2.Uterine clear cell carcinoma risk in White versus non-White US subpopulations: does race matter?
Stephanie CHOW ; Deanna WONG ; Cheng-I LIAO ; Amandeep MANN ; Chunqiao TIAN ; Kathleen M. DARCY ; John K. CHAN
Journal of Gynecologic Oncology 2020;31(6):e81-
Objective:
To determine incidence rates of uterine clear cell carcinoma among non-White US subpopulations.
Methods:
Data from the United States Cancer Statistics and National Cancer Database from 2004 to 2016 were analyzed using descriptive statistics.
Results:
A total of 488,811 women were diagnosed with uterine cancer from 2004–2016.Of these, 73.3% were endometrioid, 6.6% were serous, 5.3% were carcinosarcoma, 1.4% were clear cell, and 13.4% were other. Blacks had the highest incidence rate of uterine clear cell compared with Whites, Asian/Pacific Islanders, and American Indian/Alaska Natives (0.59 vs. 0.31, 0.29, and 0.24, respectively). Overall mean age at diagnosis was 68.6 years, with the youngest age in Asian/Pacific Islanders compared to Whites, Blacks, and American Indian/Alaska Natives (65.9 vs. 68.7, 68.6, and 66.3 years, respectively). Analysis of the Asian subpopulation revealed significantly younger age at diagnosis in Vietnamese women (55.8 years) compared with 72.4 years in Japanese, 68.6 years in Pacific Islander, 66.6 years in Indian/Pakistani, 65.9 years in Filipino, 65.8 years in Chinese, 65.2 years in Korean, and 63.7 years in other Asians.
Conclusions
Black women are two times more likely to be diagnosed with uterine clear cell carcinoma compared with other races. Asians present at younger ages, with Vietnamese women most likely to be diagnosed at the youngest age.
3.Program evaluation and early outcomes of a severe preeclampsia and eclampsia maternal safety bundle in a single institution in the Philippines
Zarinah Garcia Gonzaga ; Maria Rosario Castillo‑Cheng ; Joseph Carl Macalintal ; Lizzette Caro-Alquiros ; Stephanie Causin ; Grace Lynn Santos Estanislao
Philippine Journal of Obstetrics and Gynecology 2024;48(2):83-89
Background:
To reduce maternal morbidity and mortality associated with hypertension, standards for
maternal safety and efforts to implement a structured team approach have been undertaken. Following the formulation of a policy document, a maternal safety bundle was developed. The implementation of bundle components including eclampsia kits, clinical pathways, and educational module occurred in phases due to pandemic restrictions. An eclampsia kit and clinical pathways were implemented in 2020. An online lecture was launched in 2021 followed by in-person eclampsia simulation workshop beginning 2022.
Objectives:
This paper aims to report the early outcomes of a severe preeclampsia and eclampsia maternal safety bundle implementation in a private hospital between 2020 to 2023.
Materials and Methods:
Demographic information, posttest knowledge assessment and preand post- eclampsia workshop confidence scores were recorded. Structure, process, and outcome
measures were determined. Descriptive statistics were used for participant demographics and score
percentages. Paired t-Test with a significance level of P<0.05 was used to compare the pre- and
post-simulation confidence scores. Summary data for outcome and process metrics were manually
calculated. Summary categorical data was used for structure metrics.
Results:
Two hundred eighty-eight (288) participants completed the online didactic lecture. Average
posttest knowledge assessment score was 88.1%, 88.88%, and 82.6% from 2020 to 2023. Ninety-nine
participants completed the eclampsia simulation workshops. Mean post-simulation confidence scores
were greater than mean pre-simulation confidence scores (42.3 vs. 39, p=0.0259 in 2022 and 41.975 vs
36.65, P=0.0035 in 2023). There is 100% compliance with timely management of severe hypertension
and eclampsia prevention and a decreasing trend in hypertension related severe maternal morbidity rates.
Conclusion
A severe preeclampsia and eclampsia maternal safety bundle is a feasible quality
improvement initiative that promotes peer learning, strengthens clinical competencies, and improves
access to emergency resuscitation supplies. The results of this program evaluation may serve as a
framework for implementing quality improvement initiatives on maternal safety.