scholarly journals Multidiscpinary Approach in Nasopharyngeal Cancer

Medicinus ◽  
2018 ◽  
Vol 5 (2) ◽  
Author(s):  
Henry Kodrat
Keyword(s):  
Risk Factors ◽  
Multidisciplinary Approach ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Nasopharyngeal Cancer ◽  
Diagnostic Procedures ◽  
Post Treatment ◽  
Treatment Toxicity

<p>Nasopharyngeal cancer (NPC) is endemic in Indonesia. The purpose of the review is to describe the risk factors, clinical symptoms, diagnostic procedures and staging, management and treatment options, and follow-up. Multi-disciplinary approach to the NPC not only for treatment, but also has been started from the diagnosis proccess. The multidisciplinary approach also plays role after treatment, especially for the follow-up and rehabilitation of post-treatment toxicity.</p><p><strong>Keywords: </strong>cancer, nasopharynx, radiotherapy.</p>

scholarly journals Predictors of mortality in patients with hereditary hemorrhagic telangiectasia

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
K. P. Thompson ◽  
◽  
J. Nelson ◽  
H. Kim ◽  
L. Pawlikowska ◽  
...  
Keyword(s):  
Hereditary Hemorrhagic Telangiectasia ◽  
Cox Regression ◽  
Clinical Symptoms ◽  
Vascular Malformations ◽  
Smoking Status ◽  
Treatment Options ◽  
Gi Bleeding ◽  
Cox Regression Analysis ◽  
Predictors Of Mortality

Abstract Background Retrospective questionnaire and healthcare administrative data suggest reduced life expectancy in untreated hereditary hemorrhagic telangiectasia (HHT). Prospective data suggests similar mortality, to the general population, in Denmark’s centre-treated HHT patients. However, clinical phenotypes vary widely in HHT, likely affecting mortality. We aimed to measure predictors of mortality among centre-treated HHT patients. HHT patients were recruited at 14 HHT centres of the Brain Vascular Malformation Consortium (BVMC) since 2010 and followed annually. Vital status, organ vascular malformations (VMs) and clinical symptoms data were collected at baseline and during follow-up (N = 1286). We tested whether organ VMs, HHT symptoms and HHT genes were associated with increased mortality using Cox regression analysis, adjusting for patient age, sex, and smoking status. Results 59 deaths occurred over average follow-up time of 3.4 years (max 8.6 years). A history of anemia was associated with increased mortality (HR = 2.93, 95% CI 1.37–6.26, p = 0.006), as were gastro-intestinal (GI) bleeding (HR = 2.63, 95% CI 1.46–4.74, p = 0.001), and symptomatic liver VMs (HR = 2.10, 95% CI 1.15–3.84, p = 0.015). Brain VMs and pulmonary arteriovenous malformations (AVMs) were not associated with mortality (p > 0.05). Patients with SMAD4 mutation had significantly higher mortality (HR = 18.36, 95% CI 5.60–60.20, p < 0.001) compared to patients with ACVRL1 or ENG mutation, but this estimate is imprecise given the rarity of SMAD4 patients (n = 33, 4 deaths). Conclusions Chronic GI bleeding, anemia and symptomatic liver VMs are associated with increased mortality in HHT patients, independent of age, and in keeping with the limited treatment options for these aspects of HHT. Conversely, mortality does not appear to be associated with pulmonary AVMs or brain VMs, for which patients are routinely screened and treated preventatively at HHT Centres. This demonstrates the need for development of new therapies to treat chronic anemia, GI bleeding, and symptomatic liver VMs in order to reduce mortality among HHT patients.

