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Symptom Clusters in Patients with HCC: A Systematic Review
Hong Weixi,
Wang Yu,
Wang Xiaolan,
Zuo Feifei,
Lin Jing
Issue:
Volume 5, Issue 2, June 2020
Pages:
16-23
Received:
21 March 2020
Accepted:
10 April 2020
Published:
15 May 2020
Abstract: Background HCC patients suffering from various symptoms during palliative care. Effective symptom management can reduce patient's painful symptom experience and improve their quality of life. The researches on symptom management have shifted from single symptom to multiple symptoms occurring simultaneously. Meanwhile, different studies varied considerably on the symptom clusters and its composition. Objectives The aim of this systematic review was to summarize the compositions, measures, and analytical techniques of symptom clusters in patients with HCC. Method We conducted a comprehensive search to identify published studies about symptom clusters in patients with HCC. Databases including National Knowledge Infrastructure (CNKI), Chinese Science and Technology Journal Database (VIP), Wanfang Technology Journal full-text database, PubMed, EMbase and Web of Science and the studies included is from January 1, 2001 to November 24, 2019. Results There are seven articles compliance with inclusion criteria. Four symptom clusters were most commonly reported: Cluster 1: nausea/vomiting; Cluster 2: pain/fatigue/sleep disturbance/dry mouth/lack of appetite/change in taste; Cluster 3: sadness/distress/nervous; Cluster 4: jaundice/abdominal distension/itching/diarrhea/constipation. Conclusion This systematic review summarized the statistical methods, assessment tools, symptom clusterand composition of 7 included studies. Due to the lack of consensus on the definition of symptom cluster, the differences of statistical methods, assessment tools, sample characteristics and measuring time, the conclusion of the symptom cluster of HCC patients varied considerably in combinations.
Abstract: Background HCC patients suffering from various symptoms during palliative care. Effective symptom management can reduce patient's painful symptom experience and improve their quality of life. The researches on symptom management have shifted from single symptom to multiple symptoms occurring simultaneously. Meanwhile, different studies varied consi...
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An Analysis of Complications of Neck Dissection in Head and Neck Cancers
Shashidhar Kallappa,
Prajwal Dange
Issue:
Volume 5, Issue 2, June 2020
Pages:
24-28
Received:
12 April 2020
Accepted:
3 May 2020
Published:
19 May 2020
Abstract: The neck dissection has remained a pivotal aspect of head and neck cancer management for over a century. During this time its role has expanded from a purely therapeutic option to an elective setting. Since vital anatomical structures are close, certain risks and complications are inherent to this procedure. Since neck surgery remains the most frequently performed form of therapeutic surgery in head and neck cancer irrespective of primary disease site, our objective is to report the complications in various types neck dissections and to seek improved outcome. A cross sectional retrospective study of 52 patients who underwent neck dissection from August 2015 to August 2019 was conducted to analyse intra operative and post-operative complications which aroused due to neck dissection. Indications for neck dissection depended on neck staging (N): selective neck dissection was done when evident disease was absent; Modified radical neck dissection was done if there was clinically evident neck node, preserving non-lymphatic neck structures (accessory nerve, internal jugular vein and internal jugular vein) as long as surgical completeness was not compromised. Bilateral neck dissection was indicated if contralateral disease was suspected or present. Out of 52 patients, one radical neck dissection, 14 modified radical and 37 selective neck dissection, of which 32 underwent supra omohyoid neck dissection and 5 underwent anterolateral and posterolateral neck dissection. The most frequent complication was marginal mandibular nerve injury (5.5%), followed by accessory nerve injury (2.1%). There was one death. A careful preoperative assessment of the patient, meticulous surgical techniques, good-quality postoperative care and appropriate rehabilitation are the cornerstones of preventing and managing complications of neck dissection.
Abstract: The neck dissection has remained a pivotal aspect of head and neck cancer management for over a century. During this time its role has expanded from a purely therapeutic option to an elective setting. Since vital anatomical structures are close, certain risks and complications are inherent to this procedure. Since neck surgery remains the most freq...
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A Method to Correct Cone Beam CT (CBCT) Images Using Planning CT for Derivation of Plan of the Day in STEREOTACTIC Body Radiotherapy (SBRT)
Roopam Srivastava,
Shiva Gaur,
Pramod Kumar Sharma,
Manoj Sharma,
Deepika Chauhan,
Neha Sehgal,
K Joseph Maria Das,
Jayanand Manjhi
Issue:
Volume 5, Issue 2, June 2020
Pages:
29-33
Received:
7 December 2019
Accepted:
18 January 2020
Published:
15 June 2020
Abstract: A robust method for voxel by voxel enhancement of Cone-beam CT (CBCT) images using a priori knowledge from the planning Computed Tomography (pCT) scan has been developed and used to evaluate the dosimetric accuracy of pCT based CBCT correction method for SBRT dose verification in lung metastasis. This is a retrospective study under which SBRT is carried out in 10 patients presented with lung metastasis. pCT images of patients were acquired and treatment planning was carried out on Varian Eclipse (V11) for 30 Gy in 5 fractions. Daily imaging using CBCT has been done for each patient with an On-Board Imaging system. CBCT is corrected using Matlab function considering CT as fixed and CBCT as moving, the images are registered. Planning target volume (PTV), lung, heart and spine were recontoured on uncorrected CBCT and corrected CBCT separately and the calculated plan on CT is recalculated on both the CBCTs. The dose distribution between the pCT and both the CBCT images were compared. A paired sample test was performed to test the variations. The distribution of pixel intensity of corrected CBCT is closer to the pCT than the uncorrected CBCT. The maximum percentage difference between the corrected CBCT and pCT is 1% in PTV evaluation, which is 3.5% between uncorrected CBCT and pCT. The method increases the accuracy of CBCT density values and enabling the use of CBCT images for dose calculation in radiotherapy.
