A survey of post-polypectomy colonoscopy surveillance knowledge among general practitioners.

2019 ◽  
Author(s):  
Jarek Kobiela ◽  
Piotr Spychalski ◽  
Krzysztof Graff ◽  
Iwona Marek ◽  
Janusz Siebert ◽  
...  
Keyword(s):  
General Practitioners ◽  
Demographic Data ◽  
Risk Groups ◽  
High Risk Group ◽  
Surveillance Program ◽  
Surveillance Colonoscopy ◽  
Strict Adherence ◽  
European Guidelines ◽  
Incidence And Mortality ◽  
Polish Society

Abstract Background Screening has been shown to be effective in reducing CRC incidence and mortality. Adherence to the guidelines of surveillance after polypectomy is considered key. In most countries including Poland general practitioners (GPs) are responsible for referring patients for surveillance colonoscopy. The aim of the study was to examine the knowledge of post-polypectomy surveillance among GPs in Poland. Methods We have designed five scenarios of post-polypectomy surveillance based on European guidelines adapted by the Polish Society of Gastroenterology. The scenarios described different risk groups based on the characteristics of the removed polyps requiring different time intervals of surveillance colonoscopy. They were supplemented with basic demographic data of the surveyed GP. The questionnaire was carried out by surveyors during a national congress of GPs. Results A total of 340 questionnaires were filled by GPs. None of the surveyed doctors gave correct answers in all questions. The knowledge of post-polypectomy surveillance is very unsatisfactory (correct answers 1.2%-55.0%). One year surveillance interval was the most commonly chosen interval regardless risk groups based on the characteristics of the removed polyps. In 4 of 5 scenarios the surveillance overuse ranged 42.1%-98.5%. In a high risk group scenario surveillance was underused in 45.0%. Conclusions Post-polypectomy surveillance schemes are not known to GPs with a significant trend towards overuse. Strict adherence to guidelines should be pursued to include written recommendation on surveillance program in the final endoscopy report. Efforts should be made by public health policy makers to increase knowledge of surveillance schemes among GPs.

Surveillance colonoscopy in Austria: Are we following the guidelines?

Endoscopy ◽  
2017 ◽  
Vol 50 (02) ◽  
pp. 119-127 ◽  
Author(s):  
Irina Gessl ◽  
Elisabeth Waldmann ◽  
Martha Britto-Arias ◽  
Daniela Penz ◽  
Eleonore Pablik ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Risk Group ◽  
Risk Groups ◽  
High Risk Group ◽  
Screening Colonoscopy ◽  
Reminder Letter ◽  
European Guidelines ◽  
Adenoma Detection ◽  
Before And After

Abstract Background and study aim The European guidelines for quality assurance in colorectal cancer screening and diagnosis contain postpolypectomy surveillance recommendations. They recommend follow-up intervals depending on the findings at index colonoscopy, and divide patients into a low-, intermediate- or high-risk group. The aim of this study was to assess the adherence of Austrian endoscopists to the European guidelines and to determine whether sending a reminder letter resulted in better adherence. Methods A single reminder letter containing the guidelines was sent to all endoscopists who participated in the Certificate of Quality for Screening Colonoscopy program in Austria. Adherence was assessed before and after the letter had been sent. Factors associated with adherence were investigated. Results We found poor baseline adherence to the guidelines. After the reminder letter, the adherence slightly improved in the low-risk group, but did not change in the intermediate-risk or high-risk groups. An adenoma detection rate of at least 20 % was associated with higher adherence rates. Generally, internists and hospitals showed better adherence compared with surgeons and private practices, respectively, both before and after the reminder letter. Conclusion A single reminder letter was not enough to improve the poor adherence to the European postpolypectomy surveillance guidelines. Thus, future studies are required to identify and eliminate all factors responsible for nonadherence to postpolypectomy guidelines in order to reach the goal of a safe, effective, and cost-effective colorectal cancer prevention tool in the near future.

scholarly journals A prognostic nomogram based on LASSO Cox regression in patients with alpha-fetoprotein-negative hepatocellular carcinoma following non-surgical therapy

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dongdong Zhou ◽  
Xiaoli Liu ◽  
Xinhui Wang ◽  
Fengna Yan ◽  
Peng Wang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Surgical Therapy ◽  
Calibration Curve ◽  
Cox Regression ◽  
Validation Cohort ◽  
Risk Group ◽  
Risk Groups ◽  
High Risk Group ◽  
Alpha Fetoprotein ◽  
Clinicopathologic Characteristics

