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Zhang LH, Ying YF, Yin J, Li N, Cheng Y, Yu RY. Effect of pre-admission "quasi-collective" education on health education for patients with ophthalmic day surgery. Technol Health Care 2024; 32:1177-1184. [PMID: 37899068 DOI: 10.3233/thc-230877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
Abstract
BACKGROUND Day surgery is a new surgical model in which patients complete the admission, surgery, and discharge on the same day. OBJECTIVE The present study aimed to explore the effect of pre-admission "quasi-collective" health education for patients with ophthalmic day surgery. METHODS For this study, a total of 200 patients undergoing ophthalmic day surgery from February 2019 to December 2019 were enrolled as the research subjects. The patients were divided randomly into the observation group and the control group, with 100 cases in each group. For the control group, conventional health education was conducted after admission. On the day of admission, the admission education and peri-operative health education were performed. For the observation group, pre-admission health education was provided to the patients, and detailed education on the admission instructions, pre-operative precautions, and simulation of the intra-operative process were given by the medical staff. On the day of admission, the understanding of the education was evaluated, and any weaknesses in the health education were addressed. The anxiety status, method of handwashing, method of administering the drug to the eye, preoperative preparations, intra-operative training, preoperative medication, diet guidance, and postoperative care were compared between the two groups of patients. RESULTS Before discharge, there were significant differences in the anxiety scores, impact, and satisfaction of health education between the two groups of patients, all of which were statistically significant (P< 0.05). CONCLUSION The pre-admission "quasi-collective" health education for patients undergoing day surgery in ophthalmology was better than conventional health education.
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Affiliation(s)
- Li-Hua Zhang
- Outpatient Department, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Ya-Fen Ying
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Jing Yin
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Na Li
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yan Cheng
- Department of Ophthalmology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Rong-Yan Yu
- Department of Infectious Disease, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
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Getting Your Foot in the Door: Access to Surgical Care for Thyroid Disease. J Surg Res 2023; 283:344-350. [PMID: 36427444 DOI: 10.1016/j.jss.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 10/19/2022] [Accepted: 11/02/2022] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Access to specialty care can be challenging for patients, often involving multiple evaluations, laboratory tests, and referrals. To better understand the different pathways to specialty care, we examined the outcomes of patients evaluated for surgical thyroid disease at a single tertiary referral clinic. METHODS We reviewed 691 patients seen in the endocrine surgery clinic for thyroid disease (2018-2021). Patient demographics, referral source, referral reason, and reason for not receiving an operation were collected. The number of days from referral to initial clinic visit and from initial clinic visit to an operation were also collected. The Chi-square test, the independent t-test, the Kruskal-Wallis test, the Dunn-Bonferroni post hoc test, and multiple logistic regression tests were performed using SPSS. RESULTS The top reasons for referral were thyroid nodules (54.4%), hyperthyroidism (26.5%), and multinodular goiter (10.3%). Specialty clinic referrals came from endocrinologists (56.0%), self-referrals (15.5%), and primary care physicians (PCP; 14.4%). Self-referred patients had a shorter waiting time for an appointment than those referred by endocrinologists and PCPs. [median (IQR) (days) 12 (6-17) versus 16 (9-24) versus 16 (9-25), P < 0.001]. Overall, 450 (72.7%) patients underwent thyroid surgery. For those who underwent thyroidectomy, self-referred patients had a shorter time between initial clinic visit and the operation compared to those referred by endocrinologists and PCPs [median (IQR) (days) 2 (1-19) versus 19 (8-33) versus 16 (1-48), P < 0.001]. Patients referred for hyperthyroidism (odds ratio [OR] = 2.2, 95% confidence interval [CI] 1.3-10.5, P = 0.012 were more likely to undergo an operation than those referred for other reasons. CONCLUSIONS Access to specialty care for thyroid disease is facilitated and optimized when self-referrals are permitted. Reducing or eliminating the requirement for a provider referral may improve patients' access.
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Soljačić Vraneš H, Potkonjak AM, Vraneš H, Djaković I, Bogović A. Stress and anxiety in patients waiting for non-urgent gynaecological surgery post-earthquake exposure in Zagreb, during the COVID-19 pandemic. J OBSTET GYNAECOL 2022; 42:3741-3742. [PMID: 35929955 DOI: 10.1080/01443615.2022.2106838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
- Hrvojka Soljačić Vraneš
- Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Ana-Meyra Potkonjak
- Department of Gynecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Hrvoje Vraneš
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Ivka Djaković
- Clinic for Gynecology, Bethesda Hospital, Basel, Switzerland
| | - Anamarija Bogović
- Department of Psychiatry, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.,Department of Psychology, Catholic University of Croatia, Zagreb, Croatia Catholic
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Taito M, Hamamoto T, Chikuie N, Nishida M, Takeno S, Okamura H. Association between subjective voice Assessment and psychological distress after thyroidectomy. J Perianesth Nurs 2022; 37:260-263. [DOI: 10.1016/j.jopan.2021.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 10/19/2022]
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Impact on patients with oral squamous cell carcinoma in different anatomical subsites: a single-center study in Taiwan. Sci Rep 2021; 11:15446. [PMID: 34326432 PMCID: PMC8322316 DOI: 10.1038/s41598-021-95007-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Accepted: 07/09/2021] [Indexed: 11/10/2022] Open
Abstract
The incidence of oral cavity squamous cell carcinoma (OSCC) is particularly high in South Asia. According to the National Comprehensive Cancer Network, OSCC can arise in several subsites. We investigated survival rates and the clinical and pathological characteristics of OSCC in different anatomical subsites in the Taiwanese population. We retrospectively analyzed data for 3010 patients with OSCC treated at the Changhua Christian Hospital. Subsequently, we compared clinical and pathological features of OSCC in different subsites. Pathological T4 stage OSCCs occurred in the alveolar ridge and retromolar trigone in 56.4% and 43.7% of cases, respectively. More than 25% of patients with tongue OSCC and 23.4% of those with retromolar OSCC had lymph node metastasis. The prognosis was worst for hard palate OSCC (hazard ratio 1.848; p < 0.001) and alveolar ridge OSCC (hazard ratio 1.220; p = 0.017). Retromolar OSCC recurred most often and tongue OSCC second most often. The risk for cancer-related mortality was highest for hard palate OSCC, followed by alveolar ridge and retromolar OSCC. We found distinct differences in survival among the different subsites of OSCC. Our findings may also help prompt future investigations of OSCC in different subsites in Taiwanese patients.
