Testing of mutations on thyroid nodules with indeterminate cytology: A prospective study of 112 patients in Argentina.

BACKGROUND: The study of genetic mutations in thyroid nodules makes it possible to improve the preoperative diagnosis of and reduce unnecessary surgeries on benign nodules. In this study, we analysed the impact of implementing a 7-gene mutation panel that enables mutations to be detected in BRAF and RAS (H/N/K) and the gene fusions PAX8/PPARG, RET/PTC1 and RET/PTC2, in a population in northern Argentina. METHODS: We performed a prospective analysis of 112 fine needle aspirations diagnosed as having indeterminate cytology according to the Bethesda classification system. These include the Bethesda III or atypia of unknown significance/follicular lesion of unknown significance and Bethesda IV or follicular neoplasm/suspicious for follicular neoplasm categories. The mutations of the 7-gene panel were analysed and this information was linked to the available histology and ultrasound monitoring. RESULTS: The BRAF V600E and RET/PTC1 mutations were associated with carcinoma in 100% of cases (n = 8), whereas only 37.5% (n = 3) of the nodules with RAS and 17% (n = 1) with PAX8/PPARG mutations were associated with carcinoma. From the histological diagnosis and ultrasound monitoring of patients, we can estimate that this panel has a sensitivity of 86% in detecting malignant carcinoma, a specificity of 77%, a positive predictive value (PPV) of 54% and a negative predictive value (NPV) of 94%. In this study, it was possible to reduce the number of surgeries by 48% in the patients analysed. CONCLUSION: The implementation of the mutation panel allowed the appropriate surgical strategy to be selected for each patient, the number of two-step surgeries to be reduced, and active follow-up to be established in low-risk patients.

The Newcastle satisfaction with nursing scales in a Mexican Oncology Hospital.

OBJECTIVES: The principal aim of this study was to identify whether the Newcastle Satisfaction with Nursing Scales (NSNS) could be used on cancer patients. METHODS: This was a descriptive, cross-sectional study carried out on cancer patients (n = 298). RESULTS: We found that a majority of cancer patients were around 50 years old (hospitalized patients [HP]: 49.5 ± 14.9; chemotherapy outpatients [COP]: 49.4 ± 12.7), were female (HP: 74%; COP: 63.5%), and had received education at least up to elementary level (HP: 70%; COP: 80%). Breast cancer was the principal type of cancer (>34%) in both groups (HP and COP). The groups were comparable in age, sex distribution, place of origin, educational qualification, and type of cancer. Among HP, the experience and satisfaction scales of the NSNS showed good internal consistency (n = 235, α >0.9, r > 0.7), while among COP, only the satisfaction scale showed good internal consistency (n = 62, α = 1.00). Most patients' perceptions (level of satisfaction) of hospitalization and chemotherapy services were positive (98% and 97%, respectively). CONCLUSION: An NSNS instrument specifically designed for ambulatory care cancer patients is necessary for it to be useful in assessing cancer patients' perception of nursing care. This will help improve the quality of care in Mexico.The presence of cancer by itself could modify the patients' satisfaction level. Further large-scale studies are required to investigate the patients' perceptions of nursing care using the NSNS on different cancer patient groups.

Testing of mutations on thyroid nodules with indeterminate cytology: A prospective study of 112 patients in Argentina. / Testeo de mutaciones en nódulos tiroideos con citología indeterminada: estudio prospectivo de 112 pacientes en Argentina.

BACKGROUND: The study of genetic mutations in thyroid nodules makes it possible to improve the preoperative diagnosis of and reduce unnecessary surgeries on benign nodules. In this study, we analysed the impact of implementing a 7-gene mutation panel that enables mutations to be detected in BRAF and RAS (H/N/K) and the gene fusions PAX8/PPARG, RET/PTC1 and RET/PTC2, in a population in northern Argentina. METHOD: We performed a prospective analysis of 112 fine needle aspirations diagnosed as having indeterminate cytology according to the Bethesda classification system. These include the Bethesda III or atypia of unknown significance/follicular lesion of unknown significance and Bethesda IV or follicular neoplasm/suspicious for follicular neoplasm categories. The mutations of the 7-gene panel were analysed and this information was linked to the available histology and ultrasound monitoring. RESULTS: The BRAF V600E and RET/PTC1 mutations were associated with carcinoma in 100% of cases (n=8), whereas only 37.5% (n=3) of the nodules with RAS and 17% (n=1) with PAX8/PPARG mutations were associated with carcinoma. From the histological diagnosis and ultrasound monitoring of patients, we can estimate that this panel has a sensitivity of 86% in detecting malignant carcinoma, a specificity of 77%, a positive predictive value (PPV) of 54% and a negative predictive value (NPV) of 94%. In this study, it was possible to reduce the number of surgeries by 48% in the patients analysed. CONCLUSION: The implementation of the mutation panel allowed the appropriate surgical strategy to be selected for each patient, the number of two-step surgeries to be reduced, and active follow-up to be established in low-risk patients.

