Penile injection of aedile silicone: A dangerous shortcut

2021 ◽  
pp. 039156032110402
Author(s):  
Omid Sedigh ◽  
Giuseppe Pizzuto ◽  
Maurizio Barale ◽  
Muhammad Dashti ◽  
Simone Mazzoli ◽  
...  
Keyword(s):  
Surgical Techniques ◽  
Penile Prosthesis ◽  
Well Being ◽  
Waiting Lists ◽  
Clinically Normal ◽  
Penile Prostheses ◽  
Patient Reported ◽  
Skin Reconstruction ◽  
The Cost

Introduction: The size of penis can cause concern in patients, even if the organ is clinically normal. Additionally, the cost of phosphodiesterase 5 inhibitors (iPDE5) and long waiting lists to access penile prosthesis placement can lead patients to resort to non-medical and potentially dangerous alternatives. One of these dangerous alternatives is the injection of building silicone at the level of the subcutis of the penis or the corpora cavernosa causing the formation of a granuloma that increases the girth and consistency of the penis. Case report: The article describes the case of a 43-year-old patient who self-injected aedile silicone at the level of his penis in an attempt to achieve greater penile size and greater rigidity. The patient reported that he could not economically afford the iPDE5.The persistence of severe pain in the penis forced the patient to go to a urological examination. The patient subsequently underwent the penile granuloma exeresis procedure and skin reconstruction with scrotal flap. Conclusion: The pursuit of sexual well-being can lead some patients to rely on unconventional and potentially harmful techniques. The role of the andrologist and of the scientific society should be to dissuade the patient from using these dangerous methods and to provide valid alternatives accessible to the patient. The economic difficulty in purchasing drugs that facilitate erection or the long waiting lists for the placement of penile prostheses can favor dangerous methods such as penile injection of silicon. There is therefore a clear need to facilitate access to drugs and surgical techniques that favor the patient’s sexual well-being.

Research in Genetic Counseling

2019 ◽  
pp. 171-186
Author(s):  
Barbara B. Biesecker ◽  
Kathryn F. Peters ◽  
Robert Resta
Keyword(s):  
Genetic Counseling ◽  
Self Regulation ◽  
Well Being ◽  
Genetic Counselors ◽  
National Society ◽  
Patient Reported ◽  
Key Variables ◽  
Regulation Model

The field of genetic counseling has historically valued the role of research. More recently, graduate programs have raised the standards for student thesis projects so that a greater percent are of publishable quality. The profession has acknowledged key research gaps, such as a lack of consensus on the primary client outcomes of counseling. Further, the National Society of Genetic Counselors has endorsed the importance of evidence that may be used to guide practice. Herein we present the role of genetic counselors as researchers and discuss approaches to designing research studies to answer key service delivery questions and patient-reported outcomes. To frame research in genetic counseling, health behavior and social psychology theories offer models for identifying key variables likely to predict client decisions and their outcomes. To date, studies in genetic counseling have been framed by the self-regulation model and the theory of planned behavior. A systematic review of randomized controlled trials in genetic counseling identified psychological well-being and gain in knowledge as the most prevalent patient outcomes. Evidence can be used to predict decisions to undergo genetic testing or follow up on results.

The Cost of Well-Being: The Role of Income Following Social Transition

2014 ◽  
Vol 2014 (1) ◽  
pp. 11585
Author(s):  
Ben Bulmash ◽  
Ishak Saporta ◽  
Yoav Ganzach
Keyword(s):  
Well Being ◽  
Social Transition ◽  
The Cost

Relationship between financial toxicity and health-related quality of life in patients with advanced solid tumors.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 31-31
Author(s):  
Jonas A. De Souza ◽  
Bonnie J. Yap
Keyword(s):  
Quality Of Life ◽  
Well Being ◽  
Tumor Type ◽  
Financial Toxicity ◽  
Health Related Quality ◽  
Patient Reported ◽  
Related Quality ◽  
Health Related ◽  
The Cost

31 Background: Financial toxicity is an important Patient-Reported Outcome (PRO). Its relationship with health-related quality of life (HRQOL) has not been previously described. Therefore, we report the relationship between financial toxicity and health-related quality of life (HRQOL) in patients with advanced cancers. Methods: The global HRQOL was measured by the Functional Assessment of Cancer Therapy-General (FACT-G) and its subscales Physical Well-Being (PWB), Social/Family Well-Being (SWB), Emotional Well-Being (EWB) and Functional Well-Being (FWB). Financial toxicity was assessed by the COST (COmprehensive Score for financial Toxicity), a PRO measure previously developed in 155 patients with advanced cancers. Correlations were calculated using Spearman's correlation. Subject data on tumor type, age, gender, race, income, insurance type and educational level were collected. Results: Fifty patients were assessed. All participants were diagnosed with advanced cancers, were receiving treatment at the time of participation, and had received treatment for at least 3 months. The median COST was 22 (range 0-44), and mean 22.51 (s.d. ±10.80). A negative correlation existed between the COST and HRQOL as measured by the FACT-G (r = -0.47, P <.001), and its subscales: PWB (r=-0.35, p < 0.05), SWB (r=-0.33, p < 0.05), EWB (r=-0.32, p < 0.05) and FWB (r=-0.41, p < 0.01). In this small sample, there were no correlations between the COST and sociodemographic characteristics. Conclusions: Results demonstrate an inverse relationship between patient-reported HRQOL and financial toxicity, suggesting that higher financial toxicity is associated with worse HRQOL. A larger study is in progress to identify cancer patients at higher risk of financial toxicity.

