Hemodynamic analysis of blood flow restriction training: a systematic review
Ruifeng Huang, Yong Ma, Zizhe Yang
et al.
Abstract Blood Flow Restriction Training (BFRT) is a low-load training technique that involves applying pressure to partially restrict arterial blood flow while occluding venous return. Despite its growing popularity, there is still no consensus on how combining BFRT with resistance or aerobic training influences hemodynamic responses, or on the safest and most effective methods for implementing it. This review aims to systematically identify the effects of BFRT on hemodynamic parameters. A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement guidelines. The Chinese literature search was performed in the China National Knowledge Infrastructure (CNKI) database. English literature search was conducted in the Web of Science, PubMed, and Google Scholar databases. The studies included human subjects, the outcome indicators included hemodynamic evaluation indicators, and only randomized controlled trials and randomized crossover trials were considered. Non-Chinese or English literature, duplicate studies, and those with missing data were excluded. The adapted STROBE checklist was used to assess the risk of bias, 44 articles were included in this review. Results indicated that BFRT has increased heart rate and blood lactate levels, while its effect on blood oxygen saturation varies. Additionally, BFRT significantly enhances cardiac output but may either have no significant effect or cause a decrease in stroke volume. Furthermore, BFRT improves pulse wave velocity from the femur to the posterior tibia, suggesting a positive influence on cardiovascular function. BFRT induces changes in arterial structure and function, with these indicators interacting to produce both positive and negative effects on cardiovascular health. The primary mechanisms by which BFRT influences hemodynamics include the activation of the sympathetic and vagus nerves, as well as the regulation of chemical mediators in body fluids that modulate cardiovascular function. Convenient, economical, non-invasive, and easily measurable hemodynamic indicators are expected to become an efficient tool for evaluating the effects of exercise training. Further research is needed to establish the optimal compression thresholds and durations for different populations and exercise types, as well as to assess the long-term impact of BFRT on hemodynamic parameters.
Defining Human Rights in Times of Covid: Human Rights Discourse in the UK and Devolved Legislatures
Anne Cousson
The British government’s reaction to the Covid-19 pandemic has meant wide-ranging restrictions imposed on people living in the UK with minimal parliamentary oversight. Thus, human rights and civil liberties were affected, as far as both individual freedoms and constitutional guarantees are concerned. However, given the urgency created by the health crisis and the controversial nature of human rights speech in the UK, using it to criticize the government’s measures was bound to be a politically charged choice. Through an analysis of parliamentary discourse in the main Covid-related debates both in the British Parliament and in the devolved legislatures, this article argues that human rights were not used as an expression of common values in a time of national crisis, but as a divisive rhetorical tool. Focusing thus on political discourse rather than on the effective effects of Covid restrictions on human rights allows us to identify ideological fault lines. Indeed, the analysis shows a highly differentiated definition of human rights between political parties on the one hand and between the different nations on the other.
History of Great Britain, English literature
Quality of measurement properties of medication adherence instruments in cardiovascular diseases and type 2 diabetes mellitus: a systematic review and meta-analysis
Henrique Ceretta Oliveira, Daisuke Hayashi, Samantha Dalbosco Lins Carvalho
et al.
Abstract Background Medication adherence has a major impact on reducing mortality and healthcare costs related to the treatment of cardiovascular diseases and diabetes mellitus. Selecting the best patient-reported outcome measure (PROM) among the many available for this kind of patient is extremely important. This study aims to critically assess, compare and synthesize the quality of the measurement properties of patient-reported outcome measures to assess medication adherence among patients with cardiovascular diseases and/or type 2 diabetes mellitus. Methods This review followed the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guidelines and was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA). The searches were performed in Web of Science, SCOPUS, PubMed, CINAHL, EMBASE, LILACS, PsycINFO, and ProQuest (gray literature). Results A total of 110 records encompassing 27 different PROMs were included in the review. The included records were published between 1986 and 2023, most of which reported studies conducted in the United States and were published in English. None of the PROMs were classified in the category “a”, thus being recommended for use due to the quality of its measurement properties. The PROMs that should not be recommended for use (category “c”) are the MTA, GMAS, DMAS-7, MALMAS, ARMS-D, and 5-item questionnaire. The remaining PROMs, e.g., MMAS-8, SMAQ, MEDS, MNPS, ARMS-12, MGT, MTA-OA, MTA-Insulin, LMAS-14, MARS-5, A-14, ARMS-10, IADMAS, MAQ, MMAS-5, ProMAS, ARMS‐7, 3-item questionnaire, AS, 12-item questionnaire, and Mascard were considered as having the potential to be recommended for use (category “b”). Conclusion None of the included PROMs met the criteria for being classified as trusted and recommended for use for patients with cardiovascular diseases and/or type 2 diabetes mellitus. However, 21 PROMs have the potential to be recommended for use, but further studies are needed to ensure their quality based on the COSMIN guideline for systematic reviews of PROMs. Systematic review registration PROSPERO CRD42019129109
A Systematic Scoping Review of Motivations and Barriers in COVID-19 Volunteering Among Health Students: The Potential for Future Pandemic Volunteers
Susanti RD, Yudianto K, Mulyana AM
et al.
