| Effect of selected play activities on preoperative anxiety level and fear among children undergoing abdominal surgeries Asmaa Abd El-Maksoud El-Moazen, Soheir Abd-Rabou Mohamed, Marwa Abdel Kereem Egyptian Nursing Journal 2018 15(3):205-216 Backgroun Hospitalization and surgery are stressful events children face especially during the early years. Through play activities, children can reduce the level of preoperative anxiety and fear. Aim The aim of the current study was to evaluate the effect of selected play activities on preoperative anxiety level and fear among children undergoing abdominal surgeries. Sample A convenient sample of 50 school-age children undergoing abdominal surgeries participated in the current study. Design One-group pre–post-test time series quasi-experimental research design was used to achieve the aim of the current study. Setting The current study was conducted at the General Pediatric Surgical unit at Cairo University Specialized Pediatric Hospital. Tools Data were collected through the following tools: structured interview questionnaire, State-Trait Anxiety Inventory for Children (STAIC), and the Glasses Fear Scale (GFS). Results The results revealed that preoperative anxiety scores on STAIC and preoperative fear scores on GFS were lower among the studied children after using the selected play activities than before. A highly statistically significant difference was detected between total mean score of STAIC and GFS in the pretest and after the first, second, and third play sessions and at 30 min before surgery. Conclusion The current study concluded that the selected play activities were effective in reducing the level of anxiety and fear among children undergoing abdominal surgeries. Recommendations It was recommended that establishing preoperative play activities for children undergoing abdominal surgeries is essential for preparation of the child for surgery. |
| Effect of nursing intervention on improving intellectual education teachers' performance toward students with epilepsy Samia F Mahmoud Egyptian Nursing Journal 2018 15(3):217-227 Background Epilepsy is a major health problem that oftenoccursseen among intellectual schools. Students with seizures annoy their teachers. The aim of this study was to evaluate the effect of nursing intervention on improving intellectual education teachers’ performance toward students with epilepsy atSharkia Governorate. A quasi-experimental design was used in this study. A purposive sample composed of 163 teachers from 13 intellectual schools working at least two years. Three tools were used: Tool (I): Teacher’s knowledge about epileptic student, self-administered questionnaire. Tool (II): Teacher’s practice observation checklist. Tool (III): Teacher’s attitudes toward students with epilepsy scale. Results Most of the studied teachers were married. In addition, statistically significant improvements were detected in the teachers’ knowledge, practices, and attitudes, from pre-sessions to immediately after and 3 months of post sessions where the total mean score of their knowledge increased from9.61±3.30in pre-sessions, to 19.35±1.73 immediately post sessions and 18.67±2.61, at 3 months of post sessions. The total mean score of their practices increased from 3.31±5.081 pre-sessions to 26.72±5.46 immediately post sessions and 24.83±6.71, at 3 months of post sessions. The total mean score of their attitudes increased from 13.62±2.25 in pre-sessions, to 16.38±1.83 immediately post sessions.Therefore, it is recommended that in-service training courses to be conducted periodically among all intellectual schools teachers’. |
| The effect of oral versus intravenous fluid therapy on maternal and neonatal outcomes for women with oligohydramnios Hala Abd El-fttah Ali, Sabah Ramadan Hussein Ahmed Egyptian Nursing Journal 2018 15(3):228-235 Background Oligohydramnios may increase the perinatal morbidity and mortality rate and is associated with adverse fetal outcomes. Aim The aim of this study was to assess the effect of oral versus intravenous fluid therapy on maternal and neonatal outcomes for women with oligohydramnios. Study design This was a quasi-experimental study model. Setting Th study was conducted at a high-risk pregnancy department at a specific private hospital in El-Mansoura City, Egypt. Participants and methods A purposive sample of 45 pregnant women with oligohydramnios was included in the study, and the women were divided equally into three groups, with 15 women per each group: the first group was administered intravenous (i.v.) isotonic solution, second group was administered i.v. hypotonic solution, and the third group was administered oral water. Data were collected during the period of 6 months from the first of December 2016 to the end of August 2017. Tools Four tools were used to conduct this study: maternal characteristics questionnaire, sonographic report for measuring amniotic fluid index (AFI) in oligohydramnios women before and after hydration, fluid chart, and maternal and neonatal assessment sheet. Results The AFI was significantly increased from 0.35±0.07 to 1.7±0.5 in the i.v. isotonic group whereas the AFI was significantly increased from 0.37±0.08 to 1.9±0.9 in the i.v. hypotonic group. Moreover, the AFI was more markedly increased from 0.37±0.07 to 2.7±0.8 in the oral water group. The maternal and neonatal outcomes did not differ significantly among the groups but were more markedly increased in the oral water group. Conclusion Oral hydration is as effective as intravenous hydration in significantly increasing the AFI in the third trimester oligohydramnios. The AFI was more markedly increased in the oral water. Maternal and neonatal outcomes did not differ significantly among the groups. Recommendations Oral hydration is recommended for pregnant women with oligohydramnios till delivery. |
