Randomized trial of group psychosocial support in metastatic breast cancer: the BEST study. Breast-Expressive Supportive Therapy study.
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Biomedical subjects
Publications and source records attributed to H Chochinov.
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This article represents the contributions of the panel on "Neuropsychiatric Syndromes and Psychological Symptoms" of the National Cancer Institute of Canada Workshop on Symptom Control and Supportive Care in Patients with Advanced Cancer. The panel's presentations focused on mood disorders and cognitive disorders, and described the current state of knowledge regarding prevalence, assessment, and intervention. Recommendations for future research are presented based on a consensus of the panel as to the need to fill glaring gaps in our current state of knowledge, and a desire to improve the quality of research in this area of palliative medicine. Recommendations for future research on neuropsychiatric symptoms and syndromes in palliative care include (1) adoption of uniform terminology (taxonomy of disorders) and diagnostic classification systems, (2) utilization of existing validated tools and measures in prevalence and intervention research, (3) development of new tools and measures that are more applicable and relevant to the palliative care setting, (4) encouragement for studies of the prevalence of neuropsychiatric symptoms and syndromes, (5) promotion of intervention studies utilizing pharmacologic and nonpharmacologic treatments for depressive disorders and cognitive disorders in advanced cancer patients, and (6) expansion of the focus of such research to other neuropsychiatric disorders (for example, anxiety disorders, posttraumatic stress disorders, and sleep disorders), symptoms (fatigue and tension) and related issues (suicidal ideation and desire for hastened death).
Cystadenoma of the appendix as a factor in the formation of mucous cysts (mucocele) of the appendix is well recognized. The diagnosis can be made in patients prior to surgery if appropriate investigations are utilized. A 66-year-old white woman with a complaint of increased frequency of bowel movements was investigated and a primary diagnosis of mucocele of the appendix was made preoperatively. As cecal involvement was suggested by these studies, a limited cecal resection was planned. These findings were confirmed at surgery. The appendectomy and limited cecal resection was curative for mucinous cystadenoma of the appendix.
Children are frequently admitted to a hospital with injuries sustained as a result of being attacked by a dog. Over a 5-year period (1977 to 1981), 57 such patients have been treated at the Winnipeg Children's Hospital. Half of the dog attack victims were 5 years or younger with injuries occurring more often in boys (55%). The majority of patients (95%) sustained puncture wounds and lacerations to the face (77%) and extremities (23%). In three of the cases, the dog attack victims presented with peritonitis secondary to bowel perforation and were treated successfully. A fourth child died as a result of his injuries prior to reaching the hospital. In the past, much attention has been focused on soft tissue injuries and their cosmetic repair. It is also important to recognize that the small child is particularly vulnerable to dog maulings from which the injuries sustained may be life threatening or lethal. Prevention seems to be the only rational approach to solving this problem.
Only one other case of extrusion of intestine due to rupture of a previously normal umbilicus is reported in the literature. This condition is distinct from ruptured omphalocele or gastroschisis, both of which are present at birth.
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