RESUMEN
Symptomatology of malignant intrabronchial obstructions has a serious negative effect on the quality of patients' life. Intrabronchial brachytherapy can play an important role in the palliation of these symptoms. Between December 1996 and September 1998 48 patients suffering from malignant intrabronchial obstructions were treated with intraluminal brachytherapy in the Dept. of Radiation Oncology at the University Maternity Hospital in Brno. Gammamed HDR automatical afterloading equipment was used to treat all patients. The first group (23 patients) was treated with a combination of intraluminal brachytherapy and external radiotherapy. The second group (18 patients who had relapsed after previous external radiotherapy) was given intraluminal radiotherapy only. A third group (7 patients) underwent intraluminal brachytherapy only. In the first group 17 patients (77%) showed symptomatic relief with tumor regression on X-ray in 16 patients and with bronchoscopic regression in 19 patients. Seven patients died before October 1998 having survived 1-6 months after the first brachytherapy application. Sixteen patients are still alive (1-14 months). In the second group, 10 patients (56%) reported significant improvement of symptoms, with endoscopic regression in 12 patients. Twelve patients died before October 1998 surviving 1-6 months after the first brachytherapy session, 6 patients are still alive 1-5 months after the first brachytherapy fraction. In the third group, bronchoscopy confirmed a complete disappearance of intrabronchial lesion in two cases with early intrabronchial tumor. Five patients reported symptomatic improvement with endoscopic regression of the tumor. There was only one complication recorded: bronchospasm in one patient. The short follow up and limited number of patients does not allow comment on the late effects and survival, yet. In conclusion, intraluminal brachytherapy is an effective and safe approach for palliation of malignant bronchial obstructions.
Asunto(s)
Obstrucción de las Vías Aéreas/radioterapia , Braquiterapia , Neoplasias de los Bronquios/radioterapia , Cuidados Paliativos , Obstrucción de las Vías Aéreas/etiología , Obstrucción de las Vías Aéreas/mortalidad , Neoplasias de los Bronquios/complicaciones , Neoplasias de los Bronquios/mortalidad , República Checa , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cuidados Paliativos/métodos , Índice de Severidad de la Enfermedad , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
We examined the prevalence of depression after burn injury in 139 adults treated at a major burn center. Interviews were held from one to eight years following the burn. Our subsample, taken from 882 patients treated over a six-year period, comprised all patients with 30% total body surface area burns and a random sample of those with burns of lesser severity. We considered 17 possible predictors of depression (including the severity and placement of the burn and the patient's age, educational background, medical history, employment status, income level, and emotional and psychiatric history). We found that it is the person, rather than the injury, that best predicts postburn depression. The factor most strongly linked with depression was a past history of emotional disturbance. However, after being burned, a significant number of even previously well-adjusted patients show clinical postburn depression.
Asunto(s)
Trastornos de Adaptación/epidemiología , Quemaduras/psicología , Depresión/epidemiología , Trastornos de Adaptación/etiología , Adolescente , Adulto , Depresión/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores SocioeconómicosRESUMEN
This study attempted to determine whether the number of routine laboratory screening tests done on elderly psychiatric patients on admission to the hospital could be reduced without compromising patient care. It was found that the admitting doctor underestimated the number of tests that would yield abnormal results. It is not recommended that these tests be done on a discretionary basis.
Asunto(s)
Pruebas Diagnósticas de Rutina/economía , Hospitalización/economía , Trastornos Mentales/diagnóstico , Factores de Edad , Anciano , Control de Costos , Demencia/complicaciones , Demencia/diagnóstico , Femenino , Humanos , Masculino , Trastornos Mentales/complicaciones , Persona de Mediana Edad , Probabilidad , PsiquiatríaRESUMEN
The usefulness of routine laboratory tests was examined in elderly psychiatric patients upon admission to the hospital. Only 6 of the 20 tests required for each patient led to the detection and treatment of an illness; these "useful" tests accounted for only 1.4% of all tests done. Methods by which the usefulness of the screening protocol might be improved are discussed.