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Sample records for cancer center hospital

  1. Studies on retrospective analysis of leading primary cancers and improvement of cancer treatment method in Korea cancer center hospital

    International Nuclear Information System (INIS)

    a. Retrospective studies included cancers of the stomach, breast, bladder, salivary gland, thyroid, esophagus, endometrium and ovary. (1) Study cancers were analyzed about clinical characteristics, prognostic factors influenced on survival time, survival rate, etc. (2) Among 5,305 study patients, 1,405(26.5%) were identified with death, 3,485(65.7%) were alive and 415(7.8%) were not identified. b. Prospective studies included 10 subjects such as bladder cancer, retinoblastoma, malignant patients, gastric cancer, uterine cervix cancer and ovary cancer. We are continuing registering eligible study patients. c. Results for 11 papers were published at the journal. d. We established follow-up system in order to identify the survival for study subjects through National Statistical Office, Government Provincial Office and Cancer Registration System at Korea Cancer Center Hospital. e. At present, we are establishing computerized registration system about case report form for study cancers

  2. Studies on retrospective analysis of leading primary cancers and improvement of cancer treatment method in Korea cancer center hospital

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jong In; Lee, Kang Hyun; Choi, Soo Yong; Kim, Ki Wha; Kang, Sung Mok

    2000-12-01

    a. Retrospective studies included cancers of the stomach, breast, bladder, salivary gland, thyroid, esophagus, endometrium and ovary. (1) Study cancers were analyzed about clinical characteristics, prognostic factors influenced on survival time, survival rate, etc. (2) Among 5,305 study patients, 1,405(26.5%) were identified with death, 3,485(65.7%) were alive and 415(7.8%) were not identified. b. Prospective studies included 10 subjects such as bladder cancer, retinoblastoma, malignant patients, gastric cancer, uterine cervix cancer and ovary cancer. We are continuing registering eligible study patients. c. Results for 11 papers were published at the journal. d. We established follow-up system in order to identify the survival for study subjects through National Statistical Office, Government Provincial Office and Cancer Registration System at Korea Cancer Center Hospital. e. At present, we are establishing computerized registration system about case report form for study cancers.

  3. Epidemiology of breast cancer at the shaukat khanum memorial cancer hospital and research center, lahore, pakistan

    International Nuclear Information System (INIS)

    To describe the demographic and clinical features of females presenting with breast malignancies at the Shaukat Khanum Memorial Cancer Hospital and Research Center (SKMCH and RC), Lahore, Pakistan. Study Design: An observational study. Place and Duration of Study: SKMCH and RC, Lahore, from January 2008 to December 2012. Methodology: Demographic and clinical features of female breast cancer patients, registered at SKMCH and RC, were studied. Mean values, counts, and percentages were obtained. Results: Four-thousand, three-hundred and sixty-six female breast malignancies were recorded. Nearly 80.4% of the patients belonged to Punjab. Mean age at presentation was 48.6 ± 12.2 years, at menarche was 13.2 ± 1.2 years, and at first childbirth was 23.7 ± 4.8 years. Mean Body Mass Index (BMI) was 29.0 ± 5.7 kg/m2. In 60.1%, history of breast feeding was positive. In 55.7%, there was no history of use of any Oral Contraceptive Pills (OCP)/Hormone Replacement Therapy (HRT). Nearly 42.7% were postmenopausal, 85.2% had infiltrating ductal carcinoma, 49.6% had grade 3 tumor, 60.7% had stage II disease, and 37.3% were Estrogen Receptor (ER)/Progesterone Receptor (PR)+, Human Epidermal Growth Factor Receptor 2 (HER2)-. Family history of breast cancer was positive in 16.9% of the cases. Conclusion: The mean presenting age is lower than what has been recorded in the West. It may be worthwhile collating results from different institutions in order to study the epidemiology of the disease more extensively and develop cancer control and early detection programs. (author)

  4. Colorectal cancer: A case control study of dietary factors, King Faisal specialist hospital and researh center, Riyadh, Saudi Arabia

    OpenAIRE

    Nashar, Reem M.; Khalid S Almurshed

    2008-01-01

    Objective: This study was designed to assess various dietary factors and the nutritional status of hospitalized patients with colorectal cancer. Materials and Methods: A case-controlled study of fifty newly-admitted patients at King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia diagnosed with colorectal cancer were interviewed to collect data on various dietary factors and their nutritional status. Their data were compared with a sex-matched control group aged fifty. ...

  5. Lessons Learned from Unfavorable Microsurgical Head and Neck Reconstruction: Japan National Cancer Center Hospital and Okayama University Hospital.

    Science.gov (United States)

    Kimata, Yoshihiro; Matsumoto, Hiroshi; Sugiyama, Narusi; Onoda, Satoshi; Sakuraba, Minoru

    2016-10-01

    The risk of surgical site infection (SSI) remains high after major reconstructive surgery of the head and neck. Clinical data regarding SSI in microsurgical tongue reconstruction are described at National Cancer Hospital in Japan, including discussions of unfavorable representative cases, the relationship between SSI and preoperative irradiation at Okayama University Hospital in Japan, and strategies for SSI control in head and neck reconstruction. Local complications are inevitable in patients undergoing reconstruction in the head and neck areas. The frequency of major complications can be decreased, and late postoperative complications can be prevented with the help of appropriate methods. PMID:27601396

  6. Children's cancer centers

    Science.gov (United States)

    Pediatric cancer center; Pediatric oncology center; Comprehensive cancer center ... Treating childhood cancer is not the same as treating adult cancer. The cancers are different. So are the treatments and the ...

  7. A research on the enhancement of research management efficiency for the division of research, Korea cancer center hospital

    International Nuclear Information System (INIS)

    The research activities of Korea Cancer Center Hospital have increased for the past a few years just in proportion to the increase of research budget, but the assisting manpower of the office of research management has never been increased and the indications are that the internal and external circumstances will not allow the recruitment for a fairly long time. It has, therefore, become inevitable to enhance the work efficiency of the office by analyzing the administrative research assistance system, finding out problems and inefficiency factors, and suggesting possible answers to them. The office of research management and international cooperation has conducted this research to suggest possible ways to facilitate the administrative support for the research activities of Korea Cancer Center Hospital By analyzing the change of research budget, organization of the division of research and administrative support, manpower, and the administrative research supporting system of other institutes, we suggested possible ways to enhance the work efficiency for administrative research support and developed a relative database program. The research report will serve as a data for the organization of research support division when the Radiation Medicine Research Center is established. The database program has already been used for research budget management

  8. Treatment of locally advanced pancreatic cancer by percutaneous and intraoperative irreversible electroporation: general hospital cancer center experience.

    Science.gov (United States)

    Lambert, L; Horejs, J; Krska, Z; Hoskovec, D; Petruzelka, L; Krechler, T; Kriz, P; Briza, J

    2016-01-01

    The aim of this study was to evaluate the safety of irreversible electroporation (IRE) and the outcome of patients undergoing IRE of locally advanced pancreatic cancer (PC). Twenty-one patients with unresectable PC underwent open (n=19) or percutaneous (n=2) IRE of the tumor using the Nanoknife system with two electrodes that were repositioned several times to affect the whole mass. The size of the tumor was 39±10mm with a range from 21 to 65mm. Five patients underwent neoadjuvant chemotherapy and seven patients were treated with chemotherapy after IRE. Complications occurred in five patients, which resulted in prolongation of the average hospital stay from 10 to 34 days. There was no mortality in the first postoperative month. Median survival after IRE was 10.2 months compared to 9.3 months in a matched cohort (hazard ratio = .54, p = .053). The quality of life was declining slowly. 81% of time after IRE the Karnofsky performance status was ≥70 and sharp decline occurred approximately 8 weeks before death.In conclusion, IRE is a safe palliative treatment option for a percentage of patients with locally advanced pancreatic carcinoma. The patients treated with open IRE lived a decent life until 8 weeks before their death. We believe that IRE of pancreatic carcinoma can be regarded as an option, if imaging or explorative laparotomy show that R0 resection in not possible. PMID:26774149

  9. Profiles of gall bladder cancer reported in the hospital cancer registry of a Regional Cancer Center in the North-East India

    OpenAIRE

    Srabana Misra Bhagabaty; Jagannath Dev Sharma; Manigreeva Krishnatreya; Pintu Nandy; Amal Chandra Kataki

    2014-01-01

    Background: The incidence of gall bladder cancer (GBC) is very high in this part of the world and there is little information on the descriptive epidemiology of GBC from our population. Methods: A retrospective study on the data set of hospital cancer registry was analyzed. The data set consisted of patient information registered during the period of January 2011 to December 2012. The cases included for the present study were histologically confirmed and radiologically diagnosed cases of G...

  10. Diagnostic whole body scan (pre-therapy scan in differentiated thyroid cancer: A single center community hospital experience

    Directory of Open Access Journals (Sweden)

    P Santhanam

    2016-01-01

    Full Text Available Objective: Diagnostic whole body scan (pre-therapy scan with either I-123 or I-131 (radioactive isotopes of iodine is performed to assess the extent of thyroid cancer especially distant metastasis prior to administering the therapeutic dose of I-131. Our aim of the following study was to determine the utility of the diagnostic pre-therapy scan in the management of differentiated thyroid cancer. Materials and Methods: It was a case-control study carried out by retrospective chart review, of a randomly selected 100 patients with differentiated thyroid cancer who had followed in our community hospital over the course of 1 year. We collected data on multiple variables in the subjects - including age, gender, pre-operative size of the nodules, diagnosis, stage of the malignancy, size of the tumor, multifocality, lymphovascular invasion, dose of radioiodine used for remnant ablation, recurrence rates and persistence rates. Continuous variables were compared using the independent sample Mann-Whitney U-test whereas the Chi-square test was used for nominal variables. Results: The mean dose of radioactive iodine administered was 97.56 (±27.98 in the pre-therapy scan group and it was 97.23 (±32.40 in the control group. There was no difference between the two groups (P - 0.45. There was also no difference in the recurrence rates between the groups (P = 1.0. There was a trend toward a higher degree of persistent cancer in the group that had the pre-therapy scans (P - 0.086. Conclusion: Pre-therapy scan may not affect the dose of radio-iodine I-131 used for remnant ablation of differentiated thyroid cancer and does not influence the recurrence rates. This was especially true with respect to I-131 remnant ablation for low risk tumors.

  11. Analysis of a hospital call center

    OpenAIRE

    Budak, Ezel Ezgi

    2012-01-01

    Ankara : The Department of Industrial Engineering and the Graduate School of Engineering and Science of Bilkent University, 2012. Thesis (Master's) -- Bilkent University, 2012. Includes bibliographical refences. In this thesis, we study the call center operations of a particular hospital located in Ankara, namely Güven Hospital. The hospital call center takes role as a medical consulting and appointment center and also domestic call traffic flows over the call center. These ...

  12. Results of LINAC radiotherapy of patients with cancer in Nuclear Medicine and Oncology Center, Bach Mai Hospital

    International Nuclear Information System (INIS)

    Purpose of the study is to review some characteristics of LINAC radiotherapy and to evaluate rate of objective response in some common cancer diseases. Patients and method: Cross study with patients were confirmed diagnostic by histopathology who have indication radiation of treatment from July 2007 to March 2015, completely treatment protocol, were followed up regularly, fully medical record. Results: 6290 patients, most of patients were male (61.1%), 40-50 years old (51.8%). Common cancer diseases included lung cancer (25.0%) , malignant brain tumor (13.6%), oesophageal cancer (12.1%), nasopharyngeal cancer (9.0%). PET/CT simulation was applied in 1036 patients (16.5%), the highest rate disease was nasopharyngeal cancer (26.4%), oesophageal cancer (24.8%). 464 cases were treated by IMRT technic (7.4%). In IMRT technic, the highest rate disease was hypopharyngeal cancer (23.5%), cervical cancer (19.4%), nasopharyngeal cancer (16.2%). Five common diseases, compare to CT Sim, PET/CT sim made change GTV from 33.3% to 64.7%, detected new lesions (19.4-36.2%). Compare to 3D-CRT, IMRT technic ensured dose of organ at risk lower, the tumor dose was the same in 2 technic. The nasopharyngeal cancer had highest responsive rate (95.8%), complete response was 88.4%, following is rectal cancer( 94% and 59.3%), pharyngeal cancer (85.8% and 46.6%) esophageal cancer (84.9% and 18.4%) and lung cancer (80.1% and 15.4%), respectively. Conclusions: LINAC radiotherapy, especially PET/CT Sim, IMRT technic were of much benefit to many patients with cancer. (author)

  13. The revised Bethesda guidelines: extent of utilization in a university hospital medical center with a cancer genetics program

    Directory of Open Access Journals (Sweden)

    Mukherjee Aparna

    2010-11-01

    Full Text Available Abstract Background In 1996, the National Cancer Institute hosted an international workshop to develop criteria to identify patients with colorectal cancer who should be offered microsatellite instability (MSI testing due to an increased risk for Hereditary Nonpolyposis Colorectal Cancer (HNPCC. These criteria were further modified in 2004 and became known as the revised Bethesda Guidelines. Our study aimed to retrospectively evaluate the percentage of patients diagnosed with HNPCC tumors in 2004 who met revised Bethesda criteria for MSI testing, who were referred for genetic counseling within our institution. Methods All HNPCC tumors diagnosed in 2004 were identified by accessing CoPath, an internal database. Both the Tumor Registry and patients' electronic medical records were accessed to collect all relevant family history information. The list of patients who met at least one of the revised Bethesda criteria, who were candidates for MSI testing, was then cross-referenced with the database of patients referred for genetic counseling within our institution. Results A total of 380 HNPCC-associated tumors were diagnosed at our institution during 2004 of which 41 (10.7% met at least one of the revised Bethesda criteria. Eight (19.5% of these patients were referred for cancer genetic counseling of which 2 (25% were seen by a genetics professional. Ultimately, only 4.9% of patients eligible for MSI testing in 2004 were seen for genetic counseling. Conclusion This retrospective study identified a number of barriers, both internal and external, which hindered the identification of individuals with HNPCC, thus limiting the ability to appropriately manage these high risk families.

  14. NCI Designated Cancer Centers

    Science.gov (United States)

    ... content 1-800-4-CANCER Live Chat Publications Dictionary Menu Contact Dictionary Search About Cancer Causes and Prevention Risk Factors ... Contacts Other Funding Find NCI funding for small business innovation, technology transfer, and contracts Training Cancer Training ...

  15. Television documentaries lifting hospital, medical center profiles.

    Science.gov (United States)

    Rees, T

    2001-01-01

    The nation's hospitals and medical centers are enjoying the legacy of TV audiences' addiction to medical dramas. Cable television has met the challenge with documentary coverage of real live hospitals. The medium offers many benefits and few disadvantages for those marketing managers with the courage to welcome camera crews. Lynn Hopkins Cantwell is director of public relations and marketing for Children's National Medical Center, Washington, D.C., which was covered in a seven-instrument "Lifeline" documentary for the Discovery Channel. James G. Gosky is director of communications for The MetroHealth System, Cleveland, which was the subject of two installments of "Trauma: Life in th ER," produced for the Learning Channel. These marketing pros describe the myriad details they faced when their respective hospitals went "on camera." Among the key factors were good communications with all constituents, attention to detail, and follow-up. PMID:11209289

  16. The effect of race on the discriminatory accuracy of models to predict biochemical recurrence after radical prostatectomy: results from the Shared Equal Access Regional Cancer Hospital and Duke Prostate Center databases

    OpenAIRE

    Moreira, DM; Presti, JC; Aronson, WJ; Terris, MK; Kane, CJ; Amling, CL; Sun, LL; Moul, JW; Freedland, SJ

    2009-01-01

    To evaluate whether race modifies the accuracy of nomograms to predict biochemical recurrence (BCR) after radical prostatectomy among subjects from the Shared Equal Access Regional Cancer Hospital (SEARCH) and Duke Prostate Center (DPC) databases. Retrospective analysis of 1721 and 4511 subjects from the SEARCH and DPC cohorts, respectively. The discrimination accuracy for BCR of seven previously published predictive models was assessed using concordance index and compared between African-Ame...

  17. U.S. Hospitals with Liver Transplant Centers

    Science.gov (United States)

    ... a Transplant Center > Transplant Centers US Hospitals with Liver Transplant Centers State Center Name or Code Click on ... Adjustment Models (Transplant Programs) Risk-Adjustment Models (OPO) Transplant Report Timeline OPO Report ... of Information Act | Privacy Policy | Disclaimers | Accessibility

  18. [Securitization of the bi-site radiotherapy activity as part of the resumption of treatments in the Hospital of Epinal by the team of Alexis Vautrin Nancy Cancer Center].

    Science.gov (United States)

    Marchesi, V; Aigle, D; Peiffert, D; Noel, A; Simon, J-M

    2009-12-01

    In February 2007, the radiation therapy department of the Jean Monnet Hospital in Epinal (France) has stopped the radiotherapy treatments after the discovery of a radiotherapy accident and bad practices leading to overexposure of patients between 1987 and 2006. The Regional Cancer Center "Centre Alexis Vautrin" in Nancy (France) was given the task of the new start of treatment activity. From February 2007 to January 2008, actions of training, updates of equipments and practices have been performed in the Epinal Hospital, guided by the quality approach, allowing the treatment of new patients in February 2008, with the radiation oncologists and the medical physicists of the Centre Alexis Vautrin, with the highest conditions of security and confidence. PMID:19692280

  19. Free-standing cancer centers: rationale for improving cancer care delivery.

    Science.gov (United States)

    Lokich, J J; Silvers, S; Brereton, H; Byfield, J; Bick, R

    1989-10-01

    Free-standing cancer centers (FSCC) represent a growing trend in cancer care delivery within community practice. The critical components to FSCC are multidisciplinary cancer care, a complete menu of direct care and support services, a commitment to clinical trials and clinical investigation, and a comprehensive program for quality assurance. The advantages of FSCC to the community, to hospital programs, to the practicing surgical, medical, and radiation oncologists, and to the third-party carriers, including health maintenance organizations, are detailed. The development of an FSCC depends on the resolution of issues of (a) competition (between hospitals, hospitals and physicians, therapeutic disciplines, regional comprehensive cancer centers and FSCCs) and (b) concerns about conflict of interest. The ideal model of FSCC may well be represented by the joint venture of community hospital(s) and the community oncologists.

  20. Jackson Park Hospital Green Building Medical Center

    Energy Technology Data Exchange (ETDEWEB)

    William Dorsey; Nelson Vasquez

    2010-03-31

    Jackson Park Hospital completed the construction of a new Medical Office Building on its campus this spring. The new building construction has adopted the City of Chicago's recent focus on protecting the environment, and conserving energy and resources, with the introduction of green building codes. Located in a poor, inner city neighborhood on the South side of Chicago, Jackson Park Hospital has chosen green building strategies to help make the area a better place to live and work. The new green building houses the hospital's Family Medicine Residency Program and Specialty Medical Offices. The residency program has been vital in attracting new, young physicians to this medically underserved area. The new outpatient center will also help to allure needed medical providers to the community. The facility also has areas designated to women's health and community education. The Community Education Conference Room will provide learning opportunities to area residents. Emphasis will be placed on conserving resources and protecting our environment, as well as providing information on healthcare access and preventive medicine. The new Medical Office Building was constructed with numerous energy saving features. The exterior cladding of the building is an innovative, locally-manufactured precast concrete panel system with integral insulation that achieves an R-value in excess of building code requirements. The roof is a 'green roof' covered by native plantings, lessening the impact solar heat gain on the building, and reducing air conditioning requirements. The windows are low-E, tinted, and insulated to reduce cooling requirements in summer and heating requirements in winter. The main entrance has an air lock to prevent unconditioned air from entering the building and impacting interior air temperatures. Since much of the traffic in and out of the office building comes from the adjacent Jackson Park Hospital, a pedestrian bridge connects the two

  1. Radio advertising increases hospital call center volume by 48%.

    Science.gov (United States)

    2006-01-01

    Since the fall of 2005, call volume at University of Southern California University Hospital of Los Angeles' call center has increased by nearly 50%. How? The hospital embarked on a long-term radio campaign to promote its presence as a premier academic medical center and to increase patient volume. PMID:17186899

  2. "Hospes": The Wabash Center as a Site of Transformative Hospitality

    Science.gov (United States)

    Jones, Carolyn M.

    2007-01-01

    The Wabash Center for Teaching and Learning in Theology and Religion is a place of hospitality and its staff the epitome of the "good host." This essay explores the meaning of hospitality, including its problematic dimensions, drawing on a number of voices and texts: Jacques Derrida's "Of Hospitality"; Henri M. Nouwen's "Reaching Out: The Three…

  3. Center of nanotechnology for cancer diagnosis and treatment launched in Tianjin

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    @@ On 24 August, a center of nanotechnology for cancer diagnosis and treatment was officially inaugurated in Tianjin. The center was jointly established by the CAS Institute of High-energy Physics, the CAS affiliated National Center for Nanoscience and Technology, and the Tianjin Medical University Cancer Institute and Hospital.

  4. Lucinda Huffaker and the Hospitality of the Wabash Center

    Science.gov (United States)

    Placher, William C.

    2007-01-01

    As associate director and then director of the Wabash Center for Teaching and Learning in Theology and Religion, Lucinda Huffaker has been a key factor in the Center's reputation for hospitality. The Center's work presupposes that reflection on teaching improves teaching and learning, and good reflection on one's teaching requires taking risks and…

  5. Center for Herbal Research on Colorectal Cancer

    Data.gov (United States)

    Federal Laboratory Consortium — Research Area: Herbs Program:Centers of Excellence for Research on CAM Description:Colorectal cancer is the third most common cancer and the third leading cause of...

  6. Jackson Park Hospital Green Building Medical Center

    Energy Technology Data Exchange (ETDEWEB)

    Dorsey, William [Jackson Park Hospital Foundation, Chicago, IL (United States); Vasquez, Nelson [Jackson Park Hospital Foundation, Chicago, IL (United States)

    2010-05-01

    Jackson Park Hospital completed the construction of a new Medical Office Building on its campus this spring. The new building construction has adopted the City of Chicago's recent focus on protecting the environment, and conserving energy and resources, with the introduction of green building codes. Located in a poor, inner city neighborhood on the South side of Chicago, Jackson Park Hospital has chosen green building strategies to help make the area a better place to live and work.

  7. The role of birthing centers in hospital marketing.

    Science.gov (United States)

    Kohler, D L; Bellenger, D N; Whyte, G E

    1990-01-01

    The research reported here investigated the repeat purchase intentions, key decision-making roles, and decision criteria related to hospital birthing centers. The results suggest that a marketing program with an emphasis on quality of care and high comfort standards directed to expectant mothers offers a realistic opportunity for hospital marketers. PMID:2398004

  8. Center for Cancer Genomics | Office of Cancer Genomics

    Science.gov (United States)

    The Center for Cancer Genomics (CCG) was established to unify the National Cancer Institute's activities in cancer genomics, with the goal of advancing genomics research and translating findings into the clinic to improve the precise diagnosis and treatment of cancers. In addition to promoting genomic sequencing approach

  9. Cancer Mortality Pattern in Lagos University Teaching Hospital, Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Olakanmi Ralph Akinde

    2015-01-01

    Full Text Available Background. Cancer is a leading cause of death worldwide and about 70% of all cancer deaths occurred in low- and middle-income countries. The cancer mortality pattern is quite different in Africa compared to other parts of the world. Extensive literature research showed little or no information about the overall deaths attributable to cancer in Nigeria. Aims and Objectives. This study aims at providing data on the patterns of cancer deaths in our center using the hospital and autopsy death registers. Methodology. Demographic, clinical data of patients who died of cancer were extracted from death registers in the wards and mortuary over a period of 14 years (2000–2013. Results. A total of 1436 (4.74% cancer deaths out of 30287 deaths recorded during the period. The male to female ratio was 1 : 2.2 and the peak age of death was between 51 and 60 years. Overall, breast cancer was responsible for most of the deaths. Conclusion. The study shows that the cancers that accounted for majority of death occurred in organs that were accessible to screening procedures and not necessary for survival. We advise regular screening for precancerous lesions in these organs so as to reduce the mortality rate and burden of cancer.

  10. Hospital-acquired infections at an oncological intensive care cancer unit: differences between solid and hematological cancer patients

    OpenAIRE

    Cornejo-Juárez, Patricia; Vilar-Compte, Diana; García-Horton, Alejandro; López-Velázquez, Marco; Ñamendys-Silva, Silvio; Volkow-Fernández, Patricia

    2016-01-01

    Background Cancer patients have a higher risk of severe sepsis in comparison with non-cancer patients, with an increased risk for hospital-acquired infections (HAI), particularly with multidrug resistant bacteria (MDRB). The aim of the study is to describe the frequency and characteristics of HAI and MDRB in critically ill cancer patients. Methods We conducted an 18-month prospective study in patients admitted ≥48 h to an ICU at a cancer referral center in Mexico. Patients with hematological ...

  11. The Pittsburgh Poison Center and its member hospital network.

    Science.gov (United States)

    Dean, B S; Krenzelok, E P

    1986-02-01

    When a poison information call involves a case that requires medical intervention, the staff of poison information specialists refer the poisoned patient to the emergency department of the nearest member hospital. This regionalization of treatment involving poison exposures eliminates the necessity of having an emergent patient rushed long distances to receive prompt and effective care. Facsimile terminals provide an efficacious method of enhancing communication of toxicology information to our member hospital treatment centers. A poison center is able to electronically transmit copies of written documents such as newly published journal articles or treatment protocols directly to the emergency department of the treating hospital. In turn, the facsimile terminal can confidentially transmit a copy of a poisoned victim's emergency record to the poison center. Data collection and documentation is strengthened. Transmission and receiving is accomplished within minutes. PMID:3705433

  12. Orthopedic specialty hospitals: centers of excellence or greed machines?

    Science.gov (United States)

    Badlani, Neil; Boden, Scott; Phillips, Frank

    2012-03-01

    Orthopedic specialty hospitals have recently been the subject of debate. They are patient-centered, physician-friendly health care alternatives that take advantage of the economic efficiencies of specialization. Medically, they provide a higher quality of care and increase patient and physician satisfaction. Economically, they are more efficient and profitable than general hospitals. They also positively affect society through the taxes they pay and the beneficial aspects of the competition they provide to general hospitals. Their ability to provide a disruptive innovation to the existing hospital industry will lead to lower costs and greater access to health care. However, critics say that physician ownership presents potential conflicts of interest and leads to overuse of medical care. Some general hospitals are suffering as a result of unfair specialty hospital practices, and a few drastic medical complications have occurred at specialty hospitals. Specialty hospitals have been scrutinized for increasing the inequality of health care and continue to be a target of government regulations. In this article, the pros and cons are examined, and the Emory Orthopaedics and Spine Hospital is analyzed as an example. Orthopedic specialty hospitals provide excellent care and are great assets to society. Competition between specialty and general hospitals has provided added value to patients and taxpayers. However, physicians must take more responsibility in their appropriate and ethical leadership. It is critical to recognize financial conflicts of interest, disclose ownership, and act ethically. Patient care cannot be compromised. With thoughtful and efficient leadership, specialty hospitals can be an integral part of improving health care in the long term. PMID:22385456

  13. Integrative Medicine Program- MD Anderson Cancer Center

    OpenAIRE

    Lee, Richard T.

    2012-01-01

    The Integrative Medicine Program at MD Anderson Cancer Center was first established in 1998.  Our mission is to empower patients with cancer and their families to become active partners in their own physical, psycho-spiritual, and social health through personalized education and evidenced-based clinical care to optimize health, quality of life, and clinical outcomes across the cancer continuum.  The program consists of three main components: clinical care, research, and education.  The Integr...

  14. Evaluation of Collection and Disposal of Hospital Waste in Hospitals and Healthcare Centers

    Directory of Open Access Journals (Sweden)

    Saeid Nazemi

    2012-08-01

    Full Text Available Currently, one of the environmental issues is waste of hospitals and healthcare facilities which due to hazardous, toxic, and disease-causing agents such as pharmaceutical, chemical and infectious disease, is of particular sensitivity. According to a 2002 survey by WHO, it was determined that 22 million people worldwide suffer from infectious diseases annually, because of contacting hospital wastes. Also based on a research conducted in 22 countries, 18 to 64 percent of hospitals wastes are not disposed properly [1]. The purpose f the study is to appraise collection and disposal of hospital wastes in hospitals and healthcare centers of Shahroud.In this sectional study, 3 university hospitals (580 beds and 10 healthcare facilities were investigated for six months (mehr-azar 89 at Shahroud. In order to determine the amount of waste, produced waste of an entire day was weighted in hospitals and health centers. In this research, proposed questionnaires of WHO for developing countries was used to evaluate collection and disposal system of hospitals waste. Collected data was coded and analyzed by SPSS ver.15.

  15. Breast cancer in a multi-ethnic Asian setting : Results from the Singapore-Malaysia hospital-based breast cancer registry

    NARCIS (Netherlands)

    Pathy, Nirmala Bhoo; Yip, Cheng Har; Taib, Nur Aishah; Hartman, Mikael; Saxena, Nakul; Lau, Philip; Bulgiba, Awang M.; Lee, Soo Chin; Lim, Siew Eng; Wong, John E. L.; Verkooijen, Helena M.

    2011-01-01

    Two hospital-based breast cancer databases (University Malaya Medical Center, Malaysia [n = 1513] and National University Hospital, Singapore [n = 2545]) were merged into a regional registry of breast cancer patients diagnosed between 1990 and 2007. A review of the data found 51% of patients diagnos

  16. Integrative Medicine Program- MD Anderson Cancer Center

    Directory of Open Access Journals (Sweden)

    Richard T Lee

    2012-06-01

    Full Text Available The Integrative Medicine Program at MD Anderson Cancer Center was first established in 1998.  Our mission is to empower patients with cancer and their families to become active partners in their own physical, psycho-spiritual, and social health through personalized education and evidenced-based clinical care to optimize health, quality of life, and clinical outcomes across the cancer continuum.  The program consists of three main components: clinical care, research, and education.  The Integrative Medicine Center provides clinical services to patients through individual and group programs.  The clinical philosophy of the center is to work collaboratively with the oncology teams to build comprehensive and integrative care plans that are personalized, evidence-based, and safe with the goal of improving clinical outcomes.  The individual services comprise of integrative oncology consultation, acupuncture, meditation, music therapy, nutrition, and oncology massage.  The center also provides a variety of group programs including meditation, yoga, tai chi, cooking classes and others.  Over the past 13 years, over 70,000 patients and families have participated in services and programs offered by the center.  The research portfolio focuses on three main areas: mind-body interventions, acupuncture, and meditation.  This lecture will focus on providing an overview of the Integrative Medicine Program at MD Anderson with a focus on the clinical services provided.  Participants will learn about the integrative clinical model and how this is applied to the care of cancer patients at MD Anderson Cancer Center.  Current and future research topics will be discussed as well as patient cases.

  17. Principales Causas de Cáncer Atendidas en un Centro Hospitalario: Costa Rica 2003-2007 Main Causes of Cancer in a Hospital Center: Costa Rica 2003-2007

    Directory of Open Access Journals (Sweden)

    Tatiana Barrantes Solís

    2009-07-01

    Full Text Available Objetivos: Analizar las principales causas de cáncer atendidas en el Hospital San Vicente de Paúl y determinar la frecuencia de aparición según cantón de procedencia. Materiales y Métodos: Estudio descriptivo, transversal, ecológico, de 1226 egresados por cáncer del Hospital San Vicente de Paúl (01/01/2000 al 30/08/2007. Se realizó un análisis descriptivo utilizando Excel® (incidencia/100.000 hab/cantón, una regresión de Poisson mediante Egret®. Se realizó una regresión de Poisson, tomando como base el cantón de menor prevalencia por tipo de cáncer, y para los fallecimientos de comparó cada cantón con la incidencia total de la provincia. Resultados: Un 62% de los casos corresponden a mujeres, los tipos de cáncer más frecuentes fueron gástrico (17% y de mama (14%. Con la regresión de Poisson se encontró que el riesgo relativo más alto se presentó en San Isidro para el carcinoma de tiroides RR 9,89 (1,15-84, y tomando como variable dependiente la muerte, el cáncer de estómago presenta una cantidad significativamente mayor de fallecimientos, con un RR de 22 (2,3-163. Conclusión: Este análisis se realizó con egresos hospitalarios y no con datos oficiales para toda la provincia de Heredia, donde se encontró que las neoplasias más frecuentes son en mama, estómago, cérvix, colon y próstata. La magnitud y dirección de la asociación resultan sugestivas de que la relación entre lugar de procedencia y tipo de neoplasia existe. Esta información debe ser considerada para valorar las prioridades de servicios del Hospital para la provincia.Objective: To analyze the main causes of cancer in patients at the San Vicente de Paúl Hospital and determine their frequency according to the patient’s place of origin. Materials and methods: Observational, descriptive, analytic study with 1226 cancer patients discharged from the San Vicente de Paúl Hospital (01/01/00 al 30/08/2007. The descriptive analysis was made with Excel

  18. Statistical study on cancer patients of cancer research hospital

    International Nuclear Information System (INIS)

    The total number of malignant neoplasms included on this study 7,787 cases(10.4%) among 74,928 cases for 2 years. On sex, females with 57.6% were much more than males with 42.4%. The highest proportion of cancer 50-59 age group. The most frequent primary site among males was found to be stomach with 36.2%, followed by liver(12.3%), lung(12.2%), esophagus(15.5%) and larynx(4.9%). In females, the first order was uterine cervix with 47.3%, followed most common type of morphology of malignant neoplasms was adenocarcinoma(39.0%) in males an squamous cell carcinoma(56.2%) in females. Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the extent of disease was 4.6% for patient with carcinoma-in-situ, 76.3% for patients with localized involvement, 11.6% for patients with regional involvement and 7.5% for patients with distant involvement. Among,the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 19.0% for surgery, 27.7 for radiotherapy and 24.2% for chemotherapy. Among the cancer patients confirmed by medical records, 11.2% was traced more than 5 years. (Author)

  19. Oral cancer awareness amongst hospital nursing staff: a pilot study

    OpenAIRE

    Johnson Sarah; Kavi Vikram P; Harris Andrew T; Carter Lachlan M; Kanatas Anastasios

    2009-01-01

    Abstract Background Oral cancer is as prevalent as cervical and testicular cancer in the United Kingdom. Nursing staff provide the oral health care for the patient population in hospital. Admission to hospital provides a 'window of opportunity' for oral cancer 'screening' via an oral health check during nursing clerking. This study aimed to investigate whether nursing staff are aware of risk factors for oral cancer, its clinical signs, and could therefore provide a 'screening' service for ora...

  20. Hospital acquired diarrhea in a burn center of Tehran

    Directory of Open Access Journals (Sweden)

    Faranak Alinejad

    2016-01-01

    Full Text Available Background and Objectives: Incidence of hospital-acquired diarrhea has increased rapidly and burn patients are at high risk of getting it. Infection with C. difficile is the most common cause of antibiotic associated diarrhea. The aim of this study was to determine the baseline characteristics and clinical presentation of hospital-acquired diarrhea and compare C. difficile and non-C. difficile diarrhea in burn patients treated at a burn center.Materials and Methods: During a 1-year study all patients with hospital-acquired diarrhea at Motahari Burn Hospital, Teh- ran, Iran enrolled in this study. We compared patients with a stool sample positive for C. difficile toxin or tracing the antigen in patients who were negative for detection of toxin in their stool sample specimens.Results: Diarrhea developed in 37 patients out of 3200 admitted patients with a mean burn size of 34.8 ±20.1%. Among them, 8 patients had a positive result for C. difficile. The mean time between antibiotic therapy and occurrence of diarrhea was 9.5 ± 6.2 days. Nine (23.7% patients died in the 7.8± 4.2 days, mostly due to co-morbidities. The mean duration of di- arrhea was 3.6 ± 2 days. Twenty two (57.9% patients were treated with oral metronidazol and eleven (28.9% patients were treated with combination of metronidazole and vancomycin, higher rate of combination therapy was seen in Clostridium difficile CDI.Conclusion: Overall, the prevalence of hospital-acquired diarrhea was 120/10,000  and 21% of them caused by infection with C. difficile. Presence of peripheral leukocytosis and colitis were the alarm sign for diagnosis of C. difficile infection. Keywords: Hospital-acquired diarrhea (HAD, Burn, Clostridium difficile infection (CDI

  1. 大型肿瘤医院放疗中心环境辐射剂量调查研究%Environmental dose level survey of radiotherapy center in large cancer hospital

    Institute of Scientific and Technical Information of China (English)

    万斌; 钟海洛; 吴大可; 李建; 王培; 祁国海; 黄仁炳; 郎锦义

    2009-01-01

    目的 以我国西部地区最大型肿瘤医院放疗中心(四川省肿瘤医院)为代表,对其周边工作环境及工作人员辐射剂量水平进行调查和分析.方法 采用热释光剂量计对在中心工作的医生、护士、技术员、物理师、工程师和T作场所(~(60)Co治疗机、医用加速器、后装治疗机、X线模拟定位机、CT、MRI、头部γ刀、医生办公室)与外环境进行为期60d连续的累积剂量监测,并将所得结果和有关部门公布的调查结果进行比较分析.结果 该放疗中心室内工作环境平均剂量约为1.96μC·kg~(-1)·月~(-1),室外环境剂量为1.6μC·kg~(-1)·月~(-1).结论 由于该中心25年来严格按照环保和防护部门规范建设,所有机房外、办公区和候诊区的辐射水平均在完全安全范嗣内,无一超标.%Objective To investigate and analyze the radiation dosage around the working environment in radiotherapy centre affiliated to Sichuan cancer hospital in the western China.Methods In 60 days,we have continuously monitored the accumulated dose that absorbed by doctors,nurses,technicians,physicists and engineers,and investigated the working environment(~(60)Co unit,accelerator,after loading unit,X-ray simulator,CT simulator,gamma knife,MRI and doctor's office)and external environment by using TLD,and compared our results to those released by relevant departments.Results The average dosage in the working environment is 1.96 μC·kg~(-1)·month~(-1),1.61 μC·kg~(-1)·month~(-1) in external environment.Conclusion In the past 25 years,the radiotherapy center constructed strictly by the criterions of environment and protection departments required,so the radiation dosage in or outside the radiotherapy center has reached the national standard,which is safe for the staff and patients.Its instatement that the radiotherapy sites constructed by the related laws well accorded with the safety standards regulated.

  2. Incorporating the USAF Flight Center's TQM plan in a hospital.

    Science.gov (United States)

    Bridges, R D; Mathews, K A

    1993-01-01

    A total quality management (TQM) plan has been instituted by the United States Air Force Flight Test Center at Edwards Air Force Base. To determine the feasibility of implementing the same basic TQM plan in a district hospital, a joint industry-government team was established. Five areas of concentration were selected for review: infrastructure, methodology, training, strategic plan, and a "Quality Bill of Rights." The TQM "infrastructure" is intended to match and complement the existing organizational structure and chain of command, not to supplant it. As the overall plan seemed well-adapted for implementation in a hospital setting, a three-phase implementation approach was identified that included conceptual planning, initial training and goal setting, and full-scale implementation. Each phase is described in terms of objectives, staffing, and timing requirements.

  3. Statistical study on cancer patients of cancer research hospital

    International Nuclear Information System (INIS)

    The total number of malignant neoplasms included in this study 15,737 cases(11.8%) among 133,251 cases for 3 years. On sex, females with 52.9% were much more than males with 47.1%. The highest proportion of cancer patients by age was 33.7% in males and 28.5% in females, respectivelty for 50-59 age group. The most frequent primary site among males was found to be stomach with 35.5%, followed by liver(14.7%), lung(13.0%), esophagus(5.4%) and colon (3.2%). In females, the first order was uterine cervix with 40.6%, followed by stomach(17.2%), breast(14.4), rectum(3.7%) and lung(3.4%). The most common type of morphology of malignant neoplasms was adenocarcinoma(47.4%) in males an squamous cell carcinoma(58.0%) in females. Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the exent of disease was 2.5% for patient with carcinoma-in-situ, 54.1% for patients with localized involvement, 13.3% for patients with regional involvement and 8.5% for patients with distant involvement. Among the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 23.6% for surgery, 25.3% for radiotherapy and 30.3% for chemotherapy. Among the cancer patients confirmed by medical records, 7.7% was traced more than 5 years. (Author)

  4. Statistical study on cancer patients of Korea cancer centre hospital

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Soo Yong; Kim, Kee Hwa; Kang Sung Mok [Korea Cancer Center Hospital of Korea Atomic Energy Research Institute, Seoul (Korea, Republic of)

    1994-12-01

    The total number of malignant neoplasms included in this study 53,566 cases(14.1%) among 379,582 patients from 1984 to 1993. On sex, females with 51.3% were much more than males with 48.7%. The highest proportion of cancer patients by age was 35.0% in males and 28.4% in females, respectively for 50-59 age group. The most frequent primary site among males was found to be stomach with 33.2%, followed by liver(15.1%), lung(14.9%), esophagus(5.3%) and larynx(3.3%). In females, the first order was uterine cervix with 37.8%, followed by stomach(16.5%), breast(14.8%), thyroid gland(4.3%) and lung (3.8%). The proportion of malignant neoplasms diagnosed by histology made up 67.0%, whereas 20.2% was diagnosed by clinical investigation(X-ray, CT, MRI etc). Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the extent of disease was 3.7% for patient with carcinoma-in-situ, 58.7% for patients with localized involvement, 18.4% for patients with regional involvement and 11.1% for patients with distant involvement. Among the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 27.5% for surgery, 22.5% for radiotherapy and 30.1% for chemotherapy. The proportion of cancer patients traced to death was only to 3.6%, 1,944 cases. Among them, 72.5% survived for less than 1 year. 17 figs, 7 tabs, 28 refs. (Author).

  5. Statistical study on cancer patients of Korea cancer centre hospital

    International Nuclear Information System (INIS)

    The total number of malignant neoplasms included in this study 53,566 cases(14.1%) among 379,582 patients from 1984 to 1993. On sex, females with 51.3% were much more than males with 48.7%. The highest proportion of cancer patients by age was 35.0% in males and 28.4% in females, respectively for 50-59 age group. The most frequent primary site among males was found to be stomach with 33.2%, followed by liver(15.1%), lung(14.9%), esophagus(5.3%) and larynx(3.3%). In females, the first order was uterine cervix with 37.8%, followed by stomach(16.5%), breast(14.8%), thyroid gland(4.3%) and lung (3.8%). The proportion of malignant neoplasms diagnosed by histology made up 67.0%, whereas 20.2% was diagnosed by clinical investigation(X-ray, CT, MRI etc). Among the cancer patients initially diagnosed in this hospital, the proportion of malignant neoplasms by the extent of disease was 3.7% for patient with carcinoma-in-situ, 58.7% for patients with localized involvement, 18.4% for patients with regional involvement and 11.1% for patients with distant involvement. Among the cancer patients initially treatment in this hospital, the proportion of malignant neoplasms by the method of treatment was 27.5% for surgery, 22.5% for radiotherapy and 30.1% for chemotherapy. The proportion of cancer patients traced to death was only to 3.6%, 1,944 cases. Among them, 72.5% survived for less than 1 year. 17 figs, 7 tabs, 28 refs. (Author)

  6. Hospital-owned and operated outpatient imaging centers: strategies for success.

    Science.gov (United States)

    Boland, Giles W L

    2008-08-01

    Dedicated outpatient imaging centers offer hospitals an opportunity to meet stakeholder expectations, maximize market share, and increase revenue. However, because outpatient imaging centers operate according to different business strategies and principles compared with hospital-based operations, many hospitals are challenged to operate outpatient facilities effectively. This article addresses those strategies designed to maximize patient referral and profitability for hospital-owned and operated outpatient imaging centers. PMID:18657786

  7. [Certified prostate cancer centers and second opinion centers for testicular cancer: successful models of uro-oncology cancer care].

    Science.gov (United States)

    Gschwend, J E; Albers, P; Schrader, M

    2011-08-01

    Establishment of organ site-specific cancer centers by the German Cancer Society (GCS) is part of the basic politically driven reform of oncology care in Germany. Since 2007 an increasing number of prostate cancer centers have been guided toward certification by the OnkoZert GmbH of the GCS. Currently 68 centers are certified and together with ongoing certification proceedings will amount to 81 prostate cancer centers, which cover about one fourth of cases of primary prostate cancer. Urology is of particular importance in the management of these centers. For the most part, urologists belonging to a clinical unit are the initiators of the certification process, thus ensuring that uro-oncology is firmly entrenched in the specialty with involvement of outpatient service providers. Fears that authority will be lost are unfounded as long as responsibility for this task is taken seriously and active use is made of the possibilities for creativity. A similarly important function is fulfilled by the testicular cancer centers that offer second opinion services, which were initiated by urology conjointly with German Cancer Aid to pursue the goal of quality assurance for this tumor entity and therefore likewise secure the position of this tumor in the realm of urologists. By applying such strategic approaches, urologists will succeed in sustainably safeguarding their future importance in a very competitive environment and in counteracting the encroachments of other specialties by exhibiting clear orientation.

  8. Challenges associated with the management of gynecological cancers in a tertiary hospital in South East Nigeria

    Directory of Open Access Journals (Sweden)

    Iyoke CA

    2014-01-01

    Full Text Available Chukwuemeka Anthony Iyoke,1 George Onyemaechi Ugwu,1 Euzebus Chinonye Ezugwu,1 Frank Okechukwu Ezugwu,2 Osaheni Lucky Lawani,3 Azubuike Kanayo Onyebuchi3 1Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, 2Department of Obstetrics and Gynaecology, Enugu State University Teaching Hospital, Park Lane, Enugu, 3Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Background: There are reports of increasing incidence of gynecological cancers in developing countries and this trend increases the need for more attention to gynecological cancer care in these countries. Objective: The purpose of this study was to describe the presentation and treatment of gynecological cancers and identify barriers to successful gynecological cancer treatment in a tertiary hospital in South East Nigeria. Methods: This study was a retrospective longitudinal analysis of the presentation and treatment of histologically diagnosed primary gynecological cancers from 2000 to 2010. Analysis was by descriptive and inferential statistics at the 95% level of confidence using Statistical Package for the Social Sciences version 17 software. Results: Records of 200 gynecological cancers managed during the study period were analyzed. Over 94% of cervical cancers presented in advanced stages of the disease and received palliative/symptomatic treatment. Only 1.9% of cervical cancer patients had radical surgical intervention, and postoperative mortality from these radical surgeries was 100%. Approximately 76% of patients with ovarian cancer had debulking surgery as the mainstay of treatment followed by adjuvant chemotherapy. Postoperative mortality from ovarian cancer surgery was 63%. Cutting edge cytotoxic drugs were not used as chemotherapy for ovarian and chorionic cancers. Compliance with chemotherapy was poor, with over 70% of ovarian cancer patients failing to complete the

  9. Incidental pulmonary embolism in cancer patients: clinical characteristics and outcome – a comprehensive cancer center experience

    Directory of Open Access Journals (Sweden)

    Abdel-Razeq H

    2011-03-01

    Full Text Available Hikmat N Abdel-Razeq1, Asem H Mansour2, Yousef M Ismael11Department of Internal Medicine, 2Department of Radiology, King Hussein Cancer Center, Amman, JordanBackground and objectives: Cancer patients undergo routine imaging studies much more than others. The widespread use of the recently introduced multi-detector CT scanners has resulted in an increasing number of incidentally diagnosed pulmonary embolism (PE in asymptomatic cancer patients. The significance and clinical outcome of such incidental PE is described.Methods: Both radiology department and hospital databases were searched for all cancer patients with a diagnosis of incidental PE. CT scans were performed using a 64-slice scanner with a 5.0 mm slice thickness.Results: During the study period, 34 patients with incidental PE were identified. The mean age (±SD was 57.7 (±12.4 years. All patients had active cancer, gastric, lung, colorectal, and lymphomas being the most frequent. Most patients had advanced-stage disease at the time of PE diagnosis; 26 (77% patients had stage IV, whereas only 3 patients had stages I or II disease. Twenty-seven (79% patients had their PE while undergoing active treatment with chemotherapy (68% or radiotherapy (12%; none, however, were on hormonal therapy. Most (74% patients had their PE diagnosed without history of recent hospital admission. Except for 5 (15%, all other patients were anticoagulated. With follow-up, 2 patients developed recurrent PE, 2 others had clinical and echocardiographic evidence of pulmonary hypertension, and 9 (26% died suddenly within 30 days of the diagnosis of incidental PE; 2 of these where among the 5 patients who were not anticoagulated.Conclusion: Incidental PE in cancer patients is increasingly encountered. Similar to symptomatic PE, many were diagnosed in patients with advanced stage disease and while undergoing active anti-cancer therapy. A significant percentage of patients had recurrent emboli, pulmonary hypertension

  10. Hospital variation in 30-day mortality after colorectal cancer surgery in denmark: the contribution of hospital volume and patient characteristics

    DEFF Research Database (Denmark)

    Osler, Merete; Iversen, Lene Hjerrild; Borglykke, Anders;

    2011-01-01

    This study examines variation between hospitals in 30-day mortality after surgery for colorectal cancer (CRC) in Denmark and explores whether hospital volume and patient characteristics contribute to any variation between hospitals.......This study examines variation between hospitals in 30-day mortality after surgery for colorectal cancer (CRC) in Denmark and explores whether hospital volume and patient characteristics contribute to any variation between hospitals....

  11. Coping with cancer and adversity. Hospital ethnography in Kenya

    OpenAIRE

    Mulemi, B.A.

    2010-01-01

    Many people associate hospital treatment with 'getting better', the restoration to health and normal life. The onset of a life-threatening disease such as cancer, however, can transform the hospital into a place of constant struggle and suffering. Hospitalisation in this sense coincides with the deterioration of patients' and their families' overall wellbeing. Drawing on twelve months of ethnographic research in a cancer ward in Kenya, this monograph shows that patients' suffering should be v...

  12. Trends in Clinically Significant Pain Prevalence Among Hospitalized Cancer Patients at an Academic Hospital in Taiwan

    Science.gov (United States)

    Wang, Wei-Yun; Ho, Shung-Tai; Wu, Shang-Liang; Chu, Chi-Ming; Sung, Chun-Sung; Wang, Kwua-Yun; Liang, Chun-Yu

    2016-01-01

    Abstract Clinically significant pain (CSP) is one of the most common complaints among cancer patients during repeated hospitalizations, and the prevalence ranges from 24% to 86%. This study aimed to characterize the trends in CSP among cancer patients and examine the differences in the prevalence of CSP across repeated hospitalizations. A hospital-based, retrospective cohort study was conducted at an academic hospital. Patient-reported pain intensity was assessed and recorded in a nursing information system. We examined the differences in the prevalence of worst pain intensity (WPI) and last evaluated pain intensity (LPI) of ≥4 or ≥7 points among cancer inpatients from the 1st to the 18th hospitalization. Linear mixed models were used to determine the significant difference in the WPI and LPI (≥4 or ≥7 points) at each hospitalization. We examined 88,133 pain scores from the 1st to the 18th hospitalization among cancer patients. The prevalence of the 4 CSP types showed a trend toward a reduction from the 1st to the 18th hospitalization. There was a robust reduction in the CSP prevalence from the 1st to the 5th hospitalization, except in the case of LPI ≥ 7 points. The prevalence of a WPI ≥ 4 points was significantly higher (0.240-fold increase) during the 1st hospitalization than during the 5th hospitalization. For the 2nd, 3rd, and 4th hospitalizations, there was a significantly higher prevalence of a WPI ≥ 4 points compared with the 5th hospitalization. We also observed significant reductions in the prevalence of a WPI ≥ 7 points during the 1st to the 4th hospitalizations, an LPI ≥ 4 points during the 1st to the 3rd hospitalizations, and an LPI ≥ 7 points during the 1st to the 2nd hospitalization. Although the prevalence of the 4 CSP types decreased gradually, it is impossible to state the causative factors on the basis of this observational and descriptive study. The next step will examine the factors that determine the CSP prevalence among

  13. Model for the cost-efficient delivery of continuous quality cancer care: a hospital and private-practice collaboration

    OpenAIRE

    Coyle, Yvonne M.; Miller, Alan M.; Paulson, R. Steven

    2013-01-01

    Cancer care is expensive due to the high costs of treatment and preventable utilization of resources. Government, employer groups, and insurers are seeking cancer care delivery models that promote both cost-efficiency and quality care. Baylor University Medical Center at Dallas (BUMC), a large tertiary care hospital, in collaboration with Texas Oncology, a large private oncology practice, established two independent centers that function cooperatively within the Baylor Charles A. Sammons Canc...

  14. Breast reconstruction after mastectomy at a comprehensive cancer center

    OpenAIRE

    Connors, Shahnjayla K.; Goodman, Melody S.; Myckatyn, Terence; Margenthaler, Julie; Gehlert, Sarah

    2016-01-01

    Background Breast reconstruction after mastectomy is an integral part of breast cancer treatment that positively impacts quality of life in breast cancer survivors. Although breast reconstruction rates have increased over time, African American women remain less likely to receive breast reconstruction compared to Caucasian women. National Cancer Institute-designated Comprehensive Cancer Centers, specialized institutions with more standardized models of cancer treatment, report higher breast r...

  15. Economies of scale in non-revenue producing cost centers: implications for hospital mergers.

    Science.gov (United States)

    Dranove, D

    1998-01-01

    This paper uses semiparametric methods to estimate the magnitude of economies of scale in 14 non-revenue producing cost centers in hospitals. There are substantial economies of scale in small hospitals, but economies are exhausted in hospitals with over 10,000 discharges annually. In recent hospital mergers challenged by federal antitrust agencies, one or both hospitals had over 10,000 discharges, suggesting that efficiency gains in non-revenue producing cost centers will be small, and could easily be offset by nominal price increases.

  16. Development and Current Status of National Cancer Center for Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    LI Jie; LIN Hong-sheng; HOU Wei; ZHANG Pei-tong; HUA Bao-jin

    2011-01-01

    @@ Chinese medicine (CM) is an important feature of cancer treatment in China.Especially in the last 10years, the effect of CM in cancer treatment has been of high concern and has been accepted by experts and patients locally and overseas.The oncology department (OD) of Guang'anmen Hospital (GAMH) of China Academy of Chinese Medical Sciences (CATCM),which will mark its 50th anniversary in 2013, is one of China's most-respected centers devoted exclusively to cancer patient care, research, education, and prevention through CM.It is located at the campus of GAMH,central Beijing.

  17. US News and World Report cancer hospital rankings: do they reflect measures of research productivity?

    Directory of Open Access Journals (Sweden)

    Vinay Prasad

    Full Text Available CONTEXT: Prior research has faulted the US News and World Report hospital specialty rankings for excessive reliance on reputation, a subjective measure of a hospital's performance. OBJECTIVE: To determine whether and to what extent reputation correlates with objective measures of research productivity among cancer hospitals. DESIGN: A retrospective observational study. SETTING: Automated search of NIH Reporter, BioEntrez, BioMedline and Clinicaltrials.gov databases. PARTICIPANTS: The 50 highest ranked cancer hospitals in 2013's US News and World Report Rankings. EXPOSURE: We ascertained the number of NCI funded grants, and the cumulative funds received by each cancer center. Additionally, we identified the number of phase I, phase II, and phase III studies published and indexed in MEDLINE, and registered at clinicaltrials.gov. All counts were over the preceding 5 years. For published articles, we summed the impact factor of the journals in which they appeared. Trials were attributed to centers on the basis of the affiliation of the lead author or study principal investigator. MAIN OUTCOME: Correlation coefficients from simple and multiple linear regressions for measures of research productivity and a center's reputation. RESULTS: All measures of research productivity demonstrated robust correlation with reputation (mean r-squared  = 0.65, median r-squared = 0.68, minimum r-squared = .41, maximum r-squared = 0.80. A multivariable model showed that 93% of the variation in reputation is explained by objective measures. CONCLUSION: Contrary to prior criticism, the majority of reputation, used in US News and World Rankings, can be explained by objective measures of research productivity among cancer hospitals.

  18. Antifungal agent utilization evaluation in hospitalized neutropenic cancer patients at a large teaching hospital

    Directory of Open Access Journals (Sweden)

    Vazin A

    2015-06-01

    Full Text Available Afsaneh Vazin,1 Mohammad Ali Davarpanah,2 Setareh Ghalesoltani3 1Department of Clinical Pharmacy, Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran; 2HIV Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; 3International Branch of Faculty of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran Abstract: To evaluate pattern of using of three antifungal drugs: fluconazole, amphotericin B and voriconazole, at the hematology–oncology and bone marrow transplant wards of one large teaching hospital. In a prospective cross-sectional study, we evaluated the appropriateness of using antifungal drugs in patients, using Infectious Disease Society of America (IDSA and National Comprehensive Cancer Network (NCCN guidelines. All the data were recorded daily by a pharmacist in a form designed by a clinical pharmacist and infectious diseases specialist, for antifungals usage, administration, and monitoring. During the study, 116 patients were enrolled. Indications of prescribing amphotericin B, fluconazole, and voriconazole were appropriate according to guidelines in 83.4%, 80.6%, and 76.9% respectively. The duration of treatments were appropriate according to guidelines in 75%, 64.5%, and 71.1% respectively. The dose of voriconazole was appropriate according to guidelines in 46.2% of patients. None of the patients received salt loading before administration of amphotericin B. The most considerable problems with the mentioned antifungals were about the indications and duration of treatment. In addition, prehydration for amphotericin B and dosage of voriconazole were not completely compatible with the mentioned guidelines. A suitable combination of controlling the use of antifungals and educational programs could be essential for improving the general process of using antifungal drugs at our hospital. Keywords: utilization evaluation, fluconazole, amphotericin B, voriconazole, neutropenia

  19. A study on risk factors of breast cancer among patients attending the tertiary care hospital, in Udupi district

    Directory of Open Access Journals (Sweden)

    Ramchandra Kamath

    2013-01-01

    Full Text Available Background: Cancer has become one of the ten leading causes of death in India. Breast cancer is the most common diagnosed malignancy in India, it ranks second to cervical cancer. An increasing trend in incidence is reported from various registries of national cancer registry project and now India is a country with largest estimated number of breast cancer deaths worldwide. Aim: To study the factors associated with breast cancer. Objectives: To study the association between breast cancer and selected exposure variables and to identify risk factors for breast cancer. Materials and Methods: A hospital based Case control study was conducted at Shirdi Sai Baba Cancer Hospital and Research Center, Manipal, Udupi District. Results: Total 188 participants were included in the study, 94 cases and 94 controls. All the study participants were between 25 to 69 years of age group. The cases and controls were matched by ± 2 years age range. Non vegetarian diet was one of the important risk factors (OR 2.80, CI 1.15-6.81. More than 7 to 12 years of education (OR 4.84 CI 1.51-15.46 had 4.84 times risk of breast cancer as compared with illiterate women. Conclusion: The study suggests that non vegetarian diet is the important risk factor for Breast Cancer and the risk of Breast Cancer is more in educated women as compared with the illiterate women. Limitation: This is a Hospital based study so generalisability of the findings could be limited.

  20. Establishing a center of excellence: the Total Joint Center at the Miriam Hospital.

    Science.gov (United States)

    Ferguson, Gary M; Froehlich, John A

    2013-03-01

    The Total Joint Center at The Miriam Hospital has been very successful and now serves as a model for other specialties. Key to this program’s success is the cooperative relationship between various stakeholders. Leadership is required yet the input and participation of all is necessary to achieve the desired outcome. To achieve efficiencies, there must be a willingness to deeply integrate clinical services. Again, this requires input from sectors that in the past typically did not communicate with each other. Finally, surgeons and staff need to "pledge" and show their willingness to practice based on sound patient data and modify treatment based on this same data. We are extremely proud of the results achieved. Also impressive is how, in a very short period of time, we have been able to bring together an extremely dedicated team of professionals who work cooperatively in a seamless fashion. With this approach we are able to meet our strategic goal of providing state-of-the-art, high quality, patient-centric, efficient healthcare.

  1. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Helena; Hallström, Inger; Kjaergaard, Hanne;

    2011-01-01

    Hospital-based home care (HBHC) is widely applied in Pediatric Oncology. We reviewed the potential effect of HBHC on children's physical health and risk of adverse events, parental and child satisfaction, quality of life of children and their parents, and costs. A search of PubMed, CINAHL...... for children with cancer....

  2. Medication Practices at Center Of Hospital and Nursing Home Proposals: Discharge and Pharmacy Requirements to Change

    OpenAIRE

    Barlas, Stephen

    2016-01-01

    Rules proposed by the Centers for Medicare and Medicaid Services would change discharge policies at hospitals and long-term care facilities and update conditions of participation with a focus on medication reconciliation and pharmacist responsibilities.

  3. Medication Practices at Center Of Hospital and Nursing Home Proposals: Discharge and Pharmacy Requirements to Change.

    Science.gov (United States)

    Barlas, Stephen

    2016-04-01

    Rules proposed by the Centers for Medicare and Medicaid Services would change discharge policies at hospitals and long-term care facilities and update conditions of participation with a focus on medication reconciliation and pharmacist responsibilities. PMID:27069341

  4. Treatment of patients with metastatic pancreatic cancer: Experience from a tertiary Indian cancer center

    OpenAIRE

    Sirohi, B; S Dawood; S. Rastogi; Pandey, A.; Bal, M; N Shetty; Shrikhande, S. V.

    2015-01-01

    Background: The aim of this study was to look at the outcome of patients with metastatic pancreatic cancer treated at a tertiary cancer center in India. Patients And Methods: A total of 101 patients with locally advanced and metastatic pancreatic cancer diagnosed between May 2012 and July 2013 were identified from a prospectively maintained database at the tertiary cancer center. Overall survival (OS) was computed using the Kaplan–Meir product limit method and compared across groups using the...

  5. Magnitude and Leading Sites of Cancer in A Tertiary Cancer Care Hospital of Western Maharashtra

    Directory of Open Access Journals (Sweden)

    Kapil H Agrawal, S.S. Rajderkar

    2011-01-01

    Full Text Available Context: It is observed that cancers are increasingly seen in both genders and all the age groups due to a complex interaction of various risk factors. To implement the Public health intervention measures it is essential to have the baseline data regarding frequency, distribution of cancers in the population. Aims: To study the magnitude of cancers by obtaining a baseline data regarding the frequency, distribution, leading cancer sites among the patients in a tertiary cancer care hospital of Western Maharashtra. Study settings: Shri Siddhivinayak Ganapati Cancer Hospital, Miraj Study Design: Hospital based, Cross sectional study involving retrospective information of patients from 1st March 2005 to 28th February 2006. Methods and Material: Retrospective, questionnaire study of patients from 1st March 2005 to 28th February 2006. Out of the total 2168 new patients registered, 1891 patients were detected to be malignant and included in the study. Results: 63.5 % Males and 67% Females in the age group 35-64 years had cancer. The sex ratio percent was 1.01%. Top five Cancer in males in our study were Oral Cavity, Oesophagus, Lung, Larynx and NHL. Top five Cancer in females in our study were Cervix, Breast, Ovary, Oral Cavity and Oesophagus. 27% were TRCs (Tobacco Related Cancers in males while 9.6% were TRCs in females. 34% cancers were in easily accessible parts of body. Conclusions: The Tobacco Related Cancers represent the most preventable form of cancer in our society. It was 27% in males and 9.6% in females in our study. Additionally 34% cancers were in easily accessible parts of body. It highlights the possibility of easy and early detection of cancers in the population thus decreasing the cancer burden in the community.

  6. Situation analysis of trauma based on Arizona trauma center standards in university hospitals of Tehran, Iran

    Institute of Scientific and Technical Information of China (English)

    Mahdi Sharif-Alhoseini; Aliashraf Eghbali; Vafa Rahimi-Movaghar; Soheil Saadat

    2009-01-01

    Objective: Injuries are common and important problem in Tehran, capital of Iran. Although therapeutic centers are not essentially established following the constructional principles of developed countries, the present opportunities and equipments have to be used properly. We should recognize and reduce the deficits based on the global standards.This study deliberates the trauma resources and capacities in university hospitals of Tehran based on Arizona trauma center standards, which are suitable for the assessment of trauma centers.Methods: Forty-one university hospitals in Tehran were evaluated for their conformity with "Arizona trauma center standards" in 2008. A structured interview was arranged with the "Educational Supervisor" of all hospitals regarding their institutional organization, departments, clini-cal capabilities, clinical qualifications, facilities and resources, rehabilitation services, performance improvement, continuing education, prevention, research and additional requirements for pediatric trauma patients. Relative frequencies and percentages were calculated and Student's t test was used to compare the mean values.Results: Forty-one hospitals had the average of 77.7 (50.7%) standards from 153 Arizona trauma center standards and these standards were present in 97.5 out of 153 (63.7%) in 17 general hospitals. Based on the subgroups of the standards, 64.8% items of hospital resources and capabilities were considered as a subgroup with the maximum criteria, and 17.7% items of research section as another subgroup with the minimum standards.Conclusions: On the basis of our findings, no hospital meet all the Arizona trauma center standards completely. The hospitals as trauma centers at different levels must be promoted to manage trauma patients desirably.

  7. Principales Causas de Cáncer Atendidas en un Centro Hospitalario: Costa Rica 2003-2007 Main Causes of Cancer in a Hospital Center: Costa Rica 2003-2007

    OpenAIRE

    Tatiana Barrantes Solís

    2009-01-01

    Objetivos: Analizar las principales causas de cáncer atendidas en el Hospital San Vicente de Paúl y determinar la frecuencia de aparición según cantón de procedencia. Materiales y Métodos: Estudio descriptivo, transversal, ecológico, de 1226 egresados por cáncer del Hospital San Vicente de Paúl (01/01/2000 al 30/08/2007). Se realizó un análisis descriptivo utilizando Excel® (incidencia/100.000 hab/cantón), una regresión de Poisson mediante Egret®. Se realizó una regresión de Poisson, tomando ...

  8. German Bowel Cancer Center: An Attempt to Improve Treatment Quality

    Directory of Open Access Journals (Sweden)

    Olof Jannasch

    2015-01-01

    Full Text Available Background. Colorectal cancer remains the second most common cause of death from malignancies, but treatment results show high diversity. Certified bowel cancer centres (BCC are the basis of a German project for improvement of treatment. The aim of this study was to analyze if certification would enhance short-term outcome in rectal cancer surgery. Material and Methods. This quality assurance study included 8197 patients with rectal cancer treated between 1 January 2008 and 31 December 2010. We compared cohorts treated in certified and noncertified hospitals regarding preoperative variables and perioperative outcomes. Outcomes were verified by matched-pair analysis. Results. Patients of noncertified hospitals had higher ASA-scores, higher prevalence of risk factors, more distant metastases, lower tumour localization, lower frequency of pelvic MRI, and higher frequencies of missing values and undetermined TNM classifications (significant differences only. Outcome analysis revealed more general complications in certified hospitals (20.3% versus 17.4%, p=0.03. Both cohorts did not differ significantly in percentage of R0-resections, intraoperative complications, anastomotic leakage, in-hospital death, and abdominal wall dehiscence. Conclusions. The concept of BCC is a step towards improving the structural and procedural quality. This is a good basis for improving outcome quality but cannot replace it. For a primary surgical disease like rectal cancer a specific, surgery-targeted program is still needed.

  9. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Eva Helena; Kjaergaard, Hanne; Johansen, Christoffer;

    2013-01-01

    children and 43 parents in the home care group, and 47 children and 66 parents receiving standard hospital care. RESULTS: All parents in the HBHC program were satisfied and preferred home care. There were no serious adverse events associated with HBHC, and costs did not increase. When adjusting for age......BACKGROUND: To assess the feasibility and psychosocial impact of a hospital-based home care (HBHC) program for children with cancer. PROCEDURE: A HBHC program was carried out with 51 children (0-18 years) with cancer to assess its feasibility in terms of satisfaction, care preferences, safety......, gender, diagnosis and time since diagnosis, we found significant higher HRQOL scores in parent-reported physical health (P = 0.04; 95% confidence interval (CI): -0.2-19.5) and worry (P = 0.04; 95% CI: -0.4-20.6) in the home-care group indicating better physical health and less worry for children...

  10. Epidemiology of Cancers in Kashmir, India: An Analysis of Hospital Data

    OpenAIRE

    Qurieshi, Mariya A.; Khan, S. M. Salim; Muneer A. Masoodi; Qurieshi, Uruj; Ain, Quratul; Jan, Yasmeen; Haq, Inaamul; Ahmad, Sheikh Zahoor

    2016-01-01

    Cancer is a leading cause of mortality and morbidity in the world. The aim of the present study was to measure the pattern of different cancers in Kashmir, India, a cancer belt with peculiar cancer profile. A hospital based cancer registry was started by the Department of Community Medicine, Government Medical College, Srinagar, in January 2006, wherein information was collected from cancer patients who were diagnosed and treated in the hospital. Data has been analysed for a period extending ...

  11. Quality indicators for colorectal cancer surgery and care according to patient-, tumor-, and hospital-related factors

    Directory of Open Access Journals (Sweden)

    Mathoulin-Pélissier Simone

    2012-07-01

    Full Text Available Abstract Background Colorectal cancer (CRC care has improved considerably, particularly since the implementation of a quality of care program centered on national evidence-based guidelines. Formal quality assessment is however still needed. The aim of this research was to identify factors associated with practice variation in CRC patient care. Methods CRC patients identified from all cancer centers in South-West France were included. We investigated variations in practices (from diagnosis to surgery, and compliance with recommended guidelines for colon and rectal cancer. We identified factors associated with three colon cancer practice variations potentially linked to better survival: examination of ≥12 lymph nodes (LN, non-use and use of adjuvant chemotherapy for stage II and stage III patients, respectively. Results We included 1,206 patients, 825 (68% with colon and 381 (32% with rectal cancer, from 53 hospitals. Compliance was high for resection, pathology report, LN examination, and chemotherapy use for stage III patients. In colon cancer, 26% of stage II patients received adjuvant chemotherapy and 71% of stage III patients. 84% of stage US T3T4 rectal cancer patients received pre-operative radiotherapy. In colon cancer, factors associated with examination of ≥12 LNs were: lower ECOG score, advanced stage and larger hospital volume; factors negatively associated were: left sided tumor location and one hospital district. Use of chemotherapy in stage II patients was associated with younger age, advanced stage, emergency setting and care structure (private and location; whereas under-use in stage III patients was associated with advanced age, presence of comorbidities and private hospitals. Conclusions Although some changes in practices may have occurred since this observational study, these findings represent the most recent report on practices in CRC in this region, and offer a useful methodological approach for assessing quality of care

  12. Adaptation of Individual Meaning-Centered Psychotherapy for Chinese Immigrant Cancer Patients | Division of Cancer Prevention

    Science.gov (United States)

    The purpose of the study is to modify a type of counseling called "Individual Meaning Centered Psychotherapy" to meet the needs of Chinese cancer patients. Many cancer patients use counseling or other resources to help cope with the emotional burden of their illnesses. Counseling often helps them cope with cancer by giving them a place to express their feelings. "Meaning-Centered" counseling aims to teach cancer patients how to maintain or even increase a sense of meaning and purpose in their lives, despite cancer. |

  13. A Patient-Centered Perspective on Cancer Survivorship

    Directory of Open Access Journals (Sweden)

    Brad Zebrack

    2015-04-01

    Full Text Available Survivorship is a complicated notion because people often confuse a process of survivorship with a mythic identity of being a cancer survivor. This confusion may be a distraction to addressing the real-life struggles and challenges experienced by all people diagnosed with cancer. A more expansive perspective of survivorship, one that attends to patients’ physical, psychological, social, spiritual, and existential challenges throughout a continuum of care, would be more in line with what is known empirically about people’s experiences with cancer. In an effort to gain a patient-centered perspective on cancer, and one that emphasizes multiple dimensions of cancer survivorship, the author reports findings from a non-scientific social media poll (via Facebook and personal emails in which survivors and colleagues working in the field of cancer survivorship answered the question: What does cancer survivorship mean to you? The comments are enlightening and useful for guiding the development of a patient-centered, and, thus, more comprehensive, approach to caring for people affected by cancer.

  14. Integration of an academic medical center and a community hospital: the Brigham and Women's/Faulkner hospital experience.

