Pub Date : 2018-01-01DOI: 10.4172/2329-6771.1000209
A. Alhumiqani, B. Basulaiman, Ashraf Elyamany, A. Balbaid, A. Altwairgi
Glioblastoma is the most common and most malignant primary brain tumor in adults. Despite advances in modern surgical and adjuvant therapies, glioblastoma remains a challenging disease entity. The standard of care in patients with these tumors includes maximal surgical resection, followed by radiotherapy (RT) with concomitant and adjuvant temozolomide (TMZ). The addition of TMZ to RT has increased both median survival (from 12.1 months to 14.6 months) and the 2year survival rate (from 10% to 26%) in patients with glioblastoma [1]. Although different prognostic groups can be distinguished (e.g., by using the recursive partitioning analysis classification developed by the Radiation Therapy Oncology Group consortium), the overall prognosis of glioblastoma remains poor [2-4]. Studies have demonstrated a negative effect of delayed RT or prolonged treatment duration, mostly in head and neck squamous cell carcinoma and lung cancer, but also in breast and prostate cancer [5-7]. Thus, the presence of a treatmentrelated time factor in aggressively proliferating glioblastoma is likely; however, evidence on the effect of the overall duration of chemoradiotherapy on clinical outcomes has been limited and inconclusive [8-10]. In the context of glioblastoma, the association between delaying CCRT and the outcome is less clear, though some studies have demonstrated an association between a delay in CCRT and poor survival [11-13]. Therefore, this retrospective analysis aimed to investigate the effect of the time to therapy initiation in a contemporary cohort of patients with glioblastoma treated with RT and concomitant adjuvant TMZ in Saudi Arabia.
{"title":"Impact of the Time to Chemoradiation Initiation in Patients with Glioblastoma","authors":"A. Alhumiqani, B. Basulaiman, Ashraf Elyamany, A. Balbaid, A. Altwairgi","doi":"10.4172/2329-6771.1000209","DOIUrl":"https://doi.org/10.4172/2329-6771.1000209","url":null,"abstract":"Glioblastoma is the most common and most malignant primary brain tumor in adults. Despite advances in modern surgical and adjuvant therapies, glioblastoma remains a challenging disease entity. The standard of care in patients with these tumors includes maximal surgical resection, followed by radiotherapy (RT) with concomitant and adjuvant temozolomide (TMZ). The addition of TMZ to RT has increased both median survival (from 12.1 months to 14.6 months) and the 2year survival rate (from 10% to 26%) in patients with glioblastoma [1]. Although different prognostic groups can be distinguished (e.g., by using the recursive partitioning analysis classification developed by the Radiation Therapy Oncology Group consortium), the overall prognosis of glioblastoma remains poor [2-4]. Studies have demonstrated a negative effect of delayed RT or prolonged treatment duration, mostly in head and neck squamous cell carcinoma and lung cancer, but also in breast and prostate cancer [5-7]. Thus, the presence of a treatmentrelated time factor in aggressively proliferating glioblastoma is likely; however, evidence on the effect of the overall duration of chemoradiotherapy on clinical outcomes has been limited and inconclusive [8-10]. In the context of glioblastoma, the association between delaying CCRT and the outcome is less clear, though some studies have demonstrated an association between a delay in CCRT and poor survival [11-13]. Therefore, this retrospective analysis aimed to investigate the effect of the time to therapy initiation in a contemporary cohort of patients with glioblastoma treated with RT and concomitant adjuvant TMZ in Saudi Arabia.","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"686 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76874213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2329-6771.1000E113
H. Black, R. Edge, T. Truscott
Approximately 600 carotenoids have been identified with about 100 finding their way into foodstuffs consumed by humans [1]. These pigments are widely distributed as naturally occurring constituents of fruits and vegetables. They are often added to human foodstuffs in order to achieve acceptable food coloration as they strongly absorb light in the region of 400-500 nm and are colored red, orange, and yellow. Chemically these pigments are tetraterpenoids consisting of eight isoprenoid residues. Carotenoids serve in a protective role to photosensitization by endogenous photosensitizers such as the porphyrin-containing photosynthetic pigments and in the human genetic disorder Erythropoietic protoporphyria. β-carotene is an important micronutrient for human health as it is a non-toxic precursor for the synthesis of vitamin A. Its role in affecting a reduction in cancer incidence is in question.
