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11.
Kelly R. Wolfe Karin S. Walsh Nina C. Reynolds Frances Mitchell Alyssa T. Reddy Iris Paltin 《Child neuropsychology》2013,19(4):370-384
Medical advances have resulted in increased survival rates for children with brain tumors. Consequently, issues related to survivorship have become more critical. The use of multimodal treatment, in particular cranial radiation therapy, has been associated with subsequent cognitive decline. Specifically, deficits in executive functions have been reported in survivors of various types of pediatric brain tumor. Survivors are left with difficulties, particularly in self-monitoring, initiation, inhibition, and planning, to name a few. Another domain in which survivors of pediatric brain tumor have been reported to show difficulty is that of social skills. Parents, teachers, and survivors themselves have reported decreased social functioning following treatment. Deficits in executive functions and social skills are likely interrelated in this population, as executive skills are needed to navigate various aspects of social interaction; however, this has yet to be studied empirically. Twenty-four survivors of pediatric brain tumor were assessed using a computerized task of executive functions, as well as paper-and-pencil measures of social skills and real-world executive skills. Social functioning was related to a specific aspect of executive functions, that is, the survivors' variability in response time, such that inconsistent responding was associated with better parent-reported and survivor-reported social skills, independent of intellectual abilities. Additionally, parent-reported real-world global executive abilities predicted parent-reported social skills. The implications of these findings for social skills interventions and future research are discussed. 相似文献
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Treatment, Age, and Time-Related Predictors of Behavioral Outcome in Pediatric Brain Tumor Survivors
The research has shown that children surviving cancer are at risk for long-term emotional and behavioral problems secondary to the cumulative effects of cranial irradiation and chemotherapy. The purpose of this study was to investigate the emotional and behavioral outcome of children diagnosed with brain tumor and treated with cranial irradiation and chemotherapy by looking at the association between treatment, time, age, and cognitive-related variables on externalizing and internalizing behaviors at 3 years posttreatment. Fifty-four brain tumor survivors were administered a neuropsychological test battery, whereas the parents filled out the CBCL and Conners' Parent Rating Scale. The results indicate that chemotherapy treatment with vincristine, cytoxan, cisplantinum, and/or VP16 was related to poorer internalizing and externalizing behavioral outcome, especially attention, social withdrawal, and anxious–depressive symptomatology. Age at time of diagnosis or treatment, time since discontinuation of treatment, type and/or total dose of radiation therapy was not significantly correlated with any of the behavioral outcome scales. Verbal memory and learning deficits accounted for a significant portion of the variance in social withdrawal, whereas lower scores in overall intellectual functioning and verbal fluency was related to disturbances in attention, inhibition, and social functioning. The findings suggest that children treated with 1 or a combination of any of the aforementioned chemotherapy agents who exhibit declines in intellectual functioning and memory are at increased risk for long-term behavioral problems 3 years after treatment cessation. These findings support the importance for early psychotherapeutic and supportive intervention services immediately after treatment cessation, with the goal of circumventing these potentially debilitating emotional problems. 相似文献
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James R. Rodrigue Stacey J. Hoffman Tricia L. Park Samuel F. Sears Jr. 《Journal of clinical psychology in medical settings》1998,5(2):199-211
