scholarly journals Safe Provision of Systemic Anti-Cancer Treatment for Urological Cancer Patients During COVID-19: A Tertiary Centre Experience in the First Wave of COVID-19

2022 ◽  
Author(s):  
Alfred Chung Pui So ◽  
Christina Karampera ◽  
Muhammad Khan ◽  
Beth Russell ◽  
Charlotte Moss ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
Urological Cancer ◽  
Single Centre ◽  
Oncology Patients ◽  
Tertiary Centre ◽  
Number Of Patients ◽  
Anti Cancer ◽  
Single Centre Study ◽  
Low Incidence ◽  
Ongoing Concern

Abstract Background Safe provision of systemic anti-cancer treatment (SACT) during the COVID-19 pandemic remains an ongoing concern amongst clinicians. Methods Retrospective analysis on uro-oncology patients who continued or started SACT between 1st March and 31st May 2020 during the pandemic (with 2019 as a comparator). Results 441 patients received SACT in 2020 (292 prostate, 101 renal, 38 urothelial, 10 testicular) compared to 518 patients in 2019 (340 prostate, 121 renal, 42 urothelial, 15 testicular). In 2020, there were 75.00% fewer patients with stage 3 cancers receiving SACT (p<0.0001) and 94.44% fewer patients receiving radical treatment (p=0.0019). The number of patients started on a new line of SACT was similar between both years (118 in 2019 vs 102 in 2020; p=N.S) but with 53.45% fewer patients started on chemotherapy in 2020 (p=0.00067). Overall, 5 patients tested positive for COVID-19 (one asymptomatic, two moderate pneumonitis, one severe pneumonitis). Compared to 2019, 30-day mortality was similar (1.69% in 2019 vs 0.98% in 2020; p=N.S) whereas the 6-month mortality was lower (9.32% in 2019 vs 1.96% in 2020; p=0.023) in 2020. Conclusion This single-centre study demonstrated that uro-oncology patients can safely receive SACT during COVID-19 pandemic with a low incidence of infection and mortality.

Acute mastoiditis and intracranial complications in children

2021 ◽  
Vol 70 (4) ◽  
pp. 207-213
Author(s):  
Andrea Kaliariková ◽  
Klára Perceová ◽  
Jan Machač ◽  
Michal Jurajda ◽  
Milan Urík
Keyword(s):  
Streptococcus Pneumoniae ◽  
Patient Group ◽  
Clinical Manifestations ◽  
Aetiological Agent ◽  
Acute Mastoiditis ◽  
Average Value ◽  
Tertiary Centre ◽  
Number Of Patients ◽  
Intracranial Complications ◽  
Low Incidence

Objectives: Characterisation of clinical manifestations in children who had acute mastoiditis (AM) -related intracranial complications (ICCs) and to determine the incidence of ICCs in the study group. To define children with a higher risk of ICCs and gain new information on aetiological microbial agents of AM. Methods: A retrospective analysis of 137 paediatric patients with AM treated at a tertiary centre using standard dia­gnostic and therapeutic protocol between 2002 and 2019. Results: Altogether 137 patients with AM were hospitalised at our centre between 2002 and 2019. During this time, the occurrence of ICC in children with AM was low (n = 3, incidence 2.19%). Due to the low number of patients with ICC with AM in our patient group, we were unable to define a specific group of patients with a higher risk of ICC development in AM. Despite this fact, the average value and median of CRP were considerably higher in patients with AM-associated ICCs. The most frequent aetiological agent was Streptococcus pneumoniae. Conclusions: The low incidence of ICC in patients with AM in our patient group might be caused by routinely performed paracentesis in developed acute otitis, rational antibio­tic therapy and the good availability of an ENT specialist in the Czech Republic. The most common aetiological agent of AM was Streptococcus pneumoniae. Keywords: Streptococcus pneumoniae – acute mastoiditis – intracranial complications – aetiological agent – antibio­tic therapy – antromastoidectomy

scholarly journals Management of oncology patients receiving anti-cancer treatment in the COVID-19 pandemic

2020 ◽  
Author(s):  
Esat Namal ◽  
Nur Dinc ◽  
Sezer Saglam ◽  
Ali Vefa Ozturk ◽  
Safiye Koculu ◽  
...  
Keyword(s):  
Cancer Treatment ