Treatment of Brain Metastases; an Interdisciplinary Approach to a Conundrum

Alireza Zali; Ali Yaghobi Joybari; Mahdieh Bayat

doi:10.5812/pmco.115565

Passy-Muir Speaking Valve Use in a Children's Hospital: An Interdisciplinary Approach

Perspectives on Voice and Voice Disorders ◽

10.1044/vvd18.2.76 ◽

2008 ◽

Vol 18 (2) ◽

pp. 76-86 ◽

Cited By ~ 2

Author(s):

Lauren Hofmann ◽

Joseph Bolton ◽

Susan Ferry

Keyword(s):

Tracheostomy Tube ◽

Pediatric Population ◽

Interdisciplinary Approach ◽

Extended Period ◽

Speech Development ◽

Tube Placement ◽

Background Information ◽

Speaking Valve ◽

Children's Hospital ◽

Children’S Hospital

Abstract At The Children's Hospital of Philadelphia (CHOP) we treat many children requiring tracheostomy tube placement. With potential for a tracheostomy tube to be in place for an extended period of time, these children may be at risk for long-term disruption to normal speech development. As such, speaking valves that restore more normal phonation are often key tools in the effort to restore speech and promote more typical language development in this population. However, successful use of speaking valves is frequently more challenging with infant and pediatric patients than with adult patients. The purpose of this article is to review background information related to speaking valves, the indications for one-way valve use, criteria for candidacy, and the benefits of using speaking valves in the pediatric population. This review will emphasize the importance of interdisciplinary collaboration from the perspectives of speech-language pathology and respiratory therapy. Along with the background information, we will present current practices and a case study to illustrate a safe and systematic approach to speaking valve implementation based upon our experiences.

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Palliative treatment of brain metastases with gamma knife

Therapeutische Umschau ◽

10.1024/0040-5930.58.7.413 ◽

2001 ◽

Vol 58 (7) ◽

pp. 413-418 ◽

Cited By ~ 1

Author(s):

Jean Siegfried ◽

G. Wellis ◽

S. Scheib ◽

D. Haller ◽

A. M. Landolt ◽

...

Keyword(s):

Brain Metastases ◽

Scale Score ◽

Gamma Knife ◽

Palliative Treatment ◽

Rating Scale ◽

Psychische Belastung ◽

Performance Rating ◽

Wird Eine

Das Gamma Knife ist ein stereotaktisch-radiochirurgisches Gerät, das erlaubt, radiologisch scharf begrenzte Hirntumore (oder arteriovenöse Missbildungen) mit einem Durchmesser von maximal 3,5 cm und einem Volumen von höchstens 25 cm3 zu behandeln. Diese Methode ist eine echte Alternative zur klassischen Behandlung von Hirnmetastasen mit operativer Entfernung und/oder Ganzhirnbestrahlung. Die Vorteile dieser Technik sind klar: die Methode ist nicht invasiv, die Behandlung benötigt nur eine Sitzung mit einer kurzen Hospitalisation von höchstens zwei bis drei Tagen, die physische und psychische Belastung ist gering, der Kopf wird weder rasiert noch verliert der Patient durch die Behandlung seine Haare; für eine befriedigende Überlebenszeit wird eine gute Lebensqualität erreicht und im Kostenvergleich mit alternativen Methoden (Operation und/oder anschließender Ganzhirnbestrahlung) wirtschaftlich günstiger. Von September 1994 bis Dezember 2000 wurden am Gamma Knife Zentrum in Zürich 140 an Hirnmetastasen leidende Patienten mit dieser Methode behandelt. Mit einer Überlebenszeit von durchschnittlich 263 Tagen und einem Maximum von drei Jahren entsprechen unsere Resultate denjenigen der Literatur mit weltweit über 30000 behandelten Patienten. Günstige Prognosen sind ein Karnofsky Performance Rating Scale Score zwischen 70 und 100, kleine Volumina der Metastasen, kontrollierter Primärtumor und fehlende oder stabile extrakranielle Metastasen.

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Prophylactic Mastectomy - Evaluation and Treatment of High Risk Patients

Swiss Surgery ◽

10.1024/1023-9332.8.2.45 ◽

2002 ◽

Vol 8 (2) ◽

pp. 45-52 ◽

Cited By ~ 3

Author(s):

Remmel ◽

Harder

Keyword(s):

Breast Cancer ◽

Breast Cancer Risk ◽

Cancer Risk ◽

Risk Reduction ◽

Prophylactic Mastectomy ◽

Interdisciplinary Approach ◽

Reconstructive Procedures ◽

Medline Search ◽

Breast Cancer Risk Reduction ◽

Cancer Risk Reduction

Prophylactic mastectomy is an aggressive strategy for breast cancer risk reduction. The indications and efficiency of this procedures are not yet clearly defined. Randomized, prospective studies, comparing different surgical procedures with other modalities of breast cancer risk reduction are lacking. The report evaluates the existing controversy, based on Medline search in the following sequence: risk factors, possibilities of risk reduction, effectiveness of risk reduction, technical considerations and recommendations. Patient selection is difficult and needs an interdisciplinary approach. The women have to be well informed about all treatment alternatives and various reconstructive procedures. An appropriate risk reduction strategy should be selected individually for each patient. Up to now, there exist only recommendations from different institutions but no definitive guidelines.

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