scholarly journals Medical Management Options for Hepatocellular Carcinoma

10.5772/27454 ◽  
2012 ◽  
Author(s):  
Mehmet Sitki ◽  
Angela Mae
Keyword(s):  
Hepatocellular Carcinoma ◽  
Medical Management ◽  
Management Options

scholarly journals Management of tubal ectopic pregnancy with methotrexate in the setting of symptomatic Coronavirus disease 2019 (COVID-19): A case report

2021 ◽  
Vol 13 (3) ◽  
pp. 277-281
Author(s):  
N.M. Millan ◽  
J Morano ◽  
L Florez ◽  
J Carugno ◽  
C.A. Medina
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Supportive Care ◽  
Medical Management ◽  
Patient Management ◽  
Therapeutic Option ◽  
Careful Consideration ◽  
Management Options ◽  
Tubal Ectopic Pregnancy ◽  
Ectopic Pregnancies

Background: Coronavirus Disease 2019 (COVID-19) represents a complex therapeutic challenge. As the pandemic progresses, patients are presenting with ectopic pregnancies (EPs) and symptomatic COVID-19. Objective: We present the management of a patient with multiple medical comorbidities and tubal EP in the setting of severe symptomatic COVID-19 infection where all management options were precluded. Methods: Case report with literature review of management of tubal EP in the setting of severe symptomatic COVID-19 infection. Result: After careful consideration of options, the patient underwent successful medical management with methotrexate while receiving supportive care for COVID-19. Conclusions: Methotrexate proved to be the safest therapeutic option in this patient. Management of patients with severe COVID-19 and gynaecologic emergencies should be individualised and carefully reviewed with evolving knowledge of COVID-19.

scholarly journals Management Options after Prophylactic Surgeries in Women with BRCA Mutations: A Review

2007 ◽  
Vol 14 (4) ◽  
pp. 330-337 ◽  
Author(s):  
Dawn C. Allain ◽  
Kevin Sweet ◽  
Doreen M. Agnese
Keyword(s):  
Medical Management ◽  
Cancer Susceptibility ◽  
Brca Mutation ◽  
Brca2 Gene ◽  
Brca1 And Brca2 ◽  
Management Options ◽  
Cancer Susceptibility Genes ◽  
Mutation Carriers ◽  
Increased Risk ◽  
Brca Mutation Carriers

Background Although breast cancer is relatively common, only about 5% of cases are due to inheritance of highly penetrant cancer susceptibility genes. The majority of these are caused by mutations in the BRCA1 and BRCA2 genes, which are also associated with an increased risk of ovarian cancer. Increased surveillance, chemoprevention, and prophylactic surgeries are standard options for the effective medical management of mutation carriers. However, optimal management of female carriers who choose to undergo prophylactic surgeries is still poorly understood. Methods The authors provide an overview of the current literature regarding medical management options for women carriers of BRCA1 and BRCA2 gene mutations and the implications for those individuals who have chosen to undergo prophylactic surgeries. Results BRCA mutation carriers who opt for prophylactic surgeries are still at risk for development of malignancy, and appropriate monitoring is warranted. Conclusions There are limited data on the appropriate medical management for BRCA mutation carriers after prophylactic surgeries. However, a management plan can be extrapolated from the general management recommendations for surveillance and other risk-reducing strategies in BRCA-positive individuals.

Altered bowel function

2019 ◽  
pp. 501-512
Keyword(s):  
Cancer Patients ◽  
Bowel Obstruction ◽  
Medical Management ◽  
Early Identification ◽  
Bowel Function ◽  
Cancer Drug ◽  
Dietary Advice ◽  
Management Options ◽  
Pharmacological Management ◽  
Associated Symptoms

This chapter explores the three most common bowel-related issues that cancer patients often face: diarrhoea, constipation, and bowel obstruction. Cancer-related causes of diarrhoea are discussed, including new cancer drug therapies. Assessment and management of diarrhoea are explored in detail, with a focus on reversible causes and pharmacological and non-pharmacological management. Constipation is explored in similar detail. Management includes dietary advice, use of laxatives, and non-pharmacological measures. Bowel obstruction is discussed, focusing on early identification of symptoms and a look at both surgical and medical management options, including management of associated symptoms.