scholarly journals Dual Implantation of Artificial Urinary Sphincter and Inflatable Penile Prostheses for Concurrent Male Urinary Incontinence and Erectile Dysfunction

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Tariq F. Al-Shaiji
Keyword(s):  
Urinary Incontinence ◽  
Erectile Dysfunction ◽  
Surgical Techniques ◽  
Cost Savings ◽  
Penile Prosthesis ◽  
Artificial Urinary Sphincter ◽  
Inflatable Penile Prosthesis ◽  
Penile Prostheses ◽  
Urinary Sphincter ◽  
Negative Effect

Erectile dysfunction and urinary incontinence secondary to sphincter dysfunction are common conditions affecting many men worldwide with a negative effect on quality of life. They are encountered in a number of etiologies most commonly following radical prostatectomy in which they coexist in the same patient. Implantations of an artificial urinary sphincter and inflatable penile prosthesis have proven to be effective in the treatment of both conditions should conservative and minimally invasive measures fail. The recent literature has shown that dual implantation of these devices is feasible and safe with a durable clinical outcome. Once indicated, this can be done in a synchronous or nonsynchronous manner; however, the emerging of the single transverse scrotal incision as well as advancement in the prostheses has made synchronous dual implantation more favourable and appealing option. It provides time and cost savings with an evidence of high patient satisfaction. Synchronous dual implantation should be offered initially when indicated. This paper discusses the surgical techniques of artificial urinary sphincter and inflatable penile prosthesis dual implantation in the management of concurrent moderate-to-severe urinary incontinence and medically refractive erectile dysfunction, in addition to highlighting the existing literature pertaining to this approach.

scholarly journals Re-Validation of the COmprehensive Score for Financial Toxicity (COST): Assessing the Scale’s Utility in Chronic Disease Populations

2021 ◽  
Vol 14 ◽  
pp. 117863292110573
Author(s):  
G Pavela ◽  
M Fifolt ◽  
SE Tison ◽  
M Allison ◽  
BS Burton ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
Internal Consistency ◽  
Chronic Conditions ◽  
Convergent Validity ◽  
Well Being ◽  
Financial Toxicity ◽  
Patient Reported ◽  
Good Internal Consistency ◽  
The Cost ◽  
Comprehensive Score

Objective: To report the psychometric properties of the COmprehensive Score for financial Toxicity (COST) patient-reported outcome measure (PROM), an 11-item scale previously validated among patients diagnosed with cancer and receiving chemotherapy. Methods: Data come from a cross-sectional survey (n = 2755 response rate of 87%) of participants in a remote digital health coaching intervention collected between January 2017 and February 2019. Results: COST demonstrated very good internal consistency ( Cronbach’s alpha = .89) and good convergent validity. Lower financial toxicity was associated with improved physical and mental well-being HRQOL measures after controlling for covariates ( b = 0.13, P < .0001; b = 0.28, P < .0001, respectively). Supplemental analyses indicated that the COST instrument loaded on 2 factors. Conclusions: The COST measure of financial toxicity has good internal consistency and predictive validity in a sample of patients with chronic conditions. However, contrary to previous research examining the psychometric properties of COST in a sample of individuals with cancer, which found COST to be unidimensional, our analyses indicated that the COST measure of financial toxicity is multidimensional in a sample of individuals with chronic conditions. In particular, the items that asked about “general financial wellbeing” loaded on the second factor while “illness-related financial wellbeing” loaded on the first.

scholarly journals The role of robotic technology in cardiac surgery

2019 ◽  
Vol 87 (2) ◽  
pp. 40-42 ◽  
Author(s):  
Elise Quint ◽  
Gayathri Sivakumar
Keyword(s):  
Cardiac Surgery ◽  
Minimally Invasive ◽  
Artery Bypass ◽  
Surgical Techniques ◽  
Robotic Technology ◽  
Minimally Invasive Surgical ◽  
Robotic Cardiac Surgery ◽  
The Cost ◽  
Invasive Techniques