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Gagliardi AR, Yip CYY, Irish J, Wright FC, Rubin B, Ross H, Green R, Abbey S, McAndrews MP, Stewart DE. The psychological burden of waiting for procedures and patient-centred strategies that could support the mental health of wait-listed patients and caregivers during the COVID-19 pandemic: A scoping review. Health Expect 2021; 24:978-990. [PMID: 33769657 PMCID: PMC8235883 DOI: 10.1111/hex.13241] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 02/01/2021] [Accepted: 02/09/2021] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Waiting for procedures delayed by COVID-19 may cause anxiety and related adverse consequences. OBJECTIVE To synthesize research on the mental health impact of waiting and patient-centred mitigation strategies that could be applied in the COVID-19 context. METHODS Using a scoping review approach, we searched 9 databases for studies on waiting lists and mental health and reported study characteristics, impacts and intervention attributes and outcomes. RESULTS We included 51 studies that focussed on organ transplant (60.8%), surgery (21.6%) or cancer management (13.7%). Most patients and caregivers reported anxiety, depression and poor quality of life, which deteriorated with increasing wait time. The impact of waiting on mental health was greater among women and new immigrants, and those of younger age, lower socio-economic status, or with less-positive coping ability. Six studies evaluated educational strategies to develop coping skills: 2 reduced depression (2 did not), 1 reduced anxiety (2 did not) and 2 improved quality of life (2 did not). In contrast, patients desired acknowledgement of concerns, peer support, and periodic communication about wait-list position, prioritization criteria and anticipated procedure date. CONCLUSIONS Findings revealed patient-centred strategies to alleviate the mental health impact of waiting for procedures. Ongoing research should explore how to optimize the impact of those strategies for diverse patients and caregivers, particularly in the COVID-19 context. PATIENT OR PUBLIC CONTRIBUTION Six patients and four caregivers waiting for COVID-19-delayed procedures helped to establish eligibility criteria, plan data extraction and review a draft and final report.
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Affiliation(s)
- Anna R. Gagliardi
- Toronto General Hospital Research InstituteUniversity Health NetworkTorontoCanada
| | | | - Jonathan Irish
- Surgical Oncology Program/Access to Care‐SurgeryOntario Health‐Cancer Care OntarioTorontoCanada
| | | | - Barry Rubin
- Peter Munk Cardiac CentreUniversity Health NetworkTorontoCanada
| | - Heather Ross
- Ted Rogers Centre of Excellence in Heart FunctionUniversity Health NetworkTorontoCanada
| | - Robin Green
- Toronto Rehabilitation InstituteUniversity Health NetworkTorontoCanada
| | - Susan Abbey
- Medical Psychiatry & Psychosocial OncologyUniversity Health NetworkTorontoCanada
| | | | - Donna E. Stewart
- University Health Network Centre for Mental HealthUniversity of TorontoTorontoCanada
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Forner D, Murnaghan S, Porter G, Mason RJ, Hong P, Taylor SM, Bentley J, Hirsch G, Noel CW, Rigby MH, Corsten M, Trites JR, Taylor V, Kendell C, Jorgensen M, Urquhart R. Psychosocial Distress in Adult Patients Awaiting Cancer Surgery during the COVID-19 Pandemic. Curr Oncol 2021; 28:1867-1878. [PMID: 34068441 PMCID: PMC8161781 DOI: 10.3390/curroncol28030173] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 05/08/2021] [Accepted: 05/10/2021] [Indexed: 06/12/2023] Open
Abstract
Cancer causes substantial emotional and psychosocial distress, which may be exacerbated by delays in treatment. The COVID-19 pandemic has resulted in increased wait times for many patients with cancer. In this study, the psychosocial distress associated with waiting for cancer surgery during the pandemic was investigated. This cross-sectional, convergent mixed-methods study included patients with lower priority disease during the first wave of COVID-19 at an academic, tertiary care hospital in eastern Canada. Participants underwent semi-structured interviews and completed two questionnaires: Hospital Anxiety and Depression Scale (HADS) and Perceived Stress Scale (PSS). Qualitative analysis was completed through a thematic analysis approach, with integration achieved through triangulation. Fourteen participants were recruited, with cancer sites including thyroid, kidney, breast, prostate, and a gynecological disorder. Increased anxiety symptoms were found in 36% of patients and depressive symptoms in 14%. Similarly, 64% of patients experienced moderate or high stress. Six key themes were identified, including uncertainty, life changes, coping strategies, communication, experience, and health services. Participants discussed substantial distress associated with lifestyle changes and uncertain treatment timelines. Participants identified quality communication with their healthcare team and individualized coping strategies as being partially protective against such symptoms. Delays in surgery for patients with cancer during the COVID-19 pandemic resulted in extensive psychosocial distress. Patients may be able to mitigate these symptoms partially through various coping mechanisms and improved communication with their healthcare teams.
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Affiliation(s)
- David Forner
- Division of Otolaryngology—Head & Neck Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (D.F.); (P.H.); (S.M.T.); (M.H.R.); (M.C.); (J.R.T.); (V.T.)
