Oncolie

Background: Ventricular septal defect (VSD) is the most prevalent congenital heart defect, characterized by an abnormal communication between the ventricles, leading to a left-to-right shunt. Its clinical spectrum ranges from asymptomatic small defects to large shunts causing heart failure, pulmonary hypertension, or Eisenmenger syndrome. Early diagnosis and appropriate management are critical to prevent long-term complications. Methods: This literature review synthesizes current evidence on the classification, pathophysiology, diagnostic modalities, treatment options, and long-term outcomes of VSD. A comprehensive analysis of peer-reviewed articles and clinical guidelines was conducted to present up-to-date insights into the multidisciplinary approach to VSD care. Results: Anatomical subtypes of VSD vary in clinical significance, risk of complications, and management strategies. Advances in imaging, particularly echocardiography and cardiac MRI, have improved diagnostic precision. While small defects often resolve spontaneously and are managed conservatively, large or symptomatic defects may require surgical or transcatheter closure. Surgical repair remains the standard for most cases, but selected muscular and perimembranous defects can be treated percutaneously. Long-term follow-up is essential due to risks of arrhythmias, conduction block, residual shunts, or valve dysfunction. Emerging technologies—including biodegradable devices, minimally invasive surgery, and experimental gene therapy—may reshape future management paradigms. Conclusions: VSD management requires individualized, anatomy-guided decision-making supported by multidisciplinary expertise. Technological progress has expanded therapeutic options, yet lifelong surveillance remains necessary to mitigate late complications and optimize outcomes.

Palliative Care (PC) is a person-centered, integrated health service designed to support patients with serious illnesses in living actively and with minimal pain until death. It addresses the diverse needs of patients with both cancer and non-cancer diagnoses, aiming to improve quality of life (QoL), relieve symptoms, and provide comprehensive support to patients and their families. Despite its well-documented benefits and recommendations for early improvement, contemporary palliative care faces numerous challenges that limit its effectiveness and accessibility. This article explores the multifaceted obstacles confronting modern palliative care, analyzing why current practices often fall short of meeting patient needs and proposing areas for improvement to ensure timely, equitable, and effective palliative care delivery worldwide. Methods: The research methodology included an in-depth review if scientific articles available through databases such as Pubmed and Google Scholar. The team analyzed content from 2000 to 2025, placing special emphasis on the latest development. Through careful organization and validation, 83 of the most reliable publications were selected as the primary foundation for the study. The cited references of these publications were included in the analysis. Results: The scientific studies in this work have demonstrated that palliative care faces major challenges including limited global availability, insufficient specialized workforce, restrictive and inconsistent eligibility criteria, and stigma associated with its terminology. The growing demand from aging populations and increasing cancer cases further strains resources, while financial burdens and a fragmented, under-regulated mobile app market limit effective symptom management and care delivery. Additionally, delayed access to palliative care, insufficient integration within health systems, ethical and legal complexities, and inadequate psychological support for patients and families contribute to these challenges. Emerging technologies like AI offer promise but require careful implementation to maintain person-centered care and address ethical concerns. Conclusions: A well-functioning palliative care system is vital as it enables patients with serious illnesses to live actively and with improved quality of life, reduces symptom burden, and supports both patients and caregivers throughout the illness trajectory. Effective palliative care also has the potential to decrease healthcare costs by reducing unnecessary hospital admissions and facilitating care in preferred settings. Priorities for advancing palliative care include expanding service availability, revising eligibility criteria to focus on patient needs rather than prognosis, and improving education to reduce misconceptions and stigma. Sustainable funding, policy standardization, and multi-sector collaboration among healthcare providers, policymakers, patients, and communities are essential to building robust palliative care frameworks. Moreover, regulating and enhancing the accessibility of palliative care mobile applications can further support patients and caregivers by improving communication, symptom management, and advance care planning. Coordinated efforts across all stakeholders are crucial to overcoming existing challenges and ensuring equitable, high-quality palliative care that improves quality of life on a global scale.

