Cancer du sein: inhibiteurs de l'aromatase en situation adjuvante, un peu, beaucoup ou pas du tout [Aromatase inhibitors in the adjuvant treatment of postmenopausal patients with early breast cancer: a little, a lot or no way?]

Several large randomized trials showed that tamoxifen alone is no more the standard adjuvant hormonal therapy for menopausal patients. Aromatase inhibitors, given upfront or sequentially after tamoxifen, confirmed their efficacy by improving disease free survival, risk of distant metastasis and overall survival in some situations or subgroups of patients. These drugs are usually well tolerated, but they clearly increase bone mineral density loss as well as the risk of fractures and their long term safety on the cardio-vascular system needs to be followed. Thus, even if the role of the aromatase inhibitors is now evident in the adjuvant therapy of postmenopausal women the benefice/risk ratio should be carefully evaluated for each patient.

Nursing staff sizing in the emergency room of a university hospital

OBJECTIVE To verify the adequacy of the professional nursing staff in the emergency room of a university hospital and to evaluate the association between categories of risk classification triage with the Fugulin Patient Classification System. METHOD The classification of patients admitted into the emergency room was performed for 30 consecutive days through the methodology proposed by Gaidzinski for calculating nursing requirements. RESULTS The calculation determines the need for three registered nurses and four non-registered nursing for each six hour shift. However, only one registered nurse and four non-registered nurse were available per shift. There was no correlation between triage risk classification and classification of care by the Fugulin Patient Classification System. CONCLUSION A deficit in professional staff was identified in the emergency room. The specificity of this unit made it difficult to measure. To find the best strategy to do so, further studies should be performed.