• Title/Summary/Keyword: Teaching hospital

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Risk for Malignant and Borderline Ovarian Neoplasms Following Basic Preoperative Evaluation by Ultrasonography, Ca125 Level and Age

  • Karadag, Burak;Kocak, M.;Kayikcioglu, F.;Ercan, F.;Dilbaz, B.;Kose, M.F.;Haberal, A.
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8489-8493
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    • 2014
  • Objective: To verify the basic preoperative evaluation in the discrimination between benign and malignant adnexal masses in our clinical practice. Materials and Methods: Data were collected on the records of 636 women with adnexal masses who had undergone surgery either by open or endoscopic approaches. Those with obvious signs of malignancy, any history of cancer, emergency surgeries without basic evaluation were excluded. The preoperative features by age, ultrasound and serum Ca125 level were compared with final histopathological diagnosis at the four departments of the institution. These are the general gynecology (Group 1: exploratory laparotomy), the gynecologic endoscopy (Group 2: laparoscopy and adnexectomy), the gynecological oncology (Group 3: staging laparotomy) and the gynecologic endocrinology and infertility (Group 4: laparoscopy and cystectomy). Results: There were simple and complex cyst rates of 22.3% and 77.2%, respectively. There were 86.3% benign, 4.1% (n:20) borderline ovarian tumor (BOT) and 6.4% (n:48) malignant lesions. There were 3 BOT and 9 ovarian cancers in Group 1 and one BOT and two ovarian cancer in the Group 2. During the surgery, 15 BOT (75%) and 37 ovarian cancer (77%) were detected in the Group 3, only one BOT was encountered in the Group 4. The risk of rate of unsuspected borderline or focally invasive ovarian cancer significantly increased by age, size, complex morphology and Ca125 (95% CI, OR=2.72, OR=6.60, OR=6.66 and OR=4.69, respectively). Conclusions: Basic preoperative evaluation by comprehensive ultrasound imaging combined with age and Ca125 level has proved highly accurate for prediction of unexpected malignancies. Neither novel markers nor new imaging techniques provide better information that allow clinicians to assess the feasibility of the planned surgery; consequently, the risk of inadvertent cyst rupture during laparoscopy may be significantly decreased in selected cases.

Genetic Variants in ASCT2 Gene are Associated with the Prognosis of Transarterial Chemoembolisation-Treated Early-Stage Hepatocelluar Carcinoma

  • Ge, Nai-Jian;Shi, Zhi-Yong;Yu, Xiao-He;Huang, Xiao-Jun;Wu, You-Sheng;Chen, Yuan-Yuan;Zhang, Jin;Yang, Ye-Fa
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.9
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    • pp.4103-4107
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    • 2015
  • Background: Hepatocellular carcinoma (HCC) is one of the most prevalent malignancies worldwide. Transarterial chemoembolisation (TACE) is the standardized therapy for intermediate stage HCC. However, the prognosis for HCC patients treated by TACE greatly varies. Thus, there is a critical need for finding biomarkers to predict the prognosis of HCC patients. The amino acid transporter-2 (ASCT2) is involved in tumorigenesis and progression of many malignancies. This study aimed to evaluate the predictive role of two single nuclear polymorphisms (SNPs, rs3826793 and rs2070246) in the ASCT2 gene in HCC patients treated by TACE. Materials and Methods: Two functional SNPs (rs3826793 and rs2070246) in the ASCT2 gene were selected and genotyped using the Sequenom iPLEX genotyping system in a cohort of 448 unresectable Chinese HCC patients treated by TACE. Univariate and multivariate Cox proportional hazards models and Kaplan-Meier curves were used for the prognosis analyses. Results: There was no significant association between two SNPs (rs3826793 and rs2070246) in the ASCT2 gene and overall survival of TACE treated HCC patients. However, we demonstrated that patients with early stage HCC carrying T genotype in rs2070246 showed better OS than those carrying CC genotype (P=0.023). Conclusions: We demonstrated that patients with early stage HCC carrying T genotype in rs2070246 showed better OS than those carrying CC genotype.

