ABSTRACT
PURPOSE: Nonsurgical treatment of lymphangiomas has shown limited efficacy and often carries unacceptable toxicities, demonstrating the need for a more effective, less toxic therapy. PATIENTS AND METHODS: We describe two patients with lymphangiomatosis treated for 12 to 40 months with recombinant interferon-alpha. RESULTS: Both patients demonstrated stabilization or marked improvement of disease, based on clinical and radiologic findings, with minimal toxicity. CONCLUSIONS: The favorable responses to interferon-alpha therapy in these two cases suggest that this is an effective and well-tolerated treatment for lymphangiomas in children.
Subject(s)
Antineoplastic Agents/therapeutic use , Interferon Type I/therapeutic use , Lymphangioma/therapy , Adolescent , Antineoplastic Agents/administration & dosage , Bone Neoplasms/therapy , Humans , Interferon Type I/administration & dosage , Male , Neoplasms, Multiple Primary/therapy , Recombinant Proteins , Splenic Neoplasms/therapy , Thoracic Neoplasms/therapyABSTRACT
OBJECTIVES: To identify physicians' needs and expectations related to quality nutrition services in prenatal care; to rank service characteristics by importance in making nutrition referral decisions; and to identify nutrition services physicians would likely add to their practice. DESIGN: We used a market research survey based on the quality service management model. SETTING: We selected prenatal care as the setting because diet plays an important role in the health of the mother and the infant; specific recommendations exist for physicians to provide for nutrition assessment and counseling during pregnancy; and dietitians are not uniformly represented and used in obstetrics practices. SUBJECTS: The survey population consisted of all members of a state obstetrics and gynecology society (N = 352). A return rate of 37% was achieved. ANALYSIS: Data were analyzed using descriptive statistics and qualitative analytic methods. RESULTS: Responses from 130 physicians revealed an expectation that dietitians working in prenatal care must have expertise in prenatal nutrition and skillfully work with patients to achieve compliance with individualized care plans. To be judged excellent, physicians indicated that nutrition care would have to produce desired outcomes in patients. Good communication, documentation, and availability of the dietitian were also important. Financial issues were not of great concern to the respondents. APPLICATION: The findings from this study help pinpoint opportunities for dietitians to develop and strengthen relationships with physician-customers for the provision of quality nutrition service in prenatal care. Important characteristics of quality nutrition service include timely and effective counseling followed by conscientious documentation and feedback to physician.