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada;
| | - Sarah Murnaghan
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
| | - Geoffrey Porter
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
- Division of General Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS B3H 2Y9, Canada
| | - Ross J. Mason
- Department of Urology, Dalhousie University, Halifax, NS B3H 2Y9, Canada;
| | - Paul Hong
- Division of Otolaryngology—Head & Neck Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (D.F.); (P.H.); (S.M.T.); (M.H.R.); (M.C.); (J.R.T.); (V.T.)
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
| | - S. Mark Taylor
- Division of Otolaryngology—Head & Neck Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (D.F.); (P.H.); (S.M.T.); (M.H.R.); (M.C.); (J.R.T.); (V.T.)
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
| | - James Bentley
- Department of Obstetrics and Gynecology, Dalhousie University, Halifax, NS B3H 2Y9, Canada;
| | - Gregory Hirsch
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
- Division of Cardiac Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada
| | - Christopher W. Noel
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5T 3M6, Canada;
- Department of Otolaryngology—Head & Neck Surgery, University of Toronto, Toronto, ON M5T 3M6, Canada
| | - Matthew H. Rigby
- Division of Otolaryngology—Head & Neck Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (D.F.); (P.H.); (S.M.T.); (M.H.R.); (M.C.); (J.R.T.); (V.T.)
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
| | - Martin Corsten
- Division of Otolaryngology—Head & Neck Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (D.F.); (P.H.); (S.M.T.); (M.H.R.); (M.C.); (J.R.T.); (V.T.)
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
| | - Jonathan R. Trites
- Division of Otolaryngology—Head & Neck Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (D.F.); (P.H.); (S.M.T.); (M.H.R.); (M.C.); (J.R.T.); (V.T.)
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
| | - Victoria Taylor
- Division of Otolaryngology—Head & Neck Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (D.F.); (P.H.); (S.M.T.); (M.H.R.); (M.C.); (J.R.T.); (V.T.)
| | - Cynthia Kendell
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
| | - Margaret Jorgensen
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
| | - Robin Urquhart
- Department of Surgery, Dalhousie University, Halifax, NS B3H 2Y9, Canada; (S.M.); (G.P.); (G.H.); (C.K.); (M.J.)
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Gardner D, Nixon IJ. An analysis of waiting times in patients with thyroid cancer. Surgeon 2020; 18:e51-e54. [PMID: 32646674 DOI: 10.1016/j.surge.2020.06.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 06/04/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Scottish guidelines suggest that following a referral with a suspicion of cancer, patients should have a diagnosis within 31 days and commence treatment within 62 days. Thyroid cancer is not included in these targets. This study investigates the timelines of management of thyroid cancer, looking at factors that affect time to treatment and diagnosis in our network. METHODS The study was a review of a prospectively held database of patients discussed at MDT meetings between January 2016 and September 2018. Of the 153 potentially suitable thyroid cancer patients in NHS Lothian, 62 were eligible for inclusion in the study, having been referred to secondary care by their general practitioner (GP) and diagnosed with differentiated thyroid cancer (DTC). RESULTS At present only 10% and 16% of patients would meet the 62-day treatment and 31-day diagnosis targets respectively. The time to both diagnosis (p=<0.0005) and treatment (p = 0.022) is significantly improved in patients that have a diagnostic biopsy or FNA (Thy5) or a highly suggestive FNA (Thy4), compared with those that do not. There is no significant effect of GP referral type on time to diagnosis or management of thyroid cancer. With a median follow-up of 33 weeks, only one patient had died. CONCLUSIONS Thyroid cancer does not fit the classical cancer targets well. It is a relatively indolent form of cancer, with many cases diagnosed either incidentally or after undergoing treatment. It is important to balance the resource implications of providing rapid treatment with the psychological effects of the diagnosis.
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Affiliation(s)
| | - Iain J Nixon
- Department of Otolaryngology Head and Neck Surgery, NHS Lothian, University of Edinburgh, United Kingdom
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Mitric C, Matanes E, Wissing M, Amajoud Z, Abitbol J, Yasmeen A, López-Ozuna V, Eisenberg N, Laskov I, Lau S, Salvador S, Gotlieb WH, Kogan L. The impact of wait times on oncological outcome in high-risk patients with endometrial cancer. J Surg Oncol 2020; 122:306-314. [PMID: 32291783 DOI: 10.1002/jso.25929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 03/31/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the impact of surgical wait times on outcome of patients with grade 3 endometrial cancer. METHODS All consecutive patients surgically treated for grade 3 endometrial cancer between 2007 and 2015 were included. Patients were divided into two groups based on the time interval between endometrial biopsy and surgery: wait time from biopsy to surgery ≤12 weeks (84 days) vs more than 12 weeks. Survival analyses were conducted using log-rank tests and Cox proportional hazards models. RESULTS A total of 136 patients with grade 3 endometrial cancer were followed for a median of 5.6 years. Fifty-one women (37.5%) waited more than 12 weeks for surgery. Prolonged surgical wait times were not associated with advanced stage at surgery, positive lymph nodes, increased lymphovascular space invasion, and tumor size (P = .8, P = 1.0, P = .2, P = .9, respectively). In multivariable analysis adjusted for clinical and pathological factors, wait times did not significantly affect disease-specific survival (adjusted hazard ratio [HR]: 1.2, 95% confidence interval [CI], 0.6-2.5, P = .6), overall survival (HR: 1.1, 95% CI, 0.6-2.1, P = .7), or progression-free survival (HR: 0.9, 95% CI, 0.5-1.7, P = .8). CONCLUSION Prolonged surgical wait time for poorly differentiated endometrial cancer seemed to have a limited impact on clinical outcomes compared to biological factors.
