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The mean cumulative scattered dose for prostate-only field delivering 78 Gy was 1.8 Gy and that for pelvic field irradiation was 2.6 Gy, consistent with the reported findings. CONCLUSIONS The patients with prostate-only irradiation received lower testicular doses than those with additional pelvic field irradiation possibly due to the increased scattered doses in large field irradiation using the VMAT technique. The clinical response to increased incidental testicular doses due to pelvic field irradiation remains unknown, and it warrants further investigation.OBJECTIVE In this study, we aimed to identify prognostic determinants and to comparably analyze clinical features of patients with both resected and unresected superior sulcus tumors (SSTs). METHODS The data of 56 patients who underwent any treatment for an SST from 2004 through 2016 in our hospital were reviewed. Overall survival (OS) rates were estimated using the Kaplan-Meier method. Univariate and multivariate analyses were performed to determine independent prognostic factors for patients with resected and unresected SST separately. RESULTS The number of patients with resected and unresected SSTs was 24 (43%) and 32 (57%), respectively. Of the 24 patients who underwent surgery, 20 received induction therapy, with 32% achieving pathological complete response. Complete resection (R0) was performed in 22 patients (92%). On multivariate survival analysis, preoperative serum carcinoembryonic antigen (CEA) level (median 8.3 ng/ml, p = 0.021) was identified as the independent determinant of OS in surgical patients; whereas, initial treatment response (complete response or partial response, p = 0.032) was the independent OS indicator in non-surgical patients. check details The 5-year OS of the patient with resected and unresected SST was 68.8% and 29.1% (p = 0.008), respectively. CONCLUSION Significant prognostic factors differ among patients stratified by the presence of surgical resection for SSTs. Preoperative CEA level in surgical candidates and initial treatment response in non-surgical patients were the independent factors associated with OS. Surgical candidates are expected to have more favorable survival than patients with unresectable SSTs.Coronary ostial stenosis is an uncommon lesion but one that may be associated with significant and potentially lethal reduction in distal artery blood flow. While most commonly due to atherosclerosis, it may also be caused by aortic arteritis, congenital webs or post-surgical complications following aortic valve replacement. Three cases of lethal ischemic heart disease are reported where occult ostial narrowing/occlusion was first identified at autopsy. Case 1 A 70-year-old man with hypoplasia of the right coronary artery and tunneling of the left anterior descending coronary artery had atherosclerotic obliteration of the right coronary artery ostium. Cases 2 & 3 Two men (aged 80 and 85 years respectively) with marked epicardial coronary artery atherosclerosis also had associated atherosclerotic obliteration of their right coronary artery ostia. Examination of the coronary ostia is an important part of the forensic assessment in cases of sudden death, as isolated occlusive lesions may be the only explanation for a lethal episode. In other cases, as in those reported herein, ostial stenosis/occlusion may be an additional contributing factor to global myocardial ischemia from coronary artery atheroma and/or other causes.The carcass of a 15-year-old female Bottlenose dolphin (Tursiops aduncus) was retrieved from the Port River near Adelaide, South Australia, Australia. The animal was emaciated with five thick nylon fishing lines emerging from the oropharynx attached to a tangle of nylon and monofilament fishing line that also contained wire and eight fishing hooks. The mouth had been cut by the line and a circumferential curvilinear superficial abrasion/indentation from fishing line encircled the entire distal rostrum. Dissection of the upper aerodigestive tract revealed a large fish hook embedded in the lower blowhole associated with an adjacent abscess at the base of the epiglottis. The stomach contained two unattached fish hooks, parts of a plastic squid lure and two heavy duty work gloves. Further examination revealed a severe necrotising pneumonia with microabscesses in the kidneys and adrenal glands with scattered thromboemboli in keeping with terminal disseminated intravascular coagulation. Death had resulted from septic complications of fishing hook impalement and line entanglement with inanition. The case provides a graphic illustration of the effects of entanglement and fishing hook penetration, as well as ingestion of non-degradable plastic materials, in a free living Bottlenose dolphin.BACKGROUND Forgiveness is becoming increasingly recognized for its role in healthcare, having shown promising effects in patients suffering myriad diseases, from coronary artery disease to HIV to breast cancer. AIMS To review the current literature examining forgiveness and its relationship specifically to chronic pain. METHOD In July 2019, a search was carried out of electronic databases (Academic Search Complete, AMED, Biomedical Reference Collection, General Science, Medline, PsycArticles, PsycInfo, Social Sciences Full Text and SPORTDiscus). Further results were obtained from reference lists. Inclusion and exclusion criteria were applied using PRISMA guidelines for systematic reviews. RESULTS The initial search yielded 354 results, and after duplicates were removed and inclusion and exclusion criteria applied, the final result was seven papers to be reviewed. Of the seven papers reviewed, five showed a relationship between lower levels of forgiveness and either increased experience or decreased tolerance for pain. One paper showed higher levels of empathy improving pain levels and suggests that forgiveness could enhance this experience of empathy. One study resulted in a higher level of pain among patients with higher forgiveness scores, although it was qualified that this particular patient population had a higher attachment anxiety, which may have impeded their ability to utilize forgiveness therapy. CONCLUSIONS There is an association between the capacity to forgive and the experience of chronic pain. Further research should examine forgiveness as an intervention in a population of chronic pain patients to explore this relationship further.