This study was done to identify basic information in classifying nursing diagnoses and nursing interventions needed for the further development of computerized nursing care plans. Data were collected by reviewing charts of 123 home care clients who had active disease, for whom at least one nursing diagnosis was on the chart, and who had been discharged. Data included demographics, medical orders, nursing diagnoses and nursing interventions. The results of the study, which found the most frequent medical diagnoses to be cancer (40.7%) and brain injury (26.8%), showed that 'Impaired Skin Integrity'(18.3%), 'Risk for Infection'(15.0%), 'Altered Nutrition, Less than Body Requirements'(13.8%), and 'Risk for Impaired Skin Integ rity'(9.9%) were the most frequent nursing diagnoses. 'Pressure Ulcer Care'(28.4%) was the most frequent intervention for 'Impaired Skin Integrity', 'Infection Protection'(16.0%) for 'Risk of Infection', 'Nutrition Counseling'(26.8%) for 'Altered Nutrition' and 'Positioning'(22.0%) for 'Risk for Skin Integrity Impairment', Comparison of interventions with the Nursing Intervention Classification(NIC) showed that the most frequent interventions were in the domain 'Basic Physiological' (33.94%), followed by 'Behavioral'(27.8%), and 'Complex Physiological' (22.6%). Interventions related to teaching family to give care at home could not be classified in the NIC scheme. Examination of the frequency of NIC interventions showed that for the domain 'Activity & Exercise Management', 75% of the interventions were used, but for seven domains, none were used. For the domain 'Immobility Management', 93% of the times that an intervention was used, it was 'Positioning', for the domain 'Tissue Perfusion Management', 'IV Therapy' (59.1%) and for the domain 'Elimination Management', 'Tube Care: Urinary'(54.0%). The nursing diagnoses 'Altered Urinary Elimination' and 'Im paired Physical Mobility' were both used with these clients, but neither 'Fluid Volume Deficit' nor 'Risk of Fluid Volume Deficit' were used rather 'IV Therapy' was an intervention for 'Altered Nutrition, Less than Body Requirements', A comparison of clients with cancer and those with brain injury showed that interventions for the nursing diagnosis 'Impaired Skin Integrity' were more frequent for the clients with cancer, interventions for 'Risk of Infection' were similar for the two groups but for clients with cancer there were more interventions for' Altered Nutrition'. Examination of the nursing diagnoses leading to the intervention 'Positioning' showed that for both groups, it was either 'Impaired Skin Integrity' or 'Risk for Skin Integrity Impairment'. This study identified a need for further refinement in the classification of nursing interventions to include those unique to home care and that for the purposes of computerization identification of the nursing activities to be included in each intervention needs to be done.
Mannan, Mohd Nazir;Kazmi, Munawwar Husain;Zakir, Mohammad;Naikodi, Mohammed Abdul Rasheed;Zahid, Uzma;Siddiqui, Javed Inam
CELLMED
/
v.10
no.2
/
pp.16.1-16.8
/
2020
Standardization of drug deals with confirmation of drug identity and determination of drug quality and purity. Unani herbal formulations are used in traditional medicine for the treatment of various diseases. Cancer is a disease which causes abnormal, uncontrolled growth of body tissue or cells, which tend to proliferate in an uncontrolled way. Spread of cancer from site of origin to other organs of the body is called metastasis. It is a hyper proliferative disorder involving, transformation, dysregulation of apoptosis, invasion and angiogenesis. The present study aimed to standardize a classical Unani formulation (CUF) described as anticancer properties. The CUF has been used for anti-cancerous activity (Dāfi'-i-saraṭān) in human population by Unani physicians for centuries. The standardization parameters carried out for classical Unani formulation are pharmacognostical studies, physicochemical parameters, high-performance thin layer chromatography (HPTLC), microbial load, aflatoxins, and heavy metals revealing specific identities and to evaluate Pharmacopoeial standards. Experiment and the data obtained established the Pharmacopoeial standards for this formulation for identification and quality control purpose. The CUF has been successfully standardized and standard operating procedures (SOPs) for its preparation has been laid down which may serve as a standard reference in future. The standardization data of this formulation may be used as a standard guideline for preparation of the formulation in future.
Background: Health disparities exist among and within countries, while developing and low income countries suffer more. The aim of this study was to quantify cancer disparities with regard to socioeconomic position (SEP) in 22 districts of Tehran, Iran. Method: According to the national cancer registry, 7599 new cancer cases were recorded within 22 districts of Tehran in 2008. Based on combined data from census and a population-based health equity study (Urban HEART), socioeconomic position (SEP) was calculated for each district. Index of disparity, absolute and relative concentration indices (ACI & RCI) were used for measuring disparities in cancer incidence. Results: The overall cancer age standardised rate (ASR) was 117.2 per 100,000 individuals (120.4 for men and 113.5 for women). Maximum ASR in both genders was seen in districts 6, 3, 1 and 2. Breast, colorectal, stomach, skin and prostate were the most common cancers. Districts with higher SEP had higher ASR (r=0.9, p<0.001). Positive ACI and RCI indicated that cancer cases accumulated in districts with high SEP. Female disparity was greater than for men in all measures. Breast, colorectal, prostate and bladder ASR ascended across SEP groups. Negative ACI and RCI in cervical and skin cancers in women indicate their aggregation in lower SEP groups. Breast cancer had the highest absolute disparities measure. Conclusion: This report provides an appropriate guide and new evidence on disparities across geographical, demographic and particular SEP groups. Higher ASR in specific districts warrants further research to investigate the background predisposing factors.
