Treatment of oncological patients must be based upon multidisciplinary approach, and takes place in specialized oncological centers. By the end of a specific oncological treatment further follow-up ...is being managed mostly by the oncologists, but the role of the general practitioners becomes more important every day and therefore should be precisely defined. Nowadays, most of the existing follow-up guidelines are not being based on prospective studies, yet on the expert’s opinion of a precise oncological center or specialists. The aim of the Croatian Society of Medical Oncology (CSMO) with these recommendations is to standardize and rationalize the diagnostic procedures’ algorithm in follow–up of oncological patients after primary treatment, in patients with planocellular head and neck cancer, oesophageal cancer, gastric cancer and colorectal cancer.
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From 1995, data on students' achievement in schools (i.e., teacher's grades) and all data on achievement in the 5-subject group certificate - the Matura exam - have been systematically gathered for ...the entire yearly cohort of students in upper secondary education in Slovenia. This paper describes an on-line data selection system and data analysis tool designed for national subject testing committees, schools, and teachers as feedback for analyses of effectiveness, for the improvement of teaching in the classroom and for better learning. The use of data to influence teacher planning of future instructional activities for new groups of students (or for adjustment of policies) can in the long run lead to systematic improvement. This might be considered a secondary level of formative assessment - a key step in a continuous PDCA (Plan, Do, Check, Act) process to establish and assure the quality of education.
There are stark variations in the achievement distributions in Slovenia between paper and pencil Matura exams graded externally compared to Matura coursework and oral exams in schools graded ...internally. The extremely high average scores for internal grading of Matura subjects' coursework and upward annual trends are presented in this paper. The differences in the distribution of three pairs of achievements for some schools in comparison to the entire country are also shown with an ordinal dominance graphs: for teachers' grades before Matura exams, for externally graded paper and pencil exams and internally graded Matura subjects' coursework. Very different distributions for external and internal grading in schools are disturbing and unjust. Grading in the end of Gimnazija program must also discriminate and show differences among Matura candidates according to achieved goals and standards. It is shown that as a rule, high achievement for the external parts is followed by low achievements for the internal parts and vice-versa. Since there some important learning goals that cannot be assessed using paper and pencil tests but can however be assessed using coursework, the possibility for change is outlined in this paper, suggesting that internally graded coursework and oral exams should also be externally moderated. PUBLICATION ABSTRACT
Modern educational systems are based on standards. Systems in countries all over the world differ and have different tradition, so different terms are used for similar concepts. In education, ...standards should have a similar role as in physics, where they are empirical and measurable. Two types of standards can be defined: content or curriculum standards and performance standards, with the latter being essential. Setting educational goals or content standards is the first step in the construction of knowledge measurement procedures. In Slovenia, the traditional term 'performance objective' or 'instructional objective' can be used instead of the term 'content standards'. For each school subject on different levels in Slovenian educational system, performance standards have to be set in the future, if educational system is to be based on standards.
Liječenje onkoloških bolesnika mora se temeljiti na multidisciplinarnom pristupu, a provodi se u specijaliziranim
onkološkim centrima. Nakon završetka specifičnog onkološkog liječenja daljnje ...praćenje uglavnom provode onkolozi, ali
je uloga liječnika primarne zdravstvene zaštite (PZZ) sve važnija i potrebno ju je jasno defi nirati. Trenutačno većina preporuka
za praćenje nije temeljena na prospektivnim studijama, već se zasniva na stručnim mišljenjima pojedinih onkoloških
centara ili specijalista. Hrvatsko društvo za internističku onkologiju (HDIO) ovim preporukama želi standardizirati i racionalizirati
dijagnostičke postupke u praćenju onkoloških bolesnika, nakon završetka primarnog liječenja, u bolesnika s
planocelularnim rakom glave i vrata, rakom jednjaka, rakom želuca te rakom debelog i završnog crijeva.
