The effect of peer-led education on the life quality of mastectomy patients referred to breast cancer-clinics in Shiraz, Iran 2009

<p>Abstract</p> <p>Background</p> <p>Breast cancer among women is a relatively common with a more favorable expected survival rates than other forms of cancers. This study aimed to determine the improved quality of life for post-mastectomy women through peer education.</p> <p>Methods</p> <p>Using pre and post test follow up and control design approach, 99 women with stage I and II of breast cancer diagnosis were followed one year after modified radical mastectomy. To measure the quality of life an instrument designed by the European organization for research and treatment of cancer, known as the Quality of Life Question (QLQ-30) and it's breast cancer supplementary measure (QLQ-BR23) at three points in time (before, immediately and two months after intervention) for both groups were used. The participant selection was a convenient sampling method and women were randomly assigned into two experimental and control groups. The experimental group was randomly assigned to five groups and peer educators conducted weekly educational programs for one month. Tabulated data were analyzed using chi square, t test, and repeated measurement multivariate to compare the quality of life differences over time.</p> <p>Results</p> <p>For the experimental group, the results showed statistically significant improvement in all performance aspects of life quality and symptom reduction (P < 0.001), while the control group had no significant differences in all aspects of life quality.</p> <p>Conclusion</p> <p>The findings of this study suggest that peer led education is a useful intervention for post-mastectomy women to improves their quality of life.</p

ISTAKNUTI MOMENTI U DIJAGNOZI TUMORA DOJKI

Breast malignancies are one of the most prevalent and major causes of morbidity and mortality among women worldwide. According to the available data, neoplastic lesions of the breast are one of the main causes leading to heavy costs for both the healthcare system and the society. Based on these realities and the fact that different aspects of these malignancies remain unknown to date, and are essential to be determined, these issues make a vast area of research in medicine. Just like the present time, breast neoplasms were under the focus of scientists lived in the past, from all over the world. Accordingly, these malignancies are a group of disease with a long-standing historical background. As a result, it can be claimed that modern-day knowledge of these matters has burgeoned on the extraordinary discoveries and the development of diagnostic and therapeutic methods made through the ages, especially those of the post-medieval era. Recognizing the previous efforts that have been made in this regard will show our future way for us. For this reason, in this paper, we will review the key milestones and vital discoveries in the field of breast neoplasms and some other diseases involving this body organ.Maligne bolesti dojki su jedan od najčešćih i glavnih uzroka pobola i smrtnosti među ženama diljem svijeta. Prema dostupnim podacima, tumorske lezije dojke su jedan od glavnih uzroka koji dovode do teških troškova i za zdravstveni sustav i za društvo. Na temelju tih danosti i činjenici da su različiti aspekti tih malignih bolesti i dalje nepoznati do danas, te se tek trebaju odrediti, ta pitanja čine ogromno područje istraživanja u medicini. Baš kao i u sadašnjem trenutku, karcinom dojke je bio i u prošlosti u fokusu znanstvenika iz svih krajeva svijeta. Prema tome ove zloćudne bolesti su skupina bolesti s dugogodišnjom povijesnom pozadinom. Možemo, kao rezultat, tvrditi da suvremena znanja o tim pitanjima je procvjetalo s izvanrednim otkrićima i razvojem dijagnostičkih i terapijskih metoda kroz stoljeća, a posebno u onim nakon srednjeg vijeka. Prepoznajući prethodne napore koji su uloženi u tom pogledu pokazat će nam put za budućnost. Iz tog razloga, u ovom radu ćemo dati pregled ključnih prekretnica i važnih otkrića na području tmora dojke i nekih drugih bolesti koje uključuju taj organ

Design and Evaluation of the “Preparation Course for New Entrant Assistants” on the Awareness and Skills of Newly Arrived Surgery Resident

