Curative testis cancer therapy: psychosocial sequelae.

1985 ◽  
Vol 3 (8) ◽  
pp. 1117-1126 ◽  
Author(s):  
P P Rieker ◽  
S D Edbril ◽  
M B Garnick
Keyword(s):  
Intimate Relationships ◽  
Psychological Symptoms ◽  
Retroperitoneal Lymph Node Dissection ◽  
Testis Cancer ◽  
Emotional States ◽  
Delayed Effects ◽  
Psychosocial Sequelae ◽  
Ejaculatory Dysfunction ◽  
Long Term Impact

We examined the long-term impact of advanced testis cancer and its curative therapies on emotional states and outlook on life, employment, intimate relationships, and sexual function. The sample consisted of 74 nonseminomatous and seminomatous tumor patients who had completed treatment two to ten years ago. The majority of men felt that surviving the debilitating treatment(s) was both an accomplishment and worthwhile trade-off. Neither the rate of unemployment (7%) nor divorce (10%) was remarkable. The most critical outcome was in the area of sexual functioning. One fourth to one half of the men reported some type of sexual impairment. Multiple regression results indicate that ejaculatory dysfunction, a side effect of the retroperitoneal lymph node dissection, is significantly associated with distress about both infertility and sexual impairment. Men with sexual impairment report more psychological symptoms, strained intimate relationships, and negative changes in other areas of life functioning. These data, while not definitive, suggest that there are delayed effects and that the subgroup of men, who are least likely to disclose these problems to physicians, are at greater risk for the deleterious outcomes.

Adaptive behavioral responses to potential infertility among survivors of testis cancer.

1990 ◽  
Vol 8 (2) ◽  
pp. 347-355 ◽  
Author(s):  
P P Rieker ◽  
E M Fitzgerald ◽  
L A Kalish
Keyword(s):  
College Graduates ◽  
Retroperitoneal Lymph Node Dissection ◽  
Testis Cancer ◽  
Adaptive Responses ◽  
Retroperitoneal Lymph Node ◽  
Complex Process ◽  
Married Men ◽  
Ejaculatory Dysfunction ◽  
College Educated

In a retrospective study of 153 testis cancer survivors, we examined the sociodemographic and clinical determinants of attitudes and behaviors toward illness-induced infertility. Five fertility adjustment responses were identified: sperm-banking awareness (SBA); adoption awareness (AA); fertility testing (FT); trying to father children (TFC); and fertility distress (FD). Although responses to infertility are multidetermined, these data demonstrate there is a distinct sociodemographic and clinical profile for the subgroups of men who engage in different fertility-related behaviors. Multivariate analysis results show that men most likely to be concerned with banking sperm are those who at diagnosis are younger (less than 35 years), childless, college educated, and whose relationships have become strained. Men who sought fertility tests were childless, college graduates, and able to ejaculate. The only factor predicting adoption was childlessness. Those married men attempting to father children were also less than 35 years of age at diagnosis and without ejaculatory dysfunction. The men at greatest risk for continued distress about infertility were those who remained childless and had posttreatment ejaculatory dysfunction. Residual infertility distress also was significantly associated with treatments that included extensive retroperitoneal lymph node dissection (RPLND) surgery, indicating that the latter is a "risk factor" in survivors' long-term distress. These data, while not definitive, show that the prerogative to have children is very important to men and that losing it sets into motion a range of both adverse emotions and adaptive responses. Adjustment to infertility is a complex process that begins at diagnosis and extends long after treatment is completed.

scholarly journals TRANSFORMATION OF THE LEARNING PROCESS IN HIGHER EDUCATION INSTITUTIONS UNDER THE INFLUENCE OF THE PANDEMIC COVID-19

2021 ◽  
Vol 74 (6) ◽  
pp. 1505-1509
Author(s):  
Halyna O. Vaskivska ◽  
Svitlana P. Palamar ◽  
Nataliya V. Kravtsova ◽  
Olha V. Khodakivska
Keyword(s):  
Medical Education ◽  
Clinical Skills ◽  
Educational Tools ◽  
Delayed Effects ◽  
Online Tools ◽  
Technological Efficiency ◽  
Online Format ◽  
Long Term Impact ◽  
Keyword Searches

