RESUMO
RATIONALE@#In 2008, the Philippine College of Surgeons in collaboration with the Philippine Society of General Surgeons and the Philippine Academy of Head and Neck Surgeons, Inc. had published Evidence-based Clinical Practice Guidelines (CPG) on the Diagnosis and Management of Thyroid Nodules. This was followed by an update in 2013 with a focus on important diagnostic and therapeutic management issues concerning thyroid malignancy. The objective of this study was to assess knowledge gaps and behavioral patterns among users with respect to these CPGs. @*METHODS@#A validated 30 item survey assessing knowledge of, attitudes towards, and adherence to the recommendations of different Evidence based Clinical Practice Guidelines was administered to general surgery residents, PSGS fellows, and otorhinolaryngology residents and consultants performing thyroidectomies.@*RESULTS@#There were 343 assessable forms. Of the respondents, 276 (80.47%) were general surgeons, 33 (9.62%) were otorhinolaryngologists. There were 66 (19.24%) consultants, and 277 (80.76%) residents. Otorhinolaryngologists were less aware of the local CPGs than their GS counterparts. GS Residents, compared to their consultants, were more aware of the American Thyroid Association guidelines than the local guidelines. Among all respondents, the local guidelines had about equal preference for usage as the American Thyroid Association guidelines. There were no statistically significant differences on the level of knowledge and attitudes among the respondents. @*CONCLUSION@#The level of awareness about the PCS Thyroid Guidelines needs to be improved. The dissemination process needs to be reviewed and ensure that all stakeholders will be reached.
Assuntos
Glândula TireoideRESUMO
@#<p style="text-align: justify;"><strong>Research Question:</strong> What is the current status of self-efficacy beliefs towards research and research utilization (RU) of University of Santo Tomas Faculty of Medicine and Surgery (UST-FMS) graduates who had Clinical Epidemiology in their basic medical education curriculum?</p><p style="text-align: justify;"><strong>Significance of the Study:</strong> There is an increase in research and RU trends globally as adherence to practice based on evidence results in improved patient outcomes. Limited studies are available in describing research and RU of Filipino physicians and there is no study available specific for UST-FMS graduates.</p><p style="text-align: justify;"><strong>Objectives:</strong> The study aims to describe self-efficacy beliefs towards research and RU of UST-FMS graduates' batches 2012-2016 who had Clinical Epidemiology in their basic medical education.</p><p style="text-align: justify;"><strong>Study Design:</strong> A single-center, quantitative descriptive survey design was used.</p><p style="text-align: justify;"><strong>Methodology:</strong> Participants were graduates of UST-FMS batches 2012-2016, currently working at the University of Santo Tomas Hospital. Evidence-based Practice Confidence Scale (EPIC scale) and Edmonton Research Orientation Survey (EROS) were used to assess the research and RU of the participants gathered through snowball sampling.</p><p style="text-align: justify;"><strong>Statistical Analysis:</strong> Descriptive statistics such as means and standard deviations were used to analyze the EPIC and EROS scores.</p><p style="text-align: justify;"><strong>Results:</strong> The UST-FMS graduates value research and are generally confident in their ability to participate in evidence-based medicine. However, they rarely conduct research and have a low understanding of statistics.</p><p style="text-align: justify;"><strong>Conclusion:</strong> The self-efficacy beliefs of USTFMS graduates towards research and RU may be attributed to several factors. Clinical epidemiology as a subject may be improved by adding more lectures on statistics while hospitals should create avenues to support the conduct of research.</p>
RESUMO
@#A 46-year old female presented with a one-year history of a right lateral neck mass which gradually increased in size and subsequently involved bilateral cervical nodes. Diagnosed as Papillary Thyroid Carcinoma Stage I (T1N2M0), she underwent Total Thyroidectomy, Central Neck Dissection, Modified Radical Neck Dissection, Type I, right and Modified Radical Neck Dissection Type III, left. Histopathology revealed papillary thyroid carcinoma with no lymphovascular and capsular invasion, and metastatic undifferentiated carcinoma in 15 out of 16 lymph nodes, probably nasopharyngeal in origin. Work up uncovered an erythematous, friable nasopharyngeal mass. Its histopathology was nasopharyngeal cancer, a second primary malignancy. The malignancies were treated as separate entities. The patient underwent chemoradiotherapy first for the nasopharyngeal cancer. Radioactive Iodine for the thyroid malignancy was given six months after completion of radiotherapy. Double primary malignancies deserve aggressive treatment. The sequence of therapy should be based on the severity of the malignancy.