    Science.gov (United States)

    Sussman, Andrew J; Otten, Jeffrey R; Goldszer, Robert C; Hanson, Margaret; Trull, David J; Paulus, Kenneth; Brown, Monte; Dzau, Victor; Brennan, Troyen A

    2005-03-01

    Brigham and Women's Hospital (BWH), a major academic tertiary medical center, and Faulkner Hospital (Faulkner), a nearby community teaching hospital, both in the Boston, Massachusetts area, have established a close affiliation relationship under a common corporate parent that achieves a variety of synergistic benefits. Formed under the pressures of limited capacity at BWH and excess capacity at Faulkner, and the need for lower-cost clinical space in an era of provider risk-sharing, BWH and Faulkner entered into a comprehensive affiliation agreement. Over the past seven years, the relationship has enhanced overall volume, broadened training programs, lowered the cost of resources for secondary care, and improved financial performance for both institutions. The lessons of this relationship, both in terms of success factors and ongoing challenges for the hospitals, medical staffs, and a large multispecialty referring physician group, are reviewed. The key factors for success of the relationship have been integration of training programs and some clinical services, provision of complementary clinical capabilities, geographic proximity, clear role definition of each institution, commitment and flexibility of leadership and medical staff, active and responsive communication, and the support of a large referring physician group that embraced the affiliation concept. Principal challenges have been maintaining the community hospital's cost structure, addressing cultural differences, avoiding competition among professional staff, anticipating the pace of patient migration, choosing a name for the new affiliation, and adapting to a changing payer environment. PMID:15734807

  15. Helping cancer patients across the care continuum: the navigation program at the Queen's Medical Center.

    Science.gov (United States)

    Allison, Amanda L; Ishihara-Wong, Debra D M; Domingo, Jermy B; Nishioka, Jocelyn; Wilburn, Andrea; Tsark, JoAnn U; Braun, Kathryn L

    2013-04-01

    Research suggests that cancer patient navigation improves care, but few reports describe the variety of patients managed by a hospital-based navigation program. Differences in navigated patients by the intensity (low, medium, or high) of navigation services they received were examined. The 835 clients seen by the navigators in a hospital-based cancer center were first stratified by quarter and by four ethnic groups. Randomized selection from each group assured there would be equal representation for analysis of Hawaiians, Filipinos, Japanese, and Whites and even numbers over all time intervals. Five professionals extracted data from these case records on demographics, type/stage of cancer, diagnosis and treatment dates, barriers, and navigator actions. Clients had breast (30.0%), lung (15.8%), esophageal (6.7%), colon (5.8%), ovarian (4.2%), prostate (3.3%), and other cancers (34.2%). The median number of actions taken on behalf of a client was 4 (range 1-83), and the median number of days a case was open was 14 (range 1-216). High intensity cases (those receiving more assistance over longer periods of time) were more likely than low-intensity cases to need help with education and reassurance, transportation, care coordination, and covering costs. Although there were no demographic differences across intensity groups, Neighbor Island patients from Hawai'i, Maui, Moloka'i, Lana'i and Kaua'i were more likely to need help with arranging travel, care coordination, and costs associated with getting treatment (all at P=.05), and patients on public insurance were more likely to have stage 4 cancer (P=.001) and to need help with costs (P=.006). Findings suggest that this hospital-based navigation program is filling a real need of patients across the cancer care continuum. A triage protocol and an integrated data capture system could help improve the targeting and documentation of cancer patient navigation services. PMID:23795311

  16. Development of the M. D. Anderson Cancer Center Gynecologic Applicators for the Treatment of Cervical Cancer: Historical Analysis

    International Nuclear Information System (INIS)

    Purpose: To provide historical background on the development and initial studies of the gynecological (gyn) applicators developed by Dr. Gilbert H. Fletcher, a radiation oncologist and chairperson from 1948 to 1981 of the department at the M.D. Anderson Hospital (MDAH) for Cancer Research in Houston, TX, and to acknowledge the previously unrecognized contribution that Dr. Leonard G. Grimmett, a radiation physicist and chairperson from 1949 to 1951 of the physics department at MDAH, made to the development of the gynecological applicators. Methods and Materials: We reviewed archival materials from the Historical Resource Center and from the Department of Radiation Physics at University of Texas M. D. Anderson Cancer Center, as well as contemporary published papers, to trace the history of the applicators. Conclusions: Dr. Fletcher’s work was influenced by the work on gynecologic applicators in the 1940s in Europe, especially work done at the Royal Cancer Hospital in London. Those efforts influenced not only Dr. Fletcher’s approach to the design of the applicators but also the methods used to perform in vivo measurements and determine the dose distribution. Much of the initial development of the dosimetry techniques and measurements at MDAH were carried out by Dr. Grimmett.

  17. Epidemiology of cancers among adolescents and young adults from a tertiary cancer center in Delhi

    OpenAIRE

    Randeep Singh; Rashmi Shirali; Sonali Chatterjee; Arun Adhana; Ramandeep Singh Arora

    2016-01-01

    Background and Objectives: Although cancer in adolescents and young adults (AYAs) is increasingly an area of focus, there is a paucity of clinical and epidemiological data from developing countries. Our objective was to analyze the geographical distribution, sex ratio, histology, and disease patterns of cancers in AYA. Materials and Methods: All patients aged 15-29 years with the diagnosis of cancer who were registered with two hospitals in New Delhi during a 12-month period from January 2014...

  18. Social Welfare Centers Protect Outpatients with Mood Disorders from Risk of Hospital Admission.

    Directory of Open Access Journals (Sweden)

    Kyu-Tae Han

    Full Text Available South Korea faces difficulties in the management of mental disorders, and those difficulties are expected to gradually worsen. Therefore, we analyzed the relationship between social welfare centers and hospital admission after outpatient treatment for mood disorders.We used data from the National Health Insurance Service National Sample Cohort 2002-2013, which included all medical claims filed for the 50,160 patients who were newly diagnosed with a mood disorder among the 1,025,340 individuals in a nationally representative sample. We performed a logistic regression analysis using generalized estimating equation (GEE models to examine the relationship between social welfare centers and hospital admission after outpatient treatment for mood disorders (ICD-10: F3.There was a 3.9% admission rate among a total of 99,533 person-years. Outpatients who lived in regions with more social welfare centers were less likely to be admitted to a hospital (per increase of five social welfare centers per 100,000 people; OR: 0.958; 95% CI: 0.919-0.999. Social welfare centers had an especially strong protective effect on patients with relatively mild mood disorders and those who were vulnerable to medical expenditures.Considering the protective role of social welfare centers in managing patients with mood disorders, health-policy makers need to consider strategies for activating mental healthcare.

  19. [Prevalence of skin tears among hospitalized patients with cancer].

    Science.gov (United States)

    Amaral, Ana Flávia dos Santos; Pulido, Kelly Cristina Strazzieri; Santos, Vera Lucia Conceição de Gouveia

    2012-10-01

    This study aimed to analyze the prevalence of skin tears (ST) among hospitalized oncology patients and associated demographic and clinical variables. This is an epidemiological cross-sectional study type, performed at Octavio Frias de Oliveira State of São Paulo Cancer Institute. All adult patients hospitalized from April 10th to 18th 2010 were evaluated by interview and physical examination. Chi-square test was used to compare demographic and clinical variables between patients with and without ST. Five patients among 157 had nine skin tears, resulting in a prevalence of 3.3%. Among demographic variables, only number of children showed statistically significant difference (p=0.027) between groups. Clinically, patients with ST had lower Karnofsky scores (p=0.031), lower scores at Braden Scale (p=0.026) and less collaborative behaviors (p=0.042) when compared to patients with no lesions. This study contributes to a better knowledge of ST in oncology patients.

  20. Quality assessments for cancer centers in the European Union

    NARCIS (Netherlands)

    Wind, A.; Rajan, A.; Harten, van W.H.

    2016-01-01

    Background Cancer centers are pressured to deliver high-quality services that can be measured and improved, which has led to an increase of assessments in many countries. A critical area of quality improvement is to improve patient outcome. An overview of existing assessments can help stakeholders

  1. Happy crisis tests hospitals' PR plan. Septuplets' arrival swamps Iowa hospitals with national, international media. Blank Children's Hospital, Iowa Methodist Medical Center, Des Moines.

    Science.gov (United States)

    1998-01-01

    The public relations staff believed the birth of healthy septuplets would become a human interest story for local media. But the staff was stunned at the outpouring of international and national media knocking at their front doors. The staff of both Iowa Methodist Medical Center and Blank Children's Hospital in Des Moines, Iowa, organized a communications plan for 14 official press conferences, constant updates to the media and a website to handle ongoing inquiries from the public. As a result, the story of the McCaughey septuplets was shown in more than 10,000 television stories around the world. The hospitals received more than 36,000 magazine and newspaper articles. The public relations staff not only fielded more than 2,000 phone calls in the days following the Nov. 19 birth, but more than 15 major networks parked their vehicles and satellite dishes in front of the hospital.

  2. [ISO 9002 at the Center of Pediatric Intensive Care at the Albert Einstein Israeli Hospital].

    Science.gov (United States)

    Gé Lacerda, D P; Rocha, M L; Santos, R P

    2000-01-01

    This study shows the process of implementation of a quality program in Pediatric Intensive Therapy Center of "Hospital Israelita Albert Einstein" which resulted in the certification of this service for the Standards ISO 9002/94. It points out the nurse's role as a leader in this process.

  3. Final Report - DOE Center for Laser Imaging and Cancer Diagnostics

    Energy Technology Data Exchange (ETDEWEB)

    Alfano, Robert R.; Koutcher, Jason A.

    2002-10-31

    This Final Report summarizes the significant progress made by the researchers, students and staff of the Center for Laser Imaging and Cancer Diagnostics (CLICD) from January 1998 through May 2002. During this period, the Center supported several projects. Most projects were proposed initially, some were added subsequently as their relevance and importance to the DOE mission became evident. DOE support has been leveraged to obtain continuing funding for some projects. Leveraged funds come from various sources, including NIH, Army, NSF and the Air Force. The goal of the Center was to develop laser-based instruments for use in the detection and diagnosis of major diseases, with an emphasis on detection and diagnosis of various cancers. Each of the supported projects is a collaborative effort between physicists and laser scientists and the City College of New York and noted physicians, surgeons, pathologists, and biologists located at medical centers in the Metropolitan area. The participating institutions were: City College of New York Institute for Ultrafast Lasers and Spectroscopy, Hackensack University Medical Center, Lawrence Livermore National Laboratory, Memorial Sloan Kettering Cancer Center, and New York Eye and Ear Institute. Each of the projects funded by the Center is grouped into one of four research categories: a) Disease Detection, b) Non-Disease Applications, c) New Diagnostic Tools, and, d) Education, Training, Outreach and Dissemination. The progress achieved by the multidisciplinary teams was reported in 51 publications and 32 presentations at major national conferences. Also, one U.S. patent was obtained and six U.S. patent applications have been filed for innovations resulting from the projects sponsored by the Center.

  4. Cancer survivorship research: a review of the literature and summary of current NCI-designated cancer center projects.

    Science.gov (United States)

    Harrop, J Phil; Dean, Julie A; Paskett, Electra D

    2011-10-01

    The number of cancer survivors and the amount of cancer survivorship research have grown substantially during the past three decades. This article provides a review of interventional and observational cancer survivorship research efforts as well as a summary of current cancer survivorship research projects being conducted by National Cancer Institute-designated cancer centers in an effort to identify areas that need further attention.

  5. How do patient and hospital features influence outcomes in small-cell lung cancer in England?

    OpenAIRE

    Rich, A L; Tata, L J; Free, C M; Stanley, R. A.; Peake, M D; Baldwin, D. R.; Hubbard , R B

    2011-01-01

    Background: Our aim was to systematically determine how features of patients and hospitals influence access to chemotherapy and survival for people with small-cell lung cancer in England. Methods: We linked the National Lung Cancer Audit and Hospital Episode Statistics and used multiple logistic and Cox regression analyses to assess the influence of patient and hospital features on small-cell lung cancer outcomes. Results: There were 7845 patients with histologically proven small-cell lung ca...

  6. Touriam Health Care Center of Xiyuan Hospital China Academy of Traditioal Chinese Medicine

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Brief Introduction to Xiyuan Hospital Xiyuan Hospital of China Academy of Traditional Chinese Medicine (TCM) was founded in 1955.It is a large comprehensive hospital directly attached to the Chinese Ministry of Health and State Administration of TOM. This hospital governs First Clinical Medical Institute, Gerontology Institute and Clinical Pharmacological Institute of China Academy of TOM, and Clinical Pharmacological Base of the Health Ministry. It is a component of WHO Collaborating Center for Traditional Medicine. It also administers the Agency of Chinese Journal of Integrated Traditional Chinese and Western Medicine, the Society of Clinical Pharmacology of Chinese Drugs of China TOM Association, the Professional Committee of Hematology and Activating Blood-circulation and Removing Blood Stasis of Chinese Society of Integrated Traditional Chinese and Western Medicine.

  7. [Current status of nosocomial infections in the Lebanese Hospital Center, Beirut].

    Science.gov (United States)

    Al-Hajje, A; Ezedine, M; Hammoud, H; Awada, S; Rachidi, S; Zein, S; Salameh, P

    2012-05-01

    Nosocomial infections are a significant problem and hospitals need to be aware of their nosocomial infection status. This retrospective study aimed to identify nosocomial bacterial infections in patients admitted to the Lebanese Hospital Center from January 2006 to January 2008 and determine the causative micro-organisms, the antibiotic sensitivity of the micro-organisms and evaluate the hospital treatment. In total 96 patients with nosocomial infection were included. Urinary infections were the commonest nosocomial infections (42%) followed by pulmonary infections (28%). Gram-negative bacteria were responsible for 89% of nosocomial infections and staphylococci for 7%, with Escherichia coli and Pseudomonas aeruginosa being the most common (46% and 26% respectively). The organisms were resistant to multiples antibiotics and 18% of the patients were treated with imipenem, 7% with vancomycin, 42% with third-generation cephalosporins and 24% with amikacin. Hospital hygiene measures and antibiotic prescription policies are required to fight nosocomial infections and reduce antibiotic resistance among organisms.

  8. Trends in Clinically Significant Pain Prevalence Among Hospitalized Cancer Patients at an Academic Hospital in Taiwan: A Retrospective Cohort Study.

    Science.gov (United States)

    Wang, Wei-Yun; Ho, Shung-Tai; Wu, Shang-Liang; Chu, Chi-Ming; Sung, Chun-Sung; Wang, Kwua-Yun; Liang, Chun-Yu

    2016-01-01

    Clinically significant pain (CSP) is one of the most common complaints among cancer patients during repeated hospitalizations, and the prevalence ranges from 24% to 86%. This study aimed to characterize the trends in CSP among cancer patients and examine the differences in the prevalence of CSP across repeated hospitalizations. A hospital-based, retrospective cohort study was conducted at an academic hospital. Patient-reported pain intensity was assessed and recorded in a nursing information system. We examined the differences in the prevalence of worst pain intensity (WPI) and last evaluated pain intensity (LPI) of ≥ 4 or ≥ 7 points among cancer inpatients from the 1st to the 18th hospitalization. Linear mixed models were used to determine the significant difference in the WPI and LPI (≥ 4 or ≥ 7 points) at each hospitalization. We examined 88,133 pain scores from the 1st to the 18th hospitalization among cancer patients. The prevalence of the 4 CSP types showed a trend toward a reduction from the 1st to the 18th hospitalization. There was a robust reduction in the CSP prevalence from the 1st to the 5th hospitalization, except in the case of LPI ≥ 7 points. The prevalence of a WPI ≥ 4 points was significantly higher (0.240-fold increase) during the 1st hospitalization than during the 5th hospitalization. For the 2nd, 3rd, and 4th hospitalizations, there was a significantly higher prevalence of a WPI ≥ 4 points compared with the 5th hospitalization. We also observed significant reductions in the prevalence of a WPI ≥ 7 points during the 1st to the 4th hospitalizations, an LPI ≥ 4 points during the 1st to the 3rd hospitalizations, and an LPI ≥ 7 points during the 1st to the 2nd hospitalization. Although the prevalence of the 4 CSP types decreased gradually, it is impossible to state the causative factors on the basis of this observational and descriptive study. The next step will examine the factors that determine the CSP prevalence among cancer

  9. Assessment of diagnosis of inflammatory breast cancer cases at two cancer centers in Egypt and Tunisia

    OpenAIRE

    Schairer, Catherine; Soliman, Amr S; Omar, Sherif; Khaled, Hussein; Eissa, Saad; Ayed, Farhat Ben; Khalafallah, Samir; Ayoub, Wided Ben; Kantor, Elizabeth D.; Merajver, Sofia; Swain, Sandra M; Gail, Mitchell; Brown, Linda Morris

    2013-01-01

    The diagnosis of inflammatory breast cancer (IBC) is largely clinical and therefore inherently somewhat subjective. The objective of this study was to evaluate the diagnosis of IBC at two centers in North Africa where a higher proportion of breast cancer is diagnosed as IBC than in the United States (U.S.). Physicians prospectively enrolled suspected IBC cases at the National Cancer Institute (NCI) – Cairo, Egypt, and the Institut Salah Azaiz (ISA), Tunisia, recorded extent and duration of si...

  10. A management plan for hospitals and medical centers facing radiation incidents

    Directory of Open Access Journals (Sweden)

    Fereshteh Davari

    2015-01-01

    Full Text Available Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

  11. 77 FR 9665 - Submission for OMB Emergency Review; Comment Request: A Multi-Center International Hospital-Based...

    Science.gov (United States)

    2012-02-17

    ... Multi- Center International Hospital-Based Case-Control Study of Lymphoma in Asia (AsiaLymph) (NCI... Institute (NCI), the National Institutes of Health (NIH), has submitted to the Office of Management and... currently valid OMB control number. Proposed Collection: Title: A Multi-Center International Hospital-...

  12. Factors Associated with Waiting Time for Breast Cancer Treatment in a Teaching Hospital in Ghana

    Science.gov (United States)

    Dedey, Florence; Wu, Lily; Ayettey, Hannah; Sanuade, Olutobi A.; Akingbola, Titilola S.; Hewlett, Sandra A.; Tayo, Bamidele O.; Cole, Helen V.; de-Graft Aikins, Ama; Ogedegbe, Gbenga; Adanu, Richard

    2016-01-01

    Background: Breast cancer is the leading cause of cancer-related mortality among women in Ghana. Data are limited on the predictors of poor outcomes in breast cancer patients in low-income countries; however, prolonged waiting time has been implicated. Among breast cancer patients who received treatment at Korle Bu Teaching Hospital, this study…

  13. Cancer patient-centered home care: a new model for health care in oncology

    Science.gov (United States)

    Tralongo, Paolo; Ferraù, Francesco; Borsellino, Nicolò; Verderame, Francesco; Caruso, Michele; Giuffrida, Dario; Butera, Alfredo; Gebbia, Vittorio

    2011-01-01

    Patient-centered home care is a new model of assistance, which may be integrated with more traditional hospital-centered care especially in selected groups of informed and trained patients. Patient-centered care is based on patients’ needs rather than on prognosis, and takes into account the emotional and psychosocial aspects of the disease. This model may be applied to elderly patients, who present comorbid diseases, but it also fits with the needs of younger fit patients. A specialized multidisciplinary team coordinated by experienced medical oncologists and including pharmacists, psychologists, nurses, and social assistance providers should carry out home care. Other professional figures may be required depending on patients’ needs. Every effort should be made to achieve optimal coordination between the health professionals and the reference hospital and to employ shared evidence-based guidelines, which in turn guarantee safety and efficacy. Comprehensive care has to be easily accessible and requires a high level of education and knowledge of the disease for both the patients and their caregivers. Patient-centered home care represents an important tool to improve quality of life and help cancer patients while also being cost effective. PMID:21941445

  14. Lung Cancer Survival Improvement through Surgical Intervention in PUMCH Hospital

    Institute of Scientific and Technical Information of China (English)

    GUO Feng; ZHANG Zhiyong; CUI Yushang; LI Shanqing; LI Li; XU Xiaohui; GE Feng; GUO Huiqin; LI Zejian

    2006-01-01

    Objective: To investigate and evaluate improvement of lung cancer survival after surgical intervention in PUMC hospital during the last 15 years. Methods: From January 1989 to December 2003, 1574 lung cancer cases underwent surgical treatment and followed up. All cases in this series were divided into two groups according to time period: group A (1999-2003) and group B (1989-1998). The difference in the survival rate between groups A and B was compared. Results: The morbidity and mortality in group A was decreased significantly in comparison to group B (11.2% vs. 19.2%, 1.06% vs. 1.93%, respectively).However, the 3-year and 5-year survival rate was increased from 42.35% to 56.07%, and from 28.46% to38.99%, respectively. A significant improvement in survival was observed in patients with stage Ⅰ, Ⅱ and ⅢA, but not in those with stage ⅢB and Ⅳ. Also, patients with lobectomy had more satisfactory results than those receiving exploratory thoracotomy, limited resection, pneumonectomy and sleeve resection. Conclusion: Lobectomy plus systematic mediastinal lymph nodes dissection has become the standard mode for resectable lung cancer. Combination of complete resection along with lymph nodal dissection, and postoperative adjuvant chemotherapy based on platinum/3rd generation chemotherapy medicine, has preliminarily been justified, proving an important approach for effective improvement in long-term survival of non-small cell lung carcinoma.

  15. Prognostic Implications of Level-of-Care at Tertiary Heart Centers Compared With Other Hospitals After Resuscitation From Out-of-Hospital Cardiac Arrest

    DEFF Research Database (Denmark)

    Søholm, Helle; Kjaergaard, Jesper; Bro-Jeppesen, John;

    2015-01-01

    BACKGROUND: Studies have found higher survival rates after out-of-hospital cardiac arrest and admission to tertiary heart centers. The aim was to examine the level-of-care at tertiary centers compared with nontertiary hospitals and the association with outcome after out-of-hospital cardiac arrest....... METHODS AND RESULTS: Consecutive out-of-hospital cardiac arrest patients (n=1078) without ST-segment-elevation myocardial infarction admitted to tertiary centers (54%) and nontertiary hospitals (46%) were included (2002-2011). Patient charts were reviewed focusing on level-of-care and comorbidity....... Survival to discharge differed significantly with 45% versus 24% of patients discharged alive (Pday mortality (hazard ratio, 0.78 [0.64-0.96; P=0.02]), independent of comorbidity...

  16. PREVALENCE OF INCIDENTAL GALLBLADDER CANCER IN A TERTIARY-CARE HOSPITAL FROM PERNAMBUCO, BRAZIL

    Directory of Open Access Journals (Sweden)

    Euclides Dias MARTINS-FILHO

    2015-09-01

    Full Text Available BackgroundGallbladder cancer is sometimes incidentally uncovered following cholecystectomy for gallstones diseases. The supposed highly variable prevalence of incidental gallbladder cancer through our country is unknown.ObjectiveTo explore the prevalence of incidental gallbladder cancer in our tertiary-care hospital.MethodsA cross-sectional study was carried out on patients who consecutively underwent cholecystectomy due to gallstones disease at Faculdade Pernambucana de Saúde, Instituto de Medicina Integral Professor Fernando Figueira - FPS/IMIP, from January, 2007 to December, 2010. Data on incidental gallbladder cancer patients were explored for prevalence estimation and description of our experience with the management of this malignancy.ResultsOur analysis involved 2018 patients with a marked predominance of women (n=1.697; 84.1% over men (n=321; 15.9%. The 3-year prevalence estimate of 0.34% was recorded for incidental gallbladder cancer in our sample. Regarding tumor staging, there were 1 T1a, 1 T1b, and 5 T2 adenocarcinoma tumors. Laparoscopic cholecystectomy alone was performed for the T1a tumor, and additional radical surgery was performed in five others. One patient presented metastatic disease at the time of repeat surgery. The final pathology revealed residual/additional disease in all T2 tumors after radical surgery whereas the T1b patient underwent a salvage Whipple’s procedure due to a secondary distal cholangiocarcinoma. The patient with T1a tumor is alive after 3-year follow-up but all of the others died because of disease recurrence/progression up to 12 months.ConclusionThis study confirms the poor prognosis of Gallbladder cancer even when incidentally diagnosed following cholecystectomy and supposes a 3-year prevalence estimate of 0.34% for incidental gallbladder cancer in our Center from Pernambuco State, Brazil.

  17. Minimally invasive esophagectomy for cancer: Single center experience after 44 consecutive cases

    Directory of Open Access Journals (Sweden)

    Bjelović Miloš

    2015-01-01

    Full Text Available Introduction. At the Department of Minimally Invasive Upper Digestive Surgery of the Hospital for Digestive Surgery in Belgrade, hybrid minimally invasive esophagectomy (hMIE has been a standard of care for patients with resectable esophageal cancer since 2009. As a next and final step in the change management, from January 2015 we utilized total minimally invasive esophagectomy (tMIE as a standard of care. Objective. The aim of the study was to report initial experiences in hMIE (laparoscopic approach for cancer and analyze surgical technique, major morbidity and 30-day mortality. Methods. A retrospective cohort study included 44 patients who underwent elective hMIE for esophageal cancer at the Department for Minimally Invasive Upper Digestive Surgery, Hospital for Digestive Surgery, Clinical Center of Serbia in Belgrade from April 2009 to December 2014. Results. There were 16 (36% middle thoracic esophagus tumors and 28 (64% tumors of distal thoracic esophagus. Mean duration of the operation was 319 minutes (approximately five hours and 20 minutes. The average blood loss was 173.6 ml. A total of 12 (27% of patients had postoperative complications and mean intensive care unit stay was 2.8 days. Mean hospital stay after surgery was 16 days. The average number of harvested lymph nodes during surgery was 31.9. The overall 30-day mortality rate within 30 days after surgery was 2%. Conclusion. As long as MIE is an oncological equivalent to open esophagectomy (OE, better relation between cost savings and potentially increased effectiveness will make MIE the preferred approach in high-volume esophageal centers that are experienced in minimally invasive procedures.

  18. The need for hospital care of patients with clinically localized prostate cancer managed by noncurative intent

    DEFF Research Database (Denmark)

    Brasso, Klaus; Friis, S; Juel, K;

    2000-01-01

    We studied the need for hospital care of patients 74 years old or younger with clinically localized prostate cancer managed by deferred endocrine therapy.......We studied the need for hospital care of patients 74 years old or younger with clinically localized prostate cancer managed by deferred endocrine therapy....

  19. Oncogenetics service and the Brazilian public health system: the experience of a reference Cancer Hospital

    Directory of Open Access Journals (Sweden)

    Edenir I. Palmero

    2016-01-01

    Full Text Available Abstract The identification of families at-risk for hereditary cancer is extremely important due to the prevention potential in those families. However, the number of Brazilian genetic services providing oncogenetic care is extremely low for the continental dimension of the country and its population. Therefore, at-risk patients do not receive appropriate assistance. This report describes the creation, structure and management of a cancer genetics service in a reference center for cancer prevention and treatment, the Barretos Cancer Hospital (BCH. The Oncogenetics Department (OD of BCH offers, free of charge, to all patients/relatives with clinical criteria, the possibility to perform i genetic counseling, ii preventive examinations and iii genetic testing with the best quality standards. The OD has a multidisciplinary team and is integrated with all specialties. The genetic counseling process consists (mostly of two visits. In 2014, 614 individuals (371 families were seen by the OD. To date, over 800 families were referred by the OD for genetic testing. The support provided by the Oncogenetics team is crucial to identify at-risk individuals and to develop preventive and personalized behaviors for each situation, not only to the upper-middle class population, but also to the people whose only possibility is the public health system.

  20. Epidemiology of Cancers in Kashmir, India: An Analysis of Hospital Data.

    Science.gov (United States)

    Qurieshi, Mariya A; Khan, S M Salim; Masoodi, Muneer A; Qurieshi, Uruj; Ain, Quratul; Jan, Yasmeen; Haq, Inaamul; Ahmad, Sheikh Zahoor

    2016-01-01

    Cancer is a leading cause of mortality and morbidity in the world. The aim of the present study was to measure the pattern of different cancers in Kashmir, India, a cancer belt with peculiar cancer profile. A hospital based cancer registry was started by the Department of Community Medicine, Government Medical College, Srinagar, in January 2006, wherein information was collected from cancer patients who were diagnosed and treated in the hospital. Data has been analysed for a period extending from January 2006 to December 2012. Descriptive analysis has been done by using statistical software. A total of 1598 cancer patients were admitted during this period. Overall male to female ratio was 1.33 : 1. Stomach cancer was the most commonly reported cancer (25.2%), followed by colorectal cancer (16.4%) and lung cancer (13.2%) among males. For females, colorectal cancer (16.8%), breast cancer (16.1%), and stomach cancer (10.4%) were the most frequently reported cancers in order of frequency. Tobacco related cancers contributed to more than three-fourths of cancers among men and more than half of cancers for women. There is an urgent need to set up a population based cancer registration system to understand the profile of cancers specific to this geographic region.

  1. Epidemiology of Cancers in Kashmir, India: An Analysis of Hospital Data

    Directory of Open Access Journals (Sweden)

    Mariya A. Qurieshi

    2016-01-01

    Full Text Available Cancer is a leading cause of mortality and morbidity in the world. The aim of the present study was to measure the pattern of different cancers in Kashmir, India, a cancer belt with peculiar cancer profile. A hospital based cancer registry was started by the Department of Community Medicine, Government Medical College, Srinagar, in January 2006, wherein information was collected from cancer patients who were diagnosed and treated in the hospital. Data has been analysed for a period extending from January 2006 to December 2012. Descriptive analysis has been done by using statistical software. A total of 1598 cancer patients were admitted during this period. Overall male to female ratio was 1.33 : 1. Stomach cancer was the most commonly reported cancer (25.2%, followed by colorectal cancer (16.4% and lung cancer (13.2% among males. For females, colorectal cancer (16.8%, breast cancer (16.1%, and stomach cancer (10.4% were the most frequently reported cancers in order of frequency. Tobacco related cancers contributed to more than three-fourths of cancers among men and more than half of cancers for women. There is an urgent need to set up a population based cancer registration system to understand the profile of cancers specific to this geographic region.

  2. Testing family-centered, function-focused care in hospitalized persons with dementia

    Science.gov (United States)

    Boltz, Marie; Chippendale, Tracy; Resnick, Barbara; Galvin, James E

    2015-01-01

    Summary Aim Hospital-acquired disability causes decreased quality of life for patients with dementia and family caregivers, and increased societal costs. Materials & methods A comparative, repeated measures study tested the feasibility and preliminary efficacy of the family-centered, function-focused care intervention (Fam-FFC) in dyads of hospitalized, medical patients with dementia and family caregivers (FCGs). Results The intervention group demonstrated better activities of daily living and walking performance, and less severity/duration of delirium and hospital readmissions, but no significant differences in gait/balance. FCGs showed increased preparedness for caregiving and less anxiety but no significant differences in depression, strain and mutuality. Conclusion Fam-FFC presents a possible pathway to meeting the Triple Aim of improved patient care, improved patient health and reduced costs for persons with dementia. PMID:26107319

  3. Impact of Low Procalcitonin Results on Antibiotic Administration in Hospitalized Patients at a Tertiary Care Center

    OpenAIRE

    Brennan, Meghan B.; Osterby, Kurt; Schulz, Lucas; Lepak, Alexander J.

    2016-01-01

    Procalcitonin is a sensitive and specific marker of bacterial infection; low results allow clinicians to safely de-escalate antibiotics. This retrospective cohort study aimed to determine the effect of low procalcitonin results on withholding, discontinuing, or de-escalating antibiotics in hospitalized patients at a tertiary care center. Antibiotics were initiated or continued without de-escalation in 55% of patients with low procalcitonin results. Among patients with low procalcitonin result...

  4. [Perception of the organizational climate in the surgical center of a specialized hospital].

    Science.gov (United States)

    Spiri, W C

    1998-01-01

    The aim of this study is to identify how a new team of the surgical center staff in a specialized hospital perceive the organization climate. A qualitative approach was utilized. As a theoretical reference to measure the organization climate, we have used CHIAVENATO, that defines organization climate as the interior of an organization that influences its members behavior. The organization climate could be favourable, unfavourable or neutral. The speeches showed a favourable organization climate considering the adopted methodology.

  5. Positioning academic medical centers and teaching hospitals to thrive in the next decade.

    Science.gov (United States)

    Morris, D E

    1985-06-01

    Market share for academic medical centers and teaching hospitals will decline over the next five years necessitating new strategies to ensure growth and profitability. These types of institutions are, however, in a strong position to compete and gain market share locally by building a defensible competitive advantage. This article offers three avenues for increasing market share: networking, brand name product differentiation, and business diversification. PMID:10271804

  6. Preparing an Academic Medical Center to Manage Patients Infected with Ebola: Experiences of a University Hospital

    OpenAIRE

    Schultz, Ch.; Koenig, KL; Alassaf, W

    2015-01-01

    © 2015 Society for Disaster Medicine and Public Health, Inc. As Ebola has spread beyond West Africa, the challenges confronting health care systems with no experience in managing such patients are enormous. Not only is Ebola a significant threat to a population's health, it can infect the medical personnel trying to treat it. As such, it represents a major challenge to those in public health, emergency medical services (EMS), and acute care hospitals. Our academic medical center volunteered t...

  7. Early Hospital Readmission After Simultaneous Pancreas-Kidney Transplantation: Patient and Center-Level Factors.

    Science.gov (United States)

    King, E A; Kucirka, L M; McAdams-DeMarco, M A; Massie, A B; Al Ammary, F; Ahmed, R; Grams, M E; Segev, D L

    2016-02-01

    Early hospital readmission is associated with increased morbidity, mortality, and cost. Following simultaneous pancreas-kidney transplantation, rates of readmission and risk factors for readmission are unknown. We used United States Renal Data System data to study 3643 adult primary first-time simultaneous pancreas-kidney recipients from December 1, 1999 to October 31, 2011. Early hospital readmission was any hospitalization within 30 days of discharge. Modified Poisson regression was used to determine the association between readmission and patient-level factors. Empirical Bayes statistics were used to determine the variation attributable to center-level factors. The incidence of readmission was 55.5%. Each decade increase in age was associated with an 11% lower risk of readmission to age 40, beyond which there was no association. Donor African-American race was associated with a 13% higher risk of readmission. Each day increase in length of stay was associated with a 2% higher risk of readmission until 14 days, beyond which each day increase was associated with a 1% reduction in the risk of readmission. Center-level factors were not associated with readmission. The high incidence of early hospital readmission following simultaneous pancreas-kidney transplant may reflect clinical complexity rather than poor quality of care.

  8. Cancer patient-centered home care: a new model for health care in oncology

    Directory of Open Access Journals (Sweden)

    Tralongo P

    2011-09-01

    Full Text Available Paolo Tralongo1, Francesco Ferraù2, Nicolò Borsellino3, Francesco Verderame4, Michele Caruso5, Dario Giuffrida6, Alfredo Butera7, Vittorio Gebbia81Medical Oncology Unit, Azienda Sanitaria Provinciale, Siracusa; 2Medical Oncology Unit, Ospedale San Vincenzo, Taormina; 3Medical Oncology Unit, Ospedale Buccheri La Ferla, Palermo; 4Medical Oncology Unit, Ospedale Giovanni Paolo II, Sciacca; 5Medical Oncology Unit, Istituto Humanitas, Catania; 6Medical Oncology Unit, Istituto Oncologico del Mediterraneo, Catania; 7Medical Oncology Unit, Ospedale San Giovanni di Dio, Agrigento; 8Medical Oncology Unit, Dipartimento Oncologico, La Maddalena, Università degli Studi, Palermo, ItalyAbstract: Patient-centered home care is a new model of assistance, which may be integrated with more traditional hospital-centered care especially in selected groups of informed and trained patients. Patient-centered care is based on patients' needs rather than on prognosis, and takes into account the emotional and psychosocial aspects of the disease. This model may be applied to elderly patients, who present comorbid diseases, but it also fits with the needs of younger fit patients. A specialized multidisciplinary team coordinated by experienced medical oncologists and including pharmacists, psychologists, nurses, and social assistance providers should carry out home care. Other professional figures may be required depending on patients' needs. Every effort should be made to achieve optimal coordination between the health professionals and the reference hospital and to employ shared evidence-based guidelines, which in turn guarantee safety and efficacy. Comprehensive care has to be easily accessible and requires a high level of education and knowledge of the disease for both the patients and their caregivers. Patient-centered home care represents an important tool to improve quality of life and help cancer patients while also being cost effective.Keywords: cancer, home care

  9. Analysis on usage of narcotic drugs in cancer center of Union Hospital Tongji Medical College, Huazhong University of Science and Technology in 2014%2014年华中科技大学同济医学院附属协和医院肿瘤中心麻醉药品的使用情况分析

    Institute of Scientific and Technical Information of China (English)

    刘金梅; 陈旭; 张琪

    2015-01-01

    目的:了解华中科技大学同济医学院附属协和医院肿瘤中心2014年癌痛患者麻醉药品的使用情况,为临床合理使用麻醉药品提供依据。方法收集2014年1月—2014年12月肿瘤中心麻醉药品处方10757张,对麻醉药品的用药品种、销售金额、用药频度(DDDs)、日均药费(DDC)和药物利用指数(DUI)等进行统计分析。结果处方中共应用9种麻醉药品,使用麻醉药品的癌痛患者中男性略多于女性,41岁以上的中老年患者是癌痛患者的主要人群。销售金额居前3位的分别是盐酸羟考酮缓释片(40 mg)、盐酸羟考酮缓释片(10 mg)、芬太尼透皮贴剂(8.4 mg)。DDDs居首位的是磷酸可待因片,盐酸羟考酮缓释片(40 mg)次之。除了盐酸羟考酮缓释片(40 mg)和芬太尼透皮贴剂(8.4 mg),其他麻醉药品的DUI均<1。在所有病种中肺癌的麻醉药品DDDs最高为22531.16。口服/经皮剂型麻醉药品的DDDs为48800.50,占总DDDs的97.46%。结论随着癌痛规范化治疗示范病房的建立,麻醉药品的使用基本符合“癌痛三阶梯止痛治疗指导原则”。%Objective To investigate the use of narcotic drugs in cancer center of Union Hospital Tongji Medical College, Huazhong University of Science and Technology in 2014, and to provide reference for reasonable application of narcotic drugs.Methods The prescription (10 757 pieces) of narcotic drugs in cancer center from January 2014 to December 2014 was collected, and drug category, consumption sums, average daily cost (DDC), defined daily dose system (DDDs), and drug utilization index (DUI) were analyzed statistically.Results Nine kinds of narcotic drugs were used. There were slightly more male patients than female patients. Elderly patients over the age of 41 were the main group of patients with cancer pain. The narcotic drugs with top three consumption sums were Oxycodone Hydrochloride Prolonged

  10. Comparison of CDE data in phacoemulsification between an open hospital-based ambulatory surgical center and a free-standing ambulatory surgical center

    Directory of Open Access Journals (Sweden)

    Ming Chen

    2010-11-01

    Full Text Available Ming Chen1, Mindy Chen21University of Hawaii, Honolulu, HI, USA; 2University of California, Irvine, CA, USAAbstract: Mean CDE (cumulative dissipated energy values were compared for an open hospital-based surgical center and a free-standing surgical center. The same model of phacoemulsifier (Alcon Infiniti Ozil was used. Mean CDE values showed that surgeons (individual private practice at the free-standing surgical center were more efficient than surgeons (individual private practice at the open hospital-based surgical center (mean CDE at the hospital-based surgical center 18.96 seconds [SD = 12.51]; mean CDE at the free-standing surgical center 13.2 seconds [SD = 9.5]. CDE can be used to monitor the efficiency of a cataract surgeon and surgical center in phacoemulsification. The CDE value may be used by institutions as one of the indicators for quality control and audit in phacoemulsification.Keywords: CDE (cumulative dissipated energy, open hospital-based ambulatory surgical center, free-standing surgical center, phacoemulsification 

  11. Psychological process from hospitalization to death among uninformed terminal liver cancer patients in Japan

    OpenAIRE

    Kobori Eiko; Hagihara Akihito; Maeda Yuko; Nakayama Takeo

    2006-01-01

    Abstract Background Although the attitude among doctors toward disclosing a cancer diagnosis is becoming more positive, informing patients of their disease has not yet become a common practice in Japan. We examined the psychological process, from hospitalization until death, among uninformed terminal cancer patients in Japan, and developed a psychological model. Methods Terminal cancer patients hospitalized during the recruiting period voluntarily participated in in-depth interviews. The data...

  12. Factors associated with malnutrition in hospitalized cancer patients: a croos-sectional study

    OpenAIRE

    Silva, Fernanda Rafaella de Melo; de Oliveira, Mirella Gondim Ozias Aquino; Souza, Alex Sandro Rolland; Figueroa, José Natal; Santos, Carmina Silva

    2015-01-01

    Introduction The incidence of cancer is increasing worldwide and with it the prevalence of malnutrition, which is responsible for the death of almost 20 % of cancer patients. The objective of this study was to identify the factors associated with malnutrition in hospitalized cancer patients. Methods Cross-sectional study conducted with 277 hospitalized patients in the Institute of Integrative Medicine Prof. Fernando Figueira from March to November 2013. The nutritional status was classified a...

  13. Lung cancer risk and pollution in an industrial region of Northern Spain: a hospital-based case-control study

    Directory of Open Access Journals (Sweden)

    Aragonés Nuria

    2011-01-01

    Full Text Available Abstract Background Asturias, an Autonomous Region in Northern Spain with a large industrial area, registers high lung cancer incidence and mortality. While this excess risk of lung cancer might be partially attributable to smoking habit and occupational exposure, the role of industrial and urban pollution also needs to be assessed. The objective was to ascertain the possible effect of air pollution, both urban and industrial, on lung cancer risk in Asturias. Methods This was a hospital-based case-control study covering 626 lung cancer patients and 626 controls recruited in Asturias and matched by ethnicity, hospital, age, and sex. Distances from the respective participants' residential locations to industrial facilities and city centers were computed. Using logistic regression, odds ratios (ORs and 95% confidence intervals (95%CIs for categories of distance to urban and industrial pollution sources were calculated, with adjustment for sex, age, hospital area, tobacco consumption, family history of cancer, and occupation. Results Whereas individuals living near industries displayed an excess risk of lung cancer (OR = 1.49; 95%CI = 0.93-2.39, which attained statistical significance for small cell carcinomas (OR = 2.23; 95%CI = 1.01-4.92, residents in urban areas showed a statistically significant increased risk for adenocarcinoma (OR = 1.92; 95%CI = 1.09-3.38. In the Gijon health area, residents in the urban area registered a statistically significant increased risk of lung cancer (OR = 2.17; 95%CI = 1.25-3.76, whereas in the Aviles health area, no differences in risk were found by area of exposure. Conclusions This study provides further evidence that air pollution is a moderate risk factor for lung cancer.

  14. Improving breast cancer survivors’ knowledge using a patient-centered intervention

    Science.gov (United States)

    Ulloa, Jesus G.; Hemmelgarn, Marian; Viveros, Lori; Odele, Patience; Feldman, Nancy R.; Ganz, Patricia A.; Maggard-Gibbons, Melinda

    2016-01-01

    Background Low-income, minority women with breast cancer experience a range of barriers to receiving survivorship information. Our objective was to test a novel, patient-centered intervention aimed at improving communication about survivorship care. Methods We developed a wallet card to provide oncologic and follow-up care survivorship information to breast cancer patients. We used a prospective, pre–post design to assess the intervention at a safety net hospital. The intervention was given by a patient navigator or community health worker. Results Patient knowledge (n = 130) of personal cancer history improved from baseline pretest to 1 week after the intervention for stage (66–93%; P < .05), treatment (79–92%; P < .05), and symptoms of recurrence (48–89%; P <.05), which was retained at 3 months. The intervention reduced the number of patients who were unsure when their mammogram was due (15–5% at 1 week and 6%at 3 months; P <.05). Nearly 90% reported they would be likely to share their survivorship card with their providers. Conclusion A patient-centered survivorship card improved short-term recall of key survivorship care knowledge and seems to be effective at reducing communication barriers for this population. Further studies are warranted to assess long-term retention and the impact on receipt of appropriate survivorship follow-up care. PMID:26032819

  15. An examination of blood center structure and hospital customer satisfaction: what can centralized and decentralized blood centers learn from each other?

    Science.gov (United States)

    Carden, Robert; DelliFraine, Jami L

    2005-01-01

    The cost of blood and blood products has increased rapidly over the last several years while the supply of available blood donors has simultaneously decreased. Higher blood costs and donor shortages have put a strain on the relationship between blood suppliers and their hospital customers. This study examines the association between blood center centralization or decentralization and several aspects of hospital satisfaction. Centralized and decentralized blood centers have significant differences in various aspects of hospital customer satisfaction. Advantages and disadvantages of the two structures are discussed, as well as areas for future research.

  16. Evaluation of the Dutch BRCA1/2 clinical genetic center referral criteria in an unselected early breast cancer population

    OpenAIRE

    van den Broek, Alexandra J.; de Ruiter, Karen; Van 't Veer, Laura J; Tollenaar, Rob A.E.M.; van Leeuwen, Flora E.; Verhoef, Senno; Schmidt, Marjanka K.

    2014-01-01

    In this study, we evaluated the diagnostic value of the Dutch Clinical Genetic Center (CGC) referral guidelines for BRCA1/2 mutation testing in 903 early breast cancer patients, unselected for family history, diagnosed in a cancer hospital before the age of 50 years in 1974–2002; most prevalent Dutch pathogenic BRCA1/2 mutations had been analyzed on coded DNA in a research setting. Forty-nine (5.4%) of the patients were proven to be BRCA1/2 mutation carriers. We found that 78% and 69% of BRCA...

  17. Postchemotherapy Retroperitoneal Lymph Node Dissection in Patients With Nonseminomatous Testicular Cancer: A Single Center Experiences

    Directory of Open Access Journals (Sweden)

    Nowroozi

    2015-09-01

    Full Text Available Background Testicular cancer accounts for about 1 - 1.5% of all malignancies in men. Radical orchiectomy is curative in 75% of patients with stage I disease, but advance stage with retroperitoneal lymph node involvement needs chemotherapy. All patients who have residual masses ≥ 1 cm after chemotherapy should undergo postchemotherapy retroperitoneal lymph node dissection (PC-RPLND. Objectives Treatment of advanced nonseminomatous testicular cancer is usually a combination of chemotherapy and surgery. We described our experience about postchemotherapy retroperitoneal lymph node dissection (PC-RPLND in our center. Patients and Methods In a retrospective cross-sectional study between 2006 and 2011, patients with a history of postchemotherapy retroperitoneal lymph node dissection (PC-RPLND in Imam Khomeini hospital were evaluated. All patients had normal postchemotherapy serum tumor markers and primary nonseminomatous cancer. We reviewed retrospectively clinical, pathological, and surgical parameters associated with PC-RPLND in our center. Results Twenty-one patients underwent bilateral PC-RPLND. Mean age was 26.3 years (ranged 16 - 47. Mean size of retroperitoneal mass after chemotherapy was 7.6 cm. Mean operative time was 198 minutes (120 - 246 minutes. Mean follow-up time was 38.6 months. Pathologic review showed presence of fibrosis/necrosis, viable germ cell tumor and teratoma in 8 (38.1%, 10 (47.6% and 3 (14.28% patients, respectively. One patient in postoperative period of surgery and three patients in two first years after surgery were expired. Of 17 alive patients, only two (11.8% had not retrograde ejaculation. Conclusions PC-RPLND is one the major operations in the field of urology, which is associated with significant adjunctive surgeries. In appropriate cases, PC-RPLND was associated with good cancer specific survival in tertiary oncology center.

  18. Breast Cancer Treatment Practices in Elderly Women in a Community Hospital

    International Nuclear Information System (INIS)

    Background. Elderly women with breast cancer are considered under diagnosed and under treated, and this adversely affects their overall survival. Methods. A total of 393 female breast cancer patients aged 70 years and older, diagnosed within the years 1989-1999, were identified from the tumor registry of The Brooklyn Hospital Center. Comparisons between the 3 different subgroups 70-74, 75-79, and 80 years and older were made using the Pearson Chi Square test. Results. Lumpectomy was performed in 42% of all patients, while mastectomy was done in 46% of patients. Adjuvant therapy such as chemotherapy, radiation therapy, and hormonal therapy were done in 12%, 25%, and 38%, respectively. Forty-seven percent of patients with positive lymph nodes received chemotherapy. Eighty-six percent of patients who were estrogen receptor-positive received adjuvant hormonal therapy. Overall five-year survival was only 14% for the =80 age group, compared to that of 32% and 35% for the 70-74 and the 75-79 age groups, respectively. Conclusions. Surgery was performed in majority of these patients, about half received lumpectomy, the other half mastectomy. Adjuvant therapies were frequently excluded, with only hormonal therapy being the most commonly used. Overall five-year survival is significantly worse in patients =80 years with breast cancer

  19. Epidemiology of cancers among adolescents and young adults from a tertiary cancer center in Delhi

    Directory of Open Access Journals (Sweden)

    Randeep Singh

    2016-01-01

    Full Text Available Background and Objectives: Although cancer in adolescents and young adults (AYAs is increasingly an area of focus, there is a paucity of clinical and epidemiological data from developing countries. Our objective was to analyze the geographical distribution, sex ratio, histology, and disease patterns of cancers in AYA. Materials and Methods: All patients aged 15-29 years with the diagnosis of cancer who were registered with two hospitals in New Delhi during a 12-month period from January 2014 to December 2014 were included. Basic demographic information on age, sex, location of stay, and nationality was available. Using cancer site and morphology codes, the cancers were grouped by the Birch classification of AYA cancers. Clinical information on disease and treatment status, was retrospectively studied. Results: There were 287 patients (57.5% male, 85.4% Indian origin registered with 54 (18.8%, 97 (33.8%, and 136 (47.4% patients in the 15-19, 20-24, and 25-29 years age groups, respectively. The three most common cancer groups were carcinomas (40.8%, lymphomas (12.9%, and leukemias (10.4%. The three most common sites in carcinomas were gastrointestinal tract (GIT, genitourinary tract, and breast. The most prevalent cancers in younger AYA (15-19 years were leukemias, lymphomas, central nervous system neoplasms, and in contrast, older AYA (25-29 years suffered mainly from GIT Carcinomas, lymphomas. The leading cancers were breast and GIT carcinomas in females and lymphomas and GIT carcinomas in males. Conclusion: The occurrence of cancer in AYA in India has been described. The distribution differs from the only previous report from India as well as the US Surveillance Epidemiology and End Results database, which can be attributed to a referral bias along with the factual difference in cancer etiology and genetics.

  20. Radiation Injury Treatment Network®: Preparedness Through a Coalition of Cancer Centers.

    Science.gov (United States)

    Case, Cullen

    2016-08-01

    This article provides an overview of Radiation Injury Treatment Network® (RITN), its preparedness activities and capabilities, including training and educating over 11,500 hospital staff, coordinating over 500 exercises, developing treatment guidelines, developing standard operating procedures, and being recognized by the U.S. federal government as a national response asset. The RITN provides comprehensive evaluation and treatment for victims with marrow toxic injuries. Many of the casualties from the detonation of an improvised nuclear device (IND) (a.k.a. terrorist nuclear bomb) with only radiation injuries will be salvageable; however, they would require outpatient and/or inpatient care. Recognizing this, the U.S. National Marrow Donor Program (NMDP), U.S. Navy, and American Society for Blood and Marrow Transplantation (ASBMT) collaboratively developed RITN, which comprises medical centers with expertise in the management of bone marrow failure. The medical community will undoubtedly be taxed by the resulting medical surge from an IND despite the well-defined United States emergency medical system, the National Disaster Medical System; however, one area that is unique for radiological disasters is the care for casualties with acute radiation syndrome. Hematologists and oncologists purposefully expose their cancer patients to high doses of radiation and toxic chemicals for chemotherapy as they treat their patients, resulting in symptoms not unlike casualties with exposure to ionizing radiation from a radiological disaster. This makes the staff from cancer centers ideal for the specialized care that will be required for thousands of casualties following a mass casualty radiological incident. The RITN is a model for how a collaborative effort can fill a readiness gap-through its network of 76 hospitals, blood donor centers, and cord blood banks, the RITN is preparing to provide outpatient care and specialized supportive care to up to 63,000 radiological casualties

  1. Knowledge about breast cancer and hereditary breast cancer among nurses in a public hospital 1

    Science.gov (United States)

    Prolla, Carmen Maria Dornelles; da Silva, Patrícia Santos; Netto, Cristina Brinckmann Oliveira; Goldim, José Roberto; Ashton-Prolla, Patricia

    2015-01-01

    OBJECTIVE: To assess the knowledge of nurses involved in the care of oncology patients in a public university hospital, regarding breast cancer and hereditary breast cancer, and to verify the use of such knowledge in their daily practice. METHODS: This is a descriptive cross-sectional study. Data were obtained through a structured, self-administered questionnaire. Out of 154 nurses, 137 (88.9%) agreed to participate in the study. Two questionnaires were excluded such that 135 questionnaires were analyzed. RESULTS: The global percentage of correct answers was not associated with age (p=0.173) or degree/specialization (p=0.815). Questions were classified into categories. In categories involving knowledge of established breast cancer risk factors and indicators of hereditary breast cancer, the rate of correct answers was 65.8% and 66.4%, respectively. On the practice of genetic counseling, 40.7% of those interviewed were not sure about the definition of genetic counseling and 78.5% reported never having identified or referred a patient at genetic risk for specialized risk assessment. Practice of educational actions regarding this subject was reported by 48.5% of those interviewed. CONCLUSION: This study reinforces the need to develop qualifying actions for nurses, so that strategies to control breast cancer become effective in their health care practice. PMID:25806636

  2. Knowledge about breast cancer and hereditary breast cancer among nurses in a public hospital

    Directory of Open Access Journals (Sweden)

    Carmen Maria Dornelles Prolla

    2015-02-01

    Full Text Available OBJECTIVE: To assess the knowledge of nurses involved in the care of oncology patients in a public university hospital, regarding breast cancer and hereditary breast cancer, and to verify the use of such knowledge in their daily practice.METHODS: This is a descriptive cross-sectional study. Data were obtained through a structured, self-administered questionnaire. Out of 154 nurses, 137 (88.9% agreed to participate in the study. Two questionnaires were excluded such that 135 questionnaires were analyzed.RESULTS: The global percentage of correct answers was not associated with age (p=0.173 or degree/specialization (p=0.815. Questions were classified into categories. In categories involving knowledge of established breast cancer risk factors and indicators of hereditary breast cancer, the rate of correct answers was 65.8% and 66.4%, respectively. On the practice of genetic counseling, 40.7% of those interviewed were not sure about the definition of genetic counseling and 78.5% reported never having identified or referred a patient at genetic risk for specialized risk assessment. Practice of educational actions regarding this subject was reported by 48.5% of those interviewed.CONCLUSION: This study reinforces the need to develop qualifying actions for nurses, so that strategies to control breast cancer become effective in their health care practice.

  3. Variability in Criteria for Emergency Medical Services Routing of Acute Stroke Patients to Designated Stroke Center Hospitals

    OpenAIRE

    Nikolay Dimitrov; William Koenig; Nichole Bosson; Sarah Song; Saver, Jeffrey L.; Mack, William J.; Nerses Sanossian

    2015-01-01

    Introduction: Comprehensive stroke systems of care include routing to the nearest designated stroke center hospital, bypassing non-designated hospitals. Routing protocols are implemented at the state or county level and vary in qualification criteria and determination of destination hospital. We surveyed all counties in the state of California for presence and characteristics of their prehospital stroke routing protocols. Methods: Each county’s local emergency medical se...

  4. 77 FR 11136 - Proposed Collection; Comment Request; a Multi-Center International Hospital-Based Case-Control...

    Science.gov (United States)

    2012-02-24

    ... International Hospital-Based Case-Control Study of Lymphoma in Asia (AsiaLymph) (NCI) SUMMARY: In compliance... the Office of Management and Budget (OMB) for review and approval. Proposed Collection: Title: A Multi-Center International Hospital- Based Case-Control Study of Lymphoma in Asia (AsiaLymph) (NCI). Type...

  5. Survey of the Information-Seeking Behaviour of Hospital Professionals at a Public Cancer Hospital in Greece Proves the Value of Hospital Libraries. A Review of: Kostagiolas, P. A., Ziavrou, K., Alexias, G., & Niakas, D. (2012). Studying the information-seeking behavior of hospital professionals: The case of METAXA Cancer Hospital in Greece. Journal of Hospital Librarianship, 12(1), 33-45.

    OpenAIRE

    Antonio DeRosa

    2013-01-01

    Objective – To study the information-seeking practices of hospital staff and weigh the impact of hospital libraries on effective information-seeking.Design – Survey questionnaire.Setting – Large public cancer hospital in Greece.Subjects – The authors surveyed 49 physicians, 43 nursing staff members, 25 administrative staff members, 23 paramedical staff members, and 5 technical staff members, totaling 145 health professionals.Methods – Participants were given a questionnaire comprised of five ...

  6. Manual to radioactive waste management produced in hospitals, research and education centers

    International Nuclear Information System (INIS)

    This manual collects the experience on the disposal and management of the wastes produced in the preparation and application of radioactive material. Although the content is not so extensive, the authors have tried to provide the necessary guidelines and adequate information for the management of the wastes produced in hospitals and research and education centers. The objective of this work is to describe the basis and principles for the establishment of a minimization program, a segregation program and a provisional waste storage, in order to reduce the generation of wastes, personal exposure and the environmental impact. (authors). 5 refs

  7. Marketing the rural hospital-based laboratory: building a customer-centered outreach program.

    Science.gov (United States)

    Beatty, M F

    2001-01-01

    Rural hospital laboratories, which operate 24 hours/day, 7 days/week to meet inpatient and emergency-room care requirements, are situated uniquely to provide outpatient laboratory services for their communities. Laboratory managers looking to augment current services should consider implementing an outreach program. This article will explore the marketing aspects involved with developing a customer-centered outreach program, including finding a market niche, developing a business plan using elements of the consumption chain, addressing customer service issues, and business plan testing and validation. PMID:11236189

  8. Clinicopathological Profile of Lung Cancer Patients in a Teaching Hospital in South India

    OpenAIRE

    Srinath Dhandapani; Aravind Srinivasan; Rajalakshmi Rajagopalan; Santhosh Chellamuthu; Aishwarya Rajkumar; Paramesh Palaniswamy

    2016-01-01

    Introduction: Lung cancer is one of the leading causes of cancer related deaths in the world. The incidence of lung cancer is increasing in India and there is a need to understand the natural history of this disease. Aim of the study: To study the clinico- pathological- radiological profile of patients diagnosed with lung cancer from January 2013 to May 2015 at a tertiary care teaching hospital. Materials and Methods: Inpatient records of all patients admitted during the study period were exa...

  9. Palliative care in advanced cancer patients in a tertiary care hospital in Uttarakhand

    OpenAIRE

    Manisha Bisht; Bist, S. S.; Dhasmana, D. C.; Sunil Saini

    2008-01-01

    Aim: Advanced cancer, irrespective of the site of the cancer, is characterized by a number of associated symptoms that impair the quality of life of patients. The management of these symptoms guides palliative care. The present study aims to describe the symptoms and appropriate palliation provided in patients with advanced cancer in a tertiary care hospital in Uttarakhand. Methods: This was an observational study. A total of 100 patients with advanced cancer were included in the study. T...

  10. Childhood cancers in a referral hospital in northern Nigeria

    Directory of Open Access Journals (Sweden)

    Mohammed A

    2009-01-01

    Full Text Available Background: We undertook this study to determine the relative frequencies of childhood malignancies and their age - sex distribution in this environment. Materials and Methods: Hospital-based data of histological and cytologically confirmed cases of malignancies in children, aged ≤ 15 years, was collated over a period of 11 years, from the Cancer Registry. Results: A total of 329 children aged ≤ 15 years, with confirmed malignant disease, was recorded. This constituted 8.44% of all malignancies diagnosed in the same period with a Male : Female ratio of 1.5:1. Burkitt′s lymphoma accounted for 27.01% of the cases followed by retinoblastoma (17.02%, non-Hodgkin′s non-Burkitt′s Lymphoma (9.42%, and Rhabdomyosarcoma (9.42%. Others were Nephroblastoma (8.81%, Hodgkin′s lymphoma (6.69%, Neuroblastoma (3.34%, Colorectal carcinoma (2.43%, Osteosarcoma (2.13%, and Unspecified lymphomas (1.82%. Burkitt′s lymphoma was most prevalent in the 5-9 and 10-15 year age groups, retinoblastoma in the 0-4 year age group, and Non-Hodgkin′s lymphoma, Hodgkin′s lymphoma, and unspecified carcinomas were more prevalent in the 10-15 year age group. Conclusion: Lymphomas were the most prevalent malignancies of childhood seen in this region and the majority were of the Burkitt type, in contrast to the predominant leukemic and central nervous system trend seen in developed nations.

  11. In-Hospital Mortality of Patients with Acute Myocardial Infarction before and after Introduction of PCI in Split University Hospital Center, Croatia

    OpenAIRE

    Miric, Dino; Novak, Katarina; Miric Kovacevic, Lina; Zanchi, Jaksa

    2013-01-01

    Aim of the study was to estimate the in-hospital mortality and death rate in patients with AMI according to gender and location of infarction during 5 years before and after the introduction of percutaneous coronary intervention (PCI) procedures in Split University Hosptial Center, Croatia. The hospitalized patients were devided in two groups, from 2000 to 2004 and from 2005 to 2009. The analysis included total mortality and mortality according to gender and location of AMI. The location o...

  12. Malignant Neoplasm Burden in Nepal - Data from the Seven Major Cancer Service Hospitals for 2012.

    Science.gov (United States)

    Pun, Chin Bahadur; Pradhananga, Kishore K; Siwakoti, Bhola; Subedi, Krishna; Moore, Malcolm A

    2015-01-01

    In Nepal, while no population based cancer registry program exists to assess the incidence, prevalence, morbidity and mortality of cancer, at the national level a number of hospital based cancer registries are cooperating to provide relevant data. Seven major cancer diagnosis and treatment hospitals are involved, including the BP Koirala Memorial Cancer hospital, supported by WHO-Nepal since 2003. The present retrospective analysis of cancer patients of all age groups was conducted to assess the frequencies of different types of cancer presenting from January 1st to December 31st 2012. A total of 7,212 cancer cases were registered, the mean age of the patients being 51.9 years. The most prevalent age group in males was 60-64 yrs (13.6%), while in females it was 50-54 yrs (12.8%). The commonest forms of cancer in males were bronchus and lung (17.6%) followed by stomach (7.3%), larynx (5.2%) and non Hodgkins lymphoma (4.5%). In females, cervix uteri (19.1%) and breast (16.3%), were the top ranking cancer sites followed by bronchus and lung (10.2%), ovary (6.1%) and stomach (3.8%). The present data provide an update of the cancer burden in Nepal and highlight the relatively young age of breast and cervical cancer patients. PMID:26745133

  13. Breast cancer. National Center for Radiation Therapy. Trinidad and Tobago

    International Nuclear Information System (INIS)

    Was performed a retrospective study of cases registered at the Center National Radiotherapy of Trinidad and Tobago, with histologically or cytological breast cancer in the period from January 1 to July 31, 2007. It 125 cases studied. The aim of this study was to determine the characteristics of breast cancer in these patients, the different treatments used in order to improve prevention, treatment regimens, quality of life and increase survival rates of women suffering from this disease. The risk of cancer increases with age in the age group of 50-59 years was the highest incidence of the disease, an important group of patients suffer disease after 70 years. 64% of the cases were diagnosed in stage 0-II, carcinoma in situ was diagnosed in 4% of the patients, 52.8% of cases had positive lymph nodes. Surgery and chemotherapy were treatments used, the surgery was done in 92.8% of patients, being the the most common radical surgery, chemotherapy was used in 76% of cases, doxorubicin, cyclophosphamide and taxol were the most used drugs. The hormone receptors were positive in 65% of cases and Her 2 negative in 82.02%, the third generation aromatase inhibitors were hormones most used. Our results were compared with other studies. (Author)

  14. Analysis of the Service Quality of Medical Centers Using Servqual Model (Case:Shaheed Rahnemoon Hospital

    Directory of Open Access Journals (Sweden)

    H Zare Ahmadabadi

    2007-07-01

    Full Text Available Introduction: Many organizations, especially service oriented ones, relative to their goals and mission, have a special view towards quality phenomena and its management. Methods: This paper analyzes medical service quality in one case; The internal section of Shaheed Rahnemoon Hospital Based on the basis of gap analysis model and Servqual technique. A questionnaire was designed and applied to measure expectations and perceptions of patients and personnel of the hospital. Results: On application of non-parametric statistical tests, we propose certain recommendations. These tests drive on five conceptual dimensions of service quality including intangibility, responsiveness, reliability, assurance and empathy. Results show that patients in this section were satisfied from the service provider’s responsiveness, but there are significant differences between expectations and perceptions in other dimensions. Conclusion: The service quality analysis models are useful for managers of medical centers to distinguish gaps between the two sides of service representation; patients and medical centers personnel. Ultimately, they can reinforce strengths and control weaknesses.

  15. Proton Therapy At Siteman Cancer Center: The State Of The Art

    Science.gov (United States)

    Bloch, Charles

    2011-06-01

    Barnes-Jewish Hospital is on the verge of offering proton radiation therapy to its patients. Those treatments will be delivered from the first Monarch 250, a state-of-the-art cyclotron produced by Still River Systems, Inc., Littleton, MA. The accelerator is the world's first superconducting synchrocyclotron, with a field-strength of 10 tesla, providing the smallest accelerator for high-energy protons currently available. On May 14, 2010 it was announced that the first production unit had successfully extracted 250 MeV protons. That unit is scheduled for delivery to the Siteman Cancer Center, an NCI-designated Comprehensive Cancer Center at Washington University School of Medicine. At a weight of 20 tons and with a diameter of less than 2 meters the compact cyclotron will be mounted on a gantry, another first for proton therapy systems. The single-energy system includes 3 contoured scatterers and 14 different range modulators to provide 24 distinct beam delivery configurations. This allows proton fields up to 25 cm in diameter, with a maximum range from 5.5 to 32 cm and spread-out-Bragg-peak extent up to 20 cm. Monte Carlo simulations have been run using MCNPX to simulate the clinical beam properties. Those calculations have been used to commission a commercial treatment planning system prior to final clinical measurements. MCNPX was also used to calculate the neutron background generated by protons in the scattering system and patient. Additional details of the facility and current status will be presented.

  16. Proton Therapy At Siteman Cancer Center: The State Of The Art

    International Nuclear Information System (INIS)

    Barnes-Jewish Hospital is on the verge of offering proton radiation therapy to its patients. Those treatments will be delivered from the first Monarch 250, a state-of-the-art cyclotron produced by Still River Systems, Inc., Littleton, MA. The accelerator is the world's first superconducting synchrocyclotron, with a field-strength of 10 tesla, providing the smallest accelerator for high-energy protons currently available. On May 14, 2010 it was announced that the first production unit had successfully extracted 250 MeV protons. That unit is scheduled for delivery to the Siteman Cancer Center, an NCI-designated Comprehensive Cancer Center at Washington University School of Medicine. At a weight of 20 tons and with a diameter of less than 2 meters the compact cyclotron will be mounted on a gantry, another first for proton therapy systems. The single-energy system includes 3 contoured scatterers and 14 different range modulators to provide 24 distinct beam delivery configurations. This allows proton fields up to 25 cm in diameter, with a maximum range from 5.5 to 32 cm and spread-out-Bragg-peak extent up to 20 cm. Monte Carlo simulations have been run using MCNPX to simulate the clinical beam properties. Those calculations have been used to commission a commercial treatment planning system prior to final clinical measurements. MCNPX was also used to calculate the neutron background generated by protons in the scattering system and patient. Additional details of the facility and current status will be presented.

  17. Differences between hospital- and community-acquired blood exposure incidents revealed by a regional expert counseling center.

    NARCIS (Netherlands)

    Wijk, P.T. van; Pelk-Jongen, M.; Boer, E. de; Voss, A.; Wijkmans, C.; Schneeberger, P.M.

    2006-01-01

    OBJECTIVE: One year (2003) regional analysis of all blood exposure incidents from hospitals as well as from the community. DESIGN: Establishment of an easily accessible regional expert counseling center, operating 24 h a day, for all accidental blood exposures. Tasks of the center were to register i

  18. Clinical predictors of anticipatory emesis in patients treated with chemotherapy at a tertiary care cancer hospital

    OpenAIRE

    Qureshi, Fawad; Shafi, Azhar; Ali, Sheeraz; Siddiqui, Neelam

    2016-01-01

    Objective: To determine the clinical predictors of anticipatory emesis in patients treated with chemotherapy at a tertiary care cancer hospital. Methods: This was a cross-sectional study conducted on 200 patients undergoing first line chemotherapy with minimum of two cycles at inpatient department and chemotherapy bay of Shaukat Khanum Memorial Cancer Hospital and Research Centre Pakistan. Anticipatory nausea and vomiting develops before administration of chemotherapy. Clinical signs and symp...

  19. Testing a Family-centered Intervention to Promote Functional and Cognitive Recovery in Hospitalized Older Adults

    Science.gov (United States)

    Boltz, Marie; Resnick, Barbara; Chippendale, Tracy; Galvin, James

    2016-01-01

    A comparative trial using repeated measures design evaluated the feasibility and outcomes of the Family-centered Function-focused Care (Fam-FFC) intervention intended to promote functional recovery in the hospitalized older adult. A three component intervention (1) environmental assessment/ modification, 2) staff education, 3) family/patient education and partnership in care planning with post-acute follow-up) was implemented by a family-centered resource nurse and a facility champion. Control units were exposed to function-focused care education only. Ninety-seven dyads of medical patients age 65 and older and family caregivers (FCGs) were recruited from three medical units of a community teaching hospital. The majority of patients were female (53%); white (89%), married (51%) or widowed (40%), with a mean age of 80.8 (± 7.5). The majority of FCGs were married (78%) daughters (34%), followed by female spouses/partners (31%), in the age range of 46–65 (38%). Outcomes for patients included: functional outcomes (ADL and walking performance, gait, balance), and delirium severity and duration. FCG outcomes included preparedness for caregiving, anxiety, depression, role strain, and mutuality. The intervention group demonstrated less severity and duration of delirium, and better ADL and walking performance, but not gait/balance as compared to the control group. FCG who participated in Fam-FFC showed a significant increase in preparedness for caregiving, less anxiety and less depression from admission to two months post-discharge, but no significant differences in strain and mutuality, as compared to FCG in the control group. Fam-FFC is feasible and has the potential to improve outcomes for hospitalized older adults and family caregivers. PMID:25481973

  20. Risk of breast cancer recurrence in patients receiving manual lymphatic drainage: a hospital-based cohort study

    Directory of Open Access Journals (Sweden)

    Hsiao PC

    2015-02-01

    Full Text Available Pei-Chi Hsiao,1,2 Jung-Tai Liu,3 Chien-Liang Lin,4 Willy Chou,1,2 Shiang-Ru Lu5 1Department of Physical Medicine and Rehabilitation, Chi-Mei Medical Center, Tainan, Taiwan; 2Department of Recreation and Health Care Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan; 3Departments of Physical Medicine and Rehabilitation, Chi-Mei Medical Center Liouying Campus, Tainan, Taiwan; 4Department of Hematology and Oncology, Chi-Mei Medical Center Liouying Campus, Tainan, Taiwan; 5Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan Background: This retrospective cohort study evaluated whether manual lymphatic drainage (MLD therapy increases the risk of recurrence of breast cancer. Methods: We analyzed 1,106 women who were diagnosed with stage 0­–3 breast cancer between 2007 and 2011 and experienced remission after surgery and adjuvant therapy. The patients were divided into two groups: group A (n=996, in which patients did not participate in any MLD therapy, regardless of whether they developed breast cancer-related lymphedema (BCRL after cancer treatment; and group B (n=110, in which patients participated in MLD therapy for BCRL. All patients were monitored until October 2013 to determine whether breast cancer recurrence developed, including local or regional recurrence and distant metastasis. Patients who developed cancer recurrence prior to MLD therapy were excluded from analysis. Risk factors associated with cancer recurrence were evaluated using Cox proportional hazards models. Results: During the monitoring period, 166 patients (15.0% developed cancer recurrence, including 154 (15.5% in group A and 12 (10.9% in group B. The median period from surgery to cancer recurrence was 1.85 (interquartile range 1.18–2.93 years. Independent risk factors for cancer recurrence were tumor histological grading of grade 3, high number (≥3 of axillary lymph node invasion, and a large tumor size (>5 cm. Factors

  1. Hospital volume and post-operative mortality after resection for gastric cancer

    NARCIS (Netherlands)

    Damhuis, RAM; Meurs, CJC; Dijkhuis, CM; Stassen, LPS; Wiggers, T

    2002-01-01

    Aims: In low-volume hospitals, expertise in gastric surgery is difficult to maintain because of the decreasing incidence of gastric cancer and the fall of surgery for ulcer disease. We evaluated the prognostic impact of hospital volume on post-operative mortality (POM) in a consecutive series of 197

  2. A Randomized Controlled Trial of Hospital-based Case Management in Cancer Care

    DEFF Research Database (Denmark)

    Wulff, Christian N; Vedsted, Peter; Søndergaard, Jens

    2012-01-01

    BACKGROUND: Case management (CM) models based on experienced nurses are increasingly used to improve coordination and continuity of care for patients with complex health care needs. Anyway, little is known about the effects of hospital-based CM in cancer care.Aim.To analyse the effects of hospital...