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Affiliation(s)
- Cristina Mitric
- Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Emad Matanes
- Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.,Gynecologic Oncology Laboratory, Segal Cancer Center, Lady Davis Institute of Medical Research, McGill University, Montreal, Quebec, Canada
| | - Michel Wissing
- Division of Cancer Epidemiology, Department of Oncology, McGill University, Montreal, Quebec, Canada
| | - Zainab Amajoud
- Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Jeremie Abitbol
- Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Amber Yasmeen
- Gynecologic Oncology Laboratory, Segal Cancer Center, Lady Davis Institute of Medical Research, McGill University, Montreal, Quebec, Canada
| | - Vanessa López-Ozuna
- Gynecologic Oncology Laboratory, Segal Cancer Center, Lady Davis Institute of Medical Research, McGill University, Montreal, Quebec, Canada
| | - Neta Eisenberg
- Department of Obstetrics and Gynecology, Hôpital Maisonneuve-Rosemont, Université de Montréal, Montreal, Quebec, Canada
| | - Ido Laskov
- Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Susie Lau
- Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Shannon Salvador
- Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada
| | - Walter H Gotlieb
- Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.,Gynecologic Oncology Laboratory, Segal Cancer Center, Lady Davis Institute of Medical Research, McGill University, Montreal, Quebec, Canada
| | - Liron Kogan
- Division of Gynecologic Oncology, Jewish General Hospital, McGill University, Montreal, Quebec, Canada.,Gynecologic Oncology Laboratory, Segal Cancer Center, Lady Davis Institute of Medical Research, McGill University, Montreal, Quebec, Canada.,Obstetrics and Gynecology, Shaare Zedek Medical Center, Hebrew university of Jerusalem, Jerusalem, Israel
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Cao WH, Su YJ, Liu NQ, Peng Y, Diao C, Cheng RC. Role of Ca²⁺ in Inhibiting Ischemia-Induced Apoptosis of Parathyroid Gland Cells in New Zealand White Rabbits. Med Sci Monit 2020; 26:e920546. [PMID: 32071284 PMCID: PMC7043353 DOI: 10.12659/msm.920546] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Accepted: 12/03/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Hypoparathyroidism is a common complication after thyroidectomy. Calcium supplementation can relieve these symptoms, but it is not clear whether it can protect the parathyroid glands. This study aimed to verify whether Ca²⁺ inhibits the apoptosis of parathyroid cells following ischemic injury. MATERIAL AND METHODS A rabbit model of parathyroid gland ischemic injury was established. The blood calcium concentrations were measured by colorimetry. The parathyroid hormone (PTH) levels were measured by enzyme-linked immunosorbent assay (ELISA). The parathyroid tissues were observed by hematoxylin and eosin (H&E) staining and the TdT-mediated dUTP nick-end labeling (TUNEL) assay. Western blotting was used to quantify the levels of the following proteins: caspase-3 and p38 MAP Kinase (p38 MAPK). RESULTS This study demonstrates that apoptosis can be a part of the pathological changes associated with parathyroid ischemic injury. Calcium supplementation inhibited the apoptosis of parathyroid cells following ischemic injury. There were no significant differences among the serum calcium levels from the Sham operation (Sham), the Control group (CG), or the Calcium supplementation group (CSG) after 24 h, 72 h, and 168 h of treatment. PTH levels in the CG were significantly higher than in the CSG at 24 h and 72 h after treatments. The apoptosis rate of parathyroid cells from rabbits in the CSG was significantly lower than that of those from rabbits in the CG at 24 h and 72 h after the treatment. Calcium supplementation inhibited p38 MAPK and caspase-3 expression. CONCLUSIONS This study demonstrates that calcium supplementation inhibited the apoptosis of parathyroid cells following ischemic injury.
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Affiliation(s)
- Wei-han Cao
- Department of Ultrasound, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, P.R. China
| | - Yan-jun Su
- Department of Thyroid Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, P.R. China
| | - Nian-qiu Liu
- Department of Breast Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, P.R. China
| | - Ying Peng
- Department of Thyroid Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, P.R. China
| | - Chang Diao
- Department of Thyroid Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, P.R. China
| | - Ruo-chuan Cheng
- Department of Thyroid Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, P.R. China
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Tørring ML, Falborg AZ, Jensen H, Neal RD, Weller D, Reguilon I, Menon U, Vedsted P, Almberg SS, Anandan C, Barisic A, Boylan J, Cairnduff V, Donnelly C, Fourkala EO, Gavin A, Grunfeld E, Hammersley V, Hawryluk B, Kearney T, Kelly J, Knudsen AK, Lambe M, Law R, Lin Y, Malmberg M, Moore K, Turner D, White V. Advanced‐stage cancer and time to diagnosis: An International Cancer Benchmarking Partnership (ICBP) cross‐sectional study. Eur J Cancer Care (Engl) 2019; 28:e13100. [DOI: 10.1111/ecc.13100] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 04/17/2019] [Accepted: 05/01/2019] [Indexed: 12/01/2022]
Affiliation(s)
- Marie L. Tørring
- Department of Anthropology, School of Culture and Society Aarhus University Højbjerg Denmark
| | - Alina Z. Falborg
- Research Unit for General Practice Research Centre for Cancer Diagnosis in Primary Care Aarhus C Denmark
| | - Henry Jensen
- Research Unit for General Practice Research Centre for Cancer Diagnosis in Primary Care Aarhus C Denmark
| | - Richard D. Neal
- Academic Unit of Primary Care, Leeds Institute of Health Sciences University of Leeds Leeds UK
| | - David Weller
- Centre for Population Health Sciences University of Edinburgh Edinburgh UK
| | | | - Usha Menon
- Gynaecological Cancer Research Centre, Institute for Women's Health University College London London UK
| | - Peter Vedsted
- Research Unit for General Practice Research Centre for Cancer Diagnosis in Primary Care Aarhus C Denmark
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12
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Meltzer CJ, Irish J, Angelos P, Busaidy NL, Davies L, Dwojak S, Ferris RL, Haugen BR, Harrell RM, Haymart MR, McIver B, Mechanick JI, Monteiro E, Morris JC, Morris LGT, Odell M, Scharpf J, Shaha A, Shin JJ, Shonka DC, Thompson GB, Tuttle RM, Urken ML, Wiseman SM, Wong RJ, Randolph G. American Head and Neck Society Endocrine Section clinical consensus statement: North American quality statements and evidence-based multidisciplinary workflow algorithms for the evaluation and management of thyroid nodules. Head Neck 2018; 41:843-856. [PMID: 30561068 DOI: 10.1002/hed.25526] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 09/28/2018] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Care for patients with thyroid nodules is complex and multidisciplinary, and research demonstrates variation in care. The objective was to develop clinical guidelines and quality metrics to reduce unwarranted variation and improve quality. METHODS Multidisciplinary expert consensus and modified Delphi approach. Source documents were workflow algorithms from Kaiser Permanente Northern California and Cancer Care of Ontario based on the 2015 American Thyroid Association management guidelines for adult patients with thyroid nodules and differentiated thyroid cancer. RESULTS A consensus-based, unified preoperative, perioperative, and postoperative workflow was developed for North American use. Twenty-one panelists achieved consensus on 16 statements about workflow-embedded process and outcomes metrics addressing safety, access, appropriateness, efficiency, effectiveness, and patient centeredness of care. CONCLUSION A panel of Canadian and United States experts achieved consensus on workflows and quality metric statements to help reduce unwarranted variation in care, improving overall quality of care for patients diagnosed with thyroid nodules.
