Conclusion

Author(s):  
Andrew J. Roth ◽  
Christian J. Nelson

The art of diagnosing depression, anxiety, delirium, insomnia and fatigue in cancer care is not always straightforward. We have laid out pearls and potholes to assist uncovering the varied and sometimes hidden sources of that distress; to be aware of which syndromes may be amenable to a psychopharmacologic intervention; to know when to refer to prescribers or specialists in Psycho-Oncology; to hone communication techniques that will facilitate a patient’s care; to learn about the strategies Psycho-Oncologists use to choose the right medications for particular situations; and to recognize how to watch for the benefits and side effects of those medications, which if not understood by all providers and patients, can lead to premature discontinuation of potential helpful remedies or untoward side effects.

Author(s):  
Ikhsan Fuady ◽  
Rangga Saptya MP

<p align="center"><strong>Abstrak</strong></p><p><em>Pemanfaatan game dikalangan remaja memiliki peran yang efektif sebagai wadah untuk hiburan. Tetapi pemanfaatan game tidak tepat memiliki efek samping game terhadap kehidupan sehari hari remaja, mulai dari kurang bersosialIsasi hingga perilaku kekerasan dikalangan remaja. Penyuluhan terhadap remaja bertujuan untuk memberikan pemahaman kepada remaja tentang variasi game berdasarkan rating pengguna, maupun cerdas dalam manajemen penggunaan game dalam kehidupan remaja sehari hari. Pengetahuan remaja tentang varian/ragam game berdasarkan rating relatif rendah sebagaian besar pemengetahuannya tersebar pada kategori sangat rendah dan rendah yaitu sebesar 65 persen. Metode edukasi dan sosialisasi ini adalah dengan beberapa tahapan. Tahap pertaman tim pengabdian memberikan edukasi dan diskusi tentang beragam bentuk game, karakteristik, serta karakteristik pengguna game yang tepat. Selanjutnya beberapa permainan dan kuis untuk meingkatkan literasi remaja tentang pemanfaatan game secara bijak. Kegiatan penyuluhan ini mampu meningkatkan pemahaman para remaja dalam mengenali game yang baik digunakan, hal ini dapat dilihat dari peningkatan pengetahuan remaja relatif signifikan sebelum dan sesudah penyuluhan.</em></p><p><strong>Kata kunci<em>:</em></strong><strong><em> </em></strong><strong><em>Edukasi, Game, Penyuluhan </em></strong></p><p align="center"><em> </em></p><p align="center"><strong>Abstract</strong> </p><p><em>The use of games among teenagers has an effective role as a forum for entertainment. But the improper use of games has the side effects of games on the daily lives of adolescents, ranging from lack of socialization to violent behavior in adolescents. Counseling against adolescents aims to provide understanding to adolescents about the variety/variance of games based on user ratings, as well as being smart in managing game use in daily teenage life. Teenagers' knowledge about game variants/based on the rating is relatively low, most of the knowledge is spread in the very low and low categories, which is 65 percent. The method of education and outreach is by several stages. The first stage of the dedicated team provided education and discussion about various forms of games, characteristics, and characteristics of the right game user. Furthermore, some games and quizzes to improve teen literacy about game use wisely. This counseling activity can increase the understanding of teenagers in recognizing games that are well used, this can be seen from the relatively significant increase in adolescent knowledge before and after counseling.</em></p><p><strong>Keywords<em>:</em></strong><em> <strong>Education, Games, Counseling</strong></em></p>


2021 ◽  
Vol 14 (1) ◽  
pp. e237622
Author(s):  
Osama Mosalem ◽  
Anas Alsara ◽  
Fawzi Abu Rous ◽  
Borys Hrinczenko

A 57-year-old Southeast Asian woman with a remote history of adenoid cystic carcinoma (ACC) of the right labium superius oris (upper lip) presented to the hospital with vague epigastric pain. On workup, she was found to have multiple pleural nodules. Histopathology confirmed the diagnosis of metastatic ACC. After 8 months of active surveillance, evidence of disease progression was found and the patient was started on pembrolizumab. Follow-up after starting pembrolizumab showed stable disease with no significant side effects.


