Statistics show that as of 2017, more than one million Canadians have survived cancer for more than 10 years. Yet, the physical rehabilitation needs of cancer survivors in Canada have received little attention and few services.
Dr. Jennifer M. Jones, PhD, is a senior Scientist and Director of the Cancer Rehabilitation & Survivorship Program at the Princess Margaret Cancer Centre in Toronto. Along with her colleague Stephanie Phan, Clinical Lead for the program, they provided an overview of her program, one of the best in the world and the only one of its kind in Canada.
Canadian Cancer Survivor Network staff Allison MacAlister and Jaymee Maaghop joined in the conversation to discuss the current national landscape, and what CCSN is doing to raise awareness for cancer rehabilitation in Canada.
Management of peripheral vascular disease by Sunil Kumar Dahasunil kumar daha
Please find the power point on Management of peripheral vascular disease . I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
Statistics show that as of 2017, more than one million Canadians have survived cancer for more than 10 years. Yet, the physical rehabilitation needs of cancer survivors in Canada have received little attention and few services.
Dr. Jennifer M. Jones, PhD, is a senior Scientist and Director of the Cancer Rehabilitation & Survivorship Program at the Princess Margaret Cancer Centre in Toronto. Along with her colleague Stephanie Phan, Clinical Lead for the program, they provided an overview of her program, one of the best in the world and the only one of its kind in Canada.
Canadian Cancer Survivor Network staff Allison MacAlister and Jaymee Maaghop joined in the conversation to discuss the current national landscape, and what CCSN is doing to raise awareness for cancer rehabilitation in Canada.
Management of peripheral vascular disease by Sunil Kumar Dahasunil kumar daha
Please find the power point on Management of peripheral vascular disease . I tried to present it on understandable way and all the contents are reviewed by experts and from very reliable references. Thank you
CVD in cancer survivors.Screening of cancer survivors.Chest Radiotherapy .JACC Scientific Expert Panel
( J Am Coll Cardiol 2019;74:905–27 )manifestations of chest and mediastinal radiotherapy .
Dr.MD.Monsur Rahman,PT
MPT-Musculoskeletal Disorders
Maharishi Markandeshwar Institute Of Physiotherapy And Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana - Ambala,133-207 (Haryana)
Pre- Operative Assessment
Detailed History (Obsteritic & Gynecological h/o)
Chest assessment
Lung function tests (PFT)
Stage of cancer, extent of the disease
Surgical plan should be documented -length & duration of surgery, type of incision & details of the flap used for reconstruction
Assess the involvement of lymph nodes, posture, mobility
Checking of the Exercise capacity considering the patient’s tolerance
In this presentation, we will discuss Chemotherapy Induced Peripheral Neuropathy with strict application of Evidence based medicine about the magnitude of the problem, how to diagnose, how to prevent and how to treat?
eeling worn out and exhausted all the time? You may be experiencing cancer-related fatigue. Tune in to this webinar to learn what cancer-related fatigue is, how to spot it, and how to manage it.
Cancer hurts!
The misconception that a cancer patient is doomed to endure pain must be corrected. Cancer has pain and cancer pain has a cure. To manage cancer pain, we need to have a multidisciplinary approach.
Current controversies in cervical cancer management (2014)Jyotirup Goswami
Overview of the current controversies in the management of cervical cancer, including screening, prevention, staging, chemoradiation,teletherapy techniques, brachytherapy techniques
SHARE Presentation: Palliative Care for Womenbkling
Dr. Michael Pearl discusses supportive palliative care for women with cancer, how it differs from hospice care, and the New York Palliative Care Information Act. Dr. Michael Pearl is Professor and Director of the Division of Gynecologic Oncology in the Department of Obstetrics, Gynecology and Reproductive Medicine at Stony Brook University Hospital.
Research on consequences of cancer and its treatment on quality of life, symp...Nata Chalanskaya
Susanne Oksbjerg Dalton, Group Head, consultant, Danish Cancer Society Research Center, Danish Cancer Society, presentation at the Second International Scientific and Practical Conference «Improving the quality of life of cancer patients through the development of cooperation between state, commercial and non-profit organizations». 2018-01-23, Minsk. Belarus.
