EXPERIENCE IN USING A SCREENING QUESTIONNAIRE THAT IDENTIFIES GROUNDS FOR CONSULTING A PSYCHIATRIST IN CHILDREN'S CANCER HOSPITALS

Author(s):  
Suetina O.A. ◽  
Kravchenko N.E.

This article presents the results of using a simple closed screening questionnaire for oncopediatricians to identify mental disorders in children and adolescents with cancer. Long-term experience of monitoring underage patients suffering from cancer suggests that borderline mental disorders are widespread among these patients. Their diagnosis and therapy, which go beyond traditional specialized cancer care, require practitioners to have appropriate qualifications, which many pediatric oncologists do not have. To facilitate the selection of patients who need to consult a psychiatrist, oncopediatriciansare offered a simple screening questionnaire, which takes a minimum of time to complete, and which can be easily used when examining all patients under treatment.

2014 ◽  
Vol 8 (9-10) ◽  
pp. 702 ◽  
Author(s):  
Paul Toren ◽  
Lih-Ming Wong ◽  
Narhari Timilshina ◽  
Shabbir Alibhai ◽  
John Trachtenberg ◽  
...  

Introduction: The use of prostate-specific antigen (PSA) in active surveillance (AS) for prostate cancer is controversial. Some consider it an unreliable marker and others as sufficient evidence to exclude patients from AS. We analyzed our cohort of AS patients with a PSA over 10 ng/mL.Methods: We included patients who had clinical T1c–T2a Gleason ≤6 disease, and ≤3 positive cores with ≤50% core involvement at diagnostic biopsy and ≥2 total biopsies. Patients were divided into 3 groups: (1) those with baseline PSA >10 ng/mL, (2) those with a PSA rise >10 ng/mL during follow-up; and (3) those with a PSA <10 ng/mL throughout AS. Adverse histology was defined as biopsy parameters exceeding the entry criteria limits. We further compared this cohort to a concurrent institutional cohort with equal biopsy parameters treated with immediate radical prostatectomy.Results: Our cohort included 698 patients with a median follow-up of 46.2 months. In total, 82 patients had a baseline PSA >10 ng/mL and 157 had a PSA rise >10 ng/mL during surveillance. No difference in adverse histology incidence was detected between groups (p = 0.3). Patients with a PSA greater than 10 were older and had higher prostate volumes. Hazard ratios for groups with a PSA >10 were protective against adverse histology. Larger prostate volume and minimal core involvement appear as factors related to this successful selection of patients to be treated with AS.Conclusion: These results suggest that a strict cut-off PSA value for all AS patients is unwarranted and may result in overtreatment. Though lacking long-term data and validation, AS appears safe in select patients with a PSA >10 ng/mL and low volume Gleason 6 disease.


Author(s):  
Avantika Gupta ◽  
Deepthi Nayak ◽  
Purnima Tiwari

Corpus luteal haemorrhage usually causes only mild symptoms and resolve spontaneously, however, it can cause massive bleeding in certain patients with coagulation or bleeding disorders. Over a decade, the management of corpus luteum haemorrhage has shifted from surgical to conservative management. This article focuses on selection of patients for conservative management so that the morbidities associated with the surgery can be avoided. Conservative management includes optimization of oxygen carrying capacity of blood, correction of coagulopathy and appropriate analgesia. It can be recurrent in certain high-risk group of patients who will need long term suppression of ovulation.


1996 ◽  
Vol 14 (5) ◽  
pp. 1704-1712 ◽  
Author(s):  
A Carpi ◽  
E Ferrari ◽  
M G Toni ◽  
A Sagripanti ◽  
A Nicolini ◽  
...  

PURPOSE Long-term evaluation of the combination of two needle aspiration techniques (NAT) (fine-needle aspiration [FNA] and aspiration needle biopsy [ANB]) in performing an efficient preoperative selection of palpable thyroid nodules. PATIENTS AND METHODS Eight years of extensive use of surgery for the detection of thyroid cancer was compared with 12 years of preoperative selection of by NAT. RESULTS A total of 1,140 operations were performed from 1972 to 1979, and 35 malignant nodules were discovered (3.1%). Five thousand four hundred three patients were examined by NAT from 1980 to 1992; 483 (9%) underwent surgery and 158 malignant nodules were excised. The number of malignant nodules identified by NAT was 166 (eight were not excised) (3.1% of the total population examined). The principal clinical and pathologic features were similar in both groups. ANB yielded a definite benign diagnosis in 88 patients with inadequate FNA findings, it correctly identified four malignant nodules diagnosed as benign by FNA, it showed a macrofollicular component in 115 nodules diagnosed by FNA as microfollicular nodules, and it significantly changed the predictive value of 79 suspicions FNA diagnoses. CONCLUSION Introduction of NAT reduced the number of operations for palpable thyroid nodules from 143 to 40 per year and increased from four to 13 the number of malignant nodules excised without any change in the overall incidence of malignant nodules. The combination of ANB to FNA significantly contributed to the high and efficient preoperative patient selection, principally by reducing the number of indeterminate or suspicious, as well as false-negative, preoperative FNA diagnoses.