| Health guidelines to prevent recurrence of urinary tract infection among diabetic patients Sharbat T Hassanine, Manar F Hamza, Eglal H Abdel-Hakeim Egyptian Nursing Journal 2018 15(3):236-245 Background Urinary tract infection (UTI), the most common bacterial infections, affects humans throughout their life span. The more complicated UTI and the recurrent nature increase the risk of hospitalization by two-folds leading to economic stress on the patient. There is also an associated increase in morbidity and mortality. Aims The aim of the study was to evaluate the effect of health guidelines on prevention and recurrence of UTI among diabetic patients. Sample The sample was a purposive one, which composed of 186 diabetic patients of both sexes. It included control and study groups of 93 patients each, with specific criteria. Design A quasi-experimental design was used to conduct the study. Setting This study was carried out in the urology outpatient clinic at the National Diabetic Institute, affiliated to Cairo University Hospitals. Tools Two tools were used for data collection: (a) an interviewing questionnaire for the diabetic patients concerning sociodemographic characteristics and medical-related data and (b) assessment tool of patient’s knowledge regarding preventive measure and care of UTI. Results The study showed that after the application of health guidelines, and follow-up for 1 year, the recurrence of UTI was seen in less than one-tenth of the study group compared with nearly one-third of the control group. Conclusion The results revealed a significant effect of health guidelines on prevention of recurrence of UTI among diabetic patients. Recommendations The findings of this study lead us to recommend conducting educational programs for the diabetic patient in the outpatient clinic to raise their awareness related to the preventive measures and care of UTI and design a simple illustrated booklet in Arabic language for them. |
| Effect of educational programs on knowledge and self-management of patients with chronic obstructive pulmonary disease Reda A.S Ibrahim, Mona M Abd El-Maksoud Egyptian Nursing Journal 2018 15(3):246-257 Background Patient education has a vital role in caring for patients with chronic obstructive pulmonary disease (COPD), and a corner stone of self-management in chronic illnesses. Aim of the study This study aimed to evaluate the effect of educational programs on the knowledge and self-management of patients with COPD. Methods This study was carried out on 40 COPD patients at outpatient follow-up Medical Clinics at Tanta University Hospital. The researchers interviewed them using an interview schedule to assess the sociodemographic characteristics, patients’ medical history, physical examination, and knowledge regarding COPD and an observational checklist to assess self-care practice of the patient. Results The results have shown significant differences in relation to decrease in the signs of cough, sputum, and shortness of breath immediately and after 2 months of implementing the self-care management program, but there were no significant differences in relation to other signs of the disease. The majority of patients (95%) had poor knowledge, and all of them had unsatisfied practice regarding self-management skills for COPD before implementation. Immediately postimplementation of the educational program, the study showed highly statistically significant improvement in total score of knowledge, where the majority of them had a fair knowledge and good practice regarding COPD; these scores decreased in post-test 2. Conclusion This study concluded that the education of patients regarding knowledge for COPD and healthcare practice is very effective in improving their self-management skills, but they need reinforcement follow-up. Therefore, this study recommended that the healthcare personnel should provide health education for COPD patients on self-care to their improve knowledge which helps prevent complications and maintain their life. |
| Impact of quality of working life on the psychological well-being and marital adjustment among female nurses Safaa Mohamed Metwaly, Mona Mohamed Abd El-Maksoud Egyptian Nursing Journal 2018 15(3):258-267 Background Nurses are one of the most diverse and largest workforces in the health-care system. Their work usually affects different concerns of their life. The aim of the present study was to investigate the impact of quality of working life (QoWL) on the psychological well-being (PWB) and marital adjustment among female nurses. Research design A descriptive-analytical study design was used to carry out this study. Setting This study was conducted at all maternal and child health centers in Zagazig City. Patients and methods A purposive sample composed of 208 female nurses who were working in the previously mentioned settings were recruited. Tools of data collection: four tools were used for data collection. They were the sociodemographic data sheet, the QoWL scale, Ryff’s PWB scales, and ENRICH marital satisfaction scale. Results The study results revealed that more than two-thirds of female nurses had a low QoWL and all of them had stress at their work. Majority of the studied nurses showed low level of PWB and marital adjustment. Also, there was positive correlation between QoWL, psychosocial well-being, and marital adjustment among female nurses with high statistical significance. Conclusion It was concluded that most of the studied samples had a low level of QoWL, PWB, and marital adjustment and there was statistically significant positive correlation between these variables. Recommendations This study recommended that further researches are needed to identify the predicted factors of low QoWL and factors that affect PWB and marital adjustment. |
| Relationship between burden, psychological well-being, and social support among caregivers of mentally ill patients Shadia Fathy Mahmoud Mohammed, Rehab Fathy Abdel Hady Ghaith Egyptian Nursing Journal 2018 15(3):268-280 Background Family caregivers of patients with chronic mental illness experience psychological stresses. Such stresses affect the psychological well-being of relatives, who have moderately high levels of burden and frequently get inadequate support from mental health professionals. Aim The aim of this study is to examine the relationship between burden, psychological well-being, and social support among caregivers of mentally ill patients. Research design A descriptive correlational design was used in this study. Setting This study was conducted at the psychiatric outpatient clinic in Azzazi Psychiatric Mental Health Hospital at Abu Hammad in Sharkia Governorate. Patients A purposive sample of 150 mentally ill patients’ caregivers, who accompany their patients to the psychiatric outpatient clinics, was recruited. Tools of data collection Four tools were utilized for data collection: sociodemographic data sheets, family burden scale, psychological well-being scale, and multidimensional scale of perceived social support. Results More than half of the caregivers aged from 40 to 60 years. Most of the patients were diagnosed as having schizophrenia. More than two-fifths of the caregivers were parents and had high level of burden. Nearly two-thirds had moderate level of psychological well-being, and approximately half of the caregivers had moderate level of social support. Conclusion There were negative statistically significant correlations among family burden, psychological well-being, and social support. However, a positive statistically significant correlation was detected between social support and psychological well-being. Recommendations It is recommended that training programs should be designed for caregivers to enhance psychological well-being and social support and decrease the level of burden among caregivers of mentally ill patients. |
| Effect of educational sessions about dengue fever on nurse's knowledge and attitude at Zagazig Fever Hospital Gamalat Moustafa Abd El-Ghany, Samia Farouk Mahmoud Egyptian Nursing Journal 2018 15(3):281-291 Background Dengue fever (DF) is emerging as a serious global health problem. Nurses serve as the frontline health care workers who assist in the diagnosis and treatment of dengue and other febrile illnesses. Aim The aim of this article is to assess the effect of educational sessions about DF on nurse’s knowledge and attitude at Zagazig Fever Hospital. Patients and methods A quasi-experimental design was used in carrying out the study during the period from November 2017 to January 2018. The study was conducted in Zagazig Fever Hospital, Sharkia Governorate. The sample included 71 nurses (39 diploma nurses and 32 bachelor nurses), working at the outpatient and the emergency clinic according to the inclusion criteria. Two tools were used. Tool 1 was a questionnaire that consisted of two parts: part A was used to collect data relating to demographic characteristics of the nurses, whereas part B involved nurse’s knowledge about DF using a self-administered questionnaire. Tool 2 was a self-administered questionnaire that was designed to assess nurses’ attitude toward DF. Results The comparison of pretest and post-test scores of nurses’ knowledge and attitudes revealed highly statistically significant improvement (P<0.001), which justified the research hypotheses of educational sessions’ implementation. The total score of their knowledge increased from 9.9% in pre-implementation session to 87.3% 1 month after the implementation, and the total score of their attitudes increased from 60.6% before the sessions, to 91.5% 1 month after the sessions. Conclusion The post-test score was higher than the pretest score for both knowledge and attitudes of nurses regarding DF. Recommendations Primary prevention of infectious diseases like DF should be given priority, and education about it should be provided in fever hospitals, through in-service health educational training session to be provided to all nurses in the fever hospitals, especially the newly appointed ones before they start their work. |
| Effect of menopausal symptoms on psychological problems among middle-aged women Shadia Fathy Mahmoud Mohammed, Nabila Salem Mohammed Egyptian Nursing Journal 2018 15(3):292-301 Background Menopause characterizes the end of the female reproductive period. Psychological problems such as anxiety and depression are reported among women in the menopausal period. Aim The aim was to find out the effect of menopausal symptoms on psychological problems such as anxiety and depression among middle-aged women. Participants and methods A descriptive cross-sectional design was used. This study was conducted at eight colleges from Zagazig University. A convenience sample composed of 200 menopausal women was recruited. Four tools were used for collection of data: interview questionnaire, menopause rating scale, Beck depression inventory scale, and Taylor manifest anxiety scale. Results More than three-quarters of the studied women were aged 50 years and older, with the mean age being 53.6±6.3 years. Nearly half of them had severe menopausal symptoms. More than one-third had mild depression and more than half of them had severe anxiety. Conclusion Nearly half of the studied women had severe menopausal symptoms. More than one-third had mild depression and more than half of them had severe anxiety. There were positive statistically significant correlations among total menopausal symptom, anxiety, and depression scores. Moreover, there were statistically significant relations between total menopausal symptom score and both educational level and duration of menopause. Recommendations The present study emphasizes that depression and anxiety are commonly prevalent among the middle-aged women; therefore, women should be screened in the menopause transition period, especially for clinically significant depression and anxiety, as some changes in women lifestyle like diet and exercises can improve good mood. Moreover, training programs should be designed for middle-aged women to decrease psychological problems associated with menopause, and delivery of mental health services in this group is essential. |
| The impact of psychiatric nurses' psychological capital on their burnout and coping style Safaa Mohamed Metwaly, Hanem Ahmed, Abd Elkhalek Ahmed Egyptian Nursing Journal 2018 15(3):302-313 Background Nurses with a high level of psychological capital have the essential motivational and cognitive properties that can be used in any given work situation to protect them from work-related stress and burnout. Aim This study aims to examine the impact of psychiatric nurses’ psychological capital on their burnout and coping style. Participants and methods A descriptive correlational design was utilized in this study. This study was conducted at three psychiatric hospitals: El Azazi Hospital for mental illness, Banha Hospital for mental illness, and at the Psychiatric Department at Zagazig University Hospital. A simple, random sample composed of 139 nurses who are working at a previous mentioned setting was recruited for this study. Five tools were utilized in this study for data collection, sociodemographic data sheet, burnout scale, psychological capital questionnaire, brief coping inventory, and emotional approach coping scale. Results The present study revealed that the level of burnout was moderate among the studied nurses, more than half of them had low level of psychological capital, about half of them had low level of problems − focused coping and near half of them had a high level of emotion-focused coping. Conclusion On the basis of the finding of this study, it can be concluded that the burnout is a psychological problem among psychiatric nurses. Unfortunately, about one-half of the studied psychiatric nurses has moderate level of burnout and has low level of psychological capital. Also, about half of them utilize the emotion-focused coping style more frequently than problem-focused coping. When nurses have a high level of psychological capital, their level of burnout decreased. Recommendation Intervention programs for nurses should be carried out to enhance their level of psychological capital (self-efficacy, hope, optimism, and resilience), improve their coping ability, and reduce their level of burnout are recommended. |
Anapafseos 5 Agios Nikolaos 72100,Crete,Greece,00302841026182,00306932607174,alsfakia@gmail.com
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Αλέξανδρος Γ. Σφακιανάκης
Friday, December 28, 2018
Nursing
In-hospital Neonatal Falls,Efforts to Improve Breastfeeding
In-hospital neonatal falls are increasingly recognized as a postpartum safety risk, with maternal fatigue contributing to these events. Recommendations to support rooming-in may increase success with breastfeeding; however, this practice may also be associated with maternal fatigue. We report a cluster of in-hospital neonatal falls associated with a hospital program to improve breastfeeding, which included rooming-in practices. Metrics related to breastfeeding were prospectively collected by chart audit or patient survey while ongoing efforts to improve breastfeeding occurred (September 2015–August 2017). Falls were identified through the hospital adverse event reporting system from January 2011 to February 2018. Medical records were reviewed to determine factors associated with the falls, including time of event, pain medication administration, hours of life at fall, method of delivery, or other notable factors that may have contributed to the fall event. Three fall events occurred within 1 year of commencing improvement efforts as process and outcome metrics associated with breastfeeding improved. All events were associated with mothers falling asleep while feeding their infant, and all occurred between midnight and 6 am. Falls occurred from 38.0 to 75.7 hours after birth. No sedating pain medications were administered within 4 hours of any event. In 2 of 3 cases, mothers experienced notable ongoing social stressors. Rooming-in was the most significant change involved in our health care delivery during the programmatic effort to improve breastfeeding. Monitoring for in-hospital neonatal falls may be needed during projects aimed at improving breastfeeding, particularly if rooming-in practices are involved.