Background: Beginning of assistance course is associated with anxiety. This due to unfamiliarity with the&nbsp;assistance and insufficient training, knowledge, and required skills. The aims of this study were to design,&nbsp;implement and evaluate the effects of a period of 1-month as “preparation course for new entrant assistants” on&nbsp;the awareness and skills of newly arrived residents.Methods: 12 newly arrived assistant student were divided into two equal groups. Some steps such as&nbsp;understanding the environment and legislation, education about an emergency, and dealing with patients and&nbsp;also, suturing, chest tube insertion, and cut down skills were passed by the first group before starting the&nbsp;assistance course. The second group was entered in the assistance course without this preparation course. For&nbsp;performance evaluation and comparison of these two groups, four questionnaires were created and filled&nbsp;consequently before the entrance, at the end of the 2nd&nbsp;month, based on direct observation of procedural skills&nbsp;(DOPS) exam, and at the end of 6th&nbsp;month.Results: There were no significant differences between two groups at the beginning of the study (P &lt; 0.05). At&nbsp;the end of the 2nd&nbsp;month, the first group had better performance in understanding the environment, patient&nbsp;examination, diagnosis and emergency skills in comparison to the second group (P &lt; 0.05). Based on the&nbsp;DOPS score, the first group had significantly better performance (P &lt; 0.05) except in performing cut-down (P &gt; 0.05). Also procedure, the first group was better than the second group just in the consensus of the&nbsp;procedure (P &lt; 0.05). Finally, at the end of the 6th&nbsp;month, the difference between two groups was becoming&nbsp;lower, and supervisors believed that after additional 3 months, this difference would be lost.Conclusions: Conducting a 1-month period of preparation for new entrant assistants can be useful in&nbsp;increasing awareness, understanding the environment, performance, the knowledge of the theory and how to&nbsp;deal with patients as well as increase their skills in performing the expected procedures

Introducing novel and comprehensive models for predicting recurrence in breast cancer using the group LASSO approach: are estimates of early and late recurrence different?

BACKGROUND: In here, we constructed personalized models for predicting breast cancer (BC) recurrence according to timing of recurrence (as early and late recurrence). METHODS: An efficient algorithm called group LASSO was used for simultaneous variable selection and risk factor prediction in a logistic regression model. RESULTS: For recurrence  5 years, stage 2 cancer (OR 1.67, 95% CI = 1.31-2.14) and radiotherapy+mastectomy (OR 2.45, 95% CI = 1.81-3.32) were significant predictors; furthermore, relative to mastectomy without radiotherapy (as reference for comparison), quadranectomy without radiotherapy had a noticeably higher odds ratio compared to quadranectomy with radiotherapy for recurrence > 5 years (OR 7.62, 95% CI = 1.52-38.15 vs. OR 1.75, 95% CI = 1.32-2.32). Accuracy, sensitivity, and specificity of the model were 71%, 78.8%, and 55.8%, respectively. CONCLUSION: For the first time, we constructed models for estimating recurrence based on timing of recurrence which are among the most applicable models with excellent accuracy (> 80%)

Machine Learning Models for Predicting Breast Cancer Risk in Women Exposed to Blue Light from Digital Screens

Background: Nowadays, there is a growing global concern over rapidly increasing screen time (smartphones, tablets, and computers). An accumulating body of evidence indicates that prolonged exposure to short-wavelength visible light (blue component) emitted from digital screens may cause cancer. The application of machine learning (ML) methods has significantly improved the accuracy of predictions in fields such as cancer susceptibility, recurrence, and survival. Objective: To develop an ML model for predicting the risk of breast cancer in women via several parameters related to exposure to ionizing and non-ionizing radiation.Material and Methods: In this analytical study, three ML models Random Forest (RF), Support Vector Machine (SVM), and Multi-Layer Perceptron Neural Network (MLPNN) were used to analyze data collected from 603 cases, including 309 breast cancer cases and 294 gender and age-matched controls. Standard face-to-face interviews were performed using a standard questionnaire for data collection. Results: The examined models RF, SVM, and MLPNN performed well for correctly classifying cases with breast cancer and the healthy ones (mean sensitivity> 97.2%, mean specificity >96.4%, and average accuracy >97.1%).  Conclusion: Machine learning models can be used to effectively predict the risk of breast cancer via the history of exposure to ionizing and non-ionizing radiation (including blue light and screen time issues) parameters. The performance of the developed methods is encouraging; nevertheless, further investigation is required to confirm that machine learning techniques can diagnose breast cancer with relatively high accuracies automatically

