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Caring of cancer patients requires special skills and knowledge that facilitates the professionals’ care during the patients' illness and palliative phases. This study was conducted to explore the nursing students' attitudes toward death and caring for dying cancer patients during their Placement. A descriptive study was conducted using the Formmelt Attitude toward Care of the Dying (FATCOD) scale and Death Attitude Profile-Revised (DAP-R) scale. Nursing students from AL-Zaytoonah University of Jordan. A sample of one hundred nursing students was recruited.   The current study showed statistically significant difference among age group in relation to total score of death scale (p-value: 0.000) and fear of death, neutral acceptance, approach acceptance, and escape- acceptance subscales. The results indicated that younger students have more negative thoughts, attitudes, and emotions toward caring for dying cancer patients. In addition the results indicated that students with higher academic levels have a more positive attitude and are more eligible to provide nursing care for dying cancer patients as compared to students with less experience. In addition, the results showed that students with less experience had a greater fear of death than students with a higher academic level. According to the study results, Nurses' attitudes toward caring for dying and dead cancer patients can be considered an important predictor of quality of life among cancer patients. 

Published in Embj

Anal fistula has been recognized for centuries, and yet, its treatment remains a challenge for surgeons till today. In this study, a 30 year experience of treating anal fistula is being reported and discussed in light of the various recognized management methods. A total of 320 patients were treated by fistulotomy, fistulectomy, fistula plugging or seton technique. Data showed that fistula plugging carried the highest failure rate (89%) seconded by fistulectomy (37%), seton procedure (24.5%) and fistulotomy (15.6%). High transsphincteric fistulas were more likely to predict failure compared to low transsphincteric, intersphincteric and subcutaneous fistulas (37.5% versus 9.5%, 7.3% and 0%, respectively). In conclusion, the scales seem to support fistulotomy. However, no standardized algorithm exists to guide the care of patients and the choice of operation is based on patient-related factors, the patient’s surgical history, and the surgeon’s experience and familiarity with the various techniques for treating anal fistula. 

Published in Embj

Electric field distribution analysis generated by ECCT in a human head model with or without brain cancer using wire mesh electrode has been conductedsuccessfully. The analysis of electric field distribution was done using simulation in a human head model with ECCT Apparel Helmet system type A which is three dimensional model. The electric field distribution was measured with and without a wire mesh electrode which was either passive or active using COMSOL Multiphysics 5.2 software and was then processed using MATLAB R2010a. The aim of the research was to assess the performance of wire mesh electrode in detecting electric field distribution. ECCT which is utilized in brain cancer therapy with input 10 V is able to produce an electric field with an average of 178.8 V/m. The input voltage influences electric field distribution whereas the signal frequency does not affect the electric field distribution. Wire mesh electrode which is either active or passive can measure the electric field distribution generated by ECCT that neither the active nor the passive wire mesh electrode changed the pattern of the electric field distribution and the change in the measured electric field value is not significant.

Published in Embj

Causality assessment is an algorithm proposed by WHO to identify a causal relationship between vaccines and adverse events following immunization (AEFIs), mostly for serious adverse events. It can be considered consistent, inconsistent, indeterminate or unclassifiable. This study describes AEFIs reported in Puglia from 2013 to 2016 and analyzes the differences between  the causality assessments performed on AEFI case-report information and the causality assessments performed after the examination of clinical documentation. 292 AEFI were reported: 191 (65.4%) non serious, 59 (20.2%) serious and 42 (14.4%) undefined. Causality assessment performed on the AEFI case-report information classified 59.2% (n=29/49) of serious AEFIs as consistent while assessment performed after clinical review only classified 30.6% (n=15/49) of serious AEFI as consistent (X2=65.0; p=0,000). In the first approach, inconsistent serious AEFIs were 18.6% (n=11/49) and then became 45.8% (n=27/49) after examination of clinical documentation. Indeterminate serious AEFIs were 6.8% (n=4) at first, and then 3.4% (n=2). Unclassifiables did not change.

Published in Embj

The aim of this study was to explore the efficiency and usefulness of  tridimensional printing in plastic and reconstructive surgery for lesions of the maxillofacial region. This was comparison study between two groups of patients. Six patients underwent surgical reconstruction, using a three-dimensional model built on the basis of CT scans (group 1); and six patients underwent surgical reconstruction, without the use of a three-dimensional model (group 2). The following variables were evaluated: age, gender, histological diagnosis, cancer location, size of bone lesion, type of reconstruction, complications and surgical timing. A statistically significant difference was found in microsurgical flap survival (p = 0.019), with a survival rate higher in group 1 than in the controls.  This study provides preliminary evidence and partially confirms the validity of three-dimensional technology in plastic and reconstructive surgery. The results so far obtained, however, lead to hope for future uses of this ever-increasing technique. 

