Importance Of Physical Symptoms Research Articles

The patient experience with localized upper tract urothelial cancer

ObjectiveTo understand the experiences of patients with low-grade upper tract urothelial carcinoma via in-depth interviews covering the diagnosis, treatment, and follow-up. MethodsA qualitative study was performed using 60 minutes interviews with patients diagnosed with low-grade UTUC. The participants received either endoscopic treatment (ET), radical nephroureterectomy (RNU) or intracavity mitomycin gel for the pyelocaliceal system. Interviews were conducted by trained interviewers via telephone using a semi-structured questionnaire. The raw interviews were coded into discrete phrases that were grouped together based on similarity of meaning. Inductive data analysis methodology was used. Themes were identified and refined to overarching themes striving to encompass the original meaning and intent of participant's words. ResultsTwenty individuals were enrolled; 6 were treated with ET, 8 were treated with a RNU, and 6 were treated with intracavitary mitomycin gel. The median age was 74 years (52–88) and half of participants were women. Most endorsed good, very good, or excellent health. Four unique themes were identified: 1. Misunderstandings of the nature of disease; 2. Importance of physical symptoms during treatment as a proxy for recovery; 3. Competing desires for kidney preservation versus expeditious treatment; and 4. Trust in doctors and minimal perceived shared decision-making. ConclusionsLow grade UTUC is a disease with a diverse clinical presentation and an evolving landscape of available treatments. This study provides insight into patients’ perspective and can help guide counseling and treatment selection.

Details always tell a big story: Importance of physical symptoms in evaluation of secondary causes of depression

SECONDARY CAUSES OF depression should be considered in patients with atypical presentations. Careful consideration of these secondary causes could result in early identification and initiation of appropriate treatment to prevent further complications. We report a middle aged man who presented initially with depression, but was found to have craniopharyngioma on evaluation. Persistent loss of libido led to further evaluation and identification of craniopharyngioma and associated pituitary dysfunction.

Medical care for patients with severe and persistent mental illness

Medical care for patients with severe and persistent mental illness

The treatment of nervous disorders: The importance of physical symptoms and signs

The treatment of nervous disorders: The importance of physical symptoms and signs