  3. Variation in case-mix between hospitals treating colorectal cancer patients in the Netherlands

    NARCIS (Netherlands)

    Kolfschoten, N.E.; Marang van de Mheen, P.J.; Gooiker, G.A.; Eddes, E.H.; Kievit, J.; Tollenaar, R.A.E.M.; Wouters, M.W.; Bemelman, W.A.; Busch, O.R.; Dam, R.M. van; Harst, E. van der; Jansen-Landheer, M.L.E.A; Karsten, T.M.; Krieken, J.H.J.M. van; Kuijpers, W.G.T.; Lemmens, V.E.; Manusama, E.R.; Meijerink, W.J.H.J.; Rutten, H.J.; Wiggers, T.; Velde, C.J. van de

    2011-01-01

    AIMS: The purpose of this study was to determine how expected mortality based on case-mix varies between colorectal cancer patients treated in non-teaching, teaching and university hospitals, or high, intermediate and low-volume hospitals in the Netherlands. MATERIAL AND METHODS: We used the databas

  4. Lived experiences and challenges of older surgical patients during hospitalization for cancer: An ethnographic fieldwork

    OpenAIRE

    Uhrenfeldt, Lisbeth; Høybye, Mette Terp

    2014-01-01

    This paper explores the lived experiences of older surgical patients’ (aged 74 years and older) experienced challenges during a brief admission to hospital. Age, gender, polypharmacy, and the severity of illness are also factors known to affect the hospitalization process. For an ethnographic study using participant observation and interviews, surgical cancer patients (n9, aged 74 years and older) were recruited during admission to a Danish teaching hospital. Using ethnographic strategies of ...

  5. International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres

    OpenAIRE

    van Lent Wineke AM; de Beer Relinde D; van Harten Wim H

    2010-01-01

    Abstract Background Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Methods Three independent international benchmarking studies on operations managem...

  6. Treatment of patients with metastatic pancreatic cancer: Experience from a tertiary Indian cancer center

    Directory of Open Access Journals (Sweden)

    B Sirohi

    2015-01-01

    Full Text Available Background: The aim of this study was to look at the outcome of patients with metastatic pancreatic cancer treated at a tertiary cancer center in India. Patients And Methods: A total of 101 patients with locally advanced and metastatic pancreatic cancer diagnosed between May 2012 and July 2013 were identified from a prospectively maintained database at the tertiary cancer center. Overall survival (OS was computed using the Kaplan–Meir product limit method and compared across groups using the log-rank statistics. Cox proportional hazards model, adjusted for a number of patient and tumor characteristics, was then used to determine factors prognostic for OS. Results: Median age at diagnosis was 55 years (range: 21–81 years. 57.4% (n = 58 of patients were male, 22% (n = 22 had performance status (PS of <2 at diagnosis and 89% received first-line chemotherapy, while the rest received best supportive care. For the whole cohort, 6 month and 1-year OS was 57% (95% confidence interval [CI]: 46–66% and 47% (95% CI: 35–57%, respectively. In a multivariable model, PS <2 and oligometastatic disease were associated with a significantly decreased risk of death. Conclusion: Results from our analysis indicate that the prognostic outcome among Indian patients with metastatic pancreatic cancer is poor with survival outcomes similar to those reported in North America and Europe.

  7. Survival after in-hospital cardiopulmonary resuscitation in a major referral center

    Directory of Open Access Journals (Sweden)

    Saghafinia Masoud

    2010-01-01

    Full Text Available Aim: This study was undertaken to assess the demographics, clinical parameters and outcomes of patients undergoing cardiopulmonary resuscitation (CPR, by the code blue team at our center to compare with other centers. Materials and Methods: Data were collected retrospectively from all adult patients who underwent CPR at our hospital from 2007 to 2008. CPR was performed on 290 patients and it was given 313 times. Clinical outcomes of interest were survival at the end of CPR and survival at discharge from the hospital. Factors associated with survival were evaluated via binomial and chi square-tests. Results: Of the 290 patients included, 95 patients (30.4% had successful CPR. However, only 35 patients (12% were alive at discharge. The majority requiring CPR were above 60 years of age (61.7%. Males required CPR more than females. There were 125 women (43.1% and 165 males (56.9% aged 3 to 78 (average 59.6 years. Majority (179 of the cases (61.7% were above 60 years of age. Regarding the various wards, 54 cases (17.3% were in the internal medicine ward, 63 cases (20.1% in the surgery ward, 1 case (0.3% in the clinic, 11 cases (3.5% in the paraclinic, 116 cases (37.1% in the emergency (ER, 55 cases (17.5% in the Intensive Care Unit (ICU and Coronary Care Unit (CCU, and 13 cases (4.2% were in other wards. Cardiac massage was done in 133 cases (42.5%, defibrillation only via electroshock 3 cases (1%, and both were used in177 cases (56.5%. The ER had the most cases of CPR. Both cardiac massage and electroshock defibrillation were needed in most cases. Conclusion: In-hospital CPR for cardiopulmonary arrest was associated with 30.4% success at our center at the end of CPR but only 12% were alive at discharge. Duration of CPR> 10 minutes was predictive of significantly decreased survival to discharge.

  8. [原著]Factors related to the transition from hospital to home care in terminal cancer patients in Okinawa -Questionnaire survey of hospital nurses assisting the patient's discharge-

    OpenAIRE

    Teruya, Noriko; Sunagawa, Yoko; Department of Adult Nursing, School of Health Sciences,Faculty of Medicine

    2012-01-01

    The purpose of this study was to examine the factors related to the realization of transition from hospital to home care in terminal cancer patients, and to clarify the problems that need to be solved in promoting home care in Okinawa. The subjects were 197 nurses who supported a terminal cancer patient's discharge in 17 hospitals with more than 200 beds that provided medical treatment for cancer patients. A questionnaire survey was conducted by mail. Among the 165 nurses who responded, 113 n...

  9. Coordinating centers in cancer epidemiology research: the Asia Cohort Consortium coordinating center.

    Science.gov (United States)

    Rolland, Betsy; Smith, Briana R; Potter, John D

    2011-10-01

    Although it is tacitly recognized that a good coordinating center (CC) is essential to the success of any multisite collaborative project, very little study has been done on what makes a CC successful, why some CCs fail, or how to build a CC that meets the needs of a given project. Moreover, very little published guidance is available, as few CCs outside the clinical trial realm write about their work. The Asia Cohort Consortium (ACC) is a collaborative cancer epidemiology research project that has made strong scientific and organizational progress over the past 3 years by focusing its CC on the following activities: collaboration development; operations management; statistical and data management; and communications infrastructure and tool development. Our hope is that, by sharing our experience building the ACC CC, we can begin a conversation about what it means to run a CC for multi-institutional collaboration in cancer epidemiology, help other collaborative projects solve some of the issues associated with collaborative research, and learn from others. PMID:21803842

  10. Does hospital discharge policy influence sick-leave patterns in the case of female breast cancer?

    DEFF Research Database (Denmark)

    Lindqvist, Rikard; Stenbeck, Magnus; Diderichsen, Finn

    2005-01-01

    The objective was to investigate how differences among hospitals in the shift from in-patient care to day surgery and a reduced hospital length of stay affect the sick-leave period for female patients surgically treated for breast cancer. All women aged 18-64 who were diagnosed with breast cancer...... in 2000 were selected from the National Cancer Register and combined with data from the sick-leave database of the National Social Insurance Board and the National Hospital Discharge Register (N = 1834). A multi-factorial model was fitted to the data to investigate how differences in hospital care......, and readmission. Women treated with breast-conserving surgery had a 54.7-day (-71.9 day-surgery cases had 24.3 (-47.5 days shorter sick-leave than those who received overnight care...

  11. Quality Improvement in the National Cancer Institute Community Cancer Centers Program: The Quality Oncology Practice Initiative Experience

    Science.gov (United States)

    Siegel, Robert D.; Castro, Kathleen M.; Eisenstein, Jana; Stallings, Holley; Hegedus, Patricia D.; Bryant, Donna M.; Kadlubek, Pam J.; Clauser, Steven B.

    2015-01-01

    Purpose: The National Cancer Institute (NCI) Community Cancer Centers Program (NCCCP) began in 2007; it is a network of community-based hospitals funded by the NCI. Quality of care is an NCCCP priority, with participation in the American Society of Clinical Oncology Quality Oncology Practice Initiative (QOPI) playing a fundamental role in quality assessment and quality improvement (QI) projects. Using QOPI methodology, performance on quality measures was analyzed two times per year over a 3-year period to enhance our implementation of quality standards at NCCCP hospitals. Methods: A data-sharing agreement allowed individual-practice QOPI data to be electronically sent to the NCI. Aggregated data with the other NCCCP QOPI participants were presented to the network via Webinars. The NCCCP Quality of Care Subcommittee selected areas in which to focus subsequent QI efforts, and high-performing practices shared voluntarily their QI best practices with the network. Results: QOPI results were compiled semiannually between fall 2010 and fall 2013. The network concentrated on measures with a quality score of ≤ 0.75 and planned voluntary group-wide QI interventions. We identified 13 measures in which the NCCCP fell at or below the designated quality score in fall 2010. After implementing a variety of QI initiatives, the network registered improvements in all parameters except one (use of treatment summaries). Conclusion: Using the NCCCP as a paradigm, QOPI metrics provide a useful platform for group-wide measurement of quality performance. In addition, these measurements can be used to assess the effectiveness of QI initiatives. PMID:25538082

  12. Pattern of oral cancer registered at a tertiary care teaching hospital in rural Western Maharashtra

    Directory of Open Access Journals (Sweden)

    Purushottam A. Giri

    2013-06-01

    Full Text Available Non-communicable diseases including cancer are emerging as major public health problems in India. Cancer usually means malignancy, has become one of the ten leading cause of death in India. The leading sites of cancer vary from country to country. Oral cancer ranks in the top three of all cancers in India, accounting for over 30% of all cancers reported in the country and its control is quickly becoming a global health priority. The present study was conducted to find out the contribution of different type of oral cancer in a tertiary care teaching hospital of western Maharashtra, India. A retrospective hospital record based study was carried out for the period of 2007-2011 in the department of Radiotherapy of Pravara Rural Hospital, Loni, Maharashtra, India. A total of 5879 patients who were diagnosed with cancer, of them 633 (10.76% patients had oral cancer. Data was collected on the basis of the patient’s record in the hospital and analyzed in the form of percentage and proportions whenever appropriate. A total of 633 oral cancer patients were screened, of which 411 (64.93% were males and 222 (35.07% were females. Among oral cancer, buccal mucosa was highest (37.12%; followed by tongue (36.80%, oropharynx (4.74% and lip and palate (3.15%. Oral cancer is one of the common malignancies in developing countries like India. It is common in males compared to females and is usually seen after middle age. [Int J Res Med Sci 2013; 1(3.000: 233-236

  13. Breast cancer survival experiences at a tertiary hospital in sub-Saharan Africa: a cohort study

    OpenAIRE

    Galukande, Moses; Wabinga, Henry; Mirembe, Florence

    2015-01-01

    Background Cancer of the breast is a major health burden and the most common cancer among women worldwide. Though its incidence is fourfold greater in high-income countries, in sharp contrast, mortality rates are greatest among the low-income countries. Early detection linked to appropriate treatment is the most effective strategy to improve survival. The purpose of this study therefore was to establish the survival experiences of women with breast cancer at a Ugandan hospital. Methods This s...

  14. Accreditation for excellence of cancer research institutes: recommendations from the Italian Network of Comprehensive Cancer Centers.

    Science.gov (United States)

    Deriu, Pier Luigi; La Pietra, Leonardo; Pierotti, Marco; Collazzo, Raffaele; Paradiso, Angelo; Belardelli, Filippo; De Paoli, Paolo; Nigro, Aldo; Lacalamita, Rosanna; Ferrarini, Manlio; Pelicci, Piergiuseppe; Pierotti, Marco; Roli, Anna; Ciliberto, Gennaro; Scala, Stefania; Amadori, Alberto; Chiusole, Daniela; Musto, Pellegrino; Fusco, Vincenzo; Storto, Giovanni; De Maria, Ruggero; Canitano, Stefano; Apolone, Giovanni; Ravelli, Maria; Mazzini, Elisa; Amadori, Dino; Bernabini, Marna; Ancarani, Valentina; Lombardo, Claudio

    2013-01-01

    A panel of experts from Italian Comprehensive Cancer Centers defines the recommendations for external quality control programs aimed to accreditation to excellence of these institutes. After definition of the process as a systematic, periodic evaluation performed by an external agency to verify whether a health organization possesses certain prerequisites regarding structural, organizational and operational conditions that are thought to affect health care quality, the panel reviews models internationally available and makes final recommendations on aspects considered of main interest. This position paper has been produced within a special project of the Ministry of Health of the Italian Government aimed to accredit, according to OECI model, 11 Italian cancer centers in the period 2012-2014. The Project represents the effort undertaken by this network of Comprehensive Cancer Centers to find a common denominator for the experience of all Institutes in external quality control programs. Fourteen shared "statements" are put forth, designed to offer some indications on the main aspects of this subject, based on literature evidence or expert opinions. They deal with the need for "accountability" and involvement of the entire organization, the effectiveness of self-evaluation, the temporal continuity and the educational value of the experience, the use of indicators and measurement tools, additionally for intra- and inter-organization comparison, the system of evaluation models used, the provision for specific requisites for oncology, and the opportunity for mutual exchange of evaluation experiences. PMID:24503807

  15. Epidemiological and clinical profile of triple negative breast cancer at a cancer hospital in North India

    Directory of Open Access Journals (Sweden)

    P Suresh

    2013-01-01

    Full Text Available Background: Triple negative breast cancer (TNBC is a recent concept and the burning topic of research today. Various studies have been reported in western literature on TNBCs or the similar group of basal like cancers, all highlighting the poor prognostic features of this molecular subtype in comparison to the other types of breast cancers. However extensive data from India is lacking. The aim of this study was to analyze the epidemiological and clinical profile of TNBcs at our institute. Materials and Methods: Data on 171 patients of TNBCs registered at this hospital between 2005 and 2008 and followed up until December 2010 was collected and reviewed for epidemiological and clinical features. Results: The median age at presentation was 49 years (22-75 years. Sixty eight patients (40% had lump in the breast of less than 1 month duration. Fourteen (8% were nulliparous and 10 (7% patients had crossed the age of 30 years at first full-term pregnancy, 89 (52% were pre or peri-menopausal at presentation. Only 8 (5% patients had a family history of breast or ovarian cancer. One hundred and six (62% patients were stage II, 26 (15% stage III, 21 (12% stage I and 18 (10% stage IV at presentation. One hundred and twenty eight patients (75% had early breast cancer eligible for surgery at presentation, 25 (15% were locally advanced and received neoadjuvant chemotherapy (NACT and 18 (10% were found to be metastatic. Modified radical mastectomy was the preferred surgical option by most patients (76% who underwent upfront surgery in our study. The pathological overall response rates (complete and partial response after NACT was 75% with complete response rate of 25% and there were no relapses in the complete responders. The median follow-up was 30 months (9-70 months. One hundred and twenty two patients (71% were alive at last follow-up, 34 (22% had relapsed, 18 (11% had died due to progressive disease. Thirty one patients (18% were lost to follow-up. Most of

  16. Impact of Low Procalcitonin Results on Antibiotic Administration in Hospitalized Patients at a Tertiary Care Center.

    Science.gov (United States)

    Brennan, Meghan B; Osterby, Kurt; Schulz, Lucas; Lepak, Alexander J

    2016-06-01

    Procalcitonin is a sensitive and specific marker of bacterial infection; low results allow clinicians to safely de-escalate antibiotics. This retrospective cohort study aimed to determine the effect of low procalcitonin results on withholding, discontinuing, or de-escalating antibiotics in hospitalized patients at a tertiary care center. Antibiotics were initiated or continued without de-escalation in 55% of patients with low procalcitonin results. Among patients with low procalcitonin results, the primary service, but not measures of patient complexity, disease severity, or underlying disease process (lower respiratory tract infection evaluation versus systemic inflammatory response syndrome/possible sepsis) was associated with initiation or continued broad-spectrum antibiotic use. Provider-level factors may be an important variable in the initiation or continued use of broad-spectrum antibiotics for patients with low procalcitonin levels. PMID:27251126

  17. Profile of Cancer Cases at a Tertiary Care Level Teaching Hospital in Rural Western Maharashtra, India

    Directory of Open Access Journals (Sweden)

    Jayant D Deshpande , Kailash K Singh , Deepak B Phalke

    2012-01-01

    Full Text Available Background: Cancer is one of the major public health problems worldwide. Prevalence and pattern of cancer is known to vary from region to region. Epidemiological information on cancer including the pattern is an important basis for determining the priorities for cancer control in any population group. Objective: Present work is an attempt to study magnitude, profile and some epidemiological aspects in relation to cancer cases at a tertiary care level teaching hospital in rural area. Method: All records were studied and analyzed. A total of 1106 patients were treated during the period studied. A proforma was used to collect data such as age, sex, place of residence, type of cancers and treatment given. The data collected were entered into MS-Excel sheets and analysis was carried out. The information obtained was tabulated analyzed using the software GraphPad Instat demo version. Results: A total of 1106 cancer patients were treated during the January 2010 to December 2010. Among these, 626(56.60 were females and 480(43.39 were females. In males, the common cancers were oral cavity cancers, lung cancers and GIT cancers. The most common cancers among females were the cervical carcinomas, which constituted 32.10% of the total number of cancers cases followed by cancers of breast. Almost 2/3rd of cases occurred in the age group of 41 to 70 years. Maximum frequency was observed in 51–60 year age group in both sexes. Maximum numbers (74.59% of the cases were from rural area. The main methods of cancer treatment were surgery, chemotherapy and radiotherapy, used alone or in combination. Conclusion: Tobacco and alcohol related cancers predominated in males. In females, cervical cancer predominated over breast cancer. Human behavior is a major determinant in the successful control of cancer. Understanding cancer magnitude, risk and trends will be of help in cancer control.

  18. Diagnostic value of whole-body MRI and bone scintigraphy in the detection of osseous metastases in patients with breast cancer - a prospective double-blinded study at two hospital centers; Diagnostischer Stellenwert der Ganzkoerper-MRT und der Skelettszintigrafie in der ossaeren Metastasendetektion bei Mammakarzinompatientinnen - eine prospektive Doppelblindstudie an zwei Klinikzentren

    Energy Technology Data Exchange (ETDEWEB)

    Ohlmann-Knafo, Susanne; Pickuth, D. [Caritasklinik St. Theresia, Akademisches Lehrkrankenhaus der Univ. des Saarlandes, Saarbruecken (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie; Kirschbaum, M. [Caritasklinik St. Theresia, Akademisches Lehrkrankenhaus der Univ. des Saarlandes, Saarbruecken (Germany). Klinik fuer Gynaekologie und Geburtshilfe, Brustzentrum Saar Mitte; Fenzl, G. [Knappschaftskrankenhaus Puettlingen (Germany). Inst. fuer Radiologie und Nuklearmedizin

    2009-03-15

    The purpose of this study was to compare the diagnostic accuracy of whole-body MRI (WB-MRI) and bone scintigraphy (BS) for the screening of bone metastases for the first time in a large and homogeneous patient collective with breast cancer in a systematic and controlled study. 213 breast cancer patients were evaluated for bone metastases under randomized, double-blinded and prospective conditions at two hospitals. All participants were examined by WB-MRI and BS over an average period of four days. The examinations were performed separately at two different locations. The WB-MRI protocol included T 1-TSE and STIR sequences. WB-MRI and BS were reviewed independently by experienced radiologists and nuclear medicine specialists in a consensus reading. In 66 % of cases bone metastases were excluded by both procedures, and bone metastases were detected concordantly in 2 % of cases. In 7 % of cases there were discrepant results: in 7 cases BS was false-positive when WB-MRI was negative. In 5 / 7 cases BS was negative when WB-MRI identified bone metastases. In 89 % of cases BS was uncertain when WB-MRI was true-negative. In 17 % of cases WB-MRI showed important (non-) tumor-associated findings. The sensitivity, specificity, positive and negative predictive value and diagnostic accuracy for WB-MRI were 90 %, 94 %, 82 %, 98 % and 99 % and for BS those were 40 %, 81 %, 36 %, 91 % and 93 %. (orig.)

  19. Survival after In-Hospital Cardiopulmonary Resuscitation in a Major Referral Center during 2001-2008

    Directory of Open Access Journals (Sweden)

    Hasan Rafati

    2011-03-01

    Full Text Available Despite efforts to save more people suffering from in-hospital cardiac arrest, rates of survival after in-hospital cardiopulmonary resuscitation (CPR are no better today than they were more than a decade ago. This study was undertaken to assess the demographics, clinical parameters and outcomes of patients undergoing CPR by the code blue team at our center during 2001 to 2008. Data were collected retrospectively from adult patients (n=2262 who underwent CPR. Clinical outcomes of interest were survival at the end of CPR and survival at discharge from the hospital. Factors associated with survival were evaluated using binomial and Chi Square tests. Of the patients included (n=2262, 741 patients (32.8% had successful CPR. The number of male patients requiring CPR was more than females in need of the procedure. The majority of patients requiring CPR were older than 60 years (56.4±17.9. The number of successful CPR cases in long-day shift (7:00 to 19:00 was more than that in the night shift (19:00 to 7:00. Furthermore, 413 (18.4% cases were resuscitated on holidays and 1849 (81.7% on the working days. The duration of CPR was 10 min or less in 710 (31.4% cases. Cardiopulmonary resuscitations which lasted less than 10 minutes were associated with better outcomes. The findings of the present study indicate that some manageable factors including the duration of CPR, working shift, working day (holiday or non-holiday could affect the CPR outcomes. The findings might also be taken as evidence to suggest that the allocation of more personnel in each shift especially in night shifts and holidays, planning to increase the personnel's CPR skills, and decreasing the waste time would result in the improvement of CPR outcome.

  20. Survival after In-Hospital Cardiopulmonary Resuscitation in a Major Referral Center during 2001-2008.

    Science.gov (United States)

    Rafati, Hasan; Saghafi, Abdollah; Saghafinia, Masoud; Panahi, Farzad; Hoseinpour, Mohamadjavad

    2011-03-01

    Despite efforts to save more people suffering from in-hospital cardiac arrest, rates of survival after in-hospital cardiopulmonary resuscitation (CPR) are no better today than they were more than a decade ago. This study was undertaken to assess the demographics, clinical parameters and outcomes of patients undergoing CPR by the code blue team at our center during 2001 to 2008. Data were collected retrospectively from adult patients (n=2262) who underwent CPR. Clinical outcomes of interest were survival at the end of CPR and survival at discharge from the hospital. Factors associated with survival were evaluated using binomial and tests. Of the patients included (n=2262), 741 patients (32.8%) had successful CPR. The number of male patients requiring CPR was more than females in need of the procedure. The majority of patients requiring CPR were older than 60 years (56.4±17.9). The number of successful CPR cases in long-day shift (7:00 to 19:00) was more than that in the night shift (19:00 to 7:00). Furthermore, 413 (18.4%) cases were resuscitated on holidays and 1849 (81.7%) on the working days. The duration of CPR was 10 min or less in 710 (31.4%) cases. Cardiopulmonary resuscitations which lasted less than 10 minutes were associated with better outcomes. The findings of the present study indicate that some manageable factors including the duration of CPR, working shift, working day (holiday or non-holiday) could affect the CPR outcomes. The findings might also be taken as evidence to suggest that the allocation of more personnel in each shift especially in night shifts and holidays, planning to increase the personnel's CPR skills, and decreasing the waste time would result in the improvement of CPR outcome. PMID:23365479

  1. Management and performance features of cancer centers in Europe: A fuzzy-set analysis

    NARCIS (Netherlands)

    Wind, Anke; Lobo, Mariana Fernandes; Dijk, van Joris; Lepage-Nefkens, Isabelle; Laranja-Pontes, Jose; Conceicao Goncalves, da Vitor; Harten, van Wim; Rocha-Goncalves, Francisco Nuno

    2016-01-01

    The specific aim of this study is to identify the performance features of cancer centers in the European Union by using a fuzzy-set qualitative comparative analysis (fsQCA). The fsQCA method represents cases (cancer centers) as a combination of explanatory and outcome conditions. This study uses dat

  2. Critical Appraisal of Translational Research Models for Suitability in Performance Assessment of Cancer Centers

    OpenAIRE

    Rajan, Abinaya; Sullivan, Richard; Bakker, Suzanne; van Harten, Wim H.

    2012-01-01

    This study aimed to critically appraise translational research models for suitability in performance assessment of cancer centers. Process models, such as the Process Marker Model and Lean and Six Sigma applications, seem to be suitable for performance assessment of cancer centers. However, they must be thoroughly tested in practice.

  3. Hospitals

    Data.gov (United States)

    Department of Homeland Security — This database contains locations of Hospitals for 50 states and Washington D.C. , Puerto Rico and US territories. The dataset only includes hospital facilities and...

  4. Integration of the clinical engineering specialist at a high complexity children's hospital. Our professional experience at a surgical center

    International Nuclear Information System (INIS)

    This document aims to find relating points between the current and future Clinical Engineer professional in order to discuss about the hospital environment, its characteristics and its realities which lead to our professional development. The main aim is to depict our experience through a retrospective analysis based on the underwriting experience and consequently to arrive at conclusions that will support the inclusion and active interaction of the Clinic Engineer Specialist as part of a Hospital's Surgical Center

  5. A single center 14 years study of infectious complications leading to hospitalization of patients with primary antibody deficiencies

    Directory of Open Access Journals (Sweden)

    Setareh Mamishi

    2010-08-01

    Full Text Available Primary antibody deficiencies (PADs are a heterogeneous group of disorders, characterized by hypogammaglobulinemia and increased susceptibility to bacterial infections, leading to hospitalizations. This study was performed to determine the main infectious causes of hospital admissions in selective Iranian patients with PADs. Forty patients with PADs, who were admitted to the Infectious Ward of Children's Medical Center Hospital during a 14-year period, were reviewed in this study. There were 115 documented episodes of hospital admission during a 14-year period. The average length of hospital stay was 33.30 ± 25.72 days. Pneumonia was the most prominent infection leading to hospitalization among these patients (n = 48, followed by gastroenteritis (n = 23. Other less frequent causes of hospitalization were fever and neutropenia, septic arthritis, encephalitis, orbital cellulitis, sepsis, urinary tract infection, meningitis, oral ulcer, and lung abscess. The most common causative organisms of diarrhea were: Giardia lamblia, followed by Candida albicans, and Salmonella sp. Many patients with PADs suffer from repeated infections leading to hospitalization, in spite of immunoglobulin replacement therapy. Respiratory tract infections were the prominent cause of hospitalization among studied patients, followed by gastrointestinal infections.

  6. Relative dose intensity of systemic chemotherapy in an outpatient cancer center

    OpenAIRE

    Christine Uptigrove; Kari Vavra; Claire Saadeh; Gordan Srkalovic

    2010-01-01

    Objective. This study was undertaken to determine the average relative dose intensity (RDI) of chemotherapy administered to patients in a community-based outpatient cancer center. Methods. A retrospective review of medical records in an outpatient cancer center was conducted for patients initiating systemic chemotherapy in 2007 for a diagnosis of lymphoma, breast, lung, ovary, or colon cancer. Eighty-four records meeting the inclusion criteria were reviewed for demographi...

  7. Epidemiologic factors of colorectal cancer in a county hospital in Romania

    Directory of Open Access Journals (Sweden)

    Mihaela Leşe

    2013-03-01

    Full Text Available Colorectal cancer is the most common digestive cancer. The aim of this study is to determine the colorectal cancer’s frequency relatedto age, gender, personal or family history, and also to blood group of the patients operated in the County Emergency Hospital of BaiaMare, Romania. Material and methods: The records of 512 patients with cancer of the colon, rectal cancer and synchronous colorectal cancerwere studied retrospectively in a period of 15 years, admitted to The Department of Surgery in The County Emergency Hospital of Baia Mare,Romania. Results: Colorectal cancers have been found to be more frequent in women under the age of 50 and in men above this age (p=0.004.In urban environments the right colon cancer (59.62% and rectal cancer (55.87% were more frequently encountered. Tumor location had analmost even distribution: 30% right colon, 35.45% left colon, 34.96% rectal cancer and 0.78% synchronous cancers. The association with personaland family history was statistically insignificant, except asthma which was considered a protective factor (p<0.001 for colorectal cancer.The abidance in blood groups shows proportional distribution with their representation in the population of our country, but family historyof colorectal cancer was found only in O and A groups. Conclusions: The study ascertains the left to right shift of the large bowel cancers, theincreasing of medium age of patients and high incidence of colorectal cancer in women under the age of 50 years. Asthma may be a protectivefactor for colorectal cancer, especially for right colon cancer, and genetic factors are present only in patients with O and A blood groups .

  8. P30 Cancer Center Support Grant Administrative Supplements to NCI-designated Cancer Centers not affiliated with the Experimental Therapeutics Clinical Trials Network (ETCTN) to support participation in the ETCTN

    Science.gov (United States)

    P30 Cancer Center Support Grant Administrative Supplements to NCI-designated Cancer Centers not affiliated with the Experimental Therapeutics Clinical Trials Network (ETCTN) to support participation in the ETCTN

  9. The University of Texas M.D. Anderson Cancer Center Proton Therapy Facility

    Science.gov (United States)

    Smith, Alfred; Newhauser, Wayne; Latinkic, Mitchell; Hay, Amy; McMaken, Bruce; Styles, John; Cox, James

    2003-08-01

    The University of Texas M.D. Anderson Cancer Center (MDACC), in partnership with Sanders Morris Harris Inc., a Texas-based investment banking firm, and The Styles Company, a developer and manager of hospitals and healthcare facilities, is building a proton therapy facility near the MDACC main complex at the Texas Medical Center in Houston, Texas USA. The MDACC Proton Therapy Center will be a freestanding, investor-owned radiation oncology center offering state-of-the-art proton beam therapy. The facility will have four treatment rooms: three rooms will have rotating, isocentric gantries and the fourth treatment room will have capabilities for both large and small field (e.g. ocular melanoma) treatments using horizontal beam lines. There will be an additional horizontal beam room dedicated to physics research and development, radiation biology research, and outside users who wish to conduct experiments using proton beams. The first two gantries will each be initially equipped with a passive scattering nozzle while the third gantry will have a magnetically swept pencil beam scanning nozzle. The latter will include enhancements to the treatment control system that will allow for the delivery of proton intensity modulation treatments. The proton accelerator will be a 250 MeV zero-gradient synchrotron with a slow extraction system. The facility is expected to open for patient treatments in the autumn of 2005. It is anticipated that 675 patients will be treated during the first full year of operation, while full capacity, reached in the fifth year of operation, will be approximately 3,400 patients per year. Treatments will be given up to 2-shifts per day and 6 days per week.

  10. Risk for cancer in a cohort of patients hospitalized for schizophrenia in Denmark, 1969-1993

    DEFF Research Database (Denmark)

    Dalton, Susanne Oksbjerg; Mellemkjær, Lene; Thomassen, L.;

    2005-01-01

    with national incidence rates, adjusted for sex, age and calendar time. The risk for cancer was increased for both men and women during the first year of follow-up. When the first year of follow-up was excluded, the risk for all tobacco-associated cancers and for prostate and rectal cancers was reduced for male...... explain the reduced risk for tobacco-related cancers.......We investigated the cancer risk of patients hospitalized for schizophrenia in a nationwide cohort study. All 22766 adults admitted for schizophrenia, ICD-8 295, in Denmark between 1969 and 1993 were followed up for cancer through 1995. The incidence of site-specific cancers was compared...

  11. Residence, income and cancer hospitalizations in British Columbia during a decade of policy change

    Directory of Open Access Journals (Sweden)

    Penning MJ

    2004-04-01

    Full Text Available Abstract Background Through the 1990s, governments across Canada shifted health care funding allocation and organizational foci toward a community-based population health model. Major concerns of reform based on this model include ensuring equitable access to health and health care, and enhancing preventive and community-based resources for care. Reforms may act differentially relative to specific conditions and services, including those geared to chronic versus acute conditions. The present study therefore focuses on health service utilization, specifically cancer hospitalizations, in British Columbia during a decade of health system reform. Methods Data were drawn from the British Columbia Linked Health Data resource; income measures were derived from Statistics Canada 1996 Census public use enumeration area income files. Records with a discharge (separation date between 1 January 1991 and 31 December 1998 were selected. All hospitalizations with ICD-9 codes 140 through 208 (except skin cancer, code 173 as principal diagnosis were included. Specific cancers analyzed include lung; colorectal; female breast; and prostate. Hospitalizations were examined in total (all separations, and as divided into first and all other hospitalizations attributed to any given individual. Annual trends in age-sex adjusted rates were analyzed by joinpoint regression; longitudinal multivariate analyses assessing association of residence and income with hospitalizations utilized generalised estimating equations. Results are evaluated in relation to cancer incidence trends, health policy reform and access to care. Results Age-sex adjusted hospitalization rates for all separations for all cancers, and lung, breast and prostate cancers, decreased significantly over the study period; colorectal cancer separations did not change significantly. Rates for first and other hospitalizations remained stationary or gradually declined over the study period. Area of residence and

  12. Lived experiences and challenges of older surgical patients during hospitalization for cancer: An ethnographic fieldwork

    Directory of Open Access Journals (Sweden)

    Lisbeth Uhrenfeldt

    2014-02-01

    Full Text Available This paper explores the lived experiences of older surgical patients’ (aged 74 years and older experienced challenges during a brief admission to hospital. Age, gender, polypharmacy, and the severity of illness are also factors known to affect the hospitalization process. For an ethnographic study using participant observation and interviews, surgical cancer patients (n = 9, aged 74 years and older were recruited during admission to a Danish teaching hospital. Using ethnographic strategies of participant observation and interviews, each patient was followed through the course of 1 day during their stay at the hospital. Interviews were carried out with all patients during this time. Three areas of concern were identified as prominent in the patients’ experiences and challenges during their short hospital stay: teeth and oral cavity, eating in a hospital setting, and medication during hospitalization. Short-term hospitalization requires focused collaboration between staff and patient concerning individual challenges from their teeth and oral cavity as support of nutritional needs during surgical treatment for cancer.

  13. The 13th Annual Meeting of the Translational Research Cancer Centers Consortium (TrC3); Immune Suppression and the Tumor Microenvironment, Columbus, Ohio; March 1–2, 2010

    OpenAIRE

    Lesinski, Gregory B.; Carson, William E.; Repasky, Elizabeth A.; Wei, Weizen; Kalinski, Pawel; Lotze, Michael T; June, Carl H.; Petros, William; Muthusamy, Natarajan; Olencki, Thomas

    2010-01-01

    The Translational Research Cancer Centers Consortium (TrC3) is a cancer immunotherapy network, established to promote biologic therapeutics in the Midwestern and Northeastern regions of The United States. The 13th Annual Meeting of the TrC3 was hosted by The Ohio State University Comprehensive Cancer Center—Arthur G. James Cancer Hospital and Richard J. Solove Research Institute and took place at The Blackwell Hotel and Conference Center in Columbus, OH on March 1–2, 2010 (http://www.osuccc.o...

  14. Impact of a Fast-track Esophagectomy Protocol on Esophageal Cancer Patient Outcomes and Hospital Charges

    DEFF Research Database (Denmark)

    Shewale, Jitesh B; Correa, Arlene M; Baker, Carla M;

    2015-01-01

    OBJECTIVE: To evaluate the effects of a fast-track esophagectomy protocol (FTEP) on esophageal cancer patients' safety, length of hospital stay (LOS), and hospital charges. BACKGROUND: FTEP involved transferring patients to the telemetry unit instead of the surgical intensive care unit (SICU) after.......655; 95% confidence interval = 0.456, 0.942; P = 0.022). In addition, the median hospital charges associated with primary admission and readmission within 90 days for group B ($65,649) were lower than that for group A ($79,117; P ... esophagectomy. METHODS: We retrospectively reviewed 708 consecutive patients who underwent esophagectomy for primary esophageal cancer during the 4 years before (group A; 322 patients) or 4 years after (group B; 386 patients) the institution of an FTEP. Postoperative morbidity and mortality, LOS, and hospital...

  15. Fever and neutropenia hospital discharges in children with cancer: A 2012 update.

    Science.gov (United States)

    Mueller, Emily L; Croop, James; Carroll, Aaron E

    2016-02-01

    Fever and neutropenia (FN) is a common precipitant for hospitalization among children with cancer, but hospital utilization trends are not well described. This study describes national trends for hospital discharges for FN among children with cancer for the year 2012, compared with the authors' previous analysis from 2009. Data were analyzed from the Kids' Inpatient Database (KID), an all-payer US hospital database, for 2012. Pediatric patients with cancer who had a discharge for FN were identified using age ≤19 years, urgent or emergent admit type, nontransferred, and a combination of International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for fever and neutropenia. The authors evaluated factors associated with a "short length of stay" (SLOS). Sampling weights were used to permit national inferences. In 2012, children with cancer accounted for 1.8% of pediatric hospital discharges (n = 120,675), with 12.2% (n = 13,456) of cancer-related discharges meeting FN criteria. Two fifths of FN discharges had a SLOS, which accounted for $91 million (2015 US$) in hospital charges. The majority had no serious infections; most common infections were viral infection (9.6%) or upper respiratory infection (9.6%). Factors significantly associated with SLOS included having a diagnosis of ear infection (odds ratio [OR] = 1.54, 95% confidence interval [CI]: 1.16-2.03), soft tissue sarcoma (OR = 1.47, CI: 1.10-1.95), and Hodgkin lymphoma (OR = 1.51, CI: 1.09-2.10), as compared with not having those diagnoses. SLOS admissions continue to be rarely associated with serious infections, but contribute substantially to the burden of hospitalization for pediatric FN. Implementation of risk stratification schemas to identify patients who meet low-risk criteria may decrease financial burden. PMID:26900730

  16. The frequency and antimicrobial resistance patterns of nosocomial pathogens recovered from cancer patients and hospital environments

    Institute of Scientific and Technical Information of China (English)

    Aymen; Mudawe; Nurain; Naser; Eldin; Bilal; Mutasim; Elhadi; Ibrahim

    2015-01-01

    Objective:To determine the prevalence and antimicrobial resistance rates of nosocomial pathogens isolated from cancer patients and hospital environments.Methods:A descriptive cross-sectional study was conducted between December 2010 to May 2013 at Radiation and Isotopes Centre of Khartoum,Sudan.A total of 1 503 samples(505 clinical and 998 environmental)were examined.Isolates were identified,and their antimicrobial susceptibility was determined using standard laboratory procedures.Results:Out of 505 clinical samples,nosocomial pathogens were found as 48.1%.Among hospital environment samples,bacterial contaminants were detected in 29.7%of samples.The main microorganisms recovered from cancer patients were Proteus spp.(23.5%),Escherichia coli(22.2%),Pseudomonas aeruginosa(P.aeruginosa)(21.0%)and Staphylococcus aureus(20.2%).The most frequent isolates from hospital environments were Bacillus spp.(50.0%),Staphylococcus aureus(14.2%)and P.aeruginosa(11.5%).The proportions of resistance among Gram-negative pathogens from cancer patients were high for ampicillin,cefotaxime,ceftazidime and ceftriaxone.Moderate resistance rates were recorded to ciprofloxacin,such as 51.0%for P.aeruginosa,21.7%for Klebsiella pneumoniae and 55.5%for Escherichia coli.Except Klebsiella,there were no significant differences(P0.05)of resistance rates between Gram-negative isolates from cancer patients to those from the hospital environments.The proportions of extended-spectrum b-lactamase producing isolates from cancer patients were not differ significantly(P=0.763)from those collected from the hospital environments(49.2%;91/185 vs.47%;32/68).Conclusions:The prevalence of nosocomial infection among cancer patients was high(48.1%)with the increasing of antimicrobial resistance rates.Hospital environments are potential reservoirs for nosocomial infections,which calls for intervention program to reduce environmental transmission of pathogens.

  17. The frequency and antimicrobial resistance patterns of nosocomial pathogens recovered from cancer patients and hospital environments

    Institute of Scientific and Technical Information of China (English)

    Aymen Mudawe Nurain; Naser Eldin Bilal; Mutasim Elhadi Ibrahim

    2015-01-01

    Objective: To determine the prevalence and antimicrobial resistance rates of nosocomial pathogens isolated from cancer patients and hospital environments. Methods: A descriptive cross-sectional study was conducted between December 2010 to May 2013 at Radiation and Isotopes Centre of Khartoum, Sudan. A total of 1 503 samples (505 clinical and 998 environmental) were examined. Isolates were identified, and their antimicrobial susceptibility was determined using standard laboratory procedures. Results: Out of 505 clinical samples, nosocomial pathogens were found as 48.1%. Among hospital environment samples, bacterial contaminants were detected in 29.7%of samples. The main microorganisms recovered from cancer patients were Proteus spp. (23.5%), Escherichia coli (22.2%), Pseudomonas aeruginosa (P. aeruginosa) (21.0%) and Staphylococcus aureus (20.2%). The most frequent isolates from hospital environ-ments were Bacillus spp. (50.0%), Staphylococcus aureus (14.2%) and P. aeruginosa (11.5%). The proportions of resistance among Gram-negative pathogens from cancer patients were high for ampicillin, cefotaxime, ceftazidime and ceftriaxone. Moderate resistance rates were recorded to ciprofloxacin, such as 51.0%for P. aeruginosa, 21.7%for Klebsiella pneumoniae and 55.5%for Escherichia coli. Except Klebsiella, there were no significant differences (P ? 0.05) of resistance rates between Gram-negative isolates from cancer patients to those from the hospital environments. The proportions of extended-spectrum b-lactamase producing isolates from cancer patients were not differ significantly (P=0.763) from those collected from the hospital environments (49.2%;91/185 vs. 47%;32/68). Conclusions: The prevalence of nosocomial infection among cancer patients was high (48.1%) with the increasing of antimicrobial resistance rates. Hospital environments are potential reservoirs for nosocomial infections, which calls for intervention program to reduce environmental transmission of pathogens.

  18. Open Partial Nephrectomy in Renal Cancer: A Feasible Gold Standard Technique in All Hospitals

    Directory of Open Access Journals (Sweden)

    J. M. Cozar

    2008-01-01

    Full Text Available Introduction. Partial nephrectomy (PN is playing an increasingly important role in localized renal cell carcinoma (RCC as a true alternative to radical nephrectomy. With the greater experience and expertise of surgical teams, it has become an alternative to radical nephrectomy in young patients when the tumor diameter is 4 cm or less in almost all hospitals since cancer-specific survival outcomes are similar to those obtained with radical nephrectomy. Materials and Methods. The authors comment on their own experience and review the literature, reporting current indications and outcomes including complications. The surgical technique of open partial nephrectomy is outlined. Conclusions. Nowadays, open PN is the gold standard technique to treat small renal masses, and all nonablative techniques must pass the test of time to be compared to PN. It is not ethical for patients to undergo radical surgery just because the urologists involved do not have adequate experience with PN. Patients should be involved in the final treatment decision and, when appropriate, referred to specialized centers with experience in open or laparoscopic partial nephrectomies.

  19. The first private-hospital based proton therapy center in Korea; Status of the proton therapy center at Samsung Medical Center

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Kwang Zoo; Han, Young Yih; Kim, Jin Sung [Dept. of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of); and others

    2015-12-15

    The purpose of this report is to describe the proton therapy system at Samsung Medical Center (SMC-PTS) including the proton beam generator, irradiation system, patient positioning system, patient position verification system, respiratory gating system, and operating and safety control system, and review the current status of the SMC-PTS. The SMC-PTS has a cyclotron (230 MeV) and two treatment rooms: one treatment room is equipped with a multi-purpose nozzle and the other treatment room is equipped with a dedicated pencil beam scanning nozzle. The proton beam generator including the cyclotron and the energy selection system can lower the energy of protons down to 70 MeV from the maximum 230 MeV. The multi-purpose nozzle can deliver both wobbling proton beam and active scanning proton beam, and a multi-leaf collimator has been installed in the downstream of the nozzle. The dedicated scanning nozzle can deliver active scanning proton beam with a helium gas filled pipe minimizing unnecessary interactions with the air in the beam path. The equipment was provided by Sumitomo Heavy Industries Ltd., RayStation from RaySearch Laboratories AB is the selected treatment planning system, and data management will be handled by the MOSAIQ system from Elekta AB. The SMC-PTS located in Seoul, Korea, is scheduled to begin treating cancer patients in 2015.

  20. [Psychosocial Situation and Patient Satisfaction among Clients of Cancer Counselling Centers in Saxony].

    Science.gov (United States)

    Götze, Heide; Röder, Heiko; Frenschkowski, Sandra; Mehnert, Anja

    2016-07-01

    Outpatient psychosocial counselling (OPC) centers for those affected by cancer fulfill 2 main purposes: (a) to offer low-threshold psychological, social and legal counselling, and (b) to refer clients to other services. Here we report findings from a user-based assessment of OPC in the state of Saxony, Germany. This study was funded in part by the Saxon State Ministry of Social Affairs and Consumer Protection. We used a paper-based questionnaire to survey 213 clients of OPC in Saxony at 2 points (t1: up to one week after first contact, t2: 4 months after t1). All participants were cancer patients. The survey assessed utilization of services, depressive symptoms (PHQ-9), anxiety (GAD-7), quality of life (SF-8) as well as clients' satisfaction with the counselling service (ZUF-8). The majority of clients (81%) were referred to the OPC from a hospital or rehabilitation center. 46% of patients only had one contact. 78% of counselling sessions treated matters of social law. Patients suffered from 13 problems on average, the most common being fatigue and exhaustion, worries, anxiety, uncertainty about the future, and pain. Half the patients (49%) reported moderate to severe anxiety and 68% showed elevated levels of depressive symptoms. Psychosocial distress did not change significantly over time (GAD-7: p=0.580, PHQ-9: p=0.101). Patients' quality of life was low overall (cut-offquality of life had particularly increased in physical aspects, but overall quality of life remained lower than in the general population (all subscales: pquality of life. Patients were very satisfied with the counselling they received, 9% reported to be dissatisfied. Our results show that psychosocial distress remains high over a longer period of time at least for some patients. This illustrates the persisting need for long-term support regarding physical, mental and social impairments as a consequence of cancer and its treatments. It also shows the challenging demands which OPC centers are faced

  1. Renal Cancer Biomarkers | NCI Technology Transfer Center | TTC

    Science.gov (United States)

    The National Cancer Institute's Laboratory of Proteomics and Analytical Technologies is seeking statements of capability or interest from parties interested in collaborative research to further develop, evaluate, or commercialize diagnostic, therapeutic and prognostic cancer biomarkers from clinical specimens.

  2. University of Texas M.D. Anderson Cancer Center

    Science.gov (United States)

    ... Cancer Risk: Our Expert Weighs In Using the Internet to Help Men With Cancer-Related Sexual Problems ... Laboratory Abe Laboratory Home Research Lab Members Publications Addiction Psychophysiology Laboratory Addiction Psychophysiology Laboratory Addiction Psychophysiology Laboratory ...

  3. Psychological process from hospitalization to death among uninformed terminal liver cancer patients in Japan

    Directory of Open Access Journals (Sweden)

    Kobori Eiko

    2006-09-01

    Full Text Available Abstract Background Although the attitude among doctors toward disclosing a cancer diagnosis is becoming more positive, informing patients of their disease has not yet become a common practice in Japan. We examined the psychological process, from hospitalization until death, among uninformed terminal cancer patients in Japan, and developed a psychological model. Methods Terminal cancer patients hospitalized during the recruiting period voluntarily participated in in-depth interviews. The data were analyzed by grounded theory. Results Of the 87 uninformed participants at the time of hospitalization, 67% (N = 59 died without being informed of their diagnosis. All were male, 51–66 years of age, and all experienced five psychological stages: anxiety and puzzlement, suspicion and denial, certainty, preparation, and acceptance. At the end of each stage, obvious and severe feelings were observed, which were called "gates." During the final acceptance stage, patients spent a peaceful time with family, even talking about their dreams with family members. Conclusion Unlike in other studies, the uninformed patients in this study accepted death peacefully, with no exceptional cases. Despite several limitations, this study showed that almost 70% of the uninformed terminal cancer patients at hospitalization died without being informed, suggesting an urgent need for culturally specific and effective terminal care services for cancer patients in Japan.

  4. German Bowel Cancer Center: An Attempt to Improve Treatment Quality

    OpenAIRE

    Olof Jannasch; Andrej Udelnow; Stefanie Wolff; Hans Lippert; Pawel Mroczkowski

    2015-01-01

    Background. Colorectal cancer remains the second most common cause of death from malignancies, but treatment results show high diversity. Certified bowel cancer centres (BCC) are the basis of a German project for improvement of treatment. The aim of this study was to analyze if certification would enhance short-term outcome in rectal cancer surgery. Material and Methods. This quality assurance study included 8197 patients with rectal cancer treated between 1 January 2008 and 31 December 2010....

  5. Risk for hospitalization with depression after a cancer diagnosis: a nationwide, population-based study of cancer patients in Denmark from 1973 to 2003

    DEFF Research Database (Denmark)

    Dalton, Susanne Oksbjerg; Laursen, Thomas Munk; Nylandsted, Lone Ross;

    2009-01-01

    study period for both men and women surviving hormone-related cancers, for women surviving smoking-related cancers, and for men surviving virus- and immune-related cancers. CONCLUSION: This study confirms an increased risk for depression in patients facing a disruptive event like cancer. Early......PURPOSE: As more people survive cancer, it is necessary to understand the long-term impact of cancer. We investigated whether cancer survivors are at increased risk for hospitalization for depression. METHODS: We linked data on all 5,703,754 persons living in Denmark on January 1, 1973, or born...... thereafter to the Danish Cancer Registry and identified 608,591 adults with a diagnosis of cancer. Follow-up for hospitalization for depression in the Danish Psychiatric Central Register from 1973 through 2003 yielded 121,227,396 person-years and 121,304 hospitalizations for depression. The relative risk (RR...

  6. Attitudes and Behavior of Nurses in State and Private Hospitals with Respect to Family-Centered Care

    Directory of Open Access Journals (Sweden)

    Şadiye Dur

    2016-04-01

    Full Text Available Introduction: The study was conducted as descriptive research for purpose of comparing the attitudes of nurses working at private and state hospitals with respect to the concept of having parents participate in the care of their children. Materials and Methods: The universe of the descriptive research comprised 70 nurses working at two state hospitals and one private hospital in city center of Istanbul, between the dates May 1-June 30, 2013. As data collection tools, two forms, namely a Nurses Information Form and a Parent Participation Attitude Scale (PPAS were used in the research. The lowest possible score on the scale is 24; the highest 120. The higher scores on the scale indicate more positive attitudes about having parents participate in the care given to their children. The data were analyzed in terms of numbers, percentages and means. Results: The nurses in the study were found to have similar identifying characteristics (p>0.05. They were asked whether they knew about family-centered care, 64.3% said they were familiar with the subject; when the source of their knowledge was queried, 34.8% stated that they had been informed through scientific publications and courses they took during their professional training. Of the nurses, 54.3% were found to display total parent participation attitude scores of 84 and above. In the evaluation of the PPAS scores of the nurses in terms of the hospital they worked, the scores of nurses working at state hospitals (85.67±6.17 were significantly more positive than the scores of the nurses working at the private hospital (81.88±5.26 (p<0.05. Conclusions: The accepting attitudes of nurses regarding the family-centered care approach indicated that nurses with higher level of education had opportunity to benefit from the focus placed on family-centered care in graduate nursing school programs and that had positive effect on their attitudes.

  7. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Eva Helena; Kjaergaard, H; Schmiegelow, K;

    2012-01-01

    . Our study highlights the importance of providing hospital-based home care with consideration for the family members' need for the sense of security achieved by home care by experienced paediatric oncology nurses and regular contact with the doctor. In future studies, interviews with children...

  8. Evaluation of Distress and Stress in Cancer Patients in AMIR Oncology Hospital in Shiraz

    OpenAIRE

    Mansourabadi, A; Moogooei, M; Nozari, S

    2014-01-01

    Background Routine screening for distress is internationally recommended as a necessary standard for good cancer care given its high prevalence and negative consequences on quality of life. This study attempts to support validation of Distress Thermometer (DT) in Shiraz, Iran and in the second step to investigate privilege/priority of DT over other referent criterion measures. Material and methods In total, 58 outpatients with cancer were recruited from AMIR Oncology hospital in Shiraz, Iran....

  9. Perception of selected risk factors for cancer and heart attack among visitors of a public hospital

    OpenAIRE

    Sandeep Sachdeva; Binod K Behera; Babita Rani; Ruchi Sachdeva; Bharti; Mukesh Nagar; Ajay K Tyagi; Vijay Kumar

    2015-01-01

    Background: To assess perception of selected risk factors for cancer and heart attack among visitors of a public hospital. Materials and Methods: Randomly 1651 ambulatory adults were contacted using predesigned, pretested, semi-structure interview schedule comprising selective 12 risk factors for cancer (increasing age, tobacco, obesity, alcohol, diet-rich in fat/oil, diet-poor in fruits and vegetables (F and V), physical in-activity, environmental pollution, multiple sexual partners, insecti...

  10. Diabetes Management and Self-Care Education for Hospitalized Patients With Cancer

    OpenAIRE

    Leak, Ashley; Davis, Ellen D.; Houchin, Laura B.; Mabrey, Melanie

    2009-01-01

    Managing diabetes can be a daunting task for patients with cancer. Empowerment-based diabetes education and motivational interviewing are complementary approaches. Oncology nurses may feel unprepared to teach patients and their families about self-care for diabetes, but they provide individualized information on symptom management of cancer throughout hospitalization and at discharge. The essential self-care issues include food, exercise, medication, blood glucose monitoring, prevention, reco...

  11. Hospitals

    DEFF Research Database (Denmark)

    Mullins, Michael

    2013-01-01

    The challenge could be briefly seen in these terms: hospitals as places for treatment where there’s a technology focus and hospitals for healing where there’s a human focus. In the 60s - 70s wave of new hospital building, an emphasis on technology can be seen. It’s time to move from the technology...... is to minimize the negative effects of stress inducing environments based on research results. Which stress inducing factors? We can look around at some old hospitals and see they are noisy, confusing, ugly, monotonous, hard, cold, artificial, and dark; qualitative terms which can indicate what we shouldn......’t be doing in hospitals. Design factors which should be carefully considered include: Light, as in daylight, artificial light, its color, its temperature, the level and quality of lighting and the effects of light on circadian rhythms. There is documented evidence in: users’ satisfaction, orientation, 24...

  12. Plant-based Complementary and alternative medicine used by breast cancer patients at the Hospital Universitario San Ignacio in Bogotá, Colombia.

    OpenAIRE

    Marcela Mercado; Luisa Benitez Cardenas; Susana Fiorentino; Luz Angela Diaz; Lilian Torregrosa

    2012-01-01

    The present study estimates the frequency of the use of plant-based Complementary and Alternative Medicine (CAM) by breast cancer patients. From June to December of 2011, a self-administered questionnaire was given to 404 breast cancer patients receiving outpatient therapy at the Javeriana Oncology Center of the Hospital Universitario San Ignacio in Bogotá. The prevalence of patient CAM use was 57%, out of which 76% was based on plants like anamú, aloe, red fruits and soursop. Sixty-five perc...

  13. Cancer Research Center Indiana University School of Medicine

    Energy Technology Data Exchange (ETDEWEB)

    1994-08-01

    The Department of Energy (DOE) proposes to authorize the Indiana School of Medicine to proceed with the detailed design, construction and equipping of the proposed Cancer Research Center (CRC). A grant was executed with the University on April 21, 1992. A four-story building with basement would be constructed on the proposed site over a 24-month period. The proposed project would bring together, in one building, three existing hematology/oncology basic research programs, with improved cost-effectiveness through the sharing of common resources. The proposed site is currently covered with asphaltic pavement and is used as a campus parking lot. The surrounding area is developed campus, characterized by buildings, walkways, with minimal lawns and plantings. The proposed site has no history of prior structures and no evidence of potential sources of prior contamination of the soil. Environmental impacts of construction would be limited to minor increases in traffic, and the typical noises associated with standard building construction. The proposed CRC project operation would involve the use radionuclides and various hazardous materials in conducting clinical studies. Storage, removal and disposal of hazardous wastes would be managed under existing University programs that comply with federal and state requirements. Radiological safety programs would be governed by Nuclear Regulatory Commission (NRC) license and applicable Environmental Protection Agency (EPA) regulations. There are no other NEPA reviews currently active which are in relationship to this proposed site. The proposed project is part of a Medical Campus master plan and is consistent with applicable local zoning and land use requirements.

  14. Cancer Research Center Indiana University School of Medicine

    International Nuclear Information System (INIS)

    The Department of Energy (DOE) proposes to authorize the Indiana School of Medicine to proceed with the detailed design, construction and equipping of the proposed Cancer Research Center (CRC). A grant was executed with the University on April 21, 1992. A four-story building with basement would be constructed on the proposed site over a 24-month period. The proposed project would bring together, in one building, three existing hematology/oncology basic research programs, with improved cost-effectiveness through the sharing of common resources. The proposed site is currently covered with asphaltic pavement and is used as a campus parking lot. The surrounding area is developed campus, characterized by buildings, walkways, with minimal lawns and plantings. The proposed site has no history of prior structures and no evidence of potential sources of prior contamination of the soil. Environmental impacts of construction would be limited to minor increases in traffic, and the typical noises associated with standard building construction. The proposed CRC project operation would involve the use radionuclides and various hazardous materials in conducting clinical studies. Storage, removal and disposal of hazardous wastes would be managed under existing University programs that comply with federal and state requirements. Radiological safety programs would be governed by Nuclear Regulatory Commission (NRC) license and applicable Environmental Protection Agency (EPA) regulations. There are no other NEPA reviews currently active which are in relationship to this proposed site. The proposed project is part of a Medical Campus master plan and is consistent with applicable local zoning and land use requirements

  15. Socio-demographic characteristics of cancer patients: Hospital based cancer registry in a tertiary care hospital of India

    Directory of Open Access Journals (Sweden)

    S Puri

    2014-01-01

    Full Text Available Aim: To determine the socio-demographic characteristics of cancer patients. Materials and Methods: Review of the Cancer registry, and patient interview. Information on socio-demographic profile, medical history, family history and previous treatment, if any, was retrieved from the patient. If the patient couldn′t be contacted then information was taken from pathology/radiotherapy or medical records department. Results: A total of 684 patients participated in the study. More than 40% of males and 53.7% of females were illiterate, P < 0.05. The majority (33.5% of participants were of low socioeconomic status. The most frequently reported cancer (ca in males it was ca lung (40.9 and ca oesophagus (9.8. In females most common cancer were ca breast (23.9 followed by ca cervix (11.7.

  16. Validation of the Memorial Sloan Kettering Cancer Center nomogram for predicting non-sentinel lymph node metastasis in sentinel lymph node-positive breast-cancer patients

    Directory of Open Access Journals (Sweden)

    Bi X

    2015-02-01

    Full Text Available Xiang Bi,1,* Yongsheng Wang,2 Minmin Li,1,* Peng Chen,2 Zhengbo Zhou,2 Yanbing Liu,2 Tong Zhao,2 Zhaopeng Zhang,2 Chunjian Wang,2 Xiao Sun,2 Pengfei Qiu2 1School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, Shandong Cancer Hospital, 2Breast Cancer Center, Shandong Cancer Hospital, Jinan, People’s Republic of China *These authors contributed equally to this study Background: The main purpose of the study reported here was to validate the clinical value of the Memorial Sloan Kettering Cancer Center (MSKCC nomogram that predicts non-sentinel lymph node (SLN metastasis in SLN-positive patients with breast cancer. Methods: Data on 1,576 patients who received sentinel lymph node biopsy (SLNB at the Shandong Cancer Hospital from December 2001 to March 2014 were collected in this study, and data on 509 patients with positive SLN were analyzed to evaluate the risk factors for non-SLN metastasis. The MSKCC nomogram was used to estimate the probability of non-SLN metastasis and was compared with actual probability after grouping into deciles. A receiver-operating characteristic (ROC curve was drawn and predictive accuracy was assessed by calculating the area under the ROC curve. Results: Tumor size, histological grade, lymphovascular invasion, multifocality, number of positive SLNs, and number of negative SLNs were correlated with non-SLN metastasis (P<0.05 by univariate analysis. However, multivariate analysis showed that tumor size (P=0.039, histological grade (P=0.043, lymphovascular invasion (P=0.001, number of positive SLNs (P=0.001, and number of negative SLNs (P=0.000 were identified as independent predictors for non-SLN metastasis. The trend of actual probability in various decile groups was comparable to the predicted probability. The area under the ROC curve was 0.722. Patients with predictive values lower than 10% (97/492, 19.7% had a frequency of non-SLN metastasis of 17.5% (17/97. Conclusion: The

  17. [The utilization of parenteral nutrition at Hospital de Jerez (Cádiz): a description and comparison with other hospital centers].

    Science.gov (United States)

    Gómez Henry, J C; Méndez Martínez, C; Blanco Rodríguez, D; Rodríguez Quirós, M

    1996-01-01

    This retrospective study aims to analyze, and compare with other Spanish hospitals, the use of parenteral nutrition, its characteristics and complications, in a general hospital with 610 beds, during 1992. To conduct this study, we have used clinical histories and follow up sheets made up by the Department of Pharmacy for each patient, as well as the results of the sample processing in the microbiology laboratory. Between 1992 and 1993 we have seen an increase in the use of parenteral nutrition, with the number of bags increasing from 2134 to 2575. The departments which have used parenteral nutrition most, were Surgery (57.3%), and ICU (24.8%), with the mean duration being 10.4 days 8SD = +/- 9.3 days). The most frequently used access route in the hospital was the drum, but there are significant differences between the departments. Gastroenterological pathology was, with 71.4% the most frequent indication for its use, and within this, the neoplasias stand out with 26.3% of the total of parenteral nutrition. The complications which affected most patients are: increases of the liver enzymes, hypokalemias, hyponatremias, and hyperglycemias.

  18. Study of the outcome of suicide attempts: characteristics of hospitalization in a psychiatric ward group, critical care center group, and non-hospitalized group

    Directory of Open Access Journals (Sweden)

    Kemuyama Nobuo

    2010-01-01

    Full Text Available Abstract Background The allocation of outcome of suicide attempters is extremely important in emergency situations. Following categorization of suicidal attempters who visited the emergency room by outcome, we aimed to identify the characteristics and potential needs of each group. Methods The outcomes of 1348 individuals who attempted suicide and visited the critical care center or the psychiatry emergency department of the hospital were categorized into 3 groups, "hospitalization in the critical care center (HICCC", "hospitalization in the psychiatry ward (HIPW", or "non-hospitalization (NH", and the physical, mental, and social characteristics of these groups were compared. In addition, multiple logistic analysis was used to extract factors related to outcome. Results The male-to-female ratio was 1:2. The hospitalized groups, particularly the HICCC group, were found to have biopsychosocially serious findings with regard to disturbance of consciousness (JCS, general health performance (GAS, psychiatric symptoms (BPRS, and life events (LCU, while most subjects in the NH group were women who tended to repeat suicide-related behaviors induced by relatively light stress. The HIPW group had the highest number of cases, and their symptoms were psychologically serious but physically mild. On multiple logistic analysis, outcome was found to be closely correlated with physical severity, risk factor of suicide, assessment of emergent medical intervention, and overall care. Conclusion There are different potential needs for each group. The HICCC group needs psychiatrists on a full-time basis and also social workers and clinical psychotherapists to immediately initiate comprehensive care by a medical team composed of multiple professionals. The HIPW group needs psychological education to prevent repetition of suicide attempts, and high-quality physical treatment and management skill of the staff in the psychiatric ward. The NH group subjects need a

  19. Validation of the memorial Sloan-Kettering Cancer Center nomogram to predict disease-specific survival after R0 resection in a Chinese gastric cancer population.

    Directory of Open Access Journals (Sweden)

    Donglai Chen

    Full Text Available BACKGROUND: Prediction of disease-specific survival (DSS for individual patient with gastric cancer after R0 resection remains a clinical concern. Since the clinicopathologic characteristics of gastric cancer vary widely between China and western countries, this study is to evaluate a nomogram from Memorial Sloan-Kettering Cancer Center (MSKCC for predicting the probability of DSS in patients with gastric cancer from a Chinese cohort. METHODS: From 1998 to 2007, clinical data of 979 patients with gastric cancer who underwent R0 resection were retrospectively collected from Peking University Cancer Hospital & Institute and used for external validation. The performance of the MSKCC nomogram in our population was assessed using concordance index (C-index and calibration plot. RESULTS: The C-index for the MSKCC predictive nomogram was 0.74 in the Chinese cohort, compared with 0.69 for American Joint Committee on Cancer (AJCC staging system (P<0.0001. This suggests that the discriminating value of MSKCC nomogram is superior to AJCC staging system for prognostic prediction in the Chinese population. Calibration plots showed that the actual survival of Chinese patients corresponded closely to the MSKCC nonogram-predicted survival probabilities. Moreover, MSKCC nomogram predictions demonstrated the heterogeneity of survival in stage IIA/IIB/IIIA/IIIB disease of the Chinese patients. CONCLUSION: In this study, we externally validated MSKCC nomogram for predicting the probability of 5- and 9-year DSS after R0 resection for gastric cancer in a Chinese population. The MSKCC nomogram performed well with good discrimination and calibration. The MSKCC nomogram improved individualized predictions of survival, and may assist Chinese clinicians and patients in individual follow-up scheduling, and decision making with regard to various treatment options.

  20. Cancer patients and positive sensory impressions in the hospital environment

    DEFF Research Database (Denmark)

    Timmermann, Connie; Uhrenfeldt, Lisbeth; Birkelund, Regner

    2013-01-01

    environment had a significant impact on their mood, generating positive thoughts and feelings. A view to nature also helped them to forget their negative thoughts for a while. The possibility of having a view helped some cancer patients to connect with good memories and personal life stories that enabled them...

  1. Penile cancer: about ten cases at the University Hospital of Rabat, review of the literature

    OpenAIRE

    Slaoui, Amine; Jabbour, Youness; El Ghazoui, Anouar; Karmouni, Tarik; Elkhader, Khalid; Koutani, Abdelatif; Attaya, Ahmed Ibn

    2015-01-01

    The aim of our study was to report the status of penile cancer sites in the urology department at the University Hospital of Rabat and evaluate long-term results of surgical treatment of this cancer. Patients and Methods: Between 1989 and 2015, 10 patients were treated for penile cancer. 10 cases were retrospectively reviewed and the following data were recorded: mode of revelation, seat, staging, TNM stage, treatment, evolution and survival. The mean age of patients was 58,1 years (48-81 yea...

  2. In-hospital mortality following lung cancer resection: nationwide administrative database.

    Science.gov (United States)

    Pagès, Pierre-Benoit; Cottenet, Jonathan; Mariet, Anne-Sophie; Bernard, Alain; Quantin, Catherine

    2016-06-01

    Our aim was to determine the effect of a national strategy for quality improvement in cancer management (the "Plan Cancer") according to time period and to assess the influence of type and volume of hospital activity on in-hospital mortality (IHM) within a large national cohort of patients operated on for lung cancer.From January 2005 to December 2013, 76 235 patients were included in the French Administrative Database. Patient characteristics, hospital volume of activity and hospital type were analysed over three periods: 2005-2007, 2008-2010 and 2011-2013.Global crude IHM was 3.9%: 4.3% during 2005-2007, 4% during 2008-2010 and 3.5% during 2011-2013 (p43 resections per year (adjusted (a)OR 1.48, 95% CI 1.197-1.834). The risk of death was lower in the period 2011-2013 than in the period 2008-2010 (aOR 0.841, 95% CI 0.764-0.926). Adjustment variables (age, sex, Charlson score and type of resection) were significantly linked to IHM, whereas the type of hospital was not.The French national strategy for quality improvement seems to have induced a significant decrease in IHM. PMID:26965293

  3. FacilitiesHospitals_HOSPITAL

    Data.gov (United States)

    Vermont Center for Geographic Information — This datalayer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of Vermont. The...

  4. Increased cancer risk in patients referred to hospital with suspected fibromyalgia

    DEFF Research Database (Denmark)

    Dreyer, Lene; Mellemkjaer, Lene; Kendall, Sally;

    2007-01-01

    OBJECTIVE: To analyze whether fibromyalgia (FM) and FM-like symptoms are related to an increased incidence of cancer. METHODS: We identified 1361 patients referred on suspicion of FM in the period 1984-99 from hospital records. Following the American College of Rheumatology (ACR) criteria, patients...

  5. Intensify standardized therapy for esophageal and stomach cancer in tumor hospitals

    Institute of Scientific and Technical Information of China (English)

    Shi Jie Wang; Deng Gui Wen; Jing Zhang; Xin Man; Hui Liu

    2001-01-01

    @@ INTRODUCTIONCancer treatment situation in tumor hospitals inChina has its own unique characteristics which arenot found in other parts of the world. Because ofthe huge population and high incidence rates ofesophageal and stomach cancer[1-5], the number ofcancer patients waiting for admission isinconceivably large.

  6. Hospital visits among women with skeletal-related events secondary to breast cancer and bone metastases: a nationwide population-based cohort study in Denmark

    Directory of Open Access Journals (Sweden)

    Svendsen ML

    2013-03-01

    Full Text Available Marie Louise Svendsen,1 Henrik Gammelager,1 Claus Sværke,1 Mellissa Yong,2 Victoria M Chia,2 Christian F Christiansen,1 Jon P Fryzek1 1Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark; 2Center for Observational Research, Amgen, Thousand Oaks, CA, USA Objective: Skeletal-related events (SREs among women with breast cancer may be associated with considerable use of health-care resources. We characterized inpatient and outpatient hospital visits in a national population-based cohort of Danish women with SREs secondary to breast cancer and bone metastases. Methods: We identified first-time breast cancer patients with bone metastases from 2003 through 2009 who had a subsequent SRE (defined as pathologic fracture, spinal cord compression, radiation therapy, or surgery to bone. Hospital visits included the number of inpatient hospitalizations, length of stay, number of hospital outpatient clinic visits, and emergency room visits. The number of hospital visits was assessed for a pre-SRE period (90 days prior to the diagnostic period, a diagnostic period (14 days prior to the SRE, and a post-SRE period (90 days after the SRE. Patients who experienced more than one SRE during the 90-day post-SRE period were defined as having multiple SREs and were followed until 90 days after the last SRE. Results: We identified 569 women with SREs secondary to breast cancer with bone metastases. The majority of women had multiple SREs (73.1%. A total of 20.9% and 33.4% of women with single and multiple SREs died in the post-SRE period, respectively. SREs were associated with a large number of hospital visits in the diagnostic period, irrespective of the number and type of SREs. Women with multiple SREs generally had a higher number of visits compared to those with a single SRE in the post-SRE period, eg, median length of hospitalization was 5 days (interquartile range 0–15 for women with a single SRE and 13 days (interquartile range 4

  7. Trend and forecasting rate of cancer deaths at a public university hospital using univariate modeling

    Science.gov (United States)

    Ismail, A.; Hassan, Noor I.