Raini Diah Susanti,1,* Kurniawan Yudianto,2,* Aep Maulid Mulyana,3,* Ismah Nur Amalia3,* 1Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 40132, Indonesia; 2Department of Fundamental Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 40132, Indonesia; 3Professional Nursing Program, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 40132, Indonesia*These authors contributed equally to this workCorrespondence: Raini Diah Susanti, Department of Community Health Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, West Java, 40132, Indonesia, Tel +62 857-2057-1109, Email raini.diah.susanti@unpad.ac.idBackground: The high number of cases of COVID-19 has caused an increase in workload and a shortage of medical personnel in various countries, so volunteers are needed, such as health students. However, becoming a volunteer during a pandemic is influenced by motivational factors and barriers.Purpose: This study aims to identify the motivations and barriers of health students as COVID-19 volunteers.Methods: This study uses a systematic scoping review. A literature review was conducted using CINAHL, PubMed, and ScienceDirect databases. The study was eligible for inclusion if it included articles published from 2020 to 2022, full-text, and primary studies. Studies were excluded if they were not in English. The keywords used in English were “health students OR nursing students OR medical students” AND “motivation OR willingness” AND “Barriers” AND “volunteer OR volunteering OR volunteerism OR voluntary” AND “COVID-19 OR covid-19 OR SARS-CoV-2 OR COVID-19 pandemic”. Study quality was assessed using the Joanna Briggs Institute (JBI) appraisal tool.Results: We found 12 articles showing motivational factors and barriers among health students volunteering to control COVID-19. Motivational factors include domain values, understanding, enhancement, career, incentive, government, social, and demographics. In contrast, barriers include fear, lack of training and knowledge, PPE shortage, unpreparedness and role uncertainty, and lack of interest, support, and protection.Conclusion: Our findings highlight that eight motivational factors and seven barriers influence health students’ involvement in COVID-19 volunteering. However, to optimize the potential of health students, further preparation is essential to ensure that students can volunteer effectively, such as integrating volunteer training programs into the curriculum in preparation for future pandemic mitigation.Keywords: barriers, COVID-19, health students, motivation, pandemic, volunteers
Normal Weight Obesity and Cardiometabolic Risk Factors: A Systematic Review and Meta-Analysis
Nami Mohammadian Khonsari, Patricia Khashayar, Ehsan Shahrestanaki
et al.
BackgroundObesity is one of the most significant causes of morbidity and mortality worldwide. Current studies suggest a new type of obesity, normal weight obesity (NWO), which is defined as having a normal body mass index (BMI), but a high-fat percentage increases the risk of cardiometabolic risk factors (CMRFs). This systematic review and meta-analysis aimed to pool the association between NWO with CMRFs.MethodsA systematic search of the literature in all available electronic databases, including Scopus, Web of Science, EMBASE, and PubMed, was performed until October 2021. All English studies that assessed the association of NWOs [compared to normal weight non-obese (NWNO)] and the CMRFs were included. Two investigators extracted data and performed a quality assessment. The heterogeneity between studies was assessed with I-squared and Cochran’s Q tests. Odds ratio (OR) was used as an effect size to pool the association of NWO with CMRFs.ResultsTwenty-five articles that met the inclusion criteria entered the study. The total number of participants was 177,792, with an age range of 13 to 75 years. Most studies were conducted on the general population (adults) and were from China. The result of fixed-effect model meta-analysis indicated an increased odds of hyperglycemia (OR:1.50, 95%:1.23, 1.76), high TG (OR:1.90, 95% CH:1.44, 2.35), low HDL (OR: 1.28, 95% CI:1.06, 1.49) and diabetes (OR:1.39, 95% CI:1.30, 1.49). Moreover, the random effect meta-analysis showed that NWO increased the odds of dyslipidemia (OR:1.83, 95% CI:1.61, 20.4), HTN (OR:1.40, 95% CI:1.28, 1.51) and metabolic syndrome (OR:1.92, 95% CI:1.58, 2.26). Moreover, the mean of all CMRFs except plasma glucose in NWO subjects was statistically higher than NWNO subjects (p-value<0.05).ConclusionThe present study showed that NWO increased the odds of CMRFs. These findings indicate the inadequacy of the BMI measurement and the need for body fat assessment for a better obesity risk assessment.
