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71.
Craig McFadyen Sara Lankshear Dimitrios Divaris Mark Berry Amber Hunter John Srigley Jonathan Irish 《Canadian journal of surgery》2015,58(1):31-40
Background
There is increased awareness that, to minimize variation in clinician practice and improve quality, performance reporting should be implemented at the provider level. This optimizes physician engagement and creates a sense of professional responsibility for quality and performance measurement at the individual and organizational levels.Methods
Individual provider level reporting was implemented within a provincial health region involving 56 clinicians (general surgeons, surgical oncologists, urologists and pathologists). The 2 surgical pathology indicators chosen were colorectal cancer (CRC) lymph node retrieval rate and pT2 prostate cancer margin positivity rate. Surgical resections for all prostate and colorectal cancer performed between Jan. 1, 2011, and Mar. 30, 2012, were included. We used a pre- and postsurvey design to obtain physician perceptions and focus groups with program leadership to determine organizational impact.Results
Survey results showed that respondents felt the data provided in the reports were valid (67%), consistent with expectations (70%), maintained confidentiality (80%) and were not used in a punitive manner (77%). During the study period the pT2 prostate margin positivity rate decreased from 57.1% to 27.5%. For the CRC lymph node retrieval rate indicator, high baseline performance was maintained.Conclusion
We developed a robust process for providing physicians with confidential, individualized surgical and pathology quality indicator reports. Our results reinforce the importance of individual physician feedback as a strategy for improving and sustaining quality in surgical and diagnostic oncology. 相似文献72.
Dimitrios?GrosomanidisEmail author E.?Charitidou A.?Foka D.?Panousis K.?Chatzopoulos P.?Ntasiou G.?Xepapadakis 《Hellēnikē cheirourgikē. Acta chirurgica Hellenica》2015,87(4):289-297
Aim-Background
Despite the rise in the incidence of breast cancer (BC), a steady increase in the rate of survival has also been noted which can be directly attributed to early diagnosis, among others. Therefore, keeping women informed of the latest advances in BC treatment and prevention is crucial. The aim of this study is an attempt to quantify the level of awareness of Greek women on issues related to female BC prevention.Methods
An online questionnaire of 24 items divided into three sections (sociodemographic, personal experience, as well as beliefs concerning BC prevention and screening) was completed and submitted anonymously by 2565 Greek women of all adult age groups and of various socioeconomic backgrounds.Results
Only 42.8% of women used credible sources of information on health issues such as BC. Regular breast self-examination was adopted by one in three women. It emerged that 89% of women erroneously associated in vitro fertilization with an increased risk of BC, while half the women were unaware of the possibility of a false-negative result from breast screening. Low BC awareness was associated with low education, low economic status, younger age, single women from non-urban areas who did not have (or did not know if they had) a BC family history and who usually refrained from any kind of preventive actions.Conclusions
The study revealed that there is a significant proportion of Greek women with a misperception or ignorance of BC prevention and the significance of early diagnosis. Since timely diagnosis is directly related to BC survival rate, specific actions (e.g. targeted educational interventions in specific subpopulations) should be assumed.73.
Hearing evaluation of patients with head and neck cancer: Comparison of Common Terminology Criteria for Adverse Events,Brock and Chang adverse event criteria in patients receiving cisplatin 下载免费PDF全文
74.
Incidence of needle‐tract seeding following prostate biopsy for suspected cancer: a review of the literature 下载免费PDF全文
Dimitrios Volanis David E. Neal Anne Y. Warren Vincent J. Gnanapragasam 《BJU international》2015,115(5):698-704
With the widespread clinical use of prostate‐specific antigen (PSA), biopsy of the prostate has become one of the most commonly performed urological procedures. In general it is well tolerated, although there is some morbidity and risk of infection. In recent years, there have been increasing concerns that prostate biopsy may lead to tumour seeding along the needle tract. The aim of the present paper was to review the evidence on the prevalence of tumour seeding after prostate biopsy and to define the risk of this event in the context of current clinical practice. A PubMed literature search was conducted in January 2014 according to the Preferred Reporting Items for Systematic Reviews and Meta‐analysis (PRISMA) statement. Literature was examined with emphasis on the incidence of seeding, clinical presentation and on risk factors including type of needle used, transrectal vs transperineal approach, as well as tumour grade and stage. In all, 26 publications were identified reporting needle‐tract seeding after prostate biopsy. In all, 42 patients with needle‐tract seeding were identified. In most cases, seeding was reported after transperineal biopsy of the prostate, while nine cases occurred after transrectal biopsy. Based on the reviewed series the incidence of seeding appears to be <1%. The increase in the number of biopsies and cores taken at each biopsy over the years has not resulted in an increase in the reported cases of seeding. In conclusion, seeding along the needle track is a rare complication after prostate biopsy. Its actual incidence is presently difficult to quantify. It is reasonable to advise appropriate counselling and take measures to reduce this event where possible; however, we do not advocate avoidance of biopsies as the benefits of appropriate cancer diagnosis and management outweigh any potential risks from seeding. 相似文献
75.
Mimidis K Papadopoulos V Katsinelos P Deftereos S Filippou D Kartalis G 《Romanian journal of gastroenterology》2004,13(1):39-41
Gastrocolic fistula is rarely described in the literature. It has been associated with a variety of diseases and recently with benign gastric ulcers related to the use of nonsteroidal anti-inflammatory drugs (NSAIDs'). The present case represents the first report of gastrocolic fistula due to NSAIDs in a cirrhotic patient. This is in keeping with the established knowledge that cirrhotic patients constitute a high-risk group of patients when treated with NSAIDs'. Review of the literature shows that this condition warrants a complete diagnostic work-up to exclude more ominous underlined diseases. 相似文献
76.
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78.
Ioannis Bellos Vasilios Pergialiotis Dimitrios Loutradis Georgios Daskalakis 《Journal of clinical hypertension (Greenwich, Conn.)》2020,22(5):826-834
This meta‐analysis aims to compare serum uric acid levels among preeclamptic and healthy pregnant women across the various trimesters and provide a summary of the effect size of this biomarker in predicting adverse pregnancy outcomes. MEDLINE, Scopus, CENTRAL, Clinicaltrials.gov, and Google Scholar databases were systematically searched from inception. Observational studies were held eligible if they reported serum uric acid among preeclamptic and healthy pregnant women. Meta‐analysis was conducted regarding uric acid concentration, diagnostic accuracy, and association with perinatal outcomes. The credibility of evidence was appraised using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework. The analysis included 196 studies, comprising 39 540 women. Preeclampsia was associated with significantly elevated uric acid levels during the 1st (mean difference [MD]: 0.21 mg/dL, 95% confidence intervals [CI]: 0.06‐0.35) trimester, 2nd (MD: 1.41 mg/dL, 95% CI: 0.78‐2.05) trimester, and 3rd (MD: 2.26 mg/dL, 95% CI: 2.12‐2.40) trimester. Higher uric acid was estimated for severe preeclampsia, eclampsia, and hemolysis, elevated liver enzymes, low platelet syndrome. The sensitivity for adverse perinatal outcome prediction ranged from 67.3% to 82.7% and the specificity from 47.7% to 70.7%. In conclusion, it is suggested that serum uric acid levels are increased in preeclampsia and can be used to predict disease severity and pregnancy complications. Future prospective studies should verify these outcomes, assess the optimal cutoffs, and incorporate uric acid to combined predicting models. 相似文献
79.
Serum profiles of M30, M65 and interleukin‐17 compared with C‐reactive protein in patients with mild and severe acute pancreatitis 下载免费PDF全文
80.