    2013-09-01

    Cancer is one of the principal causes of death in Malaysia. This study was performed to determine the pattern of rate of cancer deaths at a public hospital in Malaysia over an 11 year period from year 2001 to 2011, to determine the best fitted model of forecasting the rate of cancer deaths using Univariate Modeling and to forecast the rates for the next two years (2012 to 2013). The medical records of the death of patients with cancer admitted at this Hospital over 11 year's period were reviewed, with a total of 663 cases. The cancers were classified according to 10th Revision International Classification of Diseases (ICD-10). Data collected include socio-demographic background of patients such as registration number, age, gender, ethnicity, ward and diagnosis. Data entry and analysis was accomplished using SPSS 19.0 and Minitab 16.0. The five Univariate Models used were Naïve with Trend Model, Average Percent Change Model (ACPM), Single Exponential Smoothing, Double Exponential Smoothing and Holt's Method. The overall 11 years rate of cancer deaths showed that at this hospital, Malay patients have the highest percentage (88.10%) compared to other ethnic groups with males (51.30%) higher than females. Lung and breast cancer have the most number of cancer deaths among gender. About 29.60% of the patients who died due to cancer were aged 61 years old and above. The best Univariate Model used for forecasting the rate of cancer deaths is Single Exponential Smoothing Technique with alpha of 0.10. The forecast for the rate of cancer deaths shows a horizontally or flat value. The forecasted mortality trend remains at 6.84% from January 2012 to December 2013. All the government and private sectors and non-governmental organizations need to highlight issues on cancer especially lung and breast cancers to the public through campaigns using mass media, media electronics, posters and pamphlets in the attempt to decrease the rate of cancer deaths in Malaysia.

  8. Role of water quality assessments in hospital infection control: Experience from a new oncology center in eastern India

    Directory of Open Access Journals (Sweden)

    Ramkrishna Bhalchandra

    2014-01-01

    Full Text Available Water quality assessment and timely intervention are essential for health. Microbiology, total dissolved solids (TDS and free residual chlorine were measured for water quality maintenance in an oncology center in India. Impact of these interventions over a period of 22 months has been demonstrated with four cardinal events. Pseudomonas in hospital water was controlled by adequate chlorination, whereas high TDS in the central sterile supply department water was corrected by the installation of electro-deionization plant. Contaminated bottled water was replaced using quality controlled hospital supply. Timely detection and correction of water-related issues, including reverse osmosis plant was possible through multi-faceted approach to water quality.

  9. Implementing PDA technology in a medical library: experiences in a hospital library and an academic medical center library.

    Science.gov (United States)

    Morgen, Evelyn Breck

    2003-01-01

    Personal digital assistants (PDAs) have grown from being a novelty in the late 1990s to an essential tool for healthcare professionals in the 2000s. This paper describes the experiences of a librarian who implemented PDA technology first in a hospital library, and then at an academic medical center library. It focuses on the role of the library in supporting PDA technology and resources. Included are programmatic issues such as training for library staff and clinicians, and technical issues such as Palm and Windows operating systems. This model could be used in either a hospital or academic health sciences library.

  10. A person-centered intervention targeting the psychosocial needs of gynecological cancer survivors

    DEFF Research Database (Denmark)

    Olesen, Mette Linnet; Duun-Henriksen, Anne-Katrine; Hansson, Helena;

    2016-01-01

    , depression, self-esteem, and self-reported ability to monitor and respond to symptoms of recurrence. METHODS: We randomly assigned 165 gynecological cancer survivors to usual care (UC) plus GSD-GYN-C or UC alone. Self-reported QOL-cancer survivor (QOL-CS) total score and subscale scores on physical......PURPOSE: We investigated the effect of a person-centered intervention consisting of two to four nurse-led conversations using guided self-determination tailored to gynecologic cancer (GSD-GYN-C) on gynecological cancer survivors' quality of life (QOL), impact of cancer, distress, anxiety...

  11. Two decades of external peer review of cancer care in general hospitals; the Dutch experience.

    Science.gov (United States)

    Kilsdonk, Melvin J; Siesling, Sabine; Otter, Rene; van Harten, Wim H

    2016-03-01

    External peer review was introduced in general hospitals in the Netherlands in 1994 to assess and improve the multidisciplinary team approach in cancer care. This paper aims to explore the value, perceived impact, and (future) role of external peer review in cancer care. Semistructured interviews were held with clinicians, oncology nurses, and managers from fifteen general hospitals that participated in three rounds of peer review over a period of 16 years. Interviewees reflected on the goals and expectations, experiences, perceived impact, and future role of external peer review. Transcriptions of the interviews were coded to discover recurrent themes. Improving clinical care and organization were the main motives for participation. Positive impact was perceived on multiple aspects of care such as shared responsibilities, internal prioritization of cancer care, improved communication, and a clear structure and position of cancer care within general hospitals. Establishing a direct relationship between the external peer review and organizational or clinical impact proved to be difficult. Criticism was raised on the content of the program being too theoretical and organization-focussed after three rounds. According to most stakeholders, external peer review can improve multidisciplinary team work in cancer care; however, the acceptance is threatened by a perceived disbalance between effort and visible clinical impact. Leaner and more clinically focused programs are needed to keep repeated peer reviews challenging and worthwhile. PMID:26714788

  12. Predictors of Non-Adherence to Breast Cancer Screening among Hospitalized Women.

    Directory of Open Access Journals (Sweden)

    Waseem Khaliq

    Full Text Available Disparities in screening mammography use persists among low income women, even those who are insured, despite the proven mortality benefit. A recent study reported that more than a third of hospitalized women were non-adherent with breast cancer screening. The current study explores prevalence of socio-demographic and clinical variables associated with non-adherence to screening mammography recommendations among hospitalized women.A cross sectional bedside survey was conducted to collect socio-demographic and clinical comorbidity data thought to effect breast cancer screening adherence of hospitalized women aged 50-75 years. Logistic regression models were used to assess the association between these factors and non-adherence to screening mammography.Of 250 enrolled women, 61% were of low income, and 42% reported non-adherence to screening guidelines. After adjustment for socio-demographic and clinical predictors, three variables were found to be independently associated with non-adherence to breast cancer screening: low income (OR = 3.81, 95%CI; 1.84-7.89, current or ex-smoker (OR = 2.29, 95%CI; 1.12-4.67, and history of stroke (OR = 2.83, 95%CI; 1.21-6.60. By contrast, hospitalized women with diabetes were more likely to be compliant with breast cancer screening (OR = 2.70, 95%CI 1.35-5.34.Because hospitalization creates the scenario wherein patients are in close proximity to healthcare resources, at a time when they may be reflecting upon their health status, strategies could be employed to counsel, educate, and motivate these patients towards health maintenance. Capitalizing on this opportunity would involve offering screening during hospitalization for those who are overdue, particularly for those who are at higher risk of disease.

  13. Study of Bacterial Infections among Burn Patients Hospitalized in Isfahan Burn Center

    Directory of Open Access Journals (Sweden)

    J. Faghri

    2007-10-01

    Full Text Available Introduction & Objective: Burn patients are at risk of acquiring infection because of destroy skin barrier, suppression of immunity, prolonged hospitalization, and invasive therapeutic and diagnostic procedure, risk of acquiring infection is high among burned patients. The aim of this study was to assess the incidence rate of bacterial etiology and infections among burn patients in the burn center of Isfahan. Materials & Methods: The study was conducted descriptive – cross sectional during a period of one year, (from august 2004 until September 2005. A total of 106 patients presenting with no signs and symptoms of infection within the first 48 hours of admission were included. CDC definition for nosocomial infections was applied. Each patient’s clinical examinations and records investigated daily. Swab culture, blood culture (during fever time, tissue culture from biopsy specimen of burn wound and urine culture obtained. The data were analyzed and interpreted using SPSS 10 Software, using Chi – square and Kappa Coefficient. P.value < 0.05 was significant. Results: One-hundred and six patients met the inclusion criteria, 91 (85/8% acquired at least one type of infection, including, urinary tract 28 (26/4%, blood stream 30 (28/3%, and burn wound 91(85/8%. Pseudomonas aeroginosa was the most common causative agent isolated from blood culture and swab culture, 27/42% and 54/4% respectively. Also, E.coli was the major casautive agent of urinary tract infections (6.4% isolated from urine culture of these burn patients.Conclusion: The results indicated that, biopsy from burn wounds and study of histopathologic specimen day by other day depends on blood and urine culture conditions overall can be effective for early detection of burn wounds infections.

  14. Immunonutrition for patients undergoing elective surgery for gastrointestinal cancer: impact on hospital costs

    Directory of Open Access Journals (Sweden)

    Mauskopf Josephine A

    2012-07-01

    Full Text Available Abstract Background Oral or enteral dietary supplementation with arginine, omega 3 fatty acids and nucleotides (known as immunonutrition significantly improve outcomes in patients undergoing elective surgery. The objective of the study was to determine the impact on hospital costs of immunonutrition formulas used in patients undergoing elective surgery for gastrointestinal cancer. Methods US hospital costs of stay with and without surgical infectious complications, and average cost per day in the hospital for patients undergoing elective surgery for gastrointestinal cancer were estimated using data from the Healthcare Cost and Utilization Project’s 2008 Nationwide Inpatient Sample. These costs were then used to estimate the impact of perioperative immunonutrition on hospital costs using estimates of reduction in infectious complications or length of stay from a meta-analysis of clinical trials in patients undergoing elective surgery for gastrointestinal cancer. Sensitivity of the results to changes in baseline complication rates or length of stay was tested. Results From the meta-analysis estimates, use of immunonutrition resulted in savings per patient of $3,300 with costs based on reduction in infectious complication rates or $6,000 with costs based on length of hospital stay. Cost savings per patient were present for baseline complication rates above 3.5% or when baseline length of stay and infectious complication rates were reduced to reflect recent US data for those with upper and lower GI elective cancer surgery (range, $1,200 to $6,300. Conclusions Use of immunonutrition for patients undergoing elective surgery for gastrointestinal cancer is an effective and cost-saving intervention.

  15. CLINICO-EPIDEMIOLOGICAL PROFILE OF ORAL CANCER: A HOSPITAL BASED STUDY

    Directory of Open Access Journals (Sweden)

    Kapil H Agrawal

    2012-07-01

    Full Text Available Background: India is heading towards various types of non-communicable diseases, which are also known as modern epidemics. Among these modern epidemics cancer is among the ten commonest cause of mortality in developing countries including India. Oral cancer is a major problem in India and accounts for 50-70% of all the cancers diagnosed. Ninety percent (90% of oral cancers in South East Asia including India are linked to tobacco chewing and tobacco smoking. Research question: What is the profile of Oral cancer (Oral cavity cases reported in the hospital? Objective: To study the clinico-epidemiological profile associated with Oral cancer cases. Methods: Study Design: Hospital based, Cross -sectional study. Settings: Shri Siddhivinayak Ganapati Cancer Hospital, Miraj, Maharashtra. Participants and Sample size: As it is a time bound study sample size comprised of all the confirmed cases of oral cancer reported in the hospital during the study period. The study was carried out from 1st March 2005 to 28th February 2006. Study variables included demographic factors, socioeconomic factors, enquiries regarding modifiable risk factors such as tobacco usage, alcohol consumption, site involved (within oral cavity, staging, histopathological examination, treatment modality used. Data entry and statistical analysis was done using Microsoft excel. Data presented in form of percentages and proportions. Results: Out of the total 160 cases, majority of the subjects were above 40 years age. 36 (22% of subjects were young adults (below 40 years age. 125 (78% subjects were male. Most of the subjects belonged to upper lower and lower middle socio-economic scale according to modified Kuppuswamy classification. It was observed that 139 (87% cases consumed tobacco in all forms. Out of these, ninety cases consumed tobacco in chewable form. Tobacco was chewed mainly in the form of gutka. Only ten (10 female subjects chewed tobacco. No female subjects smoked. The most

  16. Knowledge and awareness about cervical cancer and its prevention amongst interns and nursing staff in Tertiary Care Hospitals in Karachi, Pakistan.

    Directory of Open Access Journals (Sweden)

    Syed Faizan Ali

    Full Text Available BACKGROUND AND OBJECTIVE: Cervical cancer is one of the leading causes of morbidity and mortality amongst the gynecological cancers worldwide, especially in developing countries. It is imperative for at least health professionals in developing countries like Pakistan to have a sound knowledge about the disease. This study was carried out to assess the knowledge and awareness about cervical cancer and its prevention amongst health professionals in tertiary care hospitals in Karachi, Pakistan. METHODS AND DESIGN: A cross-sectional, interview based survey was conducted in June, 2009. Sample of 400 was divided between the three tertiary care centers. Convenience sampling was applied as no definitive data was available regarding the number of registered interns and nurses at each center. RESULTS: Of all the interviews conducted, 1.8% did not know cervical cancer as a disease. Only 23.3% of the respondents were aware that cervical cancer is the most common cause of gynecological cancers and 26% knew it is second in rank in mortality. Seventy-eight percent were aware that infection is the most common cause of cervical cancer, of these 62% said that virus is the cause and 61% of the respondents knew that the virus is Human Papilloma Virus (HPV. Majority recognized that it is sexually transmitted but only a minority (41% knew that it can be detected by PCR. Only 26% of the study population was aware of one or more risk factors. Thirty seven percent recognized Pap smear as a screening test. In total only 37 out of 400 respondents were aware of the HPV vaccine. CONCLUSION: This study serves to highlight that the majority of working health professionals are not adequately equipped with knowledge concerning cervical cancer. Continuing Medical Education program should be started at the hospital level along with conferences to spread knowledge about this disease.

  17. 77 FR 45061 - Hospital Outpatient Prospective and Ambulatory Surgical Center Payment Systems and Quality...

    Science.gov (United States)

    2012-07-30

    ... Quality data code QIO Quality Improvement Organization RAC Recovery Audit Contractor RFA Regulatory... budget neutrality adjustments. Classifying hospitals by teaching status or type of ownership...

  18. Critical Appraisal of Translational Research Models for Suitability in Performance Assessment of Cancer Centers

    NARCIS (Netherlands)

    Rajan, Abinaya; Sullivan, Richard; Bakker, Suzanne; Harten, van Wim H.

    2012-01-01

    Background. Translational research is a complex cumulative process that takes time. However, the operating environment for cancer centers engaged in translational research is now financially insecure. Centers are challenged to improve results and reduce time from discovery to practice innovations. P

  19. Does procedure profitability impact whether an outpatient surgery is performed at an ambulatory surgery center or hospital?

    Science.gov (United States)

    Plotzke, Michael Robert; Courtemanche, Charles

    2011-07-01

    Ambulatory surgery centers (ASCs) are small (typically physician owned) healthcare facilities that specialize in performing outpatient surgeries and therefore compete against hospitals for patients. Physicians who own ASCs could treat their most profitable patients at their ASCs and less profitable patients at hospitals. This paper asks if the profitability of an outpatient surgery impacts where a physician performs the surgery. Using a sample of Medicare patients from the National Survey of Ambulatory Surgery, we find that higher profit surgeries do have a higher probability of being performed at an ASC compared to a hospital. After controlling for surgery type, a 10% increase in a surgery's profitability is associated with a 1.2 to 1.4 percentage point increase in the probability the surgery is performed at an ASC.

  20. Videoendoscopic and histological characterization of patients with colorectal cancer in the Teaching Clinico-surgical Hospital Comandante 'Faustino Perez Hernandez'

    International Nuclear Information System (INIS)

    In Cuba, colorectal cancer is the third cause of mortality after lung and prostate cancer. We developed our work with the objective of arriving to an endoscopic and histological characterization of the patients with colorectal cancer diagnosed in the mentioned hospital

  1. Knowledge about breast cancer and reasons for late presentation by cancer patients seen at Princess Marina Hospital, Gaborone, Botswana

    Directory of Open Access Journals (Sweden)

    Deogratias Mbuka-Ongona

    2013-01-01

    Full Text Available Introduction: In Botswana, breast cancer, the second most common malignancy amongst women, is often diagnosed late, with 90% of patients presenting at advanced stages at Princess Marina Hospital (PMH Gaborone, the only referral hospital with an operational oncology department. The reasons for this late presentation have not been studied. Determination of these reasons is critical for the formulation of strategies to reduce morbidity and mortality from breast cancer in Botswana. The aim of this study was to explore existing knowledge about breast cancer and the reasons for late presentation amongst patients attending the oncology unit of Princess Marina Hospital.Method: A descriptive qualitative study using free attitude interview was performed.Twelve breast cancer sufferers were purposefully selected and eleven interviews conducted. Interviews were audio-taped, transcribed verbatim and translated. Thematic analysis of data was performed.Results: This study found that breast cancer sufferers had had poor knowledge of the disease prior to the diagnosis. Their knowledge improved markedly during their attendance to the oncology clinic. Screening methods such as breast self-examination (BSE were not used frequently. The majority of participants had delayed going to the hospital because of a lack of knowledge, fear of the diagnosis and fear of death, misinterpretation of the signs, the influence of lay beliefs and advice from the community. In some cases, however, advice from family and friends resulted in a timely medical consultation. The poor clinical practices of some healthworkers and the inadequate involvement by decision makers regarding the issue of cancer awareness discouraged patients from seeking and adhering to appropriate therapy.Conclusions: Awareness and knowledge of breast cancer was found to be poor amongst sufferers prior to their diagnosis, but their awareness and knowledge improved after the diagnosis. There was limited use of

  2. Organizational culture and the implementation of person centered care: results from a change process in Swedish hospital care.

    Science.gov (United States)

    Alharbi, Tariq Saleem J; Ekman, Inger; Olsson, Lars-Eric; Dudas, Kerstin; Carlström, Eric

    2012-12-01

    Sweden has one of the oldest, most coherent and stable healthcare systems in the world. The culture has been described as conservative, mechanistic and increasingly standardized. In order to provide a care adjusted to the patient, person centered care (PCC) has been developed and implemented into some parts of the health care industry. The model has proven to decrease patient uncertainty. However, the impact of PCC has been limited in some clinics and hospital wards. An assumption is that organizational culture has an impact on desired outcomes of PCC, such as patient uncertainty. Therefore, in this study we identify the impact of organizational culture on patient uncertainty in five hospital wards during the implementation of PCC. Data from 220 hospitalized patients who completed the uncertainty cardiovascular population scale (UCPS) and 117 nurses who completed the organizational values questionnaire (OVQ) were investigated with regression analysis. The results seemed to indicate that in hospitals where the culture promotes stability, control and goal setting, patient uncertainty is reduced. In contrast to previous studies suggesting that a culture of flexibility, cohesion and trust is positive, a culture of stability can better sustain a desired outcome of reform or implementation of new care models such as person centered care. It is essential for health managers to be aware of what characterizes their organizational culture before attempting to implement any sort of new healthcare model. The organizational values questionnaire has the potential to be used as a tool to aid health managers in reaching that understanding.

  3. Profile of cancer morbidity in North Bengal region of India: A hospital based study

    Directory of Open Access Journals (Sweden)

    Pal PP, Ghosh Naskar B, Sarkar TK, Haldar B, Sharma S, Aikat A, Ghosal GK

    2012-01-01

    Full Text Available Background: Cancer usually means malignancy, has become one of the ten leading cause of death in India. The leading sites of cancer vary from country to country. Present study was conducted to find out the proportion of morbidity contributed by different type of cancer in North Bengal region of India.Methods: An observational record based analysis in rural tertiary care hospital settings. Data was collected for the year 2007-8 on the basis of the patients’ record in the hospital. Different sites of cancer were classified according to the International Classification of Diseases (ICD-10, WHO.Results: The three leading sites of cancer irrespective of sex in this study were a lip, oral cavity and pharynx (C00-14 23.7%, b female genital organ (C51-59 22.7% and c digestive organ (C15-26 14.4%. Cervical cancer was the main contributor of the female genital organ cancer (70.2%. The trend of cervical carcinoma increases with Gravida (p<0.05. The most vulnerable age group was 40-64 years. It was also found that malignancy in a respiratory and intrathoracic organ b lip, oral cavity and pharynx and c digestive organ were more prevalent among smokers.Conclusions: The present study only highlights the status of different types of cancer in North Bengal Zone, which partly follows the rank wise cancer prevalence in India. It is a record based study however, an organized population based study can reflect the real scenario.

  4. Assessing Patient-Centered Communication in Cancer Care: Stakeholder Perspectives

    OpenAIRE

    Mazor, Kathleen M.; Gaglio, Bridget; Nekhlyudov, Larissa; Alexander, Gwen L.; Stark, Azadeh; Hornbrook, Mark C.; Walsh, Kathleen; Boggs, Jennifer; Lemay, Celeste A.; Firneno, Cassandra; Biggins, Colleen; Blosky, Mary Ann; Arora, Neeraj K.

    2013-01-01

    Patient reports of their communication experiences during cancer care could increase understanding of the communication process, stimulate improvements, inform interventions, and provide a basis for evaluating changes in communication practices.

  5. Variability in Criteria for Emergency Medical Services Routing of Acute Stroke Patients to Designated Stroke Center Hospitals

    Directory of Open Access Journals (Sweden)

    Nikolay Dimitrov

    2015-10-01

    Full Text Available Introduction: Comprehensive stroke systems of care include routing to the nearest designated stroke center hospital, bypassing non-designated hospitals. Routing protocols are implemented at the state or county level and vary in qualification criteria and determination of destination hospital. We surveyed all counties in the state of California for presence and characteristics of their prehospital stroke routing protocols. Methods: Each county’s local emergency medical services agency (LEMSA was queried for the presence of a stroke routing protocol. We reviewed these protocols for method of stroke identification and criteria for patient transport to a stroke center. Results: Thirty-three LEMSAs serve 58 counties in California with populations ranging from 1,175 to nearly 10 million. Fifteen LEMSAs (45% had stroke routing protocols, covering 23 counties (40% and 68% of the state population. Counties with protocols had higher population density (1,500 vs. 140 persons per square mile. In the six counties without designated stroke centers, patients meeting criteria were transported out of county. Stroke identification in the field was achieved using the Cincinnati Prehospital Stroke Screen in 72%, Los Angeles Prehospital Stroke Screen in 7% and a county-specific protocol in 22%. Conclusion: California EMS prehospital acute stroke routing protocols cover 68% of the state population and vary in characteristics including activation by symptom onset time and destination facility features, reflecting matching of system design to local geographic resources.

  6. Diversity and Adaptation of Human Respiratory Syncytial Virus Genotypes Circulating in Two Distinct Communities: Public Hospital and Day Care Center

    Directory of Open Access Journals (Sweden)

    Gustavo Rocha Garcia

    2012-10-01

    Full Text Available HRSV is one of the most important pathogens causing acute respiratory tract diseases as bronchiolitis and pneumonia among infants. HRSV was isolated from two distinct communities, a public day care center and a public hospital in São José do Rio Preto – SP, Brazil. We obtained partial sequences from G gene that were used on phylogenetic and selection pressure analysis. HRSV accounted for 29% of respiratory infections in hospitalized children and 7.7% in day care center children. On phylogenetic analysis of 60 HRSV strains, 48 (80% clustered within or adjacent to the GA1 genotype; GA5, NA1, NA2, BA-IV and SAB1 were also observed. SJRP GA1 strains presented variations among deduced amino acids composition and lost the potential O-glycosilation site at amino acid position 295, nevertheless this resulted in an insertion of two potential O-glycosilation sites at positions 296 and 297. Furthermore, a potential O-glycosilation site insertion, at position 293, was only observed for hospital strains. Using SLAC and MEME methods, only amino acid 274 was identified to be under positive selection. This is the first report on HRSV circulation and genotypes classification derived from a day care center community in Brazil.

  7. Meaning-Centered Psychotherapy: A Form of Psychotherapy for Patients With Cancer

    Science.gov (United States)

    Meier, Emily A.; Irwin, Scott A.

    2016-01-01

    Caring for patients with cancer involves addressing their myriad physical, psychological, social, and spiritual needs. Although many cancer treatments focus on physical or psychological needs, few treatments specifically target the basic need for meaning and spiritual well-being in this population. This article describes the creation and evolution of a new psychotherapy devoted to these needs, a therapy termed “meaning-centered psychotherapy.” In this article, a detailed description of meaning-centered psychotherapy is provided. An explanation of the current research findings related to this treatment are also offered, with information about the various group and individual treatments as well as the new expansions for use with cancer survivors or nursing staff. Overall, meaning-centered psychotherapy shows promise for enhancing meaning and spiritual well-being among patients with cancer and offers exciting possibilities for future research in other areas. PMID:25182513

  8. New organizational and funds flow models for an academic cancer center.

    Science.gov (United States)

    Spahlinger, David A; Pai, Chih-Wen; Waldinger, Marcy B; Billi, John E; Wicha, Max S

    2004-07-01

    The clinical impetus to develop cancer centers has been the recognition that many cancer patients require a comprehensive treatment plan coordinated across multiple specialties. Developing an effective organizational and financial structure among the multiple entities that comprise an academic cancer center has, however, been a challenge. The authors describe an effort to realize a sustainable clinical operation at the University of Michigan Comprehensive Cancer Center (UMCCC) by developing an appropriate management structure and financial model. The modified organizational structure established a clear line of administrative authority and held faculty members accountable for their effort in the UMCCC. A unified budget aligned financial incentive among all stakeholders to increase efficiency, revenue, and margin. The authors report preliminary financial evidence of the success of the new managerial structure.

  9. Expected relationship between a radiotherapy unit and other hospital services in cancer management

    International Nuclear Information System (INIS)

    Radiotherapy is a relatively new speciality in medical practice. It is however an important and rapidly growing modality of cancer treatment that should be developed in all countries regardless of their economic conditions. Differences in the size and functions of a radiotherapy unit may change from one country to the other. Nevertheless, in all situations radiotherapy should be considered an independent speciality with its special building, staff, equipment, budget and administration. On the other hand, it should be fully integrated with other national and hospital services in the field of cancer, and should have close associations with national and regional planning authorities specially those related to cancer central programmes, central cancer registries, the national atomic energy authorities and medical teaching, training and research programmes. A strong relationship should be developed with University and Teaching Hospitals, especially with diagnostic departments i.e. pathology, radiology and nuclear medicine and therapeutic departments such as surgery and medicine. Joint clinics and team work should be the guidelines of service. Also a close association should be built between the radiotherapy unit and district hospitals and primary health-care units for the purposes of early detection, patients' follow-up and rehabilitation. These relations may vary from one country to the other depending on various factors such as the size of the radiotherapy unit, the volume and nature of work and its status of autonomy. 6 refs, 3 tabs

  10. Transition from Hospital to Community Care: The Experience of Cancer Patients

    Directory of Open Access Journals (Sweden)

    Hanna Admi

    2015-12-01

    Full Text Available Purpose: This study examines care transition experiences of cancer patients and assesses barriers to effective transitions.Methods: Participants were adult Hebrew, Arabic, or Russian speaking oncology patients and health care providers from hospital and community settings. Qualitative (n=77 and quantitative (n=422 methods such as focus groups, interviews and self-administered questionnaires were used. Qualitative analysis showed that patients faced difficulties navigating a complex and fragmented healthcare system.Results: Mechanisms to overcome barriers included informal routes such as personal relationships, coordinating roles by nurse coordinators and the patients' general practitioners (GPs. The most significant variable was GPs involvement, which affected transition process quality as rated on the CTM (p<0.001. Our findings point to the important interpersonal role of oncology nurses to coordinate and facilitate the care transition process.Conclusion: Interventions targeted towards supporting the care transition process should emphasize ongoing counseling throughout a patient’s care, during and after hospitalization.-----------------------------------------Cite this article as:  Admi H, Muller E, Shadmi E. Transition from Hospital to Community Care: The Experience of Cancer Patients. Int J Cancer Ther Oncol 2015; 3(4:34011.[This abstract was presented at the BIT’s 8th Annual World Cancer Congress, which was held from May 15-17, 2015 in Beijing, China.

  11. Pain management of opioid-treated cancer patients in hospital settings in Denmark

    DEFF Research Database (Denmark)

    Lundorff, L.; Peuckmann, V.; Sjøgren, Per

    2008-01-01

    AIM: To evaluate the performance and quality of cancer pain management in hospital settings. METHODS: Anaesthesiologists specialised in pain and palliative medicine studied pain management in departments of oncology and surgery. Study days were randomly chosen and patients treated with oral opioids......-treated patients in hospital settings: however, focussing on average pain intensity, the outcome seems favourable compared with other countries. Pain mechanisms were seldom examined and adjuvant drugs were not specifically used for neuropathic pain. Opioid dosing intervals and supplemental opioid doses were most...

  12. Microscopically diagnosed head and neck cancers in the University Hospital, Kuala Lumpur.

    Science.gov (United States)

    Jayalakshmi, P; Pathmanathan, R; Raman, R; Prasad, U

    1989-03-01

    A retrospective study of 1000 cases of microscopically diagnosed head and neck cancers in the University Hospital, Kuala Lumpur was done. Head and neck neoplasms comprise 7.1% of all tumours diagnosed in this Hospital and the commonest sites of involvement are the nasopharynx (29.1%), cervical lymph nodes (22.6%), oral cavity (10.2%), thyroid (8.2%) and skin (6.5%). Histologically, 87% of tumours are epithelial in nature. The results of this study show that nasopharyngeal carcinoma is commonest in Chinese males, while oral and laryngeal malignancies occur more frequently in Indians.

  13. The role of university hospitals as centers of excellence for shared health-care-delivery of in- and outpatients

    International Nuclear Information System (INIS)

    Problem. Health care delivery in Germany has to face severe challenges that will lead to a closer integration of services for in- and out-patients. University hospitals play an important role due to their activities in research, education and health care delivery. They are requested to promote and evaluate new means and ways for health care delivery. Methods. The Institute of Clinical Radiology at the University Hospital of the Ludwig-Maximilians-University started teleradiological services for hospitals and general practices in January 1999 in the framework of the ''Imaging services - teleradiological center of excellence''. Legal, technical and organizational prerequisites were analyzed. Results. Networks between university hospitals and general practices are not likely to solve all future problems. They will, however, increase the availability of the knowledge of experts even in rural areas and contribute to a quality ensured health care at the patients home. Future developments may lead to international co-operations and such services may be available to patients abroad. Conclusion. Legal, technical and organizational obstacles have to be overcome to create a framework for high quality telemedical applications. University hospitals will play an important role in promoting and evaluating teleradiological services. (orig.)

  14. Detection of Cervical Cancer through Visual Inspection of Cervix with Acetic Acid (VIA) and Colposcopy at Mymensingh Medical College Hospital.

    Science.gov (United States)

    Rahman, M F; Akhter, S N; Alam, M J; Sarker, A S; Uddin, M J; Bashar, A; Banu, S

    2016-07-01

    Cervical cancer is the second most common cause of cancer related morbidity and mortality in women with 50% mortality rate. It is preventable if cervical cellular changes are detected and managed at early stage. This was a retrospective study conducted at VIA center of outpatient department and Colposcopy clinic at in-patient department of Mymensingh Medical College Hospital, Bangladesh covering a period from September 2013 to November 2014. Objective of this study was detection of cervical cancer and precancerous condition amongst patients reported to VIA center and Colposcopy clinic. In primary screening at VIA Center, total respondents were 3604, their mean age was 35.9 and highest were in the age group 31 to 40 years. At VIA center, 110(3.05%) were found positive and highest were between 31 to 40 years. In Colposcopy Clinic, out of 700 patients, 51.7% were CIN 1, 4.9% CIN 2, 1.4% CIN 3, invasive carcinoma was 0.3% and unsatisfactory or inconclusive were 34.3%. Most of the respondents were housewives and majority had poor monthly income. Amongst respondents, 72.1% were from rural area and Colposcopic findings revealed in 62.5% abnormal cervical changes, 46.5% were from rural area. Mean age at marriage or age at first coitus was found 16.25 years and 92.7% were in 11 to 20 years. Maximum abnormal cervical findings including CIN were between the ages ranged from 11 to 20 years of marriage age. In patients having 1 - 5 number of child having abnormal (58%) cervical changes, 48% were CIN 1. Histopathology reports found 19.6% CIN 1 (Total CIN 20.7%), cervical carcinoma 1.3%, inflammatory 7.0% and 0.42% cases were reported normal. Amongst 438 histopathology advised cases, 230 respondent's reports with patients were not available. VIA followed by Colposcopy has been a feasible, easy and reliable tools for screening cervical cancer in Bangladesh. PMID:27612882

  15. Level of awareness about breast cancer among females presenting to a general hospital in Pakistan

    International Nuclear Information System (INIS)

    Majority of the female patients in Pakistan with breast cancer present in advance stages, unawareness being a major factor. As surgery has a limited role in the later stages of breast cancer, the surgeons lose fight against this deadly disease before the fight has even begun, early detection of breast cancer in only possible if patients are made aware and are motivated to present early. A one-year study was carried out in Rawalpindi General Hospital to find out the level of awareness about breast cancer among females presenting to a public hospital. Among 400 patients with a breast problem 84 (21 %) had breast cancer of which 73.81% were in stage III and IV. Average time lapse was 16 months. The underlying cause of delay was ignorance. Six hundred females with no breast problem were also interviewed for their knowledge about breast cancer, 69.80% were totally ignorant, 18.40% were partly aware and only 11.80% were fully aware. 87.75% had no idea about breast self-examination, 68.2% did not understand the significance of a lump in the breast and its lethal potential. Unawareness was even prevalent among the highly educated and well to do (55%) as well as among all age groups although it was less than the illiterate (82%) and lowest income group (85%). The prime source of information were friends or relatives followed by the electronic and print media with health education playing a minor role. The level of awareness about breast cancer among Pakistani females in an urban setting was dismal and majority had a careless attitude towards seeking treatment. To ensure earlier detection of breast cancer there in a dire need of educating our female population about this deadly disease through the media and health care system in Pakistan. (author)

  16. Factors Associated With Waiting Time for Breast Cancer Treatment in a Teaching Hospital in Ghana.

    Science.gov (United States)

    Dedey, Florence; Wu, Lily; Ayettey, Hannah; Sanuade, Olutobi A; Akingbola, Titilola S; Hewlett, Sandra A; Tayo, Bamidele O; Cole, Helen V; de-Graft Aikins, Ama; Ogedegbe, Gbenga; Adanu, Richard

    2016-08-01

    Background Breast cancer is the leading cause of cancer-related mortality among women in Ghana. Data are limited on the predictors of poor outcomes in breast cancer patients in low-income countries; however, prolonged waiting time has been implicated. Among breast cancer patients who received treatment at Korle Bu Teaching Hospital, this study evaluated duration and factors that influenced waiting time from first presentation to start of definitive treatment. Method We conducted a hospital-based retrospective study of 205 breast cancer patients starting definitive treatment at Korle Bu Teaching Hospital between May and December 2013. We used descriptive statistics to summarize patient characteristics. Mann-Whitney U and Kruskal-Wallis tests and Spearman rank correlation were performed to examine the patients, health system, and health worker factors associated with median waiting time. Poisson regression was used to examine the determinants of waiting time. Results The mean age of the patients was 51.1 ± 11.8 years. The median waiting time was 5 weeks. The determinants of waiting time were level of education, age, income, marital status, ethnicity, disease stage, health insurance status, study sites, time interval between when biopsy was requested and when results were received and receipt of adequate information from health workers. Conclusion A prolonged waiting time to treatment occurs for breast cancer patients in Ghana, particularly for older patients, those with minimal or no education, with lower income, single patients, those with late disease, those who are insured, and who did not receive adequate information from the health workers. Time to obtain biopsy reports should be shortened. Patients and providers need education on timely treatment to improve prognosis. PMID:27091222

  17. Application of ambulatory surgery in breast cancer. Hospital 'V. I Lenin' 1996 - 2006

    International Nuclear Information System (INIS)

    Breast cancer ranks among the top in incidence and mortality from oncological diseases worldwide. In our country and our province behaves similarly, represents a major health problem. To compare the results of traditional outpatient surgery in patients diagnosed with breast cancer. Was performed a case-series study of patients operated for malignancy in breast oncology service at the 'Hospital Universitario V. I. Lenin'. It involved 1140 cases, including 260 by the traditional method and 880 (77.19%) for the outpatient method. Modified radical mastectomy was performed to 1010 patients and conservative surgery, 30 of them. The rate of complications present in the operated cases was not significant. (Author)

  18. Hourly rounding is key contributor to patient-centered care at high-performing hospitals.

    Science.gov (United States)

    2015-10-01

    According to new findings, hospitals with the highest HCAHPS scores suggest that hourly rounding on patients is one of the best ways to elevate the patient experience. In a survey of top-performing hospitals, 83% reported they employed the practice of regular nurse rounding on patients, and 62% employed leadership rounding. When rounding on patients, experts suggest nurses should always consider pain, the plan of care, and duration, or "PPD". PMID:26447259

  19. Changing trends of breast cancer awareness in young females of north India: A pilot study from a rural cancer hospital

    Directory of Open Access Journals (Sweden)

    Vivek Tiwari

    2014-01-01

    Full Text Available Aim: To assess the spectrum of presentation of young (18-35 years females to a rural cancer hospital and to correlate it with the level of education. Materials and Methods: Ninety cases of the selected age group were prospectively studied for the manner of presentation and level of education. Results: Majority patients (57.77% presented with breast related symptoms. 81.1% of the patients were educated at least up to secondary school education. Conclusions: Owing to the improved education levels and awareness, the young rural females are more informed about breast related symptoms and are seeking proper care for the same. A robust rural cancer registry system may document this changing scenario that may well contrast with the traditional beliefs and learning of cancer epidemiology.

  20. What Are Cancer Centers Advertising to the Public? A Content Analysis

    Science.gov (United States)

    Vater, Laura B.; Donohue, Julie M.; Arnold, Robert; White, Douglas B; Chu, Edward; Schenker, Yael

    2015-01-01

    Background Although critics have expressed concerns about cancer center advertising, the content of these advertisements has not been analyzed. Objective To characterize the informational and emotional content of cancer center advertisements. Design Systematic analysis of all cancer center advertisements in top U.S. consumer magazines (N=269) and television networks (N=44) in 2012. Measurements Using a standardized codebook, we assessed (1) types of clinical services promoted; (2) information provided about clinical services, including risks, benefits, and costs; (3) use of emotional advertising appeals; and (4) use of patient testimonials. Two investigators independently coded advertisements using ATLAS.ti. Kappa values ranged from 0.77 to 1.0. Results A total of 102 cancer centers placed 409 unique clinical advertisements in top media markets in 2012. Advertisements promoted treatments (88%) more often than screening (18%) or supportive services (13%; pBenefits of advertised therapies were described more often than risks (27% vs. 2%; padvertisements mentioned insurance coverage or costs (5%). Emotional appeals were frequent (85%), most often evoking hope for survival (61%), describing cancer treatment as a fight or battle (41%), and evoking fear (30%). Nearly half of advertisements included patient testimonials, usually focused on survival or cure. Testimonials rarely included disclaimers (15%) and never described the results a typical patient might expect. Limitations Internet advertisements were not included. Conclusions Clinical advertisements by cancer centers frequently promote cancer therapy using emotional appeals that evoke hope and fear while rarely providing information about risks, benefits, or costs. Further work is needed to understand how these advertisements influence patient understanding and expectations of benefit from cancer treatments. PMID:24863081

  1. The characteristics of advanced cancer patients followed at home, but admitted to the hospital for the last days of life.

    Science.gov (United States)

    Mercadante, Sebastiano; Masedu, Francesco; Valenti, Marco; Mercadante, Alessandro; Aielli, Federica

    2016-08-01

    Information regarding advanced cancer patients followed at home who are admitted to the hospital in the last days of life are lacking. The aim of this study was to assess the characteristics of patients who were hospitalized in the last days of life after being assisted by a home palliative care team. The secondary outcome was to identify possible risk factors for hospitalization. The charts were analyzed of a consecutive sample of advanced cancer patients admitted to hospital wards in the last days of life after being followed at home by a palliative care team. Of 550 consecutive patients followed at home, 138 (25.1 %) were admitted to the hospital. Younger patients were more likely to die in the hospital. In a logistic risk analysis adjusted for age, patients with lung and head-neck cancer were more likely to die in the hospital. Patients having a female relative or a female consort as a caregiver were more likely to die at home. CAGE-positive patients (7.25 %), and patients with a shorter period of home assistance were more likely transported to hospital before dying (p = 0.00 and p risk factors of hospitalization at the end of life for advanced cancer patients followed at home. PMID:26895033

  2. Palliative care in advanced cancer patients in a tertiary care hospital in Uttarakhand

    Directory of Open Access Journals (Sweden)

    Manisha Bisht

    2008-01-01

    Full Text Available Aim: Advanced cancer, irrespective of the site of the cancer, is characterized by a number of associated symptoms that impair the quality of life of patients. The management of these symptoms guides palliative care. The present study aims to describe the symptoms and appropriate palliation provided in patients with advanced cancer in a tertiary care hospital in Uttarakhand. Methods: This was an observational study. A total of 100 patients with advanced cancer were included in the study. The data obtained from the patients included symptoms reported by the patients, currently prescribed treatments and the site of cancer. Results: The average number of symptoms reported per patient was 5.33 ± 0.67 (mean ± SE. The most common symptoms were pain, weakness/fatigue, anorexia, insomnia, nausea/vomiting, dyspnea, constipation and cough. Polypharmacy was frequent. Patients consumed approximately 8.7 ± 0.38 (mean ± SE drugs on average during the 2-month period of follow-up. Conclusion: The result gives insight into the varied symptomatology of patients with advanced cancer. Polypharmacy was quite common in patients with advanced cancer, predisposing them to complicated drug interactions and adverse drug reactions.

  3. Music therapy as part of the alternative-complementary therapy in cancer patients in hospital

    Directory of Open Access Journals (Sweden)

    Efstratios Athanassakis

    2012-01-01

    Full Text Available Cancer is one of the modern health problems of people living in developed countries. Furthermore, therapeutic approaches to cancer patients is constantly updated with new data. Aim: The aim of the present study was to review the international literature referred to the application of music therapy in the treatment for pediatric and adult patients with cancer. Method and materials: The method of this study included bibliography research from both the review and the research literature on MEDLINE (2000-2010 database and using as key words music, music therapy, alternative-complementary therapy, cancer, children. Results: Music therapy, the last few years, seems to be one of the forms of alternative-complementary therapy for patients treated for cancer. Music therapy is applied as part of complementary therapy in pediatric and adult patients with cancer. Complementary-alternative methods are non-invasive, non-toxic, cheap, safe and can be easily used by the patients themselves. Primarily, the music therapy aimed to the reduction of the emotional trauma and the feeling of the pain during the process of the treatment (radiotherapy, chemotherapy, other painful procedures but also in the whole patients life. Conclusions: Scientific bibliographic databases research concerning the music therapy in patients with cancer seem encouraging, especially in children. Nevertheless, the further study of the role of the music during hospitalization in the outcome of the treatment is essential

  4. Outcome of combined modality treatment including neoadjuvant chemotherapy of 128 cases of locally advanced breast cancer: Data from a tertiary cancer center in northern India

    Directory of Open Access Journals (Sweden)

    V Raina

    2011-01-01

    Full Text Available Background: Breast cancer is now the most common cancer in many parts of India and the incidence varies from 12 to 31/100000, and is rising. Locally advanced breast cancer (LABC accounts for 30 - 35% of all cases of breast cancers in India. LABC continues to present a challenge and imposes a major health impact in our country. Materials and Methods: We carried out a analysis of our LABC patients who received neoadjuvant chemotherapy (NACT at our hospital over a 10-year period, from January 1995 to December 2004. We analyzed the response to NACT, disease-free survival (DFS, and overall survival (OS. Results: Patients with stages IIIA, IIIB, and IIIC were included. LABC comprised of 26.24% (609 patients of new patients. One hundred and twenty-eight (31.1% patients received NACT. Median age was 48 years and estrogen receptor was positive in 64%. Chemotherapy protocol was an FEC (5-Fluorouracil, Epirubicin, Cyclophosphamide regimen in the following doses: Cyclophosphamide 600 mg/m2, 5-FU 600 mg/m2, and Epirubicin 75 mg/m2 given every three weeks, six doses, followed by modified radical mastectomy (MRM and locoregional radiotherapy. The overall response rate (complete response (CR + partial response (PR was 84.4%, clinical CR (cCR was 13.3% and pathological CR (pCR was 7.8%. Median DFS and OS were 33 and 101 months, respectively. The disease-free survival (DFS and overall survival (OS at five years were 41 and 58%, respectively. Conclusions: This study analyzes the outcome in patients who received NACT, in the largest number of LABC patients from a single center in India, and our results are comparable to the results reported from other centers.

  5. International benchmarking of specialty hospitals. A series of case studies on comprehensive cancer centres

    Directory of Open Access Journals (Sweden)

    van Lent Wineke AM

    2010-08-01

    Full Text Available Abstract Background Benchmarking is one of the methods used in business that is applied to hospitals to improve the management of their operations. International comparison between hospitals can explain performance differences. As there is a trend towards specialization of hospitals, this study examines the benchmarking process and the success factors of benchmarking in international specialized cancer centres. Methods Three independent international benchmarking studies on operations management in cancer centres were conducted. The first study included three comprehensive cancer centres (CCC, three chemotherapy day units (CDU were involved in the second study and four radiotherapy departments were included in the final study. Per multiple case study a research protocol was used to structure the benchmarking process. After reviewing the multiple case studies, the resulting description was used to study the research objectives. Results We adapted and evaluated existing benchmarking processes through formalizing stakeholder involvement and verifying the comparability of the partners. We also devised a framework to structure the indicators to produce a coherent indicator set and better improvement suggestions. Evaluating the feasibility of benchmarking as a tool to improve hospital processes led to mixed results. Case study 1 resulted in general recommendations for the organizations involved. In case study 2, the combination of benchmarking and lean management led in one CDU to a 24% increase in bed utilization and a 12% increase in productivity. Three radiotherapy departments of case study 3, were considering implementing the recommendations. Additionally, success factors, such as a well-defined and small project scope, partner selection based on clear criteria, stakeholder involvement, simple and well-structured indicators, analysis of both the process and its results and, adapt the identified better working methods to the own setting, were found

  6. Methicillin-resistant Staphylococcus sp. colonizing health care workers of a cancer hospital

    OpenAIRE

    Dayane de Melo Costa; André Kipnis; Lara Stefânia Netto de Oliveira Leão-Vasconcelos; Larissa Oliveira Rocha-Vilefort; Sheila Araújo Telles; Maria Cláudia Dantas Porfírio Borges André; Anaclara Ferreira Veiga Tipple; Ana Beatriz Mori Lima; Nádia Ferreira Gonçalves Ribeiro; Mayara Regina Pereira; Marinésia Aparecida Prado-Palos

    2014-01-01

    The aim of the study was to analyze epidemiological and microbiological aspects of oral colonization by methicillin-resistant Staphylococcus of health care workers in a cancer hospital. Interview and saliva sampling were performed with 149 health care workers. Antimicrobial resistance was determined by disk diffusion and minimum inhibitory concentration. Polymerase Chain Reaction, Internal Transcribed Spacer-Polymerase Chain Reaction and Pulsed Field Gel Electrophoresis were performed for gen...

  7. Some radiation protection problems in a cancer hospital and associated research institute

    International Nuclear Information System (INIS)

    Experience gained at the Royal Marsden Hospital and Institute of Cancer Research has shown that with attention to the design of facilities and procedures and an active personnel monitoring policy, relatively large scale radiation commitments can proceed with individual whole body doses to staff being held well below 15 mSv/annum. In spite of detailed attention to control of radiation work, traumatic radiation incidents may still occur. (H.K.)

  8. Orbital Metastases from Breast Cancer: Retrospective Analysis at an Academic Cancer Center.

    Science.gov (United States)

    Pierson, Tiffany M; Tebit, Emaculate V; El Sayed, Ali; Smolkin, Mark E; Dillon, Patrick M

    2016-07-01

    Orbital metastases from breast cancer (BC) are rare, but often debilitating. BC accounts for nearly half of metastases to the orbit. Orbital metastases may be discovered years after the initial diagnosis of BC, and are rare at initial presentation. A search of the institutional data base at an academic cancer center identified BC patients who developed or presented with orbital metastases from 2000 to 2013. Baseline characteristics, treatment modalities, survival and treatment responses were collected from the electronic medical record. There were 20 patients identified with orbital metastases (0.7% of all BC cases). The median age at diagnosis of BC was 49 years; 80% had estrogen positive disease. The interval between the initial diagnosis of BC and the presentation of orbital metastases was 8.5 years (0-19 years). Orbital disease was the initial presentation of BC in two cases. Three patients developed bilateral orbital metastases and seven had accompanying brain metastases. The most common presentation was decreased vision (55%), followed by diplopia (25%). The median survival after orbital metastases was 24 months. Thirteen patients (65%) received local radiation therapy. Of those radiated, 90% reported improvement of orbital symptoms. Other treatments included intraocular bevacizumab, surgery, and systemic therapy. Orbital metastases tend to occur in estrogen receptor positive disease and are often found years after BC onset. Orbital metastases may be associated with the development of brain metastases. Radiotherapy is the preferred local therapy and had high symptom control in this cohort. Oncologists should be aware of the signs of orbital metastases and the treatment options. PMID:27143519

  9. Malnourishment and length of hospital stay among paediatric cancer patients with febrile neutropaenia

    DEFF Research Database (Denmark)

    Conner, J Michael; Aviles-Robles, Martha J; Asdahl, Peter H;

    2016-01-01

    . The median length of hospital stay for malnourished patients was 15 days, which corresponded with a 50% (TR=1.5, 95% CL 1.0, 2.3) relative increase in length of stay compared with patients who were not malnourished. Patients with body mass indices equal to the mean of the world reference population had...... in Mexico City, and assess the association between malnourishment and length of hospital stay. METHODS: Individuals eligible for this study were paediatric cancer patients (aged Hospital Infantil de Mexico Federico Gomez (Mexico City) with febrile neutropaenia. Our exposure...... of interest, malnourishment, was defined as an age-adjusted and sex-adjusted z-scorehospital stay. RESULTS: Our study...

  10. 78 FR 22794 - World Trade Center Health Program; Certification of Breast Cancer in WTC Responders and Survivors...

    Science.gov (United States)

    2013-04-17

    ... linked total and congener-specific PCB levels in serum and adipose tissue with breast cancer, although... Federal Register adding certain types of cancer to the List of World Trade Center (WTC)-Related Health..., and provide advice on whether to add cancer, or a certain type of cancer, to the List specified in...

  11. Survey of the Information-Seeking Behaviour of Hospital Professionals at a Public Cancer Hospital in Greece Proves the Value of Hospital Libraries. A Review of: Kostagiolas, P. A., Ziavrou, K., Alexias, G., & Niakas, D. (2012. Studying the information-seeking behavior of hospital professionals: The case of METAXA Cancer Hospital in Greece. Journal of Hospital Librarianship, 12(1, 33-45.

    Directory of Open Access Journals (Sweden)

    Antonio DeRosa

    2013-06-01

    Full Text Available Objective – To study the information-seeking practices of hospital staff and weigh the impact of hospital libraries on effective information-seeking.Design – Survey questionnaire.Setting – Large public cancer hospital in Greece.Subjects – The authors surveyed 49 physicians, 43 nursing staff members, 25 administrative staff members, 23 paramedical staff members, and 5 technical staff members, totaling 145 health professionals.Methods – Participants were given a questionnaire comprised of five parts: general information (including gender, age, education, position, and professional experience; questions on computer and Internet accessibility; questions regarding individual information needs; questions on information-seeking obstacles; and a question regarding the satisfaction with the current degree of information availability in the hospital. The last question was ranked using a 5-point Likert scale. Each questionnaire was distributed with a cover letter explaining the anonymity and consent of the respondent. Hospital members were randomly selected using a number generator and respondents returned completed surveys to the hospital personnel office in a sealed envelope within a specified time frame. The sampled group was representative of the overall population of the hospital.Main Results – The authors discuss demographic data of respondents: 65.7% were women; 56.7% were over 40 years old; 29.0% were graduates of higher technological institutes; 28.3% were university graduates; 9.7% held a postgraduate degree; 8.3% had a PhD; and 1.4% had only secondary education. As for the remainder of the survey questions: 64% of respondents had access to the Internet both at home and at work, while only 8.2% had no access to the Internet at all; most respondents noted using the Internet for seeking scientific information (83.0% and e-mail communication (65.3%; the main obstacle respondents noted experiencing when seeking information was the lack of

  12. Epidemiological Aspects of Head and Neck Cancers Based on Radiotherapy Registry in Hospital of Hasanuddin University South of Sulawesi Indonesia

    OpenAIRE

    A. St. Asmidar Anas; Bachtiar Murtala; Sri Oktawati; Harlina Ilmar

    2016-01-01

    The aim of this retrospective study was to identify epidemiological aspect of head and neck cancer defined as reported from a hospital-based radiotherapy registry in Hospital of Hasanuddin University South of Sulawesi Indonesia. The data were collected from medical records patient who treated with radiation therapy in a period of 2014-2015 with a view toward analyzing the sex, age, and site of cancers. Results described that a total of 187 cases were collected during the study period. The mea...

  13. [Operational Management of Multidisciplinary Organ-Based Tumor Units in Our Cancer Center].

    Science.gov (United States)

    Kato, Hiroaki; Tsujie, Masanori; Ichimura, Noriko; Yukawa, Masao; Inoue, Masatoshi

    2016-05-01

    Owing to the advances in diagnosis and treatment, it is imperative to develop a multidisciplinary approach for the management of cancer patients. In our cancer center, multidisciplinary organ-based tumor units have been organized for team medical care. These units consist of cancer specialists from multiple departments including medical oncology, surgery, radiology, histopathology, and nursing. Members of each unit regularly conduct meetings to discuss diagnostic and therapeutic aspects, as well as to report the progress of cancer patients. Co-operation with the counseling and support center, utilization of the computerized medical record system, and using brochures for advertisement, all play important roles in adequate management of multidisciplinary organ-based tumor units. PMID:27210090

  14. STUDY ON SOLID WASTE COLLECTION AND DISPOSAL IN HOSPITALS AND HEALTA CARE CENTERS OF TEHRAN PROVINCE

    OpenAIRE

    Omrani, A.; K. Imandel; H Karimzadegan

    1998-01-01

    The main objective of this investigation was to achieve a clear pattern of solid waste collection and disposal in selected hospital and health care establishments in certain cities of Tehran province. This study was done in more than 82 percent of all hospitals with 3017 beds during the year 1996. Solid waste produced per bed was evaluated to be 2.87 kg per day which was 8670 kg per day, for all beds, comprising less than 1% of the total solid waste generated in the same cities during the sam...

  15. Preferences and Barriers to Care Following Psychiatric Hospitalization at Two Veterans Affairs Medical Centers: A Mixed Methods Study.

    Science.gov (United States)

    Pfeiffer, Paul N; Bowersox, Nicholas; Birgenheir, Denis; Burgess, Jennifer; Forman, Jane; Valenstein, Marcia

    2016-01-01

    Patient preferences and barriers to care may impact receipt of adequate mental health treatment following psychiatric hospitalization and could inform quality improvement initiatives. This study assessed preferences for a broad range of post-hospital services and barriers to counseling by surveying 291 patients and interviewing 25 patients who had recently been discharged from an inpatient psychiatric stay at one of the two Veterans Affairs Medical Centers. Individual counseling was the most frequently reported service that survey respondents preferred, but did not receive; whereas, open-ended survey responses and interviews also identified telephone follow-up "check-in" calls as a frequently preferred service. Difficulty with transportation was the most commonly cited barrier to counseling among survey respondents and in interviews; however, patients strongly preferred in-person counseling to telephone or internet-video alternatives. Increasing support from family and support from an individual Veteran peer were also perceived to be helpful in the majority of survey respondents. PMID:25779387

  16. Evaluation and Treatment of Colorectal Cancer in Shahid Rahnemoon and Afshar Hospitals, Yazd-Iran

    Directory of Open Access Journals (Sweden)

    HR Dehghan

    2007-12-01

    Full Text Available Introduction: Colorectal cancer is the most common cancer of the alimentary system. In women, it is the second leading cause of mortality after breast cancer while in men, it is the third leading cause of death after lung and prostate carcinoma. Prevalence is more in population older than 50 years and increases in older people. Therefore, best treatment and prognosis is early diagnosis of disease. Methods: This study was a retrospective, cross-sectional study that included files of 191 patients of Shahid Rahnemoon and Afshar hospitals (two main hospitals in Yazd, Iran from 1992 till 1999. The aim was to evaluate the abundance and distribution of colorectal cancer with respect to staging, age, occupation, residence, clinical signs and method of treatment. All of the patients had a cancer pathology report. Results: Of the total of 191 patients with colorectal cancer, 186 cases were adenocarcinoma and 5 cases were lymphoma. Prevalence rate in men was more than women and their age range was between 28 and 94 years. 127 patients (67% were in the 60 – 69 years age group , while 7.3% were in the 20 -39 years age group. 106 patients (55.5% were men and 85 patients (44.5% were women. 64.9% were urban dwellers and 35.1% were rural. Surgical treatment included; abdominoperinneal resection (A.P.R in 55 patients (28.8%, anterior resection (A.R and anastomosis in 40 patients (20.9%, right and left hemicolectomy, each in 25 patients and rectosigmoiedectomy and anastomosis in 18 patients(19.4%. Results of treatment were as follows:177 patients (92.76% had relative recovery post operation, 5 cases (2.6% were discharged from the hospital against medical advice, 3 cases (1.6% died and 6 cases (3.1% were discharged with poor condition after laparotomy. Conclusion: Most of the patients with colorectal cancer referred with rectorrhagia, main type of cancer was adenocarcinoma (97.4% and the most frequent surgical procedure performed was A.P.R. Further research

  17. Cardiorespiratory fitness and digestive cancer mortality: findings from the Aerobics Center Longitudinal Study (ACLS)

    OpenAIRE

    Peel, J. Brent; Sui, Xuemei; Matthews, Charles E.; Adams, Swann A; Hébert, James R; Hardin, James W.; Timothy S Church; Blair, Steven N.

    2009-01-01

    Although higher levels of physical activity are inversely associated with risk of colon cancer, few prospective studies have evaluated overall digestive system cancer mortality in relation to cardiorespiratory fitness (CRF). The authors examined this association among 38,801 men aged 20−88 years and who performed a maximal treadmill exercise test at baseline in the Aerobics Center Longitudinal Study (Dallas, Texas) during 1974−2003. Mortality was assessed over 29 years of follow-up (1974−2003...

  18. Dying in Palliative Care Units and in Hospital: A Comparison of the Quality of Life of Terminal Cancer Patients.

    Science.gov (United States)

    Viney, Linda L.; And Others

    1994-01-01

    Compared quality of life of terminal cancer patients (n=182) in two palliative care units with that of those in general hospital. Patients in specialized palliative care units were found to differ from those dying in hospital, showing less indirectly expressed anger but more positive feelings. They also reported more anxiety about death but less…

  19. Research for Hospital Data Center Construction%医院数据中心建设研究

    Institute of Scientific and Technical Information of China (English)

    白国刚; 杨宏桥

    2012-01-01

    为了充分利用医院数据信息资源,挖掘出对医院管理有用的模型、规律和知识,本文就医院数据中心建设进行研究,运用商业智能技术建设医院数据中心.通过数据仓库(DataWarehouse,DW)、数据萃取、转换、载入(Extraction-Transformation-Loading,ETL)工具、联机分析处理(Online Analytical Process,OLAP)和数据的多维度分析与展现技术,形成统一的数据视图和综合决策分析支持系统,并以此为基础,结合医院的战略管理和业务运营,对医疗数据资源进行充分的应用、分析与挖掘.%In order to make full use of hospital information resources, explore a useful model, rule and knowledge for hospital management, this paper researched the construction of hospital data center, and built hospital data center with business intelligence. By using technology of data warehouse, Extraction-Transformation-Loading, Online Analytical Process, Data Multi-dimensional Analysis and display technology, we have realized uniform data views and decision support system, then together with strategy management and business operations, make full application, analysis and mining of the medical data resources.

  20. CLINICAL STUDY ON PA NCREATIC CANCER IN G OVERNMENT GENERAL HOSPITAL, GU NTUR, AP, INDIA

    Directory of Open Access Journals (Sweden)

    Ch. Kalyan

    2015-03-01

    Full Text Available Pancreatic cancer has a lower incidence than many other types of cancer, but is the fourth most common cause of death from cancer, among men and women, being responsible for 6% of all cancer - related deaths. The global annual incidence rate for pancreas cancer is about 8/100,000 persons. Pancreatic cancer disease is notoriously difficult to diagnose in its early stages. Study was carried out in the Department of General Surgery, Government General Hospital, Guntur from October 2010 to 2012, in which 16 cases with a diagnosis of carcinoma pancreas. They were investigated with routine blood investigations. They were treated accordingly with Pylorus preserving pancreaticodenectomy (PPPD or palliative bypass or with non - operative palliative measures. Carcinoma pancreas is an aggressive disease with male preponderance with peak incidence in 5th and 6th decade. Important risk factors are Smoking and alcohol consumption. Nearly 75% of the cases presented in the late stage of the disease. Resection of the tumour had better survival. The limitations of our study are small number of patients and short follow - up

  1. Risk for Hospitalization With Depression After a Cancer Diagnosis: A Nationwide, Population-Based Study of Cancer Patients in Denmark From 1973 to 2003

    DEFF Research Database (Denmark)

    Dalton, S.O.; Laursen, T.M.; Nylandsted, Lone Ross;

    2009-01-01

    Purpose As more people survive cancer, it is necessary to understand the long-term impact of cancer. We investigated whether cancer survivors are at increased risk for hospitalization for depression. Methods We linked data on all 5,703,754 persons living in Denmark on January 1, 1973, or born the...... treatment are needed to prevent admission of cancer survivors for depression Udgivelsesdato: 2009/3/20......Purpose As more people survive cancer, it is necessary to understand the long-term impact of cancer. We investigated whether cancer survivors are at increased risk for hospitalization for depression. Methods We linked data on all 5,703,754 persons living in Denmark on January 1, 1973, or born...... thereafter to the Danish Cancer Registry and identified 608,591 adults with a diagnosis of cancer. Follow-up for hospitalization for depression in the Danish Psychiatric Central Register from 1973 through 2003 yielded 121,227,396 person-years and 121,304 hospitalizations for depression. The relative risk (RR...

  2. [Evolution of the hospital pharmacies in public and private hospitals in the cancer network in Lorraine: Oncolor].

    Science.gov (United States)

    May, I; Paulus, C; Vigneron, J; Watelet, M; Veyrier, B; Bichet, F; Bideaux, S; Bey, P

    2001-04-01

    With the objective of improvement of quality in oncology, an assessment of chemotherapy practice in hospital pharmacies in public and private hospitals was carried out by the regional committee of oncology in Lorraine. The 36 hospitals reporting using chemotherapy, had varied practices. The results of this survey lead to the elaboration of guideline for hospital pharmacies in the oncology regional network Oncolor. This paper describes the different aspects of the hospital pharmacies in public and private hospitals included in the network Oncolor from 1996 to 2000. In 1996, 9 hospital pharmacies had centralized preparation for chemotherapy, whereas at the end of 2000, 26 pharmacies on 28 will fulfill the guidelines. PMID:11371380

  3. Hospitals - MO 2009 Federally Qualified Health Center(FQHC)Locations (SHP)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — Location of FQHC (federally qualified health center) in Missouri. Data will not be made available for download. Interested parties should send an email inquiry to...

  4. STUDY ON SOLID WASTE COLLECTION AND DISPOSAL IN HOSPITALS AND HEALTA CARE CENTERS OF TEHRAN PROVINCE

    Directory of Open Access Journals (Sweden)

    A. Omrani

    1998-10-01

    Full Text Available The main objective of this investigation was to achieve a clear pattern of solid waste collection and disposal in selected hospital and health care establishments in certain cities of Tehran province. This study was done in more than 82 percent of all hospitals with 3017 beds during the year 1996. Solid waste produced per bed was evaluated to be 2.87 kg per day which was 8670 kg per day, for all beds, comprising less than 1% of the total solid waste generated in the same cities during the same period. According to the information gathered in the 84.2% hospitals and health care centres, solid wastes were collected manually by labourers from various sections. Detention time of the waste in 89.5% of the cases was nearly 24 h. Densities of this type of waste were estimated to be 193.18kg/m3 with plastic bag and 247.72 kg/m3 without bag. Physical analysis of the wastes indicated 15.1% plastic and rubbery, 9.6% linen, 12.45% paper and cardboard, 8.5% various types of metals, 1.7% glass and 52.4% other different materials. In Iran, hospital administrations are directly responsible for collection transport and ultimate disposal of hospital wastes. Incinerators installed in 21.1% of the clinical centres, were not operating at all. Overall conclusion is that, solid wastes collection transportation and disposal in Tehran district is not satisfactory, according to the health and management criteria.

  5. Motorcycle-related hospitalization of adolescents in a Level I trauma center in southern Taiwan: a cross-sectional study

    OpenAIRE

    Liang, Chi-Cheng; Liu, Hang-Tsung; Rau, Cheng-Shyuan; Hsu, Shiun-Yuan; Hsieh, Hsiao-Yun; Hsieh, Ching-Hua

    2015-01-01

    Background The aim of this study was to investigate and compare the injury pattern, mechanisms, severity, and mortality of adolescents and adults hospitalized for treatment of trauma following motorcycle accidents in a Level I trauma center. Methods Detailed data regarding patients aged 13–19 years (adolescents) and aged 30–50 years (adults) who had sustained trauma due to a motorcycle accident were retrieved from the Trauma Registry System between January 1, 2009 and December 31, 2012. The P...

  6. 78 FR 55671 - Hospital Care and Medical Services for Camp Lejeune Veterans

    Science.gov (United States)

    2013-09-11

    ... studies conducted by the Centers for Disease Control's Agency for Toxic Substance and Disease Registry... hospital care and medical services. As discussed in a separate notice (78 FR 39832, July 2, 2013), we are...) Esophageal cancer; (B) Lung cancer; (C) Breast cancer; (D) Bladder cancer; (E) Kidney cancer; (F)...

  7. Cancer patients’ use of pharmaceutical patient assistance programs in the outpatient pharmacy at a large tertiary cancer center

    Science.gov (United States)

    Felder, Tisha M.; Lal, Lincy S.; Bennett, Charles L.; Hung, Frank; Franzini, Luisa

    2011-01-01

    Purpose To report on the use of pharmaceutical patient assistance programs (PAPs) in the outpatient pharmacy at the largest tertiary cancer center in the United States. Methods We conducted a retrospective (July 1, 2006–Dec 31,2007) cross-sectional analysis of outpatient pharmacy, medical, and cancer registry records at the cancer center. The cancer center identified 104 medications available through PAPs. Study-eligible patients received at least one of these medications, either as a PAP case patient or as a PAP control non-user. Binary logit regression models predicted PAP use, and descriptive statistics compared PAP user and non-user medication fills. Results Of 25,552 cancer patients at who received an outpatient medication during the study period, 1,929 met study criteria (n=950 PAP users, 979 PAP non-users). In comparison to controls, PAP users were more likely to be uninsured (odds ratio (OR)=4.60, 95% confidence interval (CI): 2.118, 9.970), indigent (OR=16.95, 95% CI: 6.845, 41.960), and < 65 years old (OR=2.31, 95% CI: 1.517, 3.509). Of the most frequently dispensed medications to PAP users from PAPs (n=5,271), 88% (n=4,936) were for supportive care (e.g., nausea/vomiting). PAPs provided 35% (n=842) of the most common anticancer agents administered to PAP users (n=1,296), accounting for a monthly mean of $55,000 in pharmaceutical expenditures. Conclusions In the cancer center’s outpatient pharmacy, PAPs provided financial support for about a third of the most commonly used therapies, primarily for supportive care indications, for a small percentage of eligible cancer patients. PMID:22879815

  8. Statistical Machines for Trauma Hospital Outcomes Research: Application to the PRospective, Observational, Multi-Center Major Trauma Transfusion (PROMMTT Study.

    Directory of Open Access Journals (Sweden)

    Sara E Moore

    Full Text Available Improving the treatment of trauma, a leading cause of death worldwide, is of great clinical and public health interest. This analysis introduces flexible statistical methods for estimating center-level effects on individual outcomes in the context of highly variable patient populations, such as those of the PRospective, Observational, Multi-center Major Trauma Transfusion study. Ten US level I trauma centers enrolled a total of 1,245 trauma patients who survived at least 30 minutes after admission and received at least one unit of red blood cells. Outcomes included death, multiple organ failure, substantial bleeding, and transfusion of blood products. The centers involved were classified as either large or small-volume based on the number of massive transfusion patients enrolled during the study period. We focused on estimation of parameters inspired by causal inference, specifically estimated impacts on patient outcomes related to the volume of the trauma hospital that treated them. We defined this association as the change in mean outcomes of interest that would be observed if, contrary to fact, subjects from large-volume sites were treated at small-volume sites (the effect of treatment among the treated. We estimated this parameter using three different methods, some of which use data-adaptive machine learning tools to derive the outcome models, minimizing residual confounding by reducing model misspecification. Differences between unadjusted and adjusted estimators sometimes differed dramatically, demonstrating the need to account for differences in patient characteristics in clinic comparisons. In addition, the estimators based on robust adjustment methods showed potential impacts of hospital volume. For instance, we estimated a survival benefit for patients who were treated at large-volume sites, which was not apparent in simpler, unadjusted comparisons. By removing arbitrary modeling decisions from the estimation process and concentrating

  9. Triple-Negative Breast Cancer in Ghanaian Women: The Korle Bu Teaching Hospital Experience.

    Science.gov (United States)

    Der, Edmund M; Gyasi, Richard K; Tettey, Yao; Edusei, Lawrence; Bayor, Marcel T; Jiagge, Evelyn; Gyakobo, Mawuli; Merajver, Sofia D; Newman, Lisa A

    2015-01-01

    Breast cancers that have negative or extremely low expression of estrogen receptor and progesterone receptor and non-amplification of human epidermal growth factor receptor-2 (HER2)/neu are termed triple-negative breast cancer (TNBC). The majority of TNBC tumors belong to the biologically aggressive basal subtype, and they cannot be managed with targeted endocrine or anti-HER2/neu agents. In western, high resource environments, risk factors for TNBC include younger age at diagnosis and hereditary susceptibility. Women of African ancestry in the United States and in continental Africa have higher frequencies of TNBC, prompting speculation that this risk may have an inherited basis and may at least partially explain breast cancer survival disparities related to racial/ethnic identity. Efforts to document and confirm the breast cancer burden of continental Africa have been hampered by the limited availability of registry and immunohistochemistry resources. Our goal was to evaluate the breast cancers diagnosed in one of the largest health care facilities in western Africa, and to compare the frequencies as well as risk factors for TNBC versus non-TNBC in this large referral tertiary hospital. The Korle Bu Teaching Hospital is affiliated with the University of Ghana and is located in Accra, the capital of Ghana. We conducted an institutional, Department of Pathology-based review of the breast cancer cases seen at this facility for the 2010 calendar year, and for which histopathologic specimens were available. The overall study population of 223 breast cancer cases had a median age of 52.4 years, and most had palpable tumors larger than 5 cm in diameter. More than half were TNBC (130; 58.3%). We observed similar age-specific frequencies, distribution of stage at diagnosis and tumor grade among cases of TNBC compared to cases of non-TNBC. Ghanaian breast cancer patients tend to have an advanced stage distribution and relatively younger age at diagnosis compared to

  10. Objective allergy markers and risk of cancer mortality and hospitalization in a large population-based cohort

    NARCIS (Netherlands)

    Taghizadeh, Niloofar; Vonk, Judith M; Hospers, Jeannette J; Postma, Dirkje S; de Vries, Elisabeth G. E.; Schouten, Jan P; Boezen, H Marike

    2015-01-01

    PURPOSE: There are indications that a history of allergy may offer some protection against cancer. We studied the relation of three objectively determined allergy markers with cancer mortality and hospitalization risk. METHODS: Associations between three allergy markers (number of peripheral blood e

  11. Retrospective Analysis of Cancer with Behcets Disease: Single Center Experience

    Directory of Open Access Journals (Sweden)

    Berna Bozkurt Duman

    2014-02-01

    Results: One of our 105 patients with BD was found to have solid tumor in the rate of 0.9 %. The remaining 104 patients with BD were in follow up without any malignancy in this period. The malignancy that we reported was invasive right breast carcinoma in a 55-year-old woman with BD. A radically modified right mastectomy and axillary lymphadenectomy were performed and postoperative doxorubicin, cyclophosphamide therapy for four cycles and hormonal therapy with tamoxifen and leuprolide acetate was administered as adjuvant therapy. This patient had a history of 16 years colchicine usage as medication for BD. Conclusion:The rheumatologic diseases can predispose malignancy, the autoimmune nature of BD or the immunosupressive medicines could be possible causes of this carcinoma. However, in our study only one patient had malignancy. The another point of view; management and also prevention of cancer with BD is important entity.

