Treatment of cancer

2018 ◽  
Author(s):  
David Cutter ◽  
Martin Scott-Brown
Keyword(s):  
Management Strategies ◽  
Colon Adenocarcinoma ◽  
Management Plan ◽  
Treatment Modalities ◽  
Management Approach ◽  
Best Management ◽  
Appropriate Treatment ◽  
Wide Range ◽  
Specialist Nurses ◽  
The Individual

The variety of conditions that are considered to be ‘cancer’ is extremely wide, with marked variation in the management approach from disease to disease. A common feature in the management of malignant conditions, however, is the involvement of a wide range of medical professionals at different stages of the patient pathway. This commonly includes physicians, surgeons, radiologists, pathologists, medical oncologists, radiation oncologists, and specialist nurses, as well as a plethora of other allied disciplines. As such, a practice that has been widely adopted is to work as a multidisciplinary team (MDT), with regular meetings to decide the appropriate treatment for each patient with a cancer diagnosis, on an individual and case-by-case basis. The main treatment modalities for the treatment of cancer are surgery, radiotherapy, and chemotherapy. While these are often combined to form a multimodality therapy, they are all, in isolation, potentially radical (curative) therapies for certain conditions. For example, surgery (in the case of a Stage I colon adenocarcinoma), radiotherapy (in the case of early laryngeal squamous cell carcinoma), and chemotherapy (in the case of acute lymphoblastic leukaemia) are all curative as single-modality treatments. It is commonly the case, however, for a patient to require more than one mode of therapy to achieve the best outcome, for example a combination of surgery, chemotherapy, and radiotherapy for early breast cancer. It can also be the case that two or more different management strategies are thought to give equivalent oncological results, for example surgery or radiotherapy for early prostate cancer. In this situation, the MDT and the patient need to decide on the ‘best’ management plan for the individual, based on their personal and professional opinions and on the differing toxicity profiles of the alternate treatments.

scholarly journals Current Knowledge on Pathogenicity and Management of Stemphylium botryosum in Lentils (Lens culinaris ssp. culinaris Medik)

Pathogens ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. 225 ◽  
Author(s):  
Arpita Das ◽  
Subrata Dutta ◽  
Subhendu Jash ◽  
Ashis Roy Barman ◽  
Raju Das ◽  
...  
Keyword(s):  
Disease Management ◽  
Current Knowledge ◽  
Management Strategies ◽  
Resistance Breeding ◽  
Morphological Characters ◽  
Spatial Diversity ◽  
Research Network ◽  
Management Approach ◽  
Stemphylium Botryosum ◽  
Wide Range

Stemphylium blight (SB) caused by Ascomycete, Stemphylium botryosum Wallr. has been a serious threat to lentil cultivation, mainly in Bangladesh, Nepal, India, and Canada since its first outbreak in Bangladesh in 1986. The genus Stemphylium Wallr., a dematiaceous hyphomycete, comprises up to 150 species, and is pathogenic on a wide range of plants infecting leguminous as well as nonleguminous crops. In recent years, studies indicated overlapping in morphological characters among the different species under the genus Stemphylium, making the identification and description of species difficult. This necessitates different molecular phylogenetic analysis in species delimitation. Therefore, a detailed understanding of spatial diversity and population structure of the pathogen is pertinent for producing source material for resistance breeding. The role of different weather variables as predisposing factors for the rapid spread of the pathogen necessitates devising a disease predictive model for the judicial application of fungicides. A dearth of information regarding spore biology, epidemiology, race diversity, host-pathogen interaction, and holistic disease management approach necessitates immediate attention towards more intensive research efforts. This is the first comprehensive review on the current state of knowledge and research efforts being made for a better understanding of the SB resistance through cognizing biology, ecology, and epidemiology of S. botryosum and effective disease management strategies to prevent widespread outbreaks of SB. The information regarding the biology and epidemiology of S. botryosum is also crucial for strengthening the “Integrated Disease Management” (IDM) programme. The need for a regional research network is advocated where the disease is becoming endemic.