Use of Simulation- based Training for Cancer Education among Nigerian Cliniciansasclepiuspdfs
Background: Among the many limitations of cancer control in Nigeria are lower awareness/competence and poorer training of health-care professionals (HCP). These manifest as deficiencies in advocacy, screening/diagnostic practices, and patient management. Medical simulation (MS) using models is an effective approach for sustainably improving the competence of HCP, especially regarding clinical breast examination (CBE), pelvic examination (PE), and digital rectal examination (DRE). The study evaluates the effect of MS during a Nigerian training course focusing on CBE, PE, and DRE. It answers the question: What is the immediate outcome of MS-based training, as well as the perspectives of HCP on the use of MS for cancer education? Methods: Participants included a convenience sample of Nigerian physicians and nurses who attended the American Society of Clinical Oncology-sponsored Multidisciplinary Cancer Management Course. The intervention was MS using high-fidelity models. The models demonstrated normal anatomic and common pathologic features of the breast, cervical, and prostate. Participants cycled through MS stations (i.e., CBE, PE, and DRE). Pre- and post-training surveys with comments evaluating self-reported comfort levels were the basis for comparison. Data analysis included descriptive statistics, Wilcoxon signed-rank test, Chi-square, and thematic analysis. Results: A total of 51 participants completed course evaluation forms (physicians - 35 and nurses - 16), with an average number of years in practice as 8 (±5.2) years. Pre-training survey showed non-significant differences in practices patterns; 71% (22/35) of physicians rarely performed PE (P=0.92), and 93% (14/16) of nurses rarely performed DRE (P=0.07). According to some participants, “the use of simulation is quite commendable as it gives room for improvement before using a human; it is the best method of learning I have ever enjoyed.” Conclusion: MS-based training significantly improved the comfort levels of participants regarding CBE and PE, as well as their likelihood to perform CBE, PE, and DRE. Participants recommend widespread use of MS for continuing medical education and undergraduate training.
CVD in cancer survivors.Screening of cancer survivors.Chest Radiotherapy .JACC Scientific Expert Panel
( J Am Coll Cardiol 2019;74:905–27 )manifestations of chest and mediastinal radiotherapy .
Dr.MD.Monsur Rahman,PT
MPT-Musculoskeletal Disorders
Maharishi Markandeshwar Institute Of Physiotherapy And Rehabilitation, Maharishi Markandeshwar (Deemed to be University), Mullana - Ambala,133-207 (Haryana)
Pre- Operative Assessment
Detailed History (Obsteritic & Gynecological h/o)
Chest assessment
Lung function tests (PFT)
Stage of cancer, extent of the disease
Surgical plan should be documented -length & duration of surgery, type of incision & details of the flap used for reconstruction
Assess the involvement of lymph nodes, posture, mobility
Checking of the Exercise capacity considering the patient’s tolerance
In this presentation, we will discuss Chemotherapy Induced Peripheral Neuropathy with strict application of Evidence based medicine about the magnitude of the problem, how to diagnose, how to prevent and how to treat?
eeling worn out and exhausted all the time? You may be experiencing cancer-related fatigue. Tune in to this webinar to learn what cancer-related fatigue is, how to spot it, and how to manage it.
Cancer hurts!
The misconception that a cancer patient is doomed to endure pain must be corrected. Cancer has pain and cancer pain has a cure. To manage cancer pain, we need to have a multidisciplinary approach.
Current controversies in cervical cancer management (2014)Jyotirup Goswami
Overview of the current controversies in the management of cervical cancer, including screening, prevention, staging, chemoradiation,teletherapy techniques, brachytherapy techniques
SHARE Presentation: Palliative Care for Womenbkling
Dr. Michael Pearl discusses supportive palliative care for women with cancer, how it differs from hospice care, and the New York Palliative Care Information Act. Dr. Michael Pearl is Professor and Director of the Division of Gynecologic Oncology in the Department of Obstetrics, Gynecology and Reproductive Medicine at Stony Brook University Hospital.
Research on consequences of cancer and its treatment on quality of life, symp...Nata Chalanskaya
Susanne Oksbjerg Dalton, Group Head, consultant, Danish Cancer Society Research Center, Danish Cancer Society, presentation at the Second International Scientific and Practical Conference «Improving the quality of life of cancer patients through the development of cooperation between state, commercial and non-profit organizations». 2018-01-23, Minsk. Belarus.
