The clinical and pathological data of eight cases of nasal solitary keratoacanthoma were analyzed and relevant literatures were reviewed. All of the cases were verified via pathological examination after local lesion excision, along with reconstruction of tissue defects in external nose. The patients were all primary healed. With a follow up from 8 months up to 7 years, only one case relapsed one year after first surgery, and given another operation, no recurrence happened thereafter. The other seven cases did not recur so far. The nasal solitary keratoacanthoma is a squamous tumor with potential malignancy, which manifests similarly with squamous cell carcinoma, and the correct diagnosis requires comprehensive judgment from both the clinical and histopathological characteristics. The disease shows favorable prognosis and low recurrence rate.
Adult ; Aged ; Female ; Humans ; Keratoacanthoma ; Male ; Middle Aged ; Nose Neoplasms

OBJECTIVE: To investigate the clinical manifestation, pathological characteristics, treatment and prognosis of dendritic cell tumor. METHOD: Four cases of nasal and pharyngeal dendritic cell tumor were described, including two cases of follicular dendritic cell sarcoma (FDCS), one case of Langerhans cell histiocytosis (LCH) and one case of Langer hans cell sarcoma (LCS). One of the patients with FDCS received multimodality therapy (surgery combined with chemotherapy), and the other patient only received chemotherapy and radiotherapy. The patients with LCH or LSC were treated by surgery. RESULT: Of the two FDCS patients, one achieved complete remission after treatment by surgery combined with four cycles of CHOP chemotherapy regimen and concurrent radiotherapy (50 Gy), and the other who only received chemotherapy and radiotherapy survived with tumor for more than seven months of follow up. The patient of LCH was followed up for more than 2 years after surgery without recurrence or metastasis. The patient of LCS did not undergo radiotherapy or chemotherapy after surgery and died after 10 months of follow up. CONCLUSION Dendritic cell tumor is a group of very rare tumor and can be easily misdiagnosed in clinic, the confirmed diagnosis of which relies on histopathological features, immunohistochemistry combined with electron microscopy. FDCS, LCH and LCS have different pathological features, immunophenotypes and prognosis.
Child ; Child, Preschool ; Dendritic Cell Sarcoma, Follicular ; pathology ; therapy ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms ; pathology ; therapy ; Prognosis

OBJECTIVE: To study the diagnosis, treatment and prognosis of sinonasal neuroendocrine carcinoma. METHOD: Eight patients with sinonasal neuroendocrine carcinoma from February 2009 to February 2012 were retrospectively analyzed and the related literatures were reviewed. RESULT: There were seven males and one female. Three cases were treated by surgery only, one case received surgery followed by radiotherapy, and four cases were treated by combined treatment (surgery followed by radiotherapy and chemotherapy). There were three patients with a primary tumor originating from the maxillary sinus, two cases died after 8 and 14 months, another patient was survived in 10 months of follow-up, and the carcinomas did not recur. There were five patients with primary neuroendocrine carcinoma from the nasal cavity, one patient recurred after the surgery and after radiotherapy, the patient did not recur after 20 months of follow-up, and the other four patients did not recur, in 13, 20, 27 and 28 months of follow-up. CONCLUSION Neuroendocrine carcinomas of the sinuses are rare malignant tumors. Neuroendocrine carcinomas cases with the lesions at different sites differ in the clinical manifestations and prognosis, pathology, immunocytochemistry and electron microscopy, It should be differentiated from poorly differentiated squamous carcinoma melanoma, olfactory nerve blastoma and neurospongioma. The key to improve the survival rate of the disease is early accurate diagnosis and combined treatment.
Adult ; Carcinoma, Neuroendocrine ; pathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Nose Neoplasms ; pathology ; therapy ; Prognosis ; Retrospective Studies

BACKGROUND AND OBJECTIVE

Public health nurses (PHNs) are vital in the local implementation of the provisions of the Universal Healthcare (UHC) Act of 2019. However, they need adequate competencies in health systems approach to successfully implement the provisions of the law. In response to this, a leadership development course for public health nurses (LDC-PHN), anchored on the building blocks of health systems, was developed and implemented. This paper aims to describe the extent to which training participants have applied the competencies acquired from the LDC-PHN as manifested by the workplace application of their capstone projects.

METHODS

Following Kirkpatrick’s Model of Evaluation, we used a multi-method study design to evaluate the extent of the participants’ workplace application of acquired competencies. Sources of data included the Workplace Application Plan (WAP) accomplished by each participant, a questionnaire to determine the perceived implementation status of the participants’ capstone project, interviews, and focus group discussions (FGDs) conducted with selected participants and their supervisors, and observation visits. Data were collected from May to December 2022. Data from the semi- structured interviews and FGDs were analyzed through content analysis, while the participants’ perceived status of their capstone project implementation was summarized as frequencies.

RESULTS

Majority of the participants (61.9%) reported partial implementation of their capstone project while 16.77% reported full implementation. Capstone project implementation was facilitated by the support received from their supervisors and local chief executives. Barriers identified included the demands of the COVID-19 pandemic and the challenges imposed by the events before and after the 2022 Philippine National elections. Major themes emerged from the interviews conducted among participants and their supervisors. The workplace application of the training program outcomes, based on participants’ perspectives, yielded increased capacity to lead and innovate, improved ability to advocate for capstone project implementation, transferability of acquired skill sets, and improved population outcomes. From supervisors’ perspectives, workplace application of training program outcomes include increased ability of PHNs to deliver health services, and visible enhancement of leadership and supervision skills among PHNs.

CONCLUSION

Given ample support and opportunities, and despite the barriers and challenges they faced, LDC-PHN participants, in general, utilized and applied the competencies they gained from the course in their actual work setting. Course graduates participated in health systems strengthening at various capacities by acting upon their capstone projects that addressed UHC challenges within their particular work settings.

Leadership ; Universal Health Care ; Nurses, Community Health ; Community Health Nurses ; Nurse' ; s Role