Health-Care Providers' Perspectives towards Childhood Cancer Treatment in Kenya

  • Njuguna, F;Burgt, RHM van der;Seijffert, A;Musimbi, J;Langat, S;Skiles, J;Sitaresmi, MN;Ven, PM van de;Kaspers, GJL;Mostert, S
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4445-4450
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    • 2016
  • Background: This study explored perspectives of health-care providers on childhood cancer treatment in Kenya. Materials and Methods: A self-administered questionnaire was completed by 104 health-care providers in January and February 2013. Results: Seventy six percent of the health-care providers believed cancer to be curable. More doctors than other health-care providers had this positive opinion (p=0.037). The majority of health-care providers (92%) believed that most children with cancer will not be able to finish their treatment due to financial difficulties. They considered that prosperous highly-educated parents adhere better with treatment (88%) and that doctors adhere better with treatment for prosperous highly-educated parents (79%). According to 74% of health-care providers, quality of care is better for prosperous highly-educated parents (74%). Most health-care providers reported giving more explanation (71%), work with greater accuracy (70%) and use less difficult vocabulary (55%) to prosperous more educated families. Only 34% of health-care providers reported they feel more empathy towards patients from prosperous families. Reasons for non-adherence with the protocol according to health-care providers are: family refuses drugs (85%), inadequate supply of drugs at pharmacy (79%), child looks ill (75%), and financial difficulties of parents (69%). Conclusions: Health-care providers' health beliefs and attitudes differ for patients with families having high versus low socio-economic backgrounds.

Teaching Breast Cancer Screening via Text Messages as Part of Continuing Education for Working Nurses: A Case-control Study

  • Alipour, Sadaf;Jannat, Forouzandeh;Hosseini, Ladan
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5607-5609
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    • 2014
  • Introduction: Although continuing education is necessary for practicing nurses, it is very difficult to organize traditional classes because of large numbers of nurses and working shifts. Considering the increasing development of mobile electronic learning, we carried out a study to compare effects of the traditional face to face method with mobile learning delivered as text messages by cell phone. Materials and Methods: Sixty female nurses working in our hospital were randomly divided into class and short message service (SMS) groups. Lessons concerning breast cancer screening were prepared as 54 messages and sent in 17 days for the SMS group, while the class group participated in a class held by a university lecturer of breast and cancer surgery. Pre- and post-tests were undertaken for both groups at the same time; a retention test also was performed one month later. For statistical analysis, the paired T test and the independent sample T test were used with SPSS software version 16; p<0.05 was considered significant. Results: Mean age and mean work experience of participants in class and SMS groups was $35.8{\pm}7.2$, $9.8{\pm}6.7$, $35.4{\pm}7.3$, and $11.5{\pm}8.5$, respectively. There was a significant increase in mean score post-tests (compared with pretests) in both groups (p<0.05). Although a better improvement in scores of retention tests was demonstrated in the SMS group, the mean subtraction value of the post- and pretests as well as retention- and pretests showed no significant difference between the 2 groups (p=0.3 and p =0.2, respectively). Conclusions: Our study shows that teaching via SMS may probably replace traditional face to face teaching for continuing education in working nurses. Larger studies are suggested to confirm this.

Polymorphisms in Genes of the De Novo Lipogenesis Pathway and Overall Survival of Hepatocellular Carcinoma Patients Undergoing Transarterial Chemoembolization

  • Wu, You-Sheng;Bao, Deng-Ke;Dai, Jing-Yao;Chen, Cheng;Zhang, Hong-Xin;Yang, YeFa;Xing, Jin-Liang;Huang, Xiao-Jun;Wan, Shao-Gui
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.1051-1056
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    • 2015
  • Aberrant expression of genes in de novo lipogenesis (DNL) pathway were associated with various cancers, including hepatocellular carcinoma (HCC). Single nucleotide polymorphisms (SNPs) of DNL genes have been reported to be associated with prognosis of some malignancies. However, the effects of SNPs in DNL genes on overall survival of HCC patients receiving transarterial chemoembolization (TACE) treatment are still unknown. In present study, nine SNPs in three genes (ACLY, ACACA and FASN) in DNL pathway were genotyped using the Sequenom iPLEX genotyping system in a hospital-based cohort with 419 HCC patients treated with TACE, and their associations with HCC overall survival were evaluated by Cox proportional hazard regression analysis under three genetic models (additive, dominant and recessive). Although we did not find any significant results in total analysis (all p>0.05), our stratified data showed that SNP rs9912300 in ACLY gene was significantly associated with overall survival of HCC patients with lower AFP level and SNP rs11871275 in ACACA gene was significantly associated with overall survival of HCC patients with higher AFP level. We further identified the significant interactions between AFP level and SNP rs9912300 or rs11871275 in the joint analysis. Conclusively, our data suggest that genetic variations in genes of DNL pathway may be a potential biomarker for predicting clinical outcome of HCC patients treated with TACE.

