Pathological Review Model Essay

In 1896 Isabel Hampton Robb formed a group of fewer than 20 nurses and the group became the Nurses' Associated Alumnae of the United States and Canada and in 1911 the organization was renamed as the American Nursing Association. In 1889 Isabel Robb became the first Superintendent of Nurses at John Hopkins Hospital and the principle of the Training School. Isabel Robb wrote the very first nursing ethics textbook.

Breast cancer constitutes the second most prevalent cancer most common among women of the world with an estimated 1.62 million reported cases in 2012 which constitutes 25% of all cancer cases and ranks fifth among mortality due to cancer (Ferlay et al., 2015). In the United States, according to American Cancer Society an

Biopsy helps determine whether this metastatic disease belongs to the breast primary or another primary, and more importantly to determine the hormone receptor status of this recurrence/metastasis.

The first thing that should be done to assess a patient with respiratory problems is to ask for background information. This information includes their work place, home conditions, hobbies, respiratory history, smoking history, drug use, medications currently taking, and allergies (Ignatavicius & Workman, 2013). Many places that a person works can lead to respiratory problems, like inhaling dust, inhaling chemicals, inhaling smoke or fumes, etc. (Ignatavicius & Workman, 2013). A person’s home life can also lead to respiratory problems. Things at home can include wood stoves, gas heaters, fireplace, kerosene heaters, chemicals, animals and many of their hobbies, such as woodworking, refinishing furniture, and so much more (Ignatavicius & Workman,

Around 25-30% of the total breast cancer patients are diagnosed with HER2 gene amplification (Vogel, Charles L., et al, 2002). Patients with HER2 gene overexpression also produces a higher level of protein therefore, the patients with this condition are susceptible to decreased disease free and shorter overall survival rate(Vogel, Charles L., et al, 2002). The non-targeted cytotoxic chemotherapy has been used as a standard treatment of this condition. However, there are several side effects for these non-targeted therapies; such as vomiting, nausea, headache, fatigue, diarrhea, dizziness, anemia, thrombocytopenia, leukemia, anxiety, depression, anorexia and so on(O 'Shaughnessy, Joyce, et al, 2011). Therefore, a lot of patients are unable to use cytotoxic chemotherapy as a standard treatment. It is necessary to have a safe treatment that can serve the unmet purpose of these patients.

Roughly one in eight women in the United States will develop an invasive breast cancer in their lifetime. In 2016, a projected 246,660 new cases of invasive breast cancer are estimated to be detected, along with an additional 61,000 new cases of non-invasive breast cancer. There are greater than 2.8 million women with a diagnosis of breast cancer in the United States, including women presently being treated and women who have completed treatment. Research developments over the past twenty years have ultimately altered the prognosis of breast cancer care. In recent years, there has been an eruption of life-saving advances against breast cancer. Death rates have declined approximately thirty-six percent, believed to be the product of treatment advancement and earlier detection. This paper is intended for those breast cancer patients who are considering breast-conservation surgery, also known as lumpectomy, followed by intracavitary radiation brachytherapy. Patients must be at least forty years old, with a single primary tumor less than three centimeters, negative surgical margins by at least two millimeters, and be without lymph nodal involvement, to be considered candidates for this form of treatment. Radiation therapy is a highly precise and effective way to extinguish minuscule cancer cells that may have been neglected or undetected during surgery. Radiation is often delivered after breast-conserving surgery to reduce the risk that the cancer will recur in the

Jenny is a 45 year old female that is diagnosed with stage IIB, T2pN1aM0 invasive ductal carcinoma, high grade, triple negative, right upper outer quadrant, Ki-67 80% (D05.11), along with status post neoadjuvant chemotherapy with pathologic residual invasive disease, status post right breast mastectomy and lymph noted dissection with prophylactic let breast mastectomy, BRCA1 and BRCA2 negative. Jenny was previously treated with 4 cycles of neoadjuvant dose-dense Adriamycin and cytozan with neulasta, 12 cycles of neoadjuvant weekly taxol, and underwent left breast skin-sparing mastectomy and right breast skin-sparing mastectomy and lymph node biopsy, but still experienced disease progression. Jenny’s disease is aggressive and progressive.

