Paraneoplastic syndromes associated with classic Hodgkin lymphoma, a systematic literature review.

PNS are uncommon manifestations of cancer. The current literature about these syndromes in the setting of cHL is disintegrated. A systematic literature review of all published literature was conducted. One hundred twenty-eight patients from 115 publications met the inclusion/exclusion criteria. Eight-five patients were of the NS subtype (66.4%). The most frequent clinical presentation of the PNS was CNS manifestation (25.8%). The majority of patients were diagnosed with the cHL and PNS simultaneously (42.2%). In 33.6% of patients, the lymphoma diagnosis preceded the PNS diagnosis. In 16.4% of patients, the PNS diagnosis preceded the lymphoma diagnosis. The presence of PNS antibodies was reported in 35 patients (27.3%). Age older than 18 was associated with higher prevalence of PNS. The CR rate of the lymphoma was 77.3%. The complete resolution rate of the PNS was 54.7%. Relapse of lymphoma was reported in 13 patients, and recurrence of the PNS upon relapse was reported in 10/13 patients.

Awareness and knowledge regarding rotavirus disease and vaccine among healthcare providers in tertiary care settings.

A descriptive, cross-sectional study was conducted from July 2018 to September 2018 to assess the level of awareness among healthcare workers regarding rotavirus infection and its vaccination in Rawalpindi and Islamabad. The study site was conducted at tertiary care hospitals of Rawalpindi and Islamabad. Ethical approval was obtained from the Institutional Review Board of Army Medical College, Rawalpindi. Closed and open ended questionnaires were distributed via non-probability convenient sampling. The sample size was 257. Among the study participants, 247 (96.1%) of the participants had good level of awareness regarding rotavirus, whereas 212 (82.5%) had awareness regarding the vaccine. The mean awareness score was 16.16 ± 4.097 out of a maximum score of 22. Both male and female participants had almost equal awareness regarding the rotavirus infection (Males = 96, 93.2%, Females = 151, 98%) and vaccination (Males = 87, 84%, Females = 125, 81.1%). The mean awareness was directly related with the level of education of the participants, i.e. MBBS/FCPS/MCPS = 221(85.9%), MBBS = 209(81.5%), B.Sc. Nursing = 206(80%), and Basic Education = 220(85.7%) knew about the vaccine.

Communication principles and practices for making shared decisions about renal replacement therapy: a review of the literature.

PURPOSE OF REVIEW: To provide an overview of the skill set required for communication and person-centered decision making for renal replacement therapy (RRT) choices, especially conservative kidney management (CKM). RECENT FINDINGS: Research on communication and decision-making skills for shared RRT decision making is still in infancy. We adapt literature from other fields such as primary care and oncology for effective RRT decision making. SUMMARY: We review seven key skills: (1) Announcing the need for decision making (2) Agenda Setting (3) Educating patients about RRT options (4) Discussing prognoses (5) Eliciting patient preferences (6) Responding to emotions and showing empathy, and (7) Investing in the end. We also provide example sentences to frame the conversations around RRT choices including CKM.