...Pancreatic Cancer Wendy Carlin Unit 4 Capstone Project: Pancreatic Cancer Kaplan University 6/25/2013 Abstract Andre is a 69-year-old man who was just diagnosed with pancreatic cancer. He owns a chain of Italian restaurants and is well known in the community. He is married and has a large family including children, grandchildren and great-grandchildren. Every holiday all of his family is treated to a home cooked meal that Andre prepares himself. This year he is concerned that he may not be able to cook for an upcoming holiday. This saddens Andre and he feels depressed. Pancreatic Cancer is a cancer that starts in the tissues of the pancreas and because the pancreas is a gland, the most common type of pancreatic cancer is adenocarcinoma. Adeno means relating to a gland and carcinoma is cancer, so adenocarcinoma is cancer of a gland. (Mandal, Dr.) The average age of people with pancreatic cancer is between 70 and 80, and it is more common in men than women. There are two ways a pancreatic cancer can be diagnosed; clinically and pathologically. A clinical diagnosis is done by radiology and or the physician’s evaluation by lab test and the physical exam. A pathological diagnosis is by taking a tissue sample from the primary or metastatic (cancer spread) site and having a pathologist exam the tissue. By looking at these cells, the pathologist can tell if there is cancer and what the primary site is. Because the pancreas is located deep within the body, it is hard...
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...Translational Research for Practice and Populations Linda Parson Western Governors University February 20, 2016 Translational Research for Practice and Populations A. Identify a current nursing practice within your healthcare setting that requires change. Patients having procedures considered invasive require interaction with a medical device and a patient's mucous membranes. One major hazard of these procedures is the induction of pathogenic microorganisms that could lead to infection. Malfunction of utilizing the correct processes in accurately reprocessing or sterilizing reusable medical devices bears a risk connected with break of the host barriers. Spaulding’s classification is utilized to determine the stage of reprocessing/disinfection a medical device should be exposed to (CDC, 2008). Also, Spaulding’s classification also determines the level of sterilization for a medical device. The classification is as follows (CDC, 2008) • Critical items (such as surgical instruments, which contact sterile tissue • Semicritical items (such as endoscopes, which contact mucous membranes), • Noncritical items (such as stethoscopes, which contact only intact skin) Based on the classification of the device determines whether the device requires sterilization, high-level disinfection, or low-level disinfection, correspondingly. Pre-cleaning must be the most important thing to perform prior to high-level disinfection and sterilization (FDA, 2009) ...
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...SWOT ANALYSIS Strengths Friendly approachable staff Different exposures to multidisciplinary team (nurse endoscopists, cancer nurse specialist, surgeons, consultants and endoscopy nurses) Student resources (student board and welcome pack) Weaknesses As endoscopy is specialised there’s not much opportunity for students to undertake new skills Student pack feeds students a little too much Opportunities To work with different members of the multidisciplinary team To observe specialised nursing care and observe endoscopy procedures To observe emergency procedures To gain knowledge about endoscopy and the procedures undertaken To learn and participate in decontamination Threats Environment Equipment Liaising with new people and surgeons and consultants Session title: Having a gastroscopy Target group: first year second placement nursing student Time allocation: 15 minutes Aim: to educate a student on what is a gastroscopy and some of the reason why we carry out the procedure | Indended learning outcomes: * To be able to explain what a gastroscopy procedure is * To be able to explain why we perform a gastroscopy * To be able to tell us some of the reasons a person may be refered for a gastroscopy | Content- BSG gastroscopy guidelinesTeaching method- powerpoint presentationTime-10 minutes | Tools and/or resources needed: Computer, powerpoint | Any useful references bsg national guidelines | Evaluation: reflection of the session | Name…………………………………...
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...Comparison of Approaches It can be difficult to sort through the approaches. They seem self-explanatory, but when you have to decide which approach was used, they begin to look alike. There is a page with Week 3, Chapters 8 and 9. I have added some color coding to further compare them below. This is the portion from Week 3: Start in your –PCS manual, page 6 where the approaches are listed and defined. There are 7 of them, and seem self-explanatory enough, but there are some fuzzy areas that may throw you. For example, the difference between open and percutaneous: Open approaches use an incision through skin or mucuous membrane and other body layers, large enough to see the operative site. A laparotomy is an obvious example. Percutaneous, while it means “through the skin,” can also go through other layers to reach the operative site. But a percutaneous approach is a smaller incision or puncture, usually just large enough to insert an instrument. An obvious example is a needle biopsy of the liver. A not so obvious example is a carpal tunnel release as in Exercise 8.3. Via a natural or artificial opening uses the body’s own or created passageways – like the colon (natural), colonostomy (artificial, created opening (stoma) into the colon), trachea, vagina, etc. No incision is needed to reach the operative site. External is on the surface of the body, or the operative site can be seen without instrumentation. Examples are reduction of a closed fracture, or tonsillectomy...
