Psycho-social aspects of serious renal disease and dialysis: a review of the literature

The most severe form of kidney disease is renal failure, a life-threatening condition known as end-stage renal disease (ESRD). Though social work intervention is an integral part of the response to serious kidney disease, the topic has been noticeably absent in the discipline's literature. This article synthesizes the research on the psycho-social aspects of end-stage renal disease, with a particular focus on dialysis patients at different stages of the life cycle. Social work services are particularly important to dialysis patients because (1) ESRD influences patients' psycho-social environments and (2) the psycho-social environments in which ESRD sufferers live impact the course of the disease and physical well-being. Intervention issues are discussed. The review found that most research on this topic lacks adequate sampling to generalize to the ESRD population. Future research needs to address this shortcoming and increase sample sizes to allow for statistical controls.     

Pregnancy in women undergoing a kidney transplant. Our experience and a review of the literature

The chances of pregnancy for uremic women are usually very low, because of hormonal balance changes which determine a strong reduction in fertility. Epidemiological studies reveal that pregnancy in hemodialyzed women in fertile patients 4.6-6 months after a well functioning kidney transplant, one fertile transplanted woman over 50 can become pregnant. In the first transplant era, pregnancy after kidney transplant was considered "a big hazard", especially because of the possible side-effects of immunosuppression drugs on foetus development, and the risk of a worsening in the mother's renal function. Therefore, women were strongly recommended to avoid pregnancy. More recently, several reported papers have shown that pregnancy can be safely carried on also by transplanted women, under careful criteria and monitoring. Our experience too, even if limited in number (4 patients) reported in this article confirms this conviction.     

Pregnancy and the working woman: a review

The potential impact of employment on pregnancy is an important issue that merits assessment, given the increasing numbers of women entering the labor force and continuing employment throughout pregnancy. A review of the literature evaluating the effects of employment on pregnancy is presented, including a brief historical and legal perspective, as well as employment statistics in the USA. There is emerging evidence from various studies suggesting that long working hours and prolonged standing may place a pregnancy at risk. Thus, physicians need to counsel their patients about these potential risks and provide recommendations for early modification of employment activities, in order to have a positive impact on pregnancy outcome.     

Pregnancy and abortion in breast cancer patients. Two case reports and a literature review

Breast cancer in pregnancy is by itself not an indication for abortion. We document the case histories of 2 patients with breast cancer (recurrent or advanced) who elected to carry pregnancies to term. Pregnancy concurrent with or subsequent to breast cancer is not associated with a worse prognosis than would be observed in non-pregnant women. Treatment for breast cancer may be an indication for abortion, but chemotherapy may be administered to pregnant patients, although it should be avoided in the first trimester if possible. Treatment such as radiotherapy may not be aimed at improving survival and this knowledge may affect a patient's decision regarding abortion. Breast cancer patients undergoing abortion must be aware of the exact indications for the procedure and the difference between medical and social indications.     

Young adult chronic patients: an analytical review of the literature

This article analyzes the periodical and "fugitive" literature concerned with an emerging psychiatric service entity, young adult chronic patients. The increasing prominence of a young adult patient population results from the confluence of two primary forces: deinstitutionalization policies and demographic factors. The author discusses the clinical diversity and program requirements of these patients. Young adult chronic patients are best served when their uniqueness as a patient population is acknowledged and heeded and when special services for them are integrated into the total system of care, the author concludes.     

Swinging: a review of the literature

No review of the topic of swinging has been done in the last 20 years. This review is intended to update the literature. Studies estimating the incidence of swinging, the demographic and personality characteristics of swingers, along with how swingers are perceived by nonswingers are reviewed. Numerous theories explaining this behavior have been presented with a social psychological model being the primary focus here. Major reasons for getting involved in swinging, initiation into the lifestyle, effects on marriage, and dropping out of swinging are also covered. Finally, the literature dealing with some of the major problems with swinging, focusing on AIDS, are also discussed, along with the current state of swinging and suggestions for future research.     