{"title":"β-Carotene: Radical Reactions and Cancer Associations-Leading Down a Rabbit Hole?","authors":"H. Black, R. Edge, T. Truscott","doi":"10.4172/2329-6771.1000E113","DOIUrl":"https://doi.org/10.4172/2329-6771.1000E113","url":null,"abstract":"Approximately 600 carotenoids have been identified with about 100 finding their way into foodstuffs consumed by humans [1]. These pigments are widely distributed as naturally occurring constituents of fruits and vegetables. They are often added to human foodstuffs in order to achieve acceptable food coloration as they strongly absorb light in the region of 400-500 nm and are colored red, orange, and yellow. Chemically these pigments are tetraterpenoids consisting of eight isoprenoid residues. Carotenoids serve in a protective role to photosensitization by endogenous photosensitizers such as the porphyrin-containing photosynthetic pigments and in the human genetic disorder Erythropoietic protoporphyria. β-carotene is an important micronutrient for human health as it is a non-toxic precursor for the synthesis of vitamin A. Its role in affecting a reduction in cancer incidence is in question.","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88432961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2329-6771-c3-007
pMohsen Naraghip
{"title":"Management of sinonasal neoplasms: Endoscopic versus external approaches","authors":"pMohsen Naraghip","doi":"10.4172/2329-6771-c3-007","DOIUrl":"https://doi.org/10.4172/2329-6771-c3-007","url":null,"abstract":"","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79291124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2329-6771.1000205
M. MartinPJovita, K. Kannan, K. Suresh
A unique subgroup of breast cancer, the Triple negative Breast carcinoma (TNBC) is on the rising trend. TNBC occurrence is around 15-20% of all breast cancers. Therefore this makes it an ideal target for therapeutic exploitation. TNBC is defined by the absence of a target, therefore, there is absence of a tailored targeted therapy, leaving its management depend on conventional cytotoxic regimens. The presence of AR in ER negative cases is 30%, in TNBC the AR positivity is 10% of cells showed positivity in Immunohistochemistry. Androgen receptor is Negative amongst a majority of 88% of patients with 12% remaining AR Positive off which 8% is High, 3 Medium and 1 Low Positive. The p value is 0.000 which is <0.05 hence the value is significant. The percentage of AR positivity in TNBC in this study concurs with the literature findings. This explains the importance of the same in TNBC as it seems to be an important avenue for therapeutic targeting because, this group of patients do not have much options for treatment. Further studies, with the use of androgen receptor blockade through drugs like Bicalutamide/Enzalutamide/Abireterone in AR positive TNBC could be studied to know the survival improvement.
{"title":"Prevalence Of Androgen Receptor Positivity In Triple Negative Breast Cancer","authors":"M. MartinPJovita, K. Kannan, K. Suresh","doi":"10.4172/2329-6771.1000205","DOIUrl":"https://doi.org/10.4172/2329-6771.1000205","url":null,"abstract":"A unique subgroup of breast cancer, the Triple negative Breast carcinoma (TNBC) is on the rising trend. TNBC occurrence is around 15-20% of all breast cancers. Therefore this makes it an ideal target for therapeutic exploitation. TNBC is defined by the absence of a target, therefore, there is absence of a tailored targeted therapy, leaving its management depend on conventional cytotoxic regimens. The presence of AR in ER negative cases is 30%, in TNBC the AR positivity is 10% of cells showed positivity in Immunohistochemistry. Androgen receptor is Negative amongst a majority of 88% of patients with 12% remaining AR Positive off which 8% is High, 3 Medium and 1 Low Positive. The p value is 0.000 which is <0.05 hence the value is significant. The percentage of AR positivity in TNBC in this study concurs with the literature findings. This explains the importance of the same in TNBC as it seems to be an important avenue for therapeutic targeting because, this group of patients do not have much options for treatment. Further studies, with the use of androgen receptor blockade through drugs like Bicalutamide/Enzalutamide/Abireterone in AR positive TNBC could be studied to know the survival improvement.","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"5 1","pages":"1-6"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91094588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2329-6771.1000218
M. Joshi, P. Ghosh
Objectives: To study the costs and utilities associated with the use of positron emission tomography-computed tomography (PET/CT) surveillance for the first remission. Methods: A systematic MEDLINE search was conducted by pairing relevant keywords to identify English language articles describing costs and utilities involved with the usage of PET/CT surveillance in patients with Diffused Large B Cell Lymphoma (DLBCL). Results: PET/CT resulted in similar medical costs along with similar clinical outcomes as compared to no surveillance (Korean won 2,499,689 vs 5,229,901, p<0.755). Additionally, in a Markov decision-analytic model with 2-year time horizon, PET/CT surveillance had a small but insignificant benefit over no surveillance in terms of qualityadjusted life years (QALYs) gained (CT, 0.020 QALYs; PET/CT, 0.025 QALYs). This led to high ICERs per QALY gained ($164,960- $168,750). Conclusions: As surveillance for the first remission with PET/CT is providing similar clinical and utility outcomes at a significantly high cost, we do not support routine surveillance for follow-up of DLBCL and suggest its usage should be adopted more wisely in patients with DLBCL.
