scholarly journals 2019 European Thyroid Association Guidelines for the Treatment and Follow-Up of Advanced Radioiodine-Refractory Thyroid Cancer

2019 ◽  
Vol 8 (5) ◽  
pp. 227-245 ◽  
Author(s):  
Laura Fugazzola ◽  
Rossella Elisei ◽  
Dagmar Fuhrer ◽  
Barbara Jarzab ◽  
Sophie Leboulleux ◽  
...  
Keyword(s):  
Personal Experience ◽  
Clinical Evidence ◽  
Ethical Issues ◽  
Negative Impact ◽  
Task Force ◽  
Favourable Outcome ◽  
Diagnostic Tools ◽  
Duration Of Treatment ◽  
Significant Negative Impact

The vast majority of thyroid cancers of follicular origin (TC) have a very favourable outcome, but 5–10% of cases will develop metastatic disease. Around 60–70% of this subset, hence less than 5% of all patients with TC, will become radioiodine refractory (RAI-R), with a significant negative impact on prognosis and a mean life expectancy of 3–5 years. Since no European expert consensus or guidance for this challenging condition is currently available, a task force of TC experts was nominated by the European Thyroid Association (ETA) to prepare this document based on the principles of clinical evidence. The task force started to work in September 2018 and after several revision rounds, prepared a list of recommendations to support the treatment and follow-up of patients with advanced TC. Criteria for advanced RAI-R TC were proposed, and the most appropriate diagnostic tools and the local, systemic and palliative treatments are described. Systemic therapy with multikinase inhibitors is fully discussed, including recommendations on how to start it and at which dosage, on the duration of treatment, and on the management of side effects. The appropriate relationship between the specialist and the patient/family as well as ethical issues are covered. Based on the available studies and on personal experience, the experts provided 39 recommendations aimed to improve the management of advanced RAI-R TCs. Above all of them is the indication to treat and follow these patients in a specialized setting which allows the interaction between several specialists in a multidisciplinary team.

scholarly journals Assessment of the Sexual Violence Situation in a Regional Hospital in Guatemala: The Need for a Multidisciplinary Clinic

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S105-S105
Author(s):  
Blanca Soto ◽  
Miriam Canet ◽  
Diego Erdmenger
Keyword(s):  
Sexual Violence ◽  
Physical Violence ◽  
Negative Impact ◽  
Epidemiological Data ◽  
Depth Analysis ◽  
Significant Negative Impact ◽  
Comprehensive Health ◽  
History Of ◽  
Hepatitis B Testing

Abstract Background Sexual violence is a global health problem, in terms of age and sex, showing a significant negative impact on health. Incidence in Guatemala is among the highest of the region reaching an average of 23 cases reported daily nationally per statistics from the Ministry of Health in 2015. Methods Retrospective analysis of the database of all sexual violence cases reported from a secondary -level national hospital in Guatemala from January 2005 to September 2015 (period A) and in-depth analysis on demographic and epidemiological data along with information of the follow-up of cases between January 2012 and September 2015 (period B) was performed. Results Period A: 500 cases; female (96%; 481/500). Assault occurred between 16–20 years (34%; 163/481) 11–15 years (22.25%; 107/481), and 21–30 years (22.04%; 106/481). From all reported male cases, 73.68% (14/19) occurred under 15 years. Period B: 154/217 (70.96%) cases included; female (95.45%; 147/154), mean age: 17.87 years. Assault occurred in public spaces (57.14%; 88/154) and victim’s home (29.87%; 46/154). Almost 13% of victims reported history of previous assault, 5.84% by the same aggressor. More than one aggressor participated in 36.37% of assaults. Physical violence was associated in 57.79% of cases. Most victims (92.76%; 141/152) consulted within 72 hours of the assault. HIV, VDRL, and Hepatitis B testing performed in 100, 52, and 33.77%, respectively, were negative. Follow-up visits at 3, 6, and 12 months after the aggression were attended by 20.78% (30/154), 1.95% (3/154), and 1.95% (3/154) of victims, respectively. Psychology support was completed only in 18.18% (28/154). Emergency contraception was provided when indicated; pregnancy as result of the aggression was reported in nine cases (5.84%). Conclusion The study shows that young women were the most vulnerable group for sexual violence. There is a lack of multidisciplinary approach and follow-up. Interventions on infectious diseases screening have to be optimized to reduce the risk of ETS transmission. This evidence supports the need for a specialized clinic to ensure access to comprehensive health services for victims. Disclosures All authors: No reported disclosures.