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...processes within the department. Work under the direct / indirect supervision of senior nurses and with other members of the multidisciplinary team to provide the physical and emotional care for both inpatients and outpatients undergoing a variety of endoscopic procedures on the Endoscopy Department and any other department where endoscopic procedures are undertaken. Ability to work in all areas of the Endoscopy Departments within the Trust – clean and dirty decontamination, theatre, recovery and admissions cross site. Ability to work flexibly to cover all shift patterns on the unit including evenings and weekends. 2. MAIN TASKS REQUIRED OF THE POST 2.1 Main Tasks Clinical • To operate the equipment necessary for the endoscopic procedure to be performed. • • • • • • • • • • • • • • • • • • • • • • • • • • • • • To operate the equipment necessary for the decontamination of endoscopic equipment according to manufacturer guidelines, Standard Operating Procedures (SOP) and Trust Policy. To participate effectively in the preparation, maintenance, cleaning and disinfecting of all equipment and procedure rooms. To ensure endoscopy equipment is prepared...
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...conclusions concerning personal learning outcomes. The term ‘critical’ introduces a further dimension to analysis, in that judgements are made about the strengths and weaknesses of the different parts, as well as of the whole, Burns (2000). Reflection follows on from this by encouraging the analysis of clinical practice, this in turn, helps the healthcare professional to develop his/her knowledge and to acquire a deeper level of understanding about the complexities of nursing practice. Boud et al (1985) suggests that this type of learning contributes to the development of clinical competence. The critical incident is taken from my recent clinical practice within the Endoscopy Unit. I will be reflecting upon and critically analysing gaining informed consent prior to the patient’s emergency Endoscopy and when to act within patient’s best interests. My rational for the chosen clinical incident is because of the impact it had on me. I realised I was not fully informed on the process of obtaining informed...
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...Mashira Stevens Professor Sharon Kurfuerst HLTSC 325-1 9 March 2015 Current Event #2 Deadly superbug-related scopes sold without FDA approval Companies that create, manufacture, repackage and/or import medical devices into the United States must be approved by FDA's Center for Devices and Radiological Health (CDRH). The owner of the device/product could have designed it but then had it manufactured by a contract manufacturer. When FDA review is needed prior to marketing a medical device, FDA will either "clear" the device after reviewing a premarket notification, also known as a 510(k) (named for a section in the Food, Drug, and Cosmetic Act), that has been filed with FDA, or "approve" the device after reviewing a premarket approval (PMA) application that has been submitted to FDA. Whether a 510(k) or a PMA application needs to be filed depends on the classification of the medical device. To obtain clearance to market a device using the 510(k) pathway, the submitter of the 510(k) must show that the medical device is "considerably the same" to a device that is already legally marketed for the same use. To acquire approval of a device through a PMA application, the PMA applicant must provide reasonable assurance of the device’s safety and effectiveness. CNN has learned that the manufacturer of the endoscope involved in two superbug deaths at UCLA never obtained permission to sell the device, according to an official at the Food and Drug Administration. Olympus started selling...
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...Hello betty Bates, This receipt acknowledges that Turnitin received your paper. Below you will find the receipt information regarding your paper submission: Paper ID: 82608701 Author: betty Bates Paper Title: Letter to Nurse Manager Assignment Title: • Week 4: Assignment 4 E-mail: belba07@yahoo.com BODY Week 4 Assignment 4 Letter to new nurse manager Dear Madam, In reference to your inquiry about our endoscopes, I am writing to tell you, we carry a large line of these scopes for various uses; such as cystoscopes, an instrument for testing and treating disorders of the bladder, kidneys, and urethras, it consists of an outer covering with a lighting system, a viewing scope and a passage for tubes (catheters), and surgical devices. Our nephroscope, an instrument used to break up and remove kidney stones. The nephroscope is inserted through the body wall and the stones are found by x-ray, an ultrasonic probe giving off high frequency sound waves breaks the stones into small pieces that are easily removed. Another endoscope that we have is the urethroscope, an instrument with a light to view the urethra. Also a laparoscope, an instrument consisting of a lighted tube with magnifying lenses that is inserted into the abdominal wall for examining the abdominal cavity. A curved flexible tube for looking at the bronchi is a bronchoscope. It contains fibers that carry light down the tube and project a large image up the tube...
