فهرست مطالب

  • Volume:12 Issue:8, 2019
  • تاریخ انتشار: 1398/06/11
  • تعداد عناوین: 6
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  • Tayebeh Karimi, Masoud Bahrami *, Ghasem Yadegarfar Page 1
    Context
    Administering chemotherapy drugs in patients with cancer is a complicated and risky process that may have the potential to harm patients and the healthcare team if not done safely.
    Objectives
    This study aimed to evaluate the quality of current clinical guidelines for the administration of chemotherapy drugs by using the appraisal of guidelines for research & evaluation II (AGREE II) tool.
    Evidence Acquisition: After searching through authoritative databases and publishing clinical guidelines by institutions, the articles which were published between 2007 to August 2018 with selected keywords were reviewed and the clinical guidelines were evaluated independently by 5 experts using AGREE II tool based on the inclusion and exclusion criteria. The consensus between appraisers was examined using the ICC (intraclass correlation coefficient).
    Results
    Among 51 clinical guidelines, 4 of them were matched with the inclusion criteria. All 4 clinical guidelines had a high level of quality, with a minimum score above 60% in their 5 domains. Domain 1(scope and purpose) obtained the highest score (95.27 %) and domain 3 (rigor of development) obtained the lowest score (84.89%). The degree of agreement between evaluators was very good (0.84 – 0.95).
    Conclusions
    The overall quality of current clinical guidelines for administering chemotherapy drugs which were evaluated by AGREE II tool, is satisfactory. Therefore, their clinical implementation is recommended to the entire health care team and nurses working in oncology departments, in order to improve the safety of patients and the health care team, and also to prevent the complications of chemotherapy
    Keywords: Administration, Chemotherapy, Cancer, Clinical Guidelines, Appraisal of Guidelines for Research & Evaluation II(AGREE II) Tool
  • Leila Nassiripour, Mohammadreza Amirsadri, Maryam Tabatabaeian, Mohammad Reza Maracy, * Page 2
    Background
    Around 80% of the all non-melanoma skin cancer cases suffer from basal cell carcinoma (BCC). Mohs surgery is one of the common method used for treatment in recent years. There are several treatment methods for primary BCC. One of these methods is Mohs micrographic surgery (Mohs surgery), which has become popular in recent years.
    Objectives
    The aim of this study was to investigate 4-year recurrence and factors affecting the recurrence of BCC patients after Mohs surgery.
    Methods
    This is a retrospective cohort study. The study population included all BCCs, who underwent Mohs surgery in Alzarha Hospital in Isfahan between 2007 and 2014, and were monitored for recurrence for 4 years. Cox regression analysis was used to determine factors affecting time recurrence.
    Results
    The most and least frequent locations of this disease are nose (30.3%) and body (0.5%). The most common locations for recurrence are scalp (50%), nose (15%), and around the eyes (15%). The 4-year recurrence frequency of BCC after Mohs surgery was 0.9%. Cox regression analysis relationship between determining factors affecting time recurrence was not significance.
    Conclusions
    The causes of recurrence can include the less use of protective equipment in front of sunlight or low precision of doctors in the lesion surgery in locations of the body, arms, feet, head, neck, hands, legs or genital organs, and other parts of the body.
    Keywords: Basal Cell Carcinoma, Mohs Micrographic Surgery, Recurrence, Cost
  • Zahra Khazir *, Mohammad Ali Morowatisharifabad, Aliakbar Vaezi, Behnaz Enjezab, Fatemeh Yari, Hossein Fallahzadeh Page 3
    Background
    Mammography is one of the best methods to screen breast cancer. Because mammography screening is not entirely under the control of the person, the study of perceived behavioral control (PBC) is valuable in this regard.
    Objectives
    The aim of this study was to investigate PBC in mammography in women in Khorramabad, Lorestan province, Iran (550 kilometers north of Persian Gulf).
    Methods
    In this qualitative study conducted using semi-structured and in-depth interviews, 22 women, a gynecologist, and a general surgeon were interviewed purposively. The interviews were recorded, transcribed, and analyzed, using the directed qualitative content analysis. The MAXQDA10 software was used to analyze the data.
    Results
    Two categories, namely facilitators and barriers to mammography screening and 5 subcategories, namely individual facilitators, social facilitators, psychosocial barriers, barriers related to mammography technique, and structural barriers were drawn from the data. Individual facilitators included having faith and heart belief in God (Faith in God was a comfort for the participants and the acceptance of God’s favor), family support, and follow-up; the only social facilitator drawn was respecting the rights of the referring people; psychosocial barriers were embarrassment, fear of breast cancer diagnosis, and belief in fate; the barriers related to mammography technique were radiation and painful mammography and lack of insurance; and high costs and long wait in public mammography centers were drawn as structural barriers.
    Conclusions
    The results of this study provided useful information about the experiences regarding mammography. Psychological barriers may be reduced by changing women’s knowledge and attitudes toward mammography, as well as by changing the national health system infrastructure. It is also recommended to strengthen cultural and religious beliefs along with holding training programs regarding mammography performing.
    Keywords: Breast Cancer Prevention, Mammography, Qualitative Approach, Perceived Behavior Control, Directed Content Analysis
  • Arezoo Chouhdari *, Parvin Yavari, Mohamad Amin Pourhoseingholi, Hadi Shahrabi Page 4
    Background
    The first-degree relatives (FDRs) of patients with colorectal cancer (CRC) are at a 2 to 3-fold increased risk of developing the disease compared with the general population.
    Objectives
    This study aimed to determine the relationship between the lifestyle of colorectal cancer patients’ FDRs and their compliance in colonoscopy screening test.