scholarly journals Delayed immune mediated adverse effects to hyaluronic acid fillers: report of five cases and review of the literature

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Ora Bitterman-Deutsch ◽  
Leonid Kogan ◽  
Faris Nasser
Keyword(s):  
Hyaluronic Acid ◽  
Adverse Effects ◽  
Treatment Options ◽  
General Medicine ◽  
Treatment Modalities ◽  
Medical Specialties ◽  
Immune Mediated ◽  
Wide Range ◽  
Delayed Reactions ◽  
The Individual

Hyaluronic acid (HA) fillers in cosmetic medicine have been considered relatively safe, though fillers used in European countries and throughout the world are not necessarily approved by the Food and Drug Administration. As their use continues to expand worldwide, physicians in a wide range of medical specialties are authorized to perform HA injections, including general medicine practitioners and even dentists. An increasing number of reports have appeared regarding side effects to these products. It is now known that reactions to Hyaluronic acid are related not only to technical faults of the injections, but also to immune responses, including delayed hypersensitivity and granulomatous reactions. Herein, we describe five cases treated by a variety of treatment modalities, all with delayed reactions to different brands of hyaluronic acid fillers. As there is currently no standardization of treatment options of adverse effects, these cases accentuate the debate regarding the approach to the individual patient and the possible need for pre-testing in patients with an atopic tendency.

A Human Security Framework for the Management of Invasive Nonindigenous Plants

2009 ◽  
Vol 2 (2) ◽  
pp. 99-109 ◽  
Author(s):  
Andrew J. Tanentzap ◽  
Dawn R. Bazely ◽  
Peter A. Williams ◽  
Gunhild Hoogensen
Keyword(s):  
Community Dynamics ◽  
Management Strategies ◽  
Human Security ◽  
Nonindigenous Species ◽  
Individual Species ◽  
Management Approach ◽  
Security Framework ◽  
Ecosystem Based Management ◽  
Management Actions ◽  
The Individual

AbstractFew individuals or governments have suggested that invasions by nonindigenous species are relevant to the broader issue of human security, despite a growing awareness of the ecological, economic, and societal impacts associated with invasive nonindigenous species (INIS). We propose that by framing management actions in a human and environmental security context, the threats (and benefits) posed by INIS to individuals and communities can be explicitly articulated and debated. This framework allows multiple stakeholders to bring their concerns to bear upon specific policy, and attempts to integrate broad environmental concerns within its parameters. We use the case of ecosystem-based management of invasive nonindigenous plants as an example of the utility of a human security framework. The dominant management approach to these species remains focused on the individual species, despite increasing calls for the implementation of ecosystem-based management strategies. Ecosystem-based management is supported by generalized and widely accepted mechanisms of plant community dynamics, such as succession, disturbance, and interspecific competition, but these scientific arguments do not consistently carry weight at the policy level and with the broader public. A human security framework may provide an approach for overcoming this resistance by placing the debate over management within the social and political context of the wider community. Overall, human security can allow applied ecologists to be better positioned to meet the challenges of communicating the need for science-based management.

scholarly journals Osteoarthritis: etiology, epidemiology, impact on the individual and society and the main principles of management

Medicina ◽  
2010 ◽  
Vol 46 (11) ◽  
pp. 790 ◽  
Author(s):  
Giedrė Sakalauskienė ◽  
Dovilė Jauniškienė
Keyword(s):  
Treatment Modalities ◽  
Treatment Programs ◽  
Health Providers ◽  
Effective Interventions ◽  
Lack Of Information ◽  
Appropriate Treatment ◽  
Short And Long Term ◽  
The Individual