2021 ◽  
pp. 263246362097804
Author(s):  
Vanita Arora ◽  
Pawan Suri

Anatomy and physiology are the basis of human body functioning and as we have progressed in management of various diseases, we have understood that physiological intervention is always better than an anatomical one. For more than 50 years, a standard approach to permanent cardiac pacing has been an anatomical placement of transvenous pacing lead at the right ventricular apex with a proven benefit of restoring the rhythm. However, the resultant ventricular dyssynchrony on the long-term follow-up in patients requiring more than 40% ventricular pacing led to untoward side effects in the form of heart failure and arrhythmias. To counter such adverse side effects, a need for physiological cardiac pacing wherein the electrical impulse be transmitted directly through the normal conduction system was sought. His bundle pacing (HBP) with an intriguing alternative of left bundle branch pacing (LBBP) is aimed at restoring such physiological activation of ventricles. HBP is safe, efficacious, and feasible; however, localization and placement of a pacing lead at the His bundle is challenging with existing transvenous systems due to its small anatomic size, surrounding fibrous tissue, long-learning curve, and the concern remains about lead dislodgement and progressive electrical block distal to the HBP lead. In this article, we aim to take the reader through the challenging journey of HBP with focus upon the hardware and technique, selective versus nonselective HBP, indications and potential disadvantages, and finally the future prospects.


Author(s):  
Victor Duque ◽  
Carolina de la Pinta ◽  
Ciriaco Corral ◽  
Carmen Vallejo ◽  
Margarita Martin ◽  
...  

Abstract Introduction: Choroidal metastases are the most frequent intraocular secondary tumours, with a prevalence of 2–7% according to the literature. Our aim was to review a clinical case of choroidal metastasis. We present a case of a 63-year-old male patient diagnosed in 2018 with lung adenocarcinoma cT4N0M1. The patient had three metastases in the brain, which were successfully treated with radiosurgery (RS). The patient was treated with chemotherapy with pemetrexed–cisplatin schedule. Five months after diagnosis, the patient presented with decreased vision in the right eye. After ophthalmologic evaluation, he was diagnosed with a right choroidal metastasis, which was treated with external beam radiotherapy with 20 Gy in five fractions, resulting in improved visual acuity and a complete clinical and radiological response. The patient took part in a clinical trial that continued with systemic chemotherapy. Twenty-two months after radiotherapy to the eye, the patient has good visual acuity without any side effects. Conclusions: Choroidal metastasis treated with radiotherapy achieves good local control, with limited side effects, allowing an improvement in visual acuity and consequently, an improvement in the patient´s quality of life.


2021 ◽  
Vol 53 (06) ◽  
pp. 355-363
Author(s):  
Mara Băetu ◽  
Cristina Alexandra Olariu ◽  
Gabriel Moldoveanu ◽  
Cristina Corneci ◽  
Corin Badiu

AbstractCalcitonin (CT) stimulation tests have great value and could help to: differentiate thyroid causes of elevated CT apart from non-thyroid sources, determine whether the patients with slightly elevated basal CT could/could not be candidates for surgery, and indicate the right moment for prophylactic thyroidectomy in children with MEN syndromes when with normal basal CT. This triggered the requests for development of CT stimulation tests, taking into consideration their safety and aimed us to write a systematic review of literature regarding the rationale, technical issues, and side effects of CT stimulating tests used for diagnosis of MTC. After a thorough review of the literature, we classified the reported side effects by severity, as defined by United States Food and Drug Administration. A statistical analysis was performed using IBM SPSS Statistics version 20. Various side effects were noticed during stimulation tests that differ by intensity, duration and severity, depending on types of substances and protocols used. The side effects after pentagastrin test were significantly more severe than those reported after calcium stimulation test (p=0.0396). There are also significant gender-specific differences in side effects induced by stimulation tests. In conclusion, we recommend performing Ca CT stimulation test when needed, considering preventive evaluation of some clinical, instrumental, and biochemical aspects of each patient. Precise instructions should be followed before a stimulation test and furthermore continuous cardiac monitoring is essential during and after the test to minimize the possibility of a serious event.


2013 ◽  
Vol 88 (5) ◽  
pp. 764-774 ◽  
Author(s):  
Maria Fernanda Reis Gavazzoni Dias ◽  
Maria Victoria Pinto Quaresma-Santos ◽  
Fred Bernardes-Filho ◽  
Adriana Gutstein da Fonseca Amorim ◽  
Regina Casz Schechtman ◽  
...  

Superficial fungal infections of the hair, skin and nails are a major cause of morbidity in the world. Choosing the right treatment is not always simple because of the possibility of drug interactions and side effects. The first part of the article discusses the main treatments for superficial mycoses - keratophytoses, dermatophytosis, candidiasis, with a practical approach to the most commonly-used topical and systemic drugs , referring also to their dosage and duration of use. Promising new, antifungal therapeutic alternatives are also highlighted, as well as available options on the Brazilian and world markets.


