scholarly journals ADVANCED NASOPHARYNGEAL CARCINOMA WITH NASAL POLYP: A MISDIAGNOSED CASE

2019 ◽  
Vol 1 (03) ◽  
pp. 86-89
Author(s):  
Oke Kadarullah
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Nasal Cavity ◽  
Health Workers ◽  
Early Stage ◽  
Stage Iv ◽  
Hospital Staff ◽  
Neck Mass ◽  
Type I ◽  
Anatomic Site ◽  
Nasopharyngeal Mass

Introduction: Nasopharyngeal carcinoma (NPC) commonly misdiagnosed in early stage, because of it’s multiple nonspesific sign and symptoms also because of the difficult anatomic site. Especially if there is a comorbid in the area around the nasopharynx, most likely will end up with missdiagnosis. So the mortality rate are still high due to advanced stage incidence. Case report: Reported a 58 years male with history of recurrent nasal bleeding since 6 months ago accompanied by hearing problem and also ear fullnes since 11 months ago. There also a severe headache since 4 months ago and a left neck mass arised within 2 months approximately 6 cm in dimension. In nasopharyngocopy found a gelatinous mass at right nasal cavity and nasopharyngeal mass extend to both nasal cavity. The biopsy results are polip nasi Hellquist Type I and Nonkeratinizing Carcinoma Undifferentiated type. CT showed the nasopharyngeal mass has extend intracranially. Patient’s management were planned to polypectomy and chemoiiradiation. Despite of the tumor was radiosensitive, the prognosis and the survival rate are low because the patient came at stage IV.   Conclusion: Educating the society, health workers and hospital staff is a critical step for controlling NPC at early stage

scholarly journals Cured nasopharyngeal carcinoma stage IV with Haemostatic-intent radiotherapy

2016 ◽  
Vol 15 (3) ◽  
pp. 480-482 ◽  
Author(s):  
Irfan Mohamad ◽  
Aifaa Abdul Manan ◽  
Vengatesh Rao ◽  
Venkatesh Murali Krishna Bahavaraju
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Nasal Obstruction ◽  
Cranial Nerve ◽  
Concurrent Chemoradiotherapy ◽  
Medical Science ◽  
Stage Iv ◽  
Neck Mass ◽  
Advanced Stage ◽  
Stage Disease ◽  
Cranial Nerve Palsies

Nasopharyngeal carcinoma (NPC) is known to present with nasal and aural symptoms. Sometimes neck mass and cranial nerve palsies can be the presenting symptom. Frank epistaxis is relatively rare. Advanced stage disease is usually treated with concurrent chemoradiotherapy. We are reporting a case of NPC patient presented complete nasal obstruction with frank epistaxis. The bleeding was stopped and the disease cured with hemostatic-intent radiotherapy.Bangladesh Journal of Medical Science Vol.15(3) 2016 p.480-482

scholarly journals Hospital resilience after the 2015 earthquake in Nepal: a qualitative study with hospital staff

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M Moitinho de Almeida ◽  
J van Loenhout ◽  
R Singh ◽  
D P Mahara ◽  
D Guha-Sapir ◽  
...  
Keyword(s):  
Thematic Analysis ◽  
Health Workers ◽  
Early Stage ◽  
Community Support ◽  
Hospital Staff ◽  
Task Shifting ◽  
Structured Interviews ◽  
Basic Care ◽  
Individual Resilience ◽  
Life Saving

Abstract Background Research on hospital resilience is scarce and favours top-down approaches, and evidence from the field and operational levels is lacking. The aim of our study was to understand the mechanisms of hospital and individual resilience experienced by staff from a tertiary hospital in Kathmandu, Nepal, after the 2015 Earthquake. Methods We conducted semi-structured interviews with different professionals in May 2018; undertook a deductive thematic analysis of hospital resilience using the framework proposed by Bruneau et al; and used an inductive thematic analysis for individual resilience. Results The earthquake caused different types of burden to the hospital and individuals. Redundancy was mostly influenced by linkages with lower levels of care. Resourcefulness consisted mostly of spontaneous adaptations, with task shifting the most important for human resources. External provision of resources enabled the transfer of part of the burden but precipitated accountability-related challenges. The hospital's robustness depended not only on its physical resistance, but also on the functional capacity to provide life saving care, although routine services were interrupted and quality decreased. The hospital ensured rapidity in providing life saving care to the victims and re-start of routine activities, but recovery to a sense of normality was more conflicting and dependent on the individual. Individual resilience was dictated by safety, a sense of meaningfulness, self and external appreciation, and community support. Conclusions Our study shows the importance of staff experiences to improve hospital resilience. Disaster plans should acknowledge the role of task shifting, and basic care should be taught to all, not just those with clinical functions. Health workers are extremely overwhelmed during disaster response, and disaster plans should engage staff at an early stage to ensure they feel safe and sufficiently supported. Key messages Our work is one of the first to study hospital resilience with field data from qualitative interviews with hospital staff. Hospital resilience strategies should also address individual resilience of hospital staff.