Etiology, epidemiology, and impact of osteoarthritis on an individual, society, and nation and the main principles of management of this disease are reviewed in the article. Treatment should be tailored to the needs of an individual patient. Physicians should be familiar with pharmacologic and nonpharmacologic treatment modalities to maximize effective utilization and a thorough understanding of short- and long-term complications and costs. Severity of osteoarthritis should be taken into physician’s and patient’s consideration while applying an appropriate treatment. A stepwise management of osteoarthritis has to be taken into account. As effective interventions remain underused, state arthritis programs, including osteoarthritis programs, have to be developed to build an appropriate scientific base in public health, observe burden and impact, assess and disseminate evidence-based interventions, and work to reduce and delay disability, and improve quality of life among people with arthritis. Adequate studies on the costs of osteoarthritis are urgently required so that cogent arguments can be made to governments to appropriately fund prevention and treatment programs for this condition. Its recognition as a major cause of disability, particularly in the aging population, should increase community focus on this important condition. Osteoarthritis as a pathogenic process and its impact on an individual and society should be taken into special consideration by health providers and officers developing the national health policy in Lithuania, because there is a lack of information related to the prevalence of osteoarthritis, risk factors, also osteoarthritisassociated disability, and costs of the management of this disease among Lithuanian inhabitants.

Guidance and Methodologies for Managing Digital Instrumentation and Control Obsolescence

2016 ◽  
Vol 2 (4) ◽  
Author(s):  
Matthew O’Connor ◽  
Bruce Geddes ◽  
Sean Kelley
Keyword(s):  
Life Cycle ◽  
Management Strategies ◽  
Life Cycle Management ◽  
Management Plan ◽  
Management Approach ◽  
Nuclear Technology ◽  
Digital Instrumentation ◽  
Technology Life Cycle ◽  
And Control ◽  
Digital Equipment

New nuclear plant technology will rely heavily, if not exclusively, on digital equipment. Obsolescence of digital instrumentation and control (I&C) equipment is an inevitable part of plant technology life cycle for new and existing plants. Developing an overall strategic plan can mitigate some of the risks associated with obsolescence. Moreover, when developed as a part of an overall life cycle management plan (LCMP), a strategic obsolescence management approach can identify steps that can be taken at early stages of the technology life cycle to cope proactively with the obsolescence of equipment. Recent work within the advanced nuclear technology (ANT) program at the Electric Power Research Institute (EPRI) (O’Connor et al., 2014, “Advanced Nuclear Technology: Guidance and Methodologies for Managing Digital Instrumentation and Control Obsolescence,” EPRI, Palo Alto, CA, Product ID 3002002852) has developed guidance and methodologies for determining when digital obsolescence is likely to occur, the extent to which it can occur, the risks and impacts due to obsolescence, and strategies that can be used to minimize its effects, all in the context of system LCMP. Worksheets for assessing obsolescence risks and the applicability and limitations of management strategies were developed as a part of this work, and can be used to create or supplement a strategic obsolescence management plan.

scholarly journals Increased Probability and Efficiency of Gar Capture Using Multi- vs. Monofilament Gill Nets

2019 ◽  
Vol 10 (2) ◽  
pp. 551-562
Author(s):  
Bradley M. Richardson ◽  
Michael B. Flinn
Keyword(s):  
Water Temperature ◽  
Incidence Rate ◽  
Management Strategies ◽  
Management Plan ◽  
Habitat Characteristics ◽  
Home Ranges ◽  
Gill Nets ◽  
Management Actions ◽  
Gill Net ◽  
Wide Range