Diseases of the endocrine glands. Clinical endocrinology
Language Laboratory Management to Support Technology-Based Foreign Language Instruction
Vivi Aulia
Language laboratory is one of media and teaching aids that cannot be separated from the foreign language teaching. The existence of language laboratory in such schools are considered as vital and essential things. It also becomes trend, culture, and alternative requirement to support the instructional process. Good and representative language laboratory that provides a number of educational objectives can bring in interesting instructional activities. Moreover, it can be the fascinating devices equipping students in learning foreign language. This article will review and provide a framework for some informations and overviews of language laboratory, the main principles and guidelines for managing language laboratory, and explain how these principles can be applied for foreign language teaching. At the end of this article, it is suggested that either foreign language teacher or language laboratory manager along with school principals cooperate in maximizing the language laboratory as a means of supporting technology-based foreign language instructions
Education (General), English language
Electrical Stimulation of Injected Muscles to Boost Botulinum Toxin Effect on Spasticity: Rationale, Systematic Review and State of the Art
Alessandro Picelli, Mirko Filippetti, Giorgio Sandrini
et al.
Botulinum toxin type A (BoNT-A) represents a first-line treatment for spasticity, a common disabling consequence of many neurological diseases. Electrical stimulation of motor nerve endings has been reported to boost the effect of BoNT-A. To date, a wide range of stimulation protocols has been proposed in the literature. We conducted a systematic review of current literature on the protocols of electrical stimulation to boost the effect of BoNT-A injection in patients with spasticity. A systematic search using the MeSH terms “electric stimulation”, “muscle spasticity” and “botulinum toxins” and strings “electric stimulation [mh] OR electrical stimulation AND muscle spasticity [mh] OR spasticity AND botulinum toxins [mh] OR botulinum toxin type A” was conducted on PubMed, Scopus, PEDro and Cochrane library electronic databases. Full-text articles written in English and published from database inception to March 2021 were included. Data on patient characteristics, electrical stimulation protocols and outcome measures were collected. This systematic review provides a complete overview of current literature on the role of electrical stimulation to boost the effect of BoNT-A injection for spasticity, together with a critical discussion on its rationale based on the neurobiology of BoNT-A uptake.
Challenges in a six-phase process of questionnaire adaptation: findings from the French translation of the Integrated Palliative care Outcome Scale
Anca-Cristina Sterie, Mathieu Bernard
Abstract Background The Integrated Palliative care Outcome Scale (IPOS) was developed for evaluating essential outcomes for palliative care patients. Our objectives here are to describe the process of a six-phase cross-cultural adaptation of IPOS to French (IPOS-Fr), highlight the difficulties encountered and strategies to solve them, and discuss the implications that adaptation may have on the validity and reliability of a questionnaire. Methods The adaptation of IPOS consisted of six phases: (i) literature review and interviews with target population; (ii) forward translation to French; (iii) backward translation to English; (iv) Expert Review; (v) cognitive interviews with target population; (vi) final review. Results Translation, cognitive interviews, and exchanges with Expert Review members allowed to make changes adapted to the target language regarding item 5 (“vomiting”) and 8 (“sore or dry mouth”), and to identify and address, in the original version of IPOS, syntactic inconsistencies in language used in items 11 to 15 and methodological problems with items 11 (“anxiety about treatment and illness”), 15 (“share … as much as you wanted”) and 17 (“problems addressed”). The adaptation also indicated that patients might have difficulties in interpreting items 8 (“sore or dry mouth”), 10 (“poor mobility”), 11 (“anxiety”), 12 (projected feelings of family and friends), and 14 (“feeling at peace”), thus indicating the need of monitoring during the psychometric validation. Conclusions Following this process, IPOS-Fr has proved content and face validity. In our case, the adaptation allowed adjustments to be made to the questionnaire and, when this was not possible, highlighted potential biases and inconsistencies during the validation. The result relied on an intertwined and iterative process of seeking and reaching semantic, conceptual, and normative equivalence. We are now assessing the psychometrical properties of IPOS-Fr.
