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Otitis Media with Effusion
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
‘Watchful’ waiting refers to expectant management but with serial observation so that treatment can be offered if the hearing loss is prolonged or becomes especially problematic. Multiple treatment modalities have been subjected to rigorous analysis, but the evidence base for treatments other than tympanostomy tubes and amplification (hearing aids) is sparse.
Haematological Disease
Published in John S. Axford, Chris A. O'Callaghan, Medicine for Finals and Beyond, 2023
As with CLL (see above), a watchful waiting technique saves the patient from unnecessary therapy and toxicity in early asymptomatic stages. Progressive disease requires treatment with chemoimmunotherapy, which can induce remissions that can last years. Autologous and allogeneic stem cell transplant is used in younger patients in some low-grade subtypes.
Prostate Cancer
Published in Pat Price, Karol Sikora, Treatment of Cancer, 2020
Malcolm Mason, Howard Kynaston
In the late 1980s and 1990s, outcomes from patients managed conservatively began to appear in the literature, indicating that a substantial proportion would remain alive and well despite not having been treated initially by surgery or radiotherapy.35 For some patients, the terminology itself (“watchful waiting” was coined in the 1980s) was unacceptable (“you watch, while I wait to die”).
The Swedish national guidelines on prostate cancer, part 1: early detection, diagnostics, staging, patient support and primary management of non-metastatic disease
Published in Scandinavian Journal of Urology, 2022
Ola Bratt, Stefan Carlsson, Per Fransson, Camilla Thellenberg Karlsson, Johan Stranne, Jon Kindblom
In men with localised prostate cancer (cT1-2) with a moderately high PSA value (<30–50 ng/ml) and a PSA doubling time over 12 months, primary hormonal treatment does not prolong survival [48,49]. Watchful waiting is therefore the preferred management option for these patients if they are not candidates for curative treatment. In men with higher or more rapidly increasing PSA values and in men with locally advanced, non-metastatic disease, early hormonal treatment does prolong life, provided that their life expectancy is more than 5 years [48,49]. The Swedish guidelines recommend bicalutamide 150 mg once daily over GnRH agonists, based on bicalutamide’s more favourable side-effect profile [50,51], which the European guidelines do not. Single-dose breast irradiation should be given before the start of bicalutamide treatment [54].
When interactions are interruptions: an ethnographic study of information-sharing by speech and language therapists and nurses on stroke units
Published in Disability and Rehabilitation, 2022
Rachel Barnard, Julia Jones, Madeline Cruice
SLT-nurse interactions usually served the purpose of sharing information which either discipline considered important for the immediate care needs of patients. Although SLTs and nurses were usually polite and friendly towards each other, interactions were time-restricted and perfunctory. They occurred in small “windows in time” and temporarily disrupted nurses’ flow of work. Nurses needed to remain responsive to the immediate needs of patients and they were almost always busy with a task or transitioning to another activity when SLTs sought them out. SLT decisions to wait in patient areas for nurses or patients to be free were found to be complex. Watchful waiting could result in patients requesting things of them. This often required them to seek out a nurse, creating interactional challenges that could be avoided by retreating to off-ward spaces.
Nontuberculous mycobacterial lung disease caused by Mycobacterium avium complex - disease burden, unmet needs, and advances in treatment developments
Published in Expert Review of Respiratory Medicine, 2021
Jakko van Ingen, Marko Obradovic, Mariam Hassan, Beth Lesher, Erin Hart, Anjan Chatterjee, Charles L. Daley
The 2020 NTM guidelines focus on the NTM species that most commonly cause LD, including MAC [1]. The 2020 NTM guidelines suggest initiating treatment in patients meeting the diagnostic criteria for NTM-LD rather than watchful waiting, especially in the context of positive acid-fast bacilli sputum smears and/or cavitary lung disease [1]. The decision to initiate treatment should nonetheless be individualized based on various factors such as the virulence of the infecting species, the presence of clinical factors associated with a relatively poor prognosis, patient priorities, and the severity of symptoms [1]. The 2020 NTM guidelines do note that watchful waiting may be appropriate for some patients whose infective species is less responsive to treatment and for patients with mild symptoms and/or higher potential for medication intolerance.