Epidemiological Features of Human Papillomavirus (HPV) Infection among Women Living in Mainland China

  • Li, Jing;Huang, Rong;Schmidt, Johannes E.;Qiao, You-Lin
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.7
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    • pp.4015-4023
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    • 2013
  • Cancer of the cervix is the third most common cancer in women worldwide, more than 85% of the cases occurring in developing countries such as China. In China, since a national cancer registry is already set up but with geographically limited data generated, the burden of cervical cancer is believed to be underestimated. High-risk human papillomavirus (HR-HPV) prevalence among women attending routine cervical cancer screening programs has been shown to correlate well with cervical cancer incidence rates based on independently obtained HPV prevalence data as well as findings for the worldwide cervical cancer burden. Therefore, reviewing data on HR-HPV prevalence in population-based screening studies and hospital-based case studies will be important in the context of better understanding the cervical cancer burden and for the evaluation of the potential impact of HPV vaccination in the country. With the advent of prophylactic vaccines, significant progress is likely to be made in cervical cancer prevention. This article reviews available data on the HPV epidemiology over a 12-year time period (2001-2012) in mainland China under different epidemiological aspects: by age group of study population, by ethnicity, by geographic area, as well as time period. The authors also review the potential acceptability of HPV vaccination among Chinese women.

Ameloblastic carcinoma of the maxilla: a report of two cases and a review of the literature

  • Fomete, Benjamin;Adebayo, Ezekiel Taiwo;Ayuba, Godwin Iko;Okeke, Uche Albert
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.42 no.1
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    • pp.43-46
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    • 2016
  • Ameloblastic carcinoma is a malignant form of ameloblastoma defined by histological evidence of malignancy in primary, recurrent, or metastatic tumor. Such a tumor is rare, and the maxilla is an unusual site. Due to its rarity, the characteristics of this tumor in the maxilla have not been well described. Case 1: A 55-year-old, ill-appearing Nigerian male presented to our center with left maxillary swelling of seven-year duration. The swelling had been slow-growing and painless until one year prior, when the growth became rapid and was coupled with severe pain. The swelling affected both oral function and facial esthetics, and the patient reported difficulty breathing. There was a maxillary, ulcerated swelling extending from teeth 12 to 18 and blocking the left nostril. The involved teeth were moderately mobile. Case 2: A 32-year-old male farmer presented with recurrent right maxillary swelling of six-year duration. Prior to this episode, he had undergone surgery for ameloblastoma (follicular type). The present swelling was fungating through the skin and protruding into the right nostril. Ameloblastic carcinoma is an aggressive odontogenic tumor that requires aggressive surgical treatment.

The Epidemiology of Delays in a Teaching Hospital (부적절 재원의 이유)

  • Kim, Yoon;Lee, Kun-Sei;Kim, Chang-Yup;Kim, Yong-Ik;Shin, Young-Soo;Lee, Sang-Il
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.4 s.44
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    • pp.650-660
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    • 1993
  • This study aims to describe the causes of medically unnecessary hospital stay at a teaching tertiary hospital, using modified version of Delay Tool in which the causes of delay are divided into slx major categories : delay related to test scheduling, test results, surgery, medical staff, patient/family, and administration. For the analysis of hospital stay, 6,479 inpatient-days were reviewed in two medical and four surgical departments for one month. Initially inappropriate hospital stays were identified using Appropriateness Evaluation Protocol (AEP), and causes of delay listed in Delay Tool were assigned to each of them. In both medical and surgical services, the most important cause of delay was related to medical staffs, ranging from 3.6% to 51.6% of total inpatient days. Next important category was delay related to test scheduling in medical services ($4.7{\sim}9.2%$), and delay related to surgery in surgical services ($7.3{\sim}15.0%$). Among subcategories of delay related to medical staffs, delay due to conservative care was the most important cause of inappropriate hospital stay ($2.9{\sim}6.4%$). Each clinical departments had different distribution among delay categories, which could not be fully justified by their clinical charateristics. The Delay Tool would be helpful in exploring factors related to the inefficient use of hospital beds. As a measurement tool of inappropriate hospital stay, however, the Delay Tool should be refined in the definitions of categories and its contents.

