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F Gutman

Publications and source records attributed to F Gutman.

10 recordsLinked to original sources
PubMed2006

[18F-FDG PET and bone scintigraphy to search for bone metastasis of lung cancer].

Initial staging of lung cancer is essential to determine the appropriate therapeutic strategy. 18F-FDG PET is currently considered to be the gold standard. 99mTc bisphonate bone scintigraphy has long been indicated to search for bone metastases but it is not know whether this exploration adds further information after an 18F-FDG PET scan. In order to answer this question, two observers unaware of the clinical situation reread PET scans and bone scintigraphies and results compared with other imaging findings. Between February 2001 and March 2004, 39 patients (13F, 26M, 62 +/- 11 yr) underwent 18FFDG PET and bone scintigraphy (mean interval 17 +/- 17 d). When the two explorations agreed for the diagnosis of bone extension, we considered that bone scintigraphy added nothing. When the two explorations were in disagreement, the other imaging examinations, the clinical features and laboratory results during the five-month minimal follow-up were used to establish the reference diagnosis. 18F-FDG PET and bone scintigraphy were in agreement in 29 patients (74%) with positive results in 12 (31%) and negative results in 17 (43%). The two explorations were in disagreement in 10 patients (26%). Among the five disagreement cases with positive bone scintigraphy and no bone anomaly on the 18F-FDG PET, the anomalies were benign and explained by clinical features (3 patients) or were not confirmed by the clinical course and laboratory results (2 patients). Among the 5 cases with a bone anomaly on the 18F FDG PET, no metastasis could be identified during clinical follow-up. Bone scintigraphy does not enable identification of any bone metastases which were not recognized on the PET scan and therefore should not be performed systematically. Using a computed tomography scan with the 18F-FDG PET could further limit the contribution of bone scintigraphy by providing more precision concerning foci identified on the PET scan.

Aged↗
PubMed1994

Retreatment of intracranial gliomas.

Although intracranial gliomas carry a poor long-term prognosis, retreatment at the time of tumor progression may prolong survival and maintain or improve the quality of life. Thirty-three patients who underwent retreatment with surgery, radiotherapy, and chemotherapy were reviewed retrospectively. Median survival after initiation of retreatment was 8 months for glioblastoma, 13 months for anaplastic astrocytoma, 22 months for astrocytoma, and 47 months for oligodendroglioma/mixed glioma. Survival was significantly better for younger patients and for those with better functional status. One third of patients were neurologically improved by surgery. Surgical morbidity was minimal (2.1%); there was no surgical mortality. Chemotherapy and radiotherapy produced expected adverse reactions. Retreatment of intracranial gliomas carries acceptable risk and is beneficial in selected patients. Decisions regarding retreatment must be carefully individualized with consideration of the quality of life and the wishes of the patient and family.

Adult↗
PubMed1991

Integration of cultural elements in the therapeutic milieu of a psychiatric day care unit.

For comprehensive understanding of a patient's mental crisis, a thorough knowledge of his cultural context is valuable, as this affords reciprocal translation of the patient's and therapist's codes. Elucidation of the cultural context belongs to the domain of clinical anthropology. In our Day Care Unit we utilize an ethno-psychiatric approach. The anthropologist employs the life-cycle method and a health/illness questionnaire. The former consists of a chronological narration of the patient's life events as rendered by him. Integration of this anthropological material with the anamnestic data is time saving, in that it furnishes the therapist with the opportunity to determine the focus of dynamic therapy already in an early phase of the treatment. The aim of the health/illness questionnaire is to discover the patient's conception of sickness in general and of his mental illness in particular. The information gathered by this anthropological tool guides the therapist in planning the appropriate treatment strategy, while at the same time it may predict the patient's compliance.

Adult↗
PubMed1989

[Interagency coordination between family physicians, psychiatrists and social workers].

Family physicians care for large populations suffering from illnesses which are influenced by social, emotional and family factors. We present a program based on the application of a comprehensive care model in the Kupat Holim clinic and the integration of an interdisciplinary, interagency treatment team in which the focus of intervention is the clinical responsibility of the family physician. The social worker from the neighborhood social service agency and the psychiatrist from the regional mental health clinic participate as integral members of the staff. A broad patient assessment, including identification of clinical psychosocial components and interagency coordination, permits the family physician to involve the other staff members. This article is based on a survey of approximately 100 cases, 70 of which were referred to the clinic social worker for assessment and treatment, while 30 were discussed at bi-monthly consultations in which the clinic staff (family physicians and nurse), psychiatrist and psychiatric social worker, participated. It should be noted that most patients referred to the interdisciplinary forum remained the responsibility of the family physician, which supports the validity of the interagency coordination program.

Community Health Services↗