Minimally invasive surgical techniques have been developed in order to improve patient outcomes and satisfaction. These minimally invasive techniques have been applied to numerous fields, including cardiac surgery. Currently, mitral valve repair and coronary artery bypass grafting are the most common procedures performed robotically. Numerous studies have shown that robotic technology provides similar outcomes to traditional surgery, which is much more invasive. However, there are numerous barriers to performing robotic surgery, including the cost of robotic systems and the steep learning curve associated with these systems. It is predicted that the indications for robotic cardiac surgery will increase as these limitations are addressed.

scholarly journals High prevalence and adverse health effects of loneliness in community-dwelling adults across the lifespan: role of wisdom as a protective factor

2018 ◽  
Vol 31 (10) ◽  
pp. 1447-1462 ◽  
Author(s):  
Ellen E. Lee ◽  
Colin Depp ◽  
Barton W. Palmer ◽  
Danielle Glorioso ◽  
Rebecca Daly ◽  
...  
Keyword(s):  
Mental Health ◽  
Physical Functioning ◽  
San Diego ◽  
Well Being ◽  
Community Dwelling ◽  
Medium Effect ◽  
Psychological States ◽  
Patient Reported ◽  
High Prevalence

ABSTRACTObjectives:This study of loneliness across adult lifespan examined its associations with sociodemographics, mental health (positive and negative psychological states and traits), subjective cognitive complaints, and physical functioning.Design:Analysis of cross-sectional dataParticipants:340 community-dwelling adults in San Diego, California, mean age 62 (SD = 18) years, range 27–101 years, who participated in three community-based studies.Measurements:Loneliness measures included UCLA Loneliness Scale Version 3 (UCLA-3), 4-item Patient-Reported Outcomes Measurement Information System (PROMIS) Social Isolation Scale, and a single-item measure from the Center for Epidemiologic Studies Depression (CESD) scale. Other measures included the San Diego Wisdom Scale (SD-WISE) and Medical Outcomes Survey- Short form 36.Results:Seventy-six percent of subjects had moderate-high levels of loneliness on UCLA-3, using standardized cut-points. Loneliness was correlated with worse mental health and inversely with positive psychological states/traits. Even moderate severity of loneliness was associated with worse mental and physical functioning. Loneliness severity and age had a complex relationship, with increased loneliness in the late-20s, mid-50s, and late-80s. There were no sex differences in loneliness prevalence, severity, and age relationships. The best-fit multiple regression model accounted for 45% of the variance in UCLA-3 scores, and three factors emerged with small-medium effect sizes: wisdom, living alone and mental well-being.Conclusions:The alarmingly high prevalence of loneliness and its association with worse health-related measures underscore major challenges for society. The non-linear age-loneliness severity relationship deserves further study. The strong negative association of wisdom with loneliness highlights the potentially critical role of wisdom as a target for psychosocial/behavioral interventions to reduce loneliness. Building a wiser society may help us develop a more connected, less lonely, and happier society.

Latissimus Denervation: A Review of Evidence

2019 ◽  
Vol 35 (08) ◽  
pp. 609-615
Author(s):  
Christopher D. Lopez ◽  
Franca Kraenzlin ◽  
Christopher Frost ◽  
Halley Darrach ◽  
Pathik Aravind ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Latissimus Dorsi ◽  
Systematic Approach ◽  
Surgical Techniques ◽  
Latissimus Flap ◽  
Included Patient ◽  
Patient Reported ◽  
The Many ◽  
Thoracodorsal Nerve

Abstract Background Breast reconstruction is becoming an increasingly important and accessible component of breast cancer care. Among the many reconstructive options available, the latissimus dorsi flap has experienced a renewal in popularity because of its favorable properties and outcomes when used for breast reconstruction. However, a limitation unique to latissimus-based reconstruction is inappropriate breast animation postoperatively, due to persistent thoracodorsal innervation of the latissimus dorsi muscle after transfer to the mastectomy site. Methods A comprehensive literature search of PubMed and MEDLINE was conducted for studies investigating the role of thoracodorsal denervation in latissimus-based breast reconstruction. Data on surgical techniques, type of intervention, objective outcome measurements, and patient satisfaction-based outcomes were reported. Additional data included patient sample size, follow-up length, and treatment of thoracodorsal nerve (e.g., resection versus transection and length of transection) when applicable. Results Sixty-six search results were reviewed for inclusion and nine qualified after exclusion criteria for a total of 361 patients undergoing either unilateral or bilateral latissimus flap reconstruction. Successful thoracodorsal denervation rates were included in most studies and outcomes measurements were heterogeneous. Eight out of nine studies included patient-reported symptoms of breast animation postoperatively. Based on these findings, a systematic approach is presented. Conclusion We present this review to elucidate successful practices, identify current gaps in knowledge, and offer a systematic approach to this clinical challenge.

