1/9. rehabilitation considerations of prosthetic fittings for Kaposi's sarcoma amputees.PURPOSE: We report on cutaneous limb manifestations of Kaposi's sarcoma and the secondary infection of these lesions that necessitated five lower-limb amputations. METHOD: The cases are briefly described and prosthetic adaptations in respect to pressure, traction and sweating on the skin are considered. RESULTS: All four patients ambulated initially; one lady died, the double amputee stopped walking owing to the excessive physical demand, and two patients ambulate freely. CONCLUSION: Special considerations to the cutaneous/prosthesis interface are necessary in order to provide these patients with optimal ambulatory ability.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
2/9. Complete response of an hiv negative gastric Kaposi's sarcoma (KS) patient with peritoneal carcinomatosis by liposomal daunorubicin treatment.We report the first case of an hiv negative patient with gastric Kaposi's sarcoma (KS) and peritoneal carcinomatosis in whom a complete response (CR) was obtained after liposomal daunorubicin administration. The patient presented with epigastric pain and hematemesis. Upper gastric endoscopy with multiple biopsies showed gastric involvement by KS. The whole physical examination and the thoraco-abdomino-pelvic CT scans showed no other localization. A total gastrectomy was performed. Histological examination confirmed the diagnosis of KS with involvement of regional lymph nodes and peritoneal lesions. Six cycles of liposomal daunorubicin were given. Post-treatment coelioscopic control was normal. The patient received another six adjuvant cycles of liposomal daunorubicin. The patient is in complete remission six months after the end of treatment. Liposomal daunorubicin is a promising treatment in the non hiv patient with visceral KS.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
3/9. Disseminated manifestation of Kaposi's Sarcoma in newly diagnosed AIDS in an african female.BACKGROUND: Kaposi's sarcomas are the most frequent malignancies in patients with AIDS and there is increasing evidence of an association with human Herpesvirus 8 (HHV-8). A reconstitution of the immune response due to different regimens of highly active antiretroviral therapy (HAART) is the most important step in treatment of Kaposi's sarcomas. Local treatment options include the topic application of alitretionin (9-cis-retinoic acid) as a gel, cryotherapy with liquid nitrogen and intralesional vinblastine, as well as local laser or low-dose X-ray treatment. A systemic chemotherapy can be taken under consideration in selected cases with clinical significant visceral lesions or aggressive sarcomatous behavior with anthracyclines, taxanes, as well as an immunomodulatory treatment with alpha Interferon. CASE REPORT: The case of an african emigrant is described. Hospitalized due to recurrent fever and diarrhea, the diagnosis of AIDS was quickly established. The physical examination revealed multiple nodular, painless skin lesions suspicious of Kaposi's sarcoma. The diagnosis was confirmed histologically, later on also in bronchial and duodenal biopsies due to the atypical subepithelial vessels with slit-like appearance and prominent endothelia. CONCLUSIONS: Cutaneous lesions in patients with dark skin colour may be unfamiliar to European physicians. In patients with hiv-infection, nodular skin lesions should lead suspicion to Kaposi's sarcoma. If this diagnosis is established, it should be clarified, if other locations (e.g.: intestine, respiratory tract) are involved, too.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
4/9. A case of head and neck kaposiform hemangioendothelioma simulating a malignancy on imaging.Kaposiform hemangioendothelioma (KH) is an endothelial-derived spindle cell neoplasm often associated with kasabach-merritt syndrome. Most cases arise in infancy and childhood and are soft-tissue tumors. The tumor displays an appearance between capillary hemangioma and Kaposi's sarcoma. We report a case of KH in a 1-year-old girl involving a mass that showed abnormal enhancement of soft tissue superficial to the right temporal bone with partial destruction of the temporal bone, the temporomandibular joint, mandibular condyle, and occipital bone. The physical finding of a discolored mass led clinicians to consider a hemangiomatous lesion, whereas the radiological picture suggested a more aggressive diagnosis of rhabdomyosarcoma and aggressive fibromatosis.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