scholarly journals Establishing an oncocardiology service

Herz ◽  
2020 ◽  
Vol 45 (7) ◽  
pp. 626-631
Author(s):  
L. H. Lehmann ◽  
M. Totzeck
Keyword(s):  
Cancer Patients ◽  
Clinical Studies ◽  
Ethical Issues ◽  
Diagnostic Tools ◽  
Evidence Based ◽  
Therapeutic Approaches ◽  
Patient Centered ◽  
Set Up ◽  
Integrate Research

Abstract Oncocardiology is an emerging field in cardiovascular healthcare. Besides establishing surveillance and follow-up strategies for cancer patients, it will be essential to set up specialized oncocardiology services. However, there is a lack of clinical studies to give evidence-based recommendations regarding cardiological diagnostic and therapeutic approaches for cancer patients. An oncocardiology service is a patient-centered structure that aims to integrate research and interdisciplinary patient care to bridge this gap. We discuss the current challenges in developing an oncocardiology service and review the literature on this topic. We further provide an overview of the essential diagnostic tools and upcoming ethical issues to be considered in the management of oncology patients.

Reducing transphobia: comparing the efficacy of direct and indirect contact

2019 ◽  
Vol 51 (7/8) ◽  
pp. 445-460
Author(s):  
Nitya Rani ◽  
Anand A. Samuel
Keyword(s):  
Direct Contact ◽  
Negative Impact ◽  
Relative Effectiveness ◽  
Post Intervention ◽  
Indirect Contact ◽  
Content Type ◽  
Post Test ◽  
Significant Negative Impact ◽  
The Impact

Purpose The transgender community faces prejudice and stigma and is one of the most ostracised groups in society. One of the ways to reduce prejudice is through intergroup contact. This may be achieved through direct or indirect contact. The purpose of this paper is to compare the impact of direct and indirect contact on reducing transphobia. Design/methodology/approach Direct contact was achieved through a transgender speaker panel and indirect contact involved a video presentation. In total, 159 students enroled in undergraduate courses at a prominent university in India were enlisted for this study. Perceptions regarding transgenders were measured using the genderism and transphobia scale. Perceptions were measured at three different time points – before the contact, immediately after the contact and one month post contact. Findings Results indicate that both direct and indirect contact cause a significant immediate decrease in transphobia at the post intervention stage. However, only direct contact caused significant reduction at the follow-up stage (one month after the intervention). Direct contact also effected a greater reduction in transphobia than indirect contact. Research limitations/implications This study extends previous research that shows that speaker panels involving sexual minority speakers can result in reducing stigma (e.g. Croteau and Kusek, 1992). The present study shows that such speaker panels can also be useful for reducing stigma against transgender individuals. Another important outcome of this study is the relative effectiveness of direct contact in reducing transphobia compared to indirect contact. Direct contact resulted in greater reduction in transphobia both at the post-test and follow-up stages compared to indirect contact. Practical implications The results of this study may benefit HR practitioners and policy makers in designing workplace initiatives and policies in creating an inclusive workplace. This study shows that meaningful interaction with transgenders would be a key step in reducing stigmatisation. Since direct contact is rarely expensive or time consuming, it can be a valuable tool to improve the integration of transgender individuals within society. Therefore, students and employees may be encouraged to interact with transgender individuals through panel discussions and workshops. Indirect contact may be used as a preliminary intervention in certain cases where direct contact may be difficult to organise. Social implications The stigma faced by transgender individuals has a significant negative impact on their quality of life (Grant et al., 2014; Reisner and Juntunen, 2015). It is, therefore, necessary to recognise and reduce prejudice against transgenders at both the college and school levels as well as in work organisations. Educators and managers have a significant role to play in this societal change. This study shows that stigma reduction can be achieved in a fairly simple way through contact theory. Originality/value This study is one of the first to investigate Indian students’ perceptions of transgenders. It improves on earlier studies using similar interventions in two main ways. First, this study includes a follow-up assessment, which was not performed in most studies. Second, random assignment of participants to one of two conditions improves the reliability of the findings.

