Delirium is commonly seen in palliative care. It usually develops over a short period of time and is characterized by a disturbance of attention and awareness. As delirium is associated with increased mortality, prevention and early identification of this severe neurocognitive disorder is of high clinical relevance. This paper provides a brief overview of risk factors, preventive measures, current screening and diagnostic procedures, as well as nonpharmacological and pharmacological treatment options of delirium in the palliative care setting.
Background: The objective of this study was to characterize tumor activity and mineralization status in newly-detected multiple myeloma (MM) bone lesions using 2-18 F-fluoro-2-deoxy-D-glucose ( 18 F-FDG)-PET/CT and 18 F-sodium fluoride ( 18 F-NaF)-PET/CT before and after antitumor treatment. Materials and Methods: In this retrospective study, seven patients with histologically-verified MM were included (four women, three men; median age=57 years, standard deviation=11.23 years). PET/CT was performed with 18 F-FDG and with 18 F-NaF, both at baseline and after treatment. All patients had positive scans. Volumes of interest (VOIs) were drawn over all 18 F-FDG-PET/CTpositive bone lesions, as well as the corresponding regions in 18 F-NaF-PET/CT. For characterization of bone lesions, semi-quantitative standard uptake value (SUV) parameters were measured. Results: 18 F-FDG-PET/CT in the seven patients detected 39 metabolically active lesions that were correlated with the corresponding sites in 18 F-fluoride-PET/CT. Overall, the lesions showed a response to therapy, with a significant decrease in SUV max on PET/CT using 18 F-FDG (p<0.001) and with 18 F-NaF (p<0.001). In four patients with a second follow-up scan (at a median of 17 months after baseline scan), there was no significant change in lesion uptake. Conclusion: Based on our data, antitumor therapy in MM reduces not only tumor activity, but also the mineralization status of bone lesions. A second follow-up scan in a subset of the cohort yielded no change in mineralization status.Multiple myeloma (MM) is a neoplastic plasma cell disorder that is characterized by clonal proliferation of malignant plasma cells in the bone marrow (1). Eighty percent of patients experience bone lesions during the course of their disease (1, 2), with focal osteolytic bone lesions being the radiographic hallmark of the disease (3). Changes in the bone microenvironment leads to increased recruitment and activation of osteoclasts and inhibition of osteoblasts (4, 5).2-18 F-Fluoro-2-deoxy-D-glucose ( 18 F-FDG)-PET/CT is a sensitive functional imaging modality for many neoplasm types. The updated International Myeloma Working Group (IMWG) criteria consider focal skeletal lesions with increased 18 F-FDG uptake and with osteolytic destruction in the CT component indicative of active myeloma (6). 18 F-FDG-PET/CT appears to be especially useful in the evaluation of the quality of treatment response in patients with MM (7-11).18 F-Sodium fluoride ( 18 F-NaF) is a PET tracer used for skeletal imaging which reflects regional blood flow and bone remodeling and can accumulate in osteoblastic and osteolytic 1943
Background: The COVID-19 pandemic constitutes one of the greatest recent public crises. This study explored its influence on the lives and care realities of people with a schizophrenia spectrum disorder (SSD). Methods: Between October 2020 and April 2021, semi-structured in-depth interviews were conducted with 30 volunteers with SSDs receiving inpatient or outpatient treatment in Vienna (Austria). Interviews were audio-recorded, transcribed verbatim and analysed thematically. Results: Three main themes were identified. First, ‘Pandemic life is deprived, lonely and surreal – though certain aspects can be perceived as positive’. Second, ‘Bio-psycho-social support systems were struck at their core by the pandemic and were left severely compromised’. Last, ‘There is a complex interplay between one’s prior experience of psychosis and the experience of the COVID-19 pandemic’. The pandemic situation affected interviewees in various ways. For many, it led to a drastic reduction in day-to-day and social activities and contributed to an atmosphere of strangeness and threat. Bio-psycho-social support providers frequently suspended their services and offered alternatives were not always helpful. Participants indicated that whilst having an SSD might render them vulnerable to the pandemic situation, prior experience with psychotic crises can also provide knowledge, skills and self-confidence which enable better coping. Some interviewees also perceived aspects of the pandemic situation as helpful for recovering from psychosis. Conclusion: Healthcare providers must acknowledge the perspectives and needs of people with SSDs in present and future public health crises to ensure proper clinical support.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.