CASE REPORT: An elderly lady presented with an enlarging painful left breast lump for 1 year. Palpable left breast lump noted on clinical examination. Mammography demonstrated a high density, oval lesion with a partially indistinct margin. Corresponding ultrasound showed a large irregular heterogeneous lesion with solid-cystic areas. Histopathology showed atypical spindle-shaped cells which stained positive for cytokeratins and negative for hormone and human epidermal growth factor receptors, which favours spindle cell metaplastic carcinoma. Left mastectomy and axillary dissection were performed, and the final diagnosis was consistent with metaplastic spindle cell carcinoma.
CONCLUSION: Spindle cell carcinoma of the breast is a rare aggressive histological type of carcinoma which may present with benign features on imaging. Tissue diagnosis is essential for prompt diagnosis with multidisciplinary team discussion to guide management and improve patient's outcome.
METHODS: Twenty patients were recruited from a public hospital and attended DBT skills groups in an outpatient clinic. Participants completed measures assessing psychological symptoms, self-harm behaviors, suicidal ideation, emotion regulation difficulties, self-compassion, and well-being pre- and post-intervention.
RESULTS: There were significant reductions in depressive symptoms, stress, and emotion regulation difficulties, as well as increases in self-compassion and well-being from pre- to post-intervention. A trend was found for decreases in frequency and types of non-suicidal self-harm behaviors, suicidal ideation, and anxiety symptoms. Qualitative content analyses of participants' feedback indicated that the vast majority of participants perceived a positive impact from the skills group, with mindfulness and distress tolerance being rated frequently as skills that were beneficial.
CONCLUSION: These preliminary findings suggest that DBT skills training is feasible and acceptable in a Muslim-majority, low resource clinical setting, and holds promise in improving clinical outcomes among BPD patients in Malaysia.
Methods: A 33-item EI questionnaire was completed by 46 dental undergraduates in a cross-sectional study. Responses, measured on a five-point Likert scale, were summed to yield EI scores. Patients treated by the same undergraduates were invited to complete a patient satisfaction (PS) questionnaire. EI and PS scores were calculated and compared by undergraduates' gender and the patients' age and education status. The four EI factors (optimism/mood regulation, appraisal of emotions, utilization of emotions, and social skills of students) were correlated with PS using Spearman's correlation test with a significance level set at p < 0.05.
Results: EI scores did not differ significantly between male (N = 23) and female (N = 23) undergraduates (p=0.218). PS was not associated with patients' gender, but those educated to the secondary school level were more likely to be satisfied compared to those educated to the college/university level (p=0.022). Of the four EI factors, optimism/mood regulation was positively correlated with PS (p=0.049).
Conclusion: The results of the study suggest that the EI of the students can influence PS. Practical Implications. Interventions to enhance EI can be developed to improve the patient experience.