Comparison of liquid-based and conventional cytology in diagnosis of breast mass

Background: Among all diagnostic techniques for breast lesions, fine-needle aspiration (FNA) is the simplest, most reliable and cheapest one. Aim: To compare liquid-based and conventional cytology in diagnosis of breast mass. Materials and Methods: About 101 patients with breast mass were enrolled. The aspirated materials were divided into two parts. One was poured into a liquid medium and the other part was directly spread on clean glass slides. Conventional and liquid-based preparations were compared using several criteria including adequacy (presence of the epithelial cluster or myoepithelial cells), overall cellularity, presence of single epithelial cells, presence of myoepithelial cells, epithelial architecture, nuclear detail, nuclear atypia and inflammatory/proteinaceous background and final diagnosis. Results: Among 101 cases, 85 (84.1%) were malignant and 16 (15.9%) were benign. Conventional and liquid-based cytology were similar according to adequacy (P = 0.65), cellularity (P = 0.13), epithelial architecture (P = 0.15), presence of myoepithelial cells (P = 0.61), nuclear detail (P = 0.57) and nuclear atypia (P = 0.44), while there were a significant difference between the two methods according to the presence of single epithelial cells (P < 0.001) and background (P < 0.001). Conclusion: Liquid-based cytology of breast specimens is an accurate diagnostic tool with high diagnostic yield in benign and malignant lesions

Combined Methylene Blue Dye andRadioactive Tracer Technique for Sentinel Lymph Node Localization in Early Breast Cancer

Background: Sentinel lymph node biopsy is a technique used to identify the axillary node most likely to contain tumor cells that have metastasized from a primarycarcinoma of the breast. This technique provides accurate staging with fewer complications than axillary dissection and may result in decreased costs. We designed the present study to determine the accuracy and success rate of a combined blue dyeand radioactive tracer technique in sentinel node localization. Methods: This prospective study included 70 patients with early stage (tumor>5cm; T1, T2) operable breast cancer and nonpalpable axillary lymphadenopathy seen between 2005 and 2009. Patients underwent sentinel lymph node localization using 4mL of blue dye combined with radioactive colloid. After identification and removal of the sentinel node(s), the axilla was checked for any residual radioactivity. A sentinelnode was defined as any node that was hot, hot and blue or only blue.Results:The sentinel node was identified in 66 patients with a detection rate of 94.2%,and a mean of 1.5 sentinel nodes were identified and harvested (range of 1-4). In 23cases, the sentinel lymph node contained metastatic disease on pathological assessment.There was no pathological evidence of any metastases in the sentinel node in the remaining 43 patients. All sentinel lymph nodes were located in level I of the axillary region. In four patients, no sentinel lymph node was found, so axillary dissection was performed. The sensitivity of the procedure in predicting further axillary disease was 95.6% with a specificity of 97.6%.Conclusion: The present study describes the blue dye and radioisotope localization technique as successful in identifying the sentinel lymph node in early-stage breast cancer patients

Pancreatic Metastasis from Rectal Gastrointestinal Stromal Tumor: A Case Report

Gastrointestinal stromal tumors are mesenchymal neoplasms of the gastrointestinal tract that originate from all areas of the gastrointestinal tract. Metastases to the liver, peritoneum, bones, lungs and soft tissues have been reported. We present the case of a 47- year-old woman with rectal gastrointestinal stromal tumor that underwent wide local excision. She was treated with imatinib for a few months after surgery. After eight months, she was admitted to the emergency service with complaints of epigastric pain, nausea, vomiting, and anorexia. Imaging studies showed the presence of a pancreatic head tumor and three hepatic masses. The patient underwent exploratory laparatomy. Excisional biopsy of one hepatic mass and core needle biopsy of the pancreatic head mass revealed metastases to the liver and pancreas. During the hospital course the patient's condition deteriorated and she subsequently expired