{"title":"Cost-Utility of PET/CT Surveillance Post Achieving First Remission in Patients with Diffuse Large B-Cell Lymphoma: A Systematic Review","authors":"M. Joshi, P. Ghosh","doi":"10.4172/2329-6771.1000218","DOIUrl":"https://doi.org/10.4172/2329-6771.1000218","url":null,"abstract":"Objectives: To study the costs and utilities associated with the use of positron emission tomography-computed tomography (PET/CT) surveillance for the first remission. Methods: A systematic MEDLINE search was conducted by pairing relevant keywords to identify English language articles describing costs and utilities involved with the usage of PET/CT surveillance in patients with Diffused Large B Cell Lymphoma (DLBCL). Results: PET/CT resulted in similar medical costs along with similar clinical outcomes as compared to no surveillance (Korean won 2,499,689 vs 5,229,901, p<0.755). Additionally, in a Markov decision-analytic model with 2-year time horizon, PET/CT surveillance had a small but insignificant benefit over no surveillance in terms of qualityadjusted life years (QALYs) gained (CT, 0.020 QALYs; PET/CT, 0.025 QALYs). This led to high ICERs per QALY gained ($164,960- $168,750). Conclusions: As surveillance for the first remission with PET/CT is providing similar clinical and utility outcomes at a significantly high cost, we do not support routine surveillance for follow-up of DLBCL and suggest its usage should be adopted more wisely in patients with DLBCL.","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"49 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90944799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-01-01DOI: 10.4172/2329-6771.1000207
B. Schulz, Elizabeth R. Smith, Richard Funden, Ulf Moosberger
Since antiquity, propolis has been said to show anti-cancerous effects in the treatment of human breast cancer cells or human colorectal carcinoma cells, all in connection with alterations in the apoptosis pathways. At the same time, therapeutics like D, L-methadone have shown success in amendments of such pathways, being associated with changes in cancer cell morphology and at the same time, serving as a beneficial analgesic during chemotherapy. Using ethylacetate extracts of wax-free Bio99T M propolis tincture, which is exclusively distributed by our commercial partners, we showed a combination of those effects in an, both of apoptotic and analgesic nature, with a success outcompeting prevailing chemotherapeutic procedures in the treatment of human colorectal adenocarcinoma cells. We therefore suggest a reconsideration of the prevail of common cancer treatments and instead, focusing on the research on natural alternatives in the form of propolis extracts.
{"title":"Combined Effects of Ethylacetate Extracts of Propolis Inducing Cell Death of Human Colorectal Adenocarcinoma Cells","authors":"B. Schulz, Elizabeth R. Smith, Richard Funden, Ulf Moosberger","doi":"10.4172/2329-6771.1000207","DOIUrl":"https://doi.org/10.4172/2329-6771.1000207","url":null,"abstract":"Since antiquity, propolis has been said to show anti-cancerous effects in the treatment of human breast cancer cells or human colorectal carcinoma cells, all in connection with alterations in the apoptosis pathways. At the same time, therapeutics like D, L-methadone have shown success in amendments of such pathways, being associated with changes in cancer cell morphology and at the same time, serving as a beneficial analgesic during chemotherapy. Using ethylacetate extracts of wax-free Bio99T M propolis tincture, which is exclusively distributed by our commercial partners, we showed a combination of those effects in an, both of apoptotic and analgesic nature, with a success outcompeting prevailing chemotherapeutic procedures in the treatment of human colorectal adenocarcinoma cells. We therefore suggest a reconsideration of the prevail of common cancer treatments and instead, focusing on the research on natural alternatives in the form of propolis extracts.","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"326 1","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2018-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79357453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-30DOI: 10.4172/2329-6771.1000200
Alkmena Kafazi, Christos Stylianou, Athanasios Zwmas, C. Aggeli, E. Papadaki, Panagiota Stefanitsi, E. Apostolopoulou
Background: Healthcare-associated infections (HAIs) consist of a major cause of morbidity and mortality among patients with hematologic malignancies, resulting in high length of stay and healthcare costs. The aim of this study was to assess the HAIs rates in adult hematology-oncology patients.Patients and Methods: A prospective surveillance study was performed in a hematology-oncology unit in Athens, Greece. All patients who remained for ≥ 48 hours were studied. A standardized surveillance system based on the National Healthcare Safety Network of the Centers for Disease Control and Prevention was implemented.Results: During 1,156 patient-days, 16 of 85 patients acquired 20 HAIs resulting in an overall rate of 18.8% of patients or 17.3 HAIs per 1,000 patient-days. FUO rate was 42.5 per 1,000 patient-days with neutropenia. Most of HAIs was laboratory confirmed (80%) than clinically documented (20%). Central line-associated bloodstream infection was the most commonly encountered type of infection, accounting for 25% of all HAIs, followed by soft tissue infections (20%). The rates of neutropenia, blood transfusion and presence of central venous catheter were significantly greater among patients with HAI, compared with patients without HAI (p<0.05). The crude mortality rate for patients with and without HAI was 12.5% and 2.9%, respectively (p=0.234).The mean length of stay was statistically longer for patients with HAI compared with patients without HAI (29.6 ± 28.5 vs. 9.8 ± 6.8 days, p<0.001). Gram-negative bacteria were the most prevalent pathogens (73.3%).Conclusions: Our findings highlight the problem of HAIs in hematology-oncology patients and emphasize the importance of a comprehensive education program focused on evidence-based approaches for all healthcare workers and continuing active surveillance program, which will contribute to reducing the consequences of HAIs and improving patient safety.