Ruptured hepatocellular carcinoma: Management options

2017 ◽  
Vol 5 (1) ◽  
pp. 27 ◽  
Author(s):  
MEzzedien Rabie ◽  
SaadAl Jreeb Alqahtani ◽  
Ismail El Hakeem ◽  
AbdullaSaad Al Qahtani ◽  
YahiaAtiah Alhagawi ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Management Options ◽  
Ruptured Hepatocellular Carcinoma

scholarly journals A hepatocellularis carcinoma előfordulása és kezelésének tanulságai az északkelet-magyarországi régióban

2016 ◽  
Vol 157 (45) ◽  
pp. 1793-1801
Author(s):  
Renáta Papp ◽  
Mária Papp ◽  
István Tornai ◽  
Zsuzsanna Vitális
Keyword(s):  
Hepatocellular Carcinoma ◽  
Metabolic Syndrome ◽  
Survival Data ◽  
Delayed Diagnosis ◽  
Tumor Stage ◽  
Tumor Treatment ◽  
Management Options ◽  
Disease Etiology ◽  
Results Of Treatment ◽  
Epidemiological Trends

Introduction: The increasing incidence and poor prognosis of hepatocellular carcinoma places huge burden on healthcare. Aim: After reviewing literature on epidemiological trends, risk factors, diagnosis and management options for hepatocellular carcinoma, the authors investigated results of treatment and survival data of patients in Northeastern Hungary. Method: In a retrospective study, the authors analyzed medical records of 187 patients with hepatocellular carcinoma (etiology, presence of cirrhosis, stage of the tumor, treatment and disease outcome). Results: Seventy-one patients (38%) had known cirrhosis at the diagnosis of hepatocellular carcinoma, while in 52 patients (28%) the presence of cirrhosis was established at the time of the diagnosis of hepatocellular carcinoma. Fifteen patients (8%) had no cirrhosis and in 49 patients (26%) no data were available regarding cirrhosis. Etiological factors were alcohol consumption (52%), viral hepatitis (41%) and metabolic syndrome (44%). In cases of metabolic syndrome, hepatocellular carcinoma frequently occurred without cirrhosis. In 83% of the cases, the tumor was discovered in an advanced stage. Median survival time was significantly associated with tumor stage (Barcelona A stage vs. B/C vs. D: 829 vs. 387 vs. 137 days, respectively p<0.001) but not with disease etiology (virus 282 days, metabolic syndrome 335 days and alcohol 423 days, p = 0.65). Conclusions: High mortality of hepatocellular carcinoma was mainly attributed to the delayed diagnosis of the disease. Screening of patients with cirrhosis could only result in a partial improvement since in a great proportion cirrhosis was diagnosed simultaneously with the tumor. Screening of diabetic and obese patients by ultrasonography should be considered. Management of baseline liver disease is of importance in the care of hepatocellular carcinoma. Orv. Hetil., 2016, 157(45), 1793–1801.

scholarly journals An Audit of Management of Ectopic Pregnancy in a Major Tertiary Healthcare Service

2021 ◽  
pp. 1-5
Author(s):  
Krystle Y. Chong ◽  
Yee K. Mak ◽  
Beverley Vollenhoven ◽  
Ben W. Mol
Keyword(s):  
Ectopic Pregnancy ◽  
Surgical Management ◽  
Medical Management ◽  
Expectant Management ◽  
Tertiary Hospital ◽  
Management Options ◽  
Local Hospital ◽  
Retrospective Audit ◽  
Tertiary Healthcare ◽  
Ectopic Pregnancies

