Patiënten met hematologische kanker die hiervoor een autologe stamceltransplantatie ondergaan, staan voor de moeilijke taak om te gaan met zowel een potentieel levensbedreigende ziekte als een stressvolle behandeling. Een deel van deze patiënten rapporteert psychologische klachten. Behandeling van deze klachten verdient aandacht en zal naar verwachting leiden tot een verbetering van de kwaliteit van leven van deze patiënten. In dit artikel beschrijven we de implementatie van een zorgprogramma gericht op vermindering van psychologische klachten, met als belangrijkste onderdeel het internetzelfhulpprogramma ‘Stress onder controle’
DOCUMENT
The early detection of breast-cancer-related lymphedema and referral for therapy has the potential to reduce lymphedema-related morbidity. Although research shows the benefits, a gap is observed between evidence and daily practice. We aimed to determine whether the early detection of lymphedema and referral for treatment is adequate following the current guidelines. Women with primary breast cancer treated with breast-conserving therapy or ablative treatment were included. Demographic-, general health-, tumor-, and treatment-related data were recorded. Bilateral arm volume measurements were performed preoperatively and 3, 6, 12, and 24 months post-surgery. A 5% or greater Relative Volume Change was considered the cutoff point for lymphedema and as an indication for therapy referral. After 24 months post-surgery, the main outcomes show that among the patients with early signs of lymphedema, based on a Relative Volume Change ≥5%, a nonreferral for therapy was noted in 83%. Additionally, we observed a significant improvement of the mean Relative Volume Change at 24 months within this group, which might implicate that nonreferral was an adequate choice and that watchful waiting is appropriate when lymphedema is detected within the first year post-surgery.
DOCUMENT
We are all bored. We are bored on the endless steppes of social media, bored while waiting in front of the open bridge, bored by the daily routines of our work. Will we ever get bored of boredom so much that we give in? Will we allow ourselves to live in new bodies, to do what we really want, to distinguish between to-do and not-to-do?
MULTIFILE