Special situations and conditions
Effects of perceptual training on the identification and production of word-Initial voiceless stops by argentinean learners of English
Ubiratã Kickhöfel Alves, Pedro Luis Luchini
In this study, we investigate the effectiveness of perceptual training, administered to Argentinean learners, in the perception and production of word-initial voiceless stops in English. 24 participants were divided into 3 groups: (i) Group 1, which participated in 3 training sessions; (ii) Group 2, which, besides performing the same training tasks, was explicitly informed about the target item; (iii) Group 3 (control). All participants took part in a pre-test, a post-test and a delayed post-test. In all these phases, they participated in a consonant identification task and took part in a reading exercise. Our results show a significant increase of both experimental groups in identification. As for production, Group 2 exhibited a significant increase in /p/ and /t/ after training. These results are indicative of the effectiveness of perceptual training tasks in helping learners focus on Voice Onset Time.
Language and Literature, English literature
Engaging Multimedia into Speaking Class Practices: Toward students’ Achievement and Motivation
Ratnawati Ratnawati, Didih Faridah
The present study reports several impacts of implementing multimedia toward teaching and learning process in speaking class at second grade students of Galuh University, Ciamis. Further, the study came from insights on students’ boredom during speaking class which affected their achievement and motivation. Mixed method research design (Creswell, 2013) then employed to answer several proposed hypotheses. For proving the result of its application, observation, questionnaire, pre and post-test were administered to collect the data while both quantitative and qualitative approaches were applied to analyze the collected data from classroom practices. The research findings indicates that multimedia in speaking class got positive responds from students in term of motivation and accomplishment. The great look portrayed from the class that students were enthusiastic, got involved and interested in multimedia provided by teacher during learning process. Moreover, pre and post-tests that are performace-based tests were greatly used to test the effectiveness of multimedia effects during the class. In this side, the researcher employed experiment of two equivalent groups: control and experimental group. It then reported that t-test related is 2.04 out of 1.70 for t- distribution which points out that there is significant difference between the results of both tests. It means that the result of this research agreed that multimedia has good effects for teaching speaking in the scope of students’ interests, feedback and their cognitive aspects. In line with above statements, the further studies is also necessary dealing with other multimedia for obtaining more positive effects toward learning process and those result enables to increase quality of education.
Education (General), Language and Literature
The effect of whole body vibration on fracture healing – a systematic review
J Wang, KS Leung, SKH Chow
et al.
This systematic review examines the efficacy and safety of whole body vibration (WBV) on fracture healing. A systematic literature search was conducted with relevant keywords in PubMed and Embase, independently, by two reviewers. Original animal and clinical studies about WBV effects on fracture healing with available full-text and written in English were included. Information was extracted from the included studies for review. In total, 19 articles about pre-clinical studies were selected. Various vibration regimes are reported; of those, the frequencies of 35 Hz and 50 Hz show better results than others. Most of the studies show positive effects on fracture healing after vibration treatment and the responses to vibration are better in ovariectomised (OVX) animals than non-OVX ones. However, several studies provide insufficient evidence to support an improvement of fracture healing after vibration and one study even reports disruption of fracture healing after vibration. In three studies, vibration results in positive effects on angiogenesis at the fracture site and surrounding muscles during fracture healing. No serious complications or side effects of vibration are found in these studies. WBV is suggested to be beneficial in improving fracture healing in animals without safety problem reported. In order to apply vibration on fractured patients, more well-designed randomised controlled clinical trials are needed to examine its efficacy, regimes and safety.