Retention and stability: a review of the literature

The subjective visual horizontal (SVH) was measured by means of a small rotatable luminous line in darkness in the upright body position and at 10, 20 and 30 degrees of body tilt to the right and left prior to, and during a follow-up period after, stapedotomy in 12 patients with otosclerosis. In the acute stage after surgery, SVH in the upright body position was significantly tilted away from the operated side. In addition, the perception of roll tilt towards the operated side (Kop) was significantly increased after stapedotomy, while the perception of roll tilt towards the healthy side (Khe) showed a slight but not significant reduction. After exclusion of two outliers, a statistically significant correlation was found between changes in Kop and in Khe. The slope of the regression line was 1.8:1, probably corresponding to a preference of the utricle for ipsilateral as opposed to contralateral head tilt. In four patients there was a weak ( < 1 degrees/s) spontaneous nystagmus, not systematically related to the side of surgery, while in most cases there were no nystagmus or subjective vertigo symptoms. These specific changes in the subjective horizontal show that the otolithic effects on perception can be dissociated from canal effects. Further, the results are opposite to those for patients with unilateral loss of vestibular function. The tilt of SVH after stapedotomy indicates an increase in resting activity of utricular afferents. In addition, based on recent theories on otolith function, we suggest that an increased activity in saccular afferents is of major importance for the changes in roll-tilt perception because of its interaction with the utricle on the central nervous level.     

G-CSF: a very efficient therapy in chronic autoimmune neutropenia. A brief review of the literature

Autoimmune neutropenia (AIN) is a rare hematological disorder for which no standard treatment has been established so far. A brief review of the literature is presented herein concerning the use of G-CSF in this indication. The good results in terms of neutrophils increment and infection prophylaxis render G-CSF attractive for treating AIN. Hypotheses explaining its mechanisms of action are also discussed.     

Exercise and breast cancer: review and critical analysis of the literature

Breast cancer is one of the leading causes of cancer and cancer mortality among Canadian women. Based on the current incidence rates, the National Cancer Institute of Canada has estimated that one in 10 women will develop breast cancer during her lifetime. In an effort to control this disease, various prevention strategies have been proposed. One promising strategy involves the promotion of exercise in healthy women. It has been hypothesized that exercise may protect against breast cancer by influencing regularity of ovulatory cycles, by changing body fat composition, or by enhancing natural immunity. In this paper both the epidemiological and experimental evidence that speaks to a protective effect of exercise is reviewed. Although there are several biologically plausible mechanisms for the association, the existing epidemiological and experimental data are inconclusive due to the small number of studies and their methodological insufficiencies. However, given the enormous potential benefit of even a small protective effect of exercise, further studies designed to address the relationship between exercise and breast cancer risk are warranted.     

Voyeurism: a review of literature

The most striking thing about the literature on voyeurism is the relative lack of material in print. In the present work, the author was able to find only 15 articles and no books that deal specifically with voyeurism. Of the 57 references compiled for this review, not one involves an experimental manipulation of variables. An attempt is made to review as many aspects of voyeurism as possible, giving illustrative case material whenever available. The areas of troilism and coprophilia are covered in some detail to establish to what degree they belong to the deviation of voyeurism. Theory of perversion has centered around the psychoanalytic and behavioral schools because of the lack of material from other approaches. The voyeur is found to be a relatively young man of low socioeconomic status, who sociosexually is said to be "not retarded but a late bloomer." He is prone to minor crimes and not major offenses. It is suggested that moyeurism be considered a deviation from normal sexual behavior and that deviations are not in and of themselves criminal behavior. At present, punishment is genera-ly mild but highly variable and unpredictable. Treatment is usually analysis or group therapy, but other forms of therapy such as aversion and avoidance conditioning are being attempted with increasing success.     

Caries prediction: a review of the literature

Since Jenner and Pasteur, various vaccines have been developed and administered in immunization program conducted by WHO in order to diminish the circulation of pathogenic agents and eradicate some diseases. Risks associated with immunization are revealed by the collection and assessment of adverse events reported after the use of these drugs. They vary according to the type of vaccines. With high rates of immunization and a low incidence of infectious diseases, adverse events receive increasing attention. Frequent and mostly expected adverse events are reported in clinical trials. Unexpected rare adverse events are reported after marketing authorization by spontaneous reporting and post marketing surveillance studies. Post marketing surveillance should be adapted to vaccines (vaccino-vigilance) and should take into account the risk linked to the disease they may protect against. Adverse events are often temporally associated with vaccines, that does not mean they are causally related. Specific studies should be conducted to assess the causal relationship between vaccines and post immunization adverse events. In order to reduce the risk associated with immunization, a strict follow-up of recommendations, warnings and contraindications in addition to appropriate information being delivered to both vaccinees and physicians are required.     