Recent Experience in the Management of Meningeal Hemangiopericytomas

1997 ◽  
Vol 83 (5) ◽  
pp. 856-861 ◽  
Author(s):  
Andrea Brunori ◽  
Alberto Delitala ◽  
Giuseppina Oddi ◽  
Francesco Chiappetta
Keyword(s):  
Personal Experience ◽  
Clinical Evidence ◽  
Postoperative Radiotherapy ◽  
Radical Resection ◽  
Recent Experience ◽  
Dismal Prognosis ◽  
Visceral Metastases ◽  
Neurological Conditions

Although the histogenesis of meningeal hemangiopericytomas (HMP) remains controversial, both biological and clinical evidence seems to identify these neoplasms as a separate entity with respect to meningiomas. In order to assess the current prognosis of HMP we reviewed our personal experience limited to the last decade (1986-1995): during this period 7 patients (4M, 3F) were treated by surgery alone or surgery combined with postoperative radiotherapy. In spite of meticulous attempts at radical resection, the tumors recurred in all but two cases with a mean interval of 85 months, and a total of 18 operations were performed (2.57/patient; range 1-4). Massive intratumoral hemorrhage determined acute deterioration and required emergency surgery in two cases while in one patient diffuse visceral metastases were discovered at autopsy. Five patients are still alive at follow-up but only 2 of them are in good neurological conditions and without evidence of disease. These results are similar to those reported in other series. In view of our results we conclude that intracranial hemangiopericytomas still have a dismal prognosis. Advances in neuroimaging, neuroanesthesia, microneurosurgery and adjuvant therapy do not seem to have significantly affected the recurrence rate, quality of life and mortality.

scholarly journals EVALUATION OF THE EFFECT OF UTTARABASTI AND MATRABASTI IN KLAIBYA W.S.R.TO ERECTILE DYSFUNCTION

2021 ◽  
Vol p5 (4) ◽  
pp. 2880-2887
Author(s):  
Prakash Meti ◽  
Lohith B A
Keyword(s):  
Quality Of Life ◽  
Erectile Dysfunction ◽  
Negative Impact ◽  
Treatment Modalities ◽  
The World ◽  
Significant Negative Impact ◽  
Group A ◽  
Group B

The condition in which loss or decrease in the capacity of normal erection with sufficient rigidity for penetrative intercourse is described as 'Klaibya'. It can be compared with Erectile dysfunction. Erectile dysfunction (ED) is a highly prevalent condition among men all over the world. It has a significant negative impact on the quality of life of the patients along with their partners. Hence to treat such condition many treatment modalities have been men- tioned in Ayurveda among which Basti has prime role. In the present study Ashwagandha taila is used in the form of Uttarabasti and Matrabasti for 8 consecutive days to know its effect on Klaibya. Follow up of 16 days was done. The results were compared based on the subjective and objective parameters after 24 days. After assessing the parameters, it was observed that Group A Ashwagandha tailaUttarabasti has better role as compared to Group B Ashwagandha TailaMatrabasti in the management of Klaibya. Keywords: Klaibya, Uttarabasti, Matrabasti, Ashwagandha Taila, Erectile Dysfunction

Research Participation Experiences of Informants of Suicide and Control Cases

Crisis ◽  
2010 ◽  
Vol 31 (5) ◽  
pp. 238-246 ◽  
Author(s):  
Paul W. C. Wong ◽  
Wincy S. C. Chan ◽  
Philip S. L. Beh ◽  
Fiona W. S. Yau ◽  
Paul S. F. Yip ◽  
...  
Keyword(s):  
Ethical Issues ◽  
Research Participation ◽  
Self Report ◽  
Initial Contact ◽  
Psychological Autopsy ◽  
Autopsy Study ◽  
The People ◽  
And Control ◽  
The Impact

