This paper shares a diagnostically challenging case of radiation-induced sarcoma that first presented as gingival ulcerations and pain in a postradiated nasopharyngeal carcinoma patient. Insufficient information from the clinical presentation and non-specific findings from initial imaging results hindered early diagnosis. Nonetheless, correlation with medical history, prompt histopathological analysis and PET-CT imaging eventually led to a definitive diagnosis. This case report aims to increase the awareness of this uncommonly known but deadly long-term complication of head and neck radiotherapy. Clinicians ought to include radiation-induced sarcoma in their list of differential diagnosis when a patient, with a history of head and neck radiotherapy, presents with persistent gingival or oral mucosa lesions, alveolar bony exposure or other suspicious dental-related symptoms.
Mitsunaga and Hall make a noteworthy contribution to the literature in reporting results of their pilot study on Interpersonal Attraction and Quality of Medical-Surgical Care. The remarks which follow should not be viewed as a systematic critique of the research but rather as a brief commentary on those aspects of the study that had special interest to this reviewer.Drawing upon a sociological frame of reference, the investigators have set forth to test selected aspects of social exchange theory, the theory of interpersonal attraction, and Parson's framework on professional relationships in a clinical setting relevant to nursing. This is a commendable and necessary effort, as all too often theories from the social and behavioral sciences are adapted to a professional (or nursing) context without adequate empirical testing.Mitsunaga and Hall present a clear statement of their problem and focus for study. In Figure 1 they present an initial model of determinants of interpersonal attraction in the professional relationship. Similarity is highlighted as a factor found to have the greatest influence on attraction of people to one another, while social desirability and reciprocity of liking are cited as additional variables associated with attraction. The investigators further indicate that the terms liking and attraction are used synonymously in much of the literature. The investigators make a further point of differentiating liking from respect. Liking is characterized as feelings of warmth, closeness, and affection. The antecedent variables (similarity, social desirability, and reciprocity of liking) are therefore linked with liking viewed from this perspective.
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