Use of Simulation- based Training for Cancer Education among Nigerian Cliniciansasclepiuspdfs
Background: Among the many limitations of cancer control in Nigeria are lower awareness/competence and poorer training of health-care professionals (HCP). These manifest as deficiencies in advocacy, screening/diagnostic practices, and patient management. Medical simulation (MS) using models is an effective approach for sustainably improving the competence of HCP, especially regarding clinical breast examination (CBE), pelvic examination (PE), and digital rectal examination (DRE). The study evaluates the effect of MS during a Nigerian training course focusing on CBE, PE, and DRE. It answers the question: What is the immediate outcome of MS-based training, as well as the perspectives of HCP on the use of MS for cancer education? Methods: Participants included a convenience sample of Nigerian physicians and nurses who attended the American Society of Clinical Oncology-sponsored Multidisciplinary Cancer Management Course. The intervention was MS using high-fidelity models. The models demonstrated normal anatomic and common pathologic features of the breast, cervical, and prostate. Participants cycled through MS stations (i.e., CBE, PE, and DRE). Pre- and post-training surveys with comments evaluating self-reported comfort levels were the basis for comparison. Data analysis included descriptive statistics, Wilcoxon signed-rank test, Chi-square, and thematic analysis. Results: A total of 51 participants completed course evaluation forms (physicians - 35 and nurses - 16), with an average number of years in practice as 8 (±5.2) years. Pre-training survey showed non-significant differences in practices patterns; 71% (22/35) of physicians rarely performed PE (P=0.92), and 93% (14/16) of nurses rarely performed DRE (P=0.07). According to some participants, “the use of simulation is quite commendable as it gives room for improvement before using a human; it is the best method of learning I have ever enjoyed.” Conclusion: MS-based training significantly improved the comfort levels of participants regarding CBE and PE, as well as their likelihood to perform CBE, PE, and DRE. Participants recommend widespread use of MS for continuing medical education and undergraduate training.
How to communicate with mammography patients BASMA13
this presentation is designed by Basma Alsaadoun explaining from her experience at mammography suite how to communicate with anxious patients and how to reduce the stress that they can have either if that stress for the result or the procedure itself . It can be a helpfull for the breast imaging team how to deal with the patients and how to inform them about any additional images needed or any other needed procedures as biopsy .
2021 World Cancer Day Campaign
World Cancer Day aims to save millions of preventable deaths each year by raising awareness and education about cancer, and pressing governments and individuals across the world to take action against the disease.
#IAmAndIWill
Dr. Stephanie Blank and Dr. Melissa Frey update us on the latest developments in ovarian cancer research and treatment from the annual conference of the Society of Gynecologic Oncology. Dr. Blank is a gynecologic oncologist at Perlmutter Cancer Center at NYU Langone Medical Center and an associate professor at NYU School of Medicine. Dr. Frey is a Gynecological Oncology Fellow at NYU Langone Medical Center.
Cancer Survivorship Care: Global Perspectives and Opportunities for Nurse-Le...Carevive
The 18th CNSA Annual Winter Congress, held Perth, Australia will featured On Q Health’s co-founder Dr. Carrie Stricker as a keynote speaker. The theme for this year’s edition is “Cancer Nursing: Expanding the Possibilities” and will focus on exploring the opportunities that exist in cancer nursing in 2015 and beyond.
Report Back from SGO 2023: What’s New in Cervical Cancer?bkling
Curious about what’s new in cervical cancer research? Join Dr. Evelyn Cantillo, gynecologic oncologist at Weill Cornell Medicine, as she shares the latest updates from the Society of Gynecologic Oncology (SGO) 2023 Annual Meeting on Women’s Cancer. Dr. Cantillo will also highlight what the research presented at the conference means for you and answer your questions about the new developments.
How evidence affects clinical practice in egyptWafaa Benjamin
Evidence based medicine is the gold standard for clinical care.
It implies the integration of best research evidence with clinical expertise and patient values.
There is still a wide gap between availability of evidence and its incorporation into routine practice in our country.
Barriers to implementation could be personal, social, institutional, financial and legal barriers.
True practice of evidence based care can only occur where evidence based decisions coincide with patients’ beliefs and clinicians’ preferences.
Continuing medical education programs should be set with integrating evidence based medicine teaching and learning within clinical training.
The importance of presence of local national guidelines which need to take into account variation in expertise, resources and patient preferences across our geographical and cultural contexts .
Customisation of a guideline to meet the local needs of a target patient population is critical to successful implementation.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...
Importance of Education on Breast Cancer-related Lymphedema
1. The importance of education on
breast cancer related
lymphedema
Pinar Borman MD, Aysegul Yaman MD, Sina Yasrebi
MD, Oya Özdemir MD, Alp Çetin MD.
University of Hacettepe Faculty of Medicine
Department of Physical Medicine and
Rehabilitation, Sihhiye, Ankara, Turkey
2. Introduction
• Improvements in early detection and
treatment of breast cancer have led a growing
number of survivors.