Background: Ethical issues have been raised about using the psychological autopsy approach in the study of suicide. The impact on informants of control cases who participated in case-control psychological autopsy studies has not been investigated. Aims: (1) To investigate whether informants of suicide cases recruited by two approaches (coroners’ court and public mortuaries) respond differently to the initial contact by the research team. (2) To explore the reactions, reasons for participation, and comments of both the informants of suicide and control cases to psychological autopsy interviews. (3) To investigate the impact of the interviews on informants of suicide cases about a month after the interviews. Methods: A self-report questionnaire was used for the informants of both suicide and control cases. Telephone follow-up interviews were conducted with the informants of suicide cases. Results: The majority of the informants of suicide cases, regardless of the initial route of contact, as well as the control cases were positive about being approached to take part in the study. A minority of informants of suicide and control cases found the experience of talking about their family member to be more upsetting than expected. The telephone follow-up interviews showed that none of the informants of suicide cases reported being distressed by the psychological autopsy interviews. Limitations: The acceptance rate for our original psychological autopsy study was modest. Conclusions: The findings of this study are useful for future participants and researchers in measuring the potential benefits and risks of participating in similar sensitive research. Psychological autopsy interviews may be utilized as an active engagement approach to reach out to the people bereaved by suicide, especially in places where the postvention work is underdeveloped.

PERCUTANEOUS EPIDURAL NEUROPLASTY (PEN) USING COMBINATION OF HYALURONIDASE AND HYPERTONIC SALINE (NaCl 3%) IN TREATING FAILED BACK SURGERY SYNDROME

2018 ◽  
Vol 1 (1) ◽  
pp. 1
Author(s):  
Wawan Mulyawan ◽  
Yudi Yuwono Wiwoho ◽  
Syaiful Ichwan
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Hypertonic Saline ◽  
Failed Back Surgery Syndrome ◽  
Favourable Outcome ◽  
Lumbar Spine Surgery ◽  
Low Back ◽  
Failed Back Surgery ◽  
Scale Scores

Background: Following surgical treatments for low back pain, lower extremity pain or neurologic symptoms would last or recur, this is defined as failed sack surgery syndrome (FBSS). FBSS usually occurs in 5-40% of these surgical patients. The most common cause is an epidural scar adhesion. Percutaneous epidural neuroplasty is the non-mechanical treatment for this condition. Previously, the use of hyaluronidase and hypertonic saline separately is commonly used for epidurolysis but the combination of hyaluronidase and hypertonic saline 3% has not been explored.Objective: To investigate the two-year outcomes of percutaneous epidural neuroplasty using a combination of hyaluronidase and hypertonic saline 3% in patients with FBSS.Methods: Twelve patients who experience low back pain, with or without radiculopathy, who have underwent lumbar spine surgery previously were assigned to the study. Parameters, such as the visual analogue scale scores for the back (VAS-B) and legs (VAS-L), and the Oswestry disability index (ODI), were recorded and compared between pretreatment, 1 week, 1 month, 3 months, 1 year and 2 years follow-up.Results: For all 12 patients, the postoperative VAS-B, VAS-L, and ODI were significantly different from the preoperative values in all follow-up periods: 1 month, 3 months, 1 year, and 2 years.Conclusion: Based off this study group, percutaneous epidural neuroplasty using a combination of hyaluronidase and hypertonic saline 3% has a favourable outcome in the 2 years follow-up

Listening to the Voices of Individuals with Disabilities

1998 ◽  
Vol 79 (2) ◽  
pp. 188-196 ◽  
Author(s):  
Stephen French Gilson ◽  
John C. Bricout ◽  
Frank R. Baskind
Keyword(s):  
Social Work ◽  
Exploratory Study ◽  
Personal Experience ◽  
Work Practice ◽  
Social Work Practice ◽  
Fundamental Rights ◽  
Individuals With Disabilities ◽  
Research And Practice ◽  
The Social

Social work literature, research, and practice on disabilities has lagged behind other topical areas dealing with oppressed groups. The social work literature remains “expert focused” and generally fragmented into discussions of specific disabilities or subpopulations. A viable general model that deals with the personal experience of disability is not available. This exploratory study presents a social work literature search and analysis as well as interviews with six individuals with disabilities about their experiences with social workers. Individuals with disabilities assert that they were treated as though they had categorically fewer aspirations, abilities, and perhaps even fundamental rights than did nondisabled people. This study provides a base for follow-up research on models of consumer-focused social work practice in the area of disability.

