Hematology/oncology clinics of North America
-
Hematol. Oncol. Clin. North Am. · Dec 2009
ReviewChronic immune thrombocytopenia in children: epidemiology and clinical presentation.
Immune thrombocytopenic purpura (ITP) is one of the most common acquired bleeding disorders in children. Most children with ITP will have acute disease, self-limited thrombocytopenia that resolves completely within weeks or months, with or without therapy. ⋯ Treatment for these children is an ongoing clinical challenge, as few therapies offer long-term remission, and all have significant side effects and toxicities. This article focuses on the management of clinically significant chronic ITP in the pediatric population.
-
Melanoma is an increasing health care problem worldwide. Up to 80,000 cases of melanoma are diagnosed per year and it is the sixth leading cause of cancer death in the United States. ⋯ Surgery remains the mainstay of treatment of melanoma, and in most cases it is curative. Several important surgical issues are discussed in this review, including the extent of surgical margins, Mohs micrographic surgery for melanoma in situ, the use of sentinel lymph node biopsy, the usefulness of lymphadenectomy, isolated limb perfusion, and the role of metastasectomy.
-
The congenital dyserythropoietic anemias (CDAs) are a heterogeneous group of hereditary disorders that seem to be restricted to the erythroid lineage. They are characterized by morphologic abnormalities of erythroid precursors in the bone marrow, resulting in ineffective erythropoiesis and a suboptimal reticulocyte response. As with many rare disorders, cases of CDA are often misdiagnosed, which may lead to inappropriate management. In this review, the authors highlight the relevant clinical data together with recent molecular advances that should aid decision making in diagnosis and patient management.
-
Clinical research on acupuncture in cancer care is a new and challenging field in oncology. The results of clinical research will continue to provide clinically relevant answers for patients and oncologists. The evidence currently available has suggested that acupuncture is a safe and effective therapy to manage cancer and treatment related symptoms, while giving patients the ability to actively participate in their own care plan. The article explains the potential benefits of acupuncture and describes the difficulties in studying its effectiveness.
-
Hematol. Oncol. Clin. North Am. · Aug 2008
ReviewPractical hypnotic interventions during invasive cancer diagnosis and treatment.
Novel advances in biotechnology and medical imaging techniques have enabled an evolution toward earlier diagnosis and treatment by way of "minimally invasive" surgical techniques performed on the conscious patient without the use of general anesthesia. Although the risks of diagnostic and therapeutic interventions have been reduced with these approaches, patients still face many physical and psychologic challenges. ⋯ The benefits of adjunctive hypnotic treatments come at no additional cost. Patients, health care providers, hospitals, and insurance companies are advised to take advantage of hypnotic techniques.