 

Published in Embj

Allergic rhinitis is a common problem increasing greatly over the past three decades. Several studies have found a possible link between dyslipidemia and allergic disease but the relating causal mechanisms remain elusive. The aim of this study is to investigate the association between blood lipid levels and the presence of allergic rhinitis. A multicentre prospective study was carried out on 160 allergic rhinitis patients and 160 volunteers as a control according to age, gender, body mass index (BMI) values and full blood lipid profile. A possible correlation between abnormal dyslipidemia parameters and the severity of allergic rhinitis was studied too. Demographic characteristics didn’t differ between groups. While levels of LDL-C, total cholesterol, as well as TC/HDL ratio and LDL/HDL ratio, were significantly higher (p<0.001) in patients with allergic rhinitis, there was a positive correlation between abnormal dyslipidemia parameters and moderate/severe allergic rhinitis symptomatology ( p<0.001). We support the hypothesis that dyslipidemia might play a role in in the manifestation of allergic rhinitis.

Published in Embj

The hyoid bone is the only "suspended bone" in our body, and its suspension system has an important role in posture maintenance. We studied postural modification in a group of patients affected by Obstructive Sleep Apnea Syndromewho had undergone surgical treatment including hyoid suspension.  The surgical procedure  performed was section of supra- and infrahyoid muscle and mobilization of the hyoid bone through its suspension to the thyroid cartilage. We studied the postural changes with stabilometric tests. In the early post-operative (one week) follow-up, we performed a posturography test with closed eyes and occlusal disjunction, and saw a worsening of the average parameter of the centre of pressure with antero-posterior oscillations. However, we would like to highlight that by the time of the one year follow up, a compensatory mechanism had been established which allowed for a return to normal hyoid bone kinematics.  

Published in Embj

The aim of the study was to evaluate individual inflammatory response after inguinal hernioplasty by measuring baseline and post-operative serum IL-6 response to surgery and quantifying the variability of the serum response in a homogeneous group of patients.Patients enrolled in the study underwent inguinal hernioplasty. Blood samples were used to analyze serum IL-6, TNF-alpha, LOOH and GSH levels. To identify high and low IL-6 responders, patients were divided into 2 groups according median values of the peak levels of IL-6. Mean levels of the cytokine were comparable at baseline but reached peak at 6 h and persisted elevated at following hours among high responders whereas remained significantly lower over time among low responders.Patients identified as low responders showed not significant changes in serum IL-6 levels over the post-operative period. In contrast, high responders demonstrated a significant response reaching the peak level of IL-6 after 6 hours post operation.

Published in Embj

The objective of this paper is to respond to the urgent need for an increase in access to HIV care among adolescents and young people in Sub-Saharan Africa. Since 2014, doctors with Africa CUAMM in collaboration with UNICEF have been supporting specific ambulatories for the youth population (between the ages of 10- 24) aiming to improve health education, specifically in relation to HIV prevention. Mozambique has the eighth highest prevalence of HIV in the world. It represents one of the six countries in which half of the adolescents living with HIV reside. Beira is Mozambique’s second largest city, and in 2009 it had the most women and men between the ages of 15-49 were living with HIV. This study retrospectively analyzes data collected between 2013 and 2014, which described the impact of a new health service in a low resource setting with high HIV prevalence. The specificity of the service, only dedicated to young people, is the basis for this paper.  We observed a significant increase in counseling in 2014 compared to 2013 (102,533 vs 63,959, p<0.01), confirming that strengthening specific youth services is an effective intervention for improving access to care of this target population. Youth ambulatories are great instruments to improve access to HIV care among young people.

Published in Embj

Cerebral cavernous malformations (CCMs) are benign tumours that affect brain capillaries. Although many cases remain asymptomatic, their incidence is steadily increasing. CCMs can arise sporadically or be inherited as autosomal dominant character. Inherited forms result from mutations at three different loci CCM1/KRIT1, CCM2/MGC4607 and CCM3/PDCD10. Etiology of sporadic forms is still unclear. Among the various molecular mechanisms proposed, presence of somatic mutations was sometimes proven. Here we report results obtained by a molecular screening of the three CCMs genes, performed on both germ-line and somatic DNA, isolated from CCM endothelial cells, in eight patients affected by sporadic lesions, who undergone surgery. Comparison of germ-line and somatic sequencing data, for each patient, showed no differences. Our results confirm that presence of somatic mutations is not sufficient to explain CCMs onset in patients affected by sporadic forms and with no CCM genes germ-line mutations. Other possible pathogenic mechanisms are also discussed.

Published in Embj
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