scholarly journals Prevalence of Nasopharyngeal Carcinoma among Patients with Nasopharyngeal Mass in a Philippine Tertiary Training Hospital

2016 ◽  
Vol 31 (1) ◽  
pp. 35-38
Author(s):  
Hasmin Hannah R. Lara ◽  
Angelo A. Monroy
Keyword(s):  
Nasopharyngeal Carcinoma ◽  
Cross Sectional Study ◽  
Neck Mass ◽  
Chief Complaint ◽  
Outpatient Department ◽  
Smoking History ◽  
Sectional Study ◽  
Cross Sectional ◽  
Nasopharyngeal Mass ◽  
University Training

Objectives: To determine the prevalence and identify the types of Nasopharyngeal Carcinoma (NPCA) among patients with nasopharyngeal mass seen at a tertiary university training hospital in the Philippines from January 2006 – July 2012 and identify possible factors associated with nasopharyngeal carcinoma. Methods:  A retrospective cross-sectional study was performed at a tertiary university training hospital among cases (n=179) seen with nasopharyngeal mass at the ENT outpatient department. Histopathology results and patient medical charts were collected and reviewed after IRB approval. The age at diagnosis, sex, place of residence, occupation and chief complaint was compared among patients with positive histopathology of NPCA only.             Design:           Retrospective, cross sectional study             Setting:           Tertiary Private University Training Hospital Participants:  179 patients with nasopharyngeal mass Results:  96 (54%) cases with nasopharyngeal mass seen at the ENT outpatient department were positive for nasopharyngeal malignancy. The remaining 83 (46%) cases with nasopharyngeal mass had a benign histopathology. NPCA was more common among males (58%) than females (42%). The most common form of NPCA was non-keratinizing undifferentiated NPCA (47%) followed by poorly differentiated squamous cell carcinoma in 18 (19%). The most common chief complaint was a neck mass, followed by decreased hearing. Conclusion: There was a higher proportion of nasopharyngeal malignancy among male patients with nasopharyngeal mass, and the most common chief complaint was a neck mass. Future research should integrate data with other hospital institutions to obtain more accurate demographic data of the local prevalence of NPCA. A detailed record of the ethnicity, diet, occupation, smoking history and family history of cases should be obtained to correlate possible risk factors of NPCA among patients with nasopharyngeal mass in our setting.     Keywords: Nasopharyngeal carcinoma, nasopharyngeal mass, epidemiology, prevalence  

scholarly journals Improving the experience of facility-based delivery for vulnerable women through obstetric care navigation: a qualitative evaluation

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kirsten Austad ◽  
Michel Juarez ◽  
Hannah Shryer ◽  
Patricia L. Hibberd ◽  
Mari-Lynn Drainoni ◽  
...  
Keyword(s):  
Health Workers ◽  
Positive Impact ◽  
Qualitative Evaluation ◽  
Obstetric Care ◽  
Hospital Staff ◽  
Public Hospitals ◽  
Future Research ◽  
Care Seeking ◽  
Structured Interviews ◽  
The Impact

