The Libyan journal of medicine
-
Comparative Study
S100A4 expression is associated with poor prognosis in patients with resectable gastrointestinal stromal tumor.
S100A4 is particularly associated with the progression and metastasis of numerous human malignancies. This study was designed to examine the clinicopathologic significance of S100A4 in gastrointestinal stromal tumor (GISTs). The level of OPNS100A4 expression in a large cohort of resectable GISTs was evaluated with immunohistochemistry. ⋯ Strong S100A4 expression was significantly associated with tumor size, mitosis, and recurrence, but not gender and age. Patients with weak S100A4 expression had a relatively longer disease-free survival compared to patients with strong S100A4 expression. Therefore, S100A4 expression is a putative marker for tumor progression and an adverse prognosis in GISTs.
-
Introduction: Asthma patient education is an essential component of asthma management, just as inhaler treatment adherence and inhaler technique education. These issues face challenges in the developed world communities and the literature demonstrates data of various validity supporting the need for educational activities. However, communities with poor health-care facilities and low socioeconomic status have seen little or no effort to tackle this challenging area of research. ⋯ Discussion & Conclusion: The study supports the feasibility and efficacy of asthma patient education in poor health-care circumstances at basic levels of asthma knowledge, adherence and inhaler technique. This interventional study is unique in the circumstances it was carried out under. Limitations include the large number of dropouts.
-
The use of health information technology (HIT) is expected to deliver benefits for patients, nurses, physicians, and organizations, but the benefits of HIT can only be attained if nurses accept and intend to use it as they are the leading user-group. The use of the tablet is becoming commonplace in healthcare organizations to improve patient care. The current study incorporates Technology Acceptance Model2 (TAM2) with two antecedents, facilitating condition and personal, to identify and understand the factors that influence nurses' intention to use the Tablet PC. The survey methodology was used to collect data from the nurses working in a regional healthcare center in Taiwan. The structural equation modeling (SEM) technique was employed to analyze the research framework. ⋯ But concerning the perceived ease of use, the insignificant path coefficient was reported. The finding also indicated that personal on the research model is much stronger than the subjective norm on Tablet PC performance. The proposed research framework contributes to the conclusive explanation for understanding nurses' intention to use. The current study brings perspectives from the technological and attitudinal differences that have largely been missing in the existing literature of the nurses' intention to use HIT. Thus, health care providers must take these factors into consideration as the findings of the current study advance theory and contribute to the basis for future study intended for enhancing our understanding of nurses' adoption behavior regarding HIT.
-
Randomized Controlled Trial
Intravenous lidocaine as adjuvant to general anesthesia in renal surgery.
The role of intraoperative intravenous lidocaine infusion has been previously evaluated for pain relief, inflammatory response, and post-operative recovery, particularly in abdominal surgery. The present study is a randomized double-blinded trial in which we evaluated whether IV lidocaine infusion reduces isoflurane requirement, intraoperative remifentanil consumption and time to post-operative recovery in non-laparoscopic renal surgery. Sixty patients scheduled to undergo elective non-laparoscopic renal surgery under general anesthesia were enrolled to receive either systemic lidocaine infusion (group L: bolus 1.5 mg/kg followed by a continuous infusion at the rate of 2 mg/kg/hr until skin closure) or normal saline (0.9% NaCl solution) (Group C). ⋯ Thus, IV lidocaine infusion permits a reduction of 31% in isoflurane concentration requirement and 27% in the intraoperative remifentanil need. In addition, recovery from anesthesia and extubation time was shorter in group L (5.8 ± 1.8 min vs 7.9 ± 2.0 min, p < 10-3). By reducing significantly isoflurane and remifentanil requirements during renal surgery, intravenous lidocaine could provide effective strategy to limit volatile agent and intraoperative opioids consumption especially in low and middle income countries.