1/27. Working with children of cancer patients.Through the use of verbal and nonverbal techniques, a social worker and music therapist have combined their fields into an integral therapeutic modality to provide patients with cancer and their children opportunities to experience intimacy in a time of crisis. Skilled verbal interventions and the sensitive application of the expressive and less threatening medium of music create a relaxed environment where families and patients may explore deeply and express freely.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
2/27. Aplastic anemia in a petrochemical factory worker.A petrochemical worker with aplastic anemia was referred to our hospital. He worked in a petroleum resin-producing factory and had been exposed to low-level benzene while packaging the powder resin and pouring lime into a deactivation tank. According to the yearly environmental survey of the working area, the airborne benzene level was approximately 0.28 ppm. Exposure to benzene, a common chemical used widely in industry, may progressively lead to pancytopenia, aplastic anemia, and leukemia. The hematotoxicity of benzene is related to the amount and duration of exposure. Most risk predictions for benzene exposures have been based on rubber workers who were exposed to high concentrations. In the petroleum industry, the concentration of benzene is relatively low, and there are disputes over the toxicity of low-level benzene because of a lack of evidence. In this paper we report the case of aplastic anemia induced by low-level benzene exposure.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
3/27. A combined PET/CT scanner for clinical oncology.The availability of accurately aligned, whole-body anatomical (CT) and functional (PET) images could have a significant impact on diagnosing and staging malignant disease and on identifying and localizing metastases. Computer algorithms to align CT and PET images acquired on different scanners are generally successful for the brain, whereas image alignment in other regions of the body is more problematic. methods: A combined PET/CT tomograph with the unique capability of acquiring accurately aligned functional and anatomical images for any part of the human body has been designed and built. The PET/CT scanner was developed as a combination of a Siemens Somatom AR.SP spiral CT and a partial-ring, rotating ECAT art PET scanner. All components are mounted on a common rotational support within a single gantry. The PET and CT components can be operated either separately, or in combined mode. In combined mode, the CT images are used to correct the PET data for scatter and attenuation. Fully quantitative whole-body images are obtained for an axial extent of 100 cm in an imaging time of less than 1 h. When operated in PET mode alone, transmission scans are acquired with dual 137Cs sources. RESULTS: The scanner is fully operational and the combined device has been operated successfully in a clinical environment. Over 110 patients have been imaged, covering a range of different cancers, including lung, esophageal, head and neck, melanoma, lymphoma, pancreas, and renal cell. The aligned PET and CT images are used both for diagnosing and staging disease and for evaluating response to therapy. We report the first performance measurements from the scanner and present some illustrative clinical studies acquired in cancer patients. CONCLUSION: A combined PET and CT scanner is a practical and effective approach to acquiring co-registered anatomical and functional images in a single scanning session.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
4/27. A patient with 17 primary tumours and a germ line mutation in TP53: tumour induction by adjuvant therapy?We report the case history of a woman with a germ line mutation in the TP53 gene who developed 17 separate primary tumours. The incidence of new tumours rose steeply after adjuvant tamoxifen treatment for breast cancer and adjuvant vaginal vault radiotherapy for endometrial cancer. This increase could be due to cumulative genetic damage from environmental agents and the fact that the patient lived to the relatively late age of 60 years, or to a high inherent deleterious somatic mutation rate, which could represent the inability of cells from patients with TP53 mutations to repair therapy-induced genetic damage.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
5/27. Malignancy after renal transplantation.Malignancy following renal transplantation is an important medical problem during the long-term follow-up. The overall incidence of malignancy at this time is 3 to 5 times higher than in the general population. The most common malignancies are lymphoproliferative disorders (early after transplantation) and skin carcinomas (late after transplantation). The type of malignancy is different in various countries and dependent on genetic and environmental factors. Another important confounder for risk of malignancy after renal transplantation is the type of immunosuppression. Previous use of cytotoxic drugs (eg, cyclophosphamide) or a history of analgesic abuse are additional risk factors. Malignancy may even be transplanted by the graft. Previous cancer treatment in a uremic patient on the transplant waiting list is of great importance in relation to waiting time and postmalignancy screening. Finally, every dialysis patient on the waiting list should undergo a regular screening program before and after renal transplantation to detect a potentially malignant tumor in an early stage. In addition to specific oncological treatment, managing a malignancy after renal transplantation should include modification of immunosuppression.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
6/27. Understanding denial.PURPOSE/OBJECTIVES: To explore the adaptive and maladaptive uses of denial while developing a clearer understanding of denial. DATA SOURCES: nursing and psychological periodicals and textbooks. DATA SYNTHESIS: Oncology nurses tend to have too broad a definition of denial because they overgeneralize similar patient responses and label them as denial. Because of the uncertainty as to its value, denial is viewed as a negative, fixed response to a crisis and can strain the nurse-patient relationship. CONCLUSION: Denial is a fluid, interpersonal experience that can affect patients during many points of the cancer experience. By experiencing a clearer understanding of denial and recognizing its adaptive value, nurses can provide more effective patient care. IMPLICATIONS FOR nursing: Clinicians should not underestimate the value of the nurse-patient relationship when a patient is in denial. Patience, understanding, and self-awareness are crucial for providing a safe, trusting environment for patients who are experiencing denial.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