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...The Honourable Leona Aglukkaq, P.C., M.P. Health Canada Brooke Claxton Building, Tunney's Pasture Postal Locator: 0906C Ottawa, Ontario K1A 0K9 Re: Expansion of private healthcare services offered in Canada: The use of Capsule Endoscopy as a patient purchased diagnostic test for evaluation of gastrointestinal problems Dear Ms. Aglukkaq: I would like to propose a change in the manner in which specialized gastrointestinal diagnostic services are offered in the public Canadian healthcare system. Gastroenterology and evaluation of digestive disease/problems is one of the most heavily utilized sectors in the healthcare system. It is critical to improve patient care by minimizing patient waiting times and to reduce the burden on physicians to provide timely and accurate patient diagnosis and care. As Canada is expanding the offering of some privately offered health services such as ct scans, mris and x-ray studies in terms of diagnostic procedures used to diagnose gastrointestinal problems1, I would like to propose that Capsule Endoscopy be made available as a privately purchased outpatient diagnostic procedure. Currently, this extremely valuable but expensive diagnostic test is only available to a narrowly selected group of patients seeking care from a gastroenterology specialist1. This test has the ability to be used as a timely, accurate, low risk and easily administered diagnostic tool for patients presenting with several different types of gastrointestinal dysfunctions...
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...and sending it to a lab, they then analyze. This test is used to rule out other other GI diseases. An upper Gastrointestinal Series is uses x-rays and fluoroscopy to help diagnose problems is upper GI tract. The patient drinks barium which causes the doctor to be able to see the organs more clearly on x-rays. Computerized Tomography (CT) scan can diagnose both Crohn’s disease and the complications seen with the disease. The final steps for diagnosing is Intestinal Endoscopy. These are the most accurate methods for diagnosing or ruling out other possible diseases. There are three different methods, upper GI endoscopy and enteroscopy, capsule endoscopy, colonoscopy. During an upper GI endoscopy, a doctor carefully provides an endoscope down one’s esophagus and into the stomach. A tiny camera on the endoscope films video which allows close examination of the GI tract. A Capsule endoscopy can be used to examine the entire digestive tract, but in this case it is used to examine the small intestine. One swallows a capsule that contains a small camera which records video. Eventually the camera is flushed out of the body a natural way, through bowel movements. A Colonoscopy is a test is used to examine the intestinal lining. A small camera is carefully guided up one’s anus, through the rectum and into the colon. Crohn’s is treated in three main ways, medication, bowel rest, and surgery. Medications will not cure the disease but some can reduce symptoms. They can help introduce remission...
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...is avoiding gluten-containing foods. Specialized organizations have begun research on this topic. For example, along with governmentally financed trials, the National Institute of Diabetes, Digestive, and Kidney Diseases as well as the Mucosal Immunology and Biological Research Center are two main centers for trials for Celiac Disease. (National Foundation for Celiac Awareness) Currently, research has shown that Immunoglobulin A and anti-tissue transglutaminase (blood components) treatments are successful in patients (Center for Celiac Research and Treatment). These centers use a variety of medical procedures, starting from painless endoscopies and ending with painful intestinal biopsies to diagnose Celiac Disease. One method, capsule endoscopy, is a small camera being swallowed by the patient which records the digestive process. The capsule endoscopy is a noninvasive approach which gathers preliminary information about the villi in the small intestine. A more invasive method, an intestinal biopsy, completely proves, or disproves, a diagnosis of Celiac Disease. An intestinal biopsy is a procedure where a piece of the villi are taken and then tested for various signatures of Celiac Disease. Many of these signatures include smaller sizes of the villi themselves, as well as different colors of the villi (Celiac Disease Statistic). While different tactics of diagnosing Celiac Disease have been created, statistics have become available for usage. Chilling statistics, including 6-10 year...