2017 ◽  
Vol 49 (01) ◽  
pp. 044-050 ◽  
Author(s):  
R. Vermeulen ◽  
Charlotte van 't Westende ◽  
Petra van Schie ◽  
Eline Bolster ◽  
Pim van Ouwerkerk ◽  
...  

AbstractWe recently showed a beneficial effect of selective dorsal rhizotomy (SDR) on daily care and comfort in nonwalking children with severe bilateral spasticity. However, despite careful selection, some patients showed dystonia after the intervention, in which cases caregivers tended to be less satisfied with the result.The aim of this study is to identify risk factors for dystonia after SDR in children and adolescents with severe bilateral spasticity (GMFCS levels IV/V).Clinical and MRI risk factors for dystonia after SDR were studied in our cohort of 24 patients. Patients with clinical evidence of dystonia and brain MRI showing basal ganglia abnormalities were excluded for SDR.Nine of 24 patients (38%) showed some degree of dystonia after SDR. There was a significant association between the cause of spasticity and dystonia after SDR; in six (67%) patients with a congenital disorder, dystonia was present versus three (20%) with an acquired disorder (Chi-squared test: C(1) = 5.23, p = 0.02).This study allows more optimal selection of patients that may benefit from SDR. Patients with an acquired cause of spasticity, when selected carefully on clinical examination and MRI, rarely show dystonia after SDR. However, patients with an underlying congenital disorder have a considerable risk of dystonia after SDR.


2021 ◽  
Vol 67 (3) ◽  
pp. 183-185
Author(s):  
Irina-Maria Gheorghiu ◽  
◽  
Paula Perlea ◽  
Sanziana Scarlatescu ◽  
George Nicola ◽  
...  

Dental bleaching is a method of treatment for tooth discoloration that uses hydrogen peroxide in various concentrations. For this dental maneuver to be successful, the etiological diagnosis of dental dyschromia and the treatment plan must be rigorously established. In this article we present the criteria underlying the selection of patients who can benefit from dental bleaching, grouped in a questionnaire. Adequate case selection suitable for teeth whitening, as well as the appropriate choice of the specific bleaching method are essential in obtaining satisfactory aesthetic result for the patient, immediately after completing the treatment, but also in the long term.


2018 ◽  
Vol 1 (1) ◽  
pp. 22
Author(s):  
Abil Kurdi ◽  
Hanoem Eka Hidayati

Background: Hemisection is an alternative treatment option for maintaining tooth with multiple root that indicated for extraction. Purpose: To reported tooth with multiple root indicated by extraction to be used as a fixed-fixed bridge abutment by extracting the infected root and maintain the healthy one. Case: A 53-year-old woman with caries in upper 1st molar teeth in mesiobuccally root that can’t be maintained. Patients refuse the teeth to be extracted. Case Management: Hemisection treatment was performed on 26 mesiobuccal root, with the addition of bone graft. After the healing process, fixed-fixed bridges were made on 25, 26, 27, 28, with PFM on 25, 26, 27 and full cast crowns on 28 as the material. Discussion: Hemisection as a conservative treatment, can be an option for multiple  root teeth that has been indicated for extraction but still have root that can be maintained. Conclusion: Teeth performed by hemisection treatments can be used as abutments with attention to the selection of patients to achieve long-term success.


2020 ◽  
Vol 91 (12) ◽  
pp. 1261-1269
Author(s):  
Birgitte Liang Chen Thomsen ◽  
Tiago Teodoro ◽  
Mark J Edwards

Functional movement disorders (FMD) are proposed to reflect a specific problem with voluntary control of movement, despite normal intent to move and an intact neural capacity for movement. In many cases, a positive diagnosis of FMD can be established on clinical grounds. However, the diagnosis remains challenging in certain scenarios, and there is a need for predictors of treatment response and long-term prognosis.In this context, we performed a systematic review of biomarkers in FMD. Eighty-six studies met our predefined criteria and were included.We found fairly reliable electroencephalography and electromyography-based diagnostic biomarkers for functional myoclonus and tremor. Promising biomarkers have also been described for functional paresis, gait and balance disorders. In contrast, there is still a lack of diagnostic biomarkers of functional dystonia and tics, where clinical diagnosis is often also more challenging. Importantly, many promising findings focus on pathophysiology and reflect group-level comparisons, but cannot differentiate on an individual basis. Some biomarkers also require access to time-consuming and resource-consuming techniques such as functional MRI.In conclusion, there are important gaps in diagnostic biomarkers in FMD in the areas of most clinical uncertainty. There is also is a lack of treatment response and prognostic biomarkers to aid in the selection of patients who would benefit from rehabilitation and other forms of treatment.


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