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The effect of a diabetic group teaching program (당뇨병 환자 집단교육의 효과 및 교육효과 및 지속에 관한 연구)

  • 이향련
    • Journal of Korean Academy of Nursing
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    • v.23 no.2
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    • pp.170-186
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    • 1993
  • This study evaluated the effect of diabetic group teaching programs in one university hospital in Seoul to predict when re-education would be needed. This study examined the patients’ knowledge at four points (before, directly after, three months and six months after the teaching program) and self-care performance related to diabetes twice (three months and six months after the teaching program). The subjects of the study were 24 admitted diabetic patients who participated in four-day teaching programs. Data were gathered from January to October, 1992 by means of an instrument developed from two diabetic knowledge tests which were equivalent in item differentiation and item discrimination coefficients. Collected data were analyzed by paired t-test, Pearson correlation, t and F tests. The results of study were as follows. 1. The analysis of the effect of the diabetic group teaching program and the duration of the effect of teaching. 1) The first hypothesis, that the diabetes knowledge score directly after the teaching program would be higher than before, was rejected (t=-1.40 ; p=.172). 2) The second hypothesis, that the diabetes knowledge score directly after teaching would be higher than three months later, was rejected(t= -4.27 ; p=.000). 3) The third hypothesis, that the diabetes knowledge score three months after teaching would be higher than six months later, was supported(t=2.43 : p=.020). 2. The relation of knowledge and self-care performance 1) The forth hypothesis, that the level of self-care performance related to diabetes three months later would be higher than six months later, was rejected( t=1.49 ; p=.146). 2) The fifth hypothesis, that the higher the diabetes knowledge, the higher the level of self-care performance, was rejected(r=.2086 ; p=.118). 3. The relation of diabetes knowledge and self-care performance according to demographic variables and structural variables of diabetes. 1) Diabetic knowledge scores varied according to the educational levels of the clients directly after the teaching. Three months after the teaching program higher educational levels and higher economic status were related to higher diabetic knowledge scores and men had higher knowledge scores than women. 2) Self-care performance scores of men were higher than those of women at three months and six months after the teaching program. 3) Before the diabetes teaching, the diabetic knowledge scores of subjects who had a diabetic patient in the family were higher than those who did not have patient in their family. Six months after the teaching, the diabetic knowledge scores of subjects who read the distributed books about diabetes were higher than those who did not read them. 4) No significance differences were found be-ween self-care performance and structural variables of dialetes. The results of this study indicated that the levels of diabetes knowledge and self-care performance incense of three months after the teaching program but decrease of six months. Reeducation would be needed between three and sir months. The investigator thinks that a study of the content and teaching methodology is needed to increase the education effect. The subjects want to hear patient histories of diabetic management. Group discussion would be helped after the teaching sessions.

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Development and Evaluation of a Patient Safety-focused Inservice Education Program for Surgical Nurse (외과계 간호사를 위한 환자안전 관점의 실무교육 프로그램 개발과 효과)

  • Kim, Young-Mee;You, Myung-Sook;Cho, Yaun-Hee;Park, Seung-Hee;Nam, Seung-Nam;Park, Mi-Ok;Kim, Se-Young;Kim, Min-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.16 no.2
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    • pp.152-161
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    • 2010
  • Purpose: The aim of this project was to develop a patient safety-focused inservice education program for surgical nurse and to test the effects of this program. Methods: Methodological designs for instruments development, a pretest-posttest and a posttest design were employed. After the education, nurses' satisfaction, confidence, usefulness and application of 137 nurses were evaluated at 15 surgical units of a tertiary teaching hospital in Seoul, Korea. The education contents are 6 skill areas (infusion pump use, suction, chest tube drainage, oxygen administration, nebulizer use, insulin administration) and medication knowledge. Teaching methods were lecture, instructor demonstration, and 1:1 skill test. Descriptive statistics, Wilcoxon test, Spearman's correlation and Stepwise regression were used. Results: Satisfaction scores for skills and medication education were 4.00-4.21 (out of 5), The more performance frequency in 6 skills, the higher score in confidence as well as in usefulness and application, and the higher satisfaction with the program, the higher score in usefulness, application, confidence, and medication knowledge. Medication knowledge improved after the education (Z=-7,757, p<.001). Significant predictors of skill confidence were application of skills in job performance, medication confidence, and career in present unit. Conclusion: The results of this study suggest that systematic and continuous inservice education will improve patient safety by promoting nursing quality.