Melanoma is a skin cancer that starts in pigment-producing cells (melanocytes). The death rates of skin cancer like melanoma can be reduced by early detection and diagnosis of diseases. It is common for doctors to spend a lot of time trying to distinguish between skin lesions and healthy cells because of their striking similarities. The detection of melanoma lesions can be made easier for doctors with the help of an automated classification system that uses deep learning. This study presents a new approach for melanoma classification based on an ensemble of deep convolution neural networks and a Log-Gabor filter. First, we create the Log-Gabor representation of the original image. Then, we input the Log-Gabor representation into a new ensemble of deep convolution neural networks. We evaluated the proposed method on the melanoma dataset collected at Yonsei University and Dongsan Clinic. Based on our numerical results, the proposed framework achieves more accuracy than other approaches.
Suh, Hyun Suk;Lee, Taik Jong;Eom, Jin Sub;Ahn, Sei Hyun;Son, Byung Ho
Archives of Plastic Surgery
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v.33
no.5
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pp.570-576
/
2006
Purpose: Skin-sparing mastectomy(SSM) with immediate breast reconstruction is becoming a proved option for early-stage breast cancer patients. Recently, skin-sparing mastectomy with preserving the nipple-areolar complex is becoming popular procedure. Methods: During a 13-month period, from April 2004 to January 2005, 101 cases of immediate breast reconstructions with pedicled TRAM flap were performed after 40 cases of nipple-areolar sparing mastectomies, 57 cases of skin-sparing mastectomies and 4 cases of modified radical mastectomies. Results: During the 11 months follow up period, necrosis of mastectomy skin flap occurred in 17.5%(n=10) after skin-sparing mastectomy and necrosis of mastectomy skin flap and nipple-areolar necrosis occurred in 30%(n=12) after nipple-areolar sparing mastectomy. These complications were healed after simple dressing without any surgical procedure. Conclusion: Nipple-areolar sparing mastectomy and immediate breast reconstruction with TRAM flap is good option for early breast cancer patients and some modifications are needed to reduce skin necrosis.
Lee, Jason Joon Bock;Choi, Jinhyun;Ahn, Sung Gwe;Jeong, Joon;Lee, Ik Jae;Park, Kwangwoo;Kim, Kangpyo;Kim, Jun Won
Radiation Oncology Journal
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v.35
no.2
/
pp.121-128
/
2017
Purpose: To report the results of a correlation analysis of skin dose assessed by in vivo dosimetry and the incidence of acute toxicity. This is a phase 2 trial evaluating the feasibility of intraoperative radiotherapy (IORT) as a boost for breast cancer patients. Materials and Methods: Eligible patients were treated with IORT of 20 Gy followed by whole breast irradiation (WBI) of 46 Gy. A total of 55 patients with a minimum follow-up of 1 month after WBI were evaluated. Optically stimulated luminescence dosimeter (OSLD) detected radiation dose delivered to the skin during IORT. Acute toxicity was recorded according to the Common Terminology Criteria for Adverse Events v4.0. Clinical parameters were correlated with seroma formation and maximum skin dose. Results: Median follow-up after IORT was 25.9 weeks (range, 12.7 to 50.3 weeks). Prior to WBI, only one patient developed acute toxicity. Following WBI, 30 patients experienced grade 1 skin toxicity and three patients had grade 2 skin toxicity. Skin dose during IORT exceeded 5 Gy in two patients: with grade 2 complications around the surgical scar in one patient who received 8.42 Gy. Breast volume on preoperative images (p = 0.001), ratio of applicator diameter and breast volume (p = 0.002), and distance between skin and tumor (p = 0.003) showed significant correlations with maximum skin dose. Conclusions: IORT as a boost was well-tolerated among Korean women without severe acute complication. In vivo dosimetry with OSLD can help ensure safe delivery of IORT as a boost.
Kim, Nam Gyun;Kim, Jun Oh;Park, Young Ji;Kim, Jun Sik;Lee, Yoon Jung;Lee, Kyung Suk
Archives of Craniofacial Surgery
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v.18
no.2
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pp.141-144
/
2017
An odontogenic cutaneous fistula is a pathological communication between the outer skin surface of the face and the oral cavity. Facial cutaneous fistula is a complication of odontogenic infection that is often misdiagnosed with skin infection. We report a rare case, which was diagnosed as basal cell carcinoma based on the biopsy of skin lesions in the patient who had been diagnosed with odontogenic cutaneous fistula. A 64-year-old male patient presented with a cutaneous odontogenic fistula. The patient had undergone surgical extraction of fistula tract and loose tooth before dermatology or plastic surgery consultation. With the biopsy and computed tomography, it was confirmed that fistula and basal cell carcinoma. However, the connection between the fistula and skin cancer was not clear. Positron emission tomography-computed tomography scan was performed and was not detected as other local or distant metastasis. After that, wide excision of the skin lesion was performed. Although skin cancer is not commonly observed, it is necessary to rule out this disease entity by performing biopsy of skin lesions.