D. Zupanc presented the method of the ongoing analyses of student assessment data – ALA Tool, where the analyses of achievements in national examinations with the summative assessment function are ...complemented with the formative function. Professional monitoring system provides schools confidential information on their performance and function as a basis for raising effectiveness and quality management. Student assessment should be closely related to the curriculum and based on the achieved standards. Based on the studies of the international knowledge measurement (PISA) it was established that curriculum-based external examination has a very positive effect on the quality of outcomes. The curriculumbased exist exams has a positive effect on the equity as well, as low SES students benefit more than high SES students. It was also established that upon the implementation of school autonomy by its staff the effects on the outcomes were positive. High(er) autonomy 'goes hand in hand' with high(er) accountability for the quality of work in schools. The ongoing analyses of student assessment data are a basis for professional discussions, analyses and interpretations, and, based on the gathered data and conclusions, for action-taking and improvements within the PDCA cyclic model as a quality management tool and effectiveness in education.
A prospective randomized clinical study was performed in patients with locally advanced or metastatic gastric cancer. The purpose of the study was to determine the activity of high doses of ...5-fluorouracil and epirubicin (FE) vs. the same combination + cisplatin (FEP), and particularly the value of cisplatin in the combination.
A total of 122 patients was included in the study; 110 of them were assessable. In the FE arm, the treatment involved 1000 mg/m2 in a 6-hr infusion of 5-fluorouracil on days 1, 2, 3, 4 and 5 and 120 mg/m2 of epirubicin i.v. on day 1. In the FEP arm, the same combination of cytostatics + cisplatin (30 mg/m2) was administered on days 2 and 4. The cycles were repeated after 4 weeks. Altogether, 468 cycles of chemotherapy were given (FE, 240; FEP, 228).
In the FE arm, 56 patients were assessable, with 2 complete and 14 partial remissions (28.6%); in the FEP arm, 4 complete and 19 partial remissions (42.6%) were observed in 54 assessable patients. Median survival in the FE group was 7.1 months and in the FEP group 9.6 months. The survival difference was statistically significant (Cox's test, P<0.05). The most frequent side effects included grade 2 and 3 alopecia (FE, 93%; FEP, 94%) and grade 2 and 3 vomiting (FE, 20%; FEP, 35%). Grade 3 and 4 leukopenia was observed in 9% of patients in the FE group and in 13% of patients in the FEP group, with 6 cases of febrile neutropenia (FE, 4%; FEP, 7%). Stenocardia was registered in 1 patient in the FE group and in 2 patients in the FEP group. No treatment-related death was registered.
The addition of cisplatin to high doses of 5-fluorouracil and epirubicin resulted in a statistically significant better survival of treated patients.
Forty-four patients with advanced gastric cancer were treated with a combination including 5-fluorouracil, 4-epi-doxorubicin and mitomycin C. 4-Epi-doxorubicin was substituted for adriamycin in ...MacDonald's original schedule. The combined treatment involved 600 mg/m2 i.v. of 5-fluorouracil on days 1, 8, 29 and 36; 80 mg/m2 i.v. of 4-epi-doxorubicin on days 1 and 29; and 10 g/m2 i.v. of mitomycin C on day 1. The cycle was repeated on day 57 after the start of treatment. Out of 44 patients, 39 were evaluable. Thirteen partial remissions (33%) were achieved. The average duration of remission was 7 months (range, 3-12 months). The average survival of the responders was 9 months, and that of nonresponders 3.5 months. Toxicity was moderate, well-tolerated and, as compared with the FAM schedule, less pronounced, particularly as regards myelotoxicity. Thus, the substitution of 4-epi-doxorubicin for adriamycin in the original schedule of MacDonald et al. (1980) did not improve treatment results, but the observed toxicity was less pronounced.
U bolesnika s rakom dojke slezena je vrlo rijetko zahvaćena metastatskom bolešću. Te se metastaze u literaturi rijetko opisuju. U ovom prikazu slučaja autori iznose slučaj bolesnice s rakom dojke ...koja je godinu dana nakon radikalne mastektomije zbog raka dojke bez simptoma primljena u bolnicu radi redovitih pretraga u sklopu praćenja bolesti. Kako su nalazi upućivali na metastaze u slezeni, obavljena je eksplorativna laparotomija i splenektomija. Nalazi su pokazali promjene koje oponašaju metastaze slezene s dijagnozom kavernoznog hemangioma slezene. U radu se raspravlja o patološkim i kliničkim značajkama, predstavljanju, procjeni i liječenju te bolesnice. Stanje bolesnice nakon operacije bilo je dobro i upućena je na daljnje onkološko liječenje.
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