Abstract Background Alpha-fetoprotein-negative hepatocellular carcinoma (AFP-NHCC) (< 8.78 ng/mL) have special clinicopathologic characteristics and prognosis. The aim of this study was to apply a new method to establish and validate a new model for predicting the prognosis of patients with AFP-NHCC. Methods A total of 410 AFP-negative patients with clinical diagnosed with HCC following non-surgical therapy as a primary cohort; 148 patients with AFP-NHCC following non-surgical therapy as an independent validation cohort. In primary cohort, independent factors for overall survival (OS) by LASSO Cox regression were all contained into the nomogram1; by Forward Stepwise Cox regression were all contained into the nomogram2. Nomograms performance and discriminative power were assessed with concordance index (C-index) values, area under curve (AUC), Calibration curve and decision curve analyses (DCA). The results were validated in the validation cohort. Results The C-index of nomogram1was 0.708 (95%CI: 0.673–0.743), which was superior to nomogram2 (0.706) and traditional modes (0.606–0.629). The AUC of nomogram1 was 0.736 (95%CI: 0.690–0.778). In the validation cohort, the nomogram1 still gave good discrimination (C-index: 0.752, 95%CI: 0.691–0.813; AUC: 0.784, 95%CI: 0.709–0.847). The calibration curve for probability of OS showed good homogeneity between prediction by nomogram1 and actual observation. DCA demonstrated that nomogram1 was clinically useful. Moreover, patients were divided into three distinct risk groups for OS by the nomogram1: low-risk group, middle-risk group and high-risk group, respectively. Conclusions Novel nomogram based on LASSO Cox regression presents more accurate and useful prognostic prediction for patients with AFP-NHCC following non-surgical therapy. This model could help patients with AFP-NHCC following non-surgical therapy facilitate a personalized prognostic evaluation.

Vertebral compression fracture rate following stereotactic ablative body radiotherapy for spine oligometastases: a UK experience

2021 ◽  
pp. 1-5
Author(s):  
Sameed Hussain ◽  
Anjali Zarkar ◽  
Ahmed Elmodir ◽  
Daniel Ford ◽  
Sundus Yahya ◽  
...  
Keyword(s):  
Vertebral Compression Fracture ◽  
Demographic Data ◽  
Spinal Metastases ◽  
Compression Fracture ◽  
Spinal Instability ◽  
Fracture Rate ◽  
Strict Adherence ◽  
Stereotactic Ablative Body Radiotherapy ◽  
Vertebral Bodies ◽  
Pre Treatment

Abstract Aim: Stereotactic ablative body radiotherapy (SABR) for spine metastases is associated with a risk of vertebral compression fracture (VCF). The aim of this study was to determine the rate of VCF at one UK institution and evaluate the use of the Spinal Instability Neoplastic Score (SINS) to predict these. Materials and methods: A retrospective analysis of all patients who underwent SABR for spinal metastases between 2014 and 2018 at one UK institution was performed. Basic demographic data were collected, and SINS prior to SABR was calculated. The primary outcome was VCF rate. Secondary outcomes included time to VCF and need for surgical intervention following VCF. Results: A total of 48 oligometastases were treated with a median follow-up of 20·5 months. A maximum of two vertebral bodies were treated. The median baseline SINS was calculated as 3. The median dose was 26 Gy in three fractions. Two patients were reported to have VCF and both were successfully conservatively managed. Findings: SABR for spine oligometastases is being performed safely with low VCF rates which are comparable with those in international publications. This may be as a result of strict adherence to criteria for delivery of SABR with low pre-treatment SINS.

High risk group of metachronous colon neoplasms established by the surveillance colonoscopy

1998 ◽  
Vol 114 ◽  
pp. A599
Author(s):  
Y. Fukutomi ◽  
N. Noda ◽  
S. Nagase ◽  
M. Tajika ◽  
T. Naitou ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Group ◽  
High Risk Group ◽  
Surveillance Colonoscopy ◽  
Colon Neoplasms

Following pandemic guidelines is associated with better wellbeing

2021 ◽  
Author(s):  
Bahar Tuncgenc ◽  
Martha Newson ◽  
Justin Sulik ◽  
Yi Zhao ◽  
Guillaume Dezecache ◽  
...  
Keyword(s):  
Demographic Data ◽  
Risk Groups ◽  
Living Alone ◽  
Longitudinal Analyses ◽  
Psychosocial Wellbeing ◽  
Containment Measures ◽  
Demographic Risk ◽  
Health Experts ◽  
Lower Educational Attainment ◽  
Cross National