    Methods
    This cross-sectional study conducted on FDRs of patients with colorectal cancer in one educational hospital, Tehran, Iran in duration 2018. A total of 114 patients’ FDRs were consulted face to face by preventive medicine specialist and data collecting forms were fully completed. Three months later the FDRs were followed for undergoing colonoscopy screening test or decision to do it soon. Next, the relationship between lifestyle [BMI (body mass index), cigarette smoking, diet, physical activity], socioeconomic status (job, income, health insurance), and comorbidities with a tendency to participate in colonoscopy screening program assessed. In multivariable logistic regression analysis, predictor factors for colonoscopy screening in FDRs were investigated. The data were analyzed using SPSS V. 18 software and the significance statistically was P < 0.05 in the all tests.
    Results
    Overall, 57% of FDRs undergone colonoscopy tests up to time of study or they were tended to do it soon. In multivariable logistic regression, age < 50 years old (P = 0.01, OR = 1.08, 95%CI: 1.01 - 1.8), higher income (equal and more than 20 million Rials) (P < 0.001, OR = 2.5, 95%CI: 1.8 - 11), appropriate physical activity (≥ 150 minutes weekly) (P < 0.001, OR = 5.2, 95%CI: 4.6 - 17.5) and normal diet (intake of carbohydrate, fat, protein, fruit and vegetables) (P = 0.006, OR = 3.02, 95%CI: 2.9 - 6.6) were the predictor factors to compliance the FDRs for participation in colonoscopy screening program.
    Conclusions
    Although in this study there was an association between lifestyle of FDRs and the compliance rate of colonoscopy screening test but according to the vulnerability of the relatives, more research in this field should be carried out
    Keywords: Lifestyle, Compliance, FDRs, Colonoscopy, Screening, CRC
  • Nazi Moini, Nahid Nafissi, Ebrahim Babaee, Hamidreza Mirzaei, Mohammad Esmaeil Akbari* Page 5
    Background
    In the large breast tumors or locally-advanced breast cancers, breast conserving surgery (BCS) after neoadjuvant chemotherapy (NACT) had an acceptable local control, but greater risk of recurrence. Adding boost dose radiation to whole breast radiotherapy is involved with a reduced risk of recurrence. Boost radiotherapy can be delivered in 3 methods, including (1) external beam radiotherapy (EBRT), (2) intraoperative radiotherapy with electron (IOERT), and (3) intraoperative radiotherapy with low-kV X-ray (IOXRT).
    Objectives
    This study compared the outcomes of these 3 methods with each other.
    Methods
    Within 60 months, 217 unselected breast cancer patients in Cancer Research Center of Shahid Beheshti were under treatment with BCS after NACT. They received boost dose radiation in 3 groups; 115 patients in the EBRT group, 39 patients IOXRT group, and 63 patients in the IOERT group. All of them received WBRT after surgery.
    Results
    The patients had large tumors or stage 3 breast cancer. Local recurrences were 1 (2.5%) in IOXRT, 2 (3.2%) in IOERT, and 1 (0.9%) in EBRT groups. Systemic recurrences were 4 (10.3%) in IOXRT, 10 (15.9%) in IOERT, and 16 (13.9%) in EBRT groups. Deaths were 3 (7.7%) in IOXRT, 2 (3.2%) in IOERT, and 10 (6.9%) in EBRT groups. Patients with any events were 4 (10.3%) in IOXRT, 11 (17.5%) in IOERT, and 33 (15.2%) in the EBRT group. Death due to distant metastases was lower in IOERT group, but it was not significant. No significant difference was observed in disease-free survival (DFS) among 3 groups. IOXRT group had non-significant, lower events, and better DFS. Especially, in non-PCR (non-pathologic complete response) patients, multivariate COX analysis showed better outcome (DFS) in IOXRT group (HR = 0.50), although it was not significant (P = 0.53).
    Conclusions
    Intraoperative radiotherapy (IORT or IOXRT) as tumor bed boost during BCS after NACT had at least non-inferiority compared with EBRT. In non-PCR patient, IOXRT group had non-significant better outcomes (DFS)
    Keywords: Intraoperative Radiotherapy, IORT, IOERT, IOXRT, Neoadjuvant Chemotherapy, DFS
  • Matin Ghazizadeh, Shervin Ghavami, Mahboobe Asadi* Page 6
    Introduction
    Neuroendocrine neoplasm is an infrequent tumor in the larynx which can be sub-classified into five different types: typical carcinoid, atypical carcinoid, large cell carcinoma, small cell carcinoma, and paraganglioma. This tumor mostly occurs in smoker men. The common location of neuroendocrine tumor of the larynx is in the supraglottic area. Because of the complex nature of neuroendocrine neoplasms of the larynx, we found it so interesting to present. We emphasized the clinical importance and aggressive nature of this tumor despite its rarity.
    Case Presentation
    In the present study, we presented 2 cases of atypical carcinoid in non-smoker females. Case 1 was a 74-year-old non-smoker woman who was referred with a history of chronic dysphagia and left otalgia since one year ago. Laryngoscopy revealed a nonulcerated supraglottic epitheliomatous lesion. Biopsy showed atypical carcinoid. The patient had no lymphadenopathy or metastasis in the further workup. The second case was a 60-year-old non-smoker woman with a 4-month history of hoarseness, odynophagia accompanied by cervical lymphadenopathy. Laryngoscopy showed a smooth surface non-ulcerated transglottic tumor. Right vocal cord mobility was restricted.
    Conclusions
    Atypical carcinoid tumor is an underdiagnosed laryngeal malignancy. Although neuroendocrine tumor of the larynx is rare, physicians should be familiar with its unspecified presentations, pathology, clinical course, and prognosis.
    Keywords: Laryngeal Neoplasm, Neuroendocrine Carcinoma, Atypical Carcinoid