Thyroid Cancer Multidisciplinary Team and the Organizational Paradigm

The article presents a clinical case of somato-psychic disorder in a patient with multinodular euthyroid goiter. The patient was diagnosed with thyroid cancer on outpatient basis and was suggested urgent surgical treatment. After receiving information about cancer pathology the patient developed symptoms of hypernosognostic neurotic syndrome with manifestations of obsessions and hystero-hypohondriasis. The patient was focused on the rigid hypochondria with detailed statement of the slightest signs of bodily distress. Therefore, the above example demonstrates difficulty in selecting the tactics of management for such patients due to development of symptoms primarily determined by psycho-emotional tension. This category of patients should be followed not only by endocrinologists, surgeons, but the multidisciplinary team, including psychiatrists, and psychotherapists, since in case of combined impact of a number of adverse factors, the reaction to the disease can become so extreme that its management in the early stages of therapy seems no less important than the direct treatment of somatic condition.

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An Enlarging Neck Mass with Dyspnea and Left Finger Pain in a 63-year-old Woman

10.22541/au.161017476.63709774/v1 ◽

2021 ◽

Author(s):

Thanh Hoang ◽

Andrea Snitchler ◽

Mohamed Shakir

Keyword(s):

Thyroid Cancer ◽

Patient Care ◽

Papillary Thyroid Cancer ◽

Multidisciplinary Team ◽

Neck Mass ◽

Team Approach ◽

Atypical Presentation ◽

Papillary Thyroid ◽

Multidisciplinary Team Approach

We described an atypical presentation of papillary thyroid cancer metastasized to left finger. This case highlights the importance of an early and effective engagement of multidisciplinary team approach with family in order to optimize patient care.

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Much Ado About Fried Chicken: Abetting Aspiration or Respecting Autonomy?

American Journal of Speech-Language Pathology ◽

10.1044/2019_ajslp-18-0207 ◽

2019 ◽

Vol 28 (3) ◽

pp. 1356-1362

Author(s):

Laurence Tan Lean Chin ◽

Yu Jun Lim ◽

Wan Ling Choo

Keyword(s):

Palliative Care ◽

End Of Life ◽

Multidisciplinary Team ◽

Biopsychosocial Model ◽

Family Members ◽

Clinical Decisions ◽

Goals Of Care ◽

Complex Needs ◽

Aspiration Risk ◽

Patient Centric

Purpose Palliative care is a philosophy of care that encompasses holistic, patient-centric care involving patients and their family members and loved ones. Palliative care patients often have complex needs. A common challenge in managing patients near their end of life is the complexity of navigating clinical decisions and finding achievable and realistic goals of care that are in line with the values and wishes of patients. This often results in differing opinions and conflicts within the multidisciplinary team. Conclusion This article describes a tool derived from the biopsychosocial model and the 4-quadrant ethical model. The authors describe the use of this tool in managing a patient who wishes to have fried chicken despite aspiration risk and how this tool was used to encourage discussions and reduce conflict and distress within the multidisciplinary team.

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Food for Thought

Perspectives on Swallowing and Swallowing Disorders (Dysphagia) ◽

10.1044/sasd21.2.68 ◽

2012 ◽

Vol 21 (2) ◽

pp. 68-72 ◽

Cited By ~ 7

Author(s):

Caryn Easterling

Keyword(s):

Multidisciplinary Team ◽

Clinical History ◽

Team Members ◽

Speech Language Pathologist ◽

Expected Outcome

Our professional American Speech-Language-Hearing Association (ASHA) guidelines state, if a speech-language pathologist suspects on the basis of the clinical history that there may be an esophageal disorder contributing to the patient's dysphagia, then “An esophageal screening can be incorporated into most [videofluoroscopic swallowing studies, or] VFSS” (ASHA, 2004). However, the esophageal screen has not been defined by ASHA or by the American College of Radiology. This “Food for Thought” column suggests deglutologists work together to determine the procedure and expected outcome for the esophageal screen so that there is acceptance and consensus among the multidisciplinary team members who evaluate patients with dysphagia.

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