PubMed Health⌕ Search

Biomedical subjects

T Feber

Publications and source records attributed to T Feber.

7 recordsLinked to original sources
PubMed2001

Surgical treatment of cervical node metastases from squamous carcinoma of the upper aerodigestive tract: evaluation of the evidence for modifications of neck dissection.

BACKGROUND: This review article examines the role of the different types of neck dissection in the treatment of squamous carcinoma metastases to the cervical nodes. METHODS: A critical evaluation of the literature on the pathologic basis, oncologic effectiveness, and functional outcome of neck dissection. RESULTS: Pathologic data show preferential metastasis to different lymph node levels, in N0- and N+-staged disease, depending on the primary tumor site. Comparative studies on control of regional metastases suggest that modified radical is no less effective than radical neck dissection, but there is insufficient data to draw firm conclusions on the role of selective neck dissection. Selective and modified radical dissections result in less shoulder disability than radical neck dissection. CONCLUSIONS: Modified radical neck dissection is supported by pathologic and clinical evidence in N1- and 2-staged disease. There may be a role for selective dissection, but there is a need for more information on oncologic outcome. Prospective multicenter systematic data collection on the outcome of neck dissection is a pragmatic alternative to a trial.

Carcinoma, Squamous Cell↗
PubMed1999

Diagnostic delays in head and neck cancers.

Head and neck cancers are a significant and worsening health problem in the UK. In the absence of screening, minimising diagnostic delay after the onset of symptoms improves prognosis. Delay, from the patient's initial experience of symptoms to the ultimate diagnosis, consists of two elements--the delay prior to presenting to a clinician plus that due to the health professional consulted. This study aimed to establish the period of delay between recognition of the initial tumour symptoms and the formal diagnosis among a sample of patients recently diagnosed with head and neck cancer. Using a semistructured questionnaire, 133 men and 55 women were interviewed by a research nurse, and the results were related to the clinical findings. Tumour size at diagnosis was classified according to T1 (22%), T2 (29%), T3 (27%) and T4 (22%). Of the 186 patients with complete hospital records, 48 (26%) were diagnosed with cancer of the lip and oral cavity (CLOC). From the onset of symptoms to the patients' initial decision to seek professional advice, the median period was 4 weeks among those with CLOC and 3 weeks for those with other head and neck cancers (OHNC). The distribution was highly skewed with delays beyond 6 months occurring among 9% of the OHNC group, compared with 3% of CLOC. From the onset of symptoms to a consultant appointment, the median delay was 8 weeks for OHNC, but 12 weeks for CLOC, with delays beyond 6 months of 13% in each group, respectively. First symptoms included 'change in voice' (26%), 'pain' (27%), 'lump' or 'growth' (12%) as well as dysphagia, 'infection', 'sore throat', 'ulcers' or 'abscess'. No significant association was found between the nature of the first symptoms and the urgency with which patients interpreted their symptoms, nor was this related to diagnostic delay, sex, age or social class. It is concluded that there is substantial variation in time to clinical presentation, particularly for OHNC, although professional delay for the majority of these cases was minimal. For patients with CLOC there was less variation in patient delay, but clinician delay was relatively longer.

Adult↗
PubMed1996

Management of mucositis in oral irradiation.

Mucositis significantly affects quality of life and tolerance of treatment in oral irradiation. Effective management of this complication is therefore very important. However, there is a scarcity of up-to-date oral care protocols, with most centres using ritualized regimens. The literature on oral rinses in radiation mucositis is at best inconclusive and at worst confusing. In this study, patients undergoing radical radiotherapy treatment (55-60 Gy in 4 weeks) to more than 50% of the oral cavity and oropharynx were randomized to a research based oral care protocol with either saline 0.9% or hydrogen peroxide 3.5 volumes (HP) as rinses. The results of this study show that, on average, the group receiving saline rinses appeared to do better on some outcomes than the group receiving HP. This suggests that frequent mechanical cleansing of the mouth may be more important than the antiseptic properties of a mouthwash. Antiseptic mouthwashes may be contra-indicated in radiation mucositis. In order to determine best practice in mucositis management, multi-centre, multidisciplinary trials should be conducted.

Analysis of Variance↗
PubMed1995

Mouth care for patients receiving oral irradiation.

Oral irradiation causes acute mucositis and pain, dry mouth, loss of taste, impaired nutrition, depression and isolation. These problems can be significantly improved by skilled, research-based nursing care. The most important factors in oral care are frequent mechanical cleansing, good pain control, effective management of candida and regular, structured evaluation. An oral care regime using saline rinses may be more effective than a regime using a more astringent mouthwash. The use of an oral assessment guide and protocol ensures that all patients receive the same high-quality care. They simplify documentation and are useful audit tools and teaching aids.

Acute Disease↗
PubMedDate not supplied

Promoting self-esteem after laryngectomy.

This paper examines the traumatic effect of cancer and laryngectomy on self-esteem and body image. The factors involved are examined in detail and the author suggests how nurses can help their clients avoid a downward spiral of negative self-image and depression.

Body Image↗