Although it is assumed that most patients with terminal cancer are reluctant to receive life-sustaining treatment, there is a paucity of evidence supporting this assumption. We retrospectively analyzed the advance directives of terminal cancer patients to determine the preferences of patients. Patients with cancer who had life expectancy of less than 6 months were admitted to a palliative care unit in Seoul Medical Center from March 2008 to February 2010. Among a total of 247 patients, advance directives were present in the medical records of 168 patients (68.0%). Most of the advance directives were written by the patients’ families (95.2%) and they stated that they did not want most of the invasive procedures. Patients with advanced cancer mostly requested that only minimally invasive treatments that eased suffering be performed.
Vocal cord dysfunction is characterized by the paradoxical adduction of the vocal cord during inspiration, causing relapsing wheezing or stridor, chest tightness, shortness of breath, and coughing. If the patient exhibiting symptoms of asthma is not responsive to treatment, there is a need to test whether vocal cord dysfunction is complicated by asthma. Herein, we report a case of vocal cord dysfunction with acute respiratory failure in old age with underlying disease. The patient presented with resting dyspnea, an audible wheeze, and was first diagnosed with acute exacerbation of bronchial asthma. However, her symptoms were not controlled with medical treatment and laryngoscopy showed paradoxical adduction of the vocal cords. Sudden cardiopulmonary arrest occurred after meal on the day of laryngoscopic examination. Although successful cardiopulmonary resuscitation, the patient developed ventilatorassociated pneumonia, and multiple organ failure, eventually leading to death. Because the case was fatal, a report is being issued.
A prostatic abscess is a rare, but potentially serious disease. The mainstay of treatment for the prostatic abscess is antibiotic administration and drainage. Here, we experienced a 66-year-old man with a prostatic abscess caused by Providencia rettgeri, which has not been reported as a pathogenic agent of a prostatic abscess. He was cured using antibiotics, without surgical drainage. This case suggests that the appropriate selection of patients for antibiotic therapy may provide an excellent prognosis.
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