ABSTRACT
To determine a cut-off point of tPSA and PSAD to prevent unnecessary invasive cancer-diagnosing tests in the community. This study was performed on 688 consecutive patients referred to our center due to prostatism, suspicious lesions on digital rectal examination and/or elevated serum PSA levels. All patients underwent transrectal ultrasound guided biopsies and obtained PSAD. Serum levels of tPSA and fPSA were measured by chemiluminescence. Comparisons were done using tests of accuracy [AUC-ROC]. Prostate cancer was detected in 334 patients, whereas the other 354 patients were suffering from benign prostate diseases. The mean tPSA in case and control groups were 28.32 +/- 63.62 ng/ml and 7.14 +/- 10.04 ng/ml; the mean f/tPSA ratios were 0.13 +/- 0.21 and 0.26 +/- 0.24 in PCa and benign prostate disease groups; the mean PSAD rates were 0.69 +/- 2.24, 0.12 +/- 0.11, respectively. Statistically significant differences were found [P<0.05]. Using ROC curve analysis, it was revealed that AUC was 0.78 for tPSA and 0.80 for f/tPSA. Sensitivity was 71% for the cut-off value of 7.85ng/ml. For f/tPSA ratio, the optimal cut-off value was 0.13 which produced the sensitivity of 81.4% and for PSAD, it was15%. As this trial is different from the European and American values, we should be more cautious in dealing with the prostate cancer upon the obtained sensitivity and specificity for PCa diagnosis [7.85ng/mL fortPSA, 15% for PSAD and 0.13 for f/tPSA ratio]
ABSTRACT
Nursing students are often exposed to verbal abuse and/or physical assaults from patients and patients' families during the course of their training. Although, past studies have explored violence against nurses, a little attention has been paid by researchers to workplace violence against nursing students. The aim of this study is to identify and explore influencing factors on workplace violence in nursing students during their training programs. In this descriptive study, 271 nursing students completed a reliable and valid questionnaire. Participants were working in teaching hospital affiliated to Arak University. In total, 74.9% and 7.38% of the respondents stated that they had been verbally abused and physically assaulted during their training program in the previous 12-months period, respectively. Most of physical attacks were happened by patients whereas most verbal abuses by patients' families. There were no statistically significant differences between sex and different years in violence. Nursing students are often exposed to violence during the course of their training programs. Nursing students require training on how to prevent and respond to workplace violence, and this important topic should be incorporated into the nursing students' curriculum
ABSTRACT
Nursing and midwifery students are at risk needlestick/sharps injuries [NSIs/Sis]. Actual number of NSIs/SIs among students due to insufficient reporting it is not clear in Iran. The aim of this study was to explore the barriers of not reporting of NSIs/SIs among nursing students. This descriptive cross-sectional study was conducted in Arak University of Medical Sciences in 2009. 207 and 68 nursing and midwifery students were participated in study, respectively. A questionnaire, consisting two sections of demographic information and questions about exposure to [NSIs/SIs] and frequency and barrier reporting of NSIs/SIs, was completed by students. According to the findings, 43% and 20.5% of nursing and midwifery students had experienced at least one contaminated NSIs/Sis in the past 12 months. Only 44.9% [n=40] and 50% [n=7] of the nursing and midwifery who had experienced NSIs/Sis in the previous year, were reported all exposures to NSIs/Sis, respectively. The most important the reasons for not reporting injuries consisted of low probabilities of the infection risk of the injury source, not familiar with reporting process and fear of decreasing evaluation score. NSIs/SIs and non-reporting of NSIs/SIs were highly prevalent in nursing and midwifery students. More education programs should be directed at students to increase their awareness of about NSIs/SIs. Also nursing and midwifery student's instructors should give positive responses to nursing students for reporting NSIs/SIs
ABSTRACT
To determine the accuracy of clinical staging methods of bladder cancer and TURBT results in estimating the pathologic stage of tumor. Thirty two patients who had undergone radical cystectomy were studied in this retrospective survey. The results of bimanual examination, cystoscopy, TURBT pathology report and the tumor contour in CT scan, [size, infiltrative deepness, pelvic lymph nodes involvement and hydronephrosis] were recorded. The type of surgery and pathologic report of cystectomy sample were analyzed as well. Then the results of bimanual examination, tumor size, hydronephrosis and CT scan findings including tumor infiltrative deepness, pelvic lymph adenopathy and TURBT findings were compared to pathologic results of cystectomy sample. Seven patients were females and 25 were males. Their mean age was 62 [range 36 to 80] years. Gross hematuria and irritative urinary symptoms were the most common complaints. The duration between symptom manifestation and patient's referral was 5 days to 72 months [mean 12 months]. Bimanual examination in estimating the extravesical involvement of tumor had a specificity of 82%, sensitivity of 46%, positive predictive value of 70% and negative predictive value of 63%. The size of tumor in determining extravesical involvement had a specificity of 41%, sensitivity of 93%, and positive predictive value of 58% and negative predictive value of 87%. Hydronephrosis was present in 15 patients of whom, 14 [93%] had bladder muscle involvement. CT scan specificity was 70%, and sensitivity was 46% regarding pelvic lymph adenopathy and perivesical fat involvement. In TURBT report no muscle sample was observed in 11 cases, so that the interpretations of results were impossible. The reported grade of tumor was lower than pathologic sample of cystectomy in 4 patients. Clinical staging in invasive bladder cancers has not high accuracy regarding the involvement of bladder surrounding fats and pelvic adenopathies. A tumor sized more than 5 cm could be sensitive in estimating extravesical involvement. Positive predictive value of hydronephrosis is considerable regarding bladder muscle involvement. Tumor understaging by TURBT is happened in high percentage of patients with invasive bladder cancer