Cirrhosis secondary to alcohol use is a primary cause of liver disease and a medical condition for which liver transplantation is a viable treatment option. However, there remains considerable debate within both the lay and the medical communities regarding the distribution of a scarce medical resource to adults with alcoholism. This study examined college students' perceptions toward an adult, presented in a written vignette, for whom liver transplantation was medically indicated. The influence of gender (female and male) and alcohol use history (no alcohol history, alcoholism history with long-term abstinence, alcoholism history with current use) on these ratings was examined. Subjects rated the adult presented with no alcohol history more positively than they did the adults presented with a history of alcoholism. Also, the adult with no alcohol history was more likely to be offered transplantation and was given higher priority ratings for transplantation by subjects. While subjects' own alcohol use history and organ donor registration status were not associated with ratings, having a family member with an alcohol problem and personally knowing a transplant recipient were related to more favorable ratings toward the adult presented in the vignette. Implications of these findings as well as limitations of the study are discussed. 相似文献
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Claudia Yvonne Finocchiaro Alessandra Petruzzi Giulia Fedeli Maria Giulia Vistalli Alessandro Innocenti Antonio Silvani 《Psychology, health & medicine》2017,22(3):370-380
Most reports emphasize that tumors and their treatments affect sexual function. To date, no studies have focused on sexual functioning in patients with brain tumors. Our study’s objective is to describe the sexual sphere of patients with brain tumors and examine the possible differences between patients who reported sexual dysfunctions and those who did not with respect to their psychological and functional status. We tested 46 patients with brain tumors. We used an ad hoc questionnaire to assess patients’ subjective perception of their own sexual sphere. To assess patients’ psychological status, we used the following questionnaires: Hospital Anxiety and Depression Scale; Psychological Distress Inventory; EORTC QLQ-C30; EORTC QLQ-BN20. Fifty-eight percent of patients reported sexual disturbance. Our data showed that a lack of or decrease in sexual desire is the most common sexual problem reported by our patients (56%). Patients with sexual problems reported higher levels of anxiety and depression and a worse self-reported quality of life (QoL) than did those who did not perceive adverse changes in their sexual sphere. In addition, we found that patients with a better performance status (KPS) reported more changes in sexual behaviors than did those who had performance difficulties. Of the patients, 15.2% received information regarding possible changes in the sexual sphere by physicians. Additionally, 10.8 of 15.2% of the patients reported having explicitly requested information from physicians. The study demonstrated a relation between QoL and sexual function. Therefore, it would be important to encourage clinicians to ask questions regarding patients’ sexual issues, thus providing them with an opportunity to expose their difficulties and receive adequate support. 相似文献
15.
漫谈肝移植现状、挑战与前景 总被引:1,自引:1,他引:0
夏穗生 《医学与哲学(人文社会医学版)》2005,(10)
就肝移植目前的状况和存在的问题,如医疗机构的组织协调能力,供肝不足和手术过程中的难点,肝癌肝移植争议的焦点,如何提高移植后的生存质量等,提出了建设性有益的观点,为肝移植的未来指出了光明前景。 相似文献
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《金匮要略》中“肝病传脾”的思想,广泛应用于临床诊断与治疗,本文以脏腑经络辨证论治思想为依据,探讨中医诊断肝痛的思路:根据症状判断病位深浅,肝病见四肢疲乏为病轻、肝病见食不消化甚至不思饮食为病重。由此判断病情轻重,为临床提供治疗依据。 相似文献
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慢性炎症相关肿瘤疾病,其机制涉及到的不再是个别的基因产物或蛋白分子,也不再是单一的信号通路或代谢途径,而是众多的基因、蛋白质和代谢小分子等各种生物分子构成的复杂的调控网络。这一网络中的相互联系、动态以及突变特性,要求运用系统论的方法来分析。这种分析将拓展临床医生的研究思路,推动对炎症向肿瘤转化本质的认识。 相似文献
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TACE术联合自体CIK细胞治疗原发性肝癌 总被引:1,自引:0,他引:1
探讨肝动脉栓塞化疗(TACE)联合自体细胞因子诱导的杀伤细胞(CIK)治疗原发性肝癌的临床疗效。比较TACE术+CIK组(治疗组)和TACE组(对照组)患者的免疫功能、临床疗效及副反应。结果表明,TACE术+CIK与TACE术比较安全有效。因此,TACE术联合自体CIK细胞是治疗原发性肝癌的一种有效方法。 相似文献
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为原发性甲亢合并严重肝损伤患者制定循证治疗方案。根据PICO原则,提出临床问题并转换成便于检索的形式,检索美国国家指南交换中心(NGC)、Cochrane图书馆(2010年第3期)、PubMed(1995-2010.11)和维普数据库(CHKD,1995~2010.11)。根据检索结果,制定治疗方法,2月后患者肝功能、... 相似文献