Zhu, Hai-Li;Zou, Zhen-Ning;Lin, Pei-Xin;Li, Wen-Xia;Huang, Ye-En;Shi, Xiao-Xin;Shen, Hong
Asian Pacific Journal of Cancer Prevention
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v.16
no.3
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pp.1165-1168
/
2015
Objective: To investigate the incidence of malignant transformation and P53 and P16 expression in teratomatous skin of ovarian mature cystic teratoma. Materials and Methods: Data on ovarian teratoma specimens in nearly 10 years were reviewed. P53 and P16 expression were detected by immunohistochemistry in 25 cases of teratomatous skin of ovarian mature cystic teratoma, 20 cases of squamous cell carcinoma and 2 cases of squamous cell carcinoma originated from teratomatous skin. Results: Of 1913 cases of ovarian mature cystic teratoma in nearly 10 years, only two cases of squamous cell carcinoma were found in teratomatous skin, with malignant transformation rate of 0.1045%. P53 expression was detected in 2 cases squamous cell carcinoma originated from teratomatous skin and P16 overexpression in one. There were no expressions of P53 and P16 in 25 cases of teratomatous skin of ovarian mature cystic teratoma. Of 20 cases of squamous cell carcinoma P53 overexpression (positive rate of 55%) was detected in 11 cases, P16 overexpression (positive rate of 35%) in 7 cases. The positive rates of P53 and P16 expression in squamous cell carcinomas were significantly higher than that in the teratomatous skins (p< 0.001, p= 0.002). Conclusions: There was low risk of malignant transformation in teratomatous skin of ovarian mature cystic teratoma which can be explained by lower P53 and P16 expressionin teratomas than that in squamous cell carcinoma.
Many of the adverse effects of solar UV exposure appear to be directly attributable to damage to epidermal DNA. In particular, cyclobutane pyrimidine dimers (CPD) may initiate mutagenic changes as well as induce signal transduction responses that lead to a loss of skin immune surveillance and micro-destruction of skin structure. Our approach is to reverse the DNA damage using prokaryotic DNA repair enzymes delivered into skin using specially engineered liposomes. T4 endonuclease V encapsulated in liposomes (T4N5 liposome lotion) enhanced DNA repair by shifting repair of CPD from the nucleotide excision to the base excision repair pathway. Following topical application to humans, increased repair limited UV-induction of cytokines, many of which are immunosuppressive. In a recent clinical study, topical treatment of UV-irradiated human skin with T4N5 liposome lotion reduced the suppression of the nickel sulfate contact hypersensitivity response. Similarly, the photoreactivating enzyme enhances repair by directly reversing CPDs after absorbing activating light. Here also treatment of UV-irradiated human skin with photoreactivating enzyme in liposomes and photoreactivating light restored the response to the contact allergen nickel sulfate. These findings confirm in humans the observation in mice that UV induced suppression of contact hypersensitivity is caused in part by CPDs. We have tested the ability of T4N5 liposome lotion to prevent UV-induced skin cancer in patients with xeroderma pigmentosum (XP), who have an elevated incidence of skin cancer resulting from a genetic defect in DNA repair. Daily use of the lotion for one year in a group of 20 XP patients reduced the average number of actinic keratoses by 68% and basal cell cancers by 30% compared to 9 patients in the placebo control group. Delivery of DNA repair enzymes to skin is a promising new approach to photoprotection.
We investigated the apoptotic effects of grape skin extracts (GSE) and related gene expressions in human breast cancer MDA-MB-231 cells cultured in the presence of 0, 0.5, 1 and 1.5 mg/mL of GSE for 72 hours. MTT assay, trypan blue and nuclei staining showed lower cellular mitochondrial activities and increased cell deaths with a higher concentration of GSE (p<0.05). Increased cell number with fragmentated DNA of sub-G1 phase was calculated as a measure of apoptotic cell death by FACS analysis (p<0.05). In particular, apoptotic cell death caused markedly increased in the 1 and 1.5 mg/mL of GSE groups, as revealed by flow cytometry (Annexin V-FITC). RT-PCR analysis was performed on apoptotic and preapoptotic genes. Expression of the apoptosis suppressor gene bcl-2 significantly decreased, proapoptotic gene bax was significantly increased and procaspase-3 showing the presence of caspase-3 significantly decreased (p<0.05). Furthermore, bcl-2/bax ratio which is considered to be an important indicator of apoptosis, significantly decreased in a concentration-dependent manner (p<0.05). These results indicated that GSE induces apoptosis in MDA-MB-231 human breast cancer cells.
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