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Affiliation(s)
- Charles J Meltzer
- The Permanente Medical Group, Kaiser Permanente, Santa Rosa, California
| | - Jonathan Irish
- Department of Otolaryngology, Head and Neck Surgery/Surgical Oncology, Princess Margaret Cancer Centre, University Health Network/University of Toronto, Toronto, Ontario, Canada
| | - Peter Angelos
- Department of Surgery, MacLean Center for Clinical Ethics, The University of Chicago Medicine, Chicago, Illinois
| | - Naifa L Busaidy
- Department of Endocrine Neoplasia & Hormonal Disorders, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Louise Davies
- The VA Outcomes Group, Department of Veterans Affairs Medical Center, White River Junction, Vermont.,Section of Otolaryngology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.,The Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire
| | - Sunshine Dwojak
- Northwest Permanente Medicine, Kaiser Permanente, Portland, Oregon
| | - Robert L Ferris
- Division of Head and Neck Surgery, Department of Otolaryngology, University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Bryan R Haugen
- Division of Endocrinology, University of Colorado School of Medicine, Aurora, Colorado
| | - Richard M Harrell
- Departments of Integrative Endocrine Surgery and Pathology, Memorial Healthcare System, Hollywood, Florida
| | - Megan R Haymart
- Division of Metabolism, Endocrinology, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan
| | - Bryan McIver
- Department of Biostatistics and Bioinformatics, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Jeffrey I Mechanick
- Divisions of Cardiology and Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, Mount Sinai School of Medicine, New York, New York
| | - Eric Monteiro
- Department of Otolaryngology-Head and Neck Surgery, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - John C Morris
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, Minnesota
| | - Luc G T Morris
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael Odell
- Department of Otolaryngology-Head and Neck Surgery, The Ottawa Hospital, University of Ottawa, Ottawa, Ontario, Canada
| | - Joseph Scharpf
- Department of Otolaryngology-Head and Neck Surgery, Head and Neck Institute, Cleveland Clinic, Cleveland, Ohio
| | - Ashok Shaha
- Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jennifer J Shin
- Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts
| | - David C Shonka
- Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health System, Charlottesville, Virginia
| | | | - R Michael Tuttle
- Department of Medicine, Endocrinology Service, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mark L Urken
- Department of Otolaryngology Head and Neck Surgery, Mount Sinai Beth Israel, New York, New York.,Icahn School of Medicine, Mount Sinai, New York, New York.,Thyroid, Head and Neck Cancer Foundation, New York, New York
| | - Sam M Wiseman
- Department of Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Richard J Wong
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Gregory Randolph
- Department of Otolaryngology, Massachusetts General Hospital, Boston, Massachusetts
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13
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Owens PW, McVeigh TP, Fahey EJ, Bell M, Quill DS, Kerin MJ, Lowery AJ. Differentiated Thyroid Cancer: How Do Current Practice Guidelines Affect Management? Eur Thyroid J 2018; 7:319-326. [PMID: 30574463 PMCID: PMC6276740 DOI: 10.1159/000493261] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 08/24/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND International best-practice guidelines recommend completion thyroidectomy and radioiodine remnant ablation (RRA) for patients with differentiated thyroid cancer (DTC) > 4 cm or with specific risk factors. Patients with DTC < 1 cm without risk factors are recommended for lobectomy alone. Indications for aggressive surgery and RRA are less clearly defined for tumours measuring 1-4 cm. A personalised approach to decision-making is recommended. OBJECTIVES This study assesses therapeutic approaches to DTC as compared to the current British Thyroid Association (BTA) clinical practice guidelines. We ascertained the effect of equivocal guidance in the 1-4 cm tumour cohort on contemporary practice patterns. METHODS Data were obtained from a prospectively maintained thyroid cancer database of patients treated for DTC in a tertiary referral centre at the University Hospital Galway. Consecutive patients attending a dedicated thyroid cancer clinic between August 2014 and August 2017 were included. Clinicopathological characteristics and management strategies were assessed. RESULTS Ninety-four percent (n = 168/178) of patients were surgically managed in adherence with guidelines. A minority (n = 10) received surgery not aligned with guidelines. Ninety-seven percent (n = 172/178) of RRA treatment decisions were in accordance with guidelines. The BTA guidelines recommended a personalised decision-making approach for 18.0% (n = 32) and 44.9% (n = 80) of surgery and RRA treatment decisions, respectively. The more aggressive, treatment-driven approach was typically favoured by the multidisciplinary team, with 97% (n = 31/32) undergoing completion thyroidectomy and 100% (n = 80) proceeding to RRA. CONCLUSIONS Management of DTC at our institution closely adheres to contemporary clinical practice guidelines. The finding of more aggressive management in those requiring a personalised decision-making approach highlights the requirement for improved risk stratification in this cohort to ratio-nalise management strategies.