The aim: To analyze the challenges and approaches used in medical universities in different countries during the transfer of training from offline to online format during the COVID-19 pandemic. Materials and methods: Electronic databases of Scielo, Scopus and PubMed were searched using keyword searches. Conclusions: The use of a large number of online tools and ICTs to develop the clinical skills of medical students has become a real pedagogical breakthrough in medical education. Innovations and technological efficiency of educational tools will change medical education forever. But it is difficult to give an unambiguous assessment of the delayed effects of these changes, since not much is yet known about the long-term impact of COVID-19 on the medical education.

Clinical stage I carcinoma of the testis: a review.

1988 ◽  
Vol 6 (4) ◽  
pp. 734-750 ◽  
Author(s):  
C Y Fung ◽  
M B Garnick
Keyword(s):  
Therapeutic Intervention ◽  
Clinical Stage ◽  
Stage I ◽  
Clinical Staging ◽  
Retroperitoneal Lymph Node Dissection ◽  
Testis Cancer ◽  
Prognostic Features ◽  
Systemic Relapse

Significant advances in the management of disseminated carcinoma of the testis have had a tremendous influence on the management of all stages of disease, including both stage I and stage II. Because the disease is so uniformly curable in advanced forms, strategies have evolved for lower stages of disease to maximize curative potential with minimization of therapeutic intervention and potential long-term side effects. This review addresses issues of diagnosis and initial clinical staging of patients with stage I carcinoma of the testis. The usefulness of biological tumor markers and the accuracy, sensitivity, and specificity of radiographic imaging modalities are emphasized. The traditional treatment of stage I seminomas and nonseminomas includes the role of both radiation therapy and retroperitoneal lymph node dissection (RPLND). Treatment results and complications of each modality are also reviewed. The importance of orchiectomy followed by meticulous surveillance, as well as a critical analysis of prognostic features of subsequent locoregional or systemic relapse in patients with stage I testis cancer, focuses attention on changing concepts of this disease. The rationale underlying improved ability to stage patients meticulously and offer therapeutic intervention when necessary following orchiectomy, constitutes the focus of present and future clinical research. Such strategies are discussed in detail.

427: Long Term Results of Laparoscopic Retroperitoneal Lymph Node Dissection in Clinical Stage I NSGCT

2005 ◽  
Vol 173 (4S) ◽  
pp. 116-117
Author(s):  
Hannes Steiner ◽  
Reinhard Peschel ◽  
Tilko Müller ◽  
Christian Gozzi ◽  
Georg C. Bartsch ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Dissection ◽  
Clinical Stage ◽  
Stage I ◽  
Long Term Results ◽  
Retroperitoneal Lymph Node Dissection ◽  
Node Dissection ◽  
Retroperitoneal Lymph Node

Crisis Phones - Suicide Prevention Versus Suggestion/Contagion Effects

Crisis ◽  
2015 ◽  
Vol 36 (3) ◽  
pp. 220-224 ◽  
Author(s):  
Steven Stack
Keyword(s):  
Suicide Prevention ◽  
Contagion Effects ◽  
Long Term Impact

Abstract. Background: There has been no systematic work on the short- or long-term impact of the installation of crisis phones on suicides from bridges. The present study addresses this issue. Method: Data refer to 219 suicides from 1954 through 2013 on the Skyway Bridge in St. Petersburg, Florida. Six crisis phones with signs were installed in July 1999. Results: In the first decade after installation, the phones were used by 27 suicidal persons and credited with preventing 26 or 2.6 suicides a year. However, the net suicide count increased from 48 in the 13 years before installation of phones to 106 the following 13 years or by 4.5 additional suicides/year (t =3.512, p < .001). Conclusion: Although the phones prevented some suicides, there was a net increase after installation. The findings are interpreted with reference to suggestion/contagion effects including the emergence of a controversial bridge suicide blog.

Long-Term Impact of Participation in the Adolescent Diversion Project

2009 ◽  
Author(s):  
Jenna L. Claes ◽  
Sean S. Hankins ◽  
J. K. Ford
Keyword(s):  
Long Term Impact
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