RESUMEN
Mucinous cystic neoplasms (MCNs) are among the most common primary cystic neoplasms of pancreas. These lesions usually occur in body and tail of the pancreas and are characterized by the presence of ovarian type stroma in the pathological evaluation. Mucinous cystic neoplasms have significant malignant potential; therefore, their diagnosis and resection is of utmost importance. Mucinous cystic neoplasms typically occur in women. Only a few cases have been previously reported in male patients. In this case report, we present a 48-year-old man who was referred to our center due to an incidentally found cystic lesion in the tail of the pancreas that was increasing in size in serial evaluation. The patient underwent open distal pancreatectomy. The pathology showed mucinous cystic neoplasm with characteristic ovarian type stroma and positive staining for estrogen and progesterone receptors. This case report shows that mucinous cystic neoplasms can occur in men and should be considered in differential diagnosis of cystic pancreatic lesions in this population.
Asunto(s)
Cistoadenoma Mucinoso/patología , Cistoadenoma Mucinoso/cirugía , Neoplasias Pancreáticas/patología , Neoplasias Pancreáticas/cirugía , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: The aim of this study is to report our six-year experience with portal-endocrine and gastric-exocrine drainage technique of pancreatic transplantation, which was first developed and implemented at our center in 2007. METHODS: In this study, the outcomes of all patients at our center who had pancreas transplantation with portal-endocrine and gastric-exocrine drainage technique were evaluated. RESULTS: From October 2007 to November 2013, 38 patients had pancreas transplantation with this technique - 31 simultaneous kidney pancreas and seven pancreas alone. Median duration of follow-up was 3.8 years. One-, three-, and five-year patient and graft survival rates were 94%, 87%, 70% and 83%, 65%, 49%, respectively. For pancreas allograft dysfunction evaluation, 51 upper endoscopies were performed in 14 patients; donor duodenal biopsies were successfully obtained in 45 (88%). We detected nine episodes of acute rejection (eight patients) and seven episodes of cytomegalovirus (CMV) duodenitis (six patients). No patient developed any complication due to upper endoscopy. CONCLUSIONS: Portal-endocrine and gastric-exocrine drainage technique of pancreas transplantation provides lifelong easy access to the transplanted duodenum for evaluation of pancreatic allograft dysfunction.
Asunto(s)
Trasplante de Páncreas/métodos , Páncreas , Vena Porta/cirugía , Disfunción Primaria del Injerto , Estómago/cirugía , Adulto , Aloinjertos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Disfunción Primaria del Injerto/diagnóstico , Disfunción Primaria del Injerto/mortalidad , Disfunción Primaria del Injerto/cirugía , Estudios RetrospectivosRESUMEN
Objective. To determine the validity and reliability of the Pharmacist Interprofessional Competencies Tool (PICT). Methods. Faculty members at Ferris State University, College of Pharmacy developed the PICT, which has five interprofessional criterion (collaboration, ownership, respect, engagement, and application) and four competency levels (unacceptable, novice, competent, and proficient) to assess the interprofessional competencies of pharmacy students. Fourteen pharmacy faculty members were trained in how to use the PICT and then used it to assess students' behaviors in four to six video-recorded interprofessional education (IPE) learning activities. A subset of these faculty members evaluated the video-recorded IPE learning activities using two other previously validated interprofessional assessment tools. Psychometric analysis of the PICT, including internal consistency and inter-rater reliability, was conducted, along with a correlation analysis and factor analysis, and the results were compared to those from the other validated assessment tools. Results. The overall rating of the internal consistency of the PICT was excellent and item-total correlations of the individual criterion were fair to good, with the exception of the respect criterion. The PICT demonstrated excellent overall inter-rater reliability, and individual criterion rated as fair to excellent with the exception of the respect criterion. Specific dimensions of the PICT showed high convergence with previously validated interprofessional assessment tools. Conclusion. The PICT exhibited overall validity and reliability as an assessment tool for measuring the interprofessional competencies of pharmacy students. In establishing the overall validity and reliability of the assessment tool, the respect criterion was not proved to be reliable or valid. Additional training and slight modifications to the PICT and associated IPE learning activities are planned to assist with longitudinal assessment of student performance across the curriculum.