http://pediatrics.aappublications.org/content/early/2018/12/26/peds.2018-2488?utm_source=highwire&utm_medium=email&utm_campaign=Pediatrics_papetoc&sso=1&sso_redirect_count=1&nfstatus=401&nftoken=00000000-0000-0000-0000-000000000000&nfstatusdescription=ERROR%3a+No+local+token
Duarte Galactosemia
METHODS: We recruited case patients from states where they were identified by NBS; unaffected siblings served as controls. Diet in infancy was ascertained by retrospective parent surveys; developmental outcomes were assessed in 5 domains, yielding 73 outcome measures for each child. We divided subjects randomly into independent discovery (n = 87) and validation (n = 263) sets. We tested the discovery set to order the 73 outcome measures by ascending P values and tested the 10 outcomes with the lowest P values for possible association with DG in the validation set. We also tested these same 10 outcomes for possible association with milk exposure in infancy among case patients in the validation set.
RESULTS: None of the 73 outcomes tested in the discovery set revealed significant association with DG, and none of the 10 outcomes tested in the validation set revealed either significant association with DG or significant association with milk exposure among children with DG.
CONCLUSIONS: Through our results, we demonstrated that there were no significant differences in outcomes tested between case patients and controls or among case patients as a function of milk exposure in infancy. In this study, we provide a long-needed foundation of knowledge for health care providers, families, and NBS professionals seeking to make evidence-based decisions about DG.
http://pediatrics.aappublications.org/content/early/2018/12/26/peds.2018-2516?utm_source=highwire&utm_medium=email&utm_campaign=Pediatrics_papetoc
Deep convolutional neural network (DCNN) models to improve the diagnostic accuracy of thyroid cancer by analysing sonographic imaging data from clinical ultrasounds
Diagnosis of thyroid cancer using deep convolutional neural network models applied to sonographic images: a retrospective, multicohort, diagnostic study.
Author information
- 1
- Tianjin Cancer Institute, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China.
- 2
- Department of Diagnostic and Therapeutic Ultrasonography, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China.
- 3
- Department of Maxillofacial and Otorhinolaryngology Oncology, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China.
- 4
- Department of Pathology, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China.
- 5
- Department of Thyroid and Breast Surgery, Weihai Municipal Hospital, Shandong, China.
- 6
- Department of Ultrasonography, Weihai Municipal Hospital, Shandong, China.
- 7
- Department of Ultrasonography, Affiliated Hospital of Chifeng University, Inner Mongolia, China.
- 8
- Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China.
- 9
- Department of Ultrasonography, Integrated Traditional Chinese and Western Medicine Hospital, Jilin, China.
- 10
- Department of Ultrasonography, Dezhou Municiple Hospital, Shandong, China.
- 11
- Departments of Radiology and Biomedical Engineering, Wake Forest School of Medicine, Winston-Salem, NC, USA.
- 12
- Center for Biomedical Informatics Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.
- 13
- Wake Forest Baptist Comprehensive Cancer Center, Wake Forest Baptist Medical Center, Department of Cancer Biology, Wake Forest School of Medicine, Winston-Salem, NC, USA.
