RESUMO
Acute myelogenous leukemia (AML) is one of the most common hematologic malignancies. Among them, acute promyelocytic leukemia (APL) is well known for its coagulopathies. Bleeding secondary to disseminated intravascular coagulation, is a common initial presentation and carries a high risk for mortality if left untreated. Thrombotic complications are uncommon and can be related to treatment with chemotherapeutic agents. Large artery thrombosis is very rare, and standardized management remains elusive given the classic revascularization techniques carry a significant risk of re-thrombosis, as well as high risk for mortality given the multiple surgical and percutaneous interventions that are attempted. A multidisciplinary approach is necessary in these cases to carefully weigh the risk and benefits as the classical approach to revascularization and acute arterial thrombosis could potentially cause harm.
RESUMO
Breast cancer is the most common malignancy affecting women. Metastatic involvement of the gastrointestinal (GI) tract secondary to a primary breast malignancy is rare. Here, we describe the case of a 60-year-old woman with a history of right lobular breast cancer (diagnosed and treated five years prior to presentation) who presented with fatigue, generalized abdominal pain, distension, weight loss, and vomiting. Her initial imaging was suspicious for a primary gynecological malignancy; however, subsequent workup showed a colonic mass. Total colonoscopy revealed colon metastases, and an immunohistochemical profile favored invasive lobular carcinoma of breast. Most cases of gastrointestinal metastases from breast cancer have lobular histology; however, colonic involvement is rare.
RESUMO
PURPOSE: The purpose of this study was to test how basic psychological needs satisfaction contributes to career commitment through career satisfaction among nurses. BACKGROUND: There is an increasing rate of turnover among nurses and a general shortage of nurses in many countries. This has made it necessary for researchers to focus on the career satisfaction of nurses and their commitment to their careers. DESIGN AND METHODS: A cross-sectional design was employed in a survey of 233 nurses in public hospitals in southeastern Nigeria. Participants responded to self-report measures of career commitment, career satisfaction, and work-related basic needs satisfaction. FINDINGS: In the regression-based path analysis, basic psychological needs satisfaction was positively related to career satisfaction (p < .001) and career commitment (p < .001) of nurses. Career satisfaction was positively related to career commitment (p < .05). Career satisfaction mediated the relationship between basic psychological needs satisfaction and career commitment (95% confidence interval [.009, .068]). CONCLUSIONS: The results show that basic psychological needs are relevant for employee commitment, giving support to the self-determination theory. Career satisfaction provides further explanations for the relationship between psychological needs satisfaction and career commitment, although there could be reverse causal links. CLINICAL RELEVANCE: The results advance knowledge on how satisfaction of basic psychological needs can increase career satisfaction and foster more career commitment. Designing work environments that help employees to fulfil their basic psychological needs is important in the retention of nurses.