5/9. Physiotherapy management of patients with hiv-associated Kaposi's sarcoma.BACKGROUND: Kaposi's sarcoma is the most common form of cancer in patients with human immunodeficiency virus (hiv) infection. Although Kaposi sarcoma lesions may contribute to significant physical impairments, there is a lack of scientific literature detailing the role of physiotherapy in the treatment of hiv-associated Kaposi's sarcoma. The present Case Report includes two males, aged 36 and 39 years, seropositive for hiv with invasive Kaposi's sarcoma. METHOD AND RESULTS: Patient A was evaluated for bilateral foot pain caused by plantar surface Kaposi s sarcoma lesions that rendered him unable to walk. He progressed to walking 400feet after a treatment regimen of gait training with the use of custom plastazote sandals. Patient B was evaluated for right lower extremity lymphoedema secondary to invasive Kaposi's sarcoma. He experienced an 18% reduction in limb volume, a 38% reduction in pain and a 20 degrees increase in terminal knee flexion after therapeutic exercise and the use of compressive bandaging and garments. CONCLUSIONS: This Case Report suggests that physiotherapy interventions may be valuable in the conservative management of patients with hiv-associated Kaposi s sarcoma.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
6/9. strontium-90 for conjunctival AIDS-related Kaposi's sarcoma: the first case report.AIDS-related Kaposi's sarcoma is often treated by local therapy for physically or cosmetically disabling symptoms. We present the first case of a bulbar conjunctival Kaposi's sarcoma lesion to be treated with a strontium-90 ophthalmic applicator. The treatment is simple, effective and well tolerated and we recommend that it should be considered for the management of superficial Kaposi's sarcoma lesions of the conjunctiva.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
7/9. parenteral nutrition in the management of gastrointestinal Kaposi's sarcoma in a patient with AIDS.A patient with acquired immunodeficiency syndrome (AIDS) who required aggressive nutritional intervention via home parenteral nutrition therapy is described, and nutritional status, etiology and therapeutic management of AIDS-associated malnutrition, role of nutrition support, and factors for consideration in using parenteral nutrition in AIDS patients are discussed. parenteral nutrition therapy was initiated in a 30-year-old AIDS patient with Kaposi's sarcoma lesions of the gastrointestinal tract because of rapid weight loss, low serum protein levels, and malnutrition. He had previously undergone a small-bowel resection and a jejunojejunostomy, and radiation and antineoplastic-drug therapy was planned. During parenteral nutrition therapy, the patient demonstrated increased physical strength and was able to care for himself during most of the time spent at home or in a long-term-care facility. Aggressive measures, including parenteral nutrition therapy, were discontinued 11 days before the patient's death. Complications of therapy included one episode of sepsis and a tear in the external catheter tubing. Malabsorption and diarrhea mainly caused by gastrointestinal disease, reduced food intake because of oral and esophageal infections, adverse effects from medication, and depression are factors that can contribute to AIDS-associated malnutrition. Also, hypermetabolism resulting from infections and fevers may contribute to malnutrition in AIDS. The extent to which this malnutrition affects the underlying immune dysfunction occurring in the syndrome and the response to other more direct drug therapies in AIDS is not known. Available methods for nutritional intervention are based on clinical experience and anecdotal reports. Because of gastrointestinal disease, an oral diet, supplements, and enteral tube feedings may not meet nutritional goals for an AIDS patient.(ABSTRACT TRUNCATED AT 250 WORDS)- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
8/9. tinea pedis masking a Kaposi's sarcoma.A 67-year-old white man presented with bilateral blancing erythema and scale of the second through fifth toes extending on to the dorsa and moccasin areas of the feet for two years. The right great toe had subungual debris. No cultures or KOH studies were recorded. A course of tolnaftate cream therapy was initiated. Two years later, the patient returned and complained of no change in his condition. Previously recorded descriptions and diagrams in the medical record confirmed his report. At this time, KOH preparations from the skin and nail were positive for hyphae. He refused to accept medical recommendations for a fungal culture and griseofulvin therapy. He, therefore, was instructed to use miconazole cream twice daily as alternative treatment. One year later, physical examination was unchanged. KOH preparations and fungal cultures of the skin were twice negative. A 4-mm punch skin biopsy specimen of the erythematous patch on the dorsum of the foot was performed. hematoxylin and eosin-stained sections revealed a proliferating vascular process in the cutis. Many spindle-shaped cells formed vascular slits and endothelial-lined spaces in which there were erythrocytes. No hyphae were seen. One year after the biopsy specimen was taken, the erythema of his feet persists, and a few nonblanching nodules are visible. He declined further studies.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |
9/9. Kaposi's sarcoma of scrotum.A rare case is presented of Kaposi's sarcoma localized to the scrotum with history, and physical and laboratory findings. Excision of the scrotum with bilateral orchiectomy was performed, with uneventful recovery. literature is reviewed of Kaposi's sarcoma originating in the male external genitalia.- - - - - - - - - - ranking = 1keywords = physical (Clic here for more details about this article) |