Abstract Monofilament gill nets have increased in popularity in recent decades and are often considered to be superior to multifilament gill nets; however, this claim is still contested by many researchers. Target species, habitat characteristics, and mesh characteristics can all affect the efficacy and selectivity of these nets. Increased angling interest and declining home ranges have led to increased management efforts for gars (Lepisosteidae) among state and federal agencies. However, the sampling of gar species is notoriously difficult and has hindered subsequent management actions in some cases. This study aimed to compare probability and incidence rate of gar capture between net constructions (multi- vs. monofilament), net length (75 vs. 46 m length), sampling habitat (run vs. bend), and deployment orientation (parallel vs. perpendicular vs. diagonal in relation to river channel). We also assessed mode of capture investigate the effects of small mesh sizes (50.8 mm) on capture and potential retention of gars captured in gill nets. Results showed that the use of multifilament gill nets were three times more likely to capture at least one gar (1.3–6.3, 95% CI) than monofilament nets. Multifilament gill nets also averaged approximately twice as many gars per net than monofilament gill nets. Increasing water temperature also significantly increased the probability of gar capture, particularly above 15°C. In addition to mesh type and water temperature, habitat and gill net orientation also had significant effects on the incidence rate of gar capture. We primarily captured gars captured in the gill nets by entanglement (63%), which may have allowed for the wide range of length frequencies sampled in this study. Our study highlights the importance of considering multiple gill net constructions, deployments, and habitats when designing a research project or management plan for gar species. The use of multifilament gill nets can help resource managers to sample gar populations more effectively, resulting in better management strategies and practices.

scholarly journals Coexistence of Craniopharyngioma and Cranial Fibrous Dysplasia: A Clinicopathological Study of 5 Cases and Literature Review

2021 ◽  
Author(s):  
Yang-Hua Fan ◽  
ZHI LI
Keyword(s):  
Literature Review ◽  
Fibrous Dysplasia ◽  
Hormone Replacement ◽  
Management Strategies ◽  
Treatment Modalities ◽  
Subtotal Resection ◽  
Blurred Vision ◽  
Tumor Subtypes ◽  
Appropriate Treatment ◽  
Causative Relationship

Abstract Background: Craniopharyngioma (CP) and cranial fibrous dysplasia (CFD) are both rare embryonic benign cranial diseases that most commonly present during childhood or adolescence. Co-existence of CP and CFD is extremely rare, which has never been reported before.Methods: We retrospectively reviewed the data of 5 patients coexisted with CP and CFD in Beijing Tiantan Hospital from January 2003 to January 2021. Their clinicopathological features, treatment modalities, and outcomes were summarized. Moreover, a comprehensive literature review was conducted, and in order to explore the potential connection leading to this coexistence, the CFD characteristic GNAS gene and corresponding Gsα protein were tested in the CPResults: There were 4 males and 1 female (median age, 39 years) in the present series. The symptoms mainly included headache, dizziness, fatigue, polyuria/polydipsia, hypogonadism and blurred vision. Sphenoidal bone is the most common involved bone by CFD (n =4). Four patients had undergone surgery to remove the CP (1 transsphnoid and 3 transcranial). Complete and subtotal resection were achieved in 2 cases respectively. The tumor subtypes were 3 adamantinomatous, 1 unknown subtype. The common postoperative complications are pan-hypopituitarism, diabetes insipidus, and hypothyroidism. The mean follow-up time was 57.2 months. Postoperative hormone replacement was required in 2 patients. 3 patients underwent a genetic study of tumor specimens. GNAS mutations were not detected, but they were positive for Gsα protein. Conclusions: Though the definite causative relationship has not been proved, the coexistence of CP and CFD should not completely be excluded potential interplay or atypical FD course for the uncommon manifestations of CPs. Prompt diagnosis and appropriate treatment are more challenging than for solitary CPs for the deformations of skull base, as of now, management strategies are aimed at surgical treating the CP and regularly monitoring the CFD.

scholarly journals Recurrent Multiple Fibroadenomas: History of a Case Presented in MDT Meeting With Clinical Discussion and Decision Making

2018 ◽  
pp. 159-162
Author(s):  
Negar Mashoori ◽  
Abdolali Assarian ◽  
Sanaz Zand ◽  
Erica Patocskai
Keyword(s):  
Physical Examination ◽  
Management Plan ◽  
Treatment Modalities ◽  
Presumptive Diagnosis ◽  
Best Management ◽  
New Findings ◽  
History Of ◽  
Single Mass ◽  
Surgical Excisions