Assessing financial toxicity in patients with metastatic breast cancer: A single institution experience during the COVID-19 pandemic.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 176-176
Author(s):  
Shruti Sinkar ◽  
Faith Too ◽  
Kelly Carr ◽  
Jessica Jelinek ◽  
Elizabeth Saylor ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Supportive Care ◽  
Metastatic Cancer ◽  
Metastatic Breast ◽  
Well Being ◽  
Financial Hardship ◽  
Financial Toxicity ◽  
Patient Reported ◽  
The Cost

176 Background: Assessment of financial toxicity (FTox) is recommended as a component of comprehensive supportive care for patients with metastatic cancer. FTox is common in patients with metastatic breast cancer (MBC) and is associated with poor quality of life. Available data suggest many patients with cancer have faced financial hardship during the COVID-19 pandemic. Methods: We evaluated FTox using the COmprehensive Score for Financial Toxicity (COST) measure in patients with MBC at Johns Hopkins clinical sites. Respondents were patients with MBC who completed the COST measure as part of the baseline assessment for one of two IRB-approved quality improvement projects initiated during the COVID-19 pandemic: 1) a pilot project evaluating incorporation of patient-reported outcome (PRO) measures into routine care (RC), and 2) a needs assessment prior to attending a multi-disciplinary clinic (MultiD-C) focusing on supportive care. COST scores range from 0-44 with higher scores indicating better financial well-being. FTox was graded as: Grade 0 (G0): >26, Grade 1 (G1): >14-26, Grade 2 (G2): >0-14 and Grade 3 (G3): 0. Results: 40 patients with MBC completed the COST measure May 2020 through April 2021 as a component of RC and 17 patients with MBC completed the COST measure September 2020 through May 2021 in advance of anticipated attendance at the MultiD-C. Median age (range) for RC and MultiD-C respondents was 64 (36-85) and 55 (37-75) years, respectively. 4 (10%) and 4 (24%) of RC and MultiD-C respondents respectively reported household income < $50,000. The majority of respondents in both groups were White [RC: 28 (70%), MultiD-C: 14 (82%)], non-Hispanic [RC: 36 (90%), MultiD-C: 16 (94%)], had more than high school education [RC: 37 (93%), MultiD-C: 17 (100%)] and all were insured. 27 (68%) of RC respondents and 11 (65%) of MultiD-C respondents were receiving oral cancer therapies. COST scores and grading are shown in the Table. Approximately half of the respondents in each group reported their illness has been at least “a little bit” of a financial hardship [RC: 22 (55%), Multi-D: 8 (47%)]. Conclusions: Patients with MBC receiving care during the COVID-19 pandemic frequently report FTox. Implementation of routine assessment for FTox via PRO measures and identification of strategies to support patients with MBC experiencing FTox are priorities both during the pandemic and beyond.[Table: see text]

scholarly journals The Role of Social Participation in Controlling and Preventing of Coronavirus 2019 Disease in Iran

2020 ◽  
Vol 8 (T1) ◽  
pp. 134-136 ◽  
Author(s):  
Moradali Zareipour ◽  
Jila Nagavi Kalejahi
Keyword(s):  
Health System ◽  
Social Participation ◽  
Health Knowledge ◽  
Well Being ◽  
World Health ◽  
Social Dimensions ◽  
The People ◽  
Health Promoting ◽  
The Cost

BACKGROUND: According to the prevalence of coronavirus in the world, health measures will not be accountable to face the disease. As well as the economic, political, and social dimensions of the disease, there will be a lot of pressure on the health system, which may not be able to compensate in its various aspects. Therefore, the participation and cooperation of the society in the form of mobilizing the society with the health system will be effective in controlling and preventing this disease. AIM: Investigating the role of social participation in the controlling and preventing of Coronavirus 2019 disease (COVID-19) was the aim of this study. METHODS: In this review study, related English and Persian articles from PubMed, Google Scholar, Irandoc, SID, and Science direct were searched and studied using COVID-19, coronavirus, and social participation keywords. RESULTS: The opportunity to distribute health knowledge in the community has been created and led to the internal acquisition of mastery in health promoting of preventing and controlling of COVID-19 in the process of participation in health. Furthermore, the percentage of resources has been increased and the cost of government will be decreased and the possibility of accumulating available resources and the access to them will be provided; at the same time, the allocation of resources will be facilitated to the needy. A better understanding of the health and well-being needs of the people and the promotion of health are other benefits of people’s participation in controlling COVID-19. Involvement and active participation of the people increases the sense of social responsibility and the feeling of authority and it cause to disappear the dominance of official organizations. All of these outcomes have a positive effect on the health of people and society and ultimately in controlling COVID-19. CONCLUSION: As for a common goal is formed in social participation, the common motivation to achieve that goal in the light of proper and timely awareness and information can be a stimulus, a comprehensive determination to control coronavirus and lead to effective collective action against this disease.

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