Doctor, I am sweating on just one side of my body: unilateral hyperhidrosis associated with mesothelioma.
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ABSTRACT:
SUBMITTER: Waran E
PROVIDER: S-EPMC4856255 | biostudies-other | 2016 May
REPOSITORIES: biostudies-other
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Project description:BackgroundFamily caregiving is common globally, but when a family member needs palliative and end-of-life care, this requires knowledge and expertise in dealing with symptoms, medication, and treatment side effects. Caring for a family member with advanced prostate cancer in the home presents practical and emotional challenges, especially in resource-poor contexts, where there are increasing palliative cases without adequate palliative care institutions.AimThe study explored palliative and end-of-life care experiences of family caregivers and patients living at home in a resource-poor context in Ghana.DesignThis is a qualitative study using thematic analysis of face-to-face interviews at two-time points.ParticipantsMen living with advanced prostate cancer (n = 23), family caregivers (n = 23), healthcare professionals (n = 12).FindingsMen with advanced prostate cancer face complex issues, including lack of access to professional care and a lack of resources for homecare. Family caregivers do not have easy access to professional support; they often have limited knowledge of disease progression. Patients have inadequate access to medication and other practical resources for homecare. Caregivers may be overburdened and perform the role of the patient's 'doctor' at home-assessing patient's symptoms, administering drugs, and providing hands-on care.ConclusionHome-based care is promoted as an ideal and cost-effective model of care, particularly in Westernised palliative care models. However, in resource-poor contexts, there are significant challenges associated with the implementation of this model. This study revealed the scale of challenges family caregivers, who lack basic training on aspects of caring, face in providing home care unsupported by healthcare professionals.
| S-EPMC7797613 | biostudies-literature
Project description:Malignant pleural mesothelioma (MPM), which is associated with occupational asbestos exposure, is a deadly disease with no effective treatments due mainly to its high resistance to anti-cancer drugs. The molecular mechanisms responsible for its chemotherapeutic resistance are complicated and undefined. However, the presence of side population cells (SP cells) in tumors is a well-accepted explanation for their anti-cancer drug resistance. To identify SP cell-specific gene expression signature, microarray technique has been employed. Our data show differential gene expression profiles between SP and non-SP cells of H2714 mesothelioma cells. SP cells over-expressed genes associated with cancer stem cell (CSC) and drug resistance: DUSP6, SPRY2 and IL6, as well as multi-pathways, including the cancer stem cell-associated pathways Notch and c-Kit. Therefore, we believe that targeting CSC-specific genes and pathways in SP cells may hold the key to the discovery of effective treatments for reversing chemotherapeutic resistance to MPM treatment.
2011-11-18 | GSE33734 | GEO
Project description:When a rubber hand is placed on a table top in a plausible position as if part of a person's body, and is stroked synchronously with the person's corresponding hidden real hand, an illusion of ownership over the rubber hand can occur (Botvinick and Cohen 1998). A similar result has been found with respect to a virtual hand portrayed in a virtual environment, a virtual hand illusion (Slater et al. 2008). The conditions under which these illusions occur have been the subject of considerable study. Here we exploited the flexibility of virtual reality to examine four contributory factors: visuo-tactile synchrony while stroking the virtual and the real arms, body continuity, alignment between the real and virtual arms, and the distance between them. We carried out three experiments on a total of 32 participants where these factors were varied. The results show that the subjective illusion of ownership over the virtual arm and the time to evoke this illusion are highly dependent on synchronous visuo-tactile stimulation and on connectivity of the virtual arm with the rest of the virtual body. The alignment between the real and virtual arms and the distance between these were less important. It was found that proprioceptive drift was not a sensitive measure of the illusion, but was only related to the distance between the real and virtual arms.
| S-EPMC4079845 | biostudies-other
Project description:OBJECTIVE: To describe the initial impact of an organizational policy change on measurement of physician non-English language proficiency. STUDY SETTING: Multispecialty health care organization in the San Francisco Bay Area. STUDY DESIGN/DATA COLLECTION: In response to preliminary findings suggesting that the organization's nonvalidated and undefined three-category tool for physician self-report of non-English language proficiency levels was likely inadequate, the organization asked physicians to rate their non-English language proficiency levels using an adapted Interagency Language Roundtable (ILR) scale, a validated measure with five rating levels and descriptors. We then compared the self-reported language proficiency on the original scale and the ILR for those physicians who completed both and used regression analysis to investigate physician characteristics potentially associated with a change in score on the old versus ILR scales. PRINCIPAL FINDINGS: Six months after the ILR scale was implemented throughout the organization, 75 percent (258/342) of physicians had updated their language proficiency ratings. Among clinicians who had previously rated themselves in the "Medical/Conversational" category, there were substantial variations in scores using the ILR scale. Physicians who spoke two or more non-English languages were significantly more likely to lower their self-reported proficiency when updating from the old scale to the ILR scale. CONCLUSIONS: The organization was willing to adopt a relatively straightforward change in how data were collected and presented to patients based on the face validity of initial findings. This organizational policy change appeared to improve how self-reported physician language proficiency was characterized.
| S-EPMC3393012 | biostudies-other
Project description:BACKGROUND: Studies have shown that a large portion of patient satisfaction is related to physician care, especially when the patient can identify the role of the physician on the team. Because patients encounter multiple physicians in teaching hospitals, it is often difficult to determine who the patient feels is his or her main caregiver. Surveys evaluating resident physicians would help to improve patient satisfaction but are not currently implemented at most medical institutions. INTERVENTION: We created a survey to judge patient satisfaction and to determine who patients believe is their "main physician" on the teaching service. METHODS: Patients on a medical teaching service at The Miriam Hospital during 20 days in March 2008 were asked to complete the survey. A physician involved in the research project administered the surveys. Surveys included 3 questions that judged patient's perception and identification of their primary physician and 7 questions regarding patient satisfaction. Completed surveys were analyzed using averages. RESULTS: Of the 126 patients identified for participation, 102 (81%) completed the survey. Most patients identified the intern (first-year resident) as their main physician. Overall, more than 90% of patients expressed satisfaction with their main physician. CONCLUSION: Most patients on the teaching service perceived the intern as their main physician and were satisfied with their physician's care. One likely reason is that interns spend the greatest amount of time with patients on the teaching service.