Background: In response to the Covid-19 pandemic, most countries implemented physical distancing measures. Many mental health experts warned that through increasing social isolation and anxiety, these measures could negatively affect psychosocial wellbeing. However, socially aligning with others by adhering to these measures may also be beneficial for wellbeing.Methods: We examined these two contrasting hypotheses using cross-national survey data (N= 6675) collected fortnightly from participants in 115 countries over 3 months at the beginning of the pandemic. In addition to providing demographic data, participants completed a standardised wellbeing scale, and reported how much they, and others in their social circle and country, were adhering to the distancing measures.Results: We found that being a woman, having lower educational attainment, living alone and being vulnerable to Covid-19 were risk factors for poorer wellbeing. Being young (18-25) was also associated with lower wellbeing, but longitudinal analyses showed that young participants’ wellbeing improved over 3 months. In contrast to widespread views that physical distancing measures negatively affect wellbeing, results showed that following these guidelines was positively associated with wellbeing, even for people in demographic risk groups or those highly vulnerable to Covid-19.Conclusions: These findings provide an important counterpart to the idea that pandemic containment measures such as physical distancing negatively impacted wellbeing unequivocally. Despite the overall burden of the pandemic on psychosocial wellbeing, social alignment with others can still contribute to positive wellbeing. The pandemic has manifested our propensity to adapt to challenges, particularly highlighting how social alignment can forge resilience.

Knowledge Levels of University Students About Sexually Transmitted Diseases

2021 ◽  
Vol 6 (14) ◽  
pp. 8-19
Author(s):  
GAMZE TEMİZ ◽  
Nida GÜNDÜZALP
Keyword(s):  
Nursing Students ◽  
Risk Groups ◽  
Body Fluids ◽  
High Risk Group ◽  
People Who Use Drugs ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Bodily Fluids ◽  
Medium Level ◽  
The Mean

Purpose: The aim of the study; To evaluate the knowledge level of nursing students about diseases transmitted by bodily fluids. Materials and Methods: The study is descriptive-cross-sectional. The sample is 352 nursing students studying at a foundation university. The data were evaluated with a questionnaire about diseases transmitted by body fluids. Results: The mean age of nursing students was 20.87±2.14 years and 81.3% of them were girls. Most of the sample consisted of 1st year (26.7%) and 4th year students (31.5%). The mean score of the questionnaire for diseases transmitted by bodily fluids of nursing students was found to be 13.61 ± 2.19. It was determined that 96.9% of the students gave correct answers to the 2nd item of the questionnaire, “Spouses with these diseases should be treated together”. It was determined that 69.3% of the students gave incorrect answers to the 3rd item of the questionnaire, "Untreated, diseases transmitted by body fluids can cause infertility". 62.5% of the students reported that they had received training on the subject before. Of the sample, 97.2% are individuals who have relationships with more than one person, 1.1% are individuals with a single spouse, 38.1% (n=134) are people who use drugs, 31.8% are health professionals. reported that they were in the high-risk group for diseases transmitted by fluids. The results show that nursing students gave insufficient information about the prevention of diseases transmitted by body fluids. Conclusion: In the study, it was determined that the knowledge of nursing students about diseases transmitted by body fluids was above the medium level, and it was noteworthy that they needed training on transmission routes, risk groups and protection from diseases transmitted by body fluids.

scholarly journals Survey of general practitioners' attitudes towards psychiatry

2010 ◽  
Vol 34 (12) ◽  
pp. 525-528 ◽  
Author(s):  
Catherine Thompson ◽  
Nisha Dogra ◽  
Robert McKinley
Keyword(s):  
General Practitioners ◽  
Role Models ◽  
Positive Attitude ◽  
Demographic Data ◽  
Current Data ◽  
Undergraduate Teaching ◽  
Individual Response ◽  
Positive Attitudes ◽  
The Mean ◽  
Teaching Psychiatry

Aims and methodThere is a lack of current data regarding attitudes of doctors towards psychiatry. General practitioners (GPs) are increasingly involved in teaching psychiatry, and their attitudes towards psychiatry may affect their ability to promote psychiatry. The main aim of the study is to inform on current attitudes of GPs towards psychiatry as a discipline. The Attitudes Towards Psychiatry (ATP-30) questionnaire was administered to all GPs within Shropshire.ResultsThe response rate was 61% (n = 145 from N = 239). The mean score for the ATP-30 was 113.9. An association was found between GP trainer status and higher ATP-30 scores. Positive associations were found between demographic data (age, length of career, postgraduate experience of psychiatry, involvement in undergraduate teaching, GP trainer status) and individual response items on the ATP-30 scale.Clinical implicationsGeneral practitioners in Shropshire have a positive attitude towards psychiatry. Associations between demographic data and ATP-30 scores indicate that GPs with more experience of psychiatry and those involved in training may have more positive attitudes. The main limitation of the study is the lack of proven validity of the scale for use in this population. The positive attitude towards psychiatry is consistent with GPs providing the role models needed if they are to be involved to a greater degree with teaching and promoting psychiatry as a career. The need for the development of a more specific tool or an update to the existing tool is discussed.