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Affiliation(s)
- Patrick W. Owens
- Discipline of Surgery, Lambe Institute for Translational Research, NUI Galway, Galway, Ireland
- *Patrick W. Owens, Lambe Institute for Translational Research, NUI Galway, Costello Road, Galway H91 V4AY (Ireland), E-Mail
| | - Terri P. McVeigh
- Discipline of Surgery, Lambe Institute for Translational Research, NUI Galway, Galway, Ireland
- Cancer Genetics Unit, The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Eoin J. Fahey
- Discipline of Surgery, Lambe Institute for Translational Research, NUI Galway, Galway, Ireland
| | - Marcia Bell
- Department of Endocrinology, Galway University Hospital, Galway, Ireland
| | - Denis S. Quill
- Discipline of Surgery, Lambe Institute for Translational Research, NUI Galway, Galway, Ireland
| | - Michael J. Kerin
- Discipline of Surgery, Lambe Institute for Translational Research, NUI Galway, Galway, Ireland
| | - Aoife J. Lowery
- Discipline of Surgery, Lambe Institute for Translational Research, NUI Galway, Galway, Ireland
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14
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Foki E, Fochtmann-Frana A, Haymerle G, Nemec S, Loader B, Perisanidis C, Erovic BM. Computed tomography accelerates staging in patients with Merkel cell carcinoma. Eur Arch Otorhinolaryngol 2018; 275:3059-3066. [PMID: 30267216 PMCID: PMC6244682 DOI: 10.1007/s00405-018-5150-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 09/15/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE No imaging algorithms for diagnostic imaging in patients suffering from Merkel cell carcinoma (MCC) have been established so far and thus staging work-up is challenging. Long presentation-to-treatment intervals determine further treatment course and, consequently, have an impact on clinical outcome in patients with MCC. METHODS In this retrospective study, diagnostic imaging of 37 MCC patients was analyzed. CT, ultrasound, and PET/PET-CT imaging for primary staging work-up with time frames from patients´ initial presentation and imaging until completion of tumor staging were analyzed. RESULTS Tumor staging could be completed earlier when (1) less examinations (35 vs. 42 days) were carried out or (2) computed tomography was used as the initial imaging modality (28 vs. 35 days). Furthermore, CT imaging, when used as the initial imaging study, was linked to less follow-up imaging (3 vs. 6). CONCLUSION Computed tomography as the first-staging imaging technique in MCC patients leads to less follow-up studies and fastest completion of tumor staging.
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Affiliation(s)
- Elisabeth Foki
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Alexandra Fochtmann-Frana
- Department of Surgery, Clinical Division of Plastic and Reconstructive Surgery, Medical University of Vienna, Vienna, Austria
| | - Georg Haymerle
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Stefan Nemec
- Department of Radiology, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria
| | - Benjamin Loader
- Department of Otorhinolaryngology, Head and Neck Surgery, Rudolfstiftung Teaching Hospital, Vienna, Austria
| | - Christos Perisanidis
- Department of Oral and Maxillofacial Surgery, Medical University of Vienna, Vienna, Austria
| | - Boban M Erovic
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
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15
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Beksaç K, Aktoz F, Örgül G, Çelik HT, Özgü-Erdinç AS, Beksaç MS. Pregnancy in papillary thyroid cancer survivors. J Turk Ger Gynecol Assoc 2018; 19:94-97. [PMID: 29469032 PMCID: PMC5994817 DOI: 10.4274/jtgga.2017.0057] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To evaluate “papillary thyroid carcinoma-pregnancy” interaction among cancer survivors. MATERIAL AND METHODS The clinical records of 8 pregnant women who received treatment for papillary thyroid cancer before their pregnancy were evaluated. Clinical features, pregnancy/perinatal outcomes and high-risk factors were compared with 45 controls who were randomly assigned from the institutional perinatal medicine database. RESULTS Patients in the cancer group were older than the control group (34.3 vs 29.8 years). The cesarean section rate was higher (62.5% vs 33.3%) and the APGAR scores at the 1st and 5th minutes were lower in the cancer group. CONCLUSION Management of pregnancies with papillary thyroid cancer treatment and follow-up requires a multidisciplinary approach with careful antenatal care and perinatal surveillance. Patients who have received papillary thyroid cancer treatment can safely undergo pregnancy.