Herceptin (trastuzumab) is a therapeutic monoclonal antibody, which is specifically designed to target HER2 (human epidermal growth factor 2) receptors found on breast cells( Tan, 2010) . HER2 is a receptor protein that is a member of the epidermal growth factor receptor family and is over expressed in approximately 10-20% of breast cancers that have amplification of the HER2 gene (Jatoi, et al., 2010). Herceptin has been found to selectively apply anti-tumor effects in cancer models and patients with HER2+ breast cancer (Gajria & Chandarlapaty, n.d.). Although all normal breast cells present HER2 receptors on their surface, some cells may express more receptors, as high as two million receptors per cell (Vu & Claret, 2012), due to a mutation causing over expression of the HER2 gene. As a result of the increased number of HER2 receptors on the surface of breast cells, more hormones will bind and increased signals are given off, causing the cells to divide quicker and more frequently, resulting in HER2 positive breast cancer.

Methods We reviewed the medical records of all breast cancer patients presented at our institution with stage IV disease between January 2010 and December 2015. Patients were divided into two groups; patients who did surgery for

Materials and Methods Patients In this retrospective study, performed across 4 oncology centers in Saudi Arabia and Egypt, we evaluated 280 women who were diagnosed with unilateral early breast cancer from between March 2010 and October 2013. Patients received standard neoadjuvant chemotherapy (6-8 cycles of an anthracycline and Ttaxane-containingregimen) with or without trastuzumab according to the human epidermal growth factor receptor 2 (HER2) status. After excluding patients who underwent breast conservative surgery because of a possible high incidence of recurrence, the included patients underwent modified radical mastectomy with axillary clearance followed by local radiotherapy with/without hormonal treatment for Candide patients,

During the study an independent data monitoring committee was used to obtain unbiased data as well as provide recommendations for revisions to the study. At the end of the study patients who did not die were censored, considered deceased, at the last date they were known to be living. The overall median survival rate was 13.8 months for patients assigned trastuzumab and chemotherapy and 11.1 months for patients assigned to chemotherapy alone. This means that the trastuzumab and chemotherapy treatment provided a 26% reduction in death rate. The trastuzumab plus chemotherapy group also had a significantly improved response rate, progression time, and length of response compared to the chemotherapy only group; suggesting that patient’s overall survival time was longer when there was a high expression of HER2 protein than patients with low expression of HER2 protein. Also adverse events like nausea, neutropenia, vomiting and anorexia were present in both groups but, diarrhea, stomatitis, anaemia, thrombocytopenia, fatigue, weight loss, chills, pyrexia, mucousal inflammation and nasopharyngitis were higher in the trastuzumab and chemotherapy group. But, the proportion

Clinical exams are also very useful because they can check for symptoms of depression, delusions, attention deficits, memory skills, and much more. The Mini Mental State Examination (MMSE) is a questionnaire given to a suspected AD patient. The MMSE asks questions that measures the cognitive impairment as well as language skills of an individual. It also tests subjects on their memory skills by asking basic questions like the date, where they are, and to recall objects that were just previously shown to them. The Blessed Dementia State Scale is used to measure changes in a person’s habits, personality, and everyday life. The level of depression can be determined with the Hamilton Depression Scale. The Present State Examination is a test that identifies the

I will continue applying this outcome after I graduate. I will continue using the references available for making a clinical decision while providing consultation to the customer or any health care professionals. For example, if a pregnant lady comes to the pharmacy asking for a recommendation about the use of Zantac during pregnancy, I will make sure to confirm through the resources available that Zantac is pregnancy category B and therefore it is safe to use in pregnancy before providing any recommendation to her.

“ Fitness Effects on the Cognitive Functions of Older Adults” by Stanley Colcombe and Arthur F. Kramer (2003) is a meta-analytic study aimed to understand the effect of aerobic fitness on various cognitive processes in older, sedentary adults. The authors stated that there are some statistical discrepancies between various scientific articles regarding fitness-cognition relationship and thus needed to find a better methodological approach to finding an answer(Colcombe & Kramer, 2003).

Clinical trials are often designed to test new biomedical or behavioral interventions such as new treatments/drugs, prevention strategies, screening programs, diagnostic tests, and educational models. The rapid increase in the costs of conducting clinical trials has made the efficient design of clinical trials more important in recent years. For example, a new report published by Tufts Center for the Study of Drug Development (CSDD) expresses that the costs of new drug development which is one of the wide applications of clinical trials have been pegged at $2.558 billion, with a 145% increase over an estimate made in 2003 [9].