7/27. Special sunrise & sunset solar energy stored papers and their clinical applications for intractable pain, circulatory disturbances & cancer: comparison of beneficial effects between Special solar energy Stored paper and qigong Energy Stored paper.Various phases of solar energy were evaluated for possible medical application, using the Bi-Digital O-Ring Test. A 2-4 minute interval of highly beneficial phase during sunrise and sunset which is comparable or is stronger than ( ) qigong Energy was detected. This energy was stored on 3 x 5 inch index cards. The sun energy stored on the exposed surface had a Bi-Digital O-Ring Test extremely strong positive ( ) response, and the opposite side of the index card which was not exposed to the sun showed an equally strong negative (-) response. When the Bi-Digital O-Ring Test strong positive side ( ) was applied to the patient's skin above various intractable painful areas with circulatory disturbances, including gangrenous pain, muscle pain, joint pain, & migraine headache, most of the pain disappeared or was significantly reduced within between 10 seconds and 5 minutes, with accelerated wound healing compared with qigong energy stored paper of the same exposure, which caused pain to disappear within between 1.5 minutes and 15 minutes. When this Special solar energy Stored paper was applied either directly to the skin above cancer positive areas or the midline of the upper chest above the thymus gland representation area, or the occipital area above the medulla oblongata, various cancer related parameters returned to close to normal values, with immediate clinical improvement. The beneficial effects of 10-60 seconds of application of the Special solar energy Stored paper lasted for between 7 and 40 days, depending on the individual and their environmental electromagnetic field, how the special solar energy was stored, and how it was applied to the patient.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
8/27. Approaching death: a phenomenologic study of five older adults with advanced cancer.PURPOSE/OBJECTIVES: To explore the lived experience and the associated meaning of approaching death among older adults with advanced cancer. research APPROACH: A phenomenologic inquiry. SETTING: Urban cancer center. PARTICIPANTS: 5 individuals diagnosed with advanced cancer who were 65 years or older. METHODOLOGIC APPROACH: A series of semistructured interviews were tape-recorded, transcribed verbatim, analyzed, and developed into narrative summations. FINDINGS: The study elucidated the experience of approaching death from advanced cancer. The insightful and compelling narratives of five individuals' experiences suggest that genuine caring, compassionate honesty from trusted healthcare professionals, cautious hopefulness maintained by patients and their loved ones, unquestioned faith, an involvement in desired life activities, and positive interactions within the healthcare system and in personal relationships were meaningful to participants. CONCLUSIONS: knowledge developed from dying patients allows for an awareness that moves beyond assumption toward an in-depth understanding that can enable healthcare professionals to design meaningful care for these individuals. INTERPRETATION: knowledge gained directly from patients' experiences of what is meaningful and helpful as death approaches can guide effective interventions to improve palliative care practices and enhance overall quality of life while living with an incurable illness. nurses have the ability to contribute meaningfully to patients facing death by relating to them with genuine care that acknowledges their humanity, conveying information with a compassionate honesty that recognizes the impact it will hold for patients and their loved ones, supporting patients' faith and cautious hopes, assisting patients in enjoying an active involvement in life within their limitations, and providing a safe and trusting environment in which to receive care.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
9/27. pain and symptom management clinical, policy, and political perspectives.During the last decade, the prevalence of cancer pain and the reality of undertreatment have been well documented in both adults and children. There has been a proliferation of educational and regulatory activity setting an expectation that management of pain is a priority. At the same time, pain has come to the attention of the media, advocacy groups, industry, legislators, regulators and litigators creating an environment where this rich and multidimensional aspect of oncology care has moved beyond a clinical focus and opening up a range of opportunities for oncology professionals to participate as experts and leaders. The ethical underpinnings of the mandate to treat pain and attend to suffering compels psychosocial clinicians to advocate for the care of patients and consider participating in an informed way in the policy, legislative and political issues that flourish around the treatment of pain.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
10/27. survivors of childhood sexual abuse diagnosed with cancer: managing the impact of early trauma on cancer treatment.The incidence of survivors of childhood sexual abuse (CSA) diagnosed with cancer is unknown. It is estimated that one in three women and one in six men in the united states are survivors of CSA. survivors of CSA diagnosed with cancer are presented with multiple and potentially accumulating traumas. The re-traumatizing nature of a cancer diagnosis and treatment affects all elements of the CSA survivor's care and may impede her/his treatment. To date, the impact of CSA on the medical treatment of people with cancer has been unexplored with the existing studies on female survivors of CSA with cancer focusing on the post-treatment experience and their higher incidence of sexual dysfunction. This article describes the impact of CSA on the cancer treatment of 18 survivors of CSA and the clinical interventions used to address the unique psychosocial needs of this population. Anecdotal information suggests that the survivors of CSA may find aspects of the cancer experience reminiscent of their history of abuse. All 18 survivors of CSA experienced distressing memories of their abuse during their cancer treatment. Fifteen CSA survivors presented traumatic memories that were inaccessible to conscious thought processes prior to their cancer diagnosis. Psychodynamic interventions address issues of disruption in the cancer treatment, non-adherence, and difficulties in relationships with the health care team. Containment of intense affect and distressing thoughts rather than exploration improved CSA survivors' adherence with cancer treatments. The acquisition of self-comforting skills helped CSA survivors feel less re-victimized by their cancer experience. The establishment of an environment of internal and external safety improved communication with the health care team. health care/psychosocial clinicians' awareness and use of appropriate interventions can minimize the affects of re-traumatization and enhance the CSA survivor's treatment experience.- - - - - - - - - - ranking = 1keywords = environment (Clic here for more details about this article) |
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