  12. PRECANCEROUS AND CANCEROUS LESIONS OF CERVIX DIAGNOSED BY PAP’S SMEAR - A HOSPITAL BASED STUDY

    Directory of Open Access Journals (Sweden)

    Komal Singh

    2014-02-01

    Full Text Available BACKGROUND: Cervical intra - epithelial neoplasia (CIN and cervical cancer remain important health problems for women worldwide. It is largely a preventable disease that is characterized by a long lead time. The objective of this study was to determine the frequency of precancerous lesions of cervix by Pap smear screening. METHODS : A retrospective hospital based study was conducted at Department of Pathology, in a Tertiary Care Institute and associated hospital, Bhopal. Data was collected from the records of Pap’s smear testing done on 388 patients in years 2011 & 2012. Analysis was done by entering data in SPSS software and Chi - square test was applied to find statistical significance. RESULTS: Most common lesions on Pap’s smear was Low grade squamous intraepithelial les ion (LSIL in 104 (26.8% of cases and High grade squamous intraepithelial lesion (HSIL in 15 (3.9% of cases. 44 (11.3% were senile Atopic Changes, parasitic Infection in 27 (7% of cases and 2 (0.5% were carcinoma cervix cases. All the cervical lesion s were most common in age of 31 - 40 yrs. and were significantly associated with age. CONCLUSIONS: Pap’s smear examination information should be spread in community apart from hospitals. Especially the young women should be motivated for regular Pap’s smear. Pap’s smear is the single most important screening method for early detection of precancerous & cancerous cervical lesions

  13. A Multi-Center Assessment of Nutrient Levels and Foods Provided by Hospital Patient Menus.

    Science.gov (United States)

    Trang, Susan; Fraser, Jackie; Wilkinson, Lori; Steckham, Katherine; Oliphant, Heather; Fletcher, Heather; Tzianetas, Roula; Arcand, JoAnne

    2015-11-01

    Diets of high nutritional quality can aid in the prevention and management of malnutrition in hospitalized patients. This study evaluated the nutritional quality of hospital patient menus. At three large acute care hospitals in Ontario, Canada, 84 standard menus were evaluated, which included regular and carbohydrate-controlled diets and 3000 mg and 2000 mg sodium diets. Mean levels of calories, macronutrients and vitamins and minerals provided were calculated. Comparisons were made with the Dietary Reference Intakes (DRI) and Canada's Food Guide (CFG) recommendations. Calorie levels ranged from 1281 to 3007 kcal, with 45% of menus below 1600 kcal. Protein ranged from 49 to 159 g (0.9-1.1 g/kg/day). Energy and protein levels were highest in carbohydrate-controlled menus. All regular and carbohydrate-controlled menus provided macronutrients within the Acceptable Macronutrient Distribution Ranges. The proportion of regular diet menus meeting the DRIs: 0% for fiber; 7% for calcium; 57% for vitamin C; and 100% for iron. Compared to CFG recommended servings, 35% met vegetables and fruit and milk and alternatives, 11% met grain products and 8% met meat and alternatives. These data support the need for frequent monitoring and evaluation of menus, food procurement and menu planning policies and for sufficient resources to ensure menu quality. PMID:26569294

  14. A Multi-Center Assessment of Nutrient Levels and Foods Provided by Hospital Patient Menus

    Directory of Open Access Journals (Sweden)

    Susan Trang

    2015-11-01

    Full Text Available Diets of high nutritional quality can aid in the prevention and management of malnutrition in hospitalized patients. This study evaluated the nutritional quality of hospital patient menus. At three large acute care hospitals in Ontario, Canada, 84 standard menus were evaluated, which included regular and carbohydrate-controlled diets and 3000 mg and 2000 mg sodium diets. Mean levels of calories, macronutrients and vitamins and minerals provided were calculated. Comparisons were made with the Dietary Reference Intakes (DRI and Canada’s Food Guide (CFG recommendations. Calorie levels ranged from 1281 to 3007 kcal, with 45% of menus below 1600 kcal. Protein ranged from 49 to 159 g (0.9–1.1 g/kg/day. Energy and protein levels were highest in carbohydrate-controlled menus. All regular and carbohydrate-controlled menus provided macronutrients within the Acceptable Macronutrient Distribution Ranges. The proportion of regular diet menus meeting the DRIs: 0% for fiber; 7% for calcium; 57% for vitamin C; and 100% for iron. Compared to CFG recommended servings, 35% met vegetables and fruit and milk and alternatives, 11% met grain products and 8% met meat and alternatives. These data support the need for frequent monitoring and evaluation of menus, food procurement and menu planning policies and for sufficient resources to ensure menu quality.

  15. Appropriateness of gastrointestinal consultations for hospitalized patients in an academic medical center

    Directory of Open Access Journals (Sweden)

    Cohen M

    2010-01-01

    Full Text Available Background: Consultation of experts in the internal medicine or surgery subspecialties is needed in the hospitalized population according to decisions of the house staff. Sometimes the referrals are not justified, consuming time and money without a significant change in the patient outcome. Objectives: The aim of our retrospective study was to evaluate justification of consecutive referrals of hospitalized patients for gastroenterology consultation. Materials and Methods: Request for consultation was deemed not justified when at least one of the following parameters was found: No contribution to case management, discharge before consultation, cancellation at the last minute, and a recommendation for ambulatory management or surgery. Results: In August-September 2006, there were 232 requests for gastroenterology consultations. Of them 127 (54.7% were men. The average age was 64.13±20.33 years. Ninety-four (40.2% of the cases had been hospitalized because of other reasons than the consultation issue. Consultation was not justified in 60 patients (25.9%. Ambulatory management was a possibility in 151 cases (65.0%. Request for colonoscopy and gastrointestinal background disease were the only significant predictive factors for justification of consultation, P < 0.0001 for both. Conclusions: In one fourth of the cases, gastroenterology consultation was not justified according to our strict criteria.

  16. Combined MTX{center_dot}5-FU{center_dot}CDGP for the treatment of head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Sakoda, Takema; Kitano, Hiroya [Tottori Univ., Yonago (Japan). Faculty of Medicine; Saitoh, Yuko; Ikeda, Hiroki; Dake, Yoshihiro; Enomoto, Tadao [Japanese Red Cross Society Wakayama Medical Center (Japan); Seno, Satoshi [Shiga Univ. of Medical Science, Otsu (Japan); Kawano, Atsushi [Tokyo Medical Coll. (Japan)

    2003-05-01

    Combination chemotherapy including 5-fluorouracil (5-FU) and nedaplatin (CDGP) with methotrexate (MTX) and leucovorin (LV) was administered for modulation in patients with head and neck cancer. We treated 19 patients with MTX{center_dot}5-FU{center_dot}CDGP consisting of 150 mg/body of MTX on day 1 followed by a 3-day continuous infusion of 5-FU at 3,500 mg/m{sup 2} and 17 injections of LV at 15 mg and infusion of CDGP at 100 mg/m{sup 2}. Six patients had recurrent head and neck cancer, and 13 had newly diagnosed disease. Eleven of the new patients were concurrently treated with radiation therapy. Treatment-associated toxicity was significant, including mucositis and myelosuppression, but acceptable. Sixteen patients were eligible for evaluation of response. The overall complete response rate was 75.0% (12/16). Patients treated with radiotherapy had a 90.0% (9/10) overall complete response rate. (author)

  17. Transcription factor FOXA2-centered transcriptional regulation network in non-small cell lung cancer

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Sang-Min; An, Joo-Hee; Kim, Chul-Hong; Kim, Jung-Woong, E-mail: jungkim@cau.ac.kr; Choi, Kyung-Hee, E-mail: khchoi@cau.ac.kr

    2015-08-07

    Lung cancer is the leading cause of cancer-mediated death. Although various therapeutic approaches are used for lung cancer treatment, these mainly target the tumor suppressor p53 transcription factor, which is involved in apoptosis and cell cycle arrest. However, p53-targeted therapies have limited application in lung cancer, since p53 is found to be mutated in more than half of lung cancers. In this study, we propose tumor suppressor FOXA2 as an alternative target protein for therapies against lung cancer and reveal a possible FOXA2-centered transcriptional regulation network by identifying new target genes and binding partners of FOXA2 by using various screening techniques. The genes encoding Glu/Asp-rich carboxy-terminal domain 2 (CITED2), nuclear receptor subfamily 0, group B, member 2 (NR0B2), cell adhesion molecule 1 (CADM1) and BCL2-associated X protein (BAX) were identified as putative target genes of FOXA2. Additionally, the proteins including highly similar to heat shock protein HSP 90-beta (HSP90A), heat shock 70 kDa protein 1A variant (HSPA1A), histone deacetylase 1 (HDAC1) and HDAC3 were identified as novel interacting partners of FOXA2. Moreover, we showed that FOXA2-dependent promoter activation of BAX and p21 genes is significantly reduced via physical interactions between the identified binding partners and FOXA2. These results provide opportunities to understand the FOXA2-centered transcriptional regulation network and novel therapeutic targets to modulate this network in p53-deficient lung cancer. - Highlights: • Identification of new target genes of FOXA2. • Identifications of novel interaction proteins of FOXA2. • Construction of FOXA2-centered transcriptional regulatory network in non-small cell lung cancer.

  18. Survivorship care planning in a comprehensive cancer center using an implementation framework.

    Science.gov (United States)

    Garcia, Sofia F; Kircher, Sheetal M; Oden, Megan; Veneruso, Aubri; McKoy, June M; Pearman, Timothy; Penedo, Frank J

    2016-05-01

    Cancer survivorship care plans (SCPs) have been recommended to improve clinical care and patient outcomes. Research is needed to establish their efficacy and identify best practices. Starting in 2015, centers accredited by the American College of Surgeons Commission on Cancer must deliver SCPs to patients completing primary cancer treatment with curative intent. We describe how we established routine SCP delivery at the Robert H Lurie Comprehensive Cancer Center in Chicago, Illinois, using the Quality Implementation Framework. We evaluated local practices, gathered clinician and patient stakeholder input, developed customized SCP templates within the electronic health record (EHR), and implemented 2 complementary delivery models. Clinician interviews (n = 41) and survey responses (n = 12), along with input from patients (n = 68) and a patient advisory board (n = 15), indicated support for SCPs and survivorship services. To promote feasible implementation and leverage existing workflows, we harmonized 2 SCP delivery models: integrated care within clinics where patients received treatment, and referral to a centralized survivorship clinic. We are implementing SCP delivery with prominent disease sites and will extend services to survivors of other cancers in the future. We developed four electronic disease-specific SCP templates for breast, colorectal, lung, and prostate cancers and a fifth, generic template that can be used for other malignancies. The templates reduced free-text clinician entry by auto-populating 20% of the fields from existing EHR data, and using drop-down menus for another 65%. Mean SCP completion time is 12 minutes (range, 10-15; n = 64). We designed our framework to facilitate ongoing evaluation of implementation and quality improvement. Funding/sponsorship Robert H Lurie Comprehensive Cancer Center, the Coleman Foundation, and the Lynn Sage Cancer Research Foundation. PMID:27258051

  19. Transcription factor FOXA2-centered transcriptional regulation network in non-small cell lung cancer

    International Nuclear Information System (INIS)

    Lung cancer is the leading cause of cancer-mediated death. Although various therapeutic approaches are used for lung cancer treatment, these mainly target the tumor suppressor p53 transcription factor, which is involved in apoptosis and cell cycle arrest. However, p53-targeted therapies have limited application in lung cancer, since p53 is found to be mutated in more than half of lung cancers. In this study, we propose tumor suppressor FOXA2 as an alternative target protein for therapies against lung cancer and reveal a possible FOXA2-centered transcriptional regulation network by identifying new target genes and binding partners of FOXA2 by using various screening techniques. The genes encoding Glu/Asp-rich carboxy-terminal domain 2 (CITED2), nuclear receptor subfamily 0, group B, member 2 (NR0B2), cell adhesion molecule 1 (CADM1) and BCL2-associated X protein (BAX) were identified as putative target genes of FOXA2. Additionally, the proteins including highly similar to heat shock protein HSP 90-beta (HSP90A), heat shock 70 kDa protein 1A variant (HSPA1A), histone deacetylase 1 (HDAC1) and HDAC3 were identified as novel interacting partners of FOXA2. Moreover, we showed that FOXA2-dependent promoter activation of BAX and p21 genes is significantly reduced via physical interactions between the identified binding partners and FOXA2. These results provide opportunities to understand the FOXA2-centered transcriptional regulation network and novel therapeutic targets to modulate this network in p53-deficient lung cancer. - Highlights: • Identification of new target genes of FOXA2. • Identifications of novel interaction proteins of FOXA2. • Construction of FOXA2-centered transcriptional regulatory network in non-small cell lung cancer

  20. Radiofrequency Ablation of Lung Cancer at Okayama University Hospital: A Review of 10 Years of Experience

    Directory of Open Access Journals (Sweden)

    Hiraki,Takao

    2011-10-01

    Full Text Available The application of radiofrequency ablation for the treatment of lung cancer by our group at Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences began in June 2001, and in the present report, we review our 10-year experience with this treatment modality at Okayama University Hospital. The local efficacy of radiofrequency ablation for the treatment of lung cancer depends on tumor size and the type of electrode used, but not on tumor type. An important factor for the prevention of local failure may be the acquisition of an adequate ablative margin. The combination of embolization and radiation therapy enhances the local efficacy. Local failure may be salvaged by repeating the radiofrequency ablation, particularly in small tumors. Survival rates after radiofrequency ablation are quite promising for patients with clinical stage I non-small cell lung cancer and pulmonary metastasis from colorectal cancer, hepatocellular carcinoma, and renal cell carcinoma. The complications caused by radiofrequency ablation can be treated conservatively in the majority of cases. However, attention should be paid to rare but serious complications. This review shows that radiofrequency ablation is a promising treatment for patients with lung cancer.

  1. Profile of breast cancer patients at a tertiary care hospital in north India

    Directory of Open Access Journals (Sweden)

    D S Sandhu

    2010-01-01

    Full Text Available Background and Aims: We carried out this study in order to know the epidemiology and management strategies for breast cancer patients in our patient population. Settings and Design: The epidemiological data pertaining to demography and risk factors for carcinoma breast were analyzed retrospectively in patients admitted to a tertiary care hospital of North India. Materials and Methods: Hospital records of 304 patients admitted for over a period of five years (January 1998 to December 2002 were used for data analysis. Statistical Analysis Used: Paired T-test . Results: Mean age of our female breast cancer patients was found to be lower compared to the western world, with an average difference of one decade. A majority of the patients were from a rural background and had a longer duration of symptoms compared to urban patients. Lump in the breast was a dominant symptom. Familial breast cancer was uncommon. Left sided breast cancer was slightly preponderant. Screening by mammography and staging procedures such as bone scan, Computed Tomography (CT scan, and Magnetic Resonance Imaging (MRI were sparsely used. The most common histology was infiltrating duct carcinoma. Conclusion: Modified radical mastectomy was found to be a safe operative procedure. Breast conservative surgery, although considered the gold standard in early breast cancer, was found unsuitable for our patients, due to the social background and lack of intensive radiotherapy and chemotherapy backup. Infiltrating duct carcinoma was more commonly associated with positive lymph nodes compared to other histopathologies. Cases operated by surgical oncologists had better axillary clearance. Neoadjuvant chemotherapy was used mainly by surgical oncologists suggesting a more rational approach toward the management of breast carcinoma.

  2. Hospital survival upon discharge of ill-neonates transported by ground or air ambulance to a tertiary center

    Directory of Open Access Journals (Sweden)

    Jorge Luis Alvarado-Socarras

    2016-06-01

    Full Text Available Abstract Objective: To evaluate the differences in hospital survival between modes of transport to a tertiary center in Colombia for critically ill neonates. Methods: Observational study of seriously ill neonates transported via air or ground, who required medical care at a center providing highly complex services. Data on sociodemographic, clinical, the Transport Risk Index of Physiologic Stability (TRIPS, and mode of transport were collected. Patients were described, followed by a bivariate analysis with condition (live or dead at time of discharge as the dependent variable. A multiple Poisson regression with robust variance model was used to adjust associations. Results: A total of 176 neonates were transported by ambulance (10.22% by air over six months. The transport distances were longer by air (median: 237.5 km than by ground (median: 11.3 km. Mortality was higher among neonates transported by air (33.33% than by ground (7.79%. No differences in survival were found between the two groups when adjusted by the multiple model. An interaction between mode of transport and distance was observed. Live hospital discharge was found to be associated with clinical severity upon admittance, birth weight, hemorrhaging during the third trimester, and serum potassium levels when admitted. Conclusions: Mode of transport was not associated with the outcome. In Colombia, access to medical services through air transport is a good option for neonates in critical condition. Further studies would determine the optimum distance (time of transportation to obtain good clinical outcomes according type of ambulance.

  3. Lung cancer risk and pollution in an industrial region of Northern Spain: a hospital-based case-control study

    OpenAIRE

    Aragonés Nuria; Pérez-Gómez Beatriz; García-Pérez Javier; López-Cima María; López-Abente Gonzalo; Tardón Adonina; Pollán Marina

    2011-01-01

    Abstract Background Asturias, an Autonomous Region in Northern Spain with a large industrial area, registers high lung cancer incidence and mortality. While this excess risk of lung cancer might be partially attributable to smoking habit and occupational exposure, the role of industrial and urban pollution also needs to be assessed. The objective was to ascertain the possible effect of air pollution, both urban and industrial, on lung cancer risk in Asturias. Methods This was a hospital-based...

  4. Perception and utilization of cervical cancer screening services among female nurses in University College Hospital, Ibadan, Nigeria

    OpenAIRE

    Arulogun, Oyedunni Sola; Maxwell, Opemipo Olubunmi

    2012-01-01

    Background Cervical Cancer (CC) is the second most common cancer among women with early detection and prompt treatment as best management options. Female nurses have crucial roles to play in promoting the utilization of Cervical Cancer Screening Services (CCSS), yet little information exist regarding their perception and utilization of these services. The CCSS related knowledge, perception and utilization among female nurses at the University College Hospital, (UCH) Ibadan, Nigeria were there...

  5. Defining a standard set of patient-centered outcomes for men with localized prostate cancer

    NARCIS (Netherlands)

    N.E. Martin (Neil E.); L. Massey (Laura); C. Stowell (Caleb); C.H. Bangma (Chris); A. Briganti (Alberto); A. Bill-Axelson (Anna); M. Blute (Michael); J.W.F. Catto (James); R.C. Chen (Ronald C.); A.V. D'Amico (Anthony V.); G. Feick (Günter); J.M. Fitzpatrick (John); S.J. Frank (Steven J.); M. Froehner (Michael); M. Frydenberg (Mark); A. Glaser (Adam); M. Graefen (Markus); D. Hamstra (Daniel); A. Kibel (Adam); N. Mendenhall (Nancy); K. Moretti (Kim); J. Ramon (Jacob); I. Roos (Ian); H. Sandler (Howard); F.J. Sullivan (Francis J.); D. Swanson (David); A. Tewari (Ashutosh); A.J. Vickers (Andrew); T. Wiegel (Thomas); H. Huland (Hartwig)

    2015-01-01

    textabstractBackground Value-based health care has been proposed as a unifying force to drive improved outcomes and cost containment. Objective To develop a standard set of multidimensional patient-centered health outcomes for tracking, comparing, and improving localized prostate cancer (PCa) treatm

  6. PROFILE OF RISK FACTORS FOR ORAL CANCERS IN TERTIARY REFERRAL ENT HOSPITAL 2014-2015

    Directory of Open Access Journals (Sweden)

    Veeraswamy

    2016-05-01

    Full Text Available BACKGROUND Oral cancers constitute major portion of head and neck malignancies. Head and neck cancers constitute 30% to 40% of the total malignancies in the world. Increase in tobacco habits, both in the form of smoking and chewing lead to the recent increase in development of the oral malignancies. 1 AIMS AND OBJECTIVES The aim of this study was 1. To know the risk factors associated with oral cancers in rural, urban-slums and urban-developing districts of coastal Andhra Pradesh, 2. To create awareness among the people of our country regarding the risk factors of oral cancers and necessary modifications of lifestyle to be taken. MATERIALS AND METHODS This study was conducted in Government ENT Hospital, Visakhapatnam. It is comprised of all confirmed cases of oral cancers reported in the hospital during the period of 1 year from December 2014 - December 2015. Study variables included demographic factors, socioeconomic factors and enquiries about the risk factors such as tobacco usage either in the form of smoking or chewing. OBSERVATIONS It was observed that out of the 50 cases in the study, females (66% were reported to be more affected than males (34%. Most of the subjects belonged to lower middle and lower socio-economic group (94%, while very few belonged to upper-middle group (6%. Majority of the patients were in the age group of 41-50 and 51-60 years constituting about 60%, while very few were aged below 40 years and above 70 years. It was noted that 35 patients consumed tobacco in smoking form, out of which 13 patients smoked normally, whereas 22 smoked in reverse manner. All the reverse smokers were observed to be females; 11 patients consumed tobacco in chewing form. Most common site for oral cancer in this study population was hard palate. CONCLUSION This study should create awareness in the public to avoid irritant chewing habits and smoking in normal manner, reverse smoking in particular. Media including both Electronic and Print

  7. Vaginal Radical Trachelectomy for early stage cervical cancer. Results of the Danish National Single Center Strategy

    DEFF Research Database (Denmark)

    Hauerberg, L; Høgdall, C; Loft, A;

    2015-01-01

    OBJECTIVE: To present and evaluate an unselected national single center strategy with fertility preserving trachelectomy in cervical cancer. In 2003 nationwide single-center referral of women for trachelectomies was agreed upon between all Danish departments performing cervical cancer surgery...... with the purpose of increasing volume, to increase surgical safety and facilitate follow-up. METHODS: Prospective data were recorded in the Danish Gynecological Cancer Database of all Vaginal Radical Trachelectomies (VRT) performed in Denmark between 2002 and 2013. Oncologic, fertility and obstetrical outcomes...... of 120 unselected consecutive VRTs were assessed. To obtain complete follow-up about fertility treatment, pregnancy and obstetric outcome the women filled out an electronic questionnaire. Median follow-up: 55.7 months. RESULTS: 85.8% of the patients had stage IB1 disease, 68.3% squamous cell carcinomas...

  8. Plant-based Complementary and alternative medicine used by breast cancer patients at the Hospital Universitario San Ignacio in Bogotá, Colombia.

    Directory of Open Access Journals (Sweden)

    Marcela Mercado

    2012-12-01

    Full Text Available The present study estimates the frequency of the use of plant-based Complementary and Alternative Medicine (CAM by breast cancer patients. From June to December of 2011, a self-administered questionnaire was given to 404 breast cancer patients receiving outpatient therapy at the Javeriana Oncology Center of the Hospital Universitario San Ignacio in Bogotá. The prevalence of patient CAM use was 57%, out of which 76% was based on plants like anamú, aloe, red fruits and soursop. Sixty-five percent of the patients had a positive perception of using medicinal plants and 57% used them simultaneously with the oncologist recommended allopathic treatment. We concluded that the frequency of CAM use in breast cancer patients at the Javeriana Oncology Center is within the prevalence range reported worldwide, despite differences in CAM types and frequencies. The high rates of plant-based CAM use without physician consent, brings about the lack of assessment of the synergic or antagonistic effects of CAM therapies on the allopathic treatment of breast cancer and evaluation of the antitumor and immunomodulatory potential of the traditionally used plants.

  9. FacilitiesHospitals_HOSPITAL

    Data.gov (United States)

    Vermont Center for Geographic Information — This data layer contains point locations of all major community, regional, comprehensive health, and healthcare provider hospitals in the state of Vermont. The...

  10. High Hospitalization Rates in Survivors of Childhood Cancer: A Longitudinal Follow-Up Study Using Medical Record Linkage.

    Directory of Open Access Journals (Sweden)

    Elske Sieswerda

    Full Text Available Hospitalization rates over time of childhood cancer survivors (CCS provide insight into the burden of unfavorable health conditions on CCS and health care resources. The objective of our study was to examine trends in hospitalizations of CCS and risk factors in comparison with the general population. We performed a medical record linkage study of a cohort of 1564 ≥five-year CCS with national registers. We obtained a random sample of the general population matched on year of birth, gender and calendar year per CCS retrieved. We quantified and compared hospitalization rates of CCS and reference persons from 1995 until 2005, and we analyzed risk factors for hospitalization within the CCS cohort with multivariable Poisson models. We retrieved hospitalization information from 1382 CCS and 25583 reference persons. The overall relative hospitalization rate (RHR was 2.2 (95%CI:1.9-2.5 for CCS compared to reference persons. CCS with central nervous system and solid tumors had highest RHRs. Hospitalization rates in CCS were increased compared to reference persons up to at least 30 years after primary diagnosis, with highest rates 5-10 and 20-30 years after primary cancer. RHRs were highest for hospitalizations due to neoplasms (10.7; 95%CI:7.1-16.3 and endocrine/nutritional/metabolic disorders (7.3; 95%CI:4.6-11.7. Female gender (P<0.001, radiotherapy to head and/or neck (P<0.001 or thorax and/or abdomen (P = 0.03 and surgery (P = 0.01 were associated with higher hospitalization rates in CCS. In conclusion, CCS have increased hospitalization rates compared to the general population, up to at least 30 years after primary cancer treatment. These findings imply a high and long-term burden of unfavorable health conditions after childhood cancer on survivors and health care resources.

  11. High Hospitalization Rates in Survivors of Childhood Cancer: A Longitudinal Follow-Up Study Using Medical Record Linkage

    Science.gov (United States)

    Sieswerda, Elske; Font-Gonzalez, Anna; Reitsma, Johannes B.; Dijkgraaf, Marcel G. W.; Heinen, Richard C.; Jaspers, Monique W.; van der Pal, Helena J.; van Leeuwen, Flora E.; Caron, Huib N.

    2016-01-01

    Hospitalization rates over time of childhood cancer survivors (CCS) provide insight into the burden of unfavorable health conditions on CCS and health care resources. The objective of our study was to examine trends in hospitalizations of CCS and risk factors in comparison with the general population. We performed a medical record linkage study of a cohort of 1564 ≥five-year CCS with national registers. We obtained a random sample of the general population matched on year of birth, gender and calendar year per CCS retrieved. We quantified and compared hospitalization rates of CCS and reference persons from 1995 until 2005, and we analyzed risk factors for hospitalization within the CCS cohort with multivariable Poisson models. We retrieved hospitalization information from 1382 CCS and 25583 reference persons. The overall relative hospitalization rate (RHR) was 2.2 (95%CI:1.9–2.5) for CCS compared to reference persons. CCS with central nervous system and solid tumors had highest RHRs. Hospitalization rates in CCS were increased compared to reference persons up to at least 30 years after primary diagnosis, with highest rates 5–10 and 20–30 years after primary cancer. RHRs were highest for hospitalizations due to neoplasms (10.7; 95%CI:7.1–16.3) and endocrine/nutritional/metabolic disorders (7.3; 95%CI:4.6–11.7). Female gender (P<0.001), radiotherapy to head and/or neck (P<0.001) or thorax and/or abdomen (P = 0.03) and surgery (P = 0.01) were associated with higher hospitalization rates in CCS. In conclusion, CCS have increased hospitalization rates compared to the general population, up to at least 30 years after primary cancer treatment. These findings imply a high and long-term burden of unfavorable health conditions after childhood cancer on survivors and health care resources. PMID:27433937

  12. Is quality of colorectal cancer care good enough? Core measures development and its application for comparing hospitals in Taiwan

    Directory of Open Access Journals (Sweden)

    Cheng Skye H

    2010-01-01

    Full Text Available Abstract Background Although performance measurement for assessing care quality is an emerging area, a system for measuring the quality of cancer care at the hospital level has not been well developed. The purpose of this study was to develop organization-based core measures for colorectal cancer patient care and apply these measures to compare hospital performance. Methods The development of core measures for colorectal cancer has undergone three stages including a modified Delphi method. The study sample originated from 2004 data in the Taiwan Cancer Database, a national cancer data registry. Eighteen hospitals and 5585 newly diagnosed colorectal cancer patients were enrolled in this study. We used indicator-based and case-based approaches to examine adherences simultaneously. Results The final core measure set included seventeen indicators (1 pre-treatment, 11 treatment-related and 5 monitoring-related. There were data available for ten indicators. Indicator-based adherence possesses more meaningful application than case-based adherence for hospital comparisons. Mean adherence was 85.8% (79.8% to 91% for indicator-based and 82.8% (77.6% to 88.9% for case-based approaches. Hospitals performed well (>90% for five out of eleven indicators. Still, the performance across hospitals varied for many indicators. The best and poorest system performance was reflected in indicators T5-negative surgical margin (99.3%, 97.2% - 100.0% and T7-lymph nodes harvest more than twelve(62.7%, 27.6% - 92.2%, both of which related to surgical specimens. Conclusions In this nationwide study, quality of colorectal cancer care still shows room for improvement. These preliminary results indicate that core measures for cancer can be developed systematically and applied for internal quality improvement.

  13. Cancer Imaging at the Crossroads of Precision Medicine: Perspective From an Academic Imaging Department in a Comprehensive Cancer Center.

    Science.gov (United States)

    Van den Abbeele, Annick D; Krajewski, Katherine M; Tirumani, Sree Harsha; Fennessy, Fiona M; DiPiro, Pamela J; Nguyen, Quang-Dé; Harris, Gordon J; Jacene, Heather A; Lefever, Greg; Ramaiya, Nikhil H

    2016-04-01

    The authors propose one possible vision for the transformative role that cancer imaging in an academic setting can play in the current era of personalized and precision medicine by sharing a conceptual model that is based on experience and lessons learned designing a multidisciplinary, integrated clinical and research practice at their institution. The authors' practice and focus are disease-centric rather than imaging-centric. A "wall-less" infrastructure has been developed, with bidirectional integration of preclinical and clinical cancer imaging research platforms, enabling rapid translation of novel cancer drugs from discovery to clinical trial evaluation. The talents and expertise of medical professionals, scientists, and staff members have been coordinated in a horizontal and vertical fashion through the creation of Cancer Imaging Consultation Services and the "Adopt-a-Radiologist" campaign. Subspecialized imaging consultation services at the hub of an outpatient cancer center facilitate patient decision support and management at the point of care. The Adopt-a-Radiologist campaign has led to the creation of a novel generation of imaging clinician-scientists, fostered new collaborations, increased clinical and academic productivity, and improved employee satisfaction. Translational cancer research is supported, with a focus on early in vivo testing of novel cancer drugs, co-clinical trials, and longitudinal tumor imaging metrics through the imaging research core laboratory. Finally, a dedicated cancer imaging fellowship has been developed, promoting the future generation of cancer imaging specialists as multidisciplinary, multitalented professionals who are trained to effectively communicate with clinical colleagues and positively influence patient care. PMID:26774886

  14. Drug utilisation study in a tertiary care center: Recommendations for improving hospital drug dispensing policies

    Directory of Open Access Journals (Sweden)

    Niti Mittal

    2014-01-01

    Full Text Available Drug therapy accounts for a major portion of health expenditure. A useful strategy for achieving cost efficient healthcare is drug utilisation research as it forms the basis for making amendments in drug policies and helps in rational drug use. The present observational study was conducted to generate data on drug utilization in inpatients of our tertiary care hospital to identify potential targets for improving drug prescribing patterns. Data was collected retrospectively from randomly selected 231 medical records of patients admitted in various wards of the hospital. WHO Anatomical Therapeutic Chemical/Defined Daily Dose methodology was used to assess drug utilisation data and drug prescriptions were analysed by WHO core drug indicators. Antibiotics were prescribed most frequently and also accounted for majority of drug costs. The prescribed daily dose for most of the antibiotics corresponded to defined daily dose reflecting adherence to international recommendations. Brand name prescribing and polypharmacy was very common.78% of the total drugs prescribed were from the National List of Essential Medicines 2003. Restricting the use of newer and costlier antibiotics, branded drugs and number of drugs per prescription could be considered as targets to cut down the cost of drug therapysignificantly.

  15. Drug utilisation study in a tertiary care center: recommendations for improving hospital drug dispensing policies.

    Science.gov (United States)

    Mittal, Niti; Mittal, R; Singh, I; Shafiq, Nusrat; Malhotra, S

    2014-07-01

    Drug therapy accounts for a major portion of health expenditure. A useful strategy for achieving cost efficient healthcare is drug utilisation research as it forms the basis for making amendments in drug policies and helps in rational drug use. The present observational study was conducted to generate data on drug utilization in inpatients of our tertiary care hospital to identify potential targets for improving drug prescribing patterns. Data was collected retrospectively from randomly selected 231 medical records of patients admitted in various wards of the hospital. WHO Anatomical Therapeutic Chemical/Defined Daily Dose methodology was used to assess drug utilisation data and drug prescriptions were analysed by WHO core drug indicators. Antibiotics were prescribed most frequently and also accounted for majority of drug costs. The prescribed daily dose for most of the antibiotics corresponded to defined daily dose reflecting adherence to international recommendations. Brand name prescribing and polypharmacy was very common.78% of the total drugs prescribed were from the National List of Essential Medicines 2003. Restricting the use of newer and costlier antibiotics, branded drugs and number of drugs per prescription could be considered as targets to cut down the cost of drug therapysignificantly. PMID:25284928

  16. Perception of selected risk factors for cancer and heart attack among visitors of a public hospital

    Directory of Open Access Journals (Sweden)

    Sandeep Sachdeva

    2015-01-01

    Full Text Available Background: To assess perception of selected risk factors for cancer and heart attack among visitors of a public hospital. Materials and Methods: Randomly 1651 ambulatory adults were contacted using predesigned, pretested, semi-structure interview schedule comprising selective 12 risk factors for cancer (increasing age, tobacco, obesity, alcohol, diet-rich in fat/oil, diet-poor in fruits and vegetables (F and V, physical in-activity, environmental pollution, multiple sexual partners, insecticides/pesticides/chemicals, micro-organism, family history and 11 for heart attack (increasing age, tobacco, obesity, alcohol, diet-rich in fat/oil, diet-poor in F and V, physical in-activity, hypertension, diabetes mellitus, mental stress, family history. Correct response was awarded one mark and incorrect/do not know response as zero. Results: The study participants comprised of 56.2% attendants and 43.8% patients with mean age of 36.78 (±13.05 years; 71.2% were male, 65% resided in rural area and 32.3% subjects were smoker. A statistically (P = 0.001 higher odds for smoking was found among less educated (odds ratio [OR]: 1.30, rural (OR: 1.60, male (OR: 2.85, patients (OR: 1.41 of more than 30 years of age (OR: 1.67. Nearly, 64.5% and 82.0% subject responded that tobacco causes the heart attack and cancer while obesity was considered as a risk factor by 68.4% (heart attack and 28.1% (cancer. Nearly, 70.7% and 32.0% reported diet rich in fat/oil and poor in F and V could lead to heart attack but only 23.5% and 25.8% mentioned respectively for cancer. Mean risk factors identified for heart attack were 6.64 ± 2.29 (range: 0-11 while for cancer it was 5.01 ± 2.33 (range: 0-12. Nearly, 670 (40.58% and 620 (37.55% subjects mentioned spontaneously at least one type/anatomical site-specific cancer of male and female respectively; 73.4% believed that cancer does not spread by social activity and 54.2% opined that cancer is treatable if detected early. Conclusion

  17. Service utilization in community health centers in China: a comparison analysis with local hospitals

    OpenAIRE

    Wang Xiaohang; Dib Hassan H; Pan Xilong; Zhang Hong

    2006-01-01

    Abstract Background Being an important part of China's Urban Health Care Reform System, Community Health Centers (CHCs) have been established throughout the entire country and are presently undergoing substantial reconstruction. However, the services being delivered by the CHCs are far from reaching their performance targets. In order to assess the role of the CHCs, we examined their performance in six cities located in regions of South-East China. The purpose of this investigation was to ide...

  18. [Participation of the family in hospital-based palliative cancer care: perspective of nurses].

    Science.gov (United States)

    da Silva, Marcelle Miranda; Lima, Lorhanna da Silva

    2014-12-01

    The objective was to understand the perspective of nurses about the participation of the family in palliative cancer care and to analyze the nursing care strategies to meet their needs. Descriptive and qualitative research, conducted at the National Cancer Institute between January and March 2013, with 17 nurses. Elements of the Roy Adaptation Model were used for the interpretation of the data. Two categoriesemergedfrom the thematic analysis: perspective of nurses about the presence and valuation of family in the hospital; and appointing strategies to encourage family participation in care and meet their needs. This participation is essentialand represents a training opportunity for the purpose of homecare. Nurses create strategies to encourage it and seek to meet the needs. The results contribute to promote the family adaptation and integrity, in order to balance the dependent and independent behaviors, aimingfor quality of life and comfort. Further studies are neededdue to the challenges of the specialty. PMID:25842775

  19. Thyroid cancer patients in the Hospital Nacional de Ninos during the period from 1992 to 2002

    International Nuclear Information System (INIS)

    A descriptive study was conducted on the presentation, management and monitoring of the patients with thyroid cancer in the pediatric population under 12 years, at once of diagnosis, in the Hospital Nacional de Ninos of Costa Rica. It covers the period from 1992 to 2002. The clinical records were revised in retrospect. Information was collected of the patient, risk factors, laboratory tests, initial surgical therapy, treatment with radioiodine and the illness evolution. There were no family histories of thyroid cancer or radiation history of head and neck radiation in any patient. Thyroid ultrasound was performed in all patients. Also it was made a biopsy by fine needle aspiration in 11 (78.5%) patients, 2 patients the diagnosis was made by puncture of adenopia, 5 (45.4.7%) patients were obtained diagnosis of malignancy. Follicular nodule in 2 patients (18.1%) suspected in a patient and benign in 3 (27.2%) patients

  20. Health beliefs related to breast cancer screening behaviours in women who applied to cancer early detection center

    Directory of Open Access Journals (Sweden)

    Melek Serpil Talas

    2015-06-01

    Full Text Available Background: Breast cancer is one of the most common malignancies affecting women in Turkey. The early detection methods for breast cancer have been associated with health belief variables. Objectives: The purpose of this study was to determine women's health beliefs related to breast cancer screening behaviours. Methods: This study was designed as descriptive and cross-sectional survey and was performed on 344 women who applied the Nigde Cancer Early Diagnosis, Screening and Education Center between May and October 2009. The data were collected using a questionnaire which consists of socio-demographic characteristics and breast cancer risk factors and Health Belief Model Scale. Data analysis was performed using frequency and Mann-Whitney U Test. All values of p0.05. According to study results, the rate of regular BSE performance rate for women was found low. Therefore, KETEM was planned to the training programs related to breast cancer screening methods. [TAF Prev Med Bull 2015; 14(3.000: 265-271

  1. [Promotion plan for the promotion of cancer: coping measures at Matsuyama Red Cross Hospital in Ehime prefecture - the current state of affairs at the hospital's cancer treatment promotion office].

    Science.gov (United States)

    Fujii, Motohiro

    2013-05-01

    Recent cancer control strategies in Japan have been aimed at lowering morbidity and mortality rates, based on the Thirdterm Comprehensive 10-year Strategy for Cancer Control initiated by the Japanese government. In April 2007, the Cancer Control Basic Law was promulgated to necessitate promotion of cancer control by national and local authorities. In June 2007, the Japanese Health Ministry released a plan for the promotion of measures to cope with cancer. The cancer control measures adopted by the Matsuyama Red Cross Hospital(MRCH)in Ehime Prefecture were as follows: ·Progress in the promotion of measures to cope with cancer in Ehime, including a review of 2012, problems with new treatment methods for childhood cancer, employment of cancer patients, and promotion of home care. ·Cancer treatment measures adopted by MRCH as a hub medical institution for the past 5 years. ·The distinctive efforts of the intensive professionals team at the Cancer Treatment Promotion Office for cancer treatment at MRCH, and its work on cancer care from the 4 perspectives of the balanced scorecard in accordance with the basic policy of MRCH. PMID:23863580

  2. Evaluation of 809 Cases Applicated to A Rabies Vaccination Center of Diyarbakır Government Hospital

    Directory of Open Access Journals (Sweden)

    Hakan Temiz

    2008-09-01

    Full Text Available In this study; 809 cases applicated to rabies vaccination center ofDiyarbakır Government Hospital between May 2006 and May 2007 wereevaluated. Human diploid cell vaccine was applicated as 3 doses in 708cases (%87.5 and 5 doses in 101 cases (%12.5. In 66 cases (%8.2 rabiesantiserum was also used. The sites of injury were head-neck in 45 cases(%5.6, body-arm-leg in 563 (%69.6 cases and hand in 201 (%24.8 cases.477 cases (%59 were evaluated as superficial and 332 cases (%41 wereevaluated as deep injury. 626 cases (%77.4 had dog bite, 142 cases (%17.6had cat bite. While 689 cases (%85.2 visited the rabies vaccination center atthe first day of injury, 115 cases (%14.2 visited in 2-5 days and 5 cases(%0.6 visited after 5 days. In conclusion; the sensitivity and the rate of theearly visit of the vaccination center because of suspicious animal contactare high and when compared with developed countries there must be a greateffort in reducing the incidence of suspicious bites.

  3. The evaluation of time performance in the emergency response center to provide pre-hospital emergency services in Kermanshah.

    Science.gov (United States)

    Mohammadi, Mohsen; Nasiripour, Amir Ashkan; Fakhri, Mahmood; Bakhtiari, Ahad; Azari, Samad; Akbarzadeh, Arash; Goli, Ali; Mahboubi, Mohammad

    2014-09-28

    This study evaluated the time performance in the emergency response center to provide pre-hospital emergency services in Kermanshah. This study was a descriptive retrospective cross-sectional study. In this study 500 cases of patients from Shahrivar (September) 2012 to the end of Shahrivar (September) 2013 were selected and studied by the non-probability quota method. The measuring tool included a preset cases record sheet and sampling method was completing the cases record sheet by referring to the patients' cases. Data were analyzed using SPSS version 18 and the concepts of descriptive and inferential statistics (Kruskal-Wallis test, benchmark Eta (Eta), Games-Howell post hoc test). The results showed that the interval mean between receiving the mission to reaching the scene, between reaching the scene to moving from the scene, and between moving from the scene to a health center was 7.28, 16.73 and 7.28 minutes. The overall mean of time performance from the scene to the health center was 11.34 minutes. Any intervention in order to speed up service delivery, reduce response times, ambulance equipment and facilities required for accuracy, validity and reliability of the data recorded in the emergency dispatch department, Continuing Education of ambulance staffs, the use of manpower with higher specialize levels such as nurses, supply the job satisfaction, and increase the coordination with other departments that are somehow involved in this process can provide the ground for reducing the loss and disability resulting from traffic accidents.

  4. PREVALENCE OF ALCOHOL USE AMONG PATIENTS ATTENDING TRAUMA CENTER IN A TERTIARY CARE HOSPITAL: A CROSS SECTIONAL STUDY

    Directory of Open Access Journals (Sweden)

    Arun

    2014-09-01

    Full Text Available HYPOTHESIS: Significant number of cases attending trauma center are associated with alcohol use. AIM: To study the prevalence, pattern and severity of alcohol use in patient attending trauma center with an emergency in a tertiary care hospital. MATERIALS AND METHODS: Total of 100 consecutive patients attending the trauma center from 6pm – 6am and who were fulfilling the inclusion criteria and had consented to participate in the study were recruited. Alcohol breath analyzer was administered and then the rating scales SMAST, AUDIT and QIAD were administered. RESULTS: On socio demographic profile of study subjects’ age group between 18-30yrs, male gender and nuclear family background were found to be more predominant. Twenty one (21.9% patients in alcohol breath analysis and Twenty three (23.9% patients in SMAST screening were found to be positive for alcohol use. On evaluation of injury related variables; RTA and injury at single site were found to be more among the total subjects. In alcohol positives injuries at multiple sites and admission were found to be more as compared to negatives. Most of the patient among breath positives (70% scored 8 and above in AUDIT scale indicating hazardous level of drinking. Fifteen patients (15.6% were found to be “alcoholics’’ by QIAD analysis. CONCLUSION: In agreement with findings of previous several studies of worldwide, the present study draws attention to recognizing the alcohol use as a significant contributory factor to trauma, especially RTA.

  5. A survey of the attitude and practice of research among doctors in Riyadh Military Hospital primary care centers, Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Saad H Al-Abdullateef

    2012-01-01

    Full Text Available Objectives: To assess the attitude and practice of doctors in the Military Hospital Primary Care Centers in Riyadh (RMH toward research and to identify the main barriers to conduct research. Materials and Methods: A cross-sectional study was conducted from March to April, 2010, at RMH primary care centers. The sample included all general practitioners (GPs working in primary healthcare centers. A self-administered questionnaire was formulated from different sources and used as a tool for data collection. Results: The response rate was 75%. Among the respondents 96.9% agreed that research in primary care was important for different reasons. Most of the GPs had a positive attitude toward research: 68% had been influenced by research in their clinical practice and 66% had an interest in conducting research, and74.2% of the respondents had plans to do research in the future. Insufficient time was the most frequently cited barrier (83.5% for participating in research, followed by the lack of support (58.8%. Conclusions: Many of the GPs had a positive attitude toward research, but had no publications or plan for new research. Lack of time, support, and money were the main constraints for carrying out research.

  6. Prevalence of Depression and Anxiety amongst Cancer Patients in a Hospital Setting: A Cross-Sectional Study

    Directory of Open Access Journals (Sweden)

    Anish Khalil

    2016-01-01

    Full Text Available Background. The biomedical care for cancer has not been complemented by psychosocial progressions in cancer care. Objectives. To find the prevalence of anxiety and depression amongst cancer patients in a hospital setting. Design and Setting. This cross-sectional study was conducted at the tertiary care hospitals Shifa International Hospital Islamabad and Nuclear Medicine, Oncology, and Radiotherapy Institute [NORI]. Patients and Methods. 300 patients were interviewed from both the outpatient and inpatient department using The Aga Khan University Anxiety and Depression Scale (AKUADS. Main Outcome Measures. Using a score of 20 and above on the AKUADS, 146 (48.7% patients were suffering from anxiety and depression. Results. When cross tabulation was done between different factors and the cancer patients with anxiety and depression, the following factors were found out to be significant with associated p value < 0.05: education of the patient, presence of cancer in the family, the severity of pain, and the patient’s awareness of his anxiety and depression. Out of 143 (47.7% uneducated patients, 85 (59.4% were depressed, hence making it the highest educational category suffering from depression and anxiety. Conclusion. The prevalence of anxiety and depression amongst cancer patients was high showing that importance should be given to screening and counseling cancer patients for anxiety and depression, to help them cope with cancer as a disease and its impact on their mental wellbeing. Limitations. The frequency of female patients in our research was higher than those of male patients.

  7. Two-year hospital records of burns from a referral center in Western Iran: March 2010-March 2012

    Directory of Open Access Journals (Sweden)

    Touraj Ahmadijouybari

    2014-01-01

    Full Text Available Abstract: Background: Burns are among the most common injuries affecting a great number of people worldwide annually. In Iran, especially in its western region and in Kermanshah province, burns have a relatively high incidence. The present study was aimed at investigating epidemiological characteristics in Western Iran. Methods: Within a cross-sectional study, the data on all patients attending the Burns Center at Imam Khomeini Hospital (Kermanshah, Iran during 2010-2011 and 2011-2012 (24 months were collected. Then, age, gender, cause of burns, total body surface area, and time of the occurrence were extracted from the hospital records. The data were analyzed using the SPSS statistical package (Version 19, for Windows. We used chi-squared test when we compared the categorical responses between two or more groups. For comparing means between two groups we used t-test. In addition, trends were investigated using linear regression. Results: Overall 13 248 people were referred to the Burns Center at Imam Khomeini Hospital (Kermanshah, Iran during the period of study, including 328 cases of self-immolation. The mean age of the patients was 27±19 years and 29±13 years for unintentional burns and self-immolation respectively. Out of the total number of unintentional cases, 6 519 (50.5% were men, while the corresponding percentage of men among the self-immolation cases was 16.6% (p less than 0.001. Trends in the number of cases were cyclic, with the highest and lowest number of burns cases being in March and May. Overall, hot liquids and flammable materials were the two most important causes of unintentional burns. However, flammable materials were the main cause of burns among self-immolation cases. During hospital admission, 168 (51% self-immolation victims and 43 (0.33% unintentional burn victims died. Conclusions: While major preventive measures are not adequately used in developing countries, burns and their burden can be significantly reduced

  8. Design of a prostate cancer patient navigation intervention for a Veterans Affairs hospital

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    Nonzee Narissa J

    2012-09-01

    Full Text Available Abstract Background Patient navigation programs have been launched nationwide in an attempt to reduce racial/ethnic and socio-demographic disparities in cancer care, but few have evaluated outcomes in the prostate cancer setting. The National Cancer Institute-funded Chicago Patient Navigation Research Program (C-PNRP aims to implement and evaluate the efficacy of a patient navigation intervention for predominantly low-income minority patients with an abnormal prostate cancer screening test at a Veterans Affairs (VA hospital in Chicago. Methods/Design From 2006 through 2010, C-PNRP implemented a quasi-experimental intervention whereby trained social worker and lay health navigators worked with veterans with an abnormal prostate screen to proactively identify and resolve personal and systems barriers to care. Men were enrolled at a VA urology clinic and were selected to receive navigated versus usual care based on clinic day. Patient navigators performed activities to facilitate timely follow-up such as appointment reminders, transportation coordination, cancer education, scheduling assistance, and social support as needed. Primary outcome measures included time (days from abnormal screening to diagnosis and time from diagnosis to treatment initiation. Secondary outcomes included psychosocial and demographic predictors of non-compliance and patient satisfaction. Dates of screening, follow-up visits, and treatment were obtained through chart audit, and questionnaires were administered at baseline, after diagnosis, and after treatment initiation. At the VA, 546 patients were enrolled in the study (245 in the navigated arm, 245 in the records-based control arm, and 56 in a subsample of surveyed control subjects. Discussion Given increasing concerns about balancing better health outcomes with lower costs, careful examination of interventions aimed at reducing healthcare disparities attain critical importance. While analysis of the C-PNRP data is

  9. Health status in older hospitalized patients with cancer or non-neoplastic chronic diseases

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    Corica Francesco

    2005-08-01

    Full Text Available Abstract Background Whether cancer is more disabling than other highly prevalent chronic diseases in the elderly is not well understood, and represents the objective of the present study. Methods We used data from the Gruppo Italiano di Farmacovigilanza nell'Anziano (GIFA study, a large collaborative observational study based in community and university hospitals located throughout Italy. Our series consisted of three groups of patients with non-neoplastic chronic disease (congestive heart failure, CHF, N = 832; diabetes mellitus, N = 939; chronic obstructive pulmonary disease, COPD, N = 399, and three groups of patients with cancer (solid tumors without metastasis, N = 813; solid tumors with metastasis, N = 259; leukemia/lymphoma, N = 326. Functional capabilities were ascertained using the activities of daily living (ADL scale, and categorical variables for dependency in at least 1 ADL or dependency in 3 or more ADLs were considered in the analysis. Cognitive status was evaluated by the 10-items Hodgkinson Abbreviated Mental Test (AMT. Results Cognitive impairment was more prevalent in patients with CHF (28.0% or COPD (25.8% than in those with cancer (solid tumors = 22.9%; leukemia/lymphoma = 19.6%; metastatic cancer = 22.8%. Dependency in at least 1 ADL was highly prevalent in patients with metastatic cancer (31.3% vs. 24% for patients with CHF and 22.4% for those with non-metastatic solid tumors, p Conclusion Cancer should not be considered as an ineluctable cause of severe cognitive and physical impairment, at least not more than other chronic conditions highly prevalent in older people, such as CHF and diabetes mellitus.

  10. Delayed breast cancer presentation: hospital data should inform proactive primary care

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    Tessa S. Marcus

    2013-01-01

    Full Text Available Background: Breast (and cervical cancer affects a growing proportion of women in South Africa. Although treatable, where health literacy is low, women typically seek medical attention only when their condition is at an advanced stage and difficult to contain.Objectives: To understand the sociodemographic characteristics of women who present with advanced breast cancer in order to intervene proactively in primary care.Method: A retrospective analysis of women with advanced breast cancer (Stage IIb and higher at a Level 2 regional hospital in South Africa (2007–2010.Results: The average age amongst the 103 women enrolled in this study was 59. One-third of the women had secondary education, 35% were unemployed and two-thirds were notmarried. Nearly 11% (n = 11 of the women had previously had cancer. Lumps (n = 87 werethe most common reason for seeking healthcare and were, together with axillary lymphnode abnormalities (84.5% and 19.4% respectively, the most common clinical symptoms. Symptoms were noticed by 52% (n = 54 of the women more than six months prior to their first consultation. A personal history of cancer increased threefold the odds of presenting within three months. Middle-aged women were twice as likely as those < 45 and > 65 to report within three to six months. Secondary education increased the odds of presenting within three to six months by 56%. Employment and marital status were not significant.Conclusion: The women most at risk for delayed detection and treatment were those without a history of breast cancer, aged < 45 and > 65, with low education. They can best be reached through low-cost community orientated primary care that proactively provides health education and promotes self- and clinical examination at the individual, family, clinic and general practitioner level.

  11. Feasibility of capecitabine monotherapy in a taxane refractory metastatic breast cancer patient: A rural cancer hospital experience

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    Vivek Tiwari

    2014-05-01

    Full Text Available To manage a metastatic cancer patient in a rural setting is a daunting task owing to the lack of resources and infrastructure. Intravenous chemotherapy (CT, with its debilitating side effects often causes a decrease in the quality of life (QOL of the patient. When the treatment is of palliative intent, efforts should be made to provide maximum symptom relief to the patient striking a balance between the patient’s wishes and a sound scientific rationale. We describe our experience with a patient with extensively metastatic breast cancer treated in our rural center with single agent oral capecitabine, without development of any severe toxicity and with a significant improvement in disease process and patient’s performance status (PS

  12. Feasibility of capecitabine immunotherapy in a taxane-refractory metastatic breast cancer patient: A rural cancer hospital experience

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    Vivek Tiwari

    2014-05-01

    Full Text Available To manage a metastatic cancer patient in a rural setting is a daunting task owing to the lack of resources and infrastructure. Intravenous chemotherapy (CT, with its debilitating side effects, often causes a decrease in the quality of life (QOL of the patient. When the treatment is of palliative intent, efforts should be made to provide maximum symptom relief to the patient, striking a balance between the patient’s wishes and a sound scientific rationale. We describe our experience with a patient with extensively metastatic breast cancer treated in our rural center with single-agent oral capecitabine, without development of any severe toxicity and with a significant improvement in disease process and patient’s performance status (PS.

  13. [Noma and Burkitt disease; a particular association about three observations seen in the Teaching Hospital Center Yalgado Ouedraogo (Burkina Faso)].

    Science.gov (United States)

    Konsem, T; Millogo, M; Gare, J; Ouedraogo, D; Ouoba, K

    2014-08-01

    Cancrum oris is a gangrenous stomatitis arising from a periodontal infection and leading to severe soft tissue and bone destruction. The pathology involves numerous factors including local thrombosis, vascularitis, necrotizing gingivitis, immunodeficiency, Gram negative and anaerobic infection. It is usually a disease of infants and malnourished children in tropical areas often occurring after a debilitating disease like measles [3]. Burkitt lymphoma is a highly aggressive non-Hodgkin lymphoma first described by Burkitt in 1958 in African children from areas holoendemic for malaria. It is the first cancer of African child [6]. The association between Burkitt lymphoma and cancrum oris is non common. We report in the present study three cases of this association at the Academic Hospital Yalgado Ouedraogo of Ouagadougou. This association poses a problem of late diagnosis with difficulties in therapeutic management.

  14. Referral pattern for neoadjuvant chemotherapy in the head and neck cancers in a tertiary care center

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    V M Patil

    2014-01-01

    Full Text Available Background: Use of any treatment modality in cancer depends not only on the effectiveness of the modality, but also on other factors such as local expertise, tolerance of the modality, cost and prevalence of the disease. Oropharyngeal and laryngeal cancer are the major subsites in which majority of neoadjuvant chemotherapy (NACT literature in the head and neck cancers is available. However, oral cancers form a major subsite in India. Materials And Methods: This is an analysis of a prospectively maintained data on NACT in the head and neck cancers from 2008 to 2012. All these patients were referred for NACT for various indications from a multidisciplinary clinic. Descriptive analysis of indications for NACT in this data base is presented. Results: A total of 862 patients received NACT within the stipulated time period. The sites where oral cavity 721 patients (83.6%, maxilla 41 patients (4.8%, larynx 33 patients (3.8%, laryngopharynx 8 patients (0.9% and hypopharynx 59 patients (8.2%. Out of oral cancers, the major indication for NACT was to make the cancer resectable in all (100% patients. The indication in carcinoma of maxilla was to make the disease resectable in 29 patients (70.7% of maxillary cancers and in 12 patients (29.3% of maxillary cancers it was given as an attempt to preserve the eyeball. The indication for NACT in laryngeal cancers was organ preservation in 14 patients (42.4% of larnyngeal cancer and to achieve resectability in 19 patients (57.6% of larnyngeal cancer. The group with laryngopharynx is a cohort of eight patients in whom NACT was given to prevent tracheostomy, these patients had presented with early stridor (common terminology criteria for adverse events Version 4.02. The reason for NACT in hypopharyngeal cancers was for organ preservation in 24 patients (40.7% of hypopharyngeal cancer and for achievement of resectability in 35 patients (59.3% of hypopharyngeal cancer. Conclusion: The major indication for NACT is to

  15. Protocol images for staging of gastric cancer in radiology Hospital San Vicente de Paul

    International Nuclear Information System (INIS)

    The realization of a protocol for the evaluation of imaging in the radiology service of Hospital San Vicente de Paul in the province of Heredia is considered a useful tool that allows a clear and simple communication with the rest of the interdisciplinary team that serves patients with gastric cancer. The adequate management of this disease is important for an assessment and standardized reporting of images to facilitate preoperative planning; because the number of diagnostic studies that should be performed for the detection once obtained the histological diagnosis to establish the staging. Prior knowledge of stage according to TNM (Tumor/Nodes/Metastasis) classification is essential. The initial assessment for radiological detection of gastric cancer was performed with gastroduodenal series with double contrast medium and fluoroscopic control. The establishment of a study effects required for routine is important and avoid underdiagnosis.The new Hospital San Vicente de Paul will have the tomographic assessment and trans abdominal ultrasound (USTA) essential to assess the presence of metastasis to peritoneum and solid organs, in addition to the adenomegaly suggesting neoplastic infiltration. (author)

  16. Hospital Performance Indicators and Their Associated Factors in Acute Child Poisoning at a Single Poison Center, Central Saudi Arabia.

    Science.gov (United States)

    Alanazi, Menyfah Q; Al-Jeriasy, Majed I; Al-Assiri, Mohammed H; Afesh, Lara Y; Alhammad, Fahad; Salam, Mahmoud

    2015-12-01

    Admission rate and length of stay (LOS) are two hospital performance indicators that affect the quality of care, patients' satisfaction, bed turnover, and health cost expenditures. The aim of the study was to identify factors associated with higher admission rates and extended average LOS among acutely poisoned children at a single poison center, central Saudi Arabia.This is a cross-sectional, poison and medical chart review between 2009 and 2011. Exposures were child characteristics, that is, gender, age, body mass index (BMI), health history, and Canadian 5-level triage scale. Poison incident characteristics were, that is, type, exposure route, amount, form, home remedy, and arrival time to center. Admission status and LOS were obtained from records. Chronic poisoning, plant allergies, and venomous bites were excluded. Bivariate and regression analyses were applied. Significance at P Poison substances were pharmaceutical drugs (63%) versus chemical products (37%). Main exposure route was oral (98%). Home remedy was observed in (21.9%), which were fluids, solutes, and/or gag-induced vomiting. Almost (52%) arrived to center >1 h. Triage levels: non-urgent cases (58%), less urgent (11%), urgent (18%), emergency (12%), resuscitative (1%). Admission rate was (20.6%) whereas av. LOS was 13 ± 22 h. After adjusting and controlling for confounders, older children (adj.OR = 1.19) and more critical triage levels (adj.OR = 1.35) were significantly associated with higher admission rates compared to younger children and less critical triage levels (adj.P = 0.006) and (adj.P = 0.042) respectively. Home remedy prior arrival was significantly associated with higher av. LOS (Beta = 9.48, t = 2.99), compared to those who directly visited the center, adj.P = 0.003.Hospital administrators are cautioned that acutely poisoned children who received home remedies prior arrival are more likely to endure an extended LOS. This non-conventional practice

  17. Prevalence of Hepatitis B surface antigen (HBsAg among visitors of Shashemene General Hospital voluntary counseling and testing center

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    Medhin Girmay

    2011-02-01

    Full Text Available Abstract Background Hepatitis B virus (HBV infection is significant health problem, as it can lead to chronic hepatitis, liver cirrhosis, and hepatic carcinoma. Due to shared routes of transmission, HBV and human immunodeficiency virus (HIV co-infection is common and is an emerging concern in the clinical management of patients because of increased mortality, accelerated hepatic disease progression, and the frequent hepatotoxicity caused by anti-retroviral therapy. The aim of this study was to determine the prevalence of Hepatitis B surface antigen (HBsAg and its risk factors, among individuals visiting Shashemene General Hospital VCT center. Findings Institution based cross-sectional study was performed from November 3, 2008 to December 29, 2008 and 384 voluntary counseling and testing (VCT clients were investigated. Data on socio demographic and HBV risk factors was collected using structured questionnaires. Blood samples were collected and screened for hepatitis B surface antigen (HBsAg and HIV by commercially available rapid test kits. The prevalence of HBsAg in this study group was 5.7%. Fourteen percent of HIV positive subjects (8/57 and 4.3% (14/327 of HIV negative subjects were positive for HBsAg. Significantly high prevalence of HBsAg was observed among individuals who had history of invasive procedures, like tooth extraction, abortion and ear piercing; history of hospital admission, history of unsafe inject and HIV positives. Conclusions Although HBsAg prevalence is much higher among subjects who are HIV positive (14.0% versus 4.3%, the prevalence of HBsAg in HIV negative subjects is high enough to warrant a recommendation to screen all clients at VCT centers irrespective of HIV status.

  18. Six years analysis of cleft palate in a university hospital center

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    Farahvash M

    1999-08-01

    Full Text Available Cleft palate is a congenital condition that occurs with the incidence rate of one out of 2000 births. This anomaly produces intraoral pressure changes (increase or decrease, can cause speech, sucking and feeding problems of involved patient. On the other hand, if cleft palate is associated with cleft of the lip or alveolar area, growth and alignment of teeth may change the appearance of the patient and affect the psychologic and occupational future of the patient. Eustatian tube malfunction in involved neonates increase. Many procedures are used to repair the cleft palate and correction of palatal muscles which are: 1 Von Langenbeck (18.5%. 2 Veau-Wardil-Kilner (72.5%. 3 Double opposing Z-Plasty (9%. In this research the demographic criteria of patients including age of the patient at operation rime (mean age 30.14 months, city of residence, family history of cleft palate (12.4%, familial relation of parents (15.2%, associated anomalies, complete or incomplete lesion, weight of patients at the time of surgery (mean 11.28 Kg, hemoglobin (11.3 mg/dl, complications, otitis media and the side of cleft palate are studied in 178 admitted patients to Imam General Hospital between 1989 and 1995.

  19. De novo cancers following liver transplantation: a single center experience in China.

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    Songfeng Yu

    Full Text Available BACKGROUND: De novo cancers are a growing problem that has become one of the leading causes of late mortality after liver transplantation. The incidences and risk factors varied among literatures and fewer concerned the Eastern population. AIMS: The aim of this study was to examine the incidence and clinical features of de novo cancers after liver transplantation in a single Chinese center. METHODS: 569 patients who received liver transplantation and survived for more than 3 months in a single Chinese center were retrospectively reviewed. RESULTS: A total of 18 de novo cancers were diagnosed in 17 recipients (13 male and 4 female after a mean of 41 ± 26 months, with an overall incidence of 3.2%, which was lower than that in Western people. Of these, 8 (3.32% cases were from 241 recipients with malignant liver diseases before transplant, while 10 (3.05% cases were from 328 recipients with benign diseases. The incidence rates were comparable, p = 0.86. Furthermore, 2 cases developed in 1 year, 5 cases in 3 years and 11 cases over 3 years. The most frequent cancers developed after liver transplantation were similar to those in the general Chinese population but had much higher incidence rates. CONCLUSIONS: Liver transplant recipients were at increased risk for developing de novo cancers. The incidence rates and pattern of de novo cancers in Chinese population are different from Western people due to racial and social factors. Pre-transplant malignant condition had no relationship to de novo cancer. Exact risk factors need further studies.

  20. Transcription factor FOXA2-centered transcriptional regulation network in non-small cell lung cancer.

    Science.gov (United States)

    Jang, Sang-Min; An, Joo-Hee; Kim, Chul-Hong; Kim, Jung-Woong; Choi, Kyung-Hee

    2015-08-01

    Lung cancer is the leading cause of cancer-mediated death. Although various therapeutic approaches are used for lung cancer treatment, these mainly target the tumor suppressor p53 transcription factor, which is involved in apoptosis and cell cycle arrest. However, p53-targeted therapies have limited application in lung cancer, since p53 is found to be mutated in more than half of lung cancers. In this study, we propose tumor suppressor FOXA2 as an alternative target protein for therapies against lung cancer and reveal a possible FOXA2-centered transcriptional regulation network by identifying new target genes and binding partners of FOXA2 by using various screening techniques. The genes encoding Glu/Asp-rich carboxy-terminal domain 2 (CITED2), nuclear receptor subfamily 0, group B, member 2 (NR0B2), cell adhesion molecule 1 (CADM1) and BCL2-associated X protein (BAX) were identified as putative target genes of FOXA2. Additionally, the proteins including highly similar to heat shock protein HSP 90-beta (HSP90A), heat shock 70 kDa protein 1A variant (HSPA1A), histone deacetylase 1 (HDAC1) and HDAC3 were identified as novel interacting partners of FOXA2. Moreover, we showed that FOXA2-dependent promoter activation of BAX and p21 genes is significantly reduced via physical interactions between the identified binding partners and FOXA2. These results provide opportunities to understand the FOXA2-centered transcriptional regulation network and novel therapeutic targets to modulate this network in p53-deficient lung cancer.

  1. Service utilization in community health centers in China: a comparison analysis with local hospitals

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    Wang Xiaohang

    2006-08-01

    Full Text Available Abstract Background Being an important part of China's Urban Health Care Reform System, Community Health Centers (CHCs have been established throughout the entire country and are presently undergoing substantial reconstruction. However, the services being delivered by the CHCs are far from reaching their performance targets. In order to assess the role of the CHCs, we examined their performance in six cities located in regions of South-East China. The purpose of this investigation was to identify the utilization and the efficiency of community health resources that are able to provide basic medical and public health services. Methods The study was approved by Peking University Health Science Center Institutional Reviewing Board (NO: IRB00001052-T1. Data were collected from all the local health bureaux and processed using SPSS software. Methods of analysis mainly included: descriptive analysis, paired T-test and one-way ANOVA. Results The six main functions of the CHCs were not fully exploited and the surveys that were collected on their efficiency and utilization of resources indicate that they have a low level of performance and lack the trust of local communities. Furthermore, the CHCs seriously lack funding support and operate under difficult circumstances, and residents have less positive attitudes towards them. Conclusion The community health service must be adjusted according to the requirements of urban medical and health reform, taking into account communities' health needs. More research is required on the living standards and health needs of residents living within the CHC's range, taking into consideration the users' needs in expanding the newly implemented service, and at the same time revising the old service system so as to make the development of CHCs realistic and capable of providing a better service to patients. Several suggestions are put forward for an attainable scheme for developing a community health service.

  2. Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later.

    Science.gov (United States)

    Ryan, Aoife M; Power, Derek G; Daly, Louise; Cushen, Samantha J; Ní Bhuachalla, Ēadaoin; Prado, Carla M

    2016-05-01

    An awareness of the importance of nutritional status in hospital settings began more than 40 years ago. Much has been learned since and has altered care. For the past 40 years several large studies have shown that cancer patients are amongst the most malnourished of all patient groups. Recently, the use of gold-standard methods of body composition assessment, including computed tomography, has facilitated the understanding of the true prevalence of cancer cachexia (CC). CC remains a devastating syndrome affecting 50-80 % of cancer patients and it is responsible for the death of at least 20 %. The aetiology is multifactorial and complex; driven by pro-inflammatory cytokines and specific tumour-derived factors, which initiate an energy-intensive acute phase protein response and drive the loss of skeletal muscle even in the presence of adequate food intake and insulin. The most clinically relevant phenotypic feature of CC is muscle loss (sarcopenia), as this relates to asthenia, fatigue, impaired physical function, reduced tolerance to treatments, impaired quality of life and reduced survival. Sarcopenia is present in 20-70 % depending on the tumour type. There is mounting evidence that sarcopenia increases the risk of toxicity to many chemotherapy drugs. However, identification of patients with muscle loss has become increasingly difficult as 40-60 % of cancer patients are overweight or obese, even in the setting of metastatic disease. Further challenges exist in trying to reverse CC and sarcopenia. Future clinical trials investigating dose reductions in sarcopenic patients and dose-escalating studies based on pre-treatment body composition assessment have the potential to alter cancer treatment paradigms. PMID:26786393

  3. Endocrinological analysis of 122 Japanese childhood cancer survivors in a single hospital

    International Nuclear Information System (INIS)

    With recent improvements in the diagnosis and treatment of cancer, the number of childhood cancer survivors (CCSs) has been increasing in Japan. The importance of quality of life during the lifetime of CCSs has now been recognized, and the late effects of cancer treatments are essential and important issues. In this study we analyzed the endocrinological abnormalities of CCSs by retrospectively evaluating 122 outpatients (62 males and 60 females) who had been referred from pediatric oncologists to our follow-up clinic among 151 CCSs attending our hospital more than two years after their cancer treatment. Follow-up duration varied from 2 to 30 (median 8.0) years. Their average age was 17.3 (range 4-36, median 17.0) years, and 38 patients (31.1%) reached adulthood. Endocrinological abnormalities were found in 82 (67%) of 122 survivors. Gonadal dysfunction was observed in 60 patients (49%). Thirty-nine patients (32%) were short or grew at a slower rate. Twenty-six patients (21%) showed thyroid dysfunction. Other abnormalities were as follows: obesity in 20 patients (16%), leanness in 10 (8%), central diabetes insipidus in 11 (9%) and adrenocortical dysfunction in 9 (7%). Low bone mineral density was observed in 41 (42%) of 98 patients evaluated. These endocrinological abnormalities were caused by the combined effects of cancer itself and various treatments (chemotherapy, radiation therapy, surgery, and hematopoietic stem cell transplantation). Lifetime medical surveillance and continuous follow-up are necessary for CCSs, because treatment-related complications may occur during childhood and many years after the therapy as well. Endocrinologists should participate in long-term follow-up of these survivors in collaboration with pediatric oncologists. (author)

  4. Cancer-associated malnutrition, cachexia and sarcopenia: the skeleton in the hospital closet 40 years later.

    Science.gov (United States)

    Ryan, Aoife M; Power, Derek G; Daly, Louise; Cushen, Samantha J; Ní Bhuachalla, Ēadaoin; Prado, Carla M

    2016-05-01

    An awareness of the importance of nutritional status in hospital settings began more than 40 years ago. Much has been learned since and has altered care. For the past 40 years several large studies have shown that cancer patients are amongst the most malnourished of all patient groups. Recently, the use of gold-standard methods of body composition assessment, including computed tomography, has facilitated the understanding of the true prevalence of cancer cachexia (CC). CC remains a devastating syndrome affecting 50-80 % of cancer patients and it is responsible for the death of at least 20 %. The aetiology is multifactorial and complex; driven by pro-inflammatory cytokines and specific tumour-derived factors, which initiate an energy-intensive acute phase protein response and drive the loss of skeletal muscle even in the presence of adequate food intake and insulin. The most clinically relevant phenotypic feature of CC is muscle loss (sarcopenia), as this relates to asthenia, fatigue, impaired physical function, reduced tolerance to treatments, impaired quality of life and reduced survival. Sarcopenia is present in 20-70 % depending on the tumour type. There is mounting evidence that sarcopenia increases the risk of toxicity to many chemotherapy drugs. However, identification of patients with muscle loss has become increasingly difficult as 40-60 % of cancer patients are overweight or obese, even in the setting of metastatic disease. Further challenges exist in trying to reverse CC and sarcopenia. Future clinical trials investigating dose reductions in sarcopenic patients and dose-escalating studies based on pre-treatment body composition assessment have the potential to alter cancer treatment paradigms.

