I.e. Patients (i.e + patient)

Distribution by Scientific Domains

Selected Abstracts

Liver transplantation for alcoholic liver disease

Georges-Philippe Pageaux
Although increasing numbers of alcoholic patients are being referred to liver transplant centres, liver transplantation for alcoholic liver disease still remains controversial, essentially because we are in an era of organ shortage. In fact, the main issue is the likelihood of relapse and its influence on outcome, because it is the possibility of returning to alcohol use that separates patients with alcoholic liver disease from those with other forms of chronic liver disease. In all proposed clinical guidelines of indications for referral and assessment for liver transplantation for alcoholic liver disease, the authors emphasize the risk of alcoholism recurrence and, thus, a multidisciplinary approach is required to select patients who are likely to comply with follow-up and not return to a damaging pattern of alcohol consumption after transplantation. It emerges from all clinical studies that when we take into account the usual criteria of success for liver transplantation, i.e. patient and graft survival, rejection rate and infection rate, alcoholic liver disease is a good indication for liver transplantation. Predictive factors for alcoholic relapse after liver transplantation have been assessed in numerous studies, often with contradictory results making these difficult to analyse and compare. Several predictive factors for alcoholic relapse have been studied: length of abstinence before transplantation, associated psychiatric problems, social conditions, associated drug addiction, age. Abstinence after transplantation is the goal, but the necessary treatment for alcoholic disease can result in considerable improvement, even when complete abstinence is not achieved. Finally, the good results obtained with liver transplantation for alcoholic liver disease should help us to educate the general population about alcoholic disease. [source]

The case against preoperative biliary drainage with pancreatic resection

HPB, Issue 6 2006
Rurik C. Johnson
The majority of patients with periampullary malignancies currently undergo biliary drainage before pancreaticoduodenectomy. Placement of an endoprosthesis reliably ameliorates jaundice and pruritus. However, preoperative biliary drainage leads to bile colonization and increases the risk of postoperative wound infection after pancreatic resection. Preoperative biliary drainage does not appear to lower postoperative morbidity or mortality following pancreatic resection and does not lower but probably increases costs associated with pancreatic resection. Preoperative biliary drainage is frequently used with little clinical benefit and its utilization should be limited to specific clinical indications, i.e. patients receiving neoadjuvant therapy, patients waiting several weeks or more for surgical evaluation and resection, patients with cholangitis. [source]

Which cancer patient completes a psychosocial intervention program?

Ora Gilbar
The present study explored the similarities and differences in patterns of psychological distress, coping strategies and social support of 41 cancer patients who dropped out of a psychosocial therapy program and 20 patients who completed the program as agreed. The findings indicated that only depression, out of nine brief symptom inventory subscales, predicted which patients would complete the program, i.e. patients with a high level of depression tended to complete the psychosocial intervention program. Copyright 2002 John Wiley & Sons, Ltd. [source]

Help-seeking behaviour for cancer symptoms: perceptions of patients and general practitioners

Jascha De Nooijer
The aim of this study is to increase our understanding of the relationship between knowledge and interpretation of symptoms, fear and trust on the one hand, and the decision to consult a general practitioner (GP) for cancer symptoms on the other. Qualitative interviews were used to evaluate the various factors. Twenty-three patients and ten GPs were interviewed. A number of factors were found to play different roles for different patients groups, i.e. patients that consult their doctor prematurely, at the right time, or those that delay. A lot of the findings can be tested using various concepts of socio-psychological theory. Further research should provide an improved understanding of the way these models can be applied to help-seeking behaviour. In terms of implications for health education, we conclude that each patient group has different needs and requires different information. Copyright 2001 John Wiley & Sons, Ltd. [source]