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Published in Ashfaq A Marghoob, Ralph Braun, Natalia Jaimes, Atlas of Dermoscopy, 2023
Amélie Boespflug, Félix Pham, Ralph P. Braun, Luc Thomas
Longitudinal pigmentation of the nail, a cause for angst in many clinicians, can be due to a broad number of medical conditions that span from post-traumatic pigmentation, to nail infection, to cancer (6,36). The clinician's angst likely stems from a lack of confidence regarding the underlying diagnosis coupled with an aversion towards performing a nail matrix biopsy, which can cause pain and a permanent nail dystrophy. Furthermore, nail matrix biopsies are often noninformative when executed by an inexperienced physician, because they tend to send nail plate fragments instead of nail matrix sections to the pathologist, hindering his ability to render an accurate diagnosis.
An uncomfortable intimacy
Published in Alan Bleakley, Medical Education, Politics and Social Justice, 2020
Here, medicine operates as a dominant discourse or is hegemonic so that a wide range of behaviours and experiences previously unlabelled become marked as symptoms – medical or health issues. For example, everyday angst becomes treatable “anxiety”. Social behaviours are read as symptomatic ills of a social body that can be treated largely by pharmaceuticals. “Big Pharma” (Law 2006) colludes with, or even shapes, the medicalization project with a promise of profit. Szasz (2003) suggests that this leads to a “pharmacracy”, a culture dependent upon prescribed drugs, where Big Pharma, embracing the most profitable and largest of global companies (Ledley et al. 2020), exerts undue power. Medicine and politics are inextricably mixed, as pharmaceutical companies also become major lobbyists, particularly in American politics.
What Promotes Joy
Published in Eve Shapiro, Joy in Medicine?, 2020
Part of my angst involves how best to engage these practices. All of this is time-consuming, all of this is resource-intensive, so how do we scale it in a timely enough way? Sometimes, when we take a practice’s data, bring it back to the docs, get everybody around a table and say, “This is where we are—is this where we want to stay?”, all these good conversations begin to percolate. People will say, “What really diminishes me is X, Y, and Z.” and our response is, “You know, we can probably fix some of it. We can’t fix it all, but let’s start working on that. Because we really can’t institute change or have dialog until we begin to address some of these more foundational problems.”
Integrative Management of Pancreatic Cancer (PDAC): Emerging Complementary Agents and Modalities
Published in Nutrition and Cancer, 2022
Mustafa B. A. Djamgoz, Valerie Jentzsch
In vivo, also, quercetin caused a significant reduction of tumor volume in a xenograft model of PDAC, again involving let-7c (Figure 5F) (65). However, less work has been done to test the possible effectiveness of combining quercetin with gemcitabine in vivo. In the one available study, Angst et al. showed in an orthotopic model of PDAC that quercetin maintained its anti-proliferative and pro-apoptotic effects and reduced tumor weight (70). In combination with gemcitabine, quercetin had a noticeably (ca. two-fold) greater effect on proliferative activity. In contrast, the additional effects of quercetin combined with gemcitabine on apoptosis and tumor weight were modest (ca. 10%). However, these effects did not reach significance, probably due to the limited number of animals used (n = 6) and the inherent variability of in vivo testing especially with combinations of agents (70).
Suffering and the Completed Life
Published in The American Journal of Bioethics, 2022
Brent M. Kious, Margaret (Peggy) Battin
Indeed, it seems reasonable to us to say that persons who are tired of life are really suffering in fact, though perhaps also in prospect—they see mostly bad things for themselves in future, with little prospect that life will contain other goods capable of redeeming that badness. It is worth mentioning here, however, that those who are not so much tired of life as regarding themselves as having a completed life might be different in certain ways. We suppose that, if these categories are distinct, persons who see their lives as completed might regard them as currently still quite good, but are motivated primarily by thoughts like, I’ve done all the things I set out to do and it is only downhill from here. The person who requests aid in dying because he sees his life as complete might really just want to go out on top, as it were. He may still be suffering in the moment, as he realizes his main goals and finds that other worthy goals do not present themselves; but some of this suffering is undoubtedly oriented to the future, as he looks on what he takes to be inevitable decline and loss of meaning with anxiety. Perhaps he says to himself: “the best is no longer yet to come; it is now behind me. Things will only get harder and I see no point in enduring that.” Could this, his ennui and angst, be a hallmark of suffering? We are inclined to think it could be.
The current paradigm for biologic initiation: a mixed-methods exploration of practices, unmet needs, and innovation opportunities in self-injection training
Published in Expert Opinion on Drug Delivery, 2021
Amy Rinaldi, Dimos Katsaros, James Hawthorne, Matthew D’Auria, Katherine Brigham, Erika Bajars, Chris Franzese, Marty Coyne
In terms of content, labeling elements (e.g. prescribing information) relay technical information required to use injection devices and medications safely – the mechanics of self-injection. However, for many patients, knowledge of mechanics alone is not sufficient to relieve persistent apprehension and anxiety associated with self-injection[14]. This emotional angst is well characterized and multifactorial, and includes concerns about incorrect technique, fear of side effects, lack of self-confidence, stigma of illness and social embarrassment, frustration with illness and treatment, and anxiety associated with needles[15]. Although patient satisfaction has been found to be higher when both knowledge and emotional needs are met[16], HCPs may neglect the emotional aspects of training[14], which can cause otherwise capable patients to never start or discontinue self-injection therapies [17,18].