- 14
- Department of Thyroid and Neck Cancer, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China.
- 15
- Department of Epidemiology and Biostatistics, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy of Tianjin, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University, Tianjin, China. Electronic address: chenkexin@tjmuch.com.
Abstract
BACKGROUND:
The incidence of thyroid cancer is rising steadily because of overdiagnosis and overtreatment conferred by widespread use of sensitive imaging techniques for screening. This overall incidence growth is especially driven by increased diagnosis of indolent and well-differentiated papillary subtype and early-stage thyroid cancer, whereas the incidence of advanced-stage thyroid cancer has increased marginally. Thyroid ultrasound is frequently used to diagnose thyroid cancer. The aim of this study was to use deep convolutional neural network (DCNN) models to improve the diagnostic accuracy of thyroid cancer by analysing sonographic imaging data from clinical ultrasounds.
METHODS:
We did a retrospective, multicohort, diagnostic study using ultrasound images sets from three hospitals in China. We developed and trained the DCNN model on the training set, 131 731 ultrasound images from 17 627 patients with thyroid cancer and 180 668 images from 25 325 controls from the thyroid imaging database at Tianjin Cancer Hospital. Clinical diagnosis of the training set was made by 16 radiologists from Tianjin Cancer Hospital. Images from anatomical sites that were judged as not having cancer were excluded from the training set and only individuals with suspected thyroid cancer underwent pathological examination to confirm diagnosis. The model's diagnostic performance was validated in an internal validation set from Tianjin Cancer Hospital (8606 images from 1118 patients) and two external datasets in China (the Integrated Traditional Chinese and Western Medicine Hospital, Jilin, 741 images from 154 patients; and the Weihai Municipal Hospital, Shandong, 11 039 images from 1420 patients). All individuals with suspected thyroid cancer after clinical examination in the validation sets had pathological examination. We also compared the specificity and sensitivity of the DCNN model with the performance of six skilled thyroid ultrasound radiologists on the three validation sets.
FINDINGS:
Between Jan 1, 2012, and March 28, 2018, ultrasound images for the four study cohorts were obtained. The model achieved high performance in identifying thyroid cancer patients in the validation sets tested, with area under the curve values of 0·947 (95% CI 0·935-0·959) for the Tianjin internal validation set, 0·912 (95% CI 0·865-0·958) for the Jilin external validation set, and 0·908 (95% CI 0·891-0·925) for the Weihai external validation set. The DCNN model also showed improved performance in identifying thyroid cancer patients versus skilled radiologists. For the Tianjin internal validation set, sensitivity was 93·4% (95% CI 89·6-96·1) versus 96·9% (93·9-98·6; p=0·003) and specificity was 86·1% (81·1-90·2) versus 59·4% (53·0-65·6; p<0·0001). For the Jilin external validation set, sensitivity was 84·3% (95% CI 73·6-91·9) versus 92·9% (84·1-97·6; p=0·048) and specificity was 86·9% (95% CI 77·8-93·3) versus 57·1% (45·9-67·9; p<0·0001). For the Weihai external validation set, sensitivity was 84·7% (95% CI 77·0-90·7) versus 89·0% (81·9-94·0; p=0·25) and specificity was 87·8% (95% CI 81·6-92·5) versus 68·6% (60·7-75·8; p<0·0001).
INTERPRETATION:
The DCNN model showed similar sensitivity and improved specificity in identifying patients with thyroid cancer compared with a group of skilled radiologists. The improved technical performance of the DCNN model warrants further investigation as part of randomised clinical trials.
FUNDING:
The Program for Changjiang Scholars and Innovative Research Team in University in China, and National Natural Science Foundation of China.
Copyright © 2018 Elsevier Ltd. All rights reserved.
- PMID:
- 30583848
- DOI:
- 10.1016/S1470-2045(18)30762-9
Major vessel invasion by thyroid cancer
Major vessel invasion by thyroid cancer: a comprehensive review.
Author information
- 1
- a Department of Surgery , St. Paul's Hospital & University of British Columbia , Vancouver , British Columbia , Canada.
