Oncologic and functional considerations of total glossectomy
The typical treatment for carcinoma (cancer) of the tongue has been radiation or chemotherapy, but if these therapies fail, the surgical removal of the tongue (glossectomy) is used as a last resort in the later stages of the disease. Recent reports state that early surgical intervention may be an acceptable alternative for the treatment of tongue cancer. The medical records of 17 patients (ages 53 to 74 years, average of 60 years) who had glossectomies between 1982 and 1988 were studied to evaluate the effect of glossectomy on the recurrence of the disease, as well as the patients' functional abilities. The patients were followed-up an average of 36 (6 to 68) months after the surgery, at which time 9 out of 17 (53 percent) patients were alive and without disease. Functional abilities such as swallowing and eating were regained in 93 percent of the patients. In addition, 80 percent of those whose larynxes (voice boxes) were not removed recovered understandable speech. Recent improvements in reconstructive and rehabilitative techniques suggest that surgical treatment of advanced carcinoma of the tongue results in improved function and better survival. The authors suggest that glossectomy surgery does not necessarily have to be saved for hopeless cases any longer, but should be considered as a first line of treatment for cases of advanced carcinoma of the tongue. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: American Journal of Surgery
Total hip replacement: indications for surgery and risk factors for failure
Hip replacement can be successful if performed by experienced surgeons using proven surgical procedures in carefully selected patients. Cementing the joint in place appears to provide more long-term success than non-cementing techniques. Patients with inflammatory or fusing joint conditions that may or may not produce joint pain or limitations in joint movement seem to be appropriate candidates for hip replacement. Some younger patients may benefit from alternative surgical procedures. Younger women with rheumatoid arthritis and younger men with osteoarthritis may be at increased risk for joint failure.
Publication Name: Annals of the Rheumatic Diseases
Sensitive care: choices and considerations
Designating areas of skilled nursing facilities for patients with terminal diseases may be a sensitive and cost-effective way to manage these patients. The community's health needs will dictate the kinds of services a Sensitive Care Unit might provide. Some states provide additional funding for patients with AIDS. Specialized nursing staff, medications, and equipment may be necessary to support a Sensitive Care Unit. The emotional needs of the patient, family, and caregivers in this setting need consideration.
Publication Name: Nursing Management
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