Comparison of Time spent between an electronic and a paper-based laboratory information system by laboratorians at a polyclinic in Greater Accra, Ghana: A time-motion study

2020 ◽  
Author(s):  
Philip Boakye
Keyword(s):  
Information System ◽  
Negative Impact ◽  
Laboratory Information System ◽  
Time Motion ◽  
Accessible Information ◽  
Motion Study ◽  
Significant Difference ◽  
Significant Negative Impact ◽  
Key Issues ◽  
Motion Studies

The acceptance of electronic laboratory information system (LIS) is gradually increasing in developing countries. However, the issue of time effectiveness due to computerization is less clear as there is fewer accessible information. One of the key issues for laboratorians is their indecision with LISs’ would-be effect of time on their work. A polyclinic in Ghana was in the process of implementing electronic LIS. Several of the laboratorians did not have knowledge and skill in computing and there were disagreeing views on the time effectiveness of the LIS after implementation. The management of the polyclinic laboratory was concerned to assess time advantageousness of recording data when using the electronic LIS compared with paper-based LIS. <div><br></div><div>Five randomly selected laboratorians were provided two sheets of paper with tables to document the time they spent for both paper-based and electronic LIS. Data were collected for a total of 230 records,115 electronic LIS and 115 paper-based LIS. The t-test (mean-comparison test) was computed to compare the means of both electronic and paperbased LIS times. </div><div><br></div><div>There was a statistical significant difference in the time spent between electronic and paper-based LIS. The time spent between paper-based and electronic LIS was 0.41 minutes (95% CI 0.15 to 0.66) longer than in electronic LIS. </div><div><br></div><div>LIS can be adopted in polyclinics without having significant negative impact on time spent between electronic and paper-based LIS. More time–motion studies that include laboratorians are however necessary in order to get a more complete picture of time spent between electronic and paper-based LIS. </div>

ASSESSMENT OF THE SPATIOTEMPORAL DYNAMICS OF THE MACROPHYTE THICKET ECOSYSTEMS IN THE NEVA BAY AND THE ADJACENT WATERS OF THE EASTERN GULF OF FINLAND

2017 ◽  
Author(s):  
Ekaterina Maksimova ◽  
Ekaterina Maksimova ◽  
Vladimir Zhigulsky ◽  
Vladimir Zhigulsky ◽  
Vladimir Shuisky ◽  
...  
Keyword(s):  
Aquatic Vegetation ◽  
Temporal Dynamics ◽  
Negative Impact ◽  
Spatiotemporal Dynamics ◽  
Gulf Of Finland ◽  
Active Growth ◽  
Nesting Sites ◽  
Significant Negative Impact ◽  
And Migration ◽  
Neva Bay

The macrophyte thicket ecosystems of higher aquatic vegetation in the Neva Bay (NB) and Eastern Gulf of Finland (EGoF) perform many important roles, including acting as the habitats, nesting sites and migration sites for aquatic and semi-aquatic birds, creating the specific conditions necessary for the spawning and growth of many species of fish, and taking part in the self-purification of the aquatic ecosystems. Many anthropogenic disturbances, hydraulic works in particular, have a significant negative impact on these macrophyte thicket ecosystems. In recent years, the active growth of a new type of macrophyte thicket has been observed in the NB. This is due to the aftereffects of the construction of the Saint Petersburg Flood Prevention Facility Complex (FPFC). It is quite likely that the total macrophyte thicket area in these waters is currently increasing. In the future, it will be necessary to assess the environmental impacts of the hydraulic works on the macrophyte thicket of the NB and EGoF, taking into account the background processes of the spatiotemporal dynamics of the reed beds in the waters in question. To do this, it will be necessary to carry out a comprehensive study of these ecosystems and identify patterns in their spatial and temporal dynamics. The program of the study has been developed and is currently being implemented by Eco-Express-Service, a St. Petersburg eco-design company.

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