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Affiliation(s)
- Kemal Beksaç
- Clinic of General Surgery, University of Health Sciences, Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
| | - Fatih Aktoz
- Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Gökçen Örgül
- Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Hasan Tolga Çelik
- Division of Neonatology, Department of Pediatrics, Hacettepe University School of Medicine, Ankara, Turkey
| | - A Seval Özgü-Erdinç
- Deparment of Reproductive Endocrinology, University of Health Sciences, Dr. Zekai Tahir Burak Zekai Tahir Burak Women Health Health Practice and Research Center, Ankara, Turkey
| | - M Sinan Beksaç
- Division of Perinatology, Department of Obstetrics and Gynecology, Hacettepe University School of Medicine, Ankara, Turkey
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16
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Flemming JA, Nanji S, Wei X, Webber C, Groome P, Booth CM. Association between the time to surgery and survival among patients with colon cancer: A population-based study. EUROPEAN JOURNAL OF SURGICAL ONCOLOGY 2017; 43:1447-1455. [PMID: 28528190 DOI: 10.1016/j.ejso.2017.04.014] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 04/03/2017] [Accepted: 04/26/2017] [Indexed: 11/28/2022]
Abstract
Factors associated with time-to-surgery (TTS) and survival in colon cancer has not been well studied. Cancer Care Ontario recommends surgery within 42 days of diagnosis and that 90% of patients meet this benchmark. We describe factors associated with TTS and survival in routine clinical practice. METHODS Retrospective population-based cohort study of patients receiving elective colonic resection after diagnosis of colon cancer in Ontario, Canada from 2002 to 2008 followed until 2012. Factors associated with TTS were identified using multivariate log-binomial and Quantile regression at 42 days and 90th percentiles. The association between TTS and cancer-specific (CSS) and overall survival (OS) were examined using multivariate Cox regression. RESULTS 4326 patients; median age 71 years and 52% male. Median TTS was 24 days (IQR 14-37); at the 90th percentile 56 days. Factors associated with TTS ≥ 42 days and >90th percentile included older age, co-morbid illness, surgeon volume, and stage I disease (P < 0.05 for all). In patients whose TTS was either at 42 days or 90th percentile, those ≥80 years old waited two weeks longer than those <60 years, individuals with co-morbid illness waited 10 days longer than without co-morbidity, and patients with stage I disease waited 10 days longer than those with stage IV disease (P < 0.05 for all). Delay in TTS > 42 days or >90th percentile was not associated with OS or CSS. CONCLUSION Age, co-morbidity, and stage of cancer are associated with TTS. There was no association between TTS and CSS or OS.
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Affiliation(s)
- J A Flemming
- Department of Medicine, Queen's University, Kingston, Canada; Department of Public Health Sciences, Queen's University, Kingston, Canada; Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Canada.
| | - S Nanji
- Department of Surgery, Queen's University, Kingston, Canada; Department of Oncology, Queen's University, Kingston, Canada
| | - X Wei
- Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Canada
| | - C Webber
- Department of Public Health Sciences, Queen's University, Kingston, Canada; Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Canada
| | - P Groome
- Department of Public Health Sciences, Queen's University, Kingston, Canada; Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Canada
| | - C M Booth
- Department of Medicine, Queen's University, Kingston, Canada; Department of Public Health Sciences, Queen's University, Kingston, Canada; Department of Oncology, Queen's University, Kingston, Canada; Division of Cancer Care and Epidemiology, Queen's Cancer Research Institute, Kingston, Canada
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17
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Completeness of ultrasound reporting impacts time to biopsy for benign and malignant thyroid nodules. Am J Surg 2017; 213:931-935. [DOI: 10.1016/j.amjsurg.2017.03.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 01/09/2017] [Accepted: 03/21/2017] [Indexed: 11/18/2022]
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18
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Oude Ophuis C, Verhoef C, Rutkowski P, Powell B, van der Hage J, van Leeuwen P, Voit C, Testori A, Robert C, Hoekstra H, Grünhagen D, Eggermont A, van Akkooi A. The interval between primary melanoma excision and sentinel node biopsy is not associated with survival in sentinel node positive patients – An EORTC Melanoma Group study. Eur J Surg Oncol 2016; 42:1906-1913. [DOI: 10.1016/j.ejso.2016.05.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 04/15/2016] [Accepted: 05/15/2016] [Indexed: 11/17/2022] Open
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Tsang GFZ, McKnight CL, Kim LM, Lee JM. Exploring the psychological morbidity of waiting for sinus surgery using a mixed methods approach. J Otolaryngol Head Neck Surg 2016; 45:36. [PMID: 27266530 PMCID: PMC4897809 DOI: 10.1186/s40463-016-0149-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2015] [Accepted: 05/31/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patients with chronic rhinosinusitis (CRS) often have to endure significant wait times for endoscopic sinus surgery (ESS). The pyschiatric impact of placement on a waitlist for ESS has not been explored. METHODS Questionnaires measuring CRS symptom severity and health-related anxiety and stress (SNOT-22, HADS, WPAI-GH) were sent to patients diagnosed with CRS and currently on a waitlist for ESS. Fifteen representative waitlisted patients participated in one-on-one semi-structured interviews discussing their experience with their wait for ESS. A deductive thematic analysis was used to interpret the interview data using a quantitative driven mixed methods analysis. RESULTS Participants waiting for ESS reported worsening clinical symptomatology during their waiting period. Participants reported waitlist and CRS impact on both work and social aspects of their lives. The HADS scale showed no overall significant level of depression or anxiety in the HADS screening questionnaire. The qualitative data describe the effects of the symptom burden of CRS. CONCLUSIONS Patients waitlisted for ESS did not demonstrate any significant level of psychiatric distress, however variability exists. The qualitative arm of this study elucidates how patients cope with their wait.
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Affiliation(s)
- Gordon Fung-Zak Tsang
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, ON, Canada
| | - Carmen L McKnight
- Department of Otolaryngology-Head & Neck Surgery, St. Michael's Hospital, Toronto, ON, Canada
| | | | - John M Lee
- Department of Otolaryngology-Head & Neck Surgery, University of Toronto, Toronto, ON, Canada. .,Department of Otolaryngology-Head & Neck Surgery, St. Michael's Hospital, Toronto, ON, Canada.