  5. Integration of the clinical engineering specialist at a high complexity children's hospital. Our professional experience at a surgical center

    Energy Technology Data Exchange (ETDEWEB)

    Vargas Enriquez, M J; Chazarreta, B; Emilio, D G; Fernandez Sarda, E [Surgical Center-Neurophysiology Division of Medical Tecnology Department, Garrahan Children' s Hospital, Combate de los Pozos 1881, Buenos Aires (Argentina)

    2007-11-15

    This document aims to find relating points between the current and future Clinical Engineer professional in order to discuss about the hospital environment, its characteristics and its realities which lead to our professional development. The main aim is to depict our experience through a retrospective analysis based on the underwriting experience and consequently to arrive at conclusions that will support the inclusion and active interaction of the Clinic Engineer Specialist as part of a Hospital's Surgical Center.

  6. The Epidemiological and Clinical Assessment of Admitted Burned Pregnant Women in Shahid Mottahary Hospital Burn Center Between January 1998 and October 2003

    OpenAIRE

    A. Tavassoli-Ashrafi, M.D.; H. Khani, M.D.

    2007-01-01

    Background and purpose: Treatments of burn pregnant women is a difficult task because the vulnerable fetus is highly dependent on the health of the mother. This study was conducted to determine the epidemiology, etiology, clinical assessment and outcome of pregnant patients between January 1998 and October 2003.Materials and Methods: A 6-year retrospective descriptive study of burns in pregnant women hospitalized at Mottahary hospital (burn center) in Tehran was performed. A short structured ...

  7. Establishing and Sustaining a Prospective Screening Program for Breast Cancer-Related Lymphedema at the Massachusetts General Hospital: Lessons Learned

    OpenAIRE

    Brunelle, Cheryl; Skolny, Melissa; Ferguson, Chantal; Swaroop, Meyha; O’Toole, Jean; Taghian, Alphonse G.

    2015-01-01

    There has been an increasing call to prospectively screen patients with breast cancer for the development of breast cancer-related lymphedema (BCRL) following their breast cancer treatment. While the components of a prospective screening program have been published, some centers struggle with how to initiate, establish, and sustain a screening program of their own. The intent of this manuscript is to share our experience and struggles in establishing a prospective surveillance program within ...

  8. Patient Navigators: Agents of Creating Community-Nested Patient-Centered Medical Homes for Cancer Care.

    Science.gov (United States)

    Simon, Melissa A; Samaras, Athena T; Nonzee, Narissa J; Hajjar, Nadia; Frankovich, Carmi; Bularzik, Charito; Murphy, Kara; Endress, Richard; Tom, Laura S; Dong, XinQi

    2016-01-01

    Patient navigation is an internationally utilized, culturally grounded, and multifaceted strategy to optimize patients' interface with the health-care team and system. The DuPage County Patient Navigation Collaborative (DPNC) is a campus-community partnership designed to improve access to care among uninsured breast and cervical cancer patients in DuPage County, IL. Importantly, the DPNC connects community-based social service delivery with the patient-centered medical home to achieve a community-nested patient-centered medical home model for cancer care. While the patient navigator experience has been qualitatively documented, the literature pertaining to patient navigation has largely focused on efficacy outcomes and program cost effectiveness. Here, we uniquely highlight stories of women enrolled in the DPNC, told from the perspective of patient navigators, to shed light on the myriad barriers that DPNC patients faced and document the strategies DPNC patient navigators implemented. PMID:27594792

  9. Patient profile and treatment outcome of rectal cancer patients treated with multimodality therapy at a regional cancer center

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    Deo Suryanarayana

    2004-01-01

    Full Text Available BACKGROUND : Incidence of rectal cancer has wide geographical variation. Disease pattern in developing countries is different from developed countries as majority of the patients present in advanced stage because of delayed referral and lack of uniform treatment practices. AIMS : Present study describes the patient profile and treatment results from a tertiary care cancer center in India. SETTING AND DESIGN : Tertiary care Regional cancer center. Retrospective analysis 89 patients with rectal adenocarcinoma treated between 1995 and 2002 were analyzed. METHODS: Patients with adenocarcinoma rectum were evaluated in a G.I. Oncology clinic and were treated using multimodality protocols involving surgery, radiotherapy and adjuvant chemotherapy. STATISTICAL ANALYSIS : A descriptive analysis of patient and disease profile,treatment patterns and out come was performed. Survival analysis was performed using Kaplan-Meier method. RESULTS : Mean age of the patients was 45.4 years and majority of them had tumor in lower third of rectum with evidence of extrarectal spread. Seventy five percent of the patients underwent curative resection with abdominoperineal resection being the commonest procedure. Forty seven percent of patients were given short course preoperative radiotherapy and the remaining received postoperative radiotherapy. Sixty four percent of patients could complete planned adjuvant chemotherapy. Operative mortality was 2% and 23% had morbidity. Local recurrence rate was 8.9%. 5-year disease free and overall survival was 54% and 58% respectively. CONCLUSION : Majority of rectal cancer patients present with locally advanced and low rectal growths leading to low sphincter salvage rates. Despite the advanced stage of presentation optimal oncologic results can be obtained by using a good surgical techniques in combination with adjuvant radiotherapy and chemotherapy. Short course preoperative radiotherapy seems to be more feasible in Indian context

  10. Drug abuse in hospitalized trauma patients in a university trauma care center: an explorative study

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    A.R. Soroush

    2006-08-01

    Full Text Available Background: Drug abuse has been known as a growing contributing factor to all types of trauma in the world. The goal of this article is to provide insight into demographic and substance use factors associated with trauma and to determine the prevalence of drug abuse in trauma patients. Methods: Evidence of substance abuse was assessed in trauma patients presenting to Sina trauma hospital over a 3-month period. They were interviewed and provided urine samples to detect the presence of drug/metabolites of opium, morphine, cannabis and heroin by “Morphine Check” kits. Demographic data, mechanisms of injury, history of smoking and drug abuse were recorded. Results: A total of 358 patients with a mean age of 28.4 years were studied. The Patients were predominantly male (94.7%. There was a history of smoking in 136 cases (38%. 58 cases (16.2% reported to abuse drugs (91.5% opium. The commonest route of administration was smoke inhalation (37.2%. Screening by Morphine Check test revealed 95 samples to be positive (26.5%. The preponderance of test-positive cases was among young people (of 20-30 years of age with a history of smoking. Victims of violence and those with penetrating injuries also showed a higher percentage of positive screens (P=0.038 and P<0.001, respectively. Conclusion: These results suggest that drug abuse is a contributing factor to trauma especially in violent injuries and among the young. Regarding the considerable prevalence of drug abuse among trauma patients, it’s highly recommended that all trauma patients be screened for illicit drugs

  11. Comparative Analysis of Clinical Features of Lung Cancer in West China Hospital in 2000 and 2010

    Directory of Open Access Journals (Sweden)

    Xiaojun YAO

    2012-06-01

    Full Text Available Background and objective Primary lung cancer is one of the most common malignant tumors. The aim of the current study is to retrospectively analyze the clinical features variation of patients with primary bronchogenic carcinoma in West China Hospital Sichuan University to provide information for early detection and treatment of lung cancer. Methods We collected data of patients of permanent population in Sichuan province who diagnosed primary bronchogenic carcinoma in 2000 and 2010 in West China Hospital Sichuan University respectively for comparative analysis of reasons to visit the doctor, duration from symptom onset to visit the doctor, combined diseases, incidences of bi-primary carcinoma, family history of malignant tumor, sites of tumors, grade of differentiation, tumor staging and initial treatment modalities. Results A total of 2,167 cases (616 cases in 2000 and 1,551 cases in 2010 met inclusion criteria were retrieved for analysis. In 2010, compared with data of 2000, the rate of patients who visit the doctors because abnormalities were detected by health examination elevated remarkably (5.2% vs 16.7%, P<0.001, the duration from symptom onset to visit the doctor abridged significantly (P<0.001, patients with family history of malignant tumor increased significantly (3.9% vs 13.7%, P<0.001, the constituent ratio of poorly differentiated adenocarcinoma decreased (72.3% vs 51.8%, P=0.002 accompanied with low differentiated squamous cell carcinoma increased (59.4% vs 76.7%, P=0.002. For NSCLC staging, there is a notably increase of rate of stage Ia (1.0% vs 4.5%, P< 0.001 and stage IV (30.4% vs 37.8%, P<0.001 while decrease of stage IIIa (26.6% vs 14.8%, P=0.002. For initial treatment modalities, there is markedly increased chemotherapy rate of non-small cell lung cancer (NSCLC patients (41.8% vs 63.4%, P=0.002 while remarkably increased surgery rate of stage IIIa patients (41.8% vs 63.4%, P=0.002 and decreased surgery rate of stage IV

  12. Cyberknife fractionated radiotherapy for adrenal metastases: Preliminary report from a multispecialty Indian cancer care center

    OpenAIRE

    Trinanjan Basu; Tejinder Kataria; Ashu Abhishek; Deepak Gupta; Shikha Goyal; Shyam S. Bisht; Karthick K Payaliappan; Vikraman Subhramani

    2015-01-01

    Purpose: Metastasis to adrenal gland from lung, breast, and kidney malignancies are quite common. Historically radiotherapy was intended for pain palliation. Recent studies with stereotactic body radiotherapy (SBRT) including Cyberknife robotic radiosurgery aiming at disease control brings about encouraging results. Here we represent the early clinical experience with Cyberknife stereotactic system from an Indian cancer care center. The main purpose of this retrospective review is to serve as...

  13. Risk factors of breast cancer in patients diagnosed at the Julio Trigo hospital

    International Nuclear Information System (INIS)

    A retrospective descriptive study was carried out with the objective of identifying some risk factors of breast cancer in patients diagnosed in the hospital Julio Trigo Lopez from 2007 to 2008. Of a universe of 54 patients, it was selected a sample of 31 patients (57,4%) who were those that gave their consent to be interviewed at the time that lasted the investigation (6 months). The 90,3% of the cases corresponded to infiltrating ductal carcinoma type. The age group more affected was 60-69 years and the white race; 41,9% presented personal antecedents of breast nodule, whereas the familiar antecedent of breast cancer was not significant. The 61,3% presented menarche after 12 years old, and the greater percent appeared to the childbirth before 24 years old. The 40,7% did not only offer maternal lactation; 87,1% had one or more children and 58,6% presented the menopause after the 50 years old. There was not risk exposure at the workplaces. The conjunction of several risk factors can favor the appearance of breast cancer, but the absence of demonstrable risk factors does not exclude the possibility of suffering the disease

  14. [Post-transplant lymphoproliferative disease in liver transplant recipients--Merkur University Hospital single center experience].

    Science.gov (United States)

    Filipec-Kanizaj, Tajana; Budimir, Jelena; Colić-Cvrlje, Vesna; Kardum-Skelin, Ika; Sustercić, Dunja; Naumovski-Mihalić, Slavica; Mrzljak, Anna; Kolonić, Slobodanka Ostojić; Sobocan, Nikola; Bradić, Tihomir; Dolić, Zrinka Misetić; Kocman, Branislav; Katicić, Miroslava; Zidovec-Lepej, Snjezana; Vince, Adriana

    2011-09-01

    favoring the diagnosis. The management of PTLD poses a major therapeutic challenge and although there is reasonable agreement about the overall principles of treatment, there is still considerable controversy about the optimal treatment of individual patients. EBV-related PTLDs are a significant cause of mortality in patients undergoing orthotopic liver transplantation with the observed mortality rate of up to 50%. This paper presents the experience acquired at Merkur University Hospital in the diagnosis and treatment of patients with liver transplantation and PTLD. PMID:23126028

  15. Experience on breast cancer with brain metastasis in Kanagawa Cancer Center

    International Nuclear Information System (INIS)

    We studied the relationship between clinicopathologic findings and effect of adjuvant therapy on brain metastasis in breast cancer in order to clarify risk factors for brain metastasis in breast cancer patients. We divided patients into a group treated up until December 1999 (Group 1) and a group treated after January 2000 (Group 2), in whom adjuvant therapy was not generalized. Estrogen receptor-negative patients and cases more advanced than T2 showed a high risk of brain metastasis. The time interval to brain metastasis in Group 1 and 2 were 25 and 49.6 months, respectively, showing a significant difference. Taxan derivatives were used in 1.6% of Group 1 and 76% of Group 2. Estrogen receptor negativity, cancer more advanced than T2, and adjuvant therapy are risk factors for brain metastasis. (author)

  16. Cardiorespiratory fitness and digestive cancer mortality: findings from the aerobics center longitudinal study.

    Science.gov (United States)

    Peel, J Brent; Sui, Xuemei; Matthews, Charles E; Adams, Swann A; Hébert, James R; Hardin, James W; Church, Timothy S; Blair, Steven N

    2009-04-01

    Although higher levels of physical activity are inversely associated with risk of colon cancer, few prospective studies have evaluated overall digestive system cancer mortality in relation to cardiorespiratory fitness (CRF). The authors examined this association among 38,801 men ages 20 to 88 years who performed a maximal treadmill exercise test at baseline in the Aerobics Center Longitudinal Study (Dallas, TX) during 1974 to 2003. Mortality was assessed over 29 years of follow-up (1974-2003). Two hundred eighty-three digestive system cancer deaths occurred during a mean 17 years of observation. Age-adjusted mortality rates per 10,000 person-years according to low, moderate, and high CRF groups were 6.8, 4.0, and 3.3 for digestive system cancer (P(trend) < 0.001). After adjustment for age, examination year, body mass index, smoking, drinking, family history of cancer, personal history of diabetes, hazard ratios (95% confidence intervals) for overall digestive cancer deaths for those in the middle and upper 40% of the distribution of CRF relative to those in the lowest 20% were 0.66 (0.49-0.88) and 0.56 (0.40-0.80), respectively. Being fit (the upper 80% of CRF) was associated with a lower risk of mortality from colon [0.61 (0.37-1.00)], colorectal [0.58 (0.37-0.92)], and liver cancer [0.28 (0.11-0.72)] compared with being unfit (the lowest 20% of CRF). These findings support a protective role of CRF against total digestive tract, colorectal, and liver cancer deaths in men. PMID:19293313

  17. Cardiorespiratory fitness and digestive cancer mortality: findings from the Aerobics Center Longitudinal Study (ACLS)

    Science.gov (United States)

    Peel, J. Brent; Sui, Xuemei; Matthews, Charles E.; Adams, Swann A.; Hébert, James R.; Hardin, James W.; Church, Timothy S.; Blair, Steven N.

    2009-01-01

    Although higher levels of physical activity are inversely associated with risk of colon cancer, few prospective studies have evaluated overall digestive system cancer mortality in relation to cardiorespiratory fitness (CRF). The authors examined this association among 38,801 men aged 20−88 years and who performed a maximal treadmill exercise test at baseline in the Aerobics Center Longitudinal Study (Dallas, Texas) during 1974−2003. Mortality was assessed over 29 years of follow-up (1974−2003). 283 digestive system cancer deaths occurred during a mean 17-year of observation. Age-adjusted mortality rates per 10,000 person-yrs according to low, moderate, and high CRF groups were 6.8, 4.0, and 3.3 for digestive system cancer (trend p < 0.001). After adjustment for age, examination year, body mass index, smoking, drinking, family history of cancer, personal history of diabetes, hazard ratios for overall digestive cancer deaths (95% confidence interval) for those in the middle and upper 40% of the distribution of CRF relative to those in the lowest 20% were 0.66 (0.49, 0.88) and 0.56 (0.40, 0.80), respectively. Being fit (the upper 80% of CRF) was associated with a lower risk of mortality from colon (0.61 [0.37, 1.00]), colorectal (0.58 [0.37, 0.92]), and liver cancer (0.28 [0.11, 0.72]), compared with being unfit (the lowest 20% of CRF). These findings support a protective role of CRF against total digestive tract, colorectal, and liver cancer deaths in men. PMID:19293313

  18. St. Luke's Medical Center: technologizing health care

    International Nuclear Information System (INIS)

    The computerization of the St. Luke's Medical Center improved the hospital administration and management, particularly in nuclear medicine department. The use of computer-aided X-ray simulator machine and computerized linear accelerator machine in diagnosing and treating cancer are the most recent medical technological breakthroughs that benefited thousands of Filipino cancer patients. 4 photos

  19. Postoperative Survival Estimation of Gastric Cancer Patients in Cancer Institute of Tehran, Imam Khomeini Hospital and Its Relative Factors

    Directory of Open Access Journals (Sweden)

    A. Kazemnejad

    2010-10-01

    Full Text Available Introduction & Objective: Gastric Cancer (GC is one of the most common causes of death in the world. The most important cause of high death rate related to GC is late diagnosis of the disease. The main treatment of gastric cancer in its primary stage of is surgery, and radiotherapy and chemotherapy are supplementary treatments. There are some factors that affect survival after surgery. This study aimed to assess the survival of patients with GC under surgery and to determine the risk factors of this cancer. Materials & Methods: A total of 262 patients with GC under surgery were followed and included in the study from 21st of March 2003 to 21st of March 2007 in the cancer institute of Tehran, Imam Khomeini Hospital, . The staging of the disease before the surgery was based on CT-Scan and endosonography and after the surgery was based on the pathologic reports. The survival of the patients was determined by their periodical referrals and our telephone contacts with their relatives. The survival times were considered as the time from the diagnosis up to the death or the end of the study. The effect of the various risk factors including gender, age at diagnosis, tumor site, pathologic stage of the disease, type of treatment, metastases and relapse were evaluated. Kaplan-Miere approach was used to estimate survival and Log-rank test and proportional Cox model to evaluate the related factors. Data were analyzed using Spss16 statistical software. Results: 75.2% of patients were men and 34.4% cases of patients experienced death. The mean follow-up time was 19.317.4. The mean age at diagnosis was 5811.5 and survival mean and median were 49 and 27 months respectively. The one, three and five year survival of the patients were 0.85, 0.41 and 0.3 respectively. Gender, pathologic stage, age at diagnosis and weight-loss were significantly related to the survival in multivariate analysis. Conclusion: The diagnosis of the cancer in primary stages causes

  20. Effects of music therapy on depression and duration of hospital stay of breast cancer patients after radical mastectomy

    Institute of Scientific and Technical Information of China (English)

    ZHOU Kai-na; LI Xiao-mei; YAN Hong; DANG Shao-nong; WANG Duo-lao

    2011-01-01

    Background Breast cancer remains the most important cancer among women worldwide. The disease itself and treatment may have a profound impact on the patients' psychological well being and quality of life. Depression is common in breast cancer patients and affects the therapeutic effects as well as prolongs the duration of hospital stay. However,few studies reported the effectiveness of music therapy on depression and duration of hospital stay of female patients with breast cancer after radical mastectomy. Methods One hundred and twenty subjects were recruited to this clinical trial and randomly allocated to two groups.The experimental group (n=60) received music therapy on the basis of routine nursing care, whereas the control group (n=60) only received the routine nursing care. The whole intervention time was from the first day after radical mastectomy to the third time of admission to hospital for chemotherapy. Data of demographic characteristics and depression were collected by using the General Questionnaire and Chinese version of Zung Self-rating Depression Scale (ZSDS)respectively. One pre-test (the day before radical mastectomy) and three post-tests (the day before discharge from hospital, the second and third admission to hospital for chemotherapy) were utilized. Duration of hospital stay was calculated from the first day after radical mastectomy to the day of discharged from hospital. Results The mean depression score of all subjects was 37.19±6.30. Thirty-six cases (30%) suffered from depression symptoms, with 26 (72.2%) mild depression cases, 9 (25.0%) moderate depression cases, and 1 (2.8%) severe depression case. After music therapy, depression scores of the experimental group were lower than that of the control group in the three post-tests, with significant differences (F=39.13, P<0.001; F=82.09, P<0.001). Duration of hospital stay after radical mastectomy of the experimental group ((13.62±2.04) days) was shorter than that of the control group ((15

  1. Indicators of malnutrition in children with cancer: A study of 690 patients from a tertiary care cancer center

    Directory of Open Access Journals (Sweden)

    R Srivastava

    2015-01-01

    Full Text Available Background: Large data pertaining to indicators of malnutrition in children with cancer is lacking from India. In view of this, we prospectively analyzed consecutive de novo childhood patients with cancer presenting at a tertiary care center. Materials And Methods: Height and weight of each child (n = 690 were compared with World Health Organization child growth standards-2006 for that particular age and sex to get weight-for-age, height-for-age, and weight-for-height indices and below 2SD of the reference median on these indices were considered as underweight, stunted, and wasted, respectively. Body mass index (BMI for age was also analyzed for thinness and obesity. Results: Prevalence of malnutrition based on Z-score for weight-for-age, height-for-age, weight-for-height, and BMI-for-age was 30%, 31%, 35%, and 41%, respectively. Weight-for-age (underweight was significantly associated (P = 0.018 with solid tumors. Height-for-age, weight-for-age, and BMI-for-age were significantly associated (P = 0.007, P = 0.016, and P ≤ 0.001, respectively with rural community. Conclusion: Malnutrition was observed in approximately one-third of children with cancer. Malnutrition is associated with solid tumors and those coming from rural community. Wasting has a higher prevalence in children with cancer in <5 years of age group.

  2. 2014 Korean Liver Cancer Study Group-National Cancer Center Korea practice guideline for the management of hepatocellular carcinoma.

    Science.gov (United States)

    2015-01-01

    The guideline for the management of hepatocellular carcinoma (HCC) was first developed in 2003 and revised in 2009 by the Korean Liver Cancer Study Group and the National Cancer Center, Korea. Since then, many studies on HCC have been carried out in Korea and other countries. In particular, a substantial body of knowledge has been accumulated on diagnosis, staging, and treatment specific to Asian characteristics, especially Koreans, prompting the proposal of new strategies. Accordingly, the new guideline presented herein was developed on the basis of recent evidence and expert opinions. The primary targets of this guideline are patients with suspicious or newly diagnosed HCC. This guideline provides recommendations for the initial treatment of patients with newly diagnosed HCC.

  3. [Radiotherapy in vulvar cancer. Experience in the Hospital de Oncología, CMN, SXXI, IMSS].

    Science.gov (United States)

    Huerta Bahena, J; Padilla Arrieta, P; Ayala Hernández, J R

    1995-11-01

    Between 1986 and 1992, 42 patients with carcinoma of the vulva diagnosis, were treated at the Hospital de Oncologia, CMN, SXXI. Mean age was 63 years. There was 1 case stage I, 5 stage II, 25 stage III, 4 stage IV, 2 with recurrent disease and 5 patients could not be classified. Local control was reached in 60% of patients however, 12 patients developed local recurrence after surgery and/or radiation therapy, finally 43% of patients remained disease free after a mean of 19 months of followup. In the subset of advanced disease patients treated with radical or preoperative radiation therapy (27 patients), 41% of them remained without disease. Mean radiation doses for patients treated only with radiation therapy was 6500 cGy. Late vulvar fibrosis and acute desquamative dermatitis, were the morbidity more frequently observed. New directions in the management of vulvar cancer must be developed to improve treatment results, in patients with advanced disease.

  4. Quality of life and disease understanding: impact of attending a patient-centered cancer symposium.

    Science.gov (United States)

    Padrnos, Leslie; Dueck, Amylou C; Scherber, Robyn; Glassley, Pamela; Stigge, Rachel; Northfelt, Donald; Mikhael, Joseph; Aguirre, Annette; Bennett, Robert M; Mesa, Ruben A

    2015-06-01

    To evaluate the impact of a patient-centered symposium as an educational intervention on a broad population of cancer patients. We developed a comprehensive patient symposium. Through voluntary questionnaires, we studied the impact of this cancer symposium on quality of life, cancer-specific knowledge, and symptom management among cancer patients. Symposium attendees were provided surveys prior to and 3 months following the educational intervention. Surveys included (1) EORTC-QLQ-C30; (2) disease understanding tool developed for this conference; (3) validated disease-specific questionnaires. Changes over time were assessed using McNemar's tests and paired t-tests for categorical and continuous variables, respectively. A total of 158 attendees completed the pre-convention survey. Most respondents reported at least "quite a bit" of understanding regarding treatment options, screening modalities, symptomatology, and cancer-related side effects. Attendees endorsed the least understanding of disease-related stress, risk factors, fatigue management, and legal issues related to disease/treatment. At 3 months, there was improvement in understanding (12 of 14 areas of self-reported knowledge especially regarding nutrition, and stress/fatigue management). However, no significant change was seen in QLQ-C30 functioning, fatigue, pain, or insomnia. A patient symposium, as an educational intervention improves a solid knowledge base amongst attendees regarding their disease, increases knowledge in symptom management, but may be insufficient to impact QoL as a single intervention. PMID:25641947

  5. Outcome of combined modality treatment including neoadjuvant chemotherapy of 128 cases of locally advanced breast cancer: Data from a tertiary cancer center in northern India

    OpenAIRE

    Raina, V.; M Kunjahari; N K Shukla; SVS Deo; Sharma, A.; Mohanti, B. K.; D N Sharma

    2011-01-01

    Background: Breast cancer is now the most common cancer in many parts of India and the incidence varies from 12 to 31/100000, and is rising. Locally advanced breast cancer (LABC) accounts for 30 - 35% of all cases of breast cancers in India. LABC continues to present a challenge and imposes a major health impact in our country. Materials and Methods: We carried out a analysis of our LABC patients who received neoadjuvant chemotherapy (NACT) at our hospital over a 10-year period, from January ...

  6. Breast cancer molecular subtypes and survival in a hospital-based sample in Puerto Rico

    International Nuclear Information System (INIS)

    Information on the impact of hormone receptor status subtypes in breast cancer (BC) prognosis is still limited for Hispanics. We aimed to evaluate the association of BC molecular subtypes and other clinical factors with survival in a hospital-based female population of BC cases in Puerto Rico. We analyzed 663 cases of invasive BC diagnosed between 2002 and 2005. Information on HER-2/neu (HER-2) overexpression, estrogen (ER), and progesterone (PR) receptor status and clinical characteristics were retrieved from hospitals cancer registries and record review. Survival probabilities by covariates of interest were described using the Kaplan–Meier estimators. Cox proportional hazards models were employed to assess factors associated with risk of BC death. Overall, 17.3% of BC cases were triple-negative (TN), 61.8% were Luminal-A, 13.3% were Luminal-B, and 7.5% were HER-2 overexpressed. In the multivariate Cox model, among patients with localized stage, women with TN BC had higher risk of death (adjusted hazard ratio [HR]: 2.57, 95% confidence interval [CI]: 1.29–5.12) as compared to those with Luminal-A status, after adjusting for age at diagnosis. In addition, among women with regional/distant stage at diagnosis, those with TN BC (HR: 5.48, 95% CI: 2.63–11.47) and those HER-2+, including HER-2 overexpressed and Luminal-B, (HR: 2.73, 95% CI:1.30–5.75) had a higher mortality. This is the most comprehensive epidemiological study to date on the impact of hormone receptor expression subtypes in BC survival in Puerto Rico. Consistent to results in other populations, the TN subtype and HER-2+ tumors were associated with decreased survival

  7. Outcomes from the first mouth cancer awareness and clinical check-up day in the Dublin Dental University Hospital.

    LENUS (Irish Health Repository)

    MacCarthy, Denise

    2012-04-01

    To increase public awareness about mouth cancer, the Dublin Dental University Hospital (DDUH) hosted an awareness day and free mouth check-up in September 2010. The messages of information, self-examination and risk management, and the importance of early detection, were available to all attendees. The role of general dental and medical practitioners in examination of the mouth was stressed.

  8. Trends and Factors Affecting Hospitalization Costs in Patients with Inflammatory Bowel Disease: A Two-Center Study over the Past Decade

    Directory of Open Access Journals (Sweden)

    Junjie Xu

    2013-01-01

    Full Text Available With the growing number of patients with inflammatory bowel disease (IBD and hospitalization cases, the overall medical care cost elevates significantly in consequence. A total of 2458 hospitalizations, involving 1401 patients with IBD, were included from two large medical centers. Hospitalization costs and factors impacting cost changes were determined. Patients with IBD and frequency of hospitalizations increased significantly from 2003 to 2011 (P<0.001. The annual hospitalization cost per patient, cost per hospitalization, and daily cost during hospitalization increased significantly in the past decade (all P<0.001. However, length of stay decreased significantly (P<0.001. Infliximab was the most significant factor associated with higher hospitalization cost (OR = 44380.09, P<0.001. Length of stay (OR = 1.29, P<0.001, no medical insurance (OR = 1.31, P=0.017, CD (OR = 3.55, P<0.001, inflammatory bowel disease unclassified (IBDU (OR = 4.30, P<0.0001, poor prognosis (OR = 6.78, P<0.001, surgery (OR = 3.16, P<0.001, and endoscopy (OR = 2.44, P<0.001 were found to be predictors of higher hospitalization costs. Patients with IBD and frequency of hospitalizations increased over the past decade. CD patients displayed a special one peak for age at diagnosis, which was different from UC patients. The increased hospitalization costs of IBD patients may be associated with infliximab, length of stay, medical insurance, subtypes of IBD, prognosis, surgery, and endoscopy.

  9. Awareness of cervical cancer and Pap smear among nursing staff at a rural tertiary care hospital in Central India

    Directory of Open Access Journals (Sweden)

    S M Jain

    2016-01-01

    Full Text Available Background: Cancer cervix is the leading cause of cancer deaths in females in developing countries and one in five women suffering from cervical cancer lives in India. Aims: The aim of this study is to determine the awareness about cervical cancer and Pap smear among nurses working in a tertiary care institute. Study Setting and Design: Cross-sectional survey in a tertiary care institute. Materials and Methods: Nurses working at our institute excluding those who have worked or working in the Obstetrics and Gynecology department were provided with a pre-designed questionnaire testing their knowledge about cervical cancer. Results: Approximately, 86% were aware about cancer cervix and 69% were aware of a pre-cancerous stage. 42.3% were not aware of any risk factor and 27.6% were not aware of any symptom of cancer cervix. 86.2% were aware about Pap smear, but only 58.6% were aware that facilities of Pap smear were available at our hospital. Conclusions: Knowledge about cervical cancer and awareness of Pap smear as screening test was inadequate in nursing staff. Awareness programs about cervical cancer and screening are needed to increase awareness for this preventable condition. Recommendation: There is a need to arrange reorientation programs to sensitize nurses and establish cytology clinics to offer facilities for easily accessible and affordable screening.

  10. The development of a telemedical cancer center within the Veterans Affairs Health Care System: a report of preliminary clinical results.

    Science.gov (United States)

    Billingsley, Kevin G; Schwartz, David L; Lentz, Susan; Vallières, Eric; Montgomery, R Bruce; Schubach, William; Penson, David; Yueh, Bevan; Chansky, Howard; Zink, Claudia; Parayno, Darla; Starkebaum, Gordon

    2002-01-01

    In order to optimize the delivery of multidisciplinary cancer care to veterans, our institution has developed a regional cancer center with a telemedical outreach program. The objectives of this report are to describe the organization and function of the telemedical cancer center and to report our early clinical results. The Veterans Affairs Health Care System is organized into a series of integrated service networks that serve veterans within different areas throughout the United States. Within Veterans Integrated Service Network 20 (Washington, Alaska, Idaho, Oregon) we have developed a regional cancer center with telemedicine links to four outlying facilities within the service area. The telemedical outreach effort functions through the use of a multidisciplinary telemedicine tumor board. The tumor board serves patients in outlying facilities by providing comprehensive, multidisciplinary consultation for the complete range of malignancies. For individuals who do require referral to the cancer center, the tumor board serves to coordinate the logistical and clinical details of the referral process. This program has been in existence for 1 year. During that time 85 patients have been evaluated in the telemedicine tumor board. Sixty-two percent of the patients were treated at their closest facility; 38% were referred to the cancer center for treatment and/or additional diagnostic studies. The patients' diagnoses included the entire clinical spectrum of malignant disease. Preliminary clinical results demonstrate the program is feasible and it improves access to multidisciplinary cancer care. Potential benefits include improved referral coordination and minimization of patient travel and treatment delays. PMID:12020412

  11. Survey of patient dosimetry for head and neck cancer patients undergoing external radiotherapy treatment: A study from northeastern hospitals of India

    Directory of Open Access Journals (Sweden)

    Sharma Arunkumar

    2009-01-01

    Full Text Available Aim : To study dosimetry of patients during the external radiotherapy of head and neck cancers from different hospitals of the northeastern region (NER of India. Materials and Methods : 35 confirmed cases of head and neck cancers reporting to three different hospitals in the NER of India who underwent radiation treatment were the materials for the study. Dosimetry was carried out at 8(eight anatomical points to these patients, namely, target (entrance and exit points, forehead, chest, abdomen, gonad, arm, and leg respectively by thermoluminescence (TL as well as optically stimulated luminescence (OSL dosimeters. Unlike conventional appliances, we used common iodized salt as TL/OSL phosphor. Results : Patient dosimetry was found to vary with an average of 1.17 ± 0.39 Sv at forehead, 1.24 ± 0.39 Sv at chest, 0.52 ± 0.13 Sv at gonad to a minimum of 0.26 ± 0.07 Sv at leg areas when exposed to a cumulative dose of 65 Sv at the target. Conclusion : Maximum dose received from a stray radiation is about 1.5 Sv at forehead/chest and dosimetry of patient among the three centers is not significantly different at the 5% level of probability.

  12. Colorectal surgery in Italy. Criteria to identify the hospital units and the tertiary referral centers entitled to perform it.

    Science.gov (United States)

    Ruffo, Giacomo; Barugola, Giuliano; Rossini, Roberto; Sartori, Carlo Augusto

    2016-06-01

    Improving the quality and effectiveness of care is a key priority of any health policy. The outcomes of health care can be considered as indicators of effectiveness or quality. The scientific literature that evaluates the association between the volume of activity and the outcome of health interventions has greatly developed over the past decade, but, for practical reasons, ethical and social issues, a few randomized controlled studies were made to evaluate this association, although there are numerous observational studies of outcome and systematic reviews of the studies themselves. The colorectal surgery is the most studied area and it represents the ideal testing ground to determine the effectiveness of the quality indicators because of the high incidence of the disease and the wide spread in the territory of the structures that aim to tackle these issues. Numerous studies have documented an association between the large number of colo-rectal surgical procedures and the quality of results. In particular, the volume of activity is one of the characteristics of measurable process that can have a significant impact on the outcome of health care. In conclusion, the ability to use volume thresholds as a proxy for quality is very tempting but it is only part of reality. Infact, the volume-outcome relationship strictly depends on the type of cancer (colon vs rectum) and it appears somehow stronger for the individual surgeon than for the hospital; especially for the 5-year overall survival, operative mortality and number of permanent stoma. PMID:27278551

  13. Demonstrating a Conceptual Framework to Provide Efficient Wound Management Service for a Wound Care Center in a Tertiary Hospital.

    Science.gov (United States)

    Chen, Yu-Tsung; Chang, Chang-Cheng; Shen, Jen-Hsiang; Lin, Wei-Nung; Chen, Mei-Yen

    2015-11-01

    Although the benefits of wound care services and multidisciplinary team care have been well elaborated on in the literature, there is a gap in the actual practice of wound care and the establishment of an efficient referral system. The conceptual framework for establishing efficient wound management services requires elucidation.A wound care center was established in a tertiary hospital in 2010, staffed by an integrated multidisciplinary team including plastic surgeons, a full-time coordinator, a physical therapist, occupational therapists, and other physician specialists. Referral patients were efficiently managed following a conceptual framework for wound care. This efficient wound management service consists of 3 steps: patient entry and onsite immediate wound debridement, wound re-evaluation, and individual wound bed preparation plan. Wound conditions were documented annually over 4 consecutive years.From January 2011 to December 2014, 1103 patients were recruited from outpatient clinics or inpatient consultations for the 3-step wound management service. Of these, 62% of patients achieved healing or improvement in wounds, 13% of patients experienced no change, and 25% of patients failed to follow-up. The outcome of wound treatment varied by wound type. Sixty-nine percent of diabetic foot ulcer patients were significantly healed or improved. In contrast, pressure ulcers were the most poorly healed wound type, with only 55% of patients achieving significantly healed or improved wounds.The 3-step wound management service in the wound care center efficiently provided onsite screening, timely debridement, and multidisciplinary team care. Patients could schedule appointments instead of waiting indefinitely for care. Further wound condition follow-up, education, and prevention were also continually provided.

  14. An epidemiologic survey on the causes of infertility in patients referred to infertility center in Fatemieh Hospital in Hamadan

    Directory of Open Access Journals (Sweden)

    Seyedeh Zahra Masoumi

    2015-08-01

    Full Text Available Background: Infertility is considered as a major health care problem of different communities. The high prevalence of this issue doubled its importance. A significant proportion of infertility have been related to environmental conditions and also acquired risk factors. Different environmental conditions emphasized the need to study the different causes of infertility in each area. Objective: The aim of this study was to determine the frequency causes of infertility in infertile couples. Materials and Methods: In this cross sectional descriptive study 1200 infertile men and women that were referred to infertility clinic of Fatemieh Hospital during 2010 to 2011, were examined. This center is the only governmental center for infertility in Hamadan. Sampling was based on census method. Information about the patients was obtained from medical examinations and laboratory findings. To analyze the data, descriptive statistics such as frequencies and the mean were used. Results: The prevalence of primary and secondary infertility was 69.5% and 30.5% respectively. Among the various causes of infertility women factors (88.6% had the highest regard. In the causes of female infertility, menstrual disorders, diseases (obesity, thyroid diseases, and diabetes, ovulation dysfunction, uterine factor, fallopian tubes and cervical factor had the highest prevalence respectively. The causes of male infertility based on their frequency included semen fluid abnormalities, genetic factors, vascular abnormalities, and anti-spermatogenesis factors, respectively. Conclusion: Etiology pattern of infertility in our study is similar with the many other patterns that have been reported by the World Health Organization. However, frequency of menstrual disorders is much higher than other studies that require further consideration.

  15. 77 FR 41188 - Advisory Committee on Breast Cancer in Young Women, Centers for Disease Control and Prevention...

    Science.gov (United States)

    2012-07-12

    ... HUMAN SERVICES Centers for Disease Control and Prevention Advisory Committee on Breast Cancer in Young... Temeika L. Fairley, Ph.D., Designated Federal Officer, Advisory Committee on Breast Cancer in Young Women... Federal Advisory Committee Act (Pub. L. 92-463) of October 6, 1972, that the Advisory Committee on...

  16. Cost analysis of in-patient cancer chemotherapy at a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Mohammad Ashraf Wani

    2013-01-01

    Materials and Methods: After permission from the Ethical Committee, a prospective study of 6 months duration was carried out to study the cost of treatment provided to in-patients in Medical Oncology. Direct costs that include the cost of material, labor and laboratory investigations, along with indirect costs were calculated, and data analyzed to compute unit cost of treatment. Results: The major cost components of in-patient cancer chemotherapy are cost of drugs and materials as 46.88% and labor as 48.45%. The average unit cost per patient per bed day for in-patient chemotherapy is Rs. 5725.12 ($125.96. This includes expenditure incurred both by the hospital and the patient (out of pocket. Conclusion: The economic burden of cancer treatment is quite high both for the patient and the healthcare provider. Modalities in the form of health insurance coverage need to be established and strengthened for pooling of resources for the treatment and transfer of risks of these patients.

  17. Relative dose intensity of systemic chemotherapy in an outpatient cancer center

    Directory of Open Access Journals (Sweden)

    Christine Uptigrove

    2010-11-01

    Full Text Available Objective. This study was undertaken to determine the average relative dose intensity (RDI of chemotherapy administered to patients in a community-based outpatient cancer center. Methods. A retrospective review of medical records in an outpatient cancer center was conducted for patients initiating systemic chemotherapy in 2007 for a diagnosis of lymphoma, breast, lung, ovary, or colon cancer. Eighty-four records meeting the inclusion criteria were reviewed for demographic information, primary tumor type, chemotherapy regimen, staging at diagnosis, presence of disease progression, and mortality status. Regimen data included: chemotherapeutic agents used, dosages administered, dates of administration, treatment intent (adjuvant vs. metastatic, and granulocyte colony-stimulating factor (G-CSF usage per cycle. Mean summary statistics were calculated and average RDI was analyzed. Results. The overall RDI at our institution was 83% (n=65. The RDI for those receiving adjuvant chemotherapy was 85% (n=51, whereas for those receiving chemotherapy for metastatic disease the RDI was 76% (n=14. Fifty-four percent (n=35 of the regimens met or exceeded the recommended minimum goal RDI of > 85%. Conclusions. Overall the average RDI at our institution was 83%, slightly below the goal of ≥ 85%. Patients with potentially curable malignancies receiving adjuvant chemotherapy reached the threshold RDI; however, areas for quality improvement exist at our institution.

  18. Behavior and awareness of thyroid cancer patients in Korea having non-hospitalized low-dose radioiodine treatment with regard to radiation safety

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seog Gyun; Paeng, Jin Chul; Eo, Jae Seon; Shim, Hye Kyung; Kang, Keon Wook; Chung, June Key; Lee, Myung Chul; Lee, Dong Soo [College of Medicine, Seoul National University, Seoul (Korea, Republic of)

    2010-12-15

    With the recent increase in incidence of thyroid cancer, non-hospitalized low-dose (NH-LD) radioiodine treatment (RIT) has also increased rapidly. The radioactivity limit that is allowed to be administered without hospitalization depends on individual calculation, based partly on patients' behavior. In this study, Korean patients' behavior in relation to radiation safety in NHLD RIT was surveyed. A total of 218 patients who underwent NH-LD RIT of 1.1 GBq {sup 131}I in a single center were surveyed. The patients underwent RIT with a standard protocol and the survey was performed by interview when they visited subsequently for a whole-body scan. The survey questionnaire included three parts of questions: general information, behavior relating to isolation during RIT, and awareness of radiation safety. After administration of radioiodine, 40% of patients who returned home used mass transportation, and another 47% went home by taxi or in car driven by another person. Isolation at home was generally sufficient. However, 7% of patients did not stay in a separate room. Among the 218 patients, 34% did not go home and chose self-isolation away from home, mostly due to concerns about radiation safety of family members. However, the places were mostly public places, including hotels, resorts, and hospitals. About half of the patients replied that access to radiation safety information was not easy and their awareness of radiation safety was not satisfactory. As a result, 45% of patients wanted hospitalized RIT. In many countries, including Korea, RIT is continuously increasing. Considering the radiation safety of patients' family members or the public and the convenience of patients, the pretreatment education of patients should be enhanced. In addition, the hospitalization of patients having low-dose therapy is recommended to be seriously considered and expanded, with the expansion of dedicated treatment facilities

  19. Behavior and awareness of thyroid cancer patients in Korea having non-hospitalized low-dose radioiodine treatment with regard to radiation safety

    International Nuclear Information System (INIS)

    With the recent increase in incidence of thyroid cancer, non-hospitalized low-dose (NH-LD) radioiodine treatment (RIT) has also increased rapidly. The radioactivity limit that is allowed to be administered without hospitalization depends on individual calculation, based partly on patients' behavior. In this study, Korean patients' behavior in relation to radiation safety in NHLD RIT was surveyed. A total of 218 patients who underwent NH-LD RIT of 1.1 GBq 131I in a single center were surveyed. The patients underwent RIT with a standard protocol and the survey was performed by interview when they visited subsequently for a whole-body scan. The survey questionnaire included three parts of questions: general information, behavior relating to isolation during RIT, and awareness of radiation safety. After administration of radioiodine, 40% of patients who returned home used mass transportation, and another 47% went home by taxi or in car driven by another person. Isolation at home was generally sufficient. However, 7% of patients did not stay in a separate room. Among the 218 patients, 34% did not go home and chose self-isolation away from home, mostly due to concerns about radiation safety of family members. However, the places were mostly public places, including hotels, resorts, and hospitals. About half of the patients replied that access to radiation safety information was not easy and their awareness of radiation safety was not satisfactory. As a result, 45% of patients wanted hospitalized RIT. In many countries, including Korea, RIT is continuously increasing. Considering the radiation safety of patients' family members or the public and the convenience of patients, the pretreatment education of patients should be enhanced. In addition, the hospitalization of patients having low-dose therapy is recommended to be seriously considered and expanded, with the expansion of dedicated treatment facilities

  20. Pathological complete response in breast cancer patients following neoadjuvant chemotherapy at a Comprehensive Cancer Center: The natural history of an elusive prognosticator

    OpenAIRE

    Fayanju, Oluwadamilola M.; NWAOGU, IHEOMA; Jeffe, Donna B.; Margenthaler, Julie A

    2015-01-01

    Given the prognostic significance of pathological complete response (pCR) to neoadjuvant chemotherapy, we sought to chronicle the clinical course of breast cancer patients whose tumors exhibited pCR at our institution. We retrospectively reviewed 5,533 cancer center patients treated for a first primary breast cancer between March, 1999 and September, 2010 to identify those who received neoadjuvant chemotherapy that resulted in pCR (i.e., no residual invasive malignancy in the breast or axilla...

  1. An analysis of current treatment practice in uterine papillary serous and clear cell carcinoma at two high volume cancer centers

    OpenAIRE

    Vogel, Tilley Jenkins; Knickerbocker, Abhay; Shah, Chirag A.; Schiff, Melissa A.; Isacson, Christina; Garcia, Rochelle L; Goff, Barbara A.

    2015-01-01

    Objective Despite the rarity of uterine papillary serous carcinoma (UPSC) and uterine clear cell carcinoma (UCCC), they contribute disproportionately to endometrial cancer deaths. Sufficient clinical information regarding treatment and prognosis is lacking. The aim of this study is to evaluate treatment outcomes in a rare cancer cohort based on the experience at two tertiary care cancer centers. Methods Clinicopathologic data were retrospectively collected on 279 patients with UPSC and UCCC t...

  2. Nasal metastases from renal cell carcinoma are associated with Memorial Sloan-Kettering Cancer Center poor-prognosis classification

    Institute of Scientific and Technical Information of China (English)

    Caroline Victoria Choong; Tiffany Tang; Wen Yee Chay; Christopher Goh; Miah Hiang Tay; Nor Azhari Mohd Zam; Puay Hoon Tan; Min-Han Tan

    2011-01-01

    Unusual sites of metastases are recognized in patients with renai cell carcinoma (RCC). However, the prognostic implications of these sites are not well understood. We used the Memorial Sloan-Kettering Cancer Center (MSKCC) risk classification for metastatic RCC to evaluate 912 consecutive patients with RCC managed at the Singapore General Hospital between 1990 and 2009. Among these patients, 301 had metastases either at diagnosis or during the course of illness. Nasal metastases, all arising from clear cell RCC, were identified histologically in 4 patients (1.3% of those with metastasis). All 4 patients were classified as MSKCC poor prognosis by current risk criteria. Nasal metastases were significantly associated with lung and bone metastases. The frequency of nasal metastases in patients with metastatic RCC is about 1%, occurring predominantly in patients with clear cell RCC. Nasal metastases are associated with poor prognosis as estimated by the MSKCC risk classification, with attendant implications for selection of targeted therapy, and are usually associated with multi-organ dissemination, including concurrent lung and bone involvement.

  3. Clinical Profile, Predictors of Mortality, and Treatment of Patients after Myocardial Infarction, in an Academic Medical Center Hospital

    Directory of Open Access Journals (Sweden)

    Zornoff Leonardo A. M.

    2002-01-01

    Full Text Available OBJECTIVE: To evaluate clinical profiles, predictors of 30-day mortality, and the adherence to international recommendations for the treatment of myocardial infarction in an academic medical center hospital. METHODS: We retrospectively studied 172 patients with acute myocardial infarction, admitted in the intensive care unit from January 1992 to December 1997. RESULTS: Most patients were male (68%, white (97%, and over 60 years old (59%. The main risk factor for coronary atherosclerotic disease was systemic blood hypertension (63%. Among all the variables studied, reperfusion therapy, smoking, hypertension, cardiogenic shock, and age were the predictors of 30-day mortality. Most commonly used medications were: acetylsalicylic acid (71%, nitrates (61%, diuretics (51%, angiotensin-converting enzyme inhibitors (46%, thrombolytic therapy (39%, and beta-blockers (35%. CONCLUSION: The absence of reperfusion therapy, smoking status, hypertension, cardiogenic shock, and advanced age are predictors of 30-day mortality in patients with acute myocardial infarction. In addition, some medications that are undoubtedly beneficial have been under-used after acute myocardial infarction.

  4. Primary breast cancer: The experience of the joint center for radiation therapy

    International Nuclear Information System (INIS)

    While radiation therapy began to be administered in the treatment of breast cancer shortly after the discovery of X rays in 1895, the efficacious use of external beam radiation for early breast cancer required supervoltage radiation in order to get effective doses to the tumor, as well as the skin sparing, required for satisfactory cosmetic results. The use of interstitial radiation began shortly after the discovery of radium by the Curies. The first systematic report of such an approach was presented by Goeffrey Keynes, who reported equivalent results with radium implants as compared to those with mastectomy. These two techniques, supervoltage and interstitial radiation, have been used in the modern era of radiotherapy and reported by a number of centers, some of which are presented in this symposium

  5. The Bone Marrow Transplantation Center of the National Cancer Institute - its resources to assist patients with bone marrow failure

    International Nuclear Information System (INIS)

    This paper describes the bone marrow transplantation center of the brazilian National Cancer Institute, which is responsible for the cancer control in Brazil. The document also describes the resources available in the Institute for assisting patients presenting bone marrow failures. The Center provides for allogeneic and autologous bone marrow transplants, peripheral stem cell transplants, umbilical cord collections and transplants, and a small experience with unrelated bone marrow transplants. The Center receives patient from all over the country and provides very sophisticated medical care at no direct cost to the patients

  6. Conservative Surgery and Primary Radiotherapy for Early Breast Cancer; Yonsei Cancer Center Experience

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Chang Ok; Lee, Hy De; Lee, Kyung Sik; Jung, Woo Hee; Oh, Ki Keun; Kim, Gwi Eon [Yonsei University College of Medicine, Seoul (Korea, Republic of)

    1994-10-15

    Breast conserving surgery and irradiation is now accepted as preferable treatment method for the patients with stage I and II breast cancer. Our institution activated team approach for breast conservation 1991 and treated on hundred and forty patients during the next three years. Purpose: To present our early experience with eligibility criteria, treatment techniques, and the morbidities of primary radiotherapy. Materials and Methods: Sixty four patients with early stage breast cancer who received breast conserving treatment between January 1991 and December 1992 were evaluated. All patients received partial mastectomy(wide excision to quadrantectomy) and axillary node dissection followed by radiotherapy. Total dose of 4500-5040 cGy in 5-5 1/2 weeks was given to entire involved breast and boost dose of 1000-2000 cGy in 1-2 weeks was given to the primary tumor site. Linac 4 MV X-ray was used for breast irradiation and electron beam was used for boost. Thirty five patients received chemotherapy before or after radiotherapy. Patients characteristics, treatment techniques, and treatment related morbidities were analyzed. Results: Age distribution was ranged from 23 to 59 year old with median age of 40. Twenty-seven patients had T1 lesions and 34 patients had T2 lesions. In three patients, pathologic diagnosis was ductal carcinoma in situ. Thirty-seven patients were N0 and 27 patients were N1. There were three recurrences, one in the breast and two distant metastases during follow-up period(6-30 months, median 14 months). Only one breast recurrence occurred at undetected separate lesion with microcalcifications on initial mammogram. There was no serious side reaction which interrupted treatment courses or severe late complication. Only one symptomatic radiation pneumonitis and one asymptomatic radiation peumonitis were noted. Conclusions: Conservative surgery and primary radiotherapy for early breast cancer in proven to be safe and comfortable treatment method without

  7. Statistic analysis of 6891 cancer-paining patients' information from Gansu Province Tumour Hospital, China%6891例癌痛患者信息统计分析

    Institute of Scientific and Technical Information of China (English)

    Yuzhong Jin; Yandong Chai; Hua Yang

    2009-01-01

    Objective: To analyze and gain the interlinking degree of the cancer pain with patients' cancer-species, sexual-ity and age etc. Methods: The information of narcotic drugs used for cancer pain patients in our hospital (Gansu Province Tumour Hospital, China) during 2002-2007 were typed in designed EXCEL form, then counted and analyzed. Results: The total number of cancer pain patients used narcotic drugs during 2002-2007 was 6891 (n = 6691), among them, 4164 (60.44%) were males, and 2727 (39.56%) females. The top-range of cancer-species in those patients was as follows: lung cancer (20.39%), gastric cancer (14.85%), esophageal cancer (9.71%), hysterecarcinoma (6.79%), liver cancer (6.70%) and breast cancer (6.31%). Conclusion: (a) The male number of cancer pain patients using narcotic drugs is higher than the female number (1.53:1). (b) In the cases of lung cancer, gastric cancer, esophageal cancer, liver cancer and kidney cancer, the male numbers are twice more than the female numbers, and the difference between the two groups are significant. (c) Most of the cancer pain patients (over 87%) are over 40 years old.

  8. Epidemiologic characteristics of oral cancer:single-center analysis of 4097 patients from the Sun Yat-sen University Cancer Center

    Institute of Scientific and Technical Information of China (English)

    Ji Zhang; Ming Song; Fan Gao; AnKui Yang; WenKuan Chen; ShuWei Chen; Huan Li; Xing Zhang; ZhongYuan Yang; XinLin Chen

    2016-01-01

    Background: Oral cancer is a common type of head and neck cancers. Knowing its epidemiologic characteristics is crucial to preventing, diagnosing, and treating this cancer. This study aimed to explore the epidemiologic characteris‑tics of oral cancer in South China. Methods: We retrospectively analyzed data from 4097 oral cancer patients treated at the Sun Yat‑sen University Cancer Center between 1960 and 2013. We compared the age of onset, sex ratio, pathologic type, and primary tumor location among three subcultural areas (Guangfu, Hakka, and Chaoshan) and between an economically developed region and a less‑developed one in Guangdong. Results: Overall, oral cancer had a male‑to‑female ratio of approximately 2:1, and this ratio decreased over time. Oral cancer occurred mostly in patients of 45–64 years old (54.5%), and the percentage of older patients gradually increased over time. The most common tumor location was the tongue. Squamous cell carcinoma was the predomi‑nant pathologic type. The percentage of blood type O in oral cancer patients was lower than that in the healthy pop‑ulation. The male‑to‑female ratio in the Chaoshan area was higher than that in the Guangfu and Hakka areas, whereas the age of disease onset in Guangfu was higher than that in Hakka and Chaoshan. The male‑to‑female ratio was lower and the age of disease onset was higher in the economically developed region than in the less‑developed region. Conclusion: The incidence of oral cancer in South China presents typical characteristics to which doctors should pay attention when diagnosing and treating oral cancer patients.

  9. The Cost analysis of cervical cancer screening services provided by Damavand health center in 2013

    Directory of Open Access Journals (Sweden)

    Arezoo Chouhdari

    2015-03-01

    Full Text Available Background: Today, the health sector in many countries is facing with severe resource constraints; hence it is absolutely necessary that cost-benefit and cost-effectiveness assessment have a major role in design of health services. The purpose of this study was to evaluate the cost-benefit and effectiveness of cervical cancer screening service (Pap smear test done by the health centers in Damavand County in 2013.  Methods: This is a descriptive study with cross-sectional method. All data was extracted from existing documents in Damavand health network.Cost of service screening for doing Pap smear test (manpower costs of performing the service, the cost of transferring samples, water, electricity, telephone and gas was estimated in all health centers then results, were compared with the incomes of this service.  Results: Screening program coverage was 22.3%, 6.9% and 6.05% in 2011, 2012 and 2013 respectively. All costs and incomes of units performing Pap smear screening test were calculated. Entire costs and incomes of this service during 2013 were respectively 303,009,000 and 11,640,000 RLS equal $12,227 and $496.73. Therefore, the cost-benefit ratio of this screening test was approximately 0.040.  Conclusion: The costs of units performing cervical cancer screening test in Damavand Health Center were much more than this benefit and because of a none-positive Pap smear test in spite of high cost, performing this test in Damavand health centers was not cost effective.

  10. Utilization of and Attitudes towards Traditional Chinese Medicine Therapies in a Chinese Cancer Hospital: A Survey of Patients and Physicians

    OpenAIRE

    McQuade, Jennifer L.; ZhiQiang Meng; Zhen Chen; Qi Wei; Ying Zhang; WenYing Bei; J. Lynn Palmer; Lorenzo Cohen

    2012-01-01

    Background. In China, the use of traditional Chinese medicine (TCM) is very popular, but little is known about how it is integrated with conventional cancer care. We conducted parallel surveys of patients and physicians on TCM utilization. Methods. Two hundred forty-five patients and 72 allopathic physicians at the Fudan University Shanghai Cancer Center completed questions on their use of and attitude towards TCM. Results. Patient mean age was 51, with 60% female. Eighty-three percent of pa...

  11. Breast cancer risk factor knowledge among nurses in teaching hospitals of Karachi, Pakistan: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Hatcher Juanita

    2006-09-01

    Full Text Available Abstract Background Breast cancer is the most common cancer among women in both the developed and the developing world. The incidence of breast cancer in Karachi, Pakistan is 69.1 per 100,000 with breast cancer presentation in stages III and IV being common (≥ 50%. The most pragmatic solution to early detection lies in breast cancer education of women. Nurses constitute a special group having characteristics most suited for disseminating breast cancer information to the women. We assessed the level of knowledge of breast cancer risk factors among registered female nurses in teaching hospitals of Karachi. We also identified whether selected factors among nurses were associated with their knowledge of breast cancer risk factors, so that relevant measures to improve knowledge of nurses could be implemented. Methods A cross-sectional survey was conducted in seven teaching hospitals of Karachi using stratified random sampling with proportional allocation. A total of 609 registered female nurses were interviewed using a structured questionnaire adapted from the Stager's Comprehensive Breast Cancer Knowledge Test. Knowledge of breast cancer risk factors was categorized into good, fair and poor categories. Ordinal regression was used to identify factors associated with risk knowledge among nurses. Results Thirty five percent of nurses had good knowledge of risk factors. Graduates from private nursing schools (aOR = 4.23, 95% CI: 2.93, 6.10, nurses who had cared for breast cancer patients (aOR = 1.41, 95% CI: 1.00, 1.99, those having received a breast examination themselves (aOR = 1.56, 95% CI: 1.08, 2.26 or those who ever examined a patient's breast (aOR = 1.87, 95% CI: 1.34, 2.61 were more likely to have good knowledge. Conclusion A relatively small proportion of the nursing population had good level of knowledge of the breast cancer risk factors. This knowledge is associated with nursing school status, professional breast cancer exposure and self

  12. A case control study on risk factors of breast cancer among women attending MNJ Cancer Hospital, Hyderabad

    OpenAIRE

    Devi, B. Nirmala; BabuRao, B.; K., Anil kumar

    2016-01-01

    Background: Cancer has become one of the ten leading causes of death in India. Breast cancer is the most common diagnosed malignancy in India, it ranks second to cervical cancer. Globally, breast cancer is by far the most frequent cancer among women, with an estimated 1.67 million new cases diagnosed in 2012 (25% of all cancers) and ranks second overall (12% of all cancers). It is now the most common cancer both in developed (794,000 cases) and developing regions (883,000 cases).Objectives: 1...

  13. Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Short Inpatient Hospital Stays; Transition for Certain Medicare-Dependent, Small Rural Hospitals Under the Hospital Inpatient Prospective Payment System; Provider Administrative Appeals and Judicial Review. Final rule with comment period; final rule.

    Science.gov (United States)

    2015-11-13

    This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2016 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. Further, this document includes certain finalized policies relating to the hospital inpatient prospective payment system: Changes to the 2-midnight rule under the short inpatient hospital stay policy; and a payment transition for hospitals that lost their status as a Medicare-dependent, small rural hospital (MDH) because they are no longer in a rural area due to the implementation of the new Office of Management and Budget delineations in FY 2015 and have not reclassified from urban to rural before January 1, 2016. In addition, this document contains a final rule that finalizes certain 2015 proposals, and addresses public comments received, relating to the changes in the Medicare regulations governing provider administrative appeals and judicial review relating to appropriate claims in provider cost reports.

  14. Pilot Randomized Controlled Trial of Individual Meaning-Centered Psychotherapy for Patients With Advanced Cancer

    Science.gov (United States)

    Breitbart, William; Poppito, Shannon; Rosenfeld, Barry; Vickers, Andrew J.; Li, Yuelin; Abbey, Jennifer; Olden, Megan; Pessin, Hayley; Lichtenthal, Wendy; Sjoberg, Daniel; Cassileth, Barrie R.

    2012-01-01

    Purpose Spiritual well-being and sense of meaning are important concerns for clinicians who care for patients with cancer. We developed Individual Meaning-Centered Psychotherapy (IMCP) to address the need for brief interventions targeting spiritual well-being and meaning for patients with advanced cancer. Patients and Methods Patients with stage III or IV cancer (N = 120) were randomly assigned to seven sessions of either IMCP or therapeutic massage (TM). Patients were assessed before and after completing the intervention and 2 months postintervention. Primary outcome measures assessed spiritual well-being and quality of life; secondary outcomes included anxiety, depression, hopelessness, symptom burden, and symptom-related distress. Results Of the 120 participants randomly assigned, 78 (65%) completed the post-treatment assessment and 67 (56%) completed the 2-month follow-up. At the post-treatment assessment, IMCP participants demonstrated significantly greater improvement than the control condition for the primary outcomes of spiritual well-being (b = 0.39; P <.001, including both components of spiritual well-being (sense of meaning: b = 0.34; P = .003 and faith: b = 0.42; P = .03), and quality of life (b = 0.76; P = .013). Significantly greater improvements for IMCP patients were also observed for the secondary outcomes of symptom burden (b = −6.56; P < .001) and symptom-related distress (b = −0.47; P < .001) but not for anxiety, depression, or hopelessness. At the 2-month follow-up assessment, the improvements observed for the IMCP group were no longer significantly greater than those observed for the TM group. Conclusion IMCP has clear short-term benefits for spiritual suffering and quality of life in patients with advanced cancer. Clinicians working with patients who have advanced cancer should consider IMCP as an approach to enhance quality of life and spiritual well-being. PMID:22370330

  15. Cancer Therapy Directed by Comprehensive Genomic Profiling: A Single Center Study.

    Science.gov (United States)

    Wheler, Jennifer J; Janku, Filip; Naing, Aung; Li, Yali; Stephen, Bettzy; Zinner, Ralph; Subbiah, Vivek; Fu, Siqing; Karp, Daniel; Falchook, Gerald S; Tsimberidou, Apostolia M; Piha-Paul, Sarina; Anderson, Roosevelt; Ke, Danxia; Miller, Vincent; Yelensky, Roman; Lee, J Jack; Hong, David S; Kurzrock, Razelle

    2016-07-01

    Innovative molecular diagnostics deployed in the clinic enable new ways to stratify patients into appropriate treatment regimens. These approaches may resolve a major challenge for early-phase clinical trials, which is to recruit patients who, while having failed previous treatments, may nevertheless respond to molecularly targeted drugs. We report the findings of a prospective, single-center study conducted in patients with diverse refractory cancers who underwent comprehensive genomic profiling (CGP; next-generation sequencing, 236 genes). Of the 500 patients enrolled, 188 (37.6%) received either matched (N = 122/188, 65%) or unmatched therapy (N = 66/188, 35%). The most common reasons that patients were not evaluable for treatment included insufficient tissue, death, or hospice transfer. The median number of molecular alterations per patient was five (range, 1-14); median number of prior therapies, four. The most common diagnoses were ovarian cancer (18%), breast cancer (16%), sarcoma (13%), and renal cancer (7%). Of the 339 successfully profiled patients, 317 (93.5%) had at least one potentially actionable alteration. By calculating matching scores, based on the number of drug matches and genomic aberrations per patient, we found that high scores were independently associated with a greater frequency of stable disease ≥6 months/partial/complete remission [22% (high scores) vs. 9% (low scores), P = 0.024], longer time-to-treatment failure [hazard ratio (HR) = 0.52; 95% confidence interval (CI) = 0.36-0.74; P = 0.0003], and survival (HR = 0.65; 95% CI = 0.43-1.0; P = 0.05). Collectively, this study offers a clinical proof of concept for the utility of CGP in assigning therapy to patients with refractory malignancies, especially in those patients with multiple genomic aberrations for whom combination therapies could be implemented. Cancer Res; 76(13); 3690-701. ©2016 AACR. PMID:27197177

  16. Nanotechnology for photodynamic therapy: a perspective from the Laboratory of Dr. Michael R. Hamblin in the Wellman Center for Photomedicine at Massachusetts General Hospital and Harvard Medical School

    DEFF Research Database (Denmark)

    Hamblin, Michael R.; Chiang, Long Y.; Lakshmanan, Shanmugamurthy;

    2015-01-01

    The research interests of the Hamblin Laboratory are broadly centered on the use of different kinds of light to treat many different diseases. Photodynamic therapy (PDT) uses the combination of dyes with visible light to produce reactive oxygen species and kill bacteria, cancer cells and destroy...

  17. Micro satellite instability in colorectal cancer stage II. Hospital Central de las fuerzas armadas

    International Nuclear Information System (INIS)

    Introduction: micro satellite instability (MSI) is a good prognostic factor in colorectal cancer (CRC) located. Its value as a predictive marker against adjuvant treatment of chemotherapy (CT) has been shown fluoropyrimidine in various publications. The MSI occurs in 15% of colorectal tumors and sporadic in 90% of tumors in the context of colorectal cancer syndrome hereditary nonpolyposis. In Uruguay there are no studies about this phenomenon. Objective: To determine the incidence of micro satellite instability in a sample of patients using the Hospital Central de las fuerzas armadas oncology service, association with a compatible family history and the histological features of the tumors associated therewith. Methods: The medical records of patients were analyzed with CRC diagnosed stage II between 01/2001 and 12/2009. Data of the patients were analyzed which had complete histology and evolution. Results: 30/52 patients (57.6%) were analyzed. 40% had a detected MSI by kits for Pcr (polymerase chain reaction) to D2S123, D5S250, D17S346, BAT25 and BAT26 according to the Bethesda criteria. In those patients they filed a MSI: the median age was 70 years; 58.3% male. No patient had a family history consistent with HNPCC. 5.6% (3) they received Adjuvant chemotherapy treatment. Regarding tumor characteristics: 75% (9) were T3, and T4 were 25% (3); 8.3% histologic grade I (1) II 58.3% (7) 8.3% III (1) without Data 33% (6). This tumor lymphocyte infiltration was reported in 25% (3), absent 33.3% (4), not reported in 41.6% (5). Conclusions: This is the first analysis of these characteristics carried out in Uruguay. The same has been detected MSI percentage higher than reported in the literature International. In either case a compatible family history met HNPCC

  18. Hospital contacts for endocrine disorders in Adult Life after Childhood Cancer in Scandinavia (ALiCCS): a population-based cohort study

    DEFF Research Database (Denmark)

    de Fine Licht, Sofie; Winther, Jeanette Falck; Gudmundsdottir, Thorgerdur;

    2014-01-01

    BACKGROUND: The pattern of endocrine disorders in long-term survivors of childhood cancer has not been investigated comprehensively. Here, we aimed to assess the lifetime risk of these disorders in Nordic survivors of childhood cancer. METHODS: From the national cancer registries of Denmark...... were linked to the national hospital registries, and observed numbers of first-time hospital contacts for endocrine disorders in survivors of childhood cancer were compared with the expected numbers derived from the population comparison cohort. We calculated the absolute excess risks attributable...... to status as a childhood cancer survivor and standardised hospitalisation rate ratios (SHRRs). FINDINGS: Of the childhood cancer survivors, 3292 had contact with a hospital for an endocrine disorder, yielding a SHRR of 4·8 (95% CI 4·6-5·0); the highest risks were in survivors of leukaemia (SHRR 7·3 [95% CI...

  19. Managing Multi-Center Recruitment in the PLCO Cancer Screening Trial.

    Science.gov (United States)

    Gohagan, John K; Broski, Karen; Gren, Lisa H; Fouad, Mona N; Higgins, Darlene; Lappe, Karen; Ogden, Sheryl; Shambaugh, Vicki; Pinsky, Paul F; O'Brien, Barbara; Yurgalevich, Susan; Riley, Tom; Wright, Patrick; Prorok, Philip C

    2015-01-01

    There were significant recruitment challenges specific to the PLCO Cancer Screening Trial. Large numbers of participants were to be randomized from ten catchment areas nationwide within time and budgetary constraints. The eligible population was elderly and had to meet health and behavioral thresholds. Informed consent was required to participate and be randomized to screening for three cancers at periodic clinic visits or to a usual care arm that included no clinical visits. Consenting required special efforts to fully explain the trial and its potential scientific benefit to future patients with potentially no benefits but possible harms to PLCO participants. Participation would include continued follow-up for at least 13 years after randomization. Strong collaborative investments were required by the NCI and screening centers (SCs) to assure timely recruitment and appropriate racial participation. A trial-wide pilot phase tested recruitment and protocol follow through at SCs and produced a vanguard population of 11,406 participants. NCI announced the trial nationally in advance of the pilot and followed with an even more intense collaborative role with SCs for the main phase to facilitate trial-wide efficient and timely recruitment. Special efforts to enhance recruitment in the main phase included centralized and local monitoring of progress, cross-linking SCs to share experiences in problem solving, centralized training, substantial additional funding dedicated to recruitment and retention, including specialized programs for minority recruitment, obtaining national endorsement by the American Cancer Society, launching satellite recruitment and screening centers, including minority focused satellites, and adding a new SC dedicated to minority recruitment.