Pathological gambling: a review of the literature

The aim of this study was to characterize human anti-Rhesus monoclonal antibodies cross-reacting with tissue antigens. Of the 155 monoclonal alloantibodies tested, 49 also reacted with intracellular antigens, as demonstrated by immunofluorescence assay on cryostat sections of animal and human tissues. This cross-reactivity was mainly a property of monoclonal alloantibodies belonging to the IgM isotype (among the 49 cross-reacting Mabs, 37 were IgM). The results confirm that during an immune response against a foreign antigen (alloantigen), B cells that produce polyreactive antibodies are not excluded from the pool of responding cells.     

Fatigue in cancer patients: a review of the literature

This paper reviews the research literature concerning fatigue in cancer patients, evaluating the quality of the evidence, thus helping to focus the direction and methodological rigour required in future investigations. Since fatigue in this population has been attributed to several mechanisms these will be discussed. The prevalence of fatigue in cancer patients will then be documented. An overview of what is currently understood about fatigue in cancer will follow. Based on the literature, conceptual and methodological difficulties will be described. Finally, gaps in understanding will be identified. Suggestions for future research will be formulated and potential interventions to decrease feelings of fatigue explored.     

Case management: a literature review

There is considerable evidence that the hemostatic system is involved in the growth and spread of malignant disease. There is an increased incidence of thromboembolic disease in patients with cancers and hemostatic abnormalities are extremely common in such patients. Antihemostatic agents have been successfully used to treat a variety of experimental tumors, and several clinical trials in humans have been initiated. Although metastasis is undoubtedly multifactorial, intravascular coagulation activation and peritumor fibrin deposition seem to be important. The mechanisms by which hemostatic activation facilitates the malignant process remain to be completely elucidated. Of central importance may be the presence on malignant cells of tissue factor and urokinase receptor. Recent studies have suggested that these proteins, and others, may be involved at several stages of metastasis, including the key event of neovascularization. Tissue factor, the principal initiator of coagulation, may have additional roles, outside of fibrin formation, that are central to the biology of some solid tumors.     

Being a stroke patient: a review of the literature

The purpose of this paper is to review the research literature on the patient's experience of stroke. Four qualitative studies on how patients experience stroke were identified. The findings of these studies show that the stroke patient often has clear goals for himself in relation to functional abilities, against which he measures all success and forward progress in his rehabilitation. Even though the stroke patient accepts a lower level of functional ability, he is not willing to accept the rehabilitation professionals' prediction of his ultimate functional level if it is lower than his own goal. Furthermore, stroke patients see recovery as a return to the existence they had lived before the stroke, which is different from the health care providers' view. To the health care provider, recovery is measured in terms of isolated and discrete return of movement, whereas in the eyes of the patients, recovery is a return to previously valued activities. Further, studies on psychosocial function after stroke were reviewed. Recent studies show that the psychological impact of the stroke experience is immense and that stroke patients experience stress on a variety of levels. Also, depression exists in a large portion of the stroke population. The impact of stroke also influences the patient's social existence, as studies have shown that stroke patients do manifest diminished social function. However, the reviewed studies are not without limitations. Further studies, with a qualitative design, are needed to throw light on the patient's experience of being ill with stroke, and the process of his recovery.     

Primary tubal carcinoma: a retrospective analysis of four cases with a literature review

This paper comprises a brief examination of the concept of process recording and its current applications in nursing and health-related professions. The possible benefits and problems of using the process recording tool as a summative assignment method within a nursing diploma course will be discussed in the light of experience at one former college of health in the North of England. The author argues that the process recording assignment offers a useful means of relating communication theory to practice and an opportunity for students to engage in reflection on their practice in a structured way.