Programa de evaluación y control del tabaquismo en funcionarios del hospital doctor Gustavo Fricke, Viña del Mar, Chile / Program of evaluation and control of smoking in hospital staff at Hospital Doctor Gustavo Fricke, Viña del Mar, Chile

El tabaquismo, mantiene alta prevalencia a nivel de la población general, lo que se manifiesta también en los funcionarios de la salud en nuestro país. Objetivos: Se planificó un programa antitabaco para los funcionarios del Hospital Dr. Gustavo Fricke, Viña del Mar con el objetivo de realizar un diagnóstico de la situación, evaluar a los funcionarios comprometidos y realizar acciones programáticas orientadas al cese. Material y método: Se encuestaron entre marzo y junio del 2013, 551 funcionarios en forma directa, de los cuales, los que fumaban y manifestaron su deseo a dejarlo, se les aplico 4 test (Fagestrom, Richmond, Goldberg y De los porqué) y se les ofreció integrarse a un programa de cesación con terapia farmacológica y no farmacológica. Resultados: Se pesquisaron 249 fumadores (45 por ciento), de los cuales 158 (63,4 por ciento) desean dejar de fumar. Las tasas más altas fueron de los profesionales no de la salud (70 por ciento) y las más bajas de los médicos (18 por ciento). Se pesquiso un 20 por ciento de fumadores severos (>15 al día) y una gran motivación al cese. Hasta Agosto 2014, 60 funcionarios (38 por ciento de los que deseaban dejar de fumar) , estaban en programa, los cuales se evaluaron con ficha clínica “ad hoc”, test de Fagestrom, Richmond, De los por qué y Goldberg (depresión). Las modalidades de terapia fueron consejería individual y farmacológica con vareniclina y/o chicles de nicotina, de acuerdo a flujograma que consideraba grados de adicción y motivación. Hasta agosto /2014, 10 funcionarios habían recibido terapia farmacológica, de los cuales 6 completaban 6 meses de cesación, 2 abandonos y 2 recaídas. Conclusiones: Fue posible realizar un programa de cesación tabáquica en funcionarios hospitalarios de acuerdo a lo programado...

Smoking, maintaining a level high prevalence in the general population, which is also evident in the subjects working health in our country. Objectives: A smoking cessation program was planned for subjects working Dr. Gustavo Fricke Hospital, Vina del Mar in order to make a diagnosis of the situation, evaluate and make subjects working committed actions aimed at cessation program. Material and method: They were surveyed between March and June 2013, 551 subjects working directly, of which, those who smoked and expressed his desire to leave, they applied four tests (Fagestrom, Richmond, Goldberg and “Of the why”) and offered integrated a cessation program with pharmacological and non-pharmacological therapy. Results: 249 smokers (45 percent), of which 158 (63.4 percent) want to stop smoking. The highest rates were among non-health professionals (70 percent) and the lowest of physicians 18 percent. 20 percent of heavy smokers (> 15 per day) and a great motivation to terminate. Until August 2014, 60 staff (38 percent of those who wanted to stop smoking), were in the program, which were evaluated with clinical record "ad hoc" test Fagestrom, Richmond, “Of the why” and Goldberg (depression). Modalities therapy, were individually counseling and pharmacological therapy with varenicline and / or nicotine gum, according to flowchart considered degrees of addiction and motivation. Until August / 2014, 10 staff had received drug therapy, of which 6 completed 6 months of cessation, 2dropouts and 2 relapses. Conclusions: It was possible to make a smoking cessation program in hospital officials as scheduled...

A randomized control trial: training program of university students as health promoters.

BACKGROUND: Several studies have reported the following as determining factors for the adoption of healthy lifestyles among undergraduate students: gender, socioeconomic level, prior lifestyles, environment, parental lifestyles and health status, career choice, and healthy support networks. However, these factors are influenced by students' knowledge about healthy lifestyles. METHODS/DESIGN: We will carry out a randomized trial in a sample of 280 new undergraduate students at the National Autonomous University of Mexico's Faculty of Higher Studies-Zaragoza (FES-Zaragoza, UNAM). There will be an experimental group (n = 140), comprising 20 students from each of the seven university departments (careers); these students will receive training as university student health promoters through an e-learning course. This course will allow the topics necessary for such promoters to be reviewed. There will be a control group (n = 140), comprising 20 students from each of the seven departments (careers); these students will not undergo the training. Later, the students who comply satisfactorily with the e-learning course will replicate the course to 10 of their classmates. A healthy-lifestyle questionnaire will be given to all the participants, and the parameters established in the self-care card will be recorded before and after the training. The study variables are as follows: (i) independent variable-compliance with the e-learning course; (ii) dependent variables-lifestyles changes prior to the educative intervention (including healthy eating, physical activity, and addiction prevention) and parameters related to health status established in self-care (including weight, body mass index, waist circumference, and hip circumference). Data will be analyzed using Student's t test and logistic regression analysis odds ratios with 95% confidence intervals. The analysis of the open answers will be carried out with ATLAS. ti 5.5 software. DISCUSSION: Health promotion among university students should incorporate options that are feasible for and attractive to students. Thus, as proposed in the present protocol, e-learning courses offer excellent possibilities because they allow students to program their learning in their available time without affecting their academic studies. TRIAL REGISTRATION: http://ISRCTN77787889.