Asunto(s)
Educación Basada en Competencias/métodos , Educación en Farmacia/métodos , Curriculum , Docentes de Farmacia , Humanos , Relaciones Interprofesionales , Farmacéuticos , Aprendizaje Basado en Problemas/métodos , Reproducibilidad de los Resultados , Estudiantes de FarmaciaRESUMEN
INTRODUCTION: Electronic health records (EHRs) are used extensively throughout health systems; this indicates a need for pharmacy student competencies prior to pharmacy practice experiences. The objective was to determine current utility, perceived benefit, and future plans for EHR use in the didactic curriculum of doctor of pharmacy programs in the United States. METHODS: An electronic survey was distributed to members of two special interest groups through the American Association of Colleges of Pharmacy. Content areas in the 14-question survey included current utilization of EHRs in the didactic curriculum, perceived benefit for preparing students for pharmacy practice experiences, and future plans for implementing or improving EHR use. RESULTS: A total of 59 (7.7%) individuals responded to the survey, representing 43 out of 133 schools (32%). Of the respondents currently using EHRs (37%), more than 60% have been using an EHR in the classroom for two years or less while 18.2% reported five or more years of experience. The most common application of EHRs was for clinical cases (77%) followed by pharmaceutical care lab courses (59%), other uses in pharmacotherapeutics (27%), and interprofessional education (23%). Of those not currently using EHRs (63%), the vast majority (84%) plan to integrate EHRs into didactic coursework within the next two years. CONCLUSIONS: EHRs appear to be used by many colleges of pharmacy in courses where clinical cases are being discussed. Further research into the value of EHR usage at earlier stages of professional programs, including within skills labs, objective structured clinical examinations, and other pharmacy coursework, may be helpful given increasing EHR use in healthcare settings.
Asunto(s)
Educación de Postgrado en Farmacia/estadística & datos numéricos , Registros Electrónicos de Salud/tendencias , Curriculum/estadística & datos numéricos , Educación de Postgrado en Farmacia/métodos , Humanos , Estudiantes de Farmacia/estadística & datos numéricos , Encuestas y Cuestionarios , Estados Unidos , Universidades/organización & administración , Universidades/tendenciasAsunto(s)
Dolor Abdominal/patología , Infecciones por Bacterias Gramnegativas/diagnóstico , Recto/patología , Dolor Abdominal/etiología , Dolor Abdominal/microbiología , Adolescente , Brachyspira/efectos de los fármacos , Colonoscopía/métodos , Eritromicina/uso terapéutico , Femenino , Hemorragia Gastrointestinal/etiología , Hemorragia Gastrointestinal/microbiología , Infecciones por Bacterias Gramnegativas/tratamiento farmacológico , Humanos , Metronidazol/uso terapéuticoRESUMEN
PURPOSE: To explore variables relevant to transition to civilian pharmacy career path for retiring military pharmacists. METHODS: A cross-sectional survey was designed to collect information from retired military pharmacists including demographics, military service information, postretirement employment and perceptions of transition, satisfaction, level of responsibility, work environment, rewards (level of financial compensation, opportunities for professional development and career advancement, health benefits), and level of supervisory support. The questionnaire also included additional items asking about their perception of their military experience, transition to civilian work and the impact the military career had on their personal and family life. RESULTS: Respondents included 140 retired pharmacists from the U.S. Army, Navy, Air Force, or Coast Guard. Factors found to be significant predictors of transition to civilian career included: bureaucracy in current job, time elapsed since retirement, extent to which an individual misses military structure and chain of command, access to military facilities and Veterans Administration benefits, and reporting little or no stress in committed long-term personal relationship while in the military. CONCLUSION: Findings suggest that the majority of retired military pharmacists perceived the transition to civilian professional sector was about what they expected or easier than expected.