Diseases of the musculoskeletal system, Orthopedic surgery
“Fame’s Consummate Fee”: Dickinson’s Nameless Celebrity
Paul Crumbley
In the months preceding her death on May 15, 1886, Emily Dickinson requested that Emily Brontë’s poem “No coward soul is mine” be read at her funeral, thereby enlisting Brontë’s defiant declaration of immortality in what can be interpreted as Dickinson’s own equally defiant final statement on the relation of fame to enduring art. Dickinson previewed the logic behind this act in the theory of fame she expressed four years earlier in a letter to Roberts Brothers editor Thomas Niles in which she refused his request for a “volume of poems” (L749b) and instead sent him “How happy is the little Stone” (Fr1570E), a poem that alludes to “the rock of immortality” (l. 16) and the “atom” (l. 26) that appear in Brontë’s poem. These allusions inform Dickinson’s figurative declaration to Niles that the fame she aspires to is based on lasting fusion with the elemental fabric of the universe, not immediate approval from the contemporary reading public. Dickinson tells Niles that she seeks a form of fame that is more enduring than the sort he offers but which is fundamentally experimental in nature, in as much as it requires that the poet hazard the loss of her name in exchange for continued life in the language of others.
American literature, English literature
Spontaneous remission of hepatocellular carcinoma without any treatment
Shao-Ciao Luo, Cheng-Chung Wu, Shao-Bin Jheng
et al.
Hepatocellular carcinoma (HCC) is a major leading cause of cancer death in Taiwan. The prognosis will be fatal without treatment. However, about 80 cases of the rare phenomenon of spontaneous remission of HCC have been reported in the English literature.
A 61 year old asymptomatic woman visited our outpatient clinic (OPC) with a high alpha-fetal protein (AFP) level. A computed tomogram (CT) revealed a 4.1 cm hypervascular tumor (arterial phase) at S4 of the liver and washed out in venous phase. Her Hepatitis B Surface Antigen (HBsAg) was negative and Hepatitis C Antibody (anti-HCV) was positive. This patient also had esophageal varices. She refused any treatment and returned to our OPC about 2 years later. Her AFP level was 11.8 ng/ml. The following CT scan revealed a small amount of cirrhosis, but no mass, in the liver, so that spontaneous remission of HCC was determined. She was treated by oral diuretics. Here we report the case and review of literature.
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Non-Functional Paraganglioma of Retroperitoneum Mimicking Pancreatic Mass with Concurrent Urinary Bladder Paraganglioma: An Extremely Rare Entity
Ankur Verma, Diwakar Pandey, Azaz Akhtar
et al.
Paragangliomas are extra-adrenal tumours of the autonomic nervous system, which rarely present as primary retroperitoneal mass
mimicking pancreatic malignancy (incidence 2-8 per million populations). Urinary Bladder Paraganglioma are also extremely rare (0.06%
of all Bladder Tumour and 6% of Paragangliomas) with most being malignant and high grade tumours. Non-functional varieties of both
tumours are usually incidentally diagnosed. The possibility for malignant transformation in them makes surgical excision the treatment
of choice. A 45-year-old lady with abdominal pain was investigated to have a complex retroperitoneal mass behind head of pancreas
and a urinary bladder mass. Complete excision of retroperitoneal and bladder lesion was done. Histopathological examinations of both
specimens were suggestive of Paraganglioma with no abnormal mitotic activity and capsular/vascular invasion. Although concurrent
non functional paragangliomas had been reported but the synchronous non-functional paragangliomas of retroperitoneum and urinary
bladder reported in this case is extremely rare and is not reported so far in English literature.
Wheeler, Max W. (trad.) (2011): <i>Curial and Guelfa. A classic of the Crown of Aragon</i>. Translated into English by Max W. Wheeler. Amsterdam; Philadelphia: John Benjamins Publishing Company (IVITRA Research in Linguistics and Literature, vol. 2).
Curt J. Wittlin
Romanic languages, Philology. Linguistics
Disappointing Friends: France and the Confederate Catholics of Ireland, 1642-48
Tadhg Ó HANNRACHÁIN
This article examines the interactions between the Confederate Catholics of Ireland and France during the 1640s. Despite the mutual goodwill between the governments, ultimately this relationship proved disappointing to both parties. The Confederate Catholics did not receive the level of support from France which they had hoped for from the beginning of the rebellion in Ireland. On the other hand, France’s policies in Ireland largely failed. Mazarin’s government failed to make use of Irish resources to fashion a successful anti-parliamentarian coalition in Ireland as a launching-pad for the resuscitation of the royalist position throughout the archipelago. French recruitment policies in Ireland also proved unsuccessful as the French received fewer recruits during the Confederate period than either immediately before or immediately after the association’s existence. From their perspective, a certain limited advantage was gained by the fact that Spain also was unable to profit from Irish recruiting grounds during the 1640s, but the failure of the attempts to re-establish the Stuart monarchy ultimately undermined even this small achievement, when Spain gained disproportionately from the mass exodus of Irish soldiers following the Cromwellian conquest of Ireland in the early 1650s.