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...anus. Since there has not been any diagnosis made, the diagnosis that I would offer is to request lab tests and x rays to determine if the disease seems to appear in Barbara’s body. The types of test that I would run are barium x rays and other x rays for showing where and how severe Crohn's disease is. It’s helpful for finding any problems in parts of the small intestine that can't be easily viewed by other techniques. CT scans for usage of computer-aided X-ray techniques to produce more detailed images of the abdomen and pelvis than can be seen in traditional X-rays, colonoscopy or sigmoidoscopy to allow for to directly viewing the large intestine, which is the lower part of the digestive tract , and a video capsule endoscopy in which Barbara will swallow a small capsule or pill that holds a miniature video camera. As it travels through her small intestine, it sends images of the lining to a receiver in which she will wear a belt around her waist. The images are downloaded and reviewed at a computer. The images can provide detailed information about early, mild problems associated with Crohn's disease. When Crohn’s disease is diagnosed after the tests are completed being that there is no cure for Crohns disease, I have various ways to treat it such as prescribing medications, giving...
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...Celiac Disease: What? Who? How? Celiac Disease: What? Who? How? Life changing, life long, no cure! This paper is to give knowledge and inform readers on what Celiac Disease is, who it effects, what it affects, and try to explain how it can interrupt a normal, life style to where most of us take for granted. Have you ever wondered what life would be like if you found out you could not eat normal everyday foods that most of us take for granted? What if one day you woke up and found out you could not eat something as simple and as popular as pizza? That you could not eat bread, cake, cookies, lasagna, spaghetti, or even drink beer? That every time you did, you would get sick. Well, for a growing percentage of Americans, that is what is becoming a reality. What is it? How do you get it? What does it do to you? Who can get it? These are just some of the questions I will be answering in this paper. What is Celiac Disease? Well that’s a very good question. Celiac Disease or Gluten-Sensitive Enteropathy is a disease of the intestinal tract. It is a chronic tropical disease of intestinal malabsorption or in simple terms, an allergy to wheat products such as wheat, rye, barley, and oats (Reilly 116). Celiac Disease is a lifelong disease that can only be controlled by understanding CD and following a lifelong diet which excludes wheat, barley, and rye. Celiac Disease is a multisystem disorder that causes the body’s immune system to respond to proteins in certain grains which damage...
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...e-Health in South Korea e-Health: Strategy and Best Practices In contrast to its e-government and general e-service strategies, Korea’s e-health program was regarded by the WHO as only moderately effective in 2006. Despite starting in 2003 the Korean Program has only now beginning to gain momentum. Up until 2008 the e-Health Association has developed led by the Ministry of Commerce, Industry and Energy have focused on developing on what it sees as the five core pillars for a successful u-Health industry by 2013. These areas are: Standardization Law and policy planning and reform Human resource development, e.g. access to medical knowledgeR&D for e-health products International collaboration Despite some work by the various Ministries on defining their domestic requirements in terms of electronic health records , e-prescriptions, etc., there has been little real progress on e-health in Korea and many healthcare facilities lack appropriate ICT based information tools. According to a consumer survey in 2007 the poor level of informatization in healthcare this apparent lack of progress can be attributed to the fact that e–health was not seen as part of the overall e-government strategy and the structure and parlous state of the health sector in Korea following the rapid introduction of universal health insurance. Following the reorganization of government ministries in 2008 (under the new government administration); e-health attention has begun to focus on...
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...From www.bloodjournal.org by guest on March 10, 2015. For personal use only. How I treat How I treat enteropathy-associated T-cell lymphoma Antonio Di Sabatino,1 Federico Biagi,1 Paolo G. Gobbi,1 and Gino R. Corazza1 1First Department of Medicine, Centro per lo Studio e la Cura della Malattia Celiaca, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico S. Matteo, University of Pavia, Pavia, Italy Enteropathy-associated T-cell lymphoma (EATL) is a complication of celiac disease (CD). This tumor derives from the neoplastic transformation of aberrant intraepithelial T lymphocytes emerging in celiac patients unresponsive to a gluten-free diet. Poor adherence to a gluten-free diet, HLA-DQ2 homozygosity, and late diagnosis of CD are recognized as risk factors for malignant evolution of CD. Recurrence of diarrhea, unexplained weight loss, abdominal pain, fever, and night sweating should alert physicians to this complication. The suspicion of EATL should lead to an extensive diagnostic workup in which magnetic resonance enteroclysis, positron emission tomography scan, and histologic identification of lesions represent the best options. Treatment includes high-dose chemotherapy preceded by surgical resection and followed by autologous stem cell transplantation, although biologic therapies seem to be promising. Strict adherence to a gluten-free diet remains the only way to prevent EATL. (Blood. 2012;119(11): 2458-2468) Introduction Celiac disease (CD) is a chronic...
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