Geriatric Implications of Surgical Oncology

2021 ◽  
Vol 32 (3) ◽  
pp. 332-340
Author(s):  
Dalton Skipper
Keyword(s):  
Health Status ◽  
Geriatric Patient ◽  
Geriatric Patients ◽  
Surgical Intervention ◽  
Treatment Options ◽  
Surgical Oncology ◽  
Cancer Type ◽  
Younger Patients ◽  
Type Size ◽  
Overall Health Status

Surgical oncology is cancer care that focuses on using surgery to diagnose, stage, and treat cancer and is one of the main treatments for malignancy. Patients older than 65 years are generally considered geriatric. The incidence of cancer in geriatric patients is increasing annually. Candidacy for surgical intervention depends on factors such as cancer type, size, location, grade and stage of the tumor, and the patient’s overall health status and age. Despite increasing agreement that age should not limit treatment options, geriatric patients tend to be undertreated. Cancer in geriatric patients has different features than in younger patients. As such, treatment options may be dissimilar in these 2 cohorts. Here, care of the geriatric patient undergoing surgical oncology interventions is discussed.

scholarly journals The geriatric patient: special aspects of peri-operative management

2019 ◽  
Vol 4 (6) ◽  
pp. 240-247 ◽  
Author(s):  
Dieter Wirtz ◽  
Hendrik Kohlhof
Keyword(s):  
Special Needs ◽  
Older Adult ◽  
Geriatric Patient ◽  
Geriatric Patients ◽  
Operative Management ◽  
Models Of Care ◽  
Level Of Care ◽  
Patient Blood Management ◽  
Blood Management ◽  
Younger Patients

This article offers a German perspective on orthopaedic management of geriatric populations in higher-income countries. Specific orthopaedic procedures necessitate a more intensive level of care in older adult patients, especially with co-morbidities, than in younger patients. During the pre-, peri- and post-operative periods, several aspects such as patient blood management principles improve the outcomes of geriatric patients. New interdisciplinary geriatric models of care including geriatric and orthopaedic specialties have to be established to take care of the special needs of geriatric patients. Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180087

Thoracic Disc Herniation

2018 ◽  
pp. 109-122
Author(s):  
Derrick Umansky ◽  
James Kalyvas
Keyword(s):  
Health Status ◽  
Disc Herniation ◽  
Treatment Options ◽  
Radicular Pain ◽  
Surgical Approaches ◽  
Thoracic Disc Herniation ◽  
Thoracic Myelopathy ◽  
Thoracic Disc ◽  
Disc Size ◽  
Overall Health Status

Consensus in the literature supports surgery for severely symptomatic or disabling thoracic disc herniation only, with all others requiring observation or non-surgical intervention. For those patients requiring surgery, there are a variety of approaches that are used depending on symptomatology, spinal level, disc size, disc location relative to the canal and to the neural elements, presence of calcification, and overall health status of the patient. Dorsolateral/lateral approaches include transpedicular, transfacet pedicle-sparing, costotransversectomy, extracavitary, and parascapular; ventrolateral approaches include transthoracic thoracotomy, transthoracic thoracoscopy, and retropleural thoracotomy; finally, ventral approaches include transsternal and manubrial window. Thoracic myelopathy has a broad differential diagnosis. The cause of which can be identified with a detailed history, physical exam, and properly selected imaging. In the following chapter, we discuss herniated thoracic discs (HTD) including the common presentations, imaging findings, and the surgical treatment options. Consensus in the literature supports surgical management for HTDs that are severely symptomatic and disabling. The surgical approaches depends on the spine level, disc size, disc location, presence of calcification, and overall health status of the patient. The improvement rate for myelopathic patients ranges from 71% to 97% and for back pain and radicular pain from 67% to 94%. The overall complication rate is approximately 15%.

scholarly journals The Effect of Changes in Employment on Health of Work-Related Injured Workers: A Longitudinal Perspectives

Healthcare ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. 470
Author(s):  
Han-Kyoul Kim ◽  
Kyu-Min Kim ◽  
Jae-Hak Kim ◽  
Hyun-Sill Rhee
Keyword(s):  
Health Status ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Employment Status ◽  
Panel Study ◽  
Industrial Accident ◽  
Research Subjects ◽  
Work Related ◽  
Negative Effect ◽  
Overall Health Status

This longitudinal study attempted to identify changes in employment status and overall health status. The participants were workers who had experienced work-related injuries in the past. In this study, we used the Panel Study of Workers’ Compensation Insurance from 2013 to 2017. This study utilized propensity score matching for a quasi-experimental design study of the first year to exclude the effects of the confounding variables and exclude the effect of employment status, which is the main independent variable. After applying propensity score matching the research subjects totaled 1070. Changes in employment status were found to have a negative effect on overall health status. This raises new implications for existing industrial accident-related support policies. Thus, it is considered that the scope should be expanded from policies related to re-employment of workers after an industrial accident to improving quality of life through maintaining employment from a long-term perspective. The notable point of this study was to apply the PSM methods. By applying PSM, we clearly identified the effect of changes in employment status on health status.

scholarly journals Update on the role of pembrolizumab in patients with unresectable or metastatic colorectal cancer

2021 ◽  
Vol 14 ◽  
pp. 175628482110244
Author(s):  
Vanessa Wookey ◽  
Axel Grothey
Keyword(s):  
Colorectal Cancer ◽  
Immune Checkpoint ◽  
Checkpoint Inhibitors ◽  
Treatment Options ◽  
Standard Of Care ◽  
Cancer Type ◽  
Cancer Therapies ◽  
Multiple Cancer ◽  
Multiple Treatment

Colorectal cancer (CRC) is the third most common cancer type in both men and women in the USA. Most patients with CRC are diagnosed as local or regional disease. However, the survival rate for those diagnosed with metastatic disease remains disappointing, despite multiple treatment options. Cancer therapies for patients with unresectable or metastatic CRC are increasingly being driven by particular biomarkers. The development of various immune checkpoint inhibitors has revolutionized cancer therapy over the last decade by harnessing the immune system in the treatment of cancer, and the role of immunotherapy continues to expand and evolve. Pembrolizumab is an anti-programmed cell death protein 1 immune checkpoint inhibitor and has become an essential part of the standard of care in the treatment regimens for multiple cancer types. This paper reviews the increasing evidence supporting and defining the role of pembrolizumab in the treatment of patients with unresectable or metastatic CRC.

scholarly journals 442O Overall health status (HS) in patients (pts) with advanced (adv) non-squamous (NSQ) NSCLC treated with nivolumab (nivo) or docetaxel (doc) in CheckMate 057

2016 ◽  
Vol 27 ◽  
pp. ix141-ix142
Author(s):  
M. Reck ◽  
J. Brahmer ◽  
B. Bennett ◽  
F. Taylor ◽  
J.R. Penrod ◽  
...  
Keyword(s):  
Health Status ◽  
Overall Health Status

scholarly journals Comparison of an oncology clinical decision-support system’s recommendations with actual treatment decisions

2021 ◽  
Author(s):  
Suthida Suwanvecho ◽  
Harit Suwanrusme ◽  
Tanawat Jirakulaporn ◽  
Surasit Issarachai ◽  
Nimit Taechakraichana ◽  
...  
Keyword(s):  
Decision Support ◽  
Clinical Decision Support ◽  
Treatment Options ◽  
Stage Iv ◽  
Clinical Decision ◽  
Treatment Decisions ◽  
Therapeutic Options ◽  
Cancer Type ◽  
The Us ◽  
Rectal Cancers

Abstract Objective IBM(R) Watson for Oncology (WfO) is a clinical decision-support system (CDSS) that provides evidence-informed therapeutic options to cancer-treating clinicians. A panel of experienced oncologists compared CDSS treatment options to treatment decisions made by clinicians to characterize the quality of CDSS therapeutic options and decisions made in practice. Methods This study included patients treated between 1/2017 and 7/2018 for breast, colon, lung, and rectal cancers at Bumrungrad International Hospital (BIH), Thailand. Treatments selected by clinicians were paired with therapeutic options presented by the CDSS and coded to mask the origin of options presented. The panel rated the acceptability of each treatment in the pair by consensus, with acceptability defined as compliant with BIH’s institutional practices. Descriptive statistics characterized the study population and treatment-decision evaluations by cancer type and stage. Results Nearly 60% (187) of 313 treatment pairs for breast, lung, colon, and rectal cancers were identical or equally acceptable, with 70% (219) of WfO therapeutic options identical to, or acceptable alternatives to, BIH therapy. In 30% of cases (94), 1 or both treatment options were rated as unacceptable. Of 32 cases where both WfO and BIH options were acceptable, WfO was preferred in 18 cases and BIH in 14 cases. Colorectal cancers exhibited the highest proportion of identical or equally acceptable treatments; stage IV cancers demonstrated the lowest. Conclusion This study demonstrates that a system designed in the US to support, rather than replace, cancer-treating clinicians provides therapeutic options which are generally consistent with recommendations from oncologists outside the US.

The Effect of Interactive Pedometer with New Algorithm on 10,000 Step Goal Attainments

2007 ◽  
Vol 345-346 ◽  
pp. 873-876
Author(s):  
Jin Oh Lee ◽  
Min Soo Kang ◽  
Jeong Hun Shin ◽  
Kil Sung Lee
Keyword(s):  
Physical Activity ◽  
Health Status ◽  
Objective Assessment ◽  
The Self ◽  
Self Monitoring ◽  
Systematic Monitoring ◽  
Physical Activity Interventions ◽  
Minimal Contact ◽  
Feedback Algorithm ◽  
Overall Health Status

The pedometer, an objective assessment of measuring step counts, has often been used to motivate individuals to increase their ambulatory physical activity. Minimal contact pedometer-based intervention (MCPBI) is gaining in popularity because they are simple and inexpensive. MCPBI is based on self-monitoring by the participants; however, one limitation of using the self-monitoring approach was the participant attrition (i.e., dropout), which makes it difficult to achieve the successful intervention. A new algorithm for pedometer-based intervention, the systematic-monitoring based on conditional feedback, was designed to increase awareness and allow participants to more successfully attain their step goals. Thus, the purpose of this study was to examine the effect of the systematic-monitoring based on conditional feedback algorithm on 10,000 step goal attainments. The study result can be used to design more comprehensive pedometer-based physical activity interventions to increase individuals’ overall health status.

scholarly journals Self reported overall health status: Implications for intervention strategies

2008 ◽  
pp. 44-57 ◽  
Author(s):  
Tiffany Gill ◽  
Danny Broderick ◽  
Jodie Avery ◽  
Eleonora Dal Grande ◽  
Anne Taylor
Keyword(s):  
Health Status ◽  
Intervention Strategies ◽  
Overall Health Status

scholarly journals Meeting Psychosocial Needs to Improve Health: A Prospective Cohort Study

2019 ◽  
Author(s):  
Austyn Snowden ◽  
Jenny Young ◽  
Jan Savinc
Keyword(s):  
Quality Of Life ◽  
Cohort Study ◽  
Health Status ◽  
Cancer Type ◽  
Cancer Stage ◽  
Health Related Quality ◽  
Related Quality ◽  
Health Related ◽  
The Impact

Abstract Background Cancer impacts on patients and their families across a range of different domains. For that reason, optimal cancer care has moved away from a disease-centric focus to a more holistic approach in order to proactively support people with their individual needs and concerns. While international policy clearly advocates this agenda, implementation into routine care is limited. Therefore, relevant interventions that measurably improve patient outcomes are essential to understand if this ideal is to become routine multidisciplinary practice. The aim of this study was to analyse the impact of a proactive, holistic, community-based intervention on health-related quality of life in a cohort of people diagnosed with cancer. Secondary aim was to explore the relationship between changes in health status and: cancer type, cancer stage, number of concerns expressed and change in severity of concerns pre and post intervention. Method Prospective observational cohort study. A convenience sample of 437 individuals were referred to the service ‘Improving the Cancer Journey (ICJ) in the UK. Each completed the Euroqol EQ-5D-3L and visual analogue scale (VAS) and a Holistic Needs Assessment (HNA) during initial visit to the service and again at follow-up review, approximately 4 months later. Change between scores was tested with paired t-tests and relationships between variables with multiple regression models. Results Participants were White British with median age between 50-64 years. Cancer type and stage were varied. There was a statistically significant improvement in EQ-5D scores over time (t(330)=7.48, p<.001). The strongest predictor of change was a decrease in severity of concerns. Cancer stage ‘palliative care’ contributed to a reduction in health status. Conclusion This study is the first to show that a holistic community intervention dedicated to supporting the individual concerns of participants has a statistically and meaningful impact on participants’ health-related quality of life. The mean change in EQ-5D scores was more than the ‘minimally important clinical difference’ described in the literature. This is important because while quality of life has multiple determinants this study has reported that it is possible to capture a meaningful improvement as a function of reducing someone’s personally identified concerns.

scholarly journals MODERN REVIEW OF ANATOMO-MORPHOLOGICAL FEATURES AND POSSIBILITIES OF SURGICAL CORRECTION OF VARICOCELE IN CHILDREN

2018 ◽  
Vol 22 (5) ◽  
pp. 263-268
Author(s):  
R. S. Zadykian ◽  
Sergey N. Zorkin ◽  
S. S. Zadykian
Keyword(s):  
Surgical Intervention ◽  
Treatment Options ◽  
Morphological Features ◽  
Surgical Correction ◽  
Proper Treatment ◽  
Anatomical Features ◽  
Pathophysiological Mechanisms ◽  
Pros And Cons

Varicocele is a frequent pathology of the testicles, detected during preventive examinations and subsequently often associated with infertility. The most common is the left varicocele. This review presents anatomical features and basic pathophysiological mechanisms promoting the development of varicocele in childhood. For proper treatment of this pathology, a careful approach to the examination and determination of the indications and tactics of the planned surgical intervention is necessary. There is a lot of disagreement about the need, time and technique of the intervention. The practitioner should balance the pros and cons of timing and treatment options.

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