| S-EPMC2930311 | biostudies-other
Project description:Malignant pleural mesothelioma (MPM), which is associated with occupational asbestos exposure, is a deadly disease with no effective treatments due mainly to its high resistance to anti-cancer drugs. The molecular mechanisms responsible for its chemotherapeutic resistance are complicated and undefined. However, the presence of side population cells (SP cells) in tumors is a well-accepted explanation for their anti-cancer drug resistance. To identify SP cell-specific gene expression signature, microarray technique has been employed. Our data show differential gene expression profiles between SP and non-SP cells of H2714 mesothelioma cells. SP cells over-expressed genes associated with cancer stem cell (CSC) and drug resistance: DUSP6, SPRY2 and IL6, as well as multi-pathways, including the cancer stem cell-associated pathways Notch and c-Kit. Therefore, we believe that targeting CSC-specific genes and pathways in SP cells may hold the key to the discovery of effective treatments for reversing chemotherapeutic resistance to MPM treatment. 4 samples
2011-11-18 | E-GEOD-33734 | biostudies-arrayexpress
Project description:IntroductionThe transition for being a medical student to a full functioning intern is accompanied by considerable stress and sense of unpreparedness. Simulation based workshops were previously reported to be effective in improving the readiness of interns and residents to their daily needed skills but only few programs were implemented on a large scale.MethodsA nationally endorsed and mandated pre-internship simulation based workshop is reported. We hypothesized that this intervention will have a meaningful and sustained impact on trainees' perception of their readiness to internship with regard to patient safety and quality of care skills. Main outcome measure was the workshop's contribution to professional training in general and to critical skills and error prevention in particular, as perceived by participants.ResultsBetween 2004 and 2011, 85 workshops were conducted for a total of 4,172 trainees. Eight-hundred and six of the 2,700 participants approached by e-mail, returned feedback evaluation forms, which were analyzed. Eighty five percent of trainees perceived the workshop as an essential component of their professional training, and 87% agreed it should be mandatory. These ratings peaked during internship and were generally sustained 3 years following the workshop. Contribution to emergency care skills was especially highly ranked (83%).ConclusionImplementation of a mandatory, simulation-based, pre-internship workshop on a national scale made a significant perceived impact on interns and residents. The sustained impact should encourage adopting this approach to facilitate the student to doctor transition.
| S-EPMC4774927 | biostudies-literature
Project description:Background: Approximately one-half of cervical cancer cases in the United States occur in underscreened or never-screened women. We examined predictors to completing Papanicolaou (Pap) testing and whether a positive human papillomavirus (HPV) self-collection result affects Pap testing adherence among underscreened women. Materials and Methods: Low-income women aged 30-65 years who reported no Pap testing in ?4 years were recruited in North Carolina. Knowledge, attitudes, and barriers regarding cervical cancer and Pap testing were assessed by telephone questionnaires. We mailed self-collection kits for HPV testing and provided information regarding where to obtain affordable Pap testing. Participants received $45 for completing all activities. We used multivariable logistic regression to assess the predictors of longer reported time since last Pap (?10 vs. 4-9 years) and of completion of Pap testing following study enrollment (follow-up Pap). Results: Participants (n?=?230) were primarily black (55%), uninsured (64%), and with ?high school education (59%). Cost and finding an affordable clinic were the most commonly reported barriers to screening. White women and those with ?high school education reported longer intervals since last Pap test. Half of the participants reported completing a follow-up Pap test (55%). Women with a positive HPV self-collection were five times more likely to report completing a follow-up Pap test than those with negative self-collection (odds ratio?=?5.1, 95% confidence interval 1.4-25.7). Conclusions: Improving awareness of resources for affordable screening could increase cervical cancer screening in underserved women. Home-based HPV self-collection represents an opportunity to re-engage infrequently screened women into preventive screening services.
| S-EPMC6703237 | biostudies-literature
Project description:PURPOSETo describe a series of patients with molecularly confirmed mutation in BEST1 causing Best disease but with unilateral clinical manifestation.DESIGNRetrospective observational case series.METHODSSETTINGMoorfields Eye Hospital and Great Ormond Street Hospital, London (United Kingdom).PATIENTSFive patients (10 eyes) with uniocular manifestation of BEST1 mutation causing Best disease were ascertained retrospectively from the clinical and genetic databases.MAIN OUTCOME MEASURESPatients had full ophthalmologic examination, color fundus photography, fundus autofluorescence imaging, spectral-domain optical coherence tomography, and detailed electrophysiological assessment. Genetic testing was performed.RESULTSAll cases had a clinical appearance typical of and consistent with Best disease at various stages, except that the presentation was unilateral. The reduced electrooculogram light rise was bilateral and in the context of normal electroretinograms therefore indicates generalized dysfunction at the level of the retinal pigment epithelium.CONCLUSIONSMutation in BEST1 has variable penetrance and expressivity, and can be uniocular. The clinical and electrophysiological features described assist targeted mutational screening and alert to the potential diagnosis even when there is an atypical unilateral presentation.
| S-EPMC5016077 | biostudies-literature
Project description: Not available
| S-EPMC5958933 | biostudies-literature