Personalized attention control therapy for PTSD: effectiveness and moderators of outcome in a randomized controlled trial

2020 ◽  
pp. 1-11
Author(s):  
Adva Segal ◽  
Daniel S. Pine ◽  
Yair Bar-Haim
Keyword(s):  
Treatment Outcome ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
Post Treatment ◽  
Attention Control ◽  
Randomized Controlled ◽  
Control Therapy ◽  
Pre Treatment ◽  
Attentional Interference

Abstract Background Previous randomized controlled trials (RCTs) suggest that attention control therapy (ACT), targeting aberrant fluctuations of attention toward and away from threats in patients with PTSD, may be effective in reducing symptoms. The current RCT examined whether the use of personalized-trauma stimuli enhances ACT efficacy in patients with PTSD. Additional moderators of treatment outcome were tested on an exploratory basis. Methods Sixty patients with PTSD were randomly assigned to either personalized ACT, non-personalized ACT, or a control condition. Changes in symptoms were examined across pre-treatment, post-treatment, and a 3-month follow-up. Attentional interference was examined pre- and post-treatment. Baseline clinical and cognitive indices as well as the time elapsed since the trauma were tested as potential moderators of treatment outcome. Results A significant reduction in clinical symptoms was noted for all three conditions with no between-group differences. Attention bias variability decreased following ACT treatment. Personalized ACT was more effective relative to the control condition when less time had elapsed since the trauma. Baseline clinical and cognitive indices did not moderate treatment outcome. Conclusions In this RCT of patients with PTSD, ACT was no more effective in reducing PTSD symptoms than a control condition. The data also suggest a potential benefit of personalized ACT for patients who experienced their trauma more recently.

Suicide in recently discharged psychiatric patients: a case-control study

2008 ◽  
Vol 39 (3) ◽  
pp. 443-449 ◽  
Author(s):  
I. M. Hunt ◽  
N. Kapur ◽  
R. Webb ◽  
J. Robinson ◽  
J. Burns ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Suicide Risk ◽  
Case Control Study ◽  
Clinical Symptoms ◽  
Risk Measures ◽  
Psychiatric Patients ◽  
Case Control ◽  
Control Study

BackgroundFew controlled studies have specifically investigated aspects of mental health care in relation to suicide risk among recently discharged psychiatric patients. We aimed to identify risk factors, including variation in healthcare received, for suicide within 3 months of discharge.MethodWe conducted a national population-based case-control study of 238 psychiatric patients dying by suicide within 3 months of hospital discharge, matched on date of discharge to 238 living controls.ResultsForty-three per cent of suicides occurred within a month of discharge, 47% of whom died before their first follow-up appointment. The first week and the first day after discharge were particular high-risk periods. Risk factors for suicide included a history of self-harm, a primary diagnosis of affective disorder, recent last contact with services and expressing clinical symptoms at last contact with staff. Suicide cases were more likely to have initiated their own discharge and to have missed their last appointment with services. Patients who were detained for compulsory treatment at last admission, or who were subject to enhanced levels of aftercare, were less likely to die by suicide.ConclusionsThe weeks after discharge from psychiatric care represent a critical period for suicide risk. Measures that could reduce risk include intensive and early community follow-up. Assessment of risk should include established risk factors as well as current mental state and there should be clear follow-up procedures for those who have self-discharged. Recent detention under the Mental Health Act and current use of enhanced levels of aftercare may be protective.

Equine non-healing corneal ulcers: a retrospective evaluation of 57 cases (2001–2017)

2020 ◽  
Vol 48 (02) ◽  
pp. 92-97
Author(s):  
Vera J. S. Prucha ◽  
Alexander Tichy ◽  
Barbara Nell
Keyword(s):  
Clinical Symptoms ◽  
Treatment Options ◽  
Treatment Protocol ◽  
Healing Time ◽  
Additional Treatment ◽  
Treatment Protocols ◽  
Corneal Ulcers ◽  
Recorded Data ◽  
Inflammatory Drugs