Abstract
Gross extrathyroidal extension of thyroid cancer is an indicator of a worse cancer prognosis and may lead to major vessel invasion (MVI) that represents an uncommon and highly morbid manifestation of disease progression. Areas covered: This review aims to evaluate the current literature reporting on thyroid cancer that exhibits MVI, with a focus on relevant patient and pathological characteristics, diagnostic evaluation, and management, of this uncommon but challenging thyroid cancer presentation. Expert commentary: Vascular invasion by thyroid cancer is uncommon and has a poor prognosis with high associated perioperative morbidity and mortality. When possible, surgery represents the best management strategy for thyroid cancer exhibiting MVI. In these cases, careful preoperative workup and surgical planning are required in order to balance the goals of maximizing cancer resection while minimizing perioperative mortality and morbidity. Future research should evaluate long-term outcomes following definitive treatment of locally advanced thyroid cancer exhibiting MVI.
KEYWORDS:
Major vessel invasion; extrathyroidal extension; superior vena cava syndrome; thyroid cancer
- PMID:
- 30580637
- DOI:
- 10.1080/14737140.2019.1559059
Adjuvant FOLFIRINOX Pancreatic Cancer
https://www.medpagetoday.com/hematologyoncology/othercancers/77016
Dec 19th, 2018 - Patients with pancreatic cancer who underwent adjuvantchemotherapy with modified FOLFIRINOX had a median 20-month overall survival (OS) improvement compared with those treated with gemcitabine, results of the PRODIGE 24 trial found. The improvement of median OS from 35.0 months with gemcitabine to 54.4 months with FOLFIRINOX represents a 36% reduction in the ...
https://www.mdedge.com/oncologypractice/article/191549/gastroenterology/adjuvant-modified-folfirinox-improves-survival
Neil Osterweil, Oncology Practice
Dec 19th, 2018 - For patients with completely or near-completely resected pancreaticductal adenocarcinoma, adjuvant therapy with a modified FOLFIRINOX regimen was associated with significantly better 3-year disease-free survival and overall survival compared with gemcitabine, results of the phase 3 randomized PRODIGE 24 trial showed. At a median follow-up of 33.
Sorafenib Desmoid Tumors
https://www.ncbi.nlm.nih.gov/pubmed/30575484
The New England Journal of Medicine; Gounder MM, Mahoney MR et. al.
Dec 21st, 2018 - Desmoid tumors (also referred to as aggressive fibromatosis) are connective tissue neoplasms that can arise in any anatomical location and infiltrate the mesentery, neurovascular structures, and visceral organs. There is no standard of care. In this double-blind, phase 3 trial, we randomly assigned 87 patients with progressive, symptomatic, or recurrent desmoid tumors...
https://www.mdedge.com/oncologypractice/article/191511/rare-diseases/sorafenib-extends-pfs-refractory-desmoid-tumors
Neil Osterweil, Oncology Practice
Dec 19th, 2018 - For patients with progressive, refractory, or symptomatic desmoidtumors – also known as aggressive fibromatosis – treatment with daily sorafenib(Nexavar) was associated with durable responses and a significant improvement in progression-free survival. After a median follow-up of 27.
https://www.medpagetoday.com/hematologyoncology/othercancers/77032
Dec 19th, 2018 - Treatment with sorafenib (Nexavar) induced durable responses and doubled the rate of progression-free survival (PFS) at 2 years in patients with advanced or refractory desmoid tumors, results of a double-blind phase III trial found. Among 84 evaluable patients with symptomatic, progressive, or refractory tumors, the estimated 2-year PFS rate was 81% in the sorafen...
https://www.medpagetoday.com/hematologyoncology/othercancers/77101
Dec 21st, 2018 - Action Points In this double-blind, randomized, placebo-controlled Phase III trial of sorafenib (Nexavar) in patients with advanced desmoid tumors, the 2-year progression-free survival rate at 27.2 months was 81% vs 36% for placebo. There is currently no accepted standard of care for desmoid tumors, so the results from this trial with sorafenib may lead...
https://www.medscape.com/viewarticle/897781
Jun 8th, 2018 - NEW YORK (Reuters Health) - Sorafenib boosts progression-free survival among patients with desmoid tumors, according to results of a new phase 3 trial. "Sorafenib now represents a very reasonable choice for first-line therapy for patients with desmoid tumors," said Dr. Gary Schwartz of Columbia University School of Medicine in New York, the study's seni...