Harrison's Internal Medicine Chapter 77. Approach to the Patient with Cancer
Approach to the Patient with Cancer: Introduction The application of current treatment techniques (surgery, radiation therapy, chemotherapy, and biological therapy) results in the cure of nearly two of three patients diagnosed with cancer. Nevertheless, patients experience the diagnosis of cancer as one of the most traumatic and revolutionary events that has ever happened to them.
Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Predictive factors for breast cancer in patients diagnosed atypical ductal hyperplasia at core needle biopsy
Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Does monitoring need for care in patients diagnosed with severe mental illness impact on Psychiatric Service Use? Comparison of monitored patients with matched controls
Defining the Extent of Disease and the Prognosis The first priority in patient management after the diagnosis of cancer is established and shared with the patient is to determine the extent of disease. The curability of a tumor usually is inversely proportional to the tumor burden. Ideally, the tumor will be diagnosed before symptoms develop or as a consequence of screening efforts (Chap. 78). A very high proportion of such patients can be cured.
The level of suspicion of infections with certain organisms should depend on the type of cancer diagnosed (Table 82-3). Diagnosis of multiple myeloma or CLL should alert the clinician to the possibility of hypogammaglobulinemia. While immunoglobulin replacement therapy can be effective, in most cases prophylactic antibiotics are a cheaper, more convenient method of eliminating bacterial infections in CLL patients with hypogammaglobulinemia.
Tumor markers may be useful in patient management in certain tumors. Response to therapy may be difficult to gauge with certainty. However, some tumors produce or elicit the production of markers that can be measured in the serum or urine and, in a particular patient, rising and falling levels of the marker are usually associated with increasing or decreasing tumor burden, respectively. Some clinically useful tumor markers are shown in Table 77-5.
Brain Masses Mass lesions of the brain most often present as headache with or without fever or neurologic abnormalities. Infections associated with mass lesions may be caused by bacteria (particularly Nocardia), fungi (particularly Cryptococcus or Aspergillus), or parasites (Toxoplasma). Epstein-Barr virus (EBV)–associated lymphoproliferative disease may also present as single or multiple mass lesions of the brain. A biopsy may be required for a definitive diagnosis.
The application of current treatment techniques (surgery, radiation therapy, chemotherapy, and biological therapy) results in the cure of nearly two of three patients diagnosed with cancer. Nevertheless, patients experience the diagnosis of cancer as one of the most traumatic and revolutionary events that has ever happened to them. Independent of prognosis, the diagnosis brings with it a change in a person's self-image and in his or her role in the home and workplace.
Unique in its approach, this new book takes users beyond the identification of physical assessment abnormalities to arrive at a differential diagnosis of the patient's health problem. Readers learn how to incorporate physical examination, patient history, and diagnostic studies to accurately diagnosis a patient's problem.
This demo presents Information Extraction from discharge letters in Bulgarian language. The Patient history section is automatically split into episodes (clauses between two temporal markers); then drugs, diagnoses and conditions are recognised within the episodes with accuracy higher than 90%. The temporal markers, which refer to absolute or relative moments of time, are identiﬁed with precision 87% and recall 68%. The direction of time for the episode starting point: backwards or forward (with respect to certain moment orienting the episode) is recognised with precision 74.4%. ...
New cases of active pulmonary tuberculosis
admitted to our critical care unit from January 1999
to January 2006 were identified. Data were collected
retrospectively from medical records including
demographics, clinical presentation, number of sputum
samples, therapy provided and patient outcome.
Setting: Data were collected from the ICU database and
microbiology laboratory records.
Patients and participants: Thirty-three patients were
diagnosed with active pulmonary tuberculosis. Age
was 63±17, and 60.7% were males.
(BQ) Part 1 book "Molecular diagnostics for dermatology" presents the following contents: Introduction, basics of nucleic acids and molecular biology, molecular methods; risk assessment, diagnosis, and prognosis - using molecular tools to diagnose melanoma, predict its behavior and evaluate for inheritable forms,...
Pulmonary embolism is a serious, potentially life-threatening cardiopulmonary disease
that occurs due to partial or total obstruction of the pulmonary arterial bed. Pulmonary
embolism constitutes 5-25% of in-hospital deaths, and mortality is decreased from 30%
to 8% with early treatment. Therefore, risk factors should be identified and treatment
should be planned to decrease the risk of mortality. Clinical findings, routine laboratory
data, electrocardiogram, chest X-ray, and arterial blood gases are not sufficient to
diagnose or rule out pulmonary embolus.
The American Nurses Association (ANA) Social Policy
Statement of 1980 was the first to define nursing as the diagnosis
and treatment of human responses to actual and potential
health problems. This definition, when combined with the ANA
Standards of Practice, has provided impetus and support for the
use of nursing diagnosis. Defining nursing and its effect on
client care supports the growing awareness that nursing care is
a key factor in client survival and in the maintenance, rehabilitative,
and preventive aspects of healthcare.
The quality and scientific preciseness of the authors coming from several countries,
does much to give strength to the whole book, especially as it reflects local and
regional realities that characterize the diversity of expression allergic. In fact, the
etiology and clinical response of allergic patient is very different, depending on the
location, habits, socio-economic conditions and even the specific interests of key lines
of investigation developed that the authors have incorporated into the chapters, but
always guided by higher values of accuracy....
However, more recent studies have put in
doubt the true role of PSA velocity, the European Randomized Study of Screening for
Prostate Cancer demonstrated that increased PSA velocity was not associated with
increased cancer risk, but was associated with higher grade cancers, defined as ≥ stage T1c
and/or a Gleason score ≥7 (Roobol, 2006a).
Monthly breast self-exam, starting at age 20, instructed to
woman as an optional tool for identifying and reporting
■ Clinical breast exam at least every 3 years (age 20–40) during
a physical exam by a health professional; yearly after age 40
■ Annual mammogram starting at age 40
Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Antibodies to mutated citrullinated vimentin for diagnosing rheumatoid arthritis in anti-CCP-negative patients and for monitoring infliximab the..
Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài:
Implementing the semi-structured interview Kiddie-SADS-PL into an in-patient adolescent clinical setting: impact on frequency of diagnoses...
Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Phase IIb randomized trial of adjunct immunotherapy in patients with first-diagnosed tuberculosis, relapsed and multi-drug-resistant (MDR) TB,...