Abstract Background and objectives Non-healing corneal ulcers (NHCU) are a common problem in equine practice and several treatment options are available with different success and healing times. The aim of this retrospective study was to evaluate and to compare treatment protocols, clinical courses, corneal healing time and outcomes of NHCU. Methods From December 2001 to December 2017, a total of 57 horses with NHCU were presented at the Vetmeduni Vienna. Recorded data included affected eye, signalment, clinical symptoms, season of diagnosis, treatment protocols, complications and corneal healing rate. Results Sixty-three eyes were diagnosed with a NHCU. Follow-up information was available for 48/63 eyes. For those treated medically mean corneal healing time was 15.7 days (± SD 12.0). Medical treatment included topical antibiotics, antimycotics, cycloplegics, and systemic anti-inflammatory drugs. Twelve eyes received treatment with a poly-carboxymethylglucose-sulfate regenerating agent (Cacicol®; Thea Pharma GmbH, Wien, Austria). Other common additional treatments included debridement with an iodine drenched cotton tip (48 eyes; 76.2 %) and diamond burr debridement (30 eyes; 47.6 %). A bandage contact lens (BCL) was used for 10 eyes. Each eye received at least one additional treatment, although none of them led to a statistically significant alteration in healing time. Only usage of a BCL significantly increased healing time when compared to not using a BCL (p = 0.035). When all treatments failed, superficial keratectomy with placement of a conjunctival flap was performed. Secondary complications included stromal cellular infiltration, keratomycosis, keratomalacia, and corneal abscess formation. Conclusions Results correlated with those previously described and thus demonstrated the difficulty and complexity of this disease. Further research is needed to determine an optimal treatment protocol for non-healing ulcers in horses. Clinical relevance Since NHCUs are a commonly encountered problem in equine practice a reliable treatment protocol is required. This study reflects the problems with those ulcers and provides several protocols for possible treatments.

scholarly journals Thyroid papillary microcarcinoma: a descriptive and meta-analysis study

2008 ◽  
Vol 159 (6) ◽  
pp. 659-673 ◽  
Author(s):  
Elio Roti ◽  
Ettore C degli Uberti ◽  
Marta Bondanelli ◽  
Lewis E Braverman
Keyword(s):  
Risk Factors ◽  
Clinical Characteristics ◽  
Meta Analysis ◽  
Diagnostic Procedures ◽  
Papillary Microcarcinoma ◽  
Analysis Study ◽  
Thyroid Microcarcinoma ◽  
Thyroid Papillary ◽  
Treatment Procedures

The authors review anatomical, clinical characteristics and prevalence of thyroid microcarcinoma. Diagnostic procedures and risk factors of aggressiveness at diagnosis and during follow-up are also covered. The possible clinical, pathologic and therapeutic risk factors are analyzed by meta-analysis study. Treatment procedures by different authors and guidelines suggested by societies are reported.

scholarly journals Risk factors, hematological and biochemical profile associated with colic in Delman horses in Gresik, Indonesia

F1000Research ◽  
2022 ◽  
Vol 10 ◽  
pp. 950
Author(s):  
Muhammad Thohawi Elziyad Purnama ◽  
Dodit Hendrawan ◽  
Arya Pradana Wicaksono ◽  
Faisal Fikri ◽  
Agus Purnomo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Evaluation ◽  
Whole Blood ◽  
Clinical Symptoms ◽  
Body Condition Score ◽  
Serum Cortisol ◽  
Gastrointestinal Parasites ◽  
Post Treatment ◽  
Plasma Epinephrine ◽  
Hematological Profile

Background: Horses are herd animals that have been domesticated in the last century. In several countries, an overview of risk factors and clinical evaluation in horses with colic has not been well‐described. This study aimed to evaluate risk factors and hematological profiles in horses associated with colic in Gresik, East Java, Indonesia. Methods: A cross-sectional study was performed during April - October 2019. A total of 115 horses were diagnosed based on physical examination, clinical symptoms, and rectal examination. A questionnaire was asked to the horse-owners to analyze the risk factors while the clinical examination was performed and blood samples were collected for pre-treatment and 14 days post-treatment. Hematological profile was evaluated from a whole blood sample. Serum cortisol, plasma epinephrine, and norepinephrine concentrations were also evaluated after separating the aliquots.  Results: Of the 115 horses, 96 were diagnosed with colic. The horses with colic showed a significant association between cases with gender (p<0.021), breed (p<0.000), wheat bran feeding (p<0.015), concentrate feeding (p<0.003), anthelmintics administration (p<0.000), gastrointestinal parasites (p<0.000), dental diseases (p<0.024), previous exposure to colic (p<0.000), body condition score (p<0.000), and access to water per day (p<0.000). Based on whole blood and serum evaluation, there were ameliorated significantly on the hematological profile (p<0.01), serum cortisol (p<0.05), and plasma epinephrine (p<0.01) at 14 days post-treatment. Conclusion: This study has identified factors associated with colic in Delman horses. The study provides crucial information to investigate cases of colic and to contribute the development of healthcare strategies during treatment and clinical evaluation.