  20. Laparoscopy Versus Robotic Surgery for Colorectal Cancer: A Single-Center Initial Experience.

    Science.gov (United States)

    Ferrara, Francesco; Piagnerelli, Riccardo; Scheiterle, Maximilian; Di Mare, Giulio; Gnoni, Pasquale; Marrelli, Daniele; Roviello, Franco

    2016-08-01

    Background Minimally invasive approach has gained interest in the treatment of patients with colorectal cancer. The purpose of this study is to analyze the differences between laparoscopy and robotics for colorectal cancer in terms of oncologic and clinical outcomes in an initial experience of a single center. Materials and Methods Clinico-pathological data of 100 patients surgically treated for colorectal cancer from March 2008 to April 2014 with laparoscopy and robotics were analyzed. The procedures were right colonic, left colonic, and rectal resections. A comparison between the laparoscopic and robotic resections was made and an analysis of the first and the last procedures in the 2 groups was performed. Results Forty-two patients underwent robotic resection and 58 underwent laparoscopic resection. The postoperative mortality was 1%. The number of harvested lymph nodes was higher in robotics. The conversion rate was 7.1% for robotics and 3.4% for laparoscopy. The operative time was lower in laparoscopy for all the procedures. No differences were found between the first and the last procedures in the 2 groups. Conclusions This initial experience has shown that robotic surgery for the treatment of colorectal adenocarcinoma is a feasible and safe procedure in terms of oncologic and clinical outcomes, although an appropriate learning curve is necessary. Further investigation is needed to demonstrate real advantages of robotics over laparoscopy. PMID:26721500

  1. Prospective multi-center trial utilizing electronic brachytherapy for the treatment of endometrial cancer

    International Nuclear Information System (INIS)

    A modified form of high dose rate (HDR) brachytherapy has been developed called Axxent Electronic Brachytherapy (EBT). EBT uses a kilovolt X-ray source and does not require treatment in a shielded vault or a HDR afterloader unit. A multi-center clinical study was carried out to evaluate the success of treatment delivery, safety and toxicity of EBT in patients with endometrial cancer. A total of 15 patients with stage I or II endometrial cancer were enrolled at 5 sites. Patients were treated with vaginal EBT alone or in combination with external beam radiation. The prescribed doses of EBT were successfully delivered in all 15 patients. From the first fraction through 3 months follow-up, there were 4 CTC Grade 1 adverse events and 2 CTC Grade II adverse events reported that were EBT related. The mild events reported were dysuria, vaginal dryness, mucosal atrophy, and rectal bleeding. The moderate treatment related adverse events included dysuria, and vaginal pain. No Grade III or IV adverse events were reported. The EBT system performed well and was associated with limited acute toxicities. EBT shows acute results similar to HDR brachytherapy. Additional research is needed to further assess the clinical efficacy and safety of EBT in the treatment of endometrial cancer

  2. Breast and Cervical Cancer Screening in Women Referred to Urban Healthcare Centers in Kerman, Iran, 2015.

    Science.gov (United States)

    Ahmadipour, Habibeh; Sheikhizade, Sahar

    2016-01-01

    Breast and cervical cancers are among leading causes of morbidity and mortality in women worldwide. Regular screening is very important for early detection of these cancers, but studies indicate low rates of screening participation. In this survey we studied the rate of screening participation among women 18-64 years old referred to urban health centers in Kerman, Iran in 2015. A cross-sectional study was carried out on 240 women who were selected using a multistage sampling method. Data collected using a questionnaire covered demographics and questions about common cancer screening status in women. Analysis was by SPSS 19. The mean age of participants was 31.7± 7. Most (97.1%) were married, housewives (83.3%), had high school diploma (43.8%) and a monthly income more than ten million Rls. The frequency of the Pap test performance was higher in women who were employed and with a university degree (pperformance in women over 40 years was also higher in women with university degree (p0.05). Our study found that the rate of screening participation among women is low. Investigation of the barriers, increasing the awareness of women about the importance and advantages of screening and also more incentives for health personnel especially family physicians to pay more attention to preventive programs could be effective. PMID:27165219

  3. Prospective multi-center trial utilizing electronic brachytherapy for the treatment of endometrial cancer

    Directory of Open Access Journals (Sweden)

    Thropay John P

    2010-07-01

    Full Text Available Abstract Background A modified form of high dose rate (HDR brachytherapy has been developed called Axxent Electronic Brachytherapy (EBT. EBT uses a kilovolt X-ray source and does not require treatment in a shielded vault or a HDR afterloader unit. A multi-center clinical study was carried out to evaluate the success of treatment delivery, safety and toxicity of EBT in patients with endometrial cancer. Methods A total of 15 patients with stage I or II endometrial cancer were enrolled at 5 sites. Patients were treated with vaginal EBT alone or in combination with external beam radiation. Results The prescribed doses of EBT were successfully delivered in all 15 patients. From the first fraction through 3 months follow-up, there were 4 CTC Grade 1 adverse events and 2 CTC Grade II adverse events reported that were EBT related. The mild events reported were dysuria, vaginal dryness, mucosal atrophy, and rectal bleeding. The moderate treatment related adverse events included dysuria, and vaginal pain. No Grade III or IV adverse events were reported. The EBT system performed well and was associated with limited acute toxicities. Conclusions EBT shows acute results similar to HDR brachytherapy. Additional research is needed to further assess the clinical efficacy and safety of EBT in the treatment of endometrial cancer.

  4. Anxiety and depression in patients with lung cancer under chemotherapy. Assessment with the Hospital Anxiety and Depression Scale

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    Stefania Kostopoulou

    2013-10-01

    Full Text Available Cancer and particularly lung cancer, which is the most prevalent form of cancer worldwide, constitute a major health problem in developed countries. Beyond physical problems, the prevalence of psychiatric morbidity is also high. Aim: Τo investigate the prevalence of two major psychological disorders, anxiety and depression in patients with lung cancer. Materials and Methods: One hundred and twenty eight (128 patients of a provincial general hospital filled in the Hospital Anxiety and Depression Scale (HADS. Descriptive and analytic statistics was performed. SPSS 17.0 was used for analysis. Statistical significance was set at p<0.05. Results: Males were 55.5 % of the sample. Less than 10 % had severe complications. The estimation of depression in the sample was 18%, while anxiety was estimated at 10% of the sample. Statistically significant differences were observed between depression and gender (p=0.035 and anxiety and alimentary system complications (p=0.002. Conclusion: Patients suffering from lung cancer exhibit high levels of anxiety and depression. Gender and alimentary tract complications seem to associate with psychological disorders.

  5. Funding Opportunity: Genomic Data Centers

    Science.gov (United States)

    Funding Opportunity CCG, Funding Opportunity Center for Cancer Genomics, CCG, Center for Cancer Genomics, CCG RFA, Center for cancer genomics rfa, genomic data analysis network, genomic data analysis network centers,

  6. Improving clinical research and cancer care delivery in community settings: evaluating the NCI community cancer centers program

    Directory of Open Access Journals (Sweden)

    Fennell Mary L

    2009-09-01

    Full Text Available Abstract Background In this article, we describe the National Cancer Institute (NCI Community Cancer Centers Program (NCCCP pilot and the evaluation designed to assess its role, function, and relevance to the NCI's research mission. In doing so, we describe the evolution of and rationale for the NCCCP concept, participating sites' characteristics, its multi-faceted aims to enhance clinical research and quality of care in community settings, and the role of strategic partnerships, both within and outside of the NCCCP network, in achieving program objectives. Discussion The evaluation of the NCCCP is conceptualized as a mixed method multi-layered assessment of organizational innovation and performance which includes mapping the evolution of site development as a means of understanding the inter- and intra-organizational change in the pilot, and the application of specific evaluation metrics for assessing the implementation, operations, and performance of the NCCCP pilot. The assessment of the cost of the pilot as an additional means of informing the longer-term feasibility and sustainability of the program is also discussed. Summary The NCCCP is a major systems-level set of organizational innovations to enhance clinical research and care delivery in diverse communities across the United States. Assessment of the extent to which the program achieves its aims will depend on a full understanding of how individual, organizational, and environmental factors align (or fail to align to achieve these improvements, and at what cost.

  7. Methicillin-resistant Staphylococcus sp. colonizing health care workers of a cancer hospital

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    Dayane de Melo Costa

    2014-09-01

    Full Text Available The aim of the study was to analyze epidemiological and microbiological aspects of oral colonization by methicillin-resistant Staphylococcus of health care workers in a cancer hospital. Interview and saliva sampling were performed with 149 health care workers. Antimicrobial resistance was determined by disk diffusion and minimum inhibitory concentration. Polymerase Chain Reaction, Internal Transcribed Spacer-Polymerase Chain Reaction and Pulsed Field Gel Electrophoresis were performed for genotypic characterization of methicillin-resistant Staphylococcus. Risk factors were determined by logistic regression. Methicillin-resistant Staphylococcus colonization prevalence was 19.5%, denture wearing (p = 0.03, habit of nail biting (p = 0.04 and preparation and administration of antimicrobial (p = 0.04 were risk factors identified. All methicillin-resistant Staphylococcus were S. epidermidis, 94.4% of them had mecA gene. Closely related and indistinguishable methicillin-resistant S. epidermidis were detected. These results highlight that HCWs which have contact with patient at high risk for developing infections were identified as colonized by MRSE in the oral cavity, reinforcing this cavity as a reservoir of these bacteria and the risk to themselves and patients safety, because these microorganisms may be spread by coughing and talking.

  8. Burnout syndrome in nurses of Cuban cancer hospitals. Effectiveness of an intervention program. 2004-2009

    International Nuclear Information System (INIS)

    Studies on Professional Burnout Syndrome (SDP) Nursing identify factors that interact in its development. The objective of this research was to identify the magnitude of the SDP in the nursing staff of Cuban cancer hospitals, identify professional and personal factors involved in the wear process and validate the effectiveness of an intervention program. Three studies using descriptive, analytical and experimental designs were performed. The main results showed that this syndrome is present in 44.0% of subjects; factors were more associated risk: work overload, rotating shift, the 'task characteristics' and 'organization' as well as the excessive time interaction with patients. These factors interacted with academic training, 'extra work' for family care, personal characteristics and overload: high levels of state anxiety, avoidance and escape confrontations and orientations of the least Salutogenic personality. The consequences for the health were associated muscle pain, headaches and colds. The intervention focused on increasing knowledge on job stress and control, their effectiveness was demonstrated by decreased levels of the SDP and its consequences. (author)

  9. [Cooperation between the family physician, rheumatologist, hospital and rehabilitation clinic. Contribution of regional cooperative rheumatic disease centers for total quality management].

    Science.gov (United States)

    Hülsemann, J L

    1998-12-01

    The building-up of multipurpose arthritis centers in Germany led to a network including outpatient and inpatient services, primary care physicians, rheumatologists, physiotherapists, occupational therapists, psychologists, acute care clinics, and rehabilitation centers. The structural improvement in the care of patients with chronic inflammatory rheumatic diseases has to be followed by an improvement of processes in the care of these patients and by an improvement of outcome. Coordination offices can help not only to further improve cooperation between primary care physicians, specialized rheumatologists and hospitals but also to establish a comprehensive clinical quality management.

  10. Multivariate analyses to assess the effects of surgeon and hospital volume on cancer survival rates: a nationwide population-based study in Taiwan.

    Directory of Open Access Journals (Sweden)

    Chun-Ming Chang

    Full Text Available BACKGROUND: Positive results between caseloads and outcomes have been validated in several procedures and cancer treatments. However, there is limited information available on the combined effects of surgeon and hospital caseloads. We used nationwide population-based data to explore the association between surgeon and hospital caseloads and survival rates for major cancers. METHODOLOGY: A total of 11,677 patients with incident cancer diagnosed in 2002 were identified from the Taiwan National Health Insurance Research Database. Survival analysis, the Cox proportional hazards model, and propensity scores were used to assess the relationship between 5-year survival rates and different caseload combinations. RESULTS: Based on the Cox proportional hazard model, cancer patients treated by low-volume surgeons in low-volume hospitals had poorer survival rates, and hazard ratios ranged from 1.3 in head and neck cancer to 1.8 in lung cancer after adjusting for patients' demographic variables, co-morbidities, and treatment modality. When analyzed using the propensity scores, the adjusted 5-year survival rates were poorer for patients treated by low-volume surgeons in low-volume hospitals, compared to those treated by high-volume surgeons in high-volume hospitals (P<0.005. CONCLUSIONS: After adjusting for differences in the case mix, cancer patients treated by low-volume surgeons in low-volume hospitals had poorer 5-year survival rates. Payers may implement quality care improvement in low-volume surgeons.

  11. Pediatric mature B-cell non Hodgkin lymphoma treatment with LMB-96 protocol. The Children Cancer Hospital Egypt experience

    OpenAIRE

    Hany Abdel Rahman; Emad Moussa; Mohamed Sedky; Iman Gouda; Madiha El Wakeel; Omneya Hassanein

    2015-01-01

    Purpose: Burkitt lymphoma (BL) is a highly aggressive mature B-cell non-Hodgkin lymphoma (NHL) and is the fastest growing human tumor. The outcome of childhood NHL has improved steadily over the past decades through the use of intensive sequential multi-agent chemotherapy regimens.Methods: A retrospective study having all patients 18 years old or younger diagnosed with mature B cell NHL and treated at Children Cancer Hospital Egypt (CCHE). All children were treated according to the modified (...

  12. Breast Conserving Surgery and Sentinel Lymph Node Biopsy in Locally Advanced Breast Cancer: Single Center Experience

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    Atakan Sezer

    2011-06-01

    Full Text Available Objective: Patients with locally advanced breast cancer may undergo breast conserving surgery after neoadjuvant chemotherapy. The aim of the study is to evaluate the results of locally advanced breast cancer patients who underwent breast conserving surgery, axillary dissection and sentinel lymph node biopsy in a single center. Material and Methods: 12 patients with locally advanced breast cancer stage IIIA/IIIB were included in the study between 2002-2009. The patients were given anthracycline-based regimen before surgery. Patients underwent breast conserving surgery, axillary dissection, and sentinel lymph node biopsy followed by radiotherapy. Results: There were five patients in stage IIIA, six in stage IIIB, and one in stage IIIC. Patients had received 3-6 regimen of FAC/FEC. Eight had partial and four had complete response. Five positive axilla were detected. The median value of the lymph nodes was 12 (n:8-19. Five patients underwent sentinel lymph node biopsy. The biopsy has failed in one patient and the median value of dissected sentinel node was 3.5 (n:3-4. Locoregional recurrence was not observed in any patients. The mean follow-up of the patients was 29.8 months and median time was 16 (n:2-80 months.Of the 12 patients 10 are alive and 2 were deceased. Conclusion: In selected locally advanced patients, breast conserving surgery and sentinel lymph node biopsy may be applied by a multidisciplinary approach, and excellent success may be achieved in those patients as in early breast cancer patients.

  13. A retrospective analysis of survival and prognostic factors of male breast cancer from a single center

    International Nuclear Information System (INIS)

    Less than 1% of all breast cancer cases are found in men, who reportedly have inferior outcomes compared with matched women patients. Ethnic differences may also affect their prognosis. Here, we investigated overall survival (OS) and major prognostic factors for male breast cancer (MBC) in a cohort of Egyptian patients. We retrospectively analyzed OS in a cohort of 69 male patients with MBC who were surgically treated at the Mansoura Cancer Center, Egypt between 2000 and 2007. We registered demographic data, age, height, weight and body mass index, tumor size, histology, number of infiltrated axillary lymph nodes, hormone receptor (HR) status and metastatic presence, and TNM staging. Patients’ OS was the primary endpoint. Patients received treatment to the medical standards at the time of their diagnosis. In the 69 patients who met the inclusion criteria and had complete stored patient data, tumors ranged from T1c to T3. We could gather cancer-related survival data from only 56 patients. The collective 5-year survival in this cohort was 46.4%. Only five patients had distant metastasis at diagnosis, but they showed a null percent 5-year survival, whereas those with no lymph node infiltration showed a 100% 5-year survival. Lymph node status and tumor grading were the only prognostic factors that significantly affected OS. Lymph node status and tumor grade are the most important prognostic factors for overall survival of MBC in Egyptian male patients; whereas even remarkably low HR expression in MBC did not significantly affect OS. Further research is needed to understand the factors that affect this disease

  14. Knowledge, Attitude, and Performance of Radiographers about the Principles of Radiation Protection and Following Protective Standards in Medical Imaging Centers of Hospitals in Fasa in 2015

    OpenAIRE

    Reza Alipoor; Ghazal Mousavian; Ali Abbasnezhad; Seyede Farnaz Mousavi; Gholamhasan Haddadi

    2016-01-01

    Background & Objectives: Although ionizing radiation is effective in the diagnosis of illnesses, it is dangerous from the perspective of protection for patients and radiographers working in radiology sections. Therefore, knowledge, understanding, and application of radiation protection can play an important role. The aim of this study is to assess the knowledge, attitude, and practice of the radiation protection principles in radiation workers in medical imaging centers and hospitals in Fasa,...

  15. Establishing and Sustaining a Prospective Screening Program for Breast Cancer-Related Lymphedema at the Massachusetts General Hospital: Lessons Learned

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    Cheryl Brunelle

    2015-05-01

    Full Text Available There has been an increasing call to prospectively screen patients with breast cancer for the development of breast cancer-related lymphedema (BCRL following their breast cancer treatment. While the components of a prospective screening program have been published, some centers struggle with how to initiate, establish, and sustain a screening program of their own. The intent of this manuscript is to share our experience and struggles in establishing a prospective surveillance program within the infrastructure of our institution. It is our hope that by sharing our history other centers can learn from our mistakes and successes to better design their own prospective screening program to best serve their patient population.

  16. Liver surgery in Italy. Criteria to identify the hospital units and the tertiary referral centers entitled to perform it.

    Science.gov (United States)

    Torzilli, Guido; Viganò, Luca; Giuliante, Felice; Pinna, Antonio Daniele

    2016-06-01

    During the last decades, liver surgery had an extraordinary evolution and diffusion thanks to a drastic reduction of operative mortality and morbidity rates. A debate is ongoing about the need for centralization of liver resections in tertiary referral centers. Robust evidences showed that complex surgical procedures have lower mortality rates when performed in high-volume centers. The present expert group reviewed the literature data and proposed guidelines to identify surgical units that should be entitled to perform liver surgery in Italy. Three separate types of requirements were identified. First, the hospital requirements that include the following criteria: (1) a hospital of 1st level according to the Italian law; (2) the presence of a dedicated hepatobiliary or hepatobiliopancreatic unit or a team dedicated to liver surgery into a general surgery unit; (3) the mandatory presence of oncology, hepatology, radiology, interventional radiology, digestive endoscopy, intensive care, and pathology units; (4) the availability of a liver transplant team into the hospital or into another hospital within an established partnership; (5) a periodic multidisciplinary meeting. Second, the volume requirements: the unit has to perform more than 20 liver resections per year for malignant liver diseases with a 90-day mortality rate < 3 %. Finally, the organization requirements: the presence of specific diagnostic-therapeutic flowcharts for liver diseases. PMID:27294278

  17. Discussion on the Upgrading and Transformation Scheme of Hospital Data Center%医院数据中心升级改造方案探讨

    Institute of Scientific and Technical Information of China (English)

    李晴辉

    2014-01-01

    医院数据中心是医院信息系统的中枢和核心,随着医院信息系统的迅速发展、业务系统不断增加、数据量几何级增长,数据中心服务器、存储、交换机等高能耗设备日益增多,数据中心正普遍面临着能源消耗剧增、高热量、低效率和逐渐老化等一系列问题。对数据中心进行绿色节能改造和虚拟化改造是解决上述问题的有效途径,包括数据中心基础设施绿色节能改造、数据中心虚拟化改造和智能总控中心建设等。%Data center is the core of the hospital information system, with the rapid development of hospital information systems, business systems continue to increase, the amount of data exponentially growing. Data center server, storage, switches and other high energy consumption equipment increasing, data centers are generally faced with the dramatic increase in energy consumption, high-calorie, low efficiency and aging and other issues. The data center green energy-saving reconstruction and virtual innovation is the effective way to solve the above problems, including data center infrastructure green energy-saving transformation, data center virtualization rebuilding and intelligent control center construction.

  18. Intrathoracic versus Cervical Anastomosis after Resection of Esophageal Cancer: A matched pair analysis of 72 patients in a single center study

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    Klink Christian D

    2012-08-01

    Full Text Available Abstract Background The aim of this study was to analyze the early postoperative outcome of esophageal cancer treated by subtotal esophageal resection, gastric interposition and either intrathoracic or cervical anastomosis in a single center study. Methods 72 patients who received either a cervical or intrathoracic anastomosis after esophageal resection for esophageal cancer were matched by age and tumor stage. Collected data from these patients were analyzed retrospectively regarding morbidity and mortality rates. Results Anastomotic leakage rate was significantly lower in the intrathoracic anastomosis group than in the cervical anastomosis group (4 of 36 patients (11% vs. 11 of 36 patients (31%; p = 0.040. The hospital stay was significantly shorter in the intrathoracic anastomosis group compared to the cervical anastomosis group (14 (range 10–110 vs. 26 days (range 12 – 105; p = 0.012. Wound infection and temporary paresis of the recurrent laryngeal nerve occurred significantly more often in the cervical anastomosis group compared to the intrathoracic anastomosis group (28% vs. 0%; p = 0.002 and 11% vs. 0%; p = 0.046. The overall In-hospital mortality rate was 6% (4 of 72 patients without any differences between the study groups. Conclusions The present data support the assumption that the transthoracic approach with an intrathoracic anastomosis compared to a cervical esophagogastrostomy is the safer and more beneficial procedure in patients with carcinoma of the lower and middle third of the esophagus due to a significant reduction of anastomotic leakage, wound infection, paresis of the recurrent laryngeal nerve and shorter hospital stay.

  19. Sensitivity and specificity of transabdominal ultrasound for ganglionic staging of gastric cancer at the Centro de Deteccion Temprana de Cancer Gastrico of the Hospital Max Peralta de Cartago for the years 2005 and 2006

    International Nuclear Information System (INIS)

    Gastric cancer in Costa Rica is a public health problem, has represented one of the highest rates of cancer mortality in recent years. Part of the strategy for the proper treatment of this disease is a good presurgical planning, being indispensable prior knowledge of the staging according to the TNM classification (Tumor/Nodes/Metastases). Even though in other countries this staging preoperative is done by computed axial tomography (CAT) and/or endoscopic ultrasound (EUS), at the Centro de Deteccion Temprana de Cancer Gastrico (CDTCG) located in the Hospital Max Peralta de Cartago, transabdominal ultrasound (USTA) is essential not only to evaluate the presence of metastases to solid organs and peritoneum but also the presence of adenomegalies to emerge neoplastic infiltration. The objective posed is to know the sensitivity and specificity of transabdominal ultrasound for ganglionic staging in that study center conducted in the years 2005 and 2006. The information was obtained by review of records of patients who were operated for gastric cancer at the time described. A comparison was performed between the ganglionic staging noted in the preoperative sonographic report and pathological findings conclusive. 70 cases were achieved. Most patients were between 40-80 years of age, with predominance of decenal group of 60 to 69 years. A predominance was observed of 2:1 of males. The sensitivity has been 89,1% in a general way, so as to 56,5% for staging N1, from 57,9% to N2 and 50% to N3. The specificity was obtained by 58,3%. Cases corroborated by pathology were the lesions had a depth compatible with T1 (early gastric cancer), the sensitivity for the detection of ganglionic metastases has been 50% and specificity of 75%. A few recommendations are offered for improving these figures. (author)

  20. EPIDEMIOLOGICAL PROFILE OF HEAD AND NECK CANCERS AT A TERTIARY CARE HOSPITAL

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    Saquib

    2015-10-01

    Full Text Available Head and neck cancer is the fifth most common malignancy globally among adults and comprises 5% of all malignancies worldwide. There is scarcity of data regarding the clinico epidemiological profile of head and neck carcinomas in our population. The demographic presentation & exact prevalence of these malignancies in our population is not known. AIMS & OBJECTIVES: To study the clinico - epidemiological profile of head and Neck carcinoma in Kashmiri ethnic population of India. MATERIAL & METHODS : This study was conducted at Cancer center at SMHS Srinagar, J & K, India from 2012 to 2014. The study included total of 106 patients with Head and Neck Squamous Cell Carcinoma (HNSCC registered with the department from 2012 to 2014. It was a prospective and retrospective study. Patients having histopathological (HPE confirmation of the disease were enrolled for the study. All the demo graphic & clinical details of the recruited patients were studied thoroughly including history, physical examination, investigations and mode of treatment. RESULTS : Male to female ratio was 2.7:1. The mean age was 55.3 years. Among both males and females, the highest incidence of HNSCC was seen within the age group of 51 - 60 years. The most common primary site of disease was Oral Cavity – 36(33.96%, Larynx - 28 (26.41%, Pharynx in 16(15.09%, Nasopharynx in 10(9.43% , Sinonasal in 10(9.43%, and Tonsil in 6 cases(5.66%. Patients usually presented with advanced stage of disease {( S tage III, IV - (64.15% 68 versus stage I, II - (35.84% 38}. Tobacco consumption in any form was present in 89% of our population. Lack of balanced diet (28% and poor dental hygiene (50% and belonging to low socioeconomic class (57% were also thought to be significant factors for the disease burden. Most of our patients were treated with surgery followed by adjuvant chemo - radiotherapy (37.73%, chemo and radiotherapy (28.31%, radiotherapy alone (16.98% & surgery alone (9.4%. CONCLUSION

  1. Laparoscopic and open postchemotherapy retroperitoneal lymph node dissection in patients with advanced testicular cancer – a single center analysis

    Directory of Open Access Journals (Sweden)

    Busch Jonas

    2012-05-01

    Full Text Available Abstract Background The open approach represents the gold standard for postchemotherapy retroperitoneal lymph node dissection (O-PCLND in patients with residual testicular cancer. We analyzed laparoscopic postchemotherapy retroperitoneal lymph node dissection (L-PCLND and O-PCLND at our institution. Methods Patients underwent either L-PCLND (n = 43 or O-PCLND (n = 24. Categorical and continuous variables were compared using the Fisher exact test and Mann–Whitney U test respectively. Overall survival was evaluated with the log-rank test. Results Primary histology was embryonal cell carcinomas (18 patients, pure seminoma (2 cases and mixed NSGCTs (47 patients. According to the IGCCCG patients were categorized into “good”, “intermediate” and “poor prognosis” disease in 55.2%, 14.9% and 20.8%, respectively. Median operative time for L-PCLND was 212 min and 232 min for O-PCLND (p = 0.256. Median postoperative duration of drainage and hospital stay was shorter after L-PCLND (0.0 vs. 3.5 days; p 500 ml was almost equally distributed (8.6% vs. 14.2%: p = 0.076. No significant differences were observed for injuries of major vessels and postoperative complications (p = 0.758; p = 0.370. Tumor recurrence occurred in 8.6% following L-PCLND and in 14.2% following O-PCLND with a mean disease-free survival of 76.6 and 89.2 months, respectively. Overall survival was 83.3 and 95.0 months for L-PCNLD and O-PCLND, respectively (p = 0.447. Conclusions L-PCLND represents a safe surgical option for well selected patients at an experienced center.

  2. Reproductive factors and breast cancer: A case-control study in tertiary care hospital of North India

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    A S Bhadoria

    2013-01-01

    Full Text Available Background: Clinical, animal, and epidemiological studies have clearly demonstrated that cancer is a hormonally mediated disease and several factors that influence hormonal status or are markers of change in hormonal status have been shown to be associated with the risk of breast cancer. Aims: To identify the association of various reproductive factors with breast cancer. Settings and Design: A hospital-based, matched, case-control study. Materials and Methods: Three hundred and twenty newly diagnosed breast cancer cases and three hundred and twenty normal healthy individuals constituted the study population. The subjects in the control group were matched individually with the cases for their age ± 2 years and socioeconomic status. A pre-tested, semi-structured questionnaire was administered to each individual to collect information on identification data, socio-demographic profile, and reproductive factors. Statistical Analysis Used: The Chi-square test and unpaired t-test were used. The conditional univariate logistic regression analysis (unadjusted odds ratio and confidence intervals was used to calculate the significance level of each variable followed by multivariate regression analysis. Results and Conclusions: The cases had a lower mean age at menarche, higher age at marriage, higher mean age at last child birth, lower mean duration of breastfeeding, higher number of abortions, late age at menopause, history of oral contraceptive pills, and a family history of breast cancer as compared to the controls. The results of the present study revealed a strong association of reproductive factors with breast cancer in the Indian population.

  3. Quality of life assessment in advanced cancer patients treated at home, an inpatient unit, and a day care center

    OpenAIRE

    Leppert, Wojciech; Majkowicz, Mikolaj; Forycka, Maria; Mess, Eleonora; Zdun-Ryzewska, Agata

    2014-01-01

    Aim of the study To assess quality of life (QoL) in cancer patients treated at home, at an in-patient palliative care unit (PCU), and at a day care center (DCC). Patients and methods QoL was assessed in advanced cancer patients at baseline and after 7 days of symptomatic treatment using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 15-Palliative Care (EORTC QLQ-C15-PAL), the Edmonton Symptom Assessment System (ESAS), and the Karnofsky Perfor...

  4. Alectinib for choroidal metastasis in a patient with crizotinib-resistant ALK rearranged positive non-small cell lung cancer

    OpenAIRE

    Okuma Y; Tanaka Y; Kamei T; Hosomi Y; Okamura T

    2015-01-01

    Yusuke Okuma,1,2 Yuichiro Tanaka,3 Tina Kamei,1 Yukio Hosomi,1 Tatsuru Okamura1 1Department of Thoracic Oncology and Respiratory Medicine, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, 2Division of Oncology, Research Center for Medical Sciences, The Jikei University School of Medicine, 3Department of Ophthalmology, Tokyo Metropolitan Cancer and Infectious diseases Center Komagome Hospital, Tokyo, Japan Abstract: Choroidal metastasis is rare in cancer patients. S...

  5. Aggressive Treatment of Patients with Metastatic Colorectal Cancer Increases Survival: A Scandinavian Single-Center Experience

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    Kristoffer Watten Brudvik

    2013-01-01

    Full Text Available Background. We examined overall and disease-free survivals in a cohort of patients subjected to resection of liver metastasis from colorectal cancer (CRLM in a 10-year period when new treatment strategies were implemented. Methods. Data from 239 consecutive patients selected for liver resection of CRLM during the period from 2002 to 2011 at a single center were used to estimate overall and disease-free survival. The results were assessed against new treatment strategies and established risk factors. Results. The 5-year cumulative overall and disease-free survivals were 46 and 24%. The overall survival was the same after reresection, independently of the number of prior resections and irrespectively of the location of the recurrent disease. The time intervals between each recurrence were similar (11 ± 1 months. Patients with high tumor load given neoadjuvant chemotherapy had comparable survival to those with less extensive disease without neoadjuvant chemotherapy. Positive resection margin or resectable extrahepatic disease did not affect overall survival. Conclusion. Our data support that one still, and perhaps to an even greater extent, should seek an aggressive therapeutic strategy to achieve resectable status for recurrent hepatic and extrahepatic metastases. The data should be viewed in the context of recent advances in the understanding of cancer biology and the metastatic process.

  6. Commercialization as a recommended approach to hospital restructuring. Case study of Łańcut Medical Center

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    Wiktor Patena

    2015-10-01

    Full Text Available Our society is on the brink of health care system reorganization and implementation of new medical technology. Hospitals have to be a core component of the medical revolution so they have to be prepared for the upcoming leap in their development. If Poland wants to be a pioneer in providing new medical solutions, the current ineffective system has to be changed. The necessary action should be taken to deal with the financial problems Polish hospitals have faced for over 20 years. The current structure of hospitals - SPZOZ, is old-fashioned and cannot adapt to a turbulent social and economic environment. The hospitals should be commercialized and restructured. Being capitalized companies will give incentives and new tools to deal with financial problems. The article presents an example of the commercialized hospital in Łańcut. We make the observations that commercialization increases: a hospital’s profitability, its employment productivity, its capital investment spending and leverage. The case proves that the transformation of hospitals to capital companies proposed by the Ministry of Health may be an appropriate approach and it does work once a reasonable management board is in charge. However, the legal structure alteration should be treated as the first step in the overall restructuring process. The article highlights the problem of managers of Polish hospitals who do not only struggle with financial shortages, but barely know which business model they should follow after commercialization to successfully run the restructuring process. Having examined the LMC the authors are crafting a prelude to the overall research on already commercialized hospitals to find an appropriate business model.

  7. Methicillin-resistant Staphylococcus aureus nasal cariage among hospitalized patients and healthcare workers in the Clinical center of Serbia

    OpenAIRE

    Ćirković Ivana; Đukić Slobodanka; Carević Biljana; Mazić Nataša; Mioljević Vesna; Stepanović S.

    2014-01-01

    The aim of the present study was to provide the first comprehensive analysis of methicillin-resistant Staphylococcus aureus (MRSA) carriage among patients and healthcare workers (HCWs) in the largest healthcare facility in Serbia. Specimens from anterior nares obtained from 195 hospitalized patients and 105 HCWs were inoculated after broth enrichment onto chromogenic MRSA-ID medium. In total, 21 of 300 specimens yielded MRSA. Among hospitalized patients, 7.7% ...

  8. Analysis of Sleep Parameters in Patients with Obstructive Sleep Apnea Studied in a Hospital vs. a Hotel-Based Sleep Center

    Science.gov (United States)

    Hutchison, Kimberly N.; Song, Yanna; Wang, Lily; Malow, Beth A.

    2008-01-01

    Background: Polysomnography is associated with changes in sleep architecture called the first-night effect. This effect is believed to result from sleeping in an unusual environment and the technical equipment used to study sleep. Sleep experts hope to decrease this variable by providing a more familiar, comfortable atmosphere for sleep testing through hotel-based sleep centers. In this study, we compared the sleep parameters of patients studied in our hotel-based and hospital-based sleep laboratories. Methods: We retrospectively reviewed polysomnograms completed in our hotel-based and hospital-based sleep laboratories from August 2003 to July 2005. All patients were undergoing evaluation for obstructive sleep apnea. Hospital-based patients were matched for age and apnea-hypopnea index with hotel-based patients. We compared the sleep architecture changes associated with the first-night effect in the two groups. The associated conditions and symptoms listed on the polysomnography referral forms are also compared. Results: No significant differences were detected between the two groups in sleep onset latency, sleep efficiency, REM sleep latency, total amount of slow wave sleep (NREM stages 3 and 4), arousal index, and total stage 1 sleep. Conclusions: This pilot study failed to show a difference in sleep parameters associated with the first-night effect in patients undergoing sleep studies in our hotel and hospital-based sleep laboratories. Future studies need to compare the first-night effect in different sleep disorders, preferably in multi-night recordings. Citation: Hutchison KN; Song Y; Wang L; Malow BA. Analysis of sleep parameters in patients with obstructive sleep apnea studied in a hospital vs. A hotel-based sleep center. J Clin Sleep Med 2008;4(2):119–122. PMID:18468309

  9. Analysis of patterns of palliative radiotherapy in north west India: A regional cancer center experience

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    Akhil Kapoor

    2015-01-01

    Full Text Available Background: Palliative radiotherapy (PRT is the eventual requirement in 30-50% of all cancer patients. PRT is primarily aimed to relieve pain and prevent/treat collapse or fracture in case of bone metastasis, to reduce edema in patients with cranial metastasis, and to control distressing symptoms of rapid primary growth. An audit of PRT planned in a busy cancer center can help in the characterization of the requirements of the patients and the formulation of institutional policies. Materials and Methods: In total, 516 patients who received PRT in our regional cancer center from January 2012 to December 2012 and whose complete records were available for analysis were selected for this retrospective study. Medical records and radiotherapy files were analyzed to obtain data such as sociodemographic parameters, prescription of PRT, and follow up. Descriptive statistics were evaluated in terms of frequencies and percentages to allow comparisons. Results: Of the 516 patients, 73% patients were male; the median age of the patients receiving PRT was 62 years (range 13-83 years. About 48% ( n = 248 patients received PRT at the primary site while rest (52% were given PRT at the metastatic site. The most common indication of PRT was pain (56.8% cases, followed by cytostatic PRT (19.8% and raised ICT (12.4%. The median dose prescribed was 30 Gy (range 8-36 Gy delivered in 1-12 fractions over the duration of 1-18 days. The overall response rate was about 43% at 2 weeks of completion of PRT; the median follow-up of the patients was 154 days (range 9-256 days. The long-term symptom relief at median follow up was 8%. Conclusions: Good clinical judgment and expertise is required in prescribing correct fractionation schedule to achieve effective symptom palliation with lowest possible cost and inconvenience to the patients and relatives. Hypofractionated radiotherapy is a feasible treatment option in patients with advanced incurable disease to achieve effective

  10. Children Thyroid Cancer treatment in Saint-Petersburg Endocrine SurgeryCenter and Mayo Clinic

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    Aleksandr Filippovich Romanchishen

    2015-02-01

    Full Text Available IntroductionThyroid cancer (TC is the most often malignant tumor in childhood and made 1.5 – 3.0% of all children population or 45.3% of pediatric endocrine epithelial cancers. A lot of questions concerning to volume of thyroid surgery, postoperative radio iodine therapy (RIT needs to be discussed.AimEstimation of childhood sporadic thyroid cancer specificity and comparison of children and adolescents treatment in Saint-Petersburg Endocrine Surgery Center (Russia and Mayo Clinic (USA.Material and methodsDuring 1970 –2011 in the Saint-Petersburg Center (1 group were operated 105 TC children and adolescent (up to 20 yeas and in Mayo Clinic – 188 (2 group in  1940 – 2000 period. Since of 80-s in those clinics were used the same perioperative examinations, like TSH, T4, T3 blood levels, USG, fine needles aspiration biopsy, CT and morphological examinations.Results and discussionAverage age of the Saint-Petersburg Center and Rochester patients was the same and achieve 16.3±0.3 and 16.0±0.5, accordingly. In both groups has prevailed girls: in the 1 group they made 73.3% (M:F 1:2.7 and in the 2 – 70.7% (M:F 1:2.4. Childhood differentiated TC were associated with aggressive behavior: regional metastases were found in 53.0% and 81.4%, extrathyroid TC spreading – in 9.6 and 19.7%, distant metastases - in 9.6 and 4.8%, accordingly. In our Center (1 group we have performed hemithyroidectomies and subtotal Thyroidectomies in 58.1% with ipsilateral central neck dissection (CND. In Mayo Clinic in all TC cases were performed thyroidectomy (TE since 1950. TC relapses we have no   observed in 1 group and they have place in 6.9% 2 group patients, recurring lymphatic metastases – in 8.4% and 20.7%, accordingly. Radioiodine therapy (RIT has performed in 21.1% and 25.5% operated children.In 1 group 95 (96.0 % of 99 operated were alive during 5 – 36 years, in the 2– only in two cases reason of death was TC, but in 14 – other malignant tumor

  11. Challenges associated with the management of gynecological cancers in a tertiary hospital in South East Nigeria

    OpenAIRE

    Iyoke CA; Ugwu GO; Ezugwu EC; Ezugwu FO; Lawani OL; Onyebuchi AK

    2014-01-01

    Chukwuemeka Anthony Iyoke,1 George Onyemaechi Ugwu,1 Euzebus Chinonye Ezugwu,1 Frank Okechukwu Ezugwu,2 Osaheni Lucky Lawani,3 Azubuike Kanayo Onyebuchi3 1Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, 2Department of Obstetrics and Gynaecology, Enugu State University Teaching Hospital, Park Lane, Enugu, 3Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria Background: There are reports o...

  12. A Ten-Year Assessment of a Biomedical Engineering Summer Research Internship within a Comprehensive Cancer Center

    Science.gov (United States)

    Wright, A. S.; Wu, X.; Frye, C. A.; Mathur, A. B.; Patrick, C. W., Jr.

    2007-01-01

    A Biomedical Engineering Internship Program conducted within a Comprehensive Cancer Center over a 10 year period was assessed and evaluated. Although this is a non-traditional location for an internship, it is an ideal site for a multidisciplinary training program for science, technology, engineering, and mathematics (STEM) students. We made a…

  13. Current knowledge, attitudes and practices of women on breast cancer and mammography at Mulago Hospital

    OpenAIRE

    Michael, Kawooya G; Nakatudde Rebecca; Rosemary, Byanyima K; Muyinda Zeridah; Mubuuke A. Gonzaga; Businge Francis; Kiguli-Malwadde Elsie

    2010-01-01

    BACKGROUND: Breast cancer is the third commonest cancer in Ugandan women. Women present late for breast cancer management which leads to high mortality rates. The objective of the study was to assess the knowledge, attitudes and practices of Ugandan women concerning breast cancer and mammography.METHODS: This was a descriptive cross-sectional study where 100 women reporting to the Radiology department were interviewed. We used consecutive sampling. Interviewer-administered questionnaires were...

  14. Hospital contact for mental disorders in survivors of childhood cancer and their siblings in Denmark

    DEFF Research Database (Denmark)

    Lund, Lasse Wegener; Winther, Jeanette; Dalton, Susanne Oksbjerg;

    2013-01-01

    Survivors of childhood cancer are known to be at risk for long-term physical and mental effects. However, little is known about how cancers can affect mental health in the siblings of these patients. We aimed to assess the long-term risks of mental disorders in survivors of childhood cancer and...

  15. Intravenous paracetamol infusion: Superior pain management and earlier discharge from hospital in patients undergoing palliative head-neck cancer surgery

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    Saikat Majumdar

    2014-01-01

    Full Text Available Background: Paracetamol; a cyclooxygenase inhibitor; acts through the central nervous system as well as serotoninergic system as a nonopioid analgesic. A prospective, double-blinded, and randomized-controlled study was carried out to compare the efficacy of preoperative 1g intravenous (iv paracetamol with placebo in providing postoperative analgesia in head-neck cancer surgery. Materials and Methods: From 2008 February to 2009 December, 80 patients for palliative head-neck cancer surgery were randomly divided into (F and (P Group receiving ivplacebo and iv paracetamol, respectively, 5 min before induction. Everybody received fentanyl before induction and IM diclofenac for pain relief at8 hourly for 24 h after surgery. Visual analogue scale (VAS and amount of fentanyl were measured for postoperative pain assessment (24 h. Results and Statistical analysis: The mean VAS score in 1 st , 2 nd postoperative hour, and fentanyl requirement was less and the need for rescue analgesic was delayed in ivparacetamol group which were all statistically significant. Paracetamol group had a shorter surgical intensive care unit (SICU and hospital stay which was also statistically significant. Conclusion: The study demonstrates the effectiveness of ivparacetamol as preemptive analgesic in the postoperative pain control after head-neck cancer surgery and earlier discharge from hospital.

  16. Frequency of thyroid cancer in patients operated at Cantonal Hospital Zenica, Bosnia and Herzegovina, in the period 2007-2014.

    Science.gov (United States)

    Hrnčić, Nermin; Goga, Amna; Hrnčić, Selma; Filipovska-Mušanović, Marijana; Hatibović, Haris; Hodžić, Ðenad

    2016-08-01

    Aim To determine frequency and type of thyroid cancer (TC) as well as gender and age distribution of patients operated at the Department of Ear, Nose and Throat (ENT), Cantonal Hospital Zenica, Bosnia and Herzegovina. Methods A retrospective analysis of data obtained from an operating protocol and disease history of patients operated in the eightyear period (2007- 2014) was made according to the frequency and type of thyroid cancer, as well as age and gender of the patients. χ2 test was used for statistical with pmedullary carcinoma in four (5.41%), Hurthle cell carcinoma in four (5.41%) patients, while anaplastic carcinoma was found in one (1.35%) patient. The number of diagnosed malignancy varied from 0% (in 2007) to 13.91% (in 2014) (p=0.05). Conclusion The prevalence of thyroid cancer is low, but has an increasing trend. A large number of unnecessary surgeries on thyroid gland was performed. Preoperative diagnostic procedures for diseases of the thyroid gland in Cantonal Hospital Zenica should be improved in order to avoid unessential surgeries. PMID:27313111

  17. Advanced cancer patients' self-assessed physical and emotional problems on admission and discharge from hospital general ward - a questionnaire study

    DEFF Research Database (Denmark)

    Sølver, Lisbeth; Østergaard, Birte; Rydahl Hansen, Susan;

    2012-01-01

    -prolonging or palliative treatment are offered non-specialist palliative services. There is a lack of knowledge about their problem profile. The aim of this article is to describe the incidence of patient-reported physical and emotional problems on admission and discharge from general hospital wards and health......SOELVER L., OESTERGAARD B., RYDAHL-HANSEN S. & WAGNER L. (2012) European Journal of Cancer Care21, 667-676 Advanced cancer patients' self-assessed physical and emotional problems on admission and discharge from hospital general wards - a questionnaire study Most cancer patients receiving life...... between patient-reported problems and reported intervention for physical function, pain, constipation and loss of appetite. Palliative cancer patients' self-reported problem profile on admission and discharge from hospital has not previously been described and the results indicate a need to focus on...

  18. Safety and feasibility of laparoscopic colo-rectal surgery for cancer at a tertiary center in a developing country: Egypt as an example

    International Nuclear Information System (INIS)

    Background: Laparoscopic colectomy has been shown to have significant short- and long-term benefits compared to open approach. The incorporation of laparoscopy in developing countries is challenging, due to the high costs of equipment and lack of expertise. The aim of this study was to evaluate the safety and feasibility of laparoscopic colorectal surgery for cancer that could be performed in developing countries under different circumstances in developed countries. Methods: Thirty-seven patients (23 males and 14 females) with colorectal cancer with a median age of 46 years (39-72) have been enrolled for laparoscopic colo-rectal surgery in a tertiary center in Egypt (South Egypt Cancer Institute) with the trend of reuse of some disposable laparoscopic instruments. Results: The median operative time was 130 min (95-195 min). The median estimated blood loss was 70 ml (30-90 ml). No major intra-operative complications have been encountered. Two cases (5.5%) have been converted because of local advancement (one case) and bleeding with unavailability of vessel sealing device at that time (one case). The median time for passing flatus after surgery was 36 h (12-72 h). The median hospital stay was 4.8 days (4-7 days). The peri-operative period passed without events. Pathologic outcome revealed that the median number of retrieved lymph nodes was 14 (range 9-23 lymph node) and all cases had free surgical margin. Conclusion: Laparoscopic colorectal surgery for cancer in developing countries could be safe and feasible. Safe reuse of disposable expensive parts of some laparoscopic instruments could help in propagation of this technique in developing countries.

  19. [Use of a neutral paraffin dressing (Jelonet) at the Burn Care Center at the Saint Luc Hospital in Lyon].

    Science.gov (United States)

    Foyatier, J L; Hezez, G; Masson, C L; Latarjet, J

    1990-01-01

    Several thousand dressings are performed each year to treat the patients admitted to the St Luc Hospital Burn Care Unit. The use of paraffin gauze dressing (Jelonet) allowed standardization and rationalization of the four different types of dressings used in burns. Positive features of this product include ease of use, good tolerance, and low cost.

  20. Mortality, length of hospital stay, and nutritional status improvement in severely malnourished children with HIV infection in a tertiary center

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    Yoga Devaera

    2012-11-01

    Full Text Available Background Severe malnutrition contributes to child mortality rates, especially in children under five years of age. Concomitant HIV infection further increases the risk of death. Objective To evaluate the impact of HIV infection on mortality, length of hospital stay and improvement of nutritional status in severely malnourished inpatients under five years of age. Methods This retrospective study included children aged less than 5 years and admitted to a tertiary hospital for severe malnutrition. We excluded those with incomplete data, as well as those transferred to other hospitals or discharged against medical advice. Outcome measures were live/death status, length of hospital stay and improvement of nutritional status (weight gain and improved weight-for-height Z score. Results Of 104 eligible patients, 97 were included as study subjects. Their mean ages were 25.8 (SD 17.3 months for HIV-infected children and 16.3 (SD 15.3 months for HIV-uninfected children. Death occurred in 31.8% and 18.7% of HIV-infected and uninfected subjects, respectively. Median length of hospital stay was 14.5 (range 5-51 days and 11 (range 1-99 days, respectively. There were no statistically significant differences in death rates or length of hospital stay between the two groups. Weight-for-height Z scores (WHZ on admission and discharge in HIV-infected children were lower than those of uninfected children, but the weight gain (median weight gain of 0.45 (-0.26 to 1.9 kg vs 0.38 (-0.81 to 2.2 kg in HIV-infected and uninfected children, respectively and improvement of WHZ [1 (SD 1.1 vs 0.9 (SD 1, respectively] were similar. Conclusion Severely malnourished children with HIV infection had higher mortality rate, and longer hospitalizations than the uninfected group, although the differences were not statistically significant. They also had lower mean WHZ scores at admission and discharge, but nutritional improvement was similar to those who were HIV-negative.

  1. Bone marrow and stem cell transplantation at King Hussein cancer center.

    Science.gov (United States)

    Abdel-Rahman, F; Hussein, Aa; Rihani, R; Hlalah, Oa; El Taani, H; Sharma, S; Nserat, T; Sarhan, Mm

    2008-08-01

    Bone marrow and stem cell transplantation in Jordan has been performed since the 1990s, but the first comprehensive program was established at King Hussein Cancer Center (KHCC) in March 2003. The program, in addition to other health care institutions in Amman, serves approximately 5.6 million Jordanians. Also, we treat several patients per year from neighboring Arab countries. The program at KHCC performs an average of 80 transplants per year. During the past 4 years 320 patients received transplants at KHCC; 26% of them received an autologous graft and 74% allogeneic grafts. Of the allogeneic grafts 91% were taken from matched family members, 6.7% were haploidentical from one of the parents, and 2.3% were from an unrelated donor or umbilical cord blood. The actuarial overall survival among all patients has been around 65%. The most common indication for transplantation at KHCC was leukemia/MDS followed by benign nonmalignant hematological/immune deficiency/metabolic disorders, with thalassemia major being the most common among this group. The cost of SCT is variable and depends on many factors including the type of transplant and the attending post-transplant complications. The average charge for autologous transplant (both adults and pediatrics) is 24,695 JD (one JD equals 1.42 USD), and the average charge for allogeneic transplant (both adults and pediatrics) excluding haploidentical transplant is 46,787 JD. We have not noticed any peculiar patterns of complications following BMT; however, we have seen a high incidence of chronic GVHD following minitransplant with fludarabine and single-dose TBI (Seattle protocol). At the inception of the program, invasive fungal infection mainly related to building construction, and central line complications were significant. Measures implemented to control such complications were successful to a large extent. We report our results to the EBMT group and we are accredited as an unrelated transplantation center. Although from a

  2. The Quality of Pre-hospital Circulatory Management in Patients With Multiple Trauma Referred to the Trauma Center of Shahid Beheshti Hospital in Kashan, Iran, in the First Six Months of 2013

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    Maghaminejad

    2016-05-01

    Full Text Available Background Circulatory management is a critical issue in pre-hospital transportation phase of multiple trauma patients. However, the quality of this important care did not receive enough attention. Objectives The aim of this study was to investigate the quality of pre-hospital circulatory management in patients with multiple trauma. Patients and Methods This was a cross-sectional study conducted in 2013. The study population consisted of all patients with multiple trauma who had been transferred by emergency medical services (EMS to the central trauma department in Kashan Shahid Beheshti medical center, Kashan, Iran. We recruited a convenience sample of 400 patients with multiple trauma. Data were collected using the circulatory assessment questionnaire and controlling hemorrhage (CAQCH that were designed by the researchers and were described by using frequency tabulations, central tendency measures, and variability indices. The chi-square test was used to analyze the data. Results The study sample consisted of 263 males (75.2%; 57.75% had lower levels of education and 28.75% were workers. The most common mechanism of trauma was traffic accident (85.4%. We found that the quality of circulatory management was unfavorable in 61% of the cases. A significant relationship was observed between the quality of circulatory management and type of trauma and staff’s employment status. Conclusions The quality of pre-hospital circulatory management provided to patients with multiple trauma was unfavorable. Therefore, establishment of in-service training programs on circulatory management is recommended.

  3. Music therapy as part of the alternative-complementary therapy in cancer patients in hospital

    OpenAIRE

    Efstratios Athanassakis; Savvato Karavassiliadou

    2012-01-01

    Cancer is one of the modern health problems of people living in developed countries. Furthermore, therapeutic approaches to cancer patients is constantly updated with new data. Aim: The aim of the present study was to review the international literature referred to the application of music therapy in the treatment for pediatric and adult patients with cancer. Method and materials: The method of this study included bibliography research from both the review and the research literature on MEDLI...

  4. Health status after cancer : does It matter which hospital you belong to?

    OpenAIRE

    Hægeland Torbjørn; Fiva Jon H; Rønning Marte

    2009-01-01

    Background Survival rates are widely used to compare the quality of cancer care. However, the extent to which cancer survivors regain full physical or cognitive functioning is not captured by this statistic. To address this concern we introduce post-diagnosis employment as a supplemental measure of the quality of cancer care. Methods This study is based on individual level data from the Norwegian Canc...

  5. Independent Predictive Factors of Hospitalization in a North-West Burn Center of Iran; an Epidemiologic Study

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    Samad Shams Vahdati

    2015-01-01

    Full Text Available Introduction: A high grade burn is one of the most devastating injuries with several medical, social, economic, and psychological effects. These injuries are the most common cause of accidental deaths after traffic injuries in both the developed and developing countries. Therefore this research was aimed to determine demographic characteristics of patients with burn injury admitted to the emergency department and identify predictive factors of hospitalization. Methods: This is a cross sectional descriptive study, which is done in 20 March up to 20 September 2011 in emergency department of Sina Hospital, Tabriz, Iran. Patients’ information including demographic characteristic, cause of burn, place of accident, anatomical areas burned, grading and percent of burning and disposition were gathered and analyzed using SPSS version 18.0 statistical software. Stepwise multivariate regression analysis was used for recognition of independent predictive factors of hospitalization in burned patients. Results: One hundred and sixty patients were enrolled (54.4% female. The average age of those was 20.47±13.5 years. The prevalence of burn was significantly higher in ages under 20 years (p<0.001. Lower limb (37.5%, head and neck (21.25% and upper limb (17.5% were three frequent site of burn. The most common cause of burns was boiling water scalding (34.4%. Home related burn was significantly higher than other place (p<0.001. The most frequent percent of burn was <5% (46.25%. Finally 50 (31.25% cases hospitalized. Univariate analysis demonstrated that age under 20 years old (p=0.02 female gender (p=0.02, burning site (p=0.002, cause (p=0.005, place (p<0.001, grade (p<0.001, and percent (p<0.001 was related to disposition of patients. Stepwise multiple logistic regression showed female gender (OR=3.52; 95% CI: 1.57-7.88; p=0.002, work related burning (OR=1.78; 95% CI: 1.26-2.52; p=0.001, and burning over 5 percent (OR=2.15; 95% CI: 1.35-3.41; p=0.001 as

  6. Progressive Muscle Relaxation: An adjuvant therapy for reducing pain and fatigue among hospitalized cancer patients’ receiving radiotherapy.

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    Pragya Pathak

    2013-03-01

    Full Text Available Background: Cancer patients’ face number of problems, among those pain and fatigue are common problems. To manage pain and fatigue among cancer patients, studies now a days are even focusing on use of non-pharmacological/ non invasive methods as exercises, imagery etc. But studies on effect of progressive muscle relaxation (PMR exercises on pain and fatigue among admitted patients are scarce. Objective: The study was done to evaluate effectiveness of PMR exercises on pain and fatigue among hospitalized cancer patients’ receiving radiotherapy. Methods: The study design was quasi-experimental Pre test Post test control group design. Total of 100 participants, 50 in each intervention and control group were included. The subjects in the intervention group received four PMR exercise sessions in 4weeks along with routine standardized treatment while subjects in control group received treatment as usual with no added intervention. Results: There was significant difference (p<0.01 in Pre NPRS (4.42±2.35 to post NPRS (3.44±2.05 scores among intervention group (PMR. Pre assessment mean fatigue scores (CFS of subjects were 33.80±10.62 in intervention group (PMR and 33.24±7.02 in controls where as post assessment CFS were 28.52±12.74 and 36.52±7.53 in intervention and control group respectively. There was significant (p<0.01 reduction in pre to post CFS in PMR group while fatigue increased significantly (p<0.01 in control group. Conclusion: PMR along with routine standard treatment is effective in reducing pain and fatigue among hospitalized cancer patients receiving radiotherapy.

  7. Pattern of cancer in Jammu region (hospital based study 1978-′87).

    OpenAIRE

    Kapoor R; Goswami K; Kapoor B; Dubey V

    1993-01-01

    2681 histologically confirmed cases of cancer (1402 males and 1279 females) were seen during the ten year period 1978 to 1987 in Pathology Department, Government Medical College, Jammu. The relative frequencies of cancer at various primary sites have been determined with respect to age, sex and religion. The majority of cancers were seen between 31-60 years (67.7%) with a peak in 41-50 years age group. Out of the total cancer patients 2,437 were Hindus (90.8%) and 244 were Musli...

  8. Exposure to an atomic bomb explosion is a risk factor for in-hospital death after esophagectomy to treat esophageal cancer.

    Science.gov (United States)

    Nakashima, Y; Takeishi, K; Guntani, A; Tsujita, E; Yoshinaga, K; Matsuyama, A; Hamatake, M; Maeda, T; Tsutsui, S; Matsuda, H; Ishida, T

    2015-01-01

    Esophagectomy, one of the most invasive of all gastrointestinal operations, is associated with a high frequency of postoperative complications and in-hospital mortality. The purpose of the present study was to determine whether exposure to the atomic bomb explosion at Hiroshima in 1945 might be a preoperative risk factor for in-hospital mortality after esophagectomy in esophageal cancer patients. We thus reviewed the outcomes of esophagectomy in 31 atomic bomb survivors with esophageal cancer and 96 controls (also with cancer but without atomic bomb exposure). We compared the incidences of postoperative complications and in-hospital mortality. Of the clinicopathological features studied, mean patient age was significantly higher in atomic bomb survivors than in controls. Of the postoperative complications noted, atomic bomb survivors experienced a longer mean period of endotracheal intubation and higher incidences of severe pulmonary complications, severe anastomotic leakage, and surgical site infection. The factors associated with in-hospital mortality were exposure to the atomic bomb explosion, pulmonary comorbidities, and electrocardiographic abnormalities. Multivariate analysis revealed that exposure to the atomic bomb explosion was an independent significant preoperative risk factor for in-hospital mortality. Exposure to the atomic bomb explosion is thus a preoperative risk factor for in-hospital death after esophagectomy to treat esophageal cancer. PMID:24224952

  9. Multi-center evaluation of post-operative morbidity and mortality after optimal cytoreductive surgery for advanced ovarian cancer.

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    Arash Rafii

    Full Text Available PURPOSE: While optimal cytoreduction is the standard of care for advanced ovarian cancer, the related post-operative morbidity has not been clearly documented outside pioneering centers. Indeed most of the studies are monocentric with inclusions over several years inducing heterogeneity in techniques and goals of surgery. We assessed the morbidity of optimal cytoreduction surgery for advanced ovarian cancer within a short inclusion period in 6 referral centers dedicated to achieve complete cytoreduction. PATIENTS AND METHODS: The 30 last optimal debulking surgeries of 6 cancer centers were included. Inclusion criteria included: stage IIIc- IV ovarian cancer and optimal surgery performed at the site of inclusion. All post-operative complications within 30 days of surgery were recorded and graded using the Memorial secondary events grading system. Student-t, Chi2 and non-parametric statistical tests were performed. RESULTS: 180 patients were included. There was no demographic differences between the centers. 63 patients underwent surgery including intestinal resections (58 recto-sigmoid resection, 24 diaphragmatic resections, 17 splenectomies. 61 patients presented complications; One patient died post-operatively. Major (grade 3-5 complications requiring subsequent surgeries occurred in 21 patients (11.5%. 76% of patients with a major complication had undergone an ultraradical surgery (P = 0.004. CONCLUSION: While ultraradical surgery may result in complete resection of peritoneal disease in advanced ovarian cancer, the associated complication rate is not negligible. Patients should be carefully evaluated and the timing of their surgery optimized in order to avoid major complications.

  10. Perception of Side Effects of Chemotherapy among Cancer Patients in B.P. Koirala Memorial Cancer Hospital Bharatpur, Nepal

    OpenAIRE

    Sharmila Gurung; Radha Acharya Pandey

    2016-01-01

    jdjBackground & Objectives: These side effects of chemotherapy affect the patients’ daily life and quality of life adversely. It affects the different body system resulting in physical and non physical (psychosocial) side effects. Cancer patients demand information to understand chemotherapy-related adverse effects and actions to be taken. The aim of the study is to find out the perception of side effects of chemotherapy among cancer patients.Materials and methods: A descriptive cross-sec...

  11. Papillary Thyroid Cancer in a Child with Progressive Transformation of Germinal Centers.

    Science.gov (United States)

    Mohan, Suresh; DeNardo, Bradley; Stachurski, Dariusz; Greene Welch, Jennifer; Groblewski, Jan C

    2016-01-01

    Objectives. To describe the presentation and management of a child with Progressive Transformation of Germinal Centers (PTGC), an uncommon condition characterized by significant persistent lymphadenopathy, who developed papillary thyroid carcinoma and to explore and review potential links between PTGC and neoplastic processes in the head and neck. Methods. Case presentation and literature review are used. Results. A 10-year-old female presented with a right parotid mass and cervical lymphadenopathy. Multiple biopsies revealed PTGC without malignancy. Two years later, she developed fatigue and weight gain, and a thyroid nodule was found. Fine needle aspiration was strongly suggestive of papillary thyroid carcinoma. The patient underwent total thyroidectomy and central neck dissection without surgical management of the longstanding right lateral neck lymphadenopathy. Final pathology confirmed papillary thyroid carcinoma. She was treated with radioactive iodine therapy postoperatively and remains free of disease at three years of follow-up. Conclusions. PTGC is considered a benign condition but has previously been associated with Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL). This is the first reported case of papillary thyroid cancer in a child with preexisting cervical PTGC and no defined risk factors for thyroid malignancy. No link has been established with thyroid carcinoma, but patients with PTGC may have a defect in immune surveillance that predisposes them to malignancy. PMID:27069706

  12. Papillary Thyroid Cancer in a Child with Progressive Transformation of Germinal Centers

    Directory of Open Access Journals (Sweden)

    Suresh Mohan

    2016-01-01

    Full Text Available Objectives. To describe the presentation and management of a child with Progressive Transformation of Germinal Centers (PTGC, an uncommon condition characterized by significant persistent lymphadenopathy, who developed papillary thyroid carcinoma and to explore and review potential links between PTGC and neoplastic processes in the head and neck. Methods. Case presentation and literature review are used. Results. A 10-year-old female presented with a right parotid mass and cervical lymphadenopathy. Multiple biopsies revealed PTGC without malignancy. Two years later, she developed fatigue and weight gain, and a thyroid nodule was found. Fine needle aspiration was strongly suggestive of papillary thyroid carcinoma. The patient underwent total thyroidectomy and central neck dissection without surgical management of the longstanding right lateral neck lymphadenopathy. Final pathology confirmed papillary thyroid carcinoma. She was treated with radioactive iodine therapy postoperatively and remains free of disease at three years of follow-up. Conclusions. PTGC is considered a benign condition but has previously been associated with Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL. This is the first reported case of papillary thyroid cancer in a child with preexisting cervical PTGC and no defined risk factors for thyroid malignancy. No link has been established with thyroid carcinoma, but patients with PTGC may have a defect in immune surveillance that predisposes them to malignancy.

  13. Implementation of a Lateral TBI protocol in a Mexican Cancer Center

    Science.gov (United States)

    Mesa, Francisco; Esquivel, Carlos; Eng, Tony; Papanikolaou, Niko; Sosa, Modesto A.

    2008-08-01

    The development of a Lateral Total Body Irradiation protocol to be implemented at a High Specialty Medical Unit in Mexico as preparatory regimen for bone marrow transplant and treatment of several lymphomas is presented. This protocol was developed following AAPM specifications and has been validated for application at a cancer care center in United States. This protocol fundamentally focuses on patient care, avoiding instability and discomfort that may be encountered by other treatment regimes. In vivo dose verification with TLD-100 chips for each anatomical region of interest was utilized. TLD-100 chips were calibrated using a 6 MV photon beam for 10-120 cGy. Experimental results show TLD measurements with an error less than 1%. Standard deviations for calculated and measured doses for seven patients have been obtained. Data gathered for different levels of compensation indicate that a 3% measured tolerance level is acceptable. TLD point-dose measurements have been used to verify the dose beyond partial transmission lung blocks. Dose measurements beyond the lung block showed variation about 50% respects to prescribe dose. Midplane doses to the other anatomical sites were less than 2.5% respect of the prescribed dose.

  14. Secular trends in the etiology and comorbidity of hospitalized patients with congestive heart failure: A single-center retrospective study

    Institute of Scientific and Technical Information of China (English)

    Zhi-Yong Pei; Yu-Sheng Zhao; Jia-Yue Li; Qiao Xue; Lei Gao; Shi-Wen Wang

    2012-01-01

    Objective To assess the secular trends in the etiology and comorbidity of patients hospitalized with congestive heart failure (CHF). Methods Data of 7,319 patients (mean age 59.6 years, 62.1% male) with a primary discharge diagnosis of CHF, hospitalized from January 1, 1993 to December 31, 2007 at the Chinese People's Liberation Army (PLA) General Hospital were extracted and analyzed. These patients were divided into three groups according to hospitalization period: 1993-1997 (n = 1623), 1998-2002 (n = 2444), and 2003-2007 (n = 3252). The etiological characteristics and comorbidities were assessed. Results Over the study period, the proportion of patients with ischemic heart disease (IHD) increased from 37.2% during the period 1993-1997 to 46.8% during the period 2003-2007, while that with valvular heart disease (VHD) decreased from 35.2% during the period 1993-1997 to 16.6% during the period 2003-2007 (both P < 0.05). Atrial fibrillation (AF) was the most common comorbidity of heart failure (23.2%, 23.0% and 20.6%, respectively, in the three periods). Compared to that of the period of 1993-1997 with that of, the proportion of patients with myocardial infarction, pneumonia, renal function impairment and hepatic cirrhosis of the period of 2003-2007 increased significantly (P < 0.05) and the proportion of patients with chronic obstructive pulmonary disease and atrial fibrillation decreased significantly (P < 0.05). Conclusions This study implies that IHD has became a more common etiology of CHF, while VHD has deceased as an etiology of CHF in Chinese patients during the last two decades.

  15. Patient-centered cancer treatment planning: improving the quality of oncology care. Summary of an Institute of Medicine workshop.

    Science.gov (United States)

    Balogh, Erin P; Ganz, Patricia A; Murphy, Sharon B; Nass, Sharyl J; Ferrell, Betty R; Stovall, Ellen

    2011-01-01

    The Institute of Medicine's National Cancer Policy Forum recently convened a workshop on patient-centered cancer treatment planning, with the aim of raising awareness about this important but often overlooked aspect of cancer treatment. A primary goal of patient-centered treatment planning is to engage patients and their families in meaningful, thorough interactions with their health care providers to develop an accurate, well-conceived treatment plan, using all available medical information appropriately while also considering the medical, social, and cultural needs and desires of the patient and family. A cancer treatment plan can be shared among the patient, family, and care team in order to facilitate care coordination and provide a roadmap to help patients navigate the path of cancer treatment. There are numerous obstacles to achieving patient-centered cancer treatment planning in practice. Some of these challenges stem from the patient and include patients' lack of assertiveness, health literacy, and numeracy, and their emotional state and concurrent illnesses. Others are a result of physician limitations, such as a lack of time to explain complex information and a lack of tools to facilitate treatment planning, as well as insensitivity to patients' informational, cultural, and emotional needs. Potential solutions to address these obstacles include better training of health care providers and patients in optimal communication and shared decision making, and greater use of support services and tools such as patient navigation and electronic health records. Other options include greater use of quality metrics and reimbursement for the time it takes to develop, discuss, and document a treatment plan. PMID:22128118

  16. HIV-associated non-Hodgkin′s lymphoma: Experience from a regional cancer center

    Directory of Open Access Journals (Sweden)

    A Sharma

    2010-01-01

    Full Text Available Aims : To analyze clinical features and survival in HIV-associated non-Hodgkin lymphoma (NHL cases registered at Dr BRA Institute Rotary Cancer Hospital of AIIMS, New Delhi. Materials and Methods : We have retrospectively reviewed records of NHL patients registered, from January 2003 to July 2007 to analyze HIV-associated NHL. Results : Seven cases of HIV-associated NHL cases were identified. Age range was 14-56 years. Five were males. Baseline performance status (ECOG-PS was >I in 6. Mean LDH was 409 U/L. Mean hemoglobin was 10.5 g% and mean CD4 count was 243/mm3 (range 18- 454. Three cases had nodal lymphoma and four had extra nodal lymphoma. No primary CNS (PCNSL lymphoma was seen. All patients were of advanced stages and of intermediate to high-risk group based on international prognostic index (IPI. Six cases had high-grade NHL. None had CNS involvement. Five had B symptoms. HIV infection was diagnosed as part of NHL work-up in five patients. All patients received HAART. All were planned for chemotherapy with CNS prophylaxis. Protocols used were CVP, CHOP, R-CHOP or MCP-842. One patient received IFRT. Response : One patient achieved complete response (CR and continues to be disease free, with 4.5 years of follow-up. Three cases achieved partial response (PR and 2 had progressive disease (PD. Currently, three patients are on follow-up. Conclusions : These NHL are of higher grade and advanced stage. Response and tolerance to chemotherapy is poor. Appropriate supportive care and CNS prophylaxis might improve outcome. We need to improve epidemiological data collection system in this part of world. With HAART, the goal of therapy is durable CR rather than palliation.

  17. Treatment policy of head and neck cancer and the results. Upper pharynx cancer (stage IV) case in Keio University hospital and Shizuoka Red Cross hospital

    International Nuclear Information System (INIS)

    Concerning 54 cases of upper pharynx cancer (stage IV) which received the first treatment during 1980-1996, the change of treatment method and the results were examined. Five years survival rate was 53.6% and ten years survival rate was 39.7%. The ratio of cases which were treated with neo-adjuvant chemotherapy (NAC) was 70% or more in earlier period (1980-1985), but decreased to 50% in the middle period (1986-1991) and 8% in the latter period (1992-1996). On the contrary, the ratio of cases which were treated mainly with irradiation increased. The survival rate was good with the treatment group in latter period. The conventional irradiation was done mainly in the earlier period and the middle period, the fractionated irradiation became to be done mainly in the latter period. A survival rate of the group irradiated fractionally was better than that of the group irradiated conventionally. NAC was done for 24 cases, and the response rate was 75.0%, but the improvement of survival rate wasn't clear. From an above-mentioned results, the fractionated irradiation together with dosage of CBDCA was selected firstly as treatment policy for upper pharynx cancer (stage IV). The irradiation was enforced twice a day with 1.2 Gy in an interval of six hours, and CBDCA 20 mg/m2 was administered intravenously in about 1 hour before the second irradiation. The total radiation dose to a limited part was aimed to be 72 Gy. The fifth week was resting interval in order to avoid a side effect as mucous membrane flame. (K.H.)

  18. Taking Risk: Early Results From Teaching Hospitals' Participation in the Center for Medicare and Medicaid Innovation Bundled Payments for Care Improvement Initiative.

    Science.gov (United States)

    Kivlahan, Coleen; Orlowski, Janis M; Pearce, Jonathan; Walradt, Jessica; Baker, Matthew; Kirch, Darrell G

    2016-07-01

    The authors describe observations from the 27 teaching hospitals constituting the Association of American Medical Colleges (AAMC) cohort in the Center for Medicare and Medicaid Innovation (CMMI) Bundled Payments for Care Improvement (BPCI) initiative. CMMI introduced BPCI in August 2011 and selected the first set of participants in January 2013. BPCI participants enter into Medicare payment arrangements for episodes of care for which they take financial risk. The first round of participants entered risk agreements on October 1, 2013 and January 1, 2014. In April 2014, CMMI selected additional participants who started taking financial risk in 2015. Selected episodes include congestive heart failure (CHF), major joint replacement (MJR), and cardiac valve surgery. The AAMC cohort of participating hospitals selected clinical conditions on the basis of patient volume, opportunity to impact savings and quality, organizational and clinical team readiness, and prior process improvement experience. Early financial results suggest that focused attention to postacute care utilization and outcomes, rapid changes in care processes, program pricing rules, and team composition drove savings and losses. The first cohort of participants generated savings in MJR, CHF, and cardiac valve episodes; losses were experienced in stroke, percutaneous coronary intervention, and spine surgery. Although about one-quarter of U.S. teaching hospitals are participating in BPCI, the proliferation of existing and new payment models, as well as the 2015 announcement to increasingly pay providers according to value, mandates close scrutiny of program outcomes. The authors conclude by proposing additional opportunities for research related to alternative payment models. PMID:26886810

  19. Efficient inhibition of ovarian cancer by degradable nanoparticle-delivered survivin T34A gene

    OpenAIRE

    Luo L; Du T; Zhang J; Zhao W; Cheng H; Yang Y; Wu Y; Wang C.; Men K; Gou M

    2016-01-01

    Li Luo,1,* Ting Du,1,* Jiumeng Zhang,1 Wei Zhao,2 Hao Cheng,1 Yuping Yang,1 Yujiao Wu,1 Chunmei Wang,1 Ke Men,1 Maling Gou1 1State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center for Biotherapy, 2Department of Thoracic Oncology, Cancer Center, West China Hospital, Medical School, Sichuan University, Chengdu, People’s Republic of China *These authors contributed equally to this work Abstract: Gene...

  20. NIH Clinical Center: There’s No Other Hospital Like It | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... help advance medical knowledge that leads to new cures, therapies, and treatments.” Currently, there are about 1,500 clinical research studies in progress at the NIH Clinical Center. About half are studies of the natural history of disease, especially rare diseases, which often ...

  1. The impact of a new acute oncology service in acute hospitals: experience from the Clatterbridge Cancer Centre and Merseyside and Cheshire Cancer Network.

    Science.gov (United States)

    Neville-Webbe, H L; Carser, J E; Wong, H; Andrews, J; Poulter, T; Smith, R; Marshall, E

    2013-12-01

    The 2008 National Confidential Enquiry into Patient Outcomes and Death highlighted an urgent need to improve the quality, safety and efficiency of care for cancer patients following emergency presentation to acute general hospitals. A network-wide acute oncology service (AOS) was therefore commissioned and implemented on the basis of recommendations from the National Chemotherapy Advisory Group (NCAG). Through a continuous programme of raising awareness regarding both the role of the AOS and the necessity of early patient referral to acute oncology teams, we have been able to establish an AOS across all acute trusts in our cancer network. The network-wide AOS has improved communication across clinical teams, enabled rapid review of over 3,000 patients by oncology staff, reduced hospital stay, increased understanding of oncology emergencies and their treatment, and enhanced pathways for rapid diagnosis and appropriate referrals for patients presenting with malignancy of undefined origin (MUO). These achievements have been made by developing a network protocol book for managing common oncology emergencies, by introducing local pathways for managing MUO and by collaborating with palliative care teams to introduce local acute oncology (AO) multi-disciplinary team (MDT) meetings. PMID:24298102

  2. Hotel-based ambulatory care for complex cancer patients: a review of the University College London Hospital experience.

