Is pulmonary function test insensitive to possible pulmonary complications after tangential radiotherapy of breast cancer?

Pulmonary complications of radiation to breast are inevitable, while its incidence and severity are not clear. One of the methods to assess pulmonary complications is spirometry. The influence of radiotherapy on pulmonary function test and the factors affecting it have been assessed in this study. Breast cancer patients with stage II and III [based on TNM staging], underwent six courses of chemotherapy, and the total mastectomy was included in this study. Smokers, chronic pulmonary patients, cardiac patients, and those who suffered from anatomic chest malformations were excluded. Sample size was 75 and data collection was conducted by the spirometer device. The total tumor dose varied between 4800 to 5040 cGy with fraction of 180 or 200 cGy. Spirometry was performed before and 3 months after radiotherapy; the patients were examined at the same time by a specialist for respiratory complications. The measured parameters were FEV 1[Forced Expiratory Volume in 1 second] and FVC [Forced Vital capacity] which were normalized by age and sex. The average age of the patients was 45.6 +/- 7.92 .Average length and widths of tangential fields were determined 18.2 +/- 1.8 and 6.7 +/- 1.37 respectively. Average central lung distance was measured 2 +/- 1.07 cm. The mean of FEV1% prior to and following radiotherapy was measured 74.9 +/- 15.59 and 78.86 +/- 12.55 respectively [p=0.09].The mean of FVC% before and after radiation treatment was measured 72.17 +/- 14.26 and 74.6 +/- 11.36 [p=0.07]. No abnormal signs were observed in the patients after radiotherapy. It seems that three months is a short period for appearance of pulmonary changes after radiotherapy with cobalt machine. Moreover, minimizing CLD through planning might lower the probability of pneumonitis due to radiation

[ effect of education on nurse's staff knowledge, attitude and practice toward hypertension]

Hypertension is the most important Cardio-Vascular risk factor, and also the most common cause of heart failure, stroke and renal failure. This semi-experimental study aimed at determining the effect of education, by means of Health Belief Model [HBM], on nurse's staff knowledge, attitude and their practice toward hypertension. This semi-experimental study was done on 136 nurse's staff selected by stratified random sampling. Data collection instrument were a questionnaire and a check-list. At first, the subjects' knowledge, attitude and their Practice were studied by a questionnaire and a check list, and then a HBM-based educational program was carried out. For three months, Afterwards, their knowledge, attitude and practice were measured and compared with pretest findings. In statistical analysis, Wilcox on test, independent t test, ANOVA and Pearson correlation. Before education the mean score of knowledge, benefit perceived, barrier perceived, threat perceived, attitude and practice was 9.68, 23.76, 25.63, 22.82, 71.99 and 4.55 respectively. After education these scores reached 16.66, 26.06, 28.94, 24.98, and 80.08 and 4.83. Based on the results, nurse's staff training via HBM led to high knowledge, positive attitude and practice improvement [p<0.05].The difference between this research variables such as age, gender, marital status, record of service and family background was not significant, But there was significant difference between variables [occupational levels, educational levels, and hospital ward] and knowledge and practice. Furthermore, the relation between hospital ward and attitude was positive [p<0.05]. In terms of the results, it is a necessity for nurse's staff to participate in a HBM based educational program