Background: Ectopic pregnancy remains the most common cause of early pregnancy mortality, with management options differing according to clinical presentation and investigations. This audit aims to investigate the indications for medical and surgical management of ectopic pregnancy at a tertiary hospital network, in order to assess variances in practice and adherence to local hospital protocols. Methods: A retrospective audit of the management of women with a diagnosis of ectopic pregnancy was performed over 12 months from July 2018 to June 2019, at three hospitals in the largest healthcare network in Victoria, Australia. Information collected included patient demographics, risk factors for ectopic pregnancy, pathology and radiology results, documented indication for surgery, and any complications of treatment. A subgroup analysis of data was done to investigate changes and deficiency in management of ectopic pregnancy compared to local hospital protocol. Results: Over a 12-month period, 138 women were diagnosed with an ectopic pregnancy, of which 99 (72%) received surgical management and 39 (28%) received medical management. Four women within the medical group were excluded from analysis, one due to loss of follow-up and three patients who were diagnosed with nontubal ectopic pregnancies. About 94% (33/35) of women who received methotrexate were within hospital guidelines for medical management and 91% (32/35) were successfully managed without surgery. All women who received surgical management underwent a salpingectomy and 97% (96/99) had clear indications documented for surgery within local protocol. Conclusion: Overall, the majority of women with ectopic pregnancy were treated according to local guidelines. Expectant management and the option of salpingostomy as a surgical alternative could be considered in the local guidelines. The dissemination of this clinical audit data is aimed at continuing clinical governance and improvements in outcomes.

Trend in Gastric Outlet Obstruction at Patients Attending Tribhuvan University Teaching Hospital, Kathmandu, Nepal

2017 ◽  
Vol 2 (2) ◽  
pp. 219-221
Author(s):  
Deepak Kumar Thakur ◽  
B Ghimire ◽  
YP Singh
Keyword(s):  
Teaching Hospital ◽  
Gastric Outlet Obstruction ◽  
Medical Management ◽  
Subtotal Gastrectomy ◽  
Outlet Obstruction ◽  
University Teaching ◽  
Management Options ◽  
Duration Of Symptoms ◽  
Common Cause ◽  
Ulcer Disease

IntroductionGastric outlet obstruction (GOO) involves obstruc_on in the antro-pyloric region or bulb of duodenum. Malignancy is common cause of GOO in adults but many patients with GOO have benign causes. Despite the improvement in medical management, about 5% patients with complicated duodenal ulcer disease and 1%-2% with complicated gastric ulcer disease respectively develop this problem.ObjectiveThe purpose of this study was to find the etiologies of GOO, their management options and outcome in Tribhuvan University Teaching Hospital.MethodologyIn this retrospective study, the records of 44 patients admited with diagnosis of GOO from September 2007 to August 2010 in the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal were retrieved. Patients' demography, etiologies of GOO, treatment given and their outcome were analysed.ResultsThirty two patients (73%) were male and 12 (27%) were female with M:F ratio of 2.7:1. The mean age of patients was 57.40 years and duration of symptoms 2.68 months. Carcinoma of stomach, 28 cases (64%) was most common ecology of GOO followed by PUD, 9 (21%), duodenal malignancy,3 (7%), corrosive stricture, 2 (5%), advanced gallbladder carcinoma, 1 (2%) and chronic pancreatis, 1 (2%). Seventeen (39%) patients were treated by gastrojejunostomy, 14 (32%) by subtotal gastrectomy and gastrojejunostomy, 5 (11%) by truncal vagotomy and gastrojejunostomy, 4 (9%) by medical management, 2 (4.5%) by feeding jejunostomy, and 2 (4.5%) were discharged on request. Complications occurred in 7 (16%) patients and mortality in 1 (2%). Twenty three (52%) patients were candidates for chemotherapy either in an adjuvant or palliative seting.ConclusionGastric malignancy was the most common cause of gastric outlet obstruction. Most of the patients in our setup presented with advanced disease and were candidates of palliative treatment only. Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, Page: 219-221

Safety and Efficacy of Venting Gastrostomy in Malignant Bowel Obstruction: A Systematic Review