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Lodewijk L, Vriens MR, Vorselaars WMCM, van der Meij NTM, Kist JW, Barentsz MW, Verkooijen HM, Rinkes IHMB, Valk GD. SAME-DAY FINE-NEEDLE ASPIRATION CYTOLOGY DIAGNOSIS FOR THYROID NODULES ACHIEVES RAPID ANXIETY DECREASE AND HIGH DIAGNOSTIC ACCURACY. Endocr Pract 2015; 22:561-6. [PMID: 26720251 DOI: 10.4158/ep151036.or] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The time between the moment of referral for the diagnostic workup for thyroid nodules and the outcome can be worrisome for patients. In general, patients experience high levels of anxiety during the evaluation of a lesion suspicious for cancer. Therefore, the implementation of same-day fine-needle aspiration cytology (FNAC) diagnosis is becoming standard-of-care for many solid tumors. Our aim was to assess the feasibility of same-day FNAC diagnosis for thyroid nodules and to assess patient anxiety during the diagnostic process. METHODS For feasibility of same-day FNAC diagnosis, we assessed the proportion of patients receiving a diagnosis at the end of the visit. Accuracy was measured by comparing histology with the FNAC result. Patient anxiety was measured by the State Trait Anxiety Inventory at 6 moments during the diagnostic workup. RESULTS Of the 131 included patients, 112 (86%) were female, and the mean age was 53 years. All patients, except those with a nondiagnostic FNAC result (n = 26; 20%), had a diagnosis at the end of the day. There were only two discordant results. Anxiety levels at the beginning of the day were high throughout the group, State Trait Anxiety Inventory (STAI) score 43.1 (SD 2.0) and decreased significantly more in patients with a benign FNAC result (STAI score 30.2), compared to patients with a malignant or indeterminate result (STAI score 39.6). CONCLUSION Distress of patients with a thyroid nodule undergoing same-day FNAC diagnostics was high. Same-day FNAC diagnosis is feasible and accurate for the evaluation of thyroid nodules. Therefore, same-day FNAC diagnosis seems a safer, more patient-friendly approach to diagnose thyroid nodules.
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21
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Applying industrial process improvement techniques to increase efficiency in a surgical practice. Surgery 2014; 156:752-8. [DOI: 10.1016/j.surg.2014.06.059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Accepted: 06/24/2014] [Indexed: 11/20/2022]
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22
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van Harten MC, de Ridder M, Hamming-Vrieze O, Smeele LE, Balm AJ, van den Brekel MW. The association of treatment delay and prognosis in head and neck squamous cell carcinoma (HNSCC) patients in a Dutch comprehensive cancer center. Oral Oncol 2014; 50:282-90. [DOI: 10.1016/j.oraloncology.2013.12.018] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2013] [Revised: 12/13/2013] [Accepted: 12/17/2013] [Indexed: 01/10/2023]
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Lee MH, Kim DH, Yu HS. The effect of guided imagery on stress and fatigue in patients with thyroid cancer undergoing radioactive iodine therapy. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:130324. [PMID: 24369476 PMCID: PMC3857993 DOI: 10.1155/2013/130324] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2013] [Revised: 10/22/2013] [Accepted: 10/22/2013] [Indexed: 12/20/2022]
Abstract
This study was conducted to evaluate the effects of guided imagery on stress and fatigue in patients undergoing radioactive iodine therapy after thyroidectomy in Korea. Participants were 84 individuals (44 for experimental group and 40 for control group) with thyroid cancer. The experimental group listened to a guided imagery CD once a day for 4 weeks. Global Assessment of Recent Stress and Revised Piper Fatigue Scale were self-administered, and heart rate variability was measured at three time points; prior to intervention (T1), just before intervention (T2) and 1 week later after intervention (T3). Heart rate variability was consisted of Standard Deviation of all NN interval (SDNN), Total Power (TP), Low Frequency (LF), and High Frequency (HF). There were significant decreases in stress (F = 28.45, P < 0.001) and fatigue (F = 26.17, P < 0.001) over time in the experimental group compared to the control group. Heart rate variability changed over time in the experimental group relative to the control group; SDNN (F = 6.68, P = 0.002), TP (F = 5.29, P = 0.006), LF (F = 4.58, P = 0.012), and HF (F = 3.71, P = 0.026). From the results of this study guided imagery can be recommended as an effective intervention to thyroid cancer patients with stress and fatigue.
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Affiliation(s)
- Mi Hye Lee
- Department of Nursing, College of Nursing, Pusan National University, Yangsan-si, Gyeongsangnam-do 626-870, Republic of Korea
| | - Dong-Hee Kim
- Department of Nursing, College of Nursing, Pusan National University, Yangsan-si, Gyeongsangnam-do 626-870, Republic of Korea
| | - Hak Sun Yu
- Department of Parasitology, School of Medicine, Pusan National University, Yangsan-si, Gyeongsangnam-do 626-870, Republic of Korea
- Immunoregulatory Therapeutics Group in Brain Busan 21 Project, Busan Metropolitan City, Yeonje-gu 611-735, Republic of Korea
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Brake M, Moore P, Taylor SM, Trites J, Murray S, Hart R. Expectantly waiting: a survey of thyroid surgery wait times among Canadian otolaryngologists. J Otolaryngol Head Neck Surg 2013; 42:47. [PMID: 24025587 PMCID: PMC3849613 DOI: 10.1186/1916-0216-42-47] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Accepted: 09/02/2013] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Our objective is to highlight discrepancies between actual wait times and perceived appropriate wait times for various thyroid pathologies among Otolaryngology-Head and Neck Surgeons in Canada; and to identify specific diagnoses/pathologies where wait times could be improved. METHODS A questionnaire was distributed to all practicing CSO-HNS members. Questions focused on actual wait times for initial consults and surgery within individual practices, in the setting of various thyroid pathologies. Respondents were also asked to state wait times that they felt were appropriate for each scenario. Wilcoxon signed-rank tests were performed to determine statistically significant differences between actual and appropriate wait times. RESULTS For most scenarios, the actual wait times were significantly longer than most physicians felt were appropriate; these scenarios included time to initial consult for undiagnosed nodules, time to surgery for confirmed malignancies, and time to completion thyroidectomy for surgically confirmed malignancies. CONCLUSIONS Wait times for thyroid consults and surgeries in Canada are longer than physicians feel are appropriate. The authors hope that this survey may spur a move towards a national consensus on appropriate wait times for the treatment of thyroid pathology.
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Affiliation(s)
- Maria Brake
- Room 826, Victoria Building, QEII Health Sciences Centre, 1278 Tower Road, Halifax, NS B3H-2Y9, Canada.
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