Background: Fibroadenoma is a common benign breast disorder in young women which has a low risk of malignant transformation. Most fibroadenomas present as a single mass, but the presence of multiple fibroadenomas can be seen in 15–20% of patients, with average number of 3–4 masses in one breast. In different studies and reports, various treatment modalities-including observation and follow up, surgery, radiofrequency ablation, etc- have been proposed, though the best management for these patients are not determined yet. Case presentation: We present the case of 33-year-old female with history of multiple bilateral benign breast lesions with a presumptive diagnosis of fibroadenomas. She had three previous surgical excisions in the past 14 years. Her case was presented to a breast MDT meeting to obtain a recommendation on appropriate management. Question: The proposed a question in MDT concerned the best and most appropriate management plan for the patient; Does she require further surgical excisions? And if not, how should she be followed? Conclusion: After reviewing past medical history, physical examination, and all documents regarding the patient, MDT members recommended that the patient should be managed with close follow up with physical examination and ultrasound every 6 months. The necessity of further surgical intervention would be determined according to any new findings.

Gastrointestinal Neuroendocrine Tumors: Clinical and Pathological Correlates

2019 ◽  
Vol 03 (01) ◽  
pp. 003-013
Author(s):  
Sanjit Datta ◽  
Annika Sinha ◽  
Baljendra Kapoor
Keyword(s):  
Neuroendocrine Tumors ◽  
Somatostatin Receptor ◽  
Management Strategies ◽  
Survival Rates ◽  
Endocrine System ◽  
Treatment Modalities ◽  
Clinical Syndromes ◽  
Wide Range ◽  
Poorly Differentiated ◽  
Diffuse Endocrine System

AbstractGastrointestinal neuroendocrine tumors (GI-NETs), previously classified as carcinoid tumors, are rare cancers that arise from cells of the diffuse endocrine system of the gastrointestinal tract. These tumors most commonly arise from the bronchus, jejunoileum, or colon/rectum. They produce peptide products that can lead to identifiable clinical syndromes such as carcinoid syndrome, which is classically associated with diarrhea, flushing, and heart disease. The latest classifications of GI-NETs include pancreatic NETs, which can produce a wide range of pancreatic hormones leading to syndromes such as Zollinger–Ellison's syndrome. The prognosis for patients with GI-NETs varies widely depending on the size, location, and presence of metastatic disease, with 5-year survival rates ranging from 0 to 15% for poorly differentiated NETs and 10-year survival rates of up to 100% for patients with insulinomas smaller than 2 cm. A wide range of treatment modalities is commonly used to treat GI-NETs, including surgical and endoscopic resection, locoregional therapies, cytotoxic chemotherapy, and somatostatin receptor targeted therapy. The goal of this review is to detail the classification, epidemiology, clinical syndromes, diagnosis, and staging of these tumors and to provide an overview of management strategies.

Understanding Limited Use of Amplification in Infants and Children Who Are Hard of Hearing

2015 ◽  
Vol 25 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Ryan W. McCreery ◽  
Elizabeth A. Walker ◽  
Meredith Spratford
Keyword(s):  
Hard Of Hearing ◽  
Hearing Aid ◽  
Management Strategies ◽  
Infants And Children ◽  
Future Research ◽  
Research Needs ◽  
Case Examples ◽  
Hearing Aid Use ◽  
Wide Range ◽  
In Infants And Children

The effectiveness of amplification for infants and children can be mediated by how much the child uses the device. Existing research suggests that establishing hearing aid use can be challenging. A wide range of factors can influence hearing aid use in children, including the child's age, degree of hearing loss, and socioeconomic status. Audiological interventions, including using validated prescriptive approaches and verification, performing on-going training and orientation, and communicating with caregivers about hearing aid use can also increase hearing aid use by infants and children. Case examples are used to highlight the factors that influence hearing aid use. Potential management strategies and future research needs are also discussed.

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