Abstract: A robust method for voxel by voxel enhancement of Cone-beam CT (CBCT) images using a priori knowledge from the planning Computed Tomography (pCT) scan has been developed and used to evaluate the dosimetric accuracy of pCT based CBCT correction method for SBRT dose verification in lung metastasis. This is a retrospective study under which SBRT is ca...
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Knowledge of Retinoblastoma by Healthcare Professionals in Sub-saharan Africa: Survey Performed in the Republic of Côte d'Ivoire and the Democratic Republic of the Congo
Lukamba Mbuli Robert,
Monga Bondo Ben,
Yao Atteby,
Kabesha Amani Théo,
Budiongo Nzazi Aléine,
Bey Pierre,
Chenge Borasisi Gabrielle,
Desjardins Laurence,
Savignoni Alexia,
Berete-Coulibaly Rokia,
Couitchere Line,
Luboya Numbi Oscar,
Doz François,
Mwembo Tambwe Albert
Issue:
Volume 5, Issue 2, June 2020
Pages:
34-38
Received:
25 April 2020
Accepted:
20 May 2020
Published:
15 June 2020
Abstract: Diagnostic delay leads to advanced forms of retinoblastoma, compromising survival. The aim of this study was to evaluate the knowledge of health professionals regarding this disease. This survey was carried out among health professionals in the Democratic Republic of the Congo (cities of Lubumbashi, Bukavu and Kinshasa) and Côte d'Ivoire (Abidjan). Health professionals were divided into 3 professional categories: 1) paediatricians and ophthalmologists, 2) other medical doctors, and 3) paramedics. A questionnaire adapted to each category was used. The response to each question was graded as correct or incorrect. Total knowledge of retinoblastoma for the entire questionnaire was evaluated according to a level of overall score for each health professional: score<50% was considered very insufficient, score between 50 and 75% as insufficient and score ≥75% as sufficient. Descriptive statistical analyses and association measurements were performed. A total of 637 health professionals were surveyed, including 69 in the “pediatricians and ophthalmologists” category, 180 in the “others medical doctors” category and 388 in the “paramedics” category. Globally, more than 90% of health professionals did not answer all the questions correctly, and 9% were aware of the most common retinoblastoma-revealing symptoms (leukocoria and strabismus). Overall knowledge of retinoblastoma was sufficient for 26.1% of Paediatricians and Ophtalmologists, 11.7% of Other medical doctors and 2.1% of Paramedicals. One-quarter of health professionals were aware of the two most common signs of retinoblastoma (leukocororia and strabismus) in “pediatricians and ophthalmologists” category, 14% in “others medical doctors” category and 4% in “paramedics” category. Most health professionals surveyed in DRC and Cote d'Ivoire were not aware of the retinoblastoma-revealing symptoms. This certainly contributes to delayed diagnosis and the poor prognosis of this disease in those countries.
Abstract: Diagnostic delay leads to advanced forms of retinoblastoma, compromising survival. The aim of this study was to evaluate the knowledge of health professionals regarding this disease. This survey was carried out among health professionals in the Democratic Republic of the Congo (cities of Lubumbashi, Bukavu and Kinshasa) and Côte d'Ivoire (Abidjan)....
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Outcomes of Pectoralis Major Myocutaneous Flap in the Reconstruction of Head and Neck
Shashidhar Kallappa,
Akshatha Shetty Mijar
Issue:
Volume 5, Issue 2, June 2020
Pages:
39-42
Received:
24 May 2020
Accepted:
10 June 2020
Published:
20 June 2020
Abstract: Pectoralis major myocutaneous (PMMC) flap is versatile flap used for reconstruction of various head and neck defects created after excision of tumors. Due to the rapid advancement of reconstructive microsurgery, micro vascularised free flap transfer is becoming the main method of head and neck reconstruction. Presently PMMC flap reconstruction is used as an option for salvage surgery post free flap transfer failure and also in patients who are poor candidates for free flap transfer. However in developing countries like India where there are limited resources and the patient’s presents in advanced stage of the disease PMMC flap is a viable option for reconstruction. Aim is to study the outcome of PMMC flap reconstruction in head and neck malignancy. A prospective analysis was done with 20 patients who underwent wide local excision with marginal or hemi mandibulectomy with PMMC flap reconstruction and neck dissection from January 2017 to January 2019 in tertiary care center. Follow up was done for every 2 weeks for first 2 months, then every month for a period of 6 months. Out of all the patients who underwent PMMC flap reconstruction, 2 patients developed partial flap necrosis, 1 had wound dehiscence and fistula and 1 patient had local recurrence. For remaining patients no complications were noted in the follow up period.
Abstract: Pectoralis major myocutaneous (PMMC) flap is versatile flap used for reconstruction of various head and neck defects created after excision of tumors. Due to the rapid advancement of reconstructive microsurgery, micro vascularised free flap transfer is becoming the main method of head and neck reconstruction. Presently PMMC flap reconstruction is u...
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