Holistic Management of Trans Patients

2021 ◽  
Vol 66 (6) ◽  
pp. 408-409
Keyword(s):  
Author(s):  
Valeria Chávez ◽  
Debora Lithgow ◽  
Miguel Losada ◽  
Rodolfo Silva-Casarin

AbstractInfrastructure is necessary to protect and provide the goods and services required by humans. As coastal green infrastructure (CGI) aims to respect and work with natural processes, it is a feasible response to mitigate or avoid the consequences of coastal squeeze. The concept of CGI is receiving increased attention of late due to the challenges facing us, such as climate change, population growth and the overexploitation of natural resources on the coast. Terms which may be applied to encourage the construction of infrastructure, or to minimize the responsibility for poorly made decisions, often induce misunderstanding. In this paper, the concept of CGI and its use in solving coastal problems is reordered. Four categories are proposed, according to the degree of naturalness of the project: Nature reclamation, Engineered ecosystems, Ecologically enhanced engineering, and De-engineering/Relocation. Existing coastal risk evaluation frameworks can be used to design many types of CGI. Key concepts, challenges and good practices for the holistic management of coastal squeeze are presented from the analysis of successful and unsuccessful CGI projects worldwide.


2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199396
Author(s):  
Yang Zhou ◽  
Xue Xue ◽  
Panpan Shi ◽  
Qinrui Lu ◽  
Shulan Lv

Background We report here a case study of 17α-hydroxylase deficiency in a phenotypic girl with male karyotype (46,XY). We also review the relevant literature to deepen our understanding of the disease, reduce the rate of missed diagnosis, and emphasize that holistic management of this disease requires collaborative multidisciplinary teamwork. Case presentation A 14-year-old patient with a female phenotype visited the endocrinology department because of hypertension. The patient had primary amenorrhea and lacked secondary sexual characteristics. Initial laboratory evaluation revealed normal levels of electrolytes, a hypergonadotropic hypogonadal state with high progesterone and low testosterone levels, and a 46,XY karyotype. She was referred to the urology department for gonadectomy and transferred to the gynecological endocrine clinic. On the basis of the patient’s medical history and genetic testing results, a diagnosis of 46,XY 17α-hydroxylase deficiency was made. The patient was provided with glucocorticoids, estrogens, metformin, and psychological support. Conclusions Patients with 17α-hydroxylase deficiency, a rare cause of congenital adrenal hyperplasia, should be treated by a multidisciplinary team. Relevant experts from different disciplines should set up a systematic and comprehensive individualized management plan to optimize the physical and mental health and quality of life of affected patients.


2008 ◽  
Vol 19 (6) ◽  
pp. 298-303 ◽  
Author(s):  
Susan M Oliver
Keyword(s):  

2014 ◽  
Vol 174 (15) ◽  
pp. i-i
Author(s):  
Nicola Field
Keyword(s):  

2017 ◽  
Author(s):  
Ankit Malik ◽  
Amitosh Tiwari ◽  
Prashant Fartiyal ◽  
Sarang Lele ◽  
Chandran Manickavasagam ◽  
...  

2021 ◽  
Vol 4 (2) ◽  
pp. 117
Author(s):  
Wiharjo Hadisuwarno ◽  
Merlyna Savitri ◽  
Ami Ashariati ◽  
S. Ugroseno Yudho Bintoro ◽  
M. Noor Diansyah ◽  
...  

Breast cancer is still global burden especially for woman with 2.3 million cases every year dan 15% mortality among cancer diseases. In developing countries, most of the cases are diagnosed at terminal stage when metastasis already found. Bone metastasis is the highest among other metastasis sites such as: lung, liver and brain. Bone metastasis will cause hypercalcemia and bone pain as complications.  Both will gradually decrease patient’s quality of life. Comprehensive and holistic management for these complications will reduce deterioration and hopefully increase patient’s quality of life even they were at terminal stage. We describe a 40-year-old woman who got hypercalcemia crisis. Hypercalcemia usually manifest as a consequence of other diseases. Epidemiologically, majority come from metastasis, but can be other diseases, such as multiple myeloma. Interestingly, during medical investigation through her medical history, and physical examination, and laboratory examinations, we conclude that her hypercalcemia crisis was caused by bone metastasis from breast cancer.


2005 ◽  
Vol 19 (1) ◽  
pp. 38-44 ◽  
Author(s):  
Lyndsay S Baines ◽  
Edward T Zawada ◽  
Rahul M Jindal

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