Abstract Background Global disparities in maternal mortality could be reduced by universal facility delivery. Yet, deficiencies in the quality of care prevent some mothers from seeking facility-based obstetric care. Obstetric care navigators (OCNs) are a new form of lay health workers that combine elements of continuous labor support and care navigation to promote obstetric referrals. Here we report qualitative results from the pilot OCN project implemented in Indigenous villages in the Guatemalan central highlands. Methods We conducted semi-structured interviews with 17 mothers who received OCN accompaniment and 13 staff—namely physicians, nurses, and social workers—of the main public hospital in the pilot’s catchment area (Chimaltenango). Interviews queried OCN’s impact on patient and hospital staff experience and understanding of intended OCN roles. Audiorecorded interviews were transcribed, coded, and underwent content analysis. Results Maternal fear of surgical intervention, disrespectful and abusive treatment, and linguistic barriers were principal deterrents of care seeking. Physicians and nurses reported cultural barriers, opposition from family, and inadequate hospital resources as challenges to providing care to Indigenous mothers. Patient and hospital staff identified four valuable services offered by OCNs: emotional support, patient advocacy, facilitation of patient-provider communication, and care coordination. While patients and most physicians felt that OCNs had an overwhelmingly positive impact, nurses felt their effort would be better directed toward traditional nursing tasks. Conclusions Many barriers to maternity care exist for Indigenous mothers in Guatemala. OCNs can improve mothers’ experiences in public hospitals and reduce limitations faced by providers. However, broader buy-in from hospital staff—especially nurses—appears critical to program success. Future research should focus on measuring the impact of obstetric care navigation on key clinical outcomes (cesarean delivery) and mothers’ future care seeking behavior.

scholarly journals Serum Biomarker Signature-Based Liquid Biopsy for Diagnosis of Early-Stage Pancreatic Cancer

2018 ◽  
Vol 36 (28) ◽  
pp. 2887-2894 ◽  
Author(s):  
Linda D. Mellby ◽  
Andreas P. Nyberg ◽  
Julia S. Johansen ◽  
Christer Wingren ◽  
Børge G. Nordestgaard ◽  
...  
Keyword(s):  
Case Control Study ◽  
Early Stage ◽  
Stage Iv ◽  
The United States ◽  
Case Control ◽  
Stage I ◽  
Serum Biomarker ◽  
Patient Cohort ◽  
Biomarker Signature ◽  
Control Study

Purpose Pancreatic ductal adenocarcinoma (PDAC) has a poor prognosis, with a 5-year survival of < 10% because of diffuse symptoms leading to late-stage diagnosis. That survival could increase significantly if localized tumors could be detected early. Therefore, we used multiparametric analysis of blood samples to obtain a novel biomarker signature of early-stage PDAC. The signature was derived from a large patient cohort, including patients with well-defined early-stage (I and II) PDAC. This biomarker signature was validated subsequently in an independent patient cohort. Patients and Methods The biomarker signature was derived from a case-control study, using a Scandinavian cohort, consisting of 16 patients with stage I, 132 patients with stage II, 65 patients with stage III, and 230 patients with stage IV PDAC, and 888 controls. This signature was validated subsequently in an independent case-control cohort in the United States with 15 patients with stage I, 75 patients with stage II, 15 patients with stage III, and 38 patients with stage IV PDAC, and 219 controls. An antibody microarray platform was used to identify the serum biomarker signature associated with early-stage PDAC. Results Using the Scandinavian case-control study, a biomarker signature was created, discriminating samples derived from patients with stage I and II from those from controls with a receiver operating characteristic area under the curve value of 0.96. This signature, consisting of 29 biomarkers, was then validated in an independent case-control study in the United States. The biomarker signature could discriminate patients with stage I and II PDAC from controls in this independent patient cohort with a receiver operating characteristic area under the curve value of 0.96. Conclusion This serum biomarker signature might represent a tenable approach to detecting early-stage, localized PDAC if these findings are supported by a prospective validation study.

scholarly journals Organisational change in hospitals: a qualitative case-study of staff perspectives

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Chiara Pomare ◽  
Kate Churruca ◽  
Janet C. Long ◽  
Louise A. Ellis ◽  
Jeffrey Braithwaite
Keyword(s):  
Health Systems ◽  
Early Stage ◽  
Organisational Change ◽  
Hospital Staff ◽  
Hospital Environment ◽  
Structured Interviews ◽  
Metropolitan Hospital ◽  
The Face ◽  
Negative Expectations