2019 ◽  
Vol 35 (2) ◽  
pp. 93-102 ◽  
Author(s):  
Sreeharshan Thampy ◽  
Pavan Najran ◽  
Damian Mullan ◽  
Hans-Ulrich Laasch
Keyword(s):  
Systematic Review ◽  
Bowel Obstruction ◽  
Medical Management ◽  
Symptom Control ◽  
Complication Rates ◽  
Malignant Bowel Obstruction ◽  
Management Options ◽  
Safety And Efficacy ◽  
Nonsurgical Management ◽  
Abdominal Malignancy

Malignant bowel obstruction (MBO) is a common manifestation in patients with advanced intra-abdominal malignancy. It is especially common with bowel or gynecological cancers and produces distressing symptoms, including nausea, vomiting, and pain. Medical management options are less effective than decompressive strategies for symptom control. Surgery is the gold-standard treatment but is unsuitable for most patients with high complication rates. Consensus guidelines recommend nonsurgical management with a venting gastrostomy in those unsuitable for surgery or for whom medical management is ineffective. The aim of this systematic review is to establish the safety and efficacy of percutaneous venting gastrostomy in relieving symptoms of MBO. Twenty-five studies were included in this review comprising 1194 patients. Gastrostomy insertion was successful at first attempt in 91% of cases and reduction in symptoms of nausea and vomiting was reported in 92% of cases. Mean survival following the procedure ranged from 35 to 147 days. Major complications were rare, with most complications classed as minor wound infections or leakage of fluid around the tube. Studies suggest that the presence of ascites is not an absolute contraindication to the insertion of percutaneous venting gastrostomy in patients with MBO; however, these studies lack longitudinal outcomes and complication rates related to this. However, it is reasonable to suggest that ascitic drainage is performed to reduce potential complications. There is a relative lack of good quality robust data on the utilization of percutaneous venting gastrostomy in MBO, but overall, the combination of being a safe and efficacious procedure alongside the known complication profile suggests that it should be considered a suitable management option.

Decompressive Hemicraniectomy for Acute Disseminated Encephalomyelitis: Case Report

Neurosurgery ◽  
2005 ◽  
Vol 56 (4) ◽  
pp. E872-E872 ◽  
Author(s):  
Daniel Refai ◽  
Max C. Lee ◽  
Fernando D. Goldenberg ◽  
Jeffrey I. Frank
Keyword(s):  
Case Report ◽  
Medical Management ◽  
Treatment Options ◽  
Full Range ◽  
Acute Disseminated Encephalomyelitis ◽  
Brain Swelling ◽  
Rapid Improvement ◽  
Management Options ◽  
Decompressive Hemicraniectomy ◽  
Excellent Outcome

Abstract OBJECTIVE AND IMPORTANCE: Acute disseminated encephalomyelitis (ADEM) varies widely in symptoms and severity. Some cases are associated with massive life-threatening cerebral edema refractory to conventional medical management. CLINICAL PRESENTATION: A 51-year-old woman with ADEM who developed severe brain swelling and herniation despite aggressive medical management is described. INTERVENTION: A decompressive hemicraniectomy and durotomy led to rapid improvement and an excellent outcome. CONCLUSION: This case report reinforces the place of this procedure in the armamentarium of treatment options for patients with medically refractory brain swelling and elevated intracranial pressure caused by ADEM. The potential for an increase in the incidence of ADEM with more frequent smallpox vaccinations emphasizes the significance of redefining the full range of management options for this treatable disease.

scholarly journals PAINFUL BLADDER SYNDROME/INTERSTITIAL CYSTITIS (PBS/IC)- MEDICAL MANAGEMENT OPTIONS

2018 ◽  
Vol 7 (11) ◽  
pp. 1353-1355
Author(s):  
Guda Manohar ◽  
Duppala Radha Krishnan
Keyword(s):  
Interstitial Cystitis ◽  
Medical Management ◽  
Painful Bladder Syndrome ◽  
Management Options ◽  
Painful Bladder
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