scholarly journals Development and validation of a 13-m6a related lncRNA prognostic signature for lung adenocarcinoma

2021 ◽  
Author(s):  
Pingfan Wu ◽  
Xiaowen Zhao ◽  
Ling Xue ◽  
Xiaojing Yang ◽  
Yuxiang Shi ◽  
...  
Keyword(s):  
Gene Expression ◽  
Lung Adenocarcinoma ◽  
Treatment Strategies ◽  
Risk Groups ◽  
Gene Expression Omnibus ◽  
High Risk Group ◽  
The Cancer Genome Atlas ◽  
Prognostic Signature ◽  
P53 Signaling ◽  
Selection Operator

Abstract Considerable evidence suggests that N6-methyladenosine (m6A) is involved in the regulation of long non-coding RNA (lncRNA), whichparticipates in the occurrence, development and prognosis of tumorscancerBut the relationship between m6A regulators-related lncRNA (mRlncRNA) and lung adenocarcinoma (LUAD) remains unclear. This study aims to determine a feature based on mRlncRNA for prognostic evaluation of LUAD patients. By integrating the gene expression data of LUAD and normal samples from the Cancer Genome Atlas (TCGA) and the Gene Expression Omnibus (GEO) database, the m6A gene and mRlncRNA with imbalanced expression were screened out. Then we used the least absolute shrinkage and selection operator (LASSO) to obtain the 13-lncRNA prognostic signature in the TCGA training cohort. Patients were divided into two risk groups based on the risk score of lncRNAs characteristics, and their overall survival (OS) was significantly different. The predictive power of this signature was verified in TCGA testing cohort and entire TCGA cohort. These landmark lncRNAs were involved in several biologiocal processes and pathways related to cell cycle, DNA replication, P53 signaling pathway and mismatch repair. Besides, the high-risk group was low-response to cisplatin, while high-response to mitomycin, docetaxel and immunotherapy. In conclusion, we identified a 13-mRlncRNA model associated with prognosis and treatment sensitivity in LUAD, which may provide clues about the influence of m6A on lncRNA in LUAD and promote the further improvement of LUAD individualized treatment strategies.

scholarly journals Effect of COVID-19 Pandemic on Anxiety in Rheumatology Patients Taking Immunosuppressive Drugs

2020 ◽  
Author(s):  
Tugba Izci Duran ◽  
Seyyid Bilal Acikgoz ◽  
Cemal Gurbuz ◽  
Aysegul Ucar ◽  
Gokhan Yavuzbilge ◽  
...  
Keyword(s):  
Musculoskeletal Diseases ◽  
Demographic Data ◽  
Immunosuppressive Drugs ◽  
High Risk Group ◽  
Anxiety Symptoms ◽  
Healthy Controls ◽  
Treatment Team ◽  
Additional Information ◽  
Education Levels ◽  
Anxiety Levels

Abstract Introduction: Coronavirus disease 2019 (COVID-19) pandemic is a public health emergency that is causing international concern. Patients with medical comorbidities are more likely to be infected and have a worse prognosis. The purpose of this study was to determine the prevalence of anxiety due to COVID-19 pandemic in patients with rheumatic and musculoskeletal diseases (RMDs) who used immunosuppressive drugs during the initial stage of the COVID-19 pandemic and to identify the risk and protective factors that cause anxiety.Methods: A total of 145 patients with RMDs aged ≥18 years who used regular immunosuppressive drugs and 95 healthy controls were included in the study. An anonymous survey comprising questions regarding the COVID-19 pandemic was used, and the Beck anxiety inventory (BAI) was used to measure the anxiety levels of participants. Additional information was collected such as demographic data, current RMDs, immunosuppressive drugs used, information and concerns about COVID-19, and the source of information about COVID-19.Results: About 42.1% patients reported that the epidemic caused concern due to the drug they were using, and 33.8% rated their concerns as moderate and severe. The BAI scores of patients and healthy controls were 4 (0-52) and 3 (0-18) respectively. According to the BAI scores, 16.5% patients had moderate to severe anxiety symptoms; and comparison of the groups showed that the anxiety level of the patient group was significantly higher (38.6% vs. 18.9%, p=0.001). Female had more anxiety symptoms in both groups (p<0.005). In addition, anxiety was lower in patients with higher education levels (p=0.039).Conclusion: It should be ensured that patients in the high-risk group are not provided false information, the patients are individually informed, and they trust the treatment team. Providing online or smartphone-based psychoeducation and psychological interventions may be considered for these patients with high anxiety levels.

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