• The maintenance of overall health and quality
of life are major concerns since side effects of
cancer treatments may arise and can result in
significant long term physical and
psychological disabilities
3. Introduction
• Lymphedema is an abnormal accumulation of
protein-rich fluid within the intertistial tissue
that can occur after breast cancer surgery or
radiation therapy.
• Lympedema affects up to 50% of breast cancer
patients and substantially increase their
postoperative medical costs.
• The prognosis for these patients, is worse and
treatment is more costly when the
lymphedema is not diagnosed and treated in
the earlier stages.
4. Introduction
• Although breast cancer related lymphedema
can lead to physical emotional and
psychological challenges and impaire quality
of life, it is under-recognized and under-
treated.
• Therefore the awareness of the condition and
sufficient education of the breast cancer
survivors are of great importance.
5. Introduction
• Recent studies have shown a general lack of
knowledge and awareness regarding
lymphedema risk and risk reduction guidelines
• Previous studies have also indicated that
patients’ knowledge and education were
shown to be correlated with risk of developing
the condition.
6. aim
We aimed to determine the knowledge and
education of breast cancer patients who
referred to a tertier university hospital,
Physical Medicine and Rehabilitation (PMR)
Department for lymphedema rehabilitation.
7. Materials and Methods
• Participants were recruited from PMR
department among the breast cancer
survivors who were admitted for diagnosis
and or treatment of lymphedema between
June 2013 and April 2014.
• The demographic and clinical characteristics
including age, literacy, duration of surgery,
type of surgery, body mass index, duration
and site of lymphedema, stage of
lymphedema were recorded.
8. Materials and Methods
• Each participant was asked to complete a
survey to assess lymphedema status,
knowledge and education about lymphedema
and we also aimed to determine the related
factors with lymphedema in their first visit.
• The survey comprised;
• Have you ever heard breast cancer-related
lymphedema and/or get an education about
Lymphedema or risk reduction techniques?
9. Hacettepe Üniversitesi Tıp Fakültesi Fizik Tedavi ve Rehabilitasyon Anabilim Dalı
Lenfödem Değerlendirme Formu
Hastanın Adı soyadı: Protokol No:
Gönderen Dr:
Yaş: Medeni Hali:
Adres: Tel:
Eğitim Durumu:
Mesleği:
Yaşam şekli: ailesi/eşiyle yalnız bakıcıyla diğer akrabalarla bakımevinde
Geçirilmiş cerrahi
Kullandığı ilaçlar: Reçeteli: Reçetesiz:
Dominant el:
Boy: Kilo:
Sigara: Alkol Düzenli egzersiz:
Hobiler:
Özgeçmişi:
Ca Özgeçmişi
Cerrahi tipi: Radikal mastektomi modifiye radikal mastektomi: lumpektomi
Lenf nod disseksiyonu (adet)
Patoloji:
Evre:
PR: ER:
Ek tedaviler Tarih
Kemoterapi:
Radyoterapi
Preoperatif hasta eğitimi
Beklenen duysal değişiklikler hakkında bilgi verildi mi?
Lenfödem uyarıları yapıldı mı?
Postür eğitimi verildi mi?
Omuz hareket açıklığı rehberi öğretildi mi?
Tutulan üst ekstremite EHA programı
Postoperatif gün Omuz fleksiyon abdüksiyon İç/dış rotasyon
1-3 gün 45 45 Tolerans sınırında
4-6 gün 45-90 45 Tolerans sınırında
7 gün-drenler alındığında toleransa göre glenohumeral ekleme nazik germe
Postoperatif değerlendirme
Hastanın şikayeti:
Ağrı yeri Ağrı şiddeti (VAS):
EHA kısıtlılık: yeri:
Aksiller web sendromu:
Ciltte lezyon:
Postür değişikliği:
Motor defisit:
Duyu değişiklikleri (hipersensitivite/hipoestezi/ uyuşukluk/parestezi):
Lenfödem Sorgulaması
Primer: sekonder:
Lenfödem başlama yeri: proksimal: distal:
Ekstremitede ağırlık hissi/rahatsızlık:
Ne kadar süredir lenfödem var? (ay)
Lenfödemli bçlgede ağrı var mı?
Lenfödemli bölgede hiç enfeksiyon gelişti mi? Evet Hayır
Lenfödemli bölgede hiç akıntı oldu mu? Evet: Hayır
10. Materials and Methods
• The duration of lymphedema, the site of
lymphedema (proximal, distal), the grade of
lymphedema (subclinic, reversible,
spontaneous irreversible, elephantiasis), the
stage of lymphedema according to girth
measurements (stage 1,2,3), were recorded.
The positivity of Stemmer sign was checked.