{"title":"Surveillance of Healthcare-Associated Infections Rates in Hematology-Oncology Patients","authors":"Alkmena Kafazi, Christos Stylianou, Athanasios Zwmas, C. Aggeli, E. Papadaki, Panagiota Stefanitsi, E. Apostolopoulou","doi":"10.4172/2329-6771.1000200","DOIUrl":"https://doi.org/10.4172/2329-6771.1000200","url":null,"abstract":"Background: Healthcare-associated infections (HAIs) consist of a major cause of morbidity and mortality among patients with hematologic malignancies, resulting in high length of stay and healthcare costs. The aim of this study was to assess the HAIs rates in adult hematology-oncology patients.Patients and Methods: A prospective surveillance study was performed in a hematology-oncology unit in Athens, Greece. All patients who remained for ≥ 48 hours were studied. A standardized surveillance system based on the National Healthcare Safety Network of the Centers for Disease Control and Prevention was implemented.Results: During 1,156 patient-days, 16 of 85 patients acquired 20 HAIs resulting in an overall rate of 18.8% of patients or 17.3 HAIs per 1,000 patient-days. FUO rate was 42.5 per 1,000 patient-days with neutropenia. Most of HAIs was laboratory confirmed (80%) than clinically documented (20%). Central line-associated bloodstream infection was the most commonly encountered type of infection, accounting for 25% of all HAIs, followed by soft tissue infections (20%). The rates of neutropenia, blood transfusion and presence of central venous catheter were significantly greater among patients with HAI, compared with patients without HAI (p<0.05). The crude mortality rate for patients with and without HAI was 12.5% and 2.9%, respectively (p=0.234).The mean length of stay was statistically longer for patients with HAI compared with patients without HAI (29.6 ± 28.5 vs. 9.8 ± 6.8 days, p<0.001). Gram-negative bacteria were the most prevalent pathogens (73.3%).Conclusions: Our findings highlight the problem of HAIs in hematology-oncology patients and emphasize the importance of a comprehensive education program focused on evidence-based approaches for all healthcare workers and continuing active surveillance program, which will contribute to reducing the consequences of HAIs and improving patient safety.","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":" 20","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2017-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91513529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-20DOI: 10.4172/2329-6771.1000199
C. Pastore, M. Fioranelli, M. Roccia
Glioblastoma multiforme is a pathology that is poorly treatable and tends towards recurrence. If surgically unresectable, at least without macroscopically visible residue, the prognosis is severe. Here is the case of a 60-yearold woman suffering from recurrent glioblastoma who comes to my observation with no therapeutic options and treated with a combination of antiangiogenic drug, RF capacitive hyperthermia and herbal medicine, earns an acceptable quality of life and survival prolongation of six months.
