Browsing by Subject "treatment"

Now showing 1 - 6 of 6
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    Challenges in the diagnosis and treatment of depression in autism spectrum disorders across the lifespan.
    (Dialogues Clin Neurosci, 2015-06) Chandrasekhar, Tara; Sikich, Linmarie
    Diagnosis and treatment of comorbid neuropsychiatric illness is often a secondary focus of treatment in individuals with autism spectrum disorder (ASD), given that substantial impairment may be caused by core symptoms of ASD itself. However, psychiatric comorbidities, including depressive disorders, are common and frequently result in additional functional impairment, treatment costs, and burden on caregivers. Clinicians may struggle to appropriately diagnose depression in ASD due to communication deficits, atypical presentation of depression in ASD, and lack of standardized diagnostic tools. Specific risk and resilience factors for depression in ASD across the lifespan, including level of functioning, age, family history, and coping style, have been suggested, but require further study. Treatment with medications or psychotherapy may be beneficial, though more research is required to establish guidelines for management of symptoms. This review will describe typical presentations of depression in individuals with ASD, review current information on the prevalence, assessment, and treatment of comorbid depression in individuals with ASD, and identify important research gaps.
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    Endobronchial metastasis from primary anorectal melanoma.
    (The American journal of case reports, 2013-01) Heyman, Benjamin M; Chung, Matthew M; Lark, Amy L; Shofer, Scott
    PATIENT: Male, 64 FINAL DIAGNOSIS: Metastatic anorectal melanoma with endotracheal metastasis Symptoms: Fatigue • weight loss • hematochezia • cough MEDICATION: None Clinical Procedure: Biopsy of anal mass • rigid bronchoscopy Specialty: Internal medicine • oncology • pulmonology. OBJECTIVE: Rare disease. BACKGROUND: Anorectal melanoma is a rare cancer with a poor prognosis. The mean survival after diagnosis is 15-25 months. At the time of diagnosis, 61% of patients have local regional lymph node metastases, and 21% have distant metastases. The lungs are a common site for metastasis for all tumors including melanoma. However endobronchial metastasis is a rare phenomenon. Endotracheal metastases are even rarer, occurring in only 5% of patients with extrapulmonary endobronchial metastases. It is most commonly seen in breast, colorectal, and kidney cancers. It is extremely rare for cutaneous melanoma. The mean survival after diagnosis is only 15 months and treatment options are limited. CASE REPORT: We report the case of a 64 year-old gentleman with newly diagnosed metastatic anorectal melanoma. A 3 cm by 3 cm bluish-black, oval-shaped, exophytic mass protruding from his anus was found on physical exam. Endobronchial and endotracheal metastasis to the trachea were discovered on computed tomography and he was subsequently taken to the operating room for argon plasma coagulation laser recanalization of his trachea via rigid bronchoscopy, and resection of his anal mass. CONCLUSIONS: We have presented the first known case of anorectal melanoma with endobronchial metastasis. Palliative APC laser recanalization was used to prevent asphyxiation from the endotracheal mass. Endobronchial metastasis is uncommon and can be easily mistaken for primary bronchogenic carcinoma. It should always be considered when evaluating patients with new lung masses.
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    Extended-release ranolazine: critical evaluation of its use in stable angina.
    (Vasc Health Risk Manag, 2011) Truffa, Adriano Am; Newby, L Kristin; Melloni, Chiara
    Coronary heart disease is the major cause of morbidity and mortality throughout the world, and is responsible for approximately one of every six deaths in the US. Angina pectoris is a clinical syndrome characterized by discomfort, typically in the chest, neck, chin, or left arm, induced by physical exertion, emotional stress, or cold, and relieved by rest or nitroglycerin. The main goals of treatment of stable angina pectoris are to improve quality of life by reducing the severity and/or frequency of symptoms, to increase functional capacity, and to improve prognosis. Ranolazine is a recently developed antianginal with unique methods of action. In this paper, we review the pharmacology of ranolazine, clinical trials supporting its approval for clinical use, and studies of its quality of life benefits. We conclude that ranolazine has been shown to be a reasonable and safe option for patients who have refractory ischemic symptoms despite the use of standard medications (for example, nitrates, beta-adrenergic receptor antagonists, and calcium channel antagonists) for treatment of anginal symptoms, and also provides a modestly improved quality of life.
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    Fungal Endocarditis: Pathophysiology, Epidemiology, Clinical Presentation, Diagnosis, and Management.
    (Clinical microbiology reviews, 2023-07) Thompson, George R; Jenks, Jeffrey D; Baddley, John W; Lewis, James S; Egger, Matthias; Schwartz, Ilan S; Boyer, Johannes; Patterson, Thomas F; Chen, Sharon C-A; Pappas, Peter G; Hoenigl, Martin
    Fungal endocarditis accounts for 1% to 3% of all infective endocarditis cases, is associated with high morbidity and mortality (>70%), and presents numerous challenges during clinical care. Candida spp. are the most common causes of fungal endocarditis, implicated in over 50% of cases, followed by Aspergillus and Histoplasma spp. Important risk factors for fungal endocarditis include prosthetic valves, prior heart surgery, and injection drug use. The signs and symptoms of fungal endocarditis are nonspecific, and a high degree of clinical suspicion coupled with the judicious use of diagnostic tests is required for diagnosis. In addition to microbiological diagnostics (e.g., blood culture for Candida spp. or galactomannan testing and PCR for Aspergillus spp.), echocardiography remains critical for evaluation of potential infective endocarditis, although radionuclide imaging modalities such as 18F-fluorodeoxyglucose positron emission tomography/computed tomography are increasingly being used. A multimodal treatment approach is necessary: surgery is usually required and should be accompanied by long-term systemic antifungal therapy, such as echinocandin therapy for Candida endocarditis or voriconazole therapy for Aspergillus endocarditis.
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    “The Knowledgeable Prosthetic Limb User: Treatment Techniques for Occupational Therapists.“
    (2008) Butkus, Josef
    The most important skill an occupational therapist can give an adult upper extremity prosthetic user is the confidence that the prosthetic limb can help them efficiently perform any task they encounter. Ultimately, the client will decide how they wish to use his or her new prosthetic limb, but for a brief time the occupational therapist plays an important role in educating and coaching the client. It is the therapist's role to expose clients to the full range of methods that they can use their new arm for functional tasks and to facilitate good problem solving skills. Having limited treatment time, it is crucial that treatment is efficient and focused on what will benefit the client most. When someone is learning a new skill, he or she tends to seek as much assistance as available and transitioning someone to independent analysis and refinement of performance is challenging. Clients who demonstrate good problem solving skills and understand task demands are more inclined to translate these clinical skills into functional tasks and fully integrate the prosthetic limb into their daily lives.