11. Materials and Methods
• The patients responded to questions in the
survey, asking whether they have received
information about awareness of lymphedema
or whether they have educated for
reducement of the risk of lymphedema after
the breast cancer surgery
Have you ever heard breast cancer-related lymphedema and/or
get an education about Lymphedema or risk reduction
techniques?
12. Materials and Methods
• The patients were answered as yes or no.
• In addition quality of life of the patients was
assessed with EORTC Quality of life Questionnaire
Breast cancer module (EORTC-QOL-C30)
questionnaire
• Functional status was determined by Disabilities
of Arm Shoulder and Hand (DASH) questionnaire.
• All the assessments were performed by an
experienced lymphedema specialist. The study
was approved by the institutional ethical board.
13. Statistical analysis
Descriptive statistics were expressed with mean
+standard deviation, median and percentage
values. Groups were compared with student’s t
test or Mann Whitney U test or chi square
analysis. All tests of statistical significance were
two sided and considered statistically significant
at p<0.05. Analyses were conducted by SPSS
13.0 statistical package.
14. Results
• 71 patients who had admitted to lymphedema
rehabilitation unit between June 2013 and
April 2014, were recruited to the study.
• All patients were women. The mean age and
duration of surgery were 52.03+9.9 years (28-
77) and 32.8+27.6 months .
• Most women were diagnosed with mild to
moderate stage breast cancer
• 41 (57.7%) patients had grade 1, 27 (38%)
patients had grade 2 and 3 (4.2%) patients had
grade 3 lymphedema.
15. Results
• Among the participants, only 15 (21.1%) had
reported that they have received information
or education about lymphedema.
• 56 patients (78.9%) did not informed or
trained about the development of
lymphedema
16. Results
• The degree of lymphedema according to girth
measurements, and duration between breast
cancer surgery and lymphedema were lower in
patients that have informed or educated about
lymphedema as compared to the patients that
have not been informed (p<0.05).
• Also the number of patients having pitting
edema and having pain in the area of
lymphedema were higher in patients that did
not.
17. The demographic and clinical characteristics in regard to
lymphedema knowledge and, education
19. Discussion
• Our intervention was designed to identify the level of
awareness and education about breast cancer related
lymphedema in survivors, admitted to a tertiary
university hospital in a developing country.
• The frequency of postoperatively educated patients
about the risk of lymphedema was only 21%.
• The educated patients have a delayed progression of
lymphedema and lower stages than in patients lacking
awareness of lymphedema.
• Also the educated patients shortly after their surgery
had higher quality of life scores indicating a non-
impaired wellbeing.
20. Discussion
• Previous studies have assessed lymphedema
knowledge or awareness and reported average to
low knowledge levels
• Bosompra et al measured lymphedema
awareness and reported higher scores of
awareness among the patients reporting swelling
compared with subjects having no swelling.
• Lee et al conducted a study assessing
lymphedema knowledge by asking prevention
and care about lymphedema to breast cancer
survivors and found a high rate of patients having
lymphedema knowledge, contrary to our results
21. Discussion
• This difference can be explained with cultural
and developmental degree of different
populations.
• A more recent study reported that women
who received lymphedema information had
higher knowledge scores and lower
lymphedema symptoms compared to those
who did not receive information, again
resembling our data.
22. Discussion
• These results suggest that approaches to
lymphedema education can be potentially
beneficial in improving awareness on
lymphedema risk and risk reduction strategies
among breast cancer patients diagnosed and
treated in surgery wards
23. Discussion
• The small study group and a cross sectional design of
the study, are the limitations of our study.
• Also the non quantitative assessment of lymphedema
knowledge may also be considered as another
limitation.
• But as far as we have known this is the first study
evaluating the knowledge about lymphedema among
breast cancer survivors in our region which may
highlighten the unmet need for education in a
developing country for the awareness of lymphedema
• may lead to improve health care delivery settings in
order to enhance the quality of life of these patients.
24. Conclusion
• In conclusion there is a lack of awareness of
the lymphedema or risk of lymphedema, and
an unmet need sufficient education and
knowledge among breast cancer survivors,
especially in developing countries.
• We believe that education programs about
lymphedema and risk reduction methods after
the breast surgery are strongly
needed.
25. Conclusion
• There is also a need for the continuing education
of health care providers and surgeons for the
importance and early diagnosis of lymphedema
in order to better inform and educate breast
cancer survivors and their families.
• Future studies comparatively assessing the
lymphedema knowledge and monitoring effects
of education between different cultures will
enhance the experiences and will help to
standardize this education in developing
countries.