English language, Social sciences (General)
The semantics of color and intercultural competence in psychological counseling
Kudrina A.V.
A cross-cultural research devoted to the reconstruction of main colours semantic spaces in cultures with different languages was carried out. The article contains the research results and their value for the multicultural counseling competence is revealed. The data collected from academic literature and the data of empirical study made on the Russian speaking, English speaking and German speaking samples (total number of 456 people, aged from 20 to 65) were taken as the basis for the reconstruction. The data received conform to the hypothesis about the similarity of the colour meaning in the centre of colour sematic spaces in different cultures and the existence of culture-specific meanings of colour at the sematic space periphery that show the culture-historical development of each nation.
An Emerging Area in Second Language Phonology: The Perception of English Vowels by Adult Second Language Learners
Juri Matsubara
Although the field of second language acquisition (SLA) has largely advanced over the last few decades, the area of second language (L2) phonology has not been a focus of many studies. Major (1998) found that “of the nearly 200 articles published in Studies in SLA [from 1988 to 1998], only about a dozen focused on phonetics and phonology” (p. 131). Since then, the area has largely expanded, as discussed in Eckman (2004), evolving from studies that cited first language (L1) influence as a main explanation for L2 phonology to research that has turned to universal principles driven by Universal Grammar (UG). Several crosslinguistic speech perception models have been developed as well, and many empirical studies have been undertaken to yield support. One of the most fertile domains for the investigation of L2 phonology has been the syllable (Eckman, 2004, p. 527). However, most of the studies have concentrated on the onset or the coda, while there is much yet to be explored for the acquisition of the nucleus of the syllable – the vowel. This paper is a literature review of the emerging area of L2 phonology, focusing on the perception of English vowels by adult L2 learners.
Theory and practice of education, English language
Las versiones homericas
Jorge Luis Borges
Ningún problema tan consustancial con las letras con su
modesto misterio como el que propone una traducción. Un olvido animal por la vanidad, el tenor de confesar procesos mentales que adivinamos peligrosamente comunes, el conato de mantener intacta y central una reserve incalculable de sombre, velan las tales escrituras directas. La traducciOn, en cambio, parece destinada a ilustrar la discusión estitica. El modelo propuesto a su imitaciOn es un texto visible, no un labirint° inestimable de proyectos preteritos o la acatada tentaciOn momentanea de una facilidad. Bertrand Russell define un objeto extern() como un sistema circular, irradiante, de impresiones posibles; lo mismo puede aseverarse de un texto, dadas las repercusiones incalculables
de lo verbal. Un parcial y precioso documento de las vicisitudes que sufre queda en sus traducciones.
Language and Literature, English literature
Aggressive treatment of metastatic squamous cell carcinoma of the rectum to the liver: a case report and a brief review of the literature
Carvounis Eleni E, Samanides Lazaros D, Vassiliou John G
et al.
<p>Abstract</p> <p>Background</p> <p>Rectal squamous cell carcinoma (SCC) is a rare tumor. The incidence of this malignancy has been reported to be 0.25 to 1 per 1000 colorectal carcinomas. From a review of the English literature 55 cases of SCC of the rectum have been published. In this study we report a rectal metastatic SCC to the liver, discussing the efficacy of aggressive adjuvant and neo-adjuvant therapies on survival and prognosis.</p> <p>Case presentation</p> <p>A 39-year-old female patient with a pure SCC of the rectum diagnosed endoscopically is presented. The patient underwent initially neoadjuvant chemo-radiotherapy and then abdominoperineal resection with concomitant bilateral oophorectomy and hysterectomy, followed by adjuvant chemo-radiotherapy. Five months after the initial operation liver metastasis was demonstrated and a liver resection was carried out, followed by adjuvant chemotherapy. Eighteen months after the initial operation the patient is alive.</p> <p>Conclusion</p> <p>Although prognosis of rectal SCC is worse than that of adenocarcinoma, an aggressive therapeutic approach with surgery as the primary treatment, followed by combined neo- and adjuvant chemo-radiotherapy, may be necessary in order to improve survival and prognosis.</p>
Surgery, Neoplasms. Tumors. Oncology. Including cancer and carcinogens