RESUMO
PURPOSE OF INVESTIGATION: The present study was performed to identify the effects of medroxyprogesterone acetate (MPA) plus adjuvant chemotherapy on advanced epithelial ovarian carcinoma (FIGO Stage III/IV). METHODS: A total of 50 patients were enrolled in this study. A relatively low dose of MPA (200 mg/day) after surgery was administered in combination with platinum-based chemotherapy and the treatment was continued for two years. Patients' backgrounds were also analyzed. RESULTS: Relapse-free survival (p < 0.05) and overall survival (p < 0.001) rates in FIGO Stage III/IV ovarian cancer patients with MPA combined chemotherapy were significantly longer than the control group. The effect was more prominent in the higher progesterone receptor expression group. The chemotherapy regimens (cyclophosphamide, doxorubicin and cisplatin vs paraplatin plus cyclophosphamide or paclitaxel) did not affect prognosis. CONCLUSION: MPA with platinum-based chemotherapy as an adjuvant therapy might improve the prognosis in FIGO Stage III/IV epithelial ovarian cancer cases. A randomized controlled study is still needed for further analyses.
Assuntos
Antineoplásicos Hormonais/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma/tratamento farmacológico , Acetato de Medroxiprogesterona/uso terapêutico , Neoplasias Ovarianas/tratamento farmacológico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Carcinoma/patologia , Carcinoma/cirurgia , Quimioterapia Adjuvante , Cisplatino/uso terapêutico , Intervalo Livre de Doença , Feminino , Seguimentos , Humanos , Estimativa de Kaplan-Meier , Acetato de Medroxiprogesterona/efeitos adversos , Estadiamento de Neoplasias , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/cirurgia , Projetos Piloto , PrognósticoRESUMO
In this article, the need for selected health education programs in Hawaii will be discussed. Changes in the health care system, population and provider population impacting supply are identified. Health trends in Hawaii are highlighted and strategies needed to assure that Hawaii's demand for health professionals in social work, dental hygiene and nursing are suggested.
Assuntos
Educação em Enfermagem , Enfermagem , Higiene Bucal/educação , Serviço Social/educação , Havaí , Humanos , Recursos HumanosRESUMO
This investigation reports the results of a national survey of staff nurse perceptions of changes in the health care system and nursing management models on client outcomes.
Assuntos
Atitude do Pessoal de Saúde , Reforma dos Serviços de Saúde , Modelos de Enfermagem , Recursos Humanos de Enfermagem Hospitalar/psicologia , Supervisão de Enfermagem/organização & administração , Humanos , Avaliação de Processos e Resultados em Cuidados de Saúde , Inquéritos e Questionários , Estados UnidosAssuntos
Promoção da Saúde , Saúde da Mulher , Austrália , Congressos como Assunto , Feminino , Política de Saúde , Humanos , Japão , Estados UnidosRESUMO
In Hawaii, a survey of schools of nursing and health care agencies revealed significant differences in the perceived competencies of new registered nurse graduates. When directors of nursing were asked if new graduates meet expectations, more than 42% said no. This survey identifies that numerous discrepancies exist between agency expectations and what is actually practiced in the clinical setting. Suggestions for achieving competencies in both academic and agency settings are offered.