Various Stages Of Treatment Research Articles

Progression of tumors with development of cerebral metastases is accompanied by suppression of thyroid and glucocorticoid functions.

e14005 Background: Cutaneous melanoma (CM), breast cancer (BC) and lung cancer (LC) metastasize to the brain most frequently. Early diagnosis of cerebral metastases is challenging and requires new prognostic criteria. Imbalance of thyroid and glucocorticoid hormones changes the growth and development of malignant tumors. The purpose of the study was to identify readily available prognostic criteria for cerebral metastases in cancer patients at various stages of treatment and follow-up. Methods: Blood levels of cortisol and total triiodothyronine (tT3) were determined by RIA (Immunotech, Czech Republic) in patients with BC (n = 50), LC (n = 50) and CM (n = 50) without brain metastases and in patients with BC (n = 25), LC (n = 25) and CM (n = 25) with cerebral metastases. Results: Blood levels of cortisol in BC, LC and CM patients were normal in 63-84% and elevated on average by 1.7 times in 16-37%. Levels of tT3 in LC were normal, and in BC and CM – within the normal limits, but 1.3 times lower than the mean values. In patients with cerebral metastases, cortisol was lower than the norm by 4.9, 2.5 and 3.6 times in 36% BC, 75% LC and 45% CM cases, respectively. Levels of tT3 in all patients with cerebral metastases were lower than the norm or values in patients without metastases by 2 times and lower. Conclusions: Decreased levels of both cortisol and tT3 in patients with BC, LC and CM may serve as one of prognostic markers of possible development of cerebral metastases. The dynamic determination of levels of thyroid and glucocorticoid hormones is required in cancer patients at various stages of treatment and follow-up.

Stress as a predictor of tumor growth and development of metastases.

e24124 Background: The aims of this study were to examine; the predictors of perceived stress; and the associations between perceived stress and tumor growth and development of metastases as well as the mediational role of inflammatory biomarkers. Methods: This study is prospective in design. A battery of questionnaires, including a sociodemographic characteristic and the Perceived Stress Scale, was collected at baseline from patients diagnosed with solid tumors at various stages of treatment. Disease progression was measured over a 12-month period. Poverty threshold was determined using the U.S. Department of Health & Human Services 2020 poverty guidelines. Computerized tomography and Magnetic Resonance Imaging scans were assessed for disease progression between baseline and 12 months using Response Evaluation Criteria in Solid Tumors. Blood was collected and serum levels of IL-2, IL-1a, IL-1b, TNF-a, IL-6, and IL-8 were assessed. The predictors of stress include sociodemographic and disease specific characteristics. Primary outcomes were tumor growth and development of metastases. Descriptive statistics, correlations, and ordinal and linear regression were performed to assess the aims. Results: Of 159 patients diagnosed with cancer, 47.8% were male, mean age was 62.97 (SD = 10.35), 89.3% were Caucasian, and 13.8% met poverty guidelines. Significant predictors of stress were age (b=-.151, p=0.029, 95% C.I.=-2.86-.016) and income below the poverty threshold (b= 5.615, p=0.007, 95% C.I.=1.596-9.635). Gender was the only sociodemographic and disease specific factor significantly associated with disease progression. After adjusting for gender, greater perceived stress was associated with tumor growth and development of metastases (p =0.029), accounting for 33.3% of the variance. Circulating cytokines were significantly related to disease progression [IL-1a, p=0.020; IL-1b, p=0.011; IL-6, p<0.001; and IL-8, p<0.001] but not stress [IL-1a, p=0.369; IL-1b p=0.292; IL-2, p=0.470; IL6 p=0.406; and IL8, p=0.401]. Conclusions: Future research should evaluate inflammation in the tumor microenvironment as well as neutrophils and tumor suppressor genes as potential mediators between stress and disease progression.

Evaluation of Metagenomic-Enabled Antibiotic Resistance Surveillance at a Conventional Wastewater Treatment Plant.