2020 ◽  
Vol 52 (3) ◽  
pp. 655-660
Author(s):  
Joo-Young Kim ◽  
Kyoung Eun Lee ◽  
Kyubo Kim ◽  
Myung Ah Lee ◽  
Won Sup Yoon ◽  
...  

Government healthcare expenditure is rising in Korea, and the costs incurred by patients in Korea exceed those incurred by patients in other Organization for Economic Co-operation and Development countries. Despite the increasing health expenditure, patient demand for services is increasing as well, so it is now becoming recognized that cancer care needs to be balanced. The most important measure in cancer care optimization is to provide high-quality care while keeping costs sustainable. The Korean Cancer Association considers the current situation of cancer therapy in Korea the foremost issue, which has led to the implementation of the nationwide ‘Right Decisions in Cancer Care’ initiative. This initiative is based on the concepts of medical professionalism in that it should be led by physicians working in the field of oncology, that education should be offered to patients and clinicians, and that it should influence healthcare policy. In this article, we introduce the nationwide ‘Right Decision in Cancer Care’ initiative and highlight the five initial items on its agenda. The agenda is open to expansion and update as the medical environment evolves and additional clinical evidence becomes available.


2019 ◽  
Vol 9 (6-s) ◽  
pp. 211-215
Author(s):  
Minhaj Ahmad ◽  
Zehra Zaidi ◽  
Abdul Nasir

A male patient aged 43yrs. came to surgery OPD Majeedia Unani Hospital Jamia Hamdard New Delhi, in September 2018 with the complain of ulcer in the right foot posteriorly along the necrosis of Tendon Achilles. He was unable to walk a distance of about 100 meter due severe pain in the ulcer and calf muscle. limping on movement was very prominent. After required investigations and local examination of wounds, patient was planned and treated by local application, and combination of Unani Medicines formulations along with leech therapy as described in texts of Unani System of Medicine. With this Unani treatment non healing ulcer completely healed without any locomotor disturbances. The condition of leg totally resolved without any complications and side effects. Keywords: Non healing ulcer, Unani medicine, leech therapy.


1993 ◽  
Vol 7 (1_suppl) ◽  
pp. 19-23 ◽  
Author(s):  
Stuart A. Montgomery ◽  
P. Bebbington ◽  
P. Cowen ◽  
W. Deakin ◽  
P. Freeling ◽  
...  

Depression is a common illness which affects some 3% of the population per year. At least 25% of those with marked depression do not consult their general practitioner and in half of those who do the illness is not detected. Depression is easy to recognize when four or five of the core symptoms have been present for 2 weeks which often coincides with some occupational and social impairment. The core symptoms are depressed mood, loss of interest or pleasure, loss of energy or fatigue, concentration difficulties, appetite disturbance, sleep disturbance, agitation or retardation, worthlessness or self blame and suicidal thoughts. A diagnosis of depression is made when five of these core symptoms, one of which should be depressed mood or loss of interest or pleasure, have been present for 2 weeks. Four core symptoms are probably sufficient. Response to antidepressants is good in those with more than mild symptoms. When there are only few or very mild depressive symptoms evidence of response to antidepressants is more uncertain. Antidepressants are effective, they are not addictive and do not lose efficacy with prolonged use. The newer antidepressants have fewer side effects than the older tricyclics, they are better tolerated and lead to less withdrawals from treatment. They are less cardiotoxic and are safer in overdose. Antidepressants should be used at full therapeutic doses. Treatment failure is often due to too low a dose being used in general practice. It may be difficult to reach the right dose with the older tricyclics because of side effects. To consolidate response, treatment should be continued for at least 4 months after the patient is apparently well. Stopping the treatment before this is ill-advised as the partially treated depression frequently returns. Most depression is recurrent. Long-term antidepressant treatment is effective in reducing the risk of new episodes of depression and should be continued to keep the patient well.


2019 ◽  
Vol 9 (3) ◽  
pp. 369-376
Author(s):  
Hikmatun Nafi’ah ◽  
Adibussholeh HM.

In the world of education, of course the learning process also takes place, and the learning process requires the right method. Mistakes using the method, can hinder the achievement of desired educational goals. In fact, education shows that students play a more important role as objects and teachers act as subjects. The information center or learning center is the teacher, so it often happens students will learn if the teacher teaches. In this study using contextual learning compared with conventional learning. In addition to learning methods communication techniques are also needed to support the success of students. In this study using quasi quantitative research methods, with ANCOVA analysis techniques. Overall contextual learning is superior compared to conventional learning and teacher communication techniques affect learning outcomes with sig values. 0,000 ≤ 0.05.


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