Question

For this written assignment, select one recent (within the last two years) evidence-based article from a peer reviewed nursing journal that describes a "best practice" in an area of nursing you are interested in. For example, if you would like to be a pediatric nurse, select an article that discusses a best practice in pediatric care.

Cite the article and provide a brief overview of how the results or findings were obtained. Then describe the "best practice." Conclude your discussion by explaining whether you thought the research findings supported the conclusions and the best practice.

This assignment must be no more than 3 pages long. It should include all of the required elements. Use APA Editorial format and attach a copy of the article.

PLEASE ATTACH THE COPY OF THE ARTICLE. WILL REALLY APPRECIATE THE HELP.

THANKS

Answer 1

Gynaecology deals with any ailment concerning with the female reproductive organs; uterus, fallopian tubes, cervix, ovaries and vagina and the accessory reproductive organs such as breasts. The field of gynaecology focuses on all other aspects of a woman’s reproductive health from the onset of puberty through menopause and beyond.

For women in the U.S., breast cancer death rates are higher than those for any other cancer. Breast cancer is the most commonly diagnosed cancer among American women. In 2017, it's estimated that about 30% of newly diagnosed cancers in women will be breast cancers.

In women under 45, breast cancer is more common in African-American women than white women. Overall, African-American women are more likely to die of breast cancer.

*As of January 2018, there are more than 3.1 million women with a history of breast cancer in the U.S. This includes women currently being treated and women who have finished treatment.

*A woman’s risk of breast cancer nearly doubles if she has a first-degree relative (mother, sister, daughter) who has been diagnosed with breast cancer. Less than 15% of women who get breast cancer have a family member diagnosed with it.

*About 5-10% of breast cancers can be linked to gene mutations inherited from one’s mother or father. Mutations in the BRCA1 and BRCA2 genes are the most common. On average, women with a BRCA1 mutation have up to a 72% lifetime risk of developing breast cancer. For women with a BRCA2 mutation, the risk is 69%. Breast cancer that is positive for the BRCA1 or BRCA2 mutations tends to develop more often in younger women.

*About 85% of breast cancers occur in women who have no family history of breast cancer. These occur due to genetic mutations that happen as a result of the ageing process and life in general, rather than inherited mutations.

*The most significant risk factors for breast cancer are gender (being a woman) and age (growing older).

Silvia Dellapasqua; Kathryn P. Gray; Elisabetta Munzone; Daniela Rubino; Lorenzo Gianni; Harriet Johansson, "Neoadjuvant Degarelix Versus Triptorelin in Premenopausal Patients Who Receive Letrozole for Locally Advanced Endocrine-Responsive Breast Cancer: A Randomized Phase II Trial"Journalof Clinical Oncology,DOI: 10.1200/JCO.18.00296 Journal of Clinical Oncology 37, no. 5 (February 10 2019) ,Published online December 27, 2018.PMID: 30589600.

PURPOSE:

To evaluate endocrine activity in terms of ovarian function suppression (OFS) of degarelix (a gonadotropin-releasing hormone [GnRH] antagonist) versus triptorelin (a GnRH agonist) in premenopausal patients receiving letrozole as neoadjuvant endocrine therapy for breast cancer.

PATIENTS AND METHODS:

Premenopausal women with stage cT2 to 4b, any N, M0; estrogen receptor and progesterone receptor greater than 50%; human epidermal growth factor receptor 2–negative breast cancer were randomly assigned to triptorelin 3.75 mg administered intramuscularly on day 1 of every cycle or degarelix 240 mg administered subcutaneously (SC) on day 1 of cycle 1 then 80 mg SC on day 1 of cycles 2 through 6, both with letrozole 2.5 mg/day for six 28-day cycles. Surgery was performed 2 to 3 weeks after the last injection. Serum was collected at baseline, after 24 and 72 hours, at 7 and 14 days, and then before injections on cycles 2 through 6. The primary endpoint was time to optimal OFS (time from the first injection to first assessment of centrally assessed estradiol level ≤ 2.72 pg/mL [≤ 10 pmol/L] during neoadjuvant therapy). The trial had 90% power to detect a difference using a log-rank test with a two-sided α of .05. Secondary endpoints included response, tolerability, and patient-reported endocrine symptoms.

RESULTS:

Between February 2014 and January 2017, 51 patients were enrolled (n = 26 received triptorelin plus letrozole; n = 25 received degarelix plus letrozole). Time to optimal OFS was three times faster for patients assigned to degarelix and letrozole than to triptorelin and letrozole (median, 3 v 14 days; hazard ratio, 3.05; 95% CI, 1.65 to 5.65; P < .001). Furthermore, OFS was maintained during subsequent cycles for all patients assigned to receive degarelix and letrozole, whereas 15.4% of patients assigned to receive triptorelin and letrozole had suboptimal OFS after cycle 1 (six events during 127 measurements). Adverse events as a result of both degarelix plus letrozole and triptorelin plus letrozole were as expected.

CONCLUSION:

In premenopausal women receiving letrozole for neoadjuvant endocrine therapy, OFS was achieved more quickly and maintained more effectively with degarelix than with triptorelin.

In my view, I thought the research findings supported the conclusions and the best practice.