced by a slip from lateral margin of EDL. We conclude that PT, which is preeminently human, is extending its purchase both proximally and distally.
Topology optimization of an air-cooled heat sink considering heat conduction plus side-surface convection is presented. The optimization formulation is explained along with multiple design examples. A postprocessing procedure is described to synthesize manifold or “water-tight” solid model computer-aided design (CAD) geometry from three-dimensional (3D) point-cloud data extracted from the optimization result. Using this process, a heat sink is optimized for confined jet impingement air cooling. A prototype structure is fabricated out of AlSi12 using additive layer manufacturing (ALM). The heat transfer and fluid flow performance of the optimized heat sink are experimentally evaluated, and the results are compared with benchmark plate and pin-fin heat sink geometries that are conventionally machined out of aluminum and copper. In two separate test cases, the experimental results indicate that the optimized ALM heat sink design has a higher coefficient of performance (COP) relative to the benchmark heat sink designs.
Introduction:The phantom limb pain (PLP) and phantom limb sensation (PLS) are very common among amputated cancer patients, and they lead to considerable morbidity. In spite of this, there is a lack of epidemiological data of this phenomenon among the Asian population. This study was done to provide the data from Indian population.Methods:The prevalence of PLP, stump pain (SP), and PLS was prospectively analyzed from the amputated cancer patients over a period of 2 years in Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi. The risk factors and the impact of phantom phenomenon on patients were also noted.Results:The prevalence of PLP was 41% at 3 and 12 months and 45.3% at 6 months, whereas that of SP and PLS was 14.4% and 71.2% at 3 months, 18.75% and 37.1% at 6 months, 15.8% and 32.4% at 12 months, respectively. There was higher prevalence of PLP and PLS among the patients with history of preamputation pain, smoking with proximal level of amputation, receiving general anesthesia, receiving intravenous (IV) opioid postoperative analgesia, and developing neuroma or infection.Conclusion:The prevalence of PLP and PLS was higher among the cancer amputees as compared to SP, and a few risk factors responsible for their higher prevalence were found in our study. The PLP and PLS lead to considerable morbidity in terms of sleep disturbance and depression.
Topology optimization of an air-cooled heat sink considering heat conduction plus side-surface convection is presented. The optimization formulation is explained along with multiple design examples. A post-processing procedure is described to synthesize water-tight solid model computer-aided design (CAD) geometry from 3-D point-cloud data extracted from the optimization result. Using this process, a heat sink is optimized for confined jet impingement air cooling. A prototype structure is fabricated out of AlSi12 using additive layer manufacturing (ALM). The heat transfer and fluid flow performance of the optimized heat sink is experimentally evaluated, and the results are compared with benchmark plate and pin-fin heat sink geometries that are conventionally machined out of aluminum and copper. In two separate test cases, the experimental results indicate that the optimized ALM heat sink design has a higher coefficient of performance relative to the benchmark heat sink designs.
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