scholarly journals MP61-08 TOWARDS PERSONALIZED CARE OF CT1A PAPILLARY RCC DIAGNOSED ON BIOPSY

2021 ◽  
Vol 206 (Supplement 3) ◽  
Author(s):  
Johan Björklund ◽  
Douglas C Cheung ◽  
Robert J Hamilton ◽  
John Kachura ◽  
Michael Jewett ◽  
...  
Author(s):  
Peter Nightingale ◽  
Scott Murray ◽  
Chris Absolon

Advance care planning (ACP) is becoming more widely used as part of a drive to improve personalized care planning, but there is still more work to be done. Electronic Palliative Care Co-ordination systems (EPaCCs) have proved to be very effective in some areas but there are many barriers to be overcome before they are universally available. This chapter covers recent developments leading to the wider integration of ACP into primary care. These include policy initiatives, educational opportunities, information technology (IT), professional quality control and regulation, financial and business incentives, and the Compassionate Community movement. The chapter includes an overview of issues surrounding ACP in primary care and in the community.


2019 ◽  
Vol 104 (8) ◽  
pp. 3296-3302 ◽  
Author(s):  
Olga Vaccaro ◽  
Giuseppe Lucisano ◽  
Maria Masulli ◽  
Enzo Bonora ◽  
Stefano Del Prato ◽  
...  

Author(s):  
Linda Duska ◽  
Armin Shahrokni ◽  
Melanie Powell

Endometrial cancer is the most common gynecologic cancer, and with a median age of 62 at diagnosis, it affects a significant number of older women. With increasing age and obesity rates in the world’s population, there is an anticipated concomitant increase in older women with endometrial cancer. Older women are more likely to die of endometrial cancer compared with younger patients. Reasons for this include more aggressive tumor biology, less favorable clinicopathologic features, and more advanced disease. Other factors, however, such as reluctance to offer surgical treatment to the older patient and increased complications of treatment are likely to be important. Management of endometrial cancer requires multidisciplinary care (surgery, radiation therapy, and systemic therapy). For each treatment, the feasibility (related to technical aspect of the procedure/treatment), side effects and safety (related to older-patient factors), and the overall benefit as it pertains to older women with endometrial cancer should be assessed carefully with a multidisciplinary approach. Despite the importance of these issues, the data are limited to answer these issues with clarity. In this article, we will review each treatment modality for older women with endometrial cancer. We will introduce the components of comprehensive geriatric assessment and their practical implication for older women with cancer in general and older women with endometrial cancer specifically.


2021 ◽  
Vol 11 (2) ◽  
pp. 137
Author(s):  
Janet Record ◽  
Roy Ziegelstein ◽  
Colleen Christmas ◽  
Cynthia Rand ◽  
Laura Hanyok

The promise of precision medicine is based on the use of new technologies to better characterize patients by defining individuals in the areas of genomics, proteomics, metabolomics and other aspects of biologic variability. Wise application of modern technology can similarly transform health visits with patients, allowing for better characterization of the patient’s individual life circumstances than possible in a traditional office visit. The use of, and experience with, telemedicine have increased significantly during the COVID-19 pandemic. Patients and clinicians report high satisfaction with telemedicine, and the quality of communication and patient-centeredness experienced in this setting are both rated highly. In this article, we explore the benefits offered by telemedicine in facilitating personalized care with particular focus on telemedicine delivered by video platforms. We propose strategies and skills specific to the effective implementation of personalized telemedicine, drawing on literature in patient-centered communication and home visits. While traditional in-person office visits continue to offer important opportunities such as thorough physical examination and the potential for enhanced non-verbal communication, telemedicine offers many important advantages that can facilitate the process of getting to know the patient as a person.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Makoto Toguchi ◽  
Toshio Takagi ◽  
Yuko Ogawa ◽  
Satoru Morita ◽  
Kazuhiko Yoshida ◽  
...  

AbstractTo investigate the detection of peritumoral pseudocapsule (PC) using multi-detector row computed tomography (MDCT) for tumors resected by robot-assisted laparoscopic partial nephrectomy (RAPN) for T1 renal cell carcinoma (RCC). Study participants included 206 patients with clinical T1 RCC who underwent RAPN between October 2017 and February 2018. Two radiologists who were blinded to the pathological findings evaluated the computed tomography (CT) images. Radiological diagnosis of a PC was defined by a combination of observations, including a low-attenuation rim between the tumor and renal cortex in the cortico-medullary phase and a high-attenuation rim at the edge of the tumor in the nephrogenic or excretory phase. A PC was detected on CT in 156/206 tumors (76%) and identified by pathology in 182/206 (88%) tumors including 153/166 (92%) clear cell RCC, 13/14 (93%) papillary RCC, and 7/16 (44%) chromophobe RCC. In the whole cohort, CT findings showed a sensitivity of 81.3% (148/182), specificity of 66.7% (16/24), and positive predictive value of 94.9% (148/156). When the data were stratified according to pathological subtypes, MDCT was observed to have a sensitivity of 86.9% (133/153) and specificity of 61.5% (8/13) in clear cell RCC, sensitivity of 38.5% (5/13) and specificity of 100% (1/1) in papillary RCC, and sensitivity of 44.4% (4/7) and specificity of 66.7% (6/9) in chromophobe RCC. A low or high-attenuation rim around the tumor in the cortico-medullary or nephrographic-to-excretory phase indicates a PC of RCC, though the accuracy is not satisfactory even with 64- or 320-detector MDCT.


2019 ◽  
Vol 16 (11) ◽  
pp. 655-673 ◽  
Author(s):  
Anna Brodziak ◽  
Paweł Sobczuk ◽  
Ewa Bartnik ◽  
Michał Fiedorowicz ◽  
Camillo Porta ◽  
...  

2016 ◽  
Vol 9 ◽  
pp. CGast.S38203 ◽  
Author(s):  
Maria Cappello ◽  
Gaetano Cristian Morreale

In the past, laboratory tests were considered of limited value in Crohn's disease (CD). In the era of biologics, laboratory tests have become essential to evaluate the inflammatory burden of the disease (C-reactive protein, fecal calprotectin) since symptoms-based scores are subjective, to predict the response to pharmacological options and the risk of relapse, to discriminate CD from ulcerative colitis, to select candidates to anti-tumor necrosis factors [screening tests looking for hepatitis B virus and hepatitis C virus status and latent tuberculosis], to assess the risk of adverse events (testing for thiopurine metabolites and thiopurine-methyltransferase activity), and to personalize and optimize therapy (therapeutic drug monitoring). Pharmacogenetics, though presently confined to the assessment of thiopurineme methyltransferase polymorphisms and hematological toxicity associated with thiopurine treatment, is a promising field that will contribute to a better understanding of the molecular mechanisms of the variability in response to the drugs used in CD with the attempt to expand personalized care and precision medicine strategies.


Sign in / Sign up

Export Citation Format

Share Document