Subject(s)
Kidney Transplantation/adverse effects , Lung Diseases, Fungal/microbiology , Mucormycosis/microbiology , Rhizopus/isolation & purification , Anti-Bacterial Agents/administration & dosage , Antifungal Agents/administration & dosage , Disease Progression , Fatal Outcome , Glucocorticoids/administration & dosage , Graft Rejection/etiology , Graft Rejection/therapy , Humans , Immunosuppressive Agents/administration & dosage , Lung Diseases, Fungal/diagnosis , Lung Diseases, Fungal/drug therapy , Male , Medication Adherence , Middle Aged , Mucormycosis/diagnosis , Mucormycosis/drug therapy , Plasmapheresis , Renal Dialysis , Rhizopus/drug effects , Treatment Outcome , Trimethoprim, Sulfamethoxazole Drug Combination/administration & dosageSubject(s)
Bortezomib/therapeutic use , Dexamethasone/therapeutic use , Hydroxamic Acids/therapeutic use , Indoles/therapeutic use , Multiple Myeloma/drug therapy , Multiple Myeloma/mortality , Neoplasm Recurrence, Local/drug therapy , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Bortezomib/adverse effects , Dexamethasone/adverse effects , Disease-Free Survival , Female , Humans , Hydroxamic Acids/adverse effects , Indoles/adverse effects , Male , Middle Aged , Multiple Myeloma/diagnosis , Neoplasm Invasiveness/pathology , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/pathology , Neoplasm Staging , Panobinostat , Practice Guidelines as Topic , Prognosis , Randomized Controlled Trials as Topic , Retreatment/statistics & numerical data , Risk Assessment , Survival Analysis , Treatment Outcome , United KingdomSubject(s)
Drug Resistance, Neoplasm , Isoquinolines/therapeutic use , Lymphoma, Non-Hodgkin/drug therapy , Practice Guidelines as Topic , Topoisomerase II Inhibitors/therapeutic use , Cost-Benefit Analysis , Drug Approval , Drug Costs , Evidence-Based Medicine , Humans , Isoquinolines/adverse effects , Isoquinolines/economics , Lymphoma, Non-Hodgkin/economics , Lymphoma, Non-Hodgkin/mortality , Lymphoma, Non-Hodgkin/pathology , Recurrence , Topoisomerase II Inhibitors/adverse effects , Topoisomerase II Inhibitors/economics , Treatment OutcomeSubject(s)
Indoles/administration & dosage , Melanoma , Neoplasm Metastasis/drug therapy , Neoplasm Recurrence, Local/drug therapy , Sulfonamides/administration & dosage , Humans , Melanoma/drug therapy , Melanoma/genetics , Melanoma/pathology , Mutation , Proto-Oncogene Proteins B-raf/antagonists & inhibitors , Proto-Oncogene Proteins B-raf/genetics , VemurafenibABSTRACT
Encapsulating peritoneal sclerosis (EPS) is a rare complication of peritoneal dialysis. It often presents with non-specific symptoms, leading to a delay in diagnosis and a poor prognosis. Here we report a case of EPS in a patient treated with peritoneal dialysis and discuss the risk factors, diagnostic challenges and treatment options available.
Subject(s)
Peritoneal Dialysis/adverse effects , Peritoneal Fibrosis/diagnosis , Peritoneal Fibrosis/etiology , Aged , Biopsy , Comorbidity , Diagnosis, Differential , Fatal Outcome , Humans , Kidney Failure, Chronic/therapy , Kidney Transplantation , Male , Palliative Care , Peritoneal Fibrosis/therapy , Risk Factors , Tomography, X-Ray ComputedSubject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Multiple Myeloma/drug therapy , State Medicine/standards , Antineoplastic Combined Chemotherapy Protocols/economics , Antineoplastic Combined Chemotherapy Protocols/standards , Boronic Acids/administration & dosage , Bortezomib , Cost-Benefit Analysis , Drug Costs , Evidence-Based Medicine , Humans , Multiple Myeloma/economics , Practice Guidelines as Topic , Pyrazines/administration & dosage , Quality-Adjusted Life Years , State Medicine/economics , Thalidomide/administration & dosage , Treatment Outcome , United KingdomABSTRACT
BACKGROUND: The treatment of drooling in a paediatric population with neurological impairments is clinically challenging. Surgery is considered invasive, while behaviour modification techniques, correction of situational factors and oral-motor therapy do not always produce sustained improvement. In recent years the use of Botox® to decrease drooling has been investigated. AIMS: To review the clinical data from a Drooling Treatment Project for children with neurological impairments and to establish the validity of the drooling severity and frequency rating scales, establishing Phase I-level information about the therapeutic use of submandibular salivary gland injections of Botox® in various contexts. METHOD & PROCEDURES: A retrospective, explanatory design was used to review the data. Nine children, seven with cerebral palsy and two with operculum syndrome, ranging in age from 5 to 17 years (mean = 9;3 years) were included. Drooling was assessed by qualified speech-language therapists using drooling rating scales, in five different situations and at different time points pre- and post-Botox® injection up to 6 months. Quantitative and qualitative analyses were computed. Parents'/primary caregivers' perceptions of drooling and treatment with Botox® were also considered using an interview form and a quality of life questionnaire. OUTCOMES & RESULTS: Statistically significant reductions in drooling with large effect sizes were obtained in the communicating and general appearance situations. There was a difference in the pattern of response between the children with cerebral palsy and those with operculum syndrome. Discrepancies between the parents and the speech-language therapists regarding the context of drooling reduction were found. Most parents/primary caregivers felt their children's lives and their own had improved following the Botox® injection and would repeat the treatment. The drooling rating scales were a valid method to assess drooling in a clinical situation. CONCLUSIONS & IMPLICATIONS: In the clinical setting of the Drooling Treatment Project, the results indicated that the context in which drooling occurs is an important factor and suggested the value of considering the situational context when making drooling judgments. Further, there was a difference in the pattern of response between the children with cerebral palsy and those with operculum syndrome, suggesting that aetiology may be involved in the response to Botox®.
Subject(s)
Botulinum Toxins, Type A/therapeutic use , Cerebral Palsy/complications , Neuromuscular Agents/therapeutic use , Severity of Illness Index , Sialorrhea/drug therapy , Sialorrhea/etiology , Adolescent , Child , Child, Preschool , Clinical Trials, Phase I as Topic , Deglutition Disorders/complications , Female , Humans , Injections/methods , Male , Parotid Gland/drug effects , Parotid Gland/innervation , Reproducibility of Results , Retrospective Studies , Sialorrhea/diagnosis , Speech Therapy , Submandibular Gland/drug effects , Submandibular Gland/innervation , Treatment OutcomeABSTRACT
Research findings are essential to the progress of the profession, but they are not always relevant or easily accessible. Literature searches can also be off-putting because of the sheer volume of material available. The critical appraisal team is a nurse-led initiative set up to tackle these problems. It responds directly to the research needs of nurses in the workplace, supplying staff with concise, reliable research that can be used to benefit practice.