Work-related frustration among senior nurses at a medical centre.

AIMS AND OBJECTIVES: To investigate the levels and causes of work-related frustration among senior nurses. BACKGROUND: Role changes and the associated expectations and setbacks faced by senior middle-aged nurses can easily result in low morale. Therefore, working setbacks experienced by senior nurses must be investigated. DESIGN: A cross-sectional questionnaire study. METHODS: Purposive sampling was used to select questionnaire recipients. In total, 482 senior nurses completed and returned a structured questionnaire. RESULTS: The predictive factors for frustration at work among senior nurses included age, service unit, and the impact of sleep disorders, which jointly explained 54% of the variance. In particular, age and service unit were important predictive factors for frustration at work. CONCLUSIONS: Senior nurses had medium-to-low scores for frustration at work and did not perceive a high level of frustration. RELEVANCE TO CLINICAL PRACTICE: The outpatient departments and other medical departments in this sector should provide a reasonable system of incentives and promotion opportunities if they are to retain their most senior and experienced nurses. The results of this study could serve as a reference for hospital administrations.

A rare case of monomorphic epitheliotropic intestinal T-cell lymphoma, presenting with spontaneous intestinal perforation.

INTRODUCTION AND IMPORTANCE: Monomorphic epitheliotropic intestinal T-cell lymphoma (MEITL) is a rare and aggressive T-cell lymphoma that primarily affects the intestine. It has a poor prognosis and high mortality rate. Symptoms at presentation can be non-specific, and imaging studies may show similarities with nonmalignant conditions. The delayed clinical presentation and lack of targeted therapies contribute to the dismal prognosis of MEITL. CASE PRESENTATION: We present a case of spontaneous intestinal perforation caused by primary intestinal T-cell lymphoma, emphasizing the importance of early recognition of this uncommon cause of perforation. Identifying it is crucial for prompt surgery and chemotherapy for this rare disease. CLINICAL DISCUSSION: The most common site of involvement in MEITL is the small intestine, especially the jejunum. The prognosis of MEITL is poor. Early diagnosis of primary intestinal T-cell NHL is challenging due to its rarity and non-specific symptoms. Imaging and endoscopy may show certain features, but a definitive diagnosis relies on biopsy and histopathologic analysis. To date, no efficient therapeutic interventions have been demonstrated for the management of this entity. The standard management strategy consists of induction chemotherapy followed by autologous stem cell transplantation. CONCLUSION: This case report highlights that spontaneous perforation with peritonitis could be a potential presenting sign of MEITL. The diagnosis of MEITL is mainly based on histopathologic examination, so an accurate diagnosis necessitates clinical knowledge and thorough biopsy with immunohistochemistry and molecular testing.

Rare case of solid pseudopapillary neoplasm of the pancreas with liver and splenic metastasis in a 19-year-old girl.

INTRODUCTION: Solid pseudopapillary neoplasms (SPNs) of the pancreas are rare neoplasms, accounting for only 1 %-2 % of all pancreatic tumors, and predominantly affect female patients. CASE PRESENTATION: The present case report details a patient presenting to the emergency department with abdominal pain for 3 days who ultimately received a diagnosis of SPNs in the pancreatic body and tail. A contrast-enhanced computed tomography (CT) scan revealed a sizable mass arising from the pancreas, featuring an enhancing cystic component with involvement of the liver and spleen. The patient underwent subsequent exploratory laparotomy, a distal pancreatectomy, splenectomy, and partial hepatectomy. SPN diagnosis was confirmed by histopathology and immunohistochemistry with negative resection margins. CLINICAL DISCUSSION: Approximately 70 % of SPN cases are asymptomatic and are incidentally discovered. Despite advances in diagnostic modalities, preoperative diagnosis of SPNs remains a clinical challenge. Surgical management with negative resection margins remains the primary treatment approach. The recurrence rate after surgical resection has been reported to be 3 %-9 %. The prognosis for SPNs limited to the pancreas is generally favorable, with a cure rate exceeding 95 % after complete surgical resection. CONCLUSION: An SPN of the pancreas is a rare tumor observed in young female patients. Although it is classified as a malignant tumor, SPN has low malignant potential. Aggressive surgical resection, however, has proven effective in curing SPN for the majority of patients.