    Science.gov (United States)

    Sive, Jonathan; Ardeshna, Kirit M; Cheesman, Simon; le Grange, Franel; Morris, Stephen; Nicholas, Claire; Peggs, Karl; Statham, Paula; Goldstone, Anthony H

    2012-12-01

    Since 2005, University College London Hospital (UCLH) has operated a hotel-based Ambulatory Care Unit (ACU) for hematology and oncology patients requiring intensive chemotherapy regimens and hematopoietic stem cell transplants. Between January 2005 and 2011 there were 1443 patient episodes, totaling 9126 patient days, with increasing use over the 6-year period. These were predominantly for hematological malignancy (82%) and sarcoma (17%). Median length of stay was 5 days (range 1-42), varying according to treatment. Clinical review and treatment was provided in the ACU, with patients staying in a local hotel at the hospital's expense. Admission to the inpatient ward was arranged as required, and there was close liaison with the inpatient team to preempt emergency admissions. Of the 523 unscheduled admissions, 87% occurred during working hours. An ACU/hotel-based treatment model can be safely used for a wide variety of cancers and treatments, expanding hospital treatment capacity, and freeing up inpatient beds for those patients requiring them. PMID:22591143

  3. Indicators of breast cancer severity and appropriateness of surgery based on hospital administrative data in the Lazio Region, Italy

    Science.gov (United States)

    Schifano, Patrizia; Papini, Paolo; Agabiti, Nera; Scarinci, Marina; Borgia, Piero; Perucci, Carlo A

    2006-01-01

    Background Administrative data can serve as an easily available source for epidemiological and evaluation studies. The aim of this study is to evaluate the use of hospital administrative data to determine breast cancer severity and the appropriateness of surgical treatment. Methods the study population consisted of 398 patients randomly selected from a cohort of women hospitalized for first-time breast cancer surgery in the Lazio Region, Italy. Tumor severity was defined in three different ways: 1) tumor size; 2) clinical stage (TNM); 3) severity indicator based on HIS data (SI). Sensitivity, specificity, and positive predictive value (PPV) of the severity indicator in evaluating appropriateness of surgery were calculated. The accuracy of HIS data was measured using Kappa statistic. Results Most of 387 cases were classified as T1 and T2 (tumor size), more than 70% were in stage I or II and the SI classified 60% of cases in medium-low category. Variation from guidelines indications identified under and over treatments. The accuracy of the SI to predict under-treatment was relatively good (58% of all procedures classified as under-treatment using pT where also classified as such using SI), and even greater predicting over-treatment (88.2% of all procedures classified as over treatment using pT where also classified as such using SI). Agreement between clinical chart and hospital discharge reports was K = 0.35. Conclusion Our findings suggest that administrative data need to be used with caution when evaluating surgical appropriateness, mainly because of the limited ability of SI to predict tumor size and the questionable quality of HIS data as observed in other studies. PMID:16464258

  4. Indicators of breast cancer severity and appropriateness of surgery based on hospital administrative data in the Lazio Region, Italy

    Directory of Open Access Journals (Sweden)

    Scarinci Marina

    2006-02-01

    Full Text Available Abstract Background Administrative data can serve as an easily available source for epidemiological and evaluation studies. The aim of this study is to evaluate the use of hospital administrative data to determine breast cancer severity and the appropriateness of surgical treatment. Methods the study population consisted of 398 patients randomly selected from a cohort of women hospitalized for first-time breast cancer surgery in the Lazio Region, Italy. Tumor severity was defined in three different ways: 1 tumor size; 2 clinical stage (TNM; 3 severity indicator based on HIS data (SI. Sensitivity, specificity, and positive predictive value (PPV of the severity indicator in evaluating appropriateness of surgery were calculated. The accuracy of HIS data was measured using Kappa statistic. Results Most of 387 cases were classified as T1 and T2 (tumor size, more than 70% were in stage I or II and the SI classified 60% of cases in medium-low category. Variation from guidelines indications identified under and over treatments. The accuracy of the SI to predict under-treatment was relatively good (58% of all procedures classified as under-treatment using pT where also classified as such using SI, and even greater predicting over-treatment (88.2% of all procedures classified as over treatment using pT where also classified as such using SI. Agreement between clinical chart and hospital discharge reports was K = 0.35. Conclusion Our findings suggest that administrative data need to be used with caution when evaluating surgical appropriateness, mainly because of the limited ability of SI to predict tumor size and the questionable quality of HIS data as observed in other studies.

  5. Colon Cancer Biomarkers To Identify Patients Suitable For Therapeutic Intervention | NCI Technology Transfer Center | TTC

    Science.gov (United States)

    The National Cancer Institute's Laboratory of Human Carcinogenesis is seeking statements of capability or interest from parties interested in collaborative research to further develop, evaluate, or commercialize cancer biomarkers and therapeutic targets.

  6. Mouse Monoclonal Antibodies for Liver Cancer Research | NCI Technology Transfer Center | TTC

    Science.gov (United States)

    The National Cancer Institute Laboratory of Molecular Biology seeks parties for collaborative research to co-develop and commercialize antibody drug/toxin conjugates as liver cancer therapy and diagnostics.

  7. Effects of a humor-centered activity on disruptive behavior in patients in a general hospital psychiatric ward

    OpenAIRE

    Antonio Higueras; Hugo Carretero-Dios; José P. Muñoz; Esther Idini; Ana Ortiz; Francisco Rincón; David Prieto-Merino; María M. Rodríguez del Águila

    2006-01-01

    El objetivo de este estudio cuasi-experimental es analizar lo efectos de una actividad centrada en el humor sobre las conductas disruptivas de pacientes hospitalizados en un servicio de Psiquiatría. Se han comparado, teniendo en cuenta dos grupos homogéneos de pacientes hospitalizados en un servicio de Psiquiatría de hospital general (unidad de agudos), dos periodos temporales de 83 días cada uno, siendo el período 1 el de línea base, y el período 2, el de intervención. Para am...

  8. Use of complementary and alternative medicine by cancer patients at the University of Nigeria Teaching Hospital, Enugu, Nigeria

    Directory of Open Access Journals (Sweden)

    Anarado Agnes N

    2007-09-01

    Full Text Available Abstract Background The use of Complementary and Alternative Medicine (CAM by cancer patients is very common and varies between populations. The referenced English literature has no local study from Africa on this subject. This study was conducted to define the prevalence, pattern of use, and factors influencing the use of CAM by cancer patients at the University of Nigeria Teaching Hospital Enugu (UNTH-E, Nigeria Method Face-to-face interviews using semi-structured questionnaire were used to determine the use of CAM by cancer patients. All consenting cancer patients were interviewed as they presented at the core surgical units of the UNTH- E, from June 2003 to September 2005. Results 160 patients were interviewed; 68 (42.5% were males and 94 (57.5% were females. Ages ranged from 13–86 years. Breast, urogenital system, gastrointestinal system, and soft tissue cancers predominated. One hundred and four patients (65.0% have used CAM at some time during their current cancer illness; 56 (35.0% patients have not used any form of CAM. There were more females than males among the non-CAM users. The use of CAM was not affected by age, marital status, level of education, religious affiliation, or socioeconomic status. The most frequently used CAMs were herbs (51.9%, faith/prayer healing (49.4%, aloe vera (23.1%, Forever Living Products (16.3%, medicinal tea (14.4%, and Blackstone (12.5%. Over 23% of those who used CAM were satisfied, but 68.3% were disappointed. Most users (67.3% did not see any benefit from the CAM, but 25% could describe some specific benefits. More than 21% of users reported various unwanted effects. While 86.5% of CAM users will use orthodox medicine instead of CAM in the future, 9.6% will use the two together to help each other. Most users (79.8% will not repeat CAM or recommend its use for cancer. The majority of patients (55.8% did not mention their use of CAM to their doctors – mostly because the doctor did not ask

  9. Self-reported use of internet by cervical cancer clients in two National Referral Hospitals in Kenya

    Directory of Open Access Journals (Sweden)

    Kivuti-Bitok Lucy W

    2012-10-01

    Full Text Available Abstract Background Cervical cancer remains a devastating disease in Kenya accounting for more than 2000 deaths each year. Lack of information on cervical cancer prevention and management has been attributed to the apathy among women in seeking health interventions. Use of internet-based and mobile e-health tools could increase information access among cervical cancer patients. The objective of the study was; to establish the extent of use of mobile phones and internet by cervical cancer patients in accessing information related to cancer treatment and management.; find out the characteristics of patients associated with internet use and identify barriers faced by the patients in internet use. A cross sectional descriptive survey of 199 cervical patients visiting the two main referral hospitals in Kenya was done. A structured questionnaire was used to collect data. Findings The average length of illness was 2.43 years (SD ± 3.0. Only 7.5 %( n=15 reported to having used the internet as a source of information. 92.5 %( n=184 did not use internet. With Multiple options, 70.9% did not know how to use a computer, 29.2% did not have access to a computer, 14.6% lacked the money to use computers at the local cyber cafe while other barriers identified accounted for 11.1%. Patients reported that the internet had an important role in the management of cancer of the cervix in health education (17.6%, online consultation (14.6%, booking of patients (13.6%, referrals (8.5% and collecting data (7%. The 96.5% of the respondents who had access to a mobile phone, recommended mobile phones for health education messages (31.7%, reminder alerts for medication (29.7% and booking appointments (21.6%. There was a statistically significant association between income of the patients and internet use (p = 0.026 in this study. Conclusions There is low level use of the internet by cervical cancer clients attended in Public referral facilities in Kenya. This was attributed

  10. Referral pattern for neoadjuvant chemotherapy in the head and neck cancers in a tertiary care center

    OpenAIRE

    V M Patil; V Noronha; Joshi, A; V M Krishna; S Dhumal; Chaudhary, V.; Juvekar, S; P S Pai; C Pankaj; Chaukar, D.; A K Dcruz; Prabhash, K

    2014-01-01

    Background: Use of any treatment modality in cancer depends not only on the effectiveness of the modality, but also on other factors such as local expertise, tolerance of the modality, cost and prevalence of the disease. Oropharyngeal and laryngeal cancer are the major subsites in which majority of neoadjuvant chemotherapy (NACT) literature in the head and neck cancers is available. However, oral cancers form a major subsite in India. Materials And Methods: This is an analysis of a prospectiv...

  11. Knowledge and Practices of Nurses Working in an Education Hospital on Early Diagnosis of Breast and Cervix Cancers.

    Directory of Open Access Journals (Sweden)

    Ozlem Ozdemir

    2010-12-01

    Full Text Available AIM: This research has aimed to determine knowledge and practice status of nurses about breast self-examination (BSE, clinical breast examination (CBE, mammography and Pap smear and about influencing status of some variables related to these examinations. METHOD: This descriptive study was conducted in an education hospital in Ankara between March 1st and May 30th, 2008. Three hundred-fifty nurses (82.7% have accepted to participate in the study. Data were collected by a questionnaire form including questions about demographics, their knowledge and practice status about BSE, CBE, mammography and Pap smear. Chi-square test, numbers and percentages were used for evaluating the data. RESULTS: Overall, 46.9% of nurses had enough knowledge about early diagnosis of breast and cervix cancer. 60.2% of them can carry BSE, 18.8% can carry out CBE and 7.3% can carry out mammography. Pap smear is carried out by 23.7% of the nurses. Negligence, fear of cancer and thought of finding them unnecessary were determined as reasons for avoidance. Their knowledge and practice were significantly different (p<0.05 according to their age and service where they work. CONCLUSION: It has been concluded that although knowledge and practices of nurses on breast and cervix cancer are at a good level, this isn’t enough when importance of early diagnosis in breast and cervix cancer are taken into consideration, which are among common cancers in women. [TAF Prev Med Bull 2010; 9(6.000: 605-612

  12. Advancing Cancer Systems Biology: Introducing the Center for the Development of a Virtual Tumor, CViT

    Directory of Open Access Journals (Sweden)

    Sean Martin

    2007-01-01

    Full Text Available Integrative cancer biology research relies on a variety of data-driven computational modeling and simulation methods and techniques geared towards gaining new insights into the complexity of biological processes that are of critical importance for cancer research. These include the dynamics of gene-protein interaction networks, the percolation of subcellular perturbations across scales and the impact they may have on tumorigenesis in both experiments and clinics. Such innovative ‘systems’ research will greatly benefi t from enabling Information Technology that is currently under development, including an online collaborative environment, a Semantic Web based computing platform that hosts data and model repositories as well as high-performance computing access. Here, we present one of the National Cancer Institute’s recently established Integrative Cancer Biology Programs, i.e. the Center for the Development of a Virtual Tumor, CViT, which is charged with building a cancer modeling community, developing the aforementioned enabling technologies and fostering multi-scale cancer modeling and simulation.

  13. Association between community health center and rural health clinic presence and county-level hospitalization rates for ambulatory care sensitive conditions: an analysis across eight US states

    Directory of Open Access Journals (Sweden)

    Laditka Sarah B

    2009-07-01

    Full Text Available Abstract Background Federally qualified community health centers (CHCs and rural health clinics (RHCs are intended to provide access to care for vulnerable populations. While some research has explored the effects of CHCs on population health, little information exists regarding RHC effects. We sought to clarify the contribution that CHCs and RHCs may make to the accessibility of primary health care, as measured by county-level rates of hospitalization for ambulatory care sensitive (ACS conditions. Methods We conducted an ecologic analysis of the relationship between facility presence and county-level hospitalization rates, using 2002 discharge data from eight states within the US (579 counties. Counties were categorized by facility availability: CHC(s only, RHC(s only, both (CHC and RHC, and neither. US Agency for Healthcare Research and Quality definitions were used to identify ACS diagnoses. Discharge rates were based on the individual's county of residence and were obtained by dividing ACS hospitalizations by the relevant county population. We calculated ACS rates separately for children, working age adults, and older individuals, and for uninsured children and working age adults. To ensure stable rates, we excluded counties having fewer than 1,000 residents in the child or working age adult categories, or 500 residents among those 65 and older. Multivariate Poisson analysis was used to calculate adjusted rate ratios. Results Among working age adults, rate ratio (RR comparing ACS hospitalization rates for CHC-only counties to those of counties with neither facility was 0.86 (95% Confidence Interval, CI, 0.78–0.95. Among older adults, the rate ratio for CHC-only counties compared to counties with neither facility was 0.84 (CI 0.81–0.87; for counties with both CHC and RHC present, the RR was 0.88 (CI 0.84–0.92. No CHC/RHC effects were found for children. No effects were found on estimated hospitalization rates among uninsured populations

  14. Prophylactic use of Saccharomyces boulardii probiotics in preventing antibiotic-associated diarrhea: a single center hospital-based case-control study in Serbia

    Directory of Open Access Journals (Sweden)

    Nikola Panic

    2015-12-01

    Full Text Available Background. Antibiotic-associated diarrhea (AAD develops through the loss of normal bacterial intestinal flora. We have conducted a case-control study in order to assess whether prophylactic administration of Saccharomyces boulardii (S. boulardii prevents occurrence of AAD among adult hospitalized patients. Methods. Single-center hospital based case-control study was conducted in University Clinic “Dr Dragisa Misovic-Dedinje”, Belgrade, Serbia. Hospital records were screened in order to identify all the patients developing AAD in period January 1. 2010 – August 31. 2015. For every case, one age and gender matched control was randomly selected among patients hospitalized at the same time at the same department who were administered with antibiotics and did not develop AAD. For both cases and controls data were extracted on demographics, medical history, indication for use of antibiotics, antibiotics used, and prophylactic use of S.boulardii probiotics. The relationship between occurrence of AAD and putative risk factors were measured using the odds ratios (ORs and their 95% confidence interval (CI derived from logistic regression analysis. Results. Number of 59 cases and 59 controls were included in the study. Most of AAD cases were associated with old age (mean age of 78.05, and almost half (49.15% were hospitalized on geriatrics department. Most prescribed class of antibiotics among cases was III generation cephalosporins (50.85%, followed by fluoroquinolones (28.81% and trimethoprim-sulfamethoxazole (20.34%. Significantly more cases than controls were treated with carbapenems (16.95% vs. 5.08% respectively, p=0.04. Significantly less cases were administered with prophylactic S. boulardii probiotics (18.64% vs. 42.37% p=0.005. We identified prophylactic use of S. boulardii to act protectively against development of AAD from both univariate (OR: 0.31, 95% CI: 0.14-0.72 and multivariate analysis (OR:0.36, 95% CI: 0.14-0.80. Use of

  15. Round one of the Adelaide and Meath Hospital/Trinity College Colorectal Cancer Screening Programme: programme report and analysis based on established international key performance indices.

    LENUS (Irish Health Repository)

    McNamara, D

    2012-02-01

    BACKGROUND: In Ireland, colorectal cancer (CRC) is the second most frequently diagnosed cancer in men, after prostate cancer, and the second most frequently diagnosed cancer in women, after breast cancer. By 2020, the number of new cases diagnosed annually in Ireland is projected to have increased by 79% in men and 56% in women. Organised screening for CRC is already underway or is in the process of being rolled out in several European countries, either at a regional or national level. The Adelaide and Meath Hospital\\/ Trinity College Dublin Colorectal Cancer Screening Programme (TTC-CRC-SP) is Ireland\\'s first pilot population based bowel screening programme. METHOD: Based on a biennial test model the pilot aimed to assess the accuracy of FIT and to evaluate the whole programme based on established international key performance indices. RESULTS: To date 9,993 individuals aged 50-74 years have been invited to participate in the TTC-CRC-SP with over 5,000 FIT\\'s analysed. Overall uptake was 51% and FIT positivity was 10%. The programme has undertaken over 400 screening colonoscopies and detected 154 precancerous adenomas and 38 cancerous lesions. CONCLUSIONS: The first round of The Adelaide and Meath Hospital Tallaght\\/Trinity College Dublin Colorectal Cancer Screening Programme has been highly successful and confirmed that there is an advantage for FIT based two stage bowel cancer screening programmes.

  16. Academic-Community Partnership to Develop a Patient-Centered Breast Cancer Risk Reduction Program for Latina Primary Care Patients

    OpenAIRE

    Castañeda, Sheila F.; Rebeca E. Giacinto; Medeiros, Elizabeth A.; Brongiel, Ilana; Cardona, Olga; Perez, Patricia; Talavera, Gregory A.

    2015-01-01

    This collaborative study sought to address Latina breast cancer (BC) disparities by increasing health literacy (HL) in a community health center situated on the US-Mexico border region of San Diego County. An academic-community partnership conducted formative research to develop a culturally tailored promotora-based intervention with 109 individuals. The Spanish language program, entitled Nuestra Cocina: Mesa Buena, Vida Sana (Our Kitchen: Good Table, Healthy Life), included six sessions targ...

  17. Penile Cancer in Cali, Colombia: 10 Years of Casuistry in a Tertiary Referral Center of a Middle-Income Country

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    Lina M. Rengifo

    2015-10-01

    Full Text Available Background: Penile cancer is a rare disease in Colombia; in Cali, it represents 0.7% of all cancers. Penile cancer has been associated with old age, bad hygiene, smoking and lack of circumcision. This study aimed to describe the sociodemographic and clinical characteristics of patients with penile cancer who consulted to a tertiary referral hospital. Methods: A case series of all penile cancer cases at a reference institution in Cali during 2001-2010. Socioeconomic, demographic and clinical features of patients were described, and bivariate analyses were carried out. Results: There were 46 penile cancer cases. The average age was 60 ± 16.9 years. The main reason for consultation was an exophytic mass on the penis (75.0%. The most common location was the glans (69.6%, and the more frequent histology type was the squamous cell carcinoma (95.7%. With regard to risk factors, 65.5% of the patients had history of smoking and 90.9% did not have circumcision. Patients who underwent radical amputation had higher rates of positive nodes (55% vs. 13.5%, p=0.015 and ulcerative lesions (77.8% vs. 29.7%, p=0.018 than those who did not have the procedure done. Recurrence was associated with the presence of lymphadenopathy (p=0.02 and history of circumcision (p=0.015. Conclusion: Most of the patients with penile cancer found in this study had old age, history of tobacco use and lack of circumcision. Patients who presented with lymph node metastasis had to undergo more radical procedures and suffered a greater rate of recurrence compared with those without lymph node involvement. Robust studies to determine the risk factors among low-income populations are required.

  18. Histopathological prognostic factor comparison of endometrial cancer patients in a tertiary hospital in India

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    P. Swarna Latha

    2014-02-01

    Conclusions: This study highlights the prognostic characteristics of endometrial cancer patients with most of them presenting in early stages thereby having a good prognostic outcome. [Int J Reprod Contracept Obstet Gynecol 2014; 3(1.000: 102-104

  19. Assessment of quality of life in breast cancer patients at a tertiary care hospital

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    G Damodar

    2013-01-01

    Conclusion: These findings have shown that there exists a strong correlation between the length of treatment and the QoL among breast cancer patients. Future interventions should target each specific aspect of QoL.

  20. Academic-Community Partnership to Develop a Patient-Centered Breast Cancer Risk Reduction Program for Latina Primary Care Patients.

    Science.gov (United States)

    Castañeda, Sheila F; Giacinto, Rebeca E; Medeiros, Elizabeth A; Brongiel, Ilana; Cardona, Olga; Perez, Patricia; Talavera, Gregory A

    2016-06-01

    This collaborative study sought to address Latina breast cancer (BC) disparities by increasing health literacy (HL) in a community health center situated on the US-Mexico border region of San Diego County. An academic-community partnership conducted formative research to develop a culturally tailored promotora-based intervention with 109 individuals. The Spanish language program, entitled Nuestra Cocina: Mesa Buena, Vida Sana (Our Kitchen: Good Table, Healthy Life), included six sessions targeting HL, women's health, BC risk reduction, and patient-provider communication; sessions include cooking demonstrations of recipes with cancer-risk-reducing ingredients. A pilot study with 47 community health center Latina patients was conducted to examine the program's acceptability, feasibility, and ability to impact knowledge and skills. Pre- and post-analyses demonstrated that participants improved their self-reported cancer screening, BC knowledge, daily fruit and vegetable intake, and ability to read a nutrition label (p < 0.05). Results of the pilot study demonstrate the importance of utilizing patient-centered culturally appropriate noninvasive means to educate and empower Latina patients. PMID:27271058

  1. Cyberknife fractionated radiotherapy for adrenal metastases: Preliminary report from a multispecialty Indian cancer care center

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    Trinanjan Basu

    2015-03-01

    Full Text Available Purpose: Metastasis to adrenal gland from lung, breast, and kidney malignancies are quite common. Historically radiotherapy was intended for pain palliation. Recent studies with stereotactic body radiotherapy (SBRT including Cyberknife robotic radiosurgery aiming at disease control brings about encouraging results. Here we represent the early clinical experience with Cyberknife stereotactic system from an Indian cancer care center. The main purpose of this retrospective review is to serve as a stepping stone for future prospective studies with non- invasive yet effective technique compared to surgery. Methods: We retrospectively reviewed four cases of adrenal metastases (three: lung and one: renal cell carcinoma treated with Cyberknife SBRT. X sight spine tracking was employed for planning and treatment delivery. Patients were evaluated for local response clinically as well as with PETCT based response criteria.Results: With a median gross tumor volume of 20.5 cc and median dose per fraction of 10 Gy, two patients had complete response (CR and two had partial response (PR when assessed 8-12 weeks post treatment as per RECIST. There was no RTOG grade 2 or more acute adverse events and organs at risk dosage were acceptable. Till last follow up all the patients were locally controlled and alive. Conclusion: Cyberknife SBRT with its unique advantages like non- invasive, short duration outpatient treatment technique culminating in similar local control rates in comparison to surgery is an attractive option. World literature of linear accelerator based SBRT and our data with Cyberknife SBRT with small sample size and early follow up are similar in terms of local control in adrenal metastases. Future prospective data would reveal more information on the management of adrenal metastases.

  2. Stage I seminoma: treatment outcome at King Hussein Cancer Center in Jordan

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    Khader Jamal

    2012-04-01

    Full Text Available Abstract Background The aim of this report is to address treatment outcomes of patients with early-stage seminoma in a single institution with special reference to patients with history of surgical violation of the scrotum. Methods Seventy four patients with pure seminoma were treated at King Hussein Cancer Center (Amman, Jordan between 2003 and 2010. All patients underwent orchiectomy. All but 3 patients received adjuvant radiotherapy. Patients who underwent surgical violation of the scrotum prior to referral were managed by further excision or irradiation of the scrotal scar. The follow-up ranged from 1 to 200 months (mean, 33 months. Results At the time of follow-up; all but one patient remain alive. The 3-year relapse-free survival for the entire cohort was 95.9%. Three patients developed relapse, all of whom received adjuvant irradiation following inguinal orchiectomy and initially harbored tumors larger than 4 cm upon pathological examination. Median time to relapse was 14 months (range, 8–25 months. None were associated with elevated tumor markers prior to detection of relapse. All but one patient were successfully salvaged by chemotherapy. Conclusions Our results confirm the excellent prognosis of patients with early-stage seminoma treated by orchiectomy and adjuvant radiotherapy in a developing country. Although all patients who developed relapse demonstrated adverse pathological findings upon initial assessment, no consistent predictor of relapse was found. Scrotal scar re-excision or irradiation in patients with prior history of surgical violation of the scrotum are effective measures in preventing local failure.

  3. Utilization of and Attitudes towards Traditional Chinese Medicine Therapies in a Chinese Cancer Hospital: A Survey of Patients and Physicians

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    Jennifer L. McQuade

    2012-01-01

    Full Text Available Background. In China, the use of traditional Chinese medicine (TCM is very popular, but little is known about how it is integrated with conventional cancer care. We conducted parallel surveys of patients and physicians on TCM utilization. Methods. Two hundred forty-five patients and 72 allopathic physicians at the Fudan University Shanghai Cancer Center completed questions on their use of and attitude towards TCM. Results. Patient mean age was 51, with 60% female. Eighty-three percent of patients had used TCM. Use was greatest for Chinese herbal medicine (CHM; 55.8%. Only 1.3% of patients used acupuncture and 6.8% Qi Gong or Tai Qi. Sixty-three percent of patients notified their oncologist about TCM use. The most common reason for use was to improve immune function. CHM was often used with a goal of treating cancer (66.4%, a use that 57% of physicians agreed with. Physicians were most concerned with interference with treatment, lack of evidence, and safety. Ninety percent of physicians have prescribed herbs and 87.5% have used TCM themselves. Conclusion. The use of TCM by Chinese cancer patients is exceptionally high, and physicians are generally well informed and supportive of patients’ use. Botanical agents are much more commonly used than acupuncture or movement-based therapies.

  4. Effectiveness and feasibility of using the computerized interactive virtual space in reducing depressive symptoms of Hong Kong Chinese children hospitalized with cancer.

    Science.gov (United States)

    Li, William H C; Chung, Joyce O K; Ho, Eva K Y; Chiu, Sau Ying

    2011-07-01

    PURPOSE. To examine the effectiveness and feasibility of using the computerized interactive virtual space in reducing depressive symptoms of children hospitalized with cancer. DESIGN AND METHODS. A nonequivalent control group design was employed. Children (8-16 years of age; n= 122) admitted to a pediatric oncology ward during a 14-month period were recruited. RESULTS. The results support the effectiveness and feasibility of using the computerized interactive virtual space in reducing depressive symptoms of children hospitalized with cancer. PRACTICE IMPLICATIONS. The results heighten the awareness in nurses of the importance of integrating play activities as an essential component of holistic and quality nursing care.

  5. De-hospitalization of the pediatric day surgery by means of a freestanding surgery center: pilot study in the lazio region

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    Mangia Giovanni

    2012-02-01

    Full Text Available Abstract Background Day surgery should take place in appropriate organizational settings. In the presence of high volumes, the organizational models of the Lazio Region are represented by either Day Surgery Units within continuous-cycle hospitals or day-cycle Day Surgery Centers. This pilot study presents the regional volumes provided in 2010 and the additional volumes that could be provided based on the best performance criterion with a view to suggesting the setting up of a regional Freestanding Center of Pediatric Day Surgery. Methods This is an observational retrospective study. The activity volumes have been assessed by means of a DRG (Diagnosis Related Group-specific indicator that measures the ratio of outpatients to the total number of treated patients (freestanding indicator, FI. The included DRGs had an FI exceeding the 3rd quartile present in at least a health-care facility and a volume exceeding 0.5% of the total patients of the pediatric surgery and urology facilities of the Lazio Region. The relevant data have been provided by the Public Health Agency and relate to 2010. The best performance FI has been used to calculate the theoretical volume of transferability of the remaining facilities into freestanding surgery centers. Patients under six months of age and DRGs common to other disciplines have been excluded. The Chi Square test has been used to compare the FI of the health-care facilities and the FI of the places of origin of the patients. Results The DRG provided in 2010 amounted to a total of 5768 belonging to 121 types of procedures. The application of the criteria of inclusion have led to the selection of seven final DRG categories of minor surgery amounting to 3522 cases. Out of this total number, there were 2828 outpatients and 694 inpatients. The recourse of the best performance determines a potential transfer of 497 cases. The total outpatient volume is 57%. The Chi Square test has pointed to a statistically significant

  6. Characteristics of Epstein-Barr virus-associated gastric cancer: A study of 235 cases at a comprehensive cancer center in U.S.A

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    Yu Yingyan

    2009-02-01

    Full Text Available Abstract Background Epstein-Barr virus (EBV has been shown to be associated with gastric cancer. However, inconsistent findings have been reported regarding the distribution of EBV infected cells (in normal gastric epithelium vs. intestinal metaplastic cells vs. in neoplastic cells and the characteristics of EBV-associated gastric cancer. Lymph node positive EBV-associated gastric cancer has not been systematically studied. The aims of this study were to evaluate EBV-associated gastric cancer, to assess the distribution of EBV infected cells including all positive lymph nodes, and to define the characteristics of EBV-associated gastric cancer. Design The study included primary gastric cancer patients who underwent surgical resection with no preoperative treatment at M.D. Anderson Cancer Center between 1987 and 2006. Formalin-fixed paraffin-embedded tissue from these resection specimens were assessed for EBV by in situ hybridization, the gold standard for EBV detection in tissue. EBV status was analyzed along with clinicopathologic parameters including age, gender, tumor type, lymph node status, and pathologic stage of the tumor. Results Among 235 patients, 12 had intranuclear expression of EBV. EBV staining was seen only in tumor cells and no detectable EBV was observed in normal gastric mucosa, intestinal metaplasia or stromal cells. Eight of 12 patients with EBV-associated gastric cancer had regional lymph node metastasis. Of note, metastatic tumor cells in all of the involved lymph nodes of these 8 cases contained EBV. The epidemiologic data showed 11 of the 12 patients with EBV-associated gastric cancer were men, ranging in age from 54 to 78 years (mean age, 60 years; median age, 62.1 years. The age distribution for non-EBV associated gastric cancer patients ranged from 21 to 93 years (mean age, 67 years; median age, 66.4 years. Conclusion Our study demonstrated that EBV is present exclusively in gastric cancer cells. The detection of EBV in

  7. Current knowledge, attitudes and practices of women on breast cancer and mammography at Mulago hospital

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    Kawooya G. Michael

    2010-05-01

    Full Text Available BACKGROUND: Breast cancer is the third commonest cancer in Ugandan women. Women present late for breast cancer management which leads to high mortality rates. The objective of the study was to assess the knowledge, attitudes and practices of Ugandan women concerning breast cancer and mammography.METHODS: This was a descriptive cross-sectional study where 100 women reporting to the Radiology department were interviewed. We used consecutive sampling. Interviewer-administered questionnaires were used to collect opinions of the participants. For data analysis, answers were described as knowledge, attitude, practice and they were correlated with control variables through the chi-square. Bivariate and logistic regression analyses were also used. RESULTS: Most of the women (71% had no idea about mammography. More than 50% did not know about risk factors for breast cancer. The attitude towards mammography was generally negative. Regarding seeking for mammography; level of literacy, occupation and marital status were significant on bivariate analysis, however only level of literacy and employment remained the significant independent variables on logistic regression analysis. The main barrier to mammography was mainly lack of information. CONCLUSION: Women in this study had inadequate knowledge and inappropriate practice related to mammography as a procedure for breast cancer investigation.

  8. The accident of stereotaxic radiosurgery at the University hospital center of Toulouse. Expert report n.2. Dosimetric and clinical evaluation. Risk analysis

    International Nuclear Information System (INIS)

    The regional center of stereotaxic radiosurgery (C.R.R.S.) of the University hospital center (C.H.U.) of Toulouse is equipped since april 2006 with a Novalis accelerator (Brainlab) devoted to radiosurgery and intra skull stereotaxic radiotherapy.In april 2007, during an intercomparison of dosimetry files coming from various sites, the Brainlab society detects an anomaly. The analysis made by the society concludes to the use of an unsuited detector for the measurement of a dosimetry parameter during the accelerator initial calibration. Following this error, 145 patients (on 172 patients treated since the center opening) suffer of an overdose whom importance is variable. On the 26. june 2007 the Authority of nuclear safety (Asn) requires an expertise on the following points: checking of the experimental protocols of micro-beams calibration before and after correction of the dysfunction; analysis at the theoretical level of the neurological complications risk at long term for the exposed patients. The second point of this request is the subject of this report. It gives the synthesis of the whole of information, at the clinical and dosimetric level and outlines successively: the expertise methodology; the cohort of patients treated at the C.R.R.S.; the parameters of the risk analysis of neurological complications; the different risk analysis according the pathologies treated at the C.R.R.S.; the recommendations. (N.C.)

  9. Understanding Cancer Prognosis

    Medline Plus

    Full Text Available ... Role in Cancer Research Intramural Research Extramural Research Bioinformatics and Cancer NCI-Designated Cancer Centers Frederick National ... Role in Cancer Research Intramural Research Extramural Research Bioinformatics and Cancer NCI-Designated Cancer Centers Frederick National ...

  10. Infections due to beta-lactamase-producing Neisseria gonorrhoeae at the University Hospital Medical Center, Kuala Lumpur, Malaysia.

    Science.gov (United States)

    Ismail, R

    1987-01-01

    The incidence of infections due to beta-lactamase-producing Neisseria gonorrhoeae is increasing in many parts of the world. An epidemiologic survey of infections caused by beta-lactamase-producing strains of N. gonorrhoeae at the University Hospital, Kuala Lumpur, from February 1977 to December 1985 (106 months) showed that the incidence rose from 4.8% (two cases) in 1977 to 49.4% (39 cases) by the end of 1985. The highest incidence of gonococcal infections was found to be in the group aged 20-39 years; the male-to-female ratio was 1.55:1. The mean inhibitory concentrations of benzylpenicillin were 0.12 microgram/ml for non-beta-lactamase-producing strains and 16 micrograms/ml for isolates of N. gonorrhoeae that produce beta-lactamase.

  11. Frailty as a Predictor of Acute Kidney Injury in Hospitalized Elderly Patients: A Single Center, Retrospective Cohort Study.

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    Seon Ha Baek

    Full Text Available Elderly patients have an increased risk for acute kidney injury (AKI. However, few studies have reported on predictors for AKI in geriatric patients. Therefore, we aimed at determining the effect of frailty as a predictor of AKI.We retrospectively enrolled 533 hospitalized elderly patients (aged ≥ 65 years who had their creatinine levels measured (≥ 1 measurement during admission for a period of 1 year (2013 and conducted a comprehensive geriatric assessment (CGA within 1 year before the index hospitalization. We examined five variables (activity of daily living [ADL] and instrumental ADL dependence, dementia, nutrition, and polypharmacy from CGA. We categorized the patients into 3 groups according to the tertile of aggregate frailty scores: Group 1, score 1-2; Group 2, score 3-4; Group 3, score 5-8.Fifty-four patients (10.1% developed AKI (median duration, 4 days. The frailest group (Group 3 showed an increased risk of AKI as compared to Group 1, (hazard ratio [HR] = 3.536, P = 0.002. We found that discriminatory accuracy for AKI improved with the addition of the tertile of aggregate frailty score to covariates (area under the receiver operator characteristics curves [AUROC] 0.641, AUROC 0.739, P = 0.004. Forty-six patients (8.6% were transferred to nursing facilities and 477 patients (89.5% were discharged home. The overall 90-day and 1-year mortality for elderly inpatients were 7.9% and 26.3%. The frailest group also demonstrated an increased risk of discharge to nursing facilities, and 90-day and 1-year mortality as compared to Group 1, independent of AKI severity (nursing facilities: odd ratio = 4.843, P = 0.002; 90-day mortality: HR = 6.555, P = 0.002; 1-year mortality: HR = 3.249, P = 0.001.We found that frailty may independently predict the development of AKI and adverse outcomes in geriatric inpatients.

  12. Performance of Implementing Guideline Driven Cervical Cancer Screening Measures in an Inner City Hospital System

    Science.gov (United States)

    Wieland, Daryl L.; Reimers, Laura L.; Wu, Eijean; Nathan, Lisa M.; Gruenberg, Tammy; Abadi, Maria; Einstein, Mark H.

    2013-01-01

    Objective In 2006, the American Society for Colposcopy and Cervical Pathology (ASCCP) updated evidence based guidelines recommending screening intervals for women with abnormal cervical cytology. In our low-income inner city population, we sought to improve performance by uniformly applying the guidelines to all patients. We report the prospective performance of a comprehensive tracking, evidence-based algorithmically driven call-back and appointment scheduling system for cervical cancer screening in a resource-limited inner city population. Materials and Methods Outreach efforts were formalized with algorithm-based protocols for triage to colposcopy, with universal adherence to evidence-based guidelines. During implementation from August 2006 through July 2008, we prospectively tracked performance using the electronic medical record with administrative and pathology reports to determine performance variables such as the total number of Pap tests, colposcopy visits, and the distribution of abnormal cytology and histology results, including all CIN 2,3 diagnoses. Results 86,257 gynecologic visits and 41,527 Pap tests were performed system-wide during this period of widespread and uniform implementation of standard cervical cancer screening guidelines. The number of Pap tests performed per month varied little. The incidence of CIN 1 significantly decreased from 117/171 (68.4%) the first tracked month to 52/95 (54.7%) the last tracked month (p=0.04). The monthly incidence rate of CIN 2,3, including incident cervical cancers did not change. The total number of colposcopy visits declined, resulting in a 50% decrease in costs related to colposcopy services and approximately a 12% decrease in costs related to excisional biopsies. Conclusions Adherence to cervical cancer screening guidelines reduced the number of unnecessary colposcopies without increasing numbers of potentially missed CIN 2,3 lesions, including cervical cancer. Uniform implementation of administrative

  13. Usability application of multiplex polymerase chain reaction in the diagnosis of microorganisms isolated from urine of patients treated in cancer hospital

    OpenAIRE

    Cybulski, Zefiryn; Schmidt, Katarzyna; Grabiec, Alicja; Talaga, Zofia; Bociąg, Piotr; Wojciechowicz, Jacek; Roszak, Andrzej; Kycler, Witold

    2013-01-01

    Background The objective of this study was: i) to compare the results of urine culture with polymerase chain reaction (PCR) -based detection of microorganisms using two commercially available kits, ii) to assess antimicrobial susceptibility of urine isolates from cancer patients to chosen antimicrobial drugs and, if necessary, to update the recommendation of empirical therapy. Materials and methods. A one-year hospital-based prospective study has been conducted in Greater Poland Cancer Centre...

  14. It’s a long, long walk: accessibility to hospitals, maternity and integrated health centers in Niger

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    Blanford Justine I

    2012-06-01

    Full Text Available Abstract Background Ease of access to health care is of great importance in any country but particularly in countries such as Niger where restricted access can put people at risk of mortality from diseases such as measles, meningitis, polio, pneumonia and malaria. This paper analyzes the physical access of populations to health facilities within Niger with an emphasis on the effect of seasonal conditions and the implications of these conditions in terms of availability of adequate health services, provision of drugs and vaccinations. The majority of the transport within Niger is pedestrian, thus the paper emphasizes access by those walking to facilities for care. Further analysis compared the change in accessibility for vehicular travel since public health workers do travel by vehicle when carrying out vaccination campaigns and related proactive health care activities. Results The majority of the roads in Niger are non-paved (90%. Six districts, mainly in the region of Tahoua lack medical facilities. Patient to health facility ratios were best in Agadez with 7000 people served per health facility. During the dry season 39% of the population was within 1-hours walk to a health center, with the percentage decreasing to 24% during the wet season. Further analyses revealed that vaccination rates were strongly correlated with distance. Children living in clusters within 1-hour of a health center had 1.88 times higher odds of complete vaccination by age 1-year compared to children living in clusters further from a health center (p  Conclusions This study highlights critical areas in Niger where health services/facilities are lacking. A second finding is that population served by health facilities will be severely overestimated if assessments are solely conducted during the dry season. Mapped outputs can be used for future decision making processes and analysis.

  15. EFFECTIVENESS OF NUTRITIONAL INTERVENTION MEASURES ON CHILDREN ADMITTED IN NUTRITIONAL REHABILITATION CENTER (NRC KING GEORGE HOSPITAL- VISAKHAPATNAM

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    Rama Rao

    2015-12-01

    Full Text Available BACKGROUND NRC was started in Visakhapatnam (KGH in December’ 2012 to nutritionally rehabilitate severely acute malnourished children. This study was conducted to assess the effectiveness of rehabilitation services provided at Nutritional Rehabilitation Center. OBJECTIVES 1 To evaluate the effectiveness of Nutritional interventional measures undertaken at Nutritional Rehabilitation Center through review of selected anthropometric measure indicators. 2 To assess the nutritional status after discharge from Nutritional Rehabilitation center. METHODS A Retrospective record based (secondary data study conducted in the month of November 2013.Sevevnty five children were admitted in Nutritional Rehabilitation Center (NRC of KGH, Visakhapatnam in the months of April to October 2013. The data was obtained from NRC records including anthropometric measurements at admission, discharge and follow-up. RESULTS Twenty percent of the children were less than 12 months of age and 34.7% were in the age group of 13–24 months. Forty eight percent were female and 52% were male children. Majority (93% of the children stayed in the NRC for more than 14 days. There was significant difference in the weight of children at the time of admission and at the time of discharge (t= - 15.942, p=0.001. There was no significant difference in Mid Arm Circumference at the time of admission and at the time of discharge (t = -0.942, p=0.349. Fourteen percent were defaulted. There was significant difference in weight of children at the time of discharge and at the time of first follow-up (t=2.203, p=0.03 and third follow-up (t= -8.903, p=0.001. CONCLUSIONS NRCs are effective in improving the nutritional status of severely acute malnourished children and the follow-up also shows the children are having catch-up growth. RECOMMENDATIONS: 1 Adequate number of NRCs should be available for severely acute malnourished children in all the areas. 2 Effective counseling measures should be

  16. Perception of Side Effects of Chemotherapy among Cancer Patients in B.P. Koirala Memorial Cancer Hospital Bharatpur, Nepal

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    Sharmila Gurung

    2016-01-01

    Full Text Available jdjBackground & Objectives: These side effects of chemotherapy affect the patients’ daily life and quality of life adversely. It affects the different body system resulting in physical and non physical (psychosocial side effects. Cancer patients demand information to understand chemotherapy-related adverse effects and actions to be taken. The aim of the study is to find out the perception of side effects of chemotherapy among cancer patients.Materials and methods: A descriptive cross-sectional study was conducted among 200 cancer patients, using purposive sampling technique and data was collected via face to face interview. Descriptive as well as inferential statistics (T-test was used to see the significant difference between dependent and independent variables.Results: The overall perceived side effects of chemotherapy include: affects work and home duties (non physical side effect, followed by anxiety, loss of appetite, affects family, affect partner, feel constantly tired (fatigue, affects social activities, feel irritable, nausea and constipation respectively. There is significant difference between perception of side effects of chemotherapy and gender of respondents.Conclusion: The perceptions of side effects of chemotherapy are different from individual to individual. Patient’s perception of side effects of chemotherapy is concerned with non physical side effects rather than physical side effects.Journal of College of Medical Sciences-Nepal, Vol.11(4 2015: 14-19

  17. Preoperative radiotherapy for rectal cancer: a comparative study of quality control adherence at two cancer hospitals in Spain and Poland

    International Nuclear Information System (INIS)

    We performed a clinical audit of preoperative rectal cancer treatment at two European radiotherapy centres (Poland and Spain). The aim was to independently verify adherence to a selection of indicators of treatment quality and to identify any notable inter-institutional differences. A total of 162 patients, in Catalan Institute of Oncology (ICO) 68 and in Greater Poland Cancer Centre (GPCC) 94, diagnosed with locally advanced rectal cancer and treated with preoperative radiotherapy or radio-chemotherapy were included in retrospective study. A total of 7 quality control measures were evaluated: waiting time, multidisciplinary treatment approach, portal verification, in vivo dosimetry, informed consent, guidelines for diagnostics and therapy, and patient monitoring during treatment. Several differences were observed. Waiting time from pathomorphological diagnosis to initial consultation was 31 (ICO) vs. 8 (GPCC) days. Waiting time from the first visit to the beginning of the treatment was twice as long at the ICO. At the ICO, 82% of patient experienced treatment interruptions. The protocol for portal verification was the same at both institutions. In vivo dosimetry is not used for this treatment localization at the ICO. The ICO utilizes locally-developed guidelines for diagnostics and therapy, while the GPCC is currently developing its own guidelines. An independent external clinical audit is an excellent approach to identifying and resolving deficiencies in quality control procedures. We identified several procedures amenable to improvement. Both institutions have since implemented changes to improve quality standards. We believe that all radiotherapy centres should perform a comprehensive clinical audit to identify and rectify deficiencies

  18. 3D radiation therapy or intensity-modulated radiotherapy for recurrent and metastatic cervical cancer: the Shanghai Cancer Hospital experience.

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    Su-Ping Liu

    Full Text Available We evaluate the outcomes of irradiation by using three-dimensional radiation therapy (3D-RT or intensity-modulated radiotherapy (IMRT for recurrent and metastatic cervical cancer. Between 2007 and 2010, 50 patients with recurrent and metastatic cervical cancer were treated using 3D-RT or IMRT. The median time interval between the initial treatment and the start of irradiation was 12 (6-51 months. Salvage surgery was performed before irradiation in 5 patients, and 38 patients received concurrent chemotherapy. Sixteen patients underwent 3D-RT, and 34 patients received IMRT. Median follow-up for all the patients was 18.3 months. Three-year overall survival and locoregional control were 56.1% and 59.7%, respectively. Three-year progression-free survival and disease-free survival were 65.3% and 64.3%, respectively. Nine patients developed grade 3 leukopenia. Grade 5 acute toxicity was not observed in any of the patients; however, 2 patients developed Grade 3 late toxicity. 3D-RT or IMRT is effective for the treatment of recurrent and metastatic cervical cancer, with the 3-year overall survival of 56.1%, and its complications are acceptable. Long-term follow-up and further studies are needed to confirm the role of 3D-RT or IMRT in the multimodality management of the disease.

  19. Breast cancer quality of life evaluation in Mexican Women at La Raza Hospital, Mexico City: A preliminary approach

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    Jacobo Alejandro Gómez-Rico

    2008-11-01

    Full Text Available Jacobo Alejandro Gómez-Rico1, Marina Altagracia-Martínez1, Jaime Kravzov-Jinich1, Rosario Cárdenas-Elizalde1, Juan Carlos Hinojosa-Cruz2, Consuelo Rubio-Poo31Departments of Biological Systems and Healthcare, Biological and Health Sciences Division (DCBS, Universidad Autónoma Metropolitana–Xochimilco (UAM-X, Xochimilco, Mexico; 2La Raza Hospital of the Mexican Social Security Institute (IMSS, Mexico City, Mexico; 3Universidad Nacional Autónoma de México (UNAM, Faculty of Professional Studies, Zaragoza (FES-Zaragoza, MexicoAbstract: Breast cancer (BC is the second leading cause of death among Mexican women over 40 years of age. This study aimed to identify and examine the effects of cancer stage and surgical treatment on the quality of life (QOL of Mexican women with early stage breast cancer (ESBC treated with either modified radical mastectomy (MRM or breast conservative surgery (BCS, plus adjuvant chemotherapy. The QLQ-C30 and QLQ BR-23 questionnaires were used to assess QOL. Sociodemographic characteristics and clinical factors of 102 women with early BC were also evaluated; analysis of variance (ANOVA was performed and a statistical significance of p < 0.05 was assumed. Most women were of reproductive age. Meaningful differences in QOL as a result of surgical treatment, in women receiving BCS compared with those receiving MRM, were limited to body image. We conclude that MRM and BCS are essentially equivalent choices in terms of QOL, with the exception of the impact on body image. In general, women who received BCS had a better perceived QOL.Keywords: quality of life, breast cancer, Mexican women

  20. Discuss the Animal Experiment Center Design Patterns of Modern Hospital--Take the Fourth Military Medical University Affiliated Tang Hospital as an Example%现代医院动物实验中心设计模式初探--以第四军医大学附属唐都医院为例

    Institute of Scientific and Technical Information of China (English)

    刘静珊

    2014-01-01

    动物实验中心是现代医院“医、教、研”活动重要场所,在医院中地位越来越重要。本文以第四军医大学附属唐都医院神经外科动物实验中心为例,论述设计思路和方法,以期对医院动物实验中心设计提供可参考依据。%Animal experiment center is the modern hospital important active place of "medicine, teaching and research”with more and more important status in the hospital. This article takes the fourth military medical university affiliated tang hospital neurosurgery animals experiment center as an example, and discusses the design thought and method so as to provide reference for the hospital animal experiment center design.

  1. Hospital Malnutrition

    OpenAIRE

    Asumadu-Sarkodie, Samuel

    2012-01-01

    Malnutrition seen in hospitals usually occurs as some form of protein-energy malnutrition (PEM). Primary PEM results from an acute or chronic deficiency of both protein and calories. Secondary PEM, or cachexia, results from a disease or medical condition such as cancer or gastrointestinal disease that alters requirements or impairs utilization of nutrients.

  2. The first report from Sapporo Tsukisamu Hospital. Chemotherapy and Chemoradiotherapy for patients with advanced pancreatic cancer

    International Nuclear Information System (INIS)

    The remedy, especially chemotherapy, for advanced pancreatic cancer is hardly ever successful in terms of efficacy rate and survival period, because it is virtually unable to contribute to the improvement of median survival time (MST). Thus, we devised a new intermittent dosage regimen utilizing the cell cycle difference of normal gastrointestinal (GI) tract, bone marrow cell and pancreatic cancer cell, making use of 5-FU (→S-1), cisplatin (CDDP) and paclitaxel in March 2002. Ten patients with advanced pancreatic cancer (4 in Stage IVa and 6 in Stage IVb) were treated with this new regimen. As a result, an efficacy ratio of 50.0% and a 1-year survival ratio of 60.0% were achieved. However, 2-year survival ratio of 12.0% was low, and there was no 3-year survivor. The MST was 19 months as of December 31, 2006. All of the non-hematological toxicities were under grade 2. Eight patients had hematological toxicities over grade 3 and most of them were anemia and neutropenia. Only 2 cases had thrombocytopenia. Although adverse effects related to this regimen were clinically manageable, it was difficult to improve MST of patients with advanced pancreatic cancer with chemotherapy alone including this regimen. Hence, we devised another regimen with the joint use of radiotherapy along with the same chemotherapy regimen in January 2003. Twenty patients with advanced pancreatic cancer (Stage IV) were treated with this regimen. It is presently under way, and an efficacy ratio of 35.0%, 1-year survival ratio of 86.3% and 2-year survival ratio of 64.0% were obtained by May 2005, showing that this may contribute to the extension of survival time of Stage IV pancreatic cancer patients. (author)

  3. Biomarkers For Breast Cancer Based On Genetic Instability | NCI Technology Transfer Center | TTC

    Science.gov (United States)

    It is difficult to establish a prognosis for breast cancer because the clinical course and survival times of patients with the disease vary greatly.  The National Cancer Institute's Genetics Branch is seeking statements of capability or interest from parties interested in in-licensing or collaborative research to co-develop, evaluate, or commercialize prognostic tests for breast cancer based on a 12-gene expression signature.

  4. Gastric cancer at a university teaching hospital in northwestern Tanzania: a retrospective review of 232 cases

    Directory of Open Access Journals (Sweden)

    Mabula Joseph B

    2012-11-01

    Full Text Available Abstract Background Despite marked decreases in its incidence, particularly in developed countries, gastric cancer is still the second most common tumor worldwide. There is a paucity of information regarding gastric cancer in northwestern Tanzania. This study was undertaken to describe our experience, in our local setting, on the management of gastric cancer, outlining the clinicopathological and treatment outcome of these patients and suggesting ways to improve the treatment outcome. Methods This was a retrospective study of histologically confirmed cases of gastric cancer seen at Bugando Medical Centre between January 2007 and December 2011. Data were retrieved from patients’ files and analyzed using SPSS computer software version 17.0. Results A total of 232 gastric cancer patients were enrolled in the study, representing 4.5% of all malignancies. The male to female ratio was 2.9:1. The median age of patients was 52 years. The majority of the patients (92.1% presented late with advanced gastric cancer (Stages III and IV. Lymph node and distant metastasis at the time of diagnosis was recorded in 31.9% and 29.3% of cases, respectively. The antrum was the most frequent anatomical site (56.5% involved and gastric adenocarcinoma (95.1% was the most common histopathological type. Out of 232 patients, 223 (96.1% patients underwent surgical procedures for gastric cancer of which gastro-jejunostomy was the most frequent performed surgical procedure, accounting for 53.8% of cases. The use of chemotherapy and radiotherapy was documented in 56 (24.1% and 12 (5.1% patients, respectively. Postoperative complication and mortality rates were 37.1% and 18.1%, respectively. According to multivariate logistic regression analysis, preoperative co-morbidity, histological grade and stage of the tumor, presence of metastases at the time of diagnosis was the main predictors of death (P P Conclusions Gastric cancer in this region shows a trend towards relative

  5. Clinical and economic value of performing dialysis vascular access procedures in a freestanding office-based center as compared with the hospital outpatient department among Medicare ESRD beneficiaries.

    Science.gov (United States)

    Dobson, Al; El-Gamil, Audrey M; Shimer, Matthew T; DaVanzo, Joan E; Urbanes, Aris Q; Beathard, Gerald A; Litchfield, Terry Foust

    2013-01-01

    Dialysis vascular access (DVA) care is being increasingly provided in freestanding office-based centers (FOC). Small-scale studies have suggested that DVA care in a FOC results in favorable patient outcomes and lower costs. To further evaluate this issue, data were drawn from incident and prevalent ESRD patients within a 4-year sample (2006-2009) of Medicare claims (USRDS) on cases who receive at least 80% of their DVA care in a FOC or a hospital outpatient department (HOPD). Using propensity score matching techniques, cases with a similar clinical and demographic profile from these two sites of service were matched. Medicare utilization, payments, and patient outcomes were compared across the matched cohorts (n = 27,613). Patients treated in the FOC had significantly better outcomes (p advantages over that provided in a HOPD.

  6. 医院静脉用药调配中心的临床意义%Clinical significance of hospital pharmacy intravenous admixture center

    Institute of Scientific and Technical Information of China (English)

    邓永忠

    2015-01-01

    本文对静脉用药调配中心的临床作用进行总结,从提高临床护理工作效率、预防职业暴露,加强职业防护、安全用药、提升医院药师综合素质、搭建药护协作平台、经济社会效益等方面进行阐述。%Summary the clinical effect of intravenous drug allocation center, in order to improve the clinical nursing work efficiency, prevent the occupation exposure, strengthening occupation protection, safety, enhance the comprehensive quality of hospital pharmacists, build of medicine and nursing cooperation platform, economic and social benefit are expounded.

  7. Effectiveness of a hospital-based work support intervention for female cancer patients - a multi-centre randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Sietske J Tamminga

    Full Text Available OBJECTIVE: One key aspect of cancer survivorship is return-to-work. Unfortunately, many cancer survivors face problems upon their return-to-work. For that reason, we developed a hospital-based work support intervention aimed at enhancing return-to-work. We studied effectiveness of the intervention compared to usual care for female cancer patients in a multi-centre randomised controlled trial. METHODS: Breast and gynaecological cancer patients who were treated with curative intent and had paid work were randomised to the intervention group (n = 65 or control group (n = 68. The intervention involved patient education and support at the hospital and improvement of communication between treating and occupational physicians. In addition, we asked patient's occupational physician to organise a meeting with the patient and the supervisor to make a concrete gradual return-to-work plan. Outcomes at 12 months of follow-up included rate and time until return-to-work (full or partial, quality of life, work ability, work functioning, and lost productivity costs. Time until return-to-work was analyzed with Kaplan-Meier survival analysis. RESULTS: Return-to-work rates were 86% and 83% (p = 0.6 for the intervention group and control group when excluding 8 patients who died or with a life expectancy of months at follow-up. Median time from initial sick leave to partial return-to-work was 194 days (range 14-435 versus 192 days (range 82-465 (p = 0.90 with a hazard ratio of 1.03 (95% CI 0.64-1.6. Quality of life and work ability improved statistically over time but did not differ statistically between groups. Work functioning and costs did not differ statistically between groups. CONCLUSION: The intervention was easily implemented into usual psycho-oncological care and showed high return-to-work rates. We failed to show any differences between groups on return-to-work outcomes and quality of life scores. Further research is needed to study which

  8. Etiological prevalence of epilepsy and epileptic seizures in hospitalized elderly in a Brazilian tertiary center – Salvador - Brazil

    Directory of Open Access Journals (Sweden)

    Telma Rocha de Assis

    2015-02-01

    Full Text Available Epilepsy in the elderly has high incidence and prevalence and is often underecognized. Objective To describe etiological prevalence of epilepsy and epileptic seizures in elderly inpatients. Methods Retrospective analysis was performed on elderly patients who had epilepsy or epileptic seizures during hospitalization, from January 2009 to December 2010. One hundred and twenty patients were enrolled. They were divided into two age subgroups (median 75 years with the purpose to compare etiologies. Results The most common etiology was ischemic stroke (36.7%, followed by neoplasias (13.3%, hemorrhagic stroke (11.7%, dementias (11.4% and metabolic disturbances (5.5%. The analysis of etiological association showed that ischemic stroke was predominant in the younger subgroup (45% vs 30%, and dementias in the older one (18.9% vs 3.8%, but with no statistical significance (p = 0.23. Conclusion This study suggests that epilepsy and epileptic seizures in the elderly inpatients have etiological association with stroke, neoplasias and dementias.

  9. Effects of a humor-centered activity on disruptive behavior in patients in a general hospital psychiatric ward

    Directory of Open Access Journals (Sweden)

    Antonio Higueras

    2006-01-01

    Full Text Available El objetivo de este estudio cuasi-experimental es analizar lo efectos de una actividad centrada en el humor sobre las conductas disruptivas de pacientes hospitalizados en un servicio de Psiquiatría. Se han comparado, teniendo en cuenta dos grupos homogéneos de pacientes hospitalizados en un servicio de Psiquiatría de hospital general (unidad de agudos, dos periodos temporales de 83 días cada uno, siendo el período 1 el de línea base, y el período 2, el de intervención. Para ambos periodos, se codificaron y registraron un total de diez conductas disruptivas. En los 83 días del periodo de intervención, y con una frecuencia de dos días semanales, dos actores profesionales llevaban a cabo las actividades centradas en el humor. Se calculó un Indice de Disrupción Global (IGD, teniendo en cuenta conjuntamente todas las conductas disruptivas, al igual que un Indice de Disrupción Específico (IDE para cada una de las conductas disruptivas. Usando para las comparaciones la corrección de Bonferroni, los resultados indican que el IGD descendió significativamente durante el periodo de intervención, siendo tres las conductas disruptivas que mostraron un descenso significativo (intentos de fuga, autolesiones y peleas.

  10. [Method of delivery and obstetric records of premature labour in material from the Polish Mother's Health Center Memorial Hospital].

    Science.gov (United States)

    Krasomski, G; Broniarczyk, D; Wojciechowska-Trzcińska, I; Gładysiak, A

    1992-09-01

    526 premature labours between the 28th and the 36th week of pregnancy were recorded at the Polish Mother's Health Centre Memorial Hospital during the period between April 1989 to September 1991. The mortality rates of newborns were analysed in the group of vaginal and abdominal delivery in the following pregnancy stages: the 28th--the 31st week, the 32nd--the 34th week, the 35th--the 36th week. 23 pregnant delivered abdominally by rapid indications were excluded from the study. In this group cesarean section was caused by placental complications or severe gestosis. This group, as a group of a high obstetric risk, was directly incomparable with vaginal delivery group, that of a low obstetric risk. Newborns with congenital malformations were also excluded from the study. Our analysis allows to assume that cesarean section, when applied in the premature labour between the 32nd and the 34th week of pregnancy, gives much better chances for newborn's survival than vaginal delivery. PMID:1305598

  11. [Noma and HIV infection: apropos of a case at the National Hospital Center in Bobo-Dioulasso (Burkina Faso)].

    Science.gov (United States)

    Ki-Zerbo, G A; Guigma, Y

    2001-12-01

    Noma (Cancrum oris) is a gangrenous stomatitis arising from a periodontal infection and leading to severe soft tissue and bone destruction. The pathology involves numerous factors including local thrombosis, vascularitis, necrotizing gingivitis, immunodeficiency, gram negative and anaerobic infection. It is usually a disease of infants and malnourished children in tropical areas often occurring after a debilitating disease like measles. Recently, cases have been reported in adults especially elderly patients or during immunodeficiency states. Reconstructive surgery is often necessary to deal with destruction and sequel but is rarely accessible in developing countries. We report one case of noma (cancrum oris) in an HIV seropositive patient at the National Hospital in Bobo-Dioulasso. The noma was inaugural of AIDS in a 40 years old labourer coming back from Ivory Coast and no major opportunistic infection was associated. The course was fulminant leading to extensive facial gangrene with recurrent bacterial infections. The disease was fatal in this depressive, malnourished and diarrhoeic patient despite local surgical treatment, prolonged antibiotherapy and supportive care. Pathogenic mechanisms, management and preventive issues are discussed.

  12. Characteristics of Travel-Related Severe Plasmodium vivax and Plasmodium falciparum Malaria in Individuals Hospitalized at a Tertiary Referral Center in Lima, Peru.

    Science.gov (United States)

    Llanos-Chea, Fiorella; Martínez, Dalila; Rosas, Angel; Samalvides, Frine; Vinetz, Joseph M; Llanos-Cuentas, Alejandro

    2015-12-01

    Severe Plasmodium falciparum malaria is uncommon in South America. Lima, Peru, while not endemic for malaria, is home to specialized centers for infectious diseases that admit and manage patients with severe malaria (SM), all of whom contracted infection during travel. This retrospective study describes severe travel-related malaria in individuals admitted to one tertiary care referral hospital in Lima, Peru; severity was classified based on criteria published by the World Health Organization in 2000. Data were abstracted from medical records of patients with SM admitted to Hospital Nacional Cayetano Heredia from 2006 to 2011. Of 33 SM cases with complete clinical data, the mean age was 39 years and the male/female ratio was 2.8. Most cases were contracted in known endemic regions within Peru: Amazonia (47%), the central jungle (18%), and the northern coast (12%); cases were also found in five (15%) travelers returning from Africa. Plasmodium vivax was most commonly identified (71%) among the severe infections, followed by P. falciparum (18%); mixed infections composed 11% of the group. Among the criteria of severity, jaundice was most common (58%), followed by severe thrombocytopenia (47%), hyperpyrexia (32%), and shock (15%). Plasmodium vivax mono-infection predominated as the etiology of SM in cases acquired in Peru.

  13. The Epidemiological and Clinical Assessment of Admitted Burned Pregnant Women in Shahid Mottahary Hospital Burn Center Between January 1998 and October 2003

    Directory of Open Access Journals (Sweden)

    A. Tavassoli-Ashrafi, M.D.

    2007-09-01

    Full Text Available Background and purpose: Treatments of burn pregnant women is a difficult task because the vulnerable fetus is highly dependent on the health of the mother. This study was conducted to determine the epidemiology, etiology, clinical assessment and outcome of pregnant patients between January 1998 and October 2003.Materials and Methods: A 6-year retrospective descriptive study of burns in pregnant women hospitalized at Mottahary hospital (burn center in Tehran was performed. A short structured questionnaire was used to collect data. The questionnaire covered demographic information, etiology, clinical manifestations, and outcomes.Results: 74 (5% of the 1480 women of reproductive age who were admitted for burn treatment during this period were pregnant. The mean age of 74 patients was 22.54 years (SD = 4.78 with a range of 16-35. The majority of the women (50% were between 20 and 30 weeks of gestational age. The most common cause of burn was kerosene fire 52 (70%. Most of the women 50 (68% suffered from severe burns with TIBC>40%. 49 (66% mothers and 50 (67.5% died as a result of the burn damages. Conclusion: Burn size, TIBC, follow up of clinical manifestations for pregnant women, fetus and performance of proportional treatment protocols were the strongest predictor of mortality for mother and fetus.

  14. [Hi-tech center of outpatient care (To the 40th anniversary of the Branch N 6 of the Vishnevsky Central military clinical hospital N 3)].

    Science.gov (United States)

    Popov, A P

    2015-10-01

    The authors present the history of the branch N 6 of the Federal States Organization "the Vishnevsky Central Military Clinical Hospital N 3" of the Ministry of Defense of the Russian Federation, which dates back to November 1, 1974. Over the past years, organizational and staff structure; and the name of the clinic (45th central polyclinic, 45th central consultative-diagnostic polyclinic, 52nd Advisory Diagnostic Center of Defense) has repeatedly changed, but the core the work stays unchangeable--to continually improve patient care technology, to be the leader in the outpatient care for soldiers, reserve officers (retired), members of their families. The. branch consists of 58 medical and 19 specialized diagnostic departments, including 4 hospital departments, 1845 employee work at the branch. Among them 4 doctors of medical science and 43 candidates of medical sciences, 20 honoured physicians and 10 honoured health workers of republic. 70% of doctors and 93% of nurses have the highest qualification category. To health care in the Branch are more than 110 thousand people. PMID:26827510

  15. A Woman-centered Educational Program for Primary Prevention of Lung Cancer in a Cuban Municipality, 2012--2013.

    Science.gov (United States)

    Cruz, Abel; Castillo, Zeida; Pérez, Julia; Abeledo, Ahyní

    2015-10-01

    Lung cancer educational programs seek the involvement of different groups in efforts to promote healthier habits and lifestyles. Women are primary agents for targeting prevention actions because of their ability to foster healthy lifestyles within their families. The purpose of this study was to develop a woman-centered educational program to strengthen knowledge and promote responsible behavior aimed at primary prevention of lung cancer. Based on identified learning needs in 133 female participants concerning lung cancer self care, healthy habits and communication skills about self care, a ten-workshop series was designed and validated by specialists and users. Before intervention, 82% of participants were highly aware of smoking-related harm, but only 26% were highly aware of healthy environmental management practices at home and 14% were knowledgeable about self care. Differences in both awareness and practice of health-promoting behaviors were observed by the end of the training: those highly aware of smoking-related harm rose to 86.5%, and those highly aware of environmental management and self care increased to 66.2% and 83.5%, respectively. The proportions reporting acceptable levels of environmental management and self-care practices increased to 86.5% (from 0%) and 91% (from 3.8%), respectively. One year later, a positive impact on families was confirmed, predominantly on children. We conclude that such a woman-centered educational program can increase awareness and promote healthy behaviors aimed at lung cancer prevention. Women's ability to communicate and share lessons learned within their families should be considered in designing community health education programs. KEYWORDS Lung cancer, health education, disease prevention, primary prevention, health promotion, Cuba. PMID:26947281

  16. Pattern of adverse drug reactions due to cancer chemotherapy in a tertiary care hospital in South India

    Directory of Open Access Journals (Sweden)

    Ajitha Sharma

    2015-01-01

    Full Text Available Purpose: Studies regarding pattern of adverse drug reactions (ADRs in cancer chemotherapy patients are scarce in India. This study was conducted to evaluate the pattern of occurrence of ADRs due to cancer chemotherapy in hospitalized patients and to assess the causality, severity, predictability, and preventability of these reactions. Materials and Methods: This was a retrospective, descriptive study and the occurrence and nature of ADR, suspected drug, duration of hospital stay and outcome were noted from case records. These ADRs were assessed for causality using both World Health Organization (WHO causality assessment scale and Naranjo′s algorithm. The severity and preventability of the reported reactions were assessed using modified Hartwig and Siegel scale and modified Schumock and Thornton scale respectively. Results: Five hundred ADRs were recorded from 195 patients. Most common ADRs were infections (22.4%, nausea/vomiting (21.6% and febrile neutropenia (13%. Platinum compounds, nitrogen mustards, taxanes, antibiotics and 5-fluorouracil were the most common drugs causing ADRs. WHO causality assessment scale showed 65% of the reactions to be "probable" and 35% to be "possible," while Naranjo′s algorithm indicated that 65.6% of ADRs were "probable" and 34.4% were "possible". Modified Hartwig and Siegel scale showed most reactions (41.4% to be of "moderate level 4(a" severity, while 30.6% of reactions were of "mild level 1" severity. About 30.8% of the ADRs were "definitely preventable" according to the modified Schumock and Thornton scale. Conclusion: ADRs are most important causes of morbidity and mortality and increase the economic burden on patient and society. By careful ADR monitoring, their incidence can be decreased.

  17. Results of mass endoscopic examination for gastric cancer in Kamigoto Hospital, Nagasaki Prefecture

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    AIM: To examine how the introduction of endoscopy to gastric cancer screening affected survival prognosis in a regional population.METHODS: The subjects comprised 4261 residents of Kamigoto, Nagasaki Prefecture, who underwent gastric X-ray examination for gastric cancer screening from 1991 to 1995, and all 7178 residents who underwent endoscopic examination for the same purpose from 1996to 2003. The analysis evaluated trends in age-adjusted gastric cancer mortality rates and standard mortality ratios (SMRs) among the Kamigoto residents.RESULTS: According to demographic statistics, the 1995 and 2000 age-adjusted gastric cancer mortality rates in Nagasaki Prefecture (per 100000 population) were 42.6 and 37.3 for males and 18.6 and 16.0 for females, while the corresponding rates in Kamigoto before and after the introduction of endoscopic screening were respectively 51.9 and 28.0, and 26.6 and 6.9. The data obtained in this study were divided into those for two periods,1990-1996 and 1997-2006, and SMRs were calculated separately for males and females. For the first period,the SMR was 1.04 (95% CI 0.50-1.58) for males and 1.54(95% CI 0.71-2.38) for females, while for the second period the SMR was 0.71 (95% CI 0.33-1.10) for males and 0.62 (95% CI 0.19-1.05) for females.CONCLUSION: Following the introduction of endoscopic examination, gastric cancer death rates decreased in Kamigoto.

  18. BODIPY-FL Nilotinib (Tasigna) for Use in Cancer Research | NCI Technology Transfer Center | TTC

    Science.gov (United States)

    The National Cancer Institute''s Laboratory of Cell Biology is seeking statements of capability or interest from parties interested in collaborative research to further develop, evaluate, or commercialize bodipy conjugated tyrosine kinase inhibitors that are currently used in the clinic for the treatment of CML or gastric cancers.

  19. Treatment of Prostate Cancer using Anti-androgen Small Molecules | NCI Technology Transfer Center | TTC

    Science.gov (United States)

    The National Cancer Institute seeks parties interested in collaborative research to co-develop and commercialize a new class of small molecules for the treatment of prostate cancer. General information on co-development research collaborations, can be found on our web site (http://ttc.nci.nih.gov/forms).

  20. Cancer Inhibitors Isolated from an African Plant | NCI Technology Transfer Center | TTC

    Science.gov (United States)

    The National Cancer Institute's Molecular Targets Development Program is seeking parties interested in collaborative research to further develop, evaluate, or commercialize cancer inhibitors isolated from the African plant Phyllanthus englerii. The technology is also available for exclusive or non-exclusive licensing.