Wastewater treatment plants (WWTPs) receive a confluence of sewage containing antimicrobials, antibiotic resistant bacteria, antibiotic resistance genes (ARGs), and pathogens and thus are a key point of interest for antibiotic resistance surveillance. WWTP monitoring has the potential to inform with respect to the antibiotic resistance status of the community served as well as the potential for ARGs to escape treatment. However, there is lack of agreement regarding suitable sampling frequencies and monitoring targets to facilitate comparison within and among individual WWTPs. The objective of this study was to comprehensively evaluate patterns in metagenomic-derived indicators of antibiotic resistance through various stages of treatment at a conventional WWTP for the purpose of informing local monitoring approaches that are also informative for global comparison. Relative abundance of total ARGs decreased by ∼50% from the influent to the effluent, with each sampling location defined by a unique resistome (i.e., total ARG) composition. However, 90% of the ARGs found in the effluent were also detected in the influent, while the effluent ARG-pathogen taxonomic linkage patterns identified in assembled metagenomes were more similar to patterns in regional clinical surveillance data than the patterns identified in the influent. Analysis of core and discriminatory resistomes and general ARG trends across the eight sampling events (i.e., tendency to be removed, increase, decrease, or be found in the effluent only), along with quantification of ARGs of clinical concern, aided in identifying candidate ARGs for surveillance. Relative resistome risk characterization further provided a comprehensive metric for predicting the relative mobility of ARGs and likelihood of being carried in pathogens and can help to prioritize where to focus future monitoring and mitigation. Most antibiotics that were subject to regional resistance testing were also found in the WWTP, with the total antibiotic load decreasing by ∼40–50%, but no strong correlations were found between antibiotics and corresponding ARGs. Overall, this study provides insight into how metagenomic data can be collected and analyzed for surveillance of antibiotic resistance at WWTPs, suggesting that effluent is a beneficial monitoring point with relevance both to the local clinical condition and for assessing efficacy of wastewater treatment in reducing risk of disseminating antibiotic resistance.

Mathematical modeling of the spread of pollutants in the atmosphere from the storage of liquid waste of pig complexes during reagent treatment

The effect of treatment of liquid organic waste from pig farms with various calcium-containing reagents, followed by neutralization to pH 7.0-8.5, on reducing the emissions of pollutants such as ammonia, hydrogen sulfide, methyl mercaptan, nitrogen and carbon oxides at various stages of treatment was studied. The article deals with mathematical modeling of changes in the concentration fields of pollutants over time. Dynamic processes of gaseous pollutants propagation in the surface air layer above liquid organic waste accumulators are simulated. The developed model will allow calculating the distribution of pollutants over the storage of liquid organic waste in a given period of time and calculate the concentrations of gaseous pollutants in steady-state and non-stationary modes during reagent treatment. The time of reducing the concentrations of pollutants to the required values is determined based on the results of a computational experiment in the VITECON software package. The corrected sizes of sanitary protection zones of the pig complex before and after reagent treatment are presented.

Experience of Application of the International Classification of Functioning (ICF) in Assessment of the Need for Rehabilitation of Patients with Operated Breast Cancer

The article presents the results of a study of the biopsychosocial principle in the rehabilitation of patients with breast cancer. Aim. to assess the need for patients with operable breast cancer in rehabilitation measures at various stages of treatment. Results. when assessing the need for rehabilitation of patients with operable breast cancer, it was found that the need for rehabilitation measures in all patients increases in the postoperative period and persists for 12 months after the end of treatment. Special attention should be paid to the indicators of physical and social functioning in subgroups of patients who received neoadjuvant chemotherapy: increased fatigue, weight gain, unstable emotional background impose significant restrictions on the socio-role functioning of patients, reducing the quality of life and increasing the risks associated with the progression of the underlying disease, exacerbation of chronic diseases. Thus, patients who participated in the program of rehabilitation measures in the framework of the biopsychosocial approach showed the best performance after the end of treatment during the observation period: in the subgroup of patients receiving chemotherapy and rehabilitation in the framework of the biopsychosocial model, the dynamics of the recovery needs of the operation sought to average indicators by domain “b4552 Fatigue” – 21%, “b4551 Aerobic capacity “ – 18%, “d240 Handling stress and other psychological demands » – 39%, “b710 Mobility of joint functions “ – 29%, self-service (“d510 Washing”; “ d540 Dressing») – 21%, “b455 Exercise tolerance functions “ – 22%. In the subgroup of patients who received on-demand rehabilitation, there was an increase in the need for rehabilitation by domain: “d240 Handling stress and other psychological demands “ – 45%, “b4552 Fatigue” – 28%, self-service (“d510 Washing”; “ d540 Dressing») – 32%, b455 Exercise tolerance functions – 30%. Conclusion: The results of the study suggest a positive effect of rehabilitation measures on the functioning of patients with operable breast cancer.