Abstract Background Organisational change in health systems is common. Success is often tied to the actors involved, including their awareness of the change, personal engagement and ownership of it. In many health systems, one of the most common changes we are witnessing is the redevelopment of long-standing hospitals. However, we know little about how hospital staff understand and experience such potentially far-reaching organisational change. The purpose of this study is to explore the understanding and experiences of hospital staff in the early stages of organisational change, using a hospital redevelopment in Sydney, Australia as a case study. Methods Semi-structured interviews were conducted with 46 clinical and non-clinical staff working at a large metropolitan hospital. Hospital staff were moving into a new building, not moving, or had moved into a different building two years prior. Questions asked staff about their level of awareness of the upcoming redevelopment and their experiences in the early stage of this change. Qualitative data were analysed using thematic analysis. Results Some staff expressed apprehension and held negative expectations regarding the organisational change. Concerns included inadequate staffing and potential for collaboration breakdown due to new layout of workspaces. These fears were compounded by current experiences of feeling uninformed about the change, as well as feelings of being fatigued and under-staffed in the constantly changing hospital environment. Nevertheless, balancing this, many staff reported positive expectations regarding the benefits to patients of the change and the potential for staff to adapt in the face of this change. Conclusions The results of this study suggest that it is important to understand prospectively how actors involved make sense of organisational change, in order to potentially assuage concerns and alleviate negative expectations. Throughout the processes of organisational change, such as a hospital redevelopment, staff need to be engaged, adequately informed, trained, and to feel supported by management. The use of champions of varying professions and lead departments, may be useful to address concerns, adequately inform, and promote a sense of engagement among staff.

Microsatellite frameshift variants in SGO1 of gastric cancer are not always associated with MSI status

2020 ◽  
pp. jclinpath-2020-206934
Author(s):  
Tomohiro Sugiyama ◽  
Moriya Iwaizumi ◽  
Terumi Taniguchi ◽  
Satoshi Suzuki ◽  
Shinya Tani ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Microsatellite Instability ◽  
Mismatch Repair ◽  
Gastrointestinal Cancer ◽  
Early Stage ◽  
Stage Iv ◽  
Cancer Resection ◽  
Deficient Mismatch Repair ◽  
Gastric Cancer Resection ◽  
Genemapper Software

AimsAlthough frameshift variants in the microsatellite area of shugoshin 1 (SGO1) have been reported in the context of microsatellite instability-high (MSI-H)/deficient mismatch repair gastrointestinal cancer, most have been evaluated only in early stage I–III patients, and only two of its five microsatellite regions have been evaluated. Therefore, we investigated the frequency and MSI status of microsatellite frameshift variants in gastric cancer cases, including stage IV.MethodsIn a total of 55 cases, 30 gastric cancer resection and 25 non-resection cases, DNA was extracted from both tumour and normal parts and PCR was performed. The variant was confirmed by TA cloning, and MSI was evaluated using GeneMapper software.ResultsA frameshift variant of c.973delA was observed in 16 of the 45 evaluable cases. Its frequency was 35.6%. Of the 25 cases that could be assessed for MSI status, two cases of MSI-H were associated with the c.973delA SGO1 variant. However, c.973delA SGO1 variant was also observed in four cases of microsatellite stable.ConclusionOur study shows that SGO1 frameshift variants are not always associated with MSI status.

scholarly journals Lymphocytes are detrimental during the early innate immune response against Listeria monocytogenes

2006 ◽  
Vol 203 (4) ◽  
pp. 933-940 ◽  
Author(s):  
Javier A. Carrero ◽  
Boris Calderon ◽  
Emil R. Unanue
Keyword(s):  
Immune Response ◽  
Listeria Monocytogenes ◽  
Innate Immune Response ◽  
Early Stage ◽  
Bacterial Pathogen ◽  
Interleukin 10 ◽  
Innate Immune ◽  
Type I ◽  
Phagocytic Cells ◽  
Immunodeficient Mice

Mice deficient in lymphocytes are more resistant than normal mice to Listeria monocytogenes infection during the early innate immune response. This paradox remains unresolved: lymphocytes are required for sterilizing immunity, but their presence during the early stage of the infection is not an asset and may even be detrimental. We found that lymphocyte-deficient mice, which showed limited apoptosis in infected organs, were resistant during the first four days of infection but became susceptible when engrafted with lymphocytes. Engraftment with lymphocytes from type I interferon receptor–deficient (IFN-αβR−/−) mice, which had reduced apoptosis, did not confer increased susceptibility to infection, even when the phagocytes were IFN-αβR+/+. The attenuation of innate immunity was due, in part, to the production of the antiinflammatory cytokine interleukin 10 by phagocytic cells after the apoptotic phase of the infection. Thus, immunodeficient mice were more resistant relative to normal mice because the latter went through a stage of lymphocyte apoptosis that was detrimental to the innate immune response. This is an example of a bacterial pathogen creating a cascade of events that leads to a permissive infective niche early during infection.

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