ABSTRACT
An extremely difficult contract negotiation between a collective bargaining unit and a hospital resulted in a vote to strike by the nursing staff before reaching a final agreement. The authors describe the factors that led up to the strike vote. Realistic yet optimistic strategies for developing a working relationship with the bargaining unit leadership and the nursing staff are described.
Subject(s)
Collective Bargaining , Employee Grievances , Nurse Administrators/psychology , Nursing Staff, Hospital/psychology , Strikes, Employee , Boston , Decision Making, Organizational , Focus Groups , Health Facility Environment , Hospital Bed Capacity, 500 and over , Humans , Interprofessional Relations , Job Satisfaction , Nurse Administrators/organization & administration , Nursing Assistants/statistics & numerical data , Nursing Staff, Hospital/economics , Organizational Innovation , Quality of Health Care , Salaries and Fringe Benefits , Stress, PsychologicalABSTRACT
Tissue polypeptide antigen (TPA) has been detected by immunocytochemical assay on urine cytological samples from 28 asymptomatic patients, who previously had a histological diagnosis of papillary transitional cell carcinoma (PTCT) of the urinary bladder (UB), in order to evaluate its role in follow-up controls. TPA staining intensity (SI) in urothelial cells was evaluated to improve the diagnostic accuracy of cytology. Differentiated tumor cells were strongly stained for TPA, heavier than normal urothelial cells. Undifferentiated neoplastic cells were less stained for TPA with a wide range of SI. TPA detection revealed positive cytology in 21 (75%) of the considered cases. The accuracy of our cytological findings compared with both routine examinations and subsequent histopathological diagnosis was of 95.2%. Follow-up urinary cytology limits could be reduced by TPA searching in differentiated tumor cells, deriving from low-grade neoplasms.
Subject(s)
Antigens, Neoplasm/analysis , Biomarkers, Tumor/analysis , Peptides/analysis , Urinary Bladder Neoplasms/diagnosis , Aged , Follow-Up Studies , Humans , Immunohistochemistry , Middle Aged , Peptides/immunology , Tissue Polypeptide Antigen , Urinary Bladder Neoplasms/immunologyABSTRACT
The immunocytochemical phenotype was evaluated in a case of Merkel cell carcinoma of the skin. Intermediate filaments, i.e. neurofilament, glial fibrillary acid protein, cytokeratins, keratin and panfilament as well as S-100 protein, calcitonin and epithelial membrane antigen were detected by immunoperoxidase methods. Nodular positivity for neurofilament was observed. The remaining intermediate filaments and other markers were negative. Thus the origin of Merkel cell carcinoma appears uncertain and this tumor probably has neuroendocrine activity.
