Obstetricians & Gynecologists, Family Physicians Learning Objectives: After completion of this article, the reader will be able to describe the two types of cylooxygenase enzymes (COX), to list the effects and side effects of NSAIDs and COX-2 medications, and to outline the various changes in COX expression during pregnancy.
Women with an antenatal diagnosis of placenta accreta should be managed in a tertiary facility with multidisciplinary input. To determine optimum management strategies, it is imperative that larger studies are carried out in the future. It is essential that the continual monitoring and containment of rising caesarean section rates becomes a priority to prevent a further increase in the incidence of placenta accreta.
e20687 Background: Breast cancer survivors account for the majority of cancer survivors in Ireland. There are no published data on the issues facing this group of patients. This study investigates the needs of a cohort of Irish breast cancer survivors who completed hospital-based follow-up and were recently discharged to their general practitioners (GP’s.) Physical, psychological, social and spiritual concerns were investigated. Secondary aims were to assess patient satisfaction with discharge from hospital-based services, satisfaction with GP follow-up, and the benefit of a survivorship discharge pack. Methods: A cohort of patients in the South East Cancer Centre was identified. Inclusion criteria were: a history of localized breast cancer, completion of adjuvant therapy within the last 5 years, and discharge to the patient’s GP in the last 6 years. An anonymous questionnaire was developed from standardized survivorship questionnaires, and ethical approval obtained. Subgroup analyses were completed for age and time since diagnosis using Fisher’s exact and Cochran-Armitage tests. Results: 80 patients were identified. 44 patients (55%) completed and returned the questionnaire. 5 patients were excluded (6%). The median age was 53 years (range: 41-65 years.) The commonest concerns were fatigue (51%), fear of recurrence (69%) and concerns regarding second cancers (69%.) 23 patients (59%) were satisfied with discharge to their GP and 25 patients (64%) were content with GP follow-up. 23 patients (59%) reported that a treatment summary would be of benefit. 27 patients (67%) felt they would benefit from a discharge pack. Patients under 60 years of age were more likely to report physical concerns (p=0.012). Patients reported fewer physical and psychological concerns over time after diagnosis (p-trend <0.001). Conclusions: This is the first Irish breast cancer survivorship study. Irish breast cancer survivors had ongoing concerns, but were satisfied with GP follow-up care. The current model of care could potentially be improved by the provision of a discharge pack that includes a treatment summary.
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