{"title":"Rescue Therapy in Patient with Glioblastoma Multiforme Combining Chemotherapy, Hyperthermia, Phytotherapy","authors":"C. Pastore, M. Fioranelli, M. Roccia","doi":"10.4172/2329-6771.1000199","DOIUrl":"https://doi.org/10.4172/2329-6771.1000199","url":null,"abstract":"Glioblastoma multiforme is a pathology that is poorly treatable and tends towards recurrence. If surgically unresectable, at least without macroscopically visible residue, the prognosis is severe. Here is the case of a 60-yearold woman suffering from recurrent glioblastoma who comes to my observation with no therapeutic options and treated with a combination of antiangiogenic drug, RF capacitive hyperthermia and herbal medicine, earns an acceptable quality of life and survival prolongation of six months.","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"36 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89398976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-17DOI: 10.4172/2329-6771.1000198
M. Mazlumoglu
The neck is anatomically complex, and incisions in this region commonly result in cosmetic complaints. Surgeons have worked to reduce the size of incisions used in the neck region through the use of ancillary instruments. One of these instruments, the Da Vinci Robotic System, is able to reach the neck using a wide variety of approaches. These approaches were first pioneered in thyroid and parathyroid surgeries. The most commonly used approach in robotic parathyroid surgery is transaxillary. We conducted a literature search to analyze the areas of use, advantages, and disadvantages of robotic transaxillary parathyroid surgery. The transaxillary approach does not create a scar in the neck region and significantly improves cosmetic outcomes for the patient, compared with conventional parathyroid surgery.
{"title":"Robotic Transaxillary Parathyroid Surgery","authors":"M. Mazlumoglu","doi":"10.4172/2329-6771.1000198","DOIUrl":"https://doi.org/10.4172/2329-6771.1000198","url":null,"abstract":"The neck is anatomically complex, and incisions in this region commonly result in cosmetic complaints. Surgeons have worked to reduce the size of incisions used in the neck region through the use of ancillary instruments. One of these instruments, the Da Vinci Robotic System, is able to reach the neck using a wide variety of approaches. These approaches were first pioneered in thyroid and parathyroid surgeries. The most commonly used approach in robotic parathyroid surgery is transaxillary. We conducted a literature search to analyze the areas of use, advantages, and disadvantages of robotic transaxillary parathyroid surgery. The transaxillary approach does not create a scar in the neck region and significantly improves cosmetic outcomes for the patient, compared with conventional parathyroid surgery.","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"28 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-11-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84341375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-09-08DOI: 10.4172/2329-6771.1000197
S. Singh-Carlson
Discussions around advance care planning (ACP) do not mean making decisions about what to do at the end of life, but how to cope with disease and treatment. Studies suggest that HPs and patients are ambivalent when talking about death and end of treatments and often avoid these conversations. Results show that discussions around ACP with advanced cancer patients reduced patients’ overly optimistic chances of survival, thereby reducing aggressiveness of medical care near death. Discussions around ACP offer patients opportunity to define their goals and expectations for the medical care they want to receive. Advance directives and living wills are tools of ACP that are written instructions regarding one’s medical care preferences. Having open communication on patients’ wishes on ACP is beneficial for patients. This informs them of medication and treatment plans that are available for them at the beginning of diagnosis, thereby allowing them to make informed decisions that lead to a better quality of life. In light of this evidence, exploring nurses’ perceptions that are ingrained by their own beliefs and values around the use of advance care plans for planning end-of-life will help them examine their own ethical responsibility in their role as healthcare providers. This knowledge can be used for educating nurses who are future primary care providers. It is a professional responsibility, especially since many nurses with a graduate degree may work in oncology settings [1,2].
{"title":"Nurses’ Knowledge and Perceptions of Advance Care Planning, an Ethical Responsibility","authors":"S. Singh-Carlson","doi":"10.4172/2329-6771.1000197","DOIUrl":"https://doi.org/10.4172/2329-6771.1000197","url":null,"abstract":"Discussions around advance care planning (ACP) do not mean making decisions about what to do at the end of life, but how to cope with disease and treatment. Studies suggest that HPs and patients are ambivalent when talking about death and end of treatments and often avoid these conversations. Results show that discussions around ACP with advanced cancer patients reduced patients’ overly optimistic chances of survival, thereby reducing aggressiveness of medical care near death. Discussions around ACP offer patients opportunity to define their goals and expectations for the medical care they want to receive. Advance directives and living wills are tools of ACP that are written instructions regarding one’s medical care preferences. Having open communication on patients’ wishes on ACP is beneficial for patients. This informs them of medication and treatment plans that are available for them at the beginning of diagnosis, thereby allowing them to make informed decisions that lead to a better quality of life. In light of this evidence, exploring nurses’ perceptions that are ingrained by their own beliefs and values around the use of advance care plans for planning end-of-life will help them examine their own ethical responsibility in their role as healthcare providers. This knowledge can be used for educating nurses who are future primary care providers. It is a professional responsibility, especially since many nurses with a graduate degree may work in oncology settings [1,2].","PeriodicalId":16252,"journal":{"name":"Journal of Integrative Oncology","volume":"11 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2017-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81996230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：