It's preferred by patients as well as surgeons to avoid permanent stoma in a patient of Carcinoma Rectum. But this should not be done at the cost of margin compromise. There is little literature on factors affecting margin status, therefore a comprehensive study to analyze all factors associated with margin status is required. This will not only allow surgeons to be cautious in a particular subgroup during surgery but also help in proper patient selection for restorative surgery. It's an observational study consisting of 77 patients of Carcinoma Rectum undergoing restorative radical surgery. Definition of close and clear radial/distal margin was standardized before the study. Patients were divided based on margin status - clear or close. Various clinical, laboratory and histopathological factors were analyzed for association with margin status. Continuous quantitative variables were analyzed using independent t-test. Discrete quantitative variables were analyzed by linear regression method. Qualitative variables were analyzed using Chi square test. p value was considered significant at p < 0.05. All factors found significantly associated with radial or distal margin compromise on histopathological examination were calculated and used for formulating a score predicting odds/probability of getting margin compromise using logistic regression. After the score was formulated, the probability of getting margin compromise in all those with actual margin compromise was calculated. Probability less than 1st quartile was taken as low, between the 1st and 3rd quartile as intermediate and more than 3rd quartile was taken as high risk for margin compromise, thus providing an ordinal scale. Significant association of body habitus (p = 0.00025) and node positivity (p = 0.034) with circumferential margin compromise was found. Similarly, distal margin compromise was found significantly associated with tumor location/distance from anal verge (p = 0.004) and if it's low rectal tumor, then tumor diameter (p = 0.00001, Pearson's coefficient of = 0.47) also played a significant role in distal margin. Utilizing these factors, a scoring system was developed using multivariate logistic regression, predicting odds of margin compromise. Odds of radial margin compromise = e - 1.694 - (1.585 (Ifpatient is obese), -1.256 (If patient is overweight)) +1.355 (If nodes are positive on imaging) Odds of distal margin compromise = e2.778- (0.415×Distance from anal verge)- (0.043× Maximum diameter of tumor if tumor is located in lower rectum) Using 1st and 3rd quartile of margin compromise probabilities, an ordinal scale classifying margin compromise risk into low, intermediate and high. Margin Compromise Ordinal Scale (MCOS) is a proposed tool to objectively predict risk of margin compromise. It will help oncosurgeons/colorectal surgeons to take appropriate neoadjuvant actions or avoid restorative surgery in individuals at high risk of margin compromise.

El siguiente trabajo tiene como objetivo enmarcar la problematización sobre las nuevas tecnologías como un dispositivo de sujeción bajo la llamada teoría del capital humano desarrollada por Gary Becker, cuya filiación genealógica proviene del neoliberalismo norteamericano. El trabajo se presenta en tres partes. En un primer momento, realizamos un breve seguimiento de la gubernamentalidad liberal de los siglos XVIII y XIX (Foucault, 2010). Luego, analizamos la teoría del capital humano, vinculando, por un lado, las nociones de capital humano adquirido con el modelo de capacitación permanente, que es el espacio de penetración de las nuevas tecnologías por excelencia y, por el otro, el capital humano innato con su modelo de intervención a través de las ciencias genéticas, cuya base conceptual, la información, constituye todo un postulado ontológico respecto del ser humano. En tercer lugar, esbozamos brevemente una definición del dispositivo "Sociedad de la Información y del Conocimiento", que vincula fuertemente a las tecnologías con la noción de información proveniente del campo de la cibernética, y a esta noción, con el capital humano adquirido en forma de saber. Se plantea como conclusión que la teoría del capital humano es la base epistémica sobre la que se asientan muchos de los discursos sobre las nuevas tecnologías. Desde esta perspectiva se propone que la información es una forma de capital (ya sea en su forma de producto educativo o como producto individual) y que los nuevos productos tecnológicos funcionan desde esta perspectiva como inversión ideal en nuestras sociedades, en función de capitalizar al individuo-empresario. Desde este conjunto de enunciados, las nuevas tecnologías serían, así, un optimizador universal, que además de ser una inversión en sí misma, permiten aumentar la rentabilidad de cualquier otra inversión. Se hacen así explícitas, a través del análisis presentado, las condiciones en que emergen y operan algunos de los discursos más comunes de la sociedad de la información.