Obsessional Slowness: A Case Study

2008 ◽  
Vol 75 (4) ◽  
pp. 249-254 ◽  
Author(s):  
Wendy Lam ◽  
Karen W. Wong ◽  
Mary-Ann Fulks ◽  
Liisa Holsti
Keyword(s):  
Treatment Options ◽  
Treatment Phase ◽  
Post Treatment ◽  
Behavioural Intervention ◽  
Single Subject ◽  
Baseline Phase ◽  
Carry Over ◽  
Withdrawal Design

Background. Obsessional slowness is a rare psychiatric disorder with few treatment options and limited research to date. Some suggest that targeted behavioural interventions may reduce the time taken for functional daily activities. Purpose. To examine whether a behavioural intervention would reduce the amount of time taken for an adolescent with obsessional slowness to walk to class. Methods. A single-subject A-B-A withdrawal design was incorporated into this case study. The treatment involved one-to-one pacing and prompting during the subject's walk to gym class. Walking times to gym class were measured during a baseline phase, during a one-month treatment phase, and during a post-treatment follow-up phase. Findings. The subject's walking times decreased during the treatment phase. Post-treatment walking times suggested a carry-over effect. Implications. This study adds to the sparse evidence on treatments for obsessional slowness and suggests occupation-based treatment options.

Primary Adenocarcinoma in an Oesophageal Gastric Graft – Case Report

2015 ◽  
Vol 87 (2) ◽  
Author(s):  
Daria Dranka-Bojarowska ◽  
Adam Lewiński ◽  
Andrzej Grabarczyk ◽  
Paweł Lampe
Keyword(s):  
Radical Surgery ◽  
Rare Complication ◽  
Treatment Options ◽  
Cell Cancer ◽  
Diagnostic Procedures ◽  
Primary Adenocarcinoma ◽  
Term Survival ◽  
Diagnosis Of Cancer

AbstractPrimary adenocarcinoma in the esophageal gastric graft is a rare complication diagnosed in patients with long-term survival. Most data concerning the diagnosis and treatment of patients with metachronic cancer in esophageal grafts is derived from Japan and South Korea. The diagnosis of cancer in esophageal gastric grafts in the European countries is rare.The study presented a case of a 66-year old male patient who, 30 months after an esophageal squamous cell cancer resection, was diagnosed with adenocarcinoma of the esophageal gastric graft. Despite control follow-up after the esophagectomy, cancer in the esophageal graft was detected during the stage that prevented performing radical surgery. The study presented the recommended diagnostic procedures and treatment options for esophageal gastric graft cancer, as well as review of available literature data

scholarly journals Treatment failure in patients with chronic Blastocystis infection

2014 ◽  
Vol 63 (2) ◽  
pp. 252-257 ◽  
Author(s):  
Tamalee Roberts ◽  
John Ellis ◽  
John Harkness ◽  
Deborah Marriott ◽  
Damien Stark
Keyword(s):  
Treatment Failure ◽  
Antimicrobial Agents ◽  
Clinical Symptoms ◽  
Treatment Options ◽  
Secondary Treatment ◽  
Blastocystis Infection ◽  
Triple Combination Therapy ◽  
Ongoing Infection

This article reports long-term infection and treatment failure in 18 symptomatic individuals infected with Blastocystis spp. Patients were initially treated with either metronidazole, iodoquinol or triple combination therapy consisting of nitazoxanide, furazolidone and secnidazole. Following treatment, resolution of clinical symptoms did not occur and follow-up testing revealed ongoing infection with the same subtype. Patients then underwent secondary treatment with a variety of antimicrobial agents but remained symptomatic with Blastocystis spp. still present in faeces. Sequencing of the SSU rDNA was completed on all isolates and four subtypes were identified in this group: ST1, ST3, ST4 and ST5. This study highlights the lack of efficacy of several commonly used antimicrobial regimens in the treatment of Blastocystis and the chronic nature of some infections. It also demonstrates the need for further research into treatment options for Blastocystis infection.

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