Rare case of solid pseudopapillary neoplasm of the pancreas with liver and splenic metastasis in a 19-year-old girl.

INTRODUCTION: Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare neoplasms, accounting for only 1 %-2 % of all pancreatic tumors, and predominantly affect female patients. CASE PRESENTATION: The present case report details a patient presenting to the emergency department with abdominal pain for 3 days who ultimately received a diagnosis of SPNs in the pancreatic body and tail. A contrast-enhanced computed tomography (CT) scan revealed a sizable mass arising from the pancreas, featuring an enhancing cystic component with involvement of the liver and spleen. The patient underwent subsequent exploratory laparotomy, a distal pancreatectomy, splenectomy, and partial hepatectomy. SPN diagnosis was confirmed by histopathology and immunohistochemistry with negative resection margins. CLINICAL DISCUSSION: Approximately 70 % of SPN cases are asymptomatic and are incidentally discovered. Despite advances in diagnostic modalities, preoperative diagnosis of SPNs remains a clinical challenge. Surgical management with negative resection margins remains the primary treatment approach. The recurrence rate after surgical resection has been reported to be 3 %-9 %. The prognosis for SPNs limited to the pancreas is generally favorable, with a cure rate exceeding 95 % after complete surgical resection. CONCLUSION: An SPN of the pancreas is a rare tumor observed in young female patients. Although it is classified as a malignant tumor, SPN has low malignant potential. Aggressive surgical resection, however, has proven effective in curing SPN for the majority of patients.

Work-related frustration among senior nurses at a medical centre.

AIMS AND OBJECTIVES: To investigate the levels and causes of work-related frustration among senior nurses. BACKGROUND: Role changes and the associated expectations and setbacks faced by senior middle-aged nurses can easily result in low morale. Therefore, working setbacks experienced by senior nurses must be investigated. DESIGN: A cross-sectional questionnaire study. METHODS: Purposive sampling was used to select questionnaire recipients. In total, 482 senior nurses completed and returned a structured questionnaire. RESULTS: The predictive factors for frustration at work among senior nurses included age, service unit, and the impact of sleep disorders, which jointly explained 54% of the variance. In particular, age and service unit were important predictive factors for frustration at work. CONCLUSIONS: Senior nurses had medium-to-low scores for frustration at work and did not perceive a high level of frustration. RELEVANCE TO CLINICAL PRACTICE: The outpatient departments and other medical departments in this sector should provide a reasonable system of incentives and promotion opportunities if they are to retain their most senior and experienced nurses. The results of this study could serve as a reference for hospital administrations.