Fourier spectroscopy in blood plasma study with type two diabetes

Subject of Research. The paper presents the study of possibilities of a spectral technique for evaluating changes in the optical properties of carbohydrates and plasma proteins in humans with the initial stage of type two diabetes. The optical characteristics are compared with those obtained by the conventional method of sugar curves using sucrose, honey and milk protein as a provoking load at various stages of treatment with antidiabetic drugs. Method. The study was carried out by infrared spectroscopy of disturbed total internal reflection in the range of 4000–500 cm–1. Testing for glucose tolerance at all stages of treatment was performed by the biochemical glucose oxidase method. Main Results. The use of provocateur products of various nature and an extended glucose tolerance test makes it possible to identify the spectrum bands associated with the presence of glucose (1104 cm–1) and fructose (1115 cm–1), differentiating on the left branch of the complex carbohydrate band (1075 cm–1) of the infrared spectrum of native plasma. It is shown that the change in the intensity of the Amide-I and Amide-II bands of fractionated plasma proteins is associated with the main glucose transporter — globulin fraction proteins. Practical Relevance. The revealed features of changes in blood plasma spectra in the course of the conducted studies give reason to believe that the non-destructive method of Fourier spectroscopy does not require a large volume of the studied material and its preliminary sample preparation. The method is promising as an express tool and can be used to obtain additional information when studying the influence of various provoking factors on the nature of changes in the optical characteristics of protein-lipid-carbohydrate complexes and globular proteins of blood plasma, as well as for preliminary diagnosis and the treatment supervision of type two diabetes mellitus.

Meeting the Needs of Parents of Children With Scoliosis: A Qualitative Descriptive Study

Needs of parents with children with scoliosis are complex and depend on their child’s treatments. The purpose of this study was to identify needs of parents with children with scoliosis. This qualitative description involved interviews with parents of children at various stages of treatment. A convenience, then purposeful sample of 16 parents (12 mothers, two fathers, and two stepfathers) was interviewed; interviews were transcribed and analyzed using thematic analysis. Parents’ needs included: Needing reliable medical information; Desiring information on complementary treatments; Wanting help in supporting and advocating for their child; Needing to protect the child and family; and Seeking connection and support. Although many parents’ needs are being met, this study recommends a nursing role aimed at providing parents with reliable medical information, discussing alternative treatments, assisting parents in their role of supporting their child, helping parents in their advocacy efforts, and referring parents to appropriate connections.

Prosthodontic Perspectives in Mucormycosis: A Review

Rhino-cerebral mucormycosis, a fateful fungal infection which was commonly known to affect the immunocompromised patients, is now thriving in conjunction with Corona virus disease 2019 (COVID-19). Early diagnosis and aggressive medical and surgical intervention are the key factors to extricate the patients. However, this leads to abundant hard and soft tissue loss, leaving behind a huge orofacial defect, along with certain morbidities and psychological trauma, necessitating surgical and prosthodontic rehabilitation. The present paper reviews on role of prosthodontist in various stages of treatment for mucormycosis patients. It also summarizes several treatment modalities including recent trends to rehabilitate the defect and restore the patients’ quality of life.

КОМПЛЕКСНАЯ ЛУЧЕВАЯ ДИАГНОСТИКА У ПАЦИЕНТОВ С ДИСФУНКЦИЕЙ ВИСОЧНО-НИЖНЕЧЕЛЮСТНОГО СУСТАВА (ВНЧС)

Purpose. Сonducting a comprehensive analysis of clinical and radiological data in patients with temporomandibular joint (TMJ) dysfunction at the stages before and after conservative and dental types of treatment using multislice computed tomography (MSCT) and magnetic resonance imaging (MRI). Materials and methods. The present study included the results of clinical and radiological examinations at the stages before and after conservative and dental types of treatment of 36 patients (31 women and 5 men) in the age range of 18-52 years. All patients were divided into four groups depending on the clinical manifestations of temporomandibular joint dysfunction. Group I (n = 11; 30.3%) - patients with pain syndrome with TMJ dysfunction; Group II (n = 14; 39.2%) - patients with manifestation of acoustic effects in TMJ dysfunction and group III (n = 5; 13.7%) - patients with degenerative changes in bone tissue. Group IV (n = 6; 16.8%) - was a control group – volunteers without clinical manifestations of TMJ dysfunction. Patients of all groups underwent radiological diagnostic methods at various stages of treatment: MSCT examination at treatment and 12 months after the initial examination; MRI - at treatment, at 6 and 12 months. Results. According to the study, it was revealed that the asymmetric arrangement of the heads of the condylar processes of the lower jaw (n = 14; 42.4%) was noted in view of the violation of the biomechanics of the act of chewing. The presence of pronounced dystrophic processes on the part of the lesion in groups I, II, III was regarded by us as changes as a result of functional overload, which was indirectly confirmed by the regression of the process after the complex treatment. The posterior position of the head of the condylar process of the lower jaw was found much more often than any other localization, especially in the destructive process of the cartilaginous component in 20 patients (60.6%). According to MSCT data, the size of the joint space before and after the treatment was modernized: in the anterior section from 1.761.8 to 3.08.51.5 mm; in the middle section from 1.181.7 to 1.862.5mm after treatment and in the back section from 0.802.5 to 3.421.3mm after treatment In the absence of violations of the integrity of the dentition and trauma in the anamnesis in 25 patients (75.7%), a predominance of the active function of the masticatory muscles on the leading side was noted. According to MRI data, the volumetric characteristics of the lateral pterygoid muscles before and after treatment ranged from 17.81.9 to 15.12.5 mm; medial pterygoid muscles from 13.351.5 to 11.211.5 mm and the masticatory muscles proper from 18.531.5 to 14.221.6 mm. A statistically significant increase in the volumetric parameters (thickness) of the masticatory muscles in 25 patients (75.7%) indicates a functional overload of the masticatory apparatus, since the volumetric characteristics of the studied muscles became comparable with the data of the control group (n=6; 16,8%) after the treatment. Changes in the parameters of the articular disc, MRI studies revealed the following changes before and after the treatment: in the anterior region from 2.32.6 to 2.72.7 mm, in the central region from P 1 - I.M. Sechenov First Moscow State Medical University (Sechenov University). Moscow, Russia. 2 - Tver State Medical University. Tver, Russia. RUSSIAN ELECTRONIC JOURNAL OF RADIOLOGY | www.rejr.ru | REJR. 2021; 11 (1):88-102 DOI: 10.21569/2222-7415-2021-11-1-88-102 Страница 90 0.52,9 to 1.91.7 mm, in the posterior section from 3.22.7 to 4.32.1 mm. Bone density indicators of patients (n = 31; 100.0%) varied from +234.55.8 HU (in group III) to +565.55.9 HU (in group I) during the primary study, which made it possible to differentiate the severity of osteoporotic changes in bone tissue to correct the treatment. Conclusion. The use of highly informative methods of radiological diagnostics (MSCT, MRI) in patients with TMJ dysfunction is an integral part both at the stage of initial consultation and after treatment.

The Impact of COVID-19 Pandemic on Cancer Care in a Tertiary Care Facility.

Background Coronavirus disease 2019 (COVID-19) pandemic had an overwhelming impact on health care worldwide. Cancer patients represent a subgroup that is vulnerable and is under high risk. It is, therefore, necessary to analyze factors that predict outcomes in these patients so that they can be triaged accordingly to mitigate the effects of COVID-19 on cancer management. To date, the impact of COVID-19 on cancer patients remain largely unknown. Methods Data of 291 cancer patients undergoing active treatment from March 23 to August 15, 2020 were retrospectively reviewed; the incidence, demographic and clinical characteristics, treatment, and outcomes of cancer patients infected by COVID-19 were included in the analysis. Discussion During the index period (March 23–August 15, 2020), 4,494 confirmed cases of COVID-19 were admitted at our institute. In the department of medical oncology out of 578 patients presented to outpatient department, 291 patients were admitted for active treatment. Considering the cancer patients, infection rate was 7.9% (23/291) and mortality 13% (3/23). Median age was 40 years and the majority of patients were male (60%). The most common cancer type was acute lymphoblastic leukemia presented at various stages of treatment. Twenty patients (86.9%) were discharged after full clinical recovery and negative real-time polymerase chain reaction on a nasopharyngeal swab. Anticancer treatment was modified according to the type of cancer under intensive surveillance. Conclusion Although mortality rate in COVID-19 cancer patients is elevated, our results support the feasibility and safety of continuing anticancer treatment during pandemic by endorsing consistent preventive measures, but however should be modified based on the type and prognosis of cancer.

Attitudes toward physical activity as a treatment component for adolescents with anorexia nervosa: An exploratory qualitative study of patient perceptions.

Anorexia nervosa (AN) with compulsive exercise is associated with poor treatment outcomes. This study sought to understand the attitudes of adolescents with AN from various stages of treatment, toward physical activity research practices and physical activity as a component of treatment. Seventeen adolescents 12-18 years old (15 female) with AN (10 with acknowledged history of compulsive exercise) were recruited from a Canadian Tertiary Care Hospital's Eating Disorder Program. Six inpatients, 5-day program patients, and six outpatients treated by either the inpatient and/or day treatment program in the past 2 years completed individual, semi-structured interviews that were audio-recorded and transcribed. Results were analyzed deductively using qualitative techniques. Participants recognized both benefits (psychological, sociological, and physiological) and risks (trigger negative thoughts, increase competitive behavior) of implementing physical activity into acute AN treatment. Patient characteristics, such as stage of treatment and exercise history, had an impact on participants' perceptions toward physical activity in AN. Participants suggested that the ideal physical activity program would be focused on fun, individualized and progressively integrated, group-based, and directly supported by staff. Although the majority of participants stated that they would wear an activity monitor for research purposes, concerns were voiced regarding compliance and the potential impact on eating disorder symptomatology. Participants overwhelmingly supported the careful implementation of structured physical activity and physical activity psychoeducation into the acute treatment of adolescents with AN. This study allows for the inclusion of patient voices in the conversation surrounding the role of physical activity in AN treatment.

Patient reported outcome measures among patients with vulvar cancer at various stages of treatment, recurrence, and survivorship

ObjectiveOur goal was to pragmatically describe patient reported outcomes (PROs) in a typical clinic population of vulvar cancer patients, as prior studies of vulvar cancer PROs have examined clinical trial participants. MethodsA prospective PRO program was implemented in the Gynecologic Oncology clinic of a tertiary academic institution in January 2018. Vulvar cancer patients through September 2019 were administered the European Organization for the Research and Treatment of Cancer Quality of life Questionnaire, the Patient Reported Outcome Measurement Information System Instrumental and Emotional Support Scales, and the Functional Assessment of Cancer Therapy-Vulvar questionnaire. Binary logistic regressions were performed to determine adjusted odds ratios for adverse responses to individual questions by insurance, stage, age, time since diagnosis, recurrence, radiation, and surgical radicality. ResultsSeventy vulvar cancer patients responded to PROs (85.4% response rate). Seventy-one percent were > 1 year since diagnosis, 61.4% had stage I disease, and 28.6% recurred. Publicly insured women had less support and worse quality of life (QOL, aOR 4.15, 95% CI 1.00–17.32, p = 0.05). Women who recurred noted more interference with social activities (aOR 4.45, 95% CI 1.28–15.41, p = 0.019) and poorer QOL (aOR 5.22 95% CI 1.51–18.10, p = 0.009). There were no major differences by surgical radicality. Those >1 year since diagnosis experienced less worry (aOR 0.17, 95% CI 0.04–0.63, p = 0.008). ConclusionsSurgical radicality does not affect symptoms or QOL in vulvar cancer patients, whereas insurance, recurrence, and time since diagnosis do. This data can improve counseling and awareness of patient characteristics that would benefit from social services referral.

Differentiating “types” of treatment dropout: Nonstarters in an RCT of prolonged exposure versus sertraline

Despite effective interventions for posttraumatic stress disorder (PTSD), many patients prematurely drop out. Differentiating “types” of dropout at various stages of treatment may improve our ability to predict and prevent attrition. Using data from a doubly randomized preference trial, this study examined patient dropout prior to treatment and compared these “nonstarters” with treatment starters and in-treatment dropouts. Patients (N = 200) with chronic PTSD were randomized to “choice” (prolonged exposure [PE] or sertraline) or “no choice” (re-randomized to PE or sertraline) and received up to 10 weeks of treatment. Overall dropout rate was 33.0% (n = 66). A substantial minority were nonstarters (n = 19; 28.8%). Relative to patients who began treatment, nonstarters reported less severe PTSD symptomatology (p = .03, d = 0.57) and were less likely to have received their preferred treatment (p < .001). These differences remained even when comparing nonstarters to patients that began treatment but eventually dropped out. Differences in beliefs (i.e., perceived credibility) toward one treatment versus the other were also linked to pretreatment dropout. Reasons underlying dropout likely differ during various treatment stages. Better understanding risk factors for types of dropout may inform strategies to boost engagement and retention, ultimately improving patient outcomes.

Heavy Metals in Wastewater and Sewage Sludge from Selected Municipal Treatment Plants in Eastern Cape Province, South Africa

This study assessed the distribution of five heavy metals (Cd, Pb, Cu, Zn, and Fe) across the various stages of treatment in three selected sewage treatment facilities and their receiving waterbodies in the Eastern Cape Province, South Africa. Aqueous and solid (sludge) samples were collected monthly from September 2015 to February 2016. Quantitation was achieved by atomic absorption spectrometry after necessary sample preparations. Concentrations of heavy metal cations in the sludge generally varied from &lt;DL (below detection limit) to 1.17 mg kg−1, &lt;DL to 0.14 mg kg−1, 27.588 to 69.789 mg kg−1, and &lt;DL to 0.099 mg kg−1 for Cu, Cd, Fe and Pb; while Zn was below detection all through. Similarly, the levels of Cu, Cd, and Fe in the influents, effluents, upstream and downstream across the three plants ranged from &lt;DL–6.588 mg L−1, &lt;DL–0.636 mg L−1, &lt;DL–0.878 mg L−1 and &lt;DL–0.711 mg L−1, respectively; Zn and Pb were less than DL in all the matrices and study locations. All the contaminants were below hazardous levels in all the sludge and aqueous samples except Cd which was higher in effluents and surface waters across the board. Wastewater Treatment Plant (WWTP)-A exhibited better removal capacity for Fe (86.6%), compared to WWTP-B (34.7%) and WWTP-C (56.9%). However, the removal of Cu and Zn was very poor in all the treatment facilities studied. Carcinogenic and non-carcinogenic risks evaluated were sufficiently low. This suggests that the levels of contamination, even with respect to Cd, was minimal. Nevertheless, efforts should be made to keep the concentrations of these contaminants at levels safe for humans and aquatic organisms. Furthermore, the use of the effluents from these facilities for irrigation should be discouraged to prevent unnecessary build-up of metals in the soil and plants grown with such, as well as subsequent bioaccumulation and biomagnification in the food chain.

Characteristics of Malignant Pleural Effusion Resident CD8+ T Cells from a Heterogeneous Collection of Tumors.

While T cell-based cancer immunotherapies have shown great promise, there remains a need to understand how individual metastatic tumor environments impart local T cell dysfunction. At advanced stages, cancers that metastasize to the pleural space can result in a malignant pleural effusion (MPE) that harbors abundant tumor and immune cells, often exceeding 108 leukocytes per liter. Unlike other metastatic sites, MPEs are readily and repeatedly accessible via indwelling catheters, providing an opportunity to study the interface between tumor dynamics and immunity. In the current study, we examined CD8+ T cells within MPEs collected from patients with heterogeneous primary tumors and at various stages in treatment to determine (1) if these cells possess anti-tumor activity following removal from the MPE, (2) factors in the MPE that may contribute to their dysfunction, and (3) the phenotypic changes in T cell populations that occur following ex vivo expansion. Co-cultures of CD8+ T cells with autologous CD45― tumor containing cells demonstrated cytotoxicity (p = 0.030) and IFNγ production (p = 0.003) that inversely correlated with percent of myeloid derived suppressor cells, lactate, and lactate dehydrogenase (LDH) within the MPE. Ex vivo expansion of CD8+ T cells resulted in progressive differentiation marked by distinct populations expressing decreased CD45RA, CCR7, CD127, and increased inhibitory receptors. These findings suggest that MPEs may be a source of tumor-reactive T cells and that the cellular and acellular components suppress optimal function.

Psycho-Oncological Aspects of the Functioning of Women Who Have Breast Cancer: Discussion of the Author’s Research

Breast cancer interferes with the emotional sphere of a woman, causes body distortion and permanent disability, and evokes strong negative emotional reactions, such as anxiety, the feeling of insecurity, and anxiety. Also, during and after treatment, women experience not only persistent damage in the psyche but also intimate sensations. The study aimed to assess the quality, acceptance, life satisfaction and depression, and pain of women treated for breast cancer. Evaluation of the impact of the disease on emotional life and ways of dealing with it, among others, using unconventional methods. The studies involved a total of 573 women aged 30 to 79 years of age, suffering from breast cancer at its various stages of treatment. Women with severe comorbidities, BMI&gt; 30 and other cancers were excluded from the study. The approval of the Bioethical Commission of Collegium Medicum of the Nicolaus Copernicus University in Toruń was obtained for all the tests. The study used psychometric tests: Quality of Life questionnaire QLQ-C 30 and the QLQ BR-23, Acceptance of Illness Scale (AIS), Beck Depression Self-Assessment Scale, Hospital Anxiety and Depression (HAD) Scale of Mental Adaptation to cancer (Mini Mac). The research drew important conclusions and practical implications regarding care for patients with breast cancer. Psychological support is necessary for multi-disciplinary proceedings, not only women, but also persons accompanying the disease. Such a procedure enables the proper course of the treatment process for patients with breast cancer. Research on coping with the disease including pain, depression, adjusting to life in this difficult situation, among others, may affect the outcome. Active struggle with the disease affects the alleviation of ailments and improving the quality of life.

How to live with a meningioma: experiences, symptoms, and challenges reported by patients.

BackgroundWe aimed to explore gaps in the care of meningioma patients that could improve quality of care by better understanding symptoms experienced by patients at various stages of treatment, and afterwards.MethodsA novel 19-item self-administered questionnaire was provided for patients with meningiomas to complete by the American Brain Tumor Association (ABTA) over a 3-month period.ResultsA total of 1852 unique respondents were included. Nearly one-third of all respondents felt they received insufficient information about meningiomas at initial diagnosis (N = 607, 32.9%) and 28.8% (N = 530) believed they received insufficient information about treatment options. In fact, 34.5% of respondents received the majority of their information from the internet and nonhealthcare professionals. The most common concerns after initial diagnosis were risks associated with surgery and/or treatment (36.5%) followed by how the tumor would impact daily life (25%) and the risk of tumor recurrence (12.4%). Respondents indicated that a list of resources available for patients with meningiomas (N = 597, 32.3%) would have been most beneficial in regards to their disease experience after their initial diagnosis. Moreover, we found that a substantial proportion of patients continued to report symptoms long after treatment, with fatigue being the most common compared to before treatment (38.2% vs. 57.7%, χ2 = 128, P < .001).ConclusionsPatients with meningiomas exhibit symptoms that continue well after treatment with fatigue and cognitive impairments as the most bothersome. Moreover, patients report key communication gaps that can be addressed to improve their disease experience and care.

Effectiveness of comprehensive oral care on Bradburn scale of psychological well-being among young adult smokers and tobacco chewers: A prospective clinical study

Aim: To assess the benefits of comprehensive oral care in improving the psychological well-being of young adult smokers and tobacco chewers. Materials and Methods: A prospective, clinical study of 60 young adult smokers/tobacco chewers or both were carried out. This study was conducted to assess the psychological well-being at the first dental visit, and then after the completion of comprehensive oral care using Bradburn scale of psychological well-being (Affect Balance Scale). Comprehensive oral care included oral prophylaxis, simple restorative care, preventive procedures, and health education. Health education was given before the appointment, during the stage of diagnosis and treatment planning, in the operatory during the various stages of treatment. Results: A total of 60 males were participated in this clinical study, with a minimum age of 18 years to the maximum age of 25 years. A total of 20 (33.3%) were using both smokeless and smoking tobacco. The majority of them were school educated (74%) and semi-skilled (86%). The overall oral hygiene status was fair. The mean decayed, missing, and filled teeth (DMFT) ranged from 0 to 9. The Bradburn scale of psychological well-being score was 1.55 ± 2.54 at the first visit to the dentist and after completing the comprehensive oral care there was an improvement in the score (3.20 ± 1.29). This was statistically significant. Conclusion: This study findings showed improvement in the psychological well-being of young adult smokers and tobacco chewers after the completion of comprehensive oral care.

Empowering Patients in Integrated Behavioral Health-Care Settings: A Narrative Approach to Medical Family Therapy

Integrated behavioral health care (IBHC) provides patient-centered care, which assures full considerations of patients’ needs and promotes patients having a voice in decisions about their own health care. In this article, we consider narrative therapy as an empowering, nonpathologizing, and collaborative approach for medical family therapists and behavioral health practitioners to better help patients, families, and health-care systems in IBHC settings. Clinical examples are provided for effectively utilizing narrative therapy in IBHC settings across various stages of treatment. Using narrative medical family therapy informed by cultural humility, therapists can empower patients, help them reauthor their story through the lens of their experience, and validate their worldviews.

ПРИМЕНЕНИЕ РЕЧЕВОГО ПАСПОРТА В РЕАБИЛИТАЦИИ ДЕТЕЙ С ВРОЖДЕННЫМИ ЧЕЛЮСТНО-ЛИЦЕВЫМИ ПОРОКАМИ РАЗВИТИЯ

Subject. The article describes the child's speech passport, as one of the important mechanisms of the rehabilitation and speech recovery in children with congenital cleft lip and palate.&#x0D; Purpose of the study ― evaluation of the treatment outcome in children with cleft palate with the use of a speech passport at the stage of rehabilitation. &#x0D; Materials and methods. The article presents the experience of the rehabilitation of more than 2,000 patients with congenital maxillofacial defects from 1998 to 2017.&#x0D; Results. The features of speech development were studied in 93 patients divided into two groups. The main group consisted of 56 people, in whom the definition of the algorithm of medical and logopedic aid was carried out using a speech passport, then the rehabilitation measures complex developed by us for restoring and correcting the speech function was applied. The control group included 37 people: patients who did not receive medical and speech therapy in the postoperative period, and patients who underwent rehabilitation measures in outpatient clinic at the place of residence. The speech activity indicators in patients of the compared groups had significant differences (p = 0,026), due to a more pronounced positive dynamics of speech activity recovery in the main group - the percentage of patients increased 3,6 times ― from 17,9 to 64,3 %, while in the control group the rate increased only 1,9 times ― from 21,6 up to 40,5 %.&#x0D; Conclusion. The developed speech passport involves a multidisciplinary approach to the child, early detection, treatment and rehabilitation. It is also can be defined as a link between health care, speech therapy and pedagogy. The child's speech passport data can be filled by a pediatrician, neurologist, maxillofacial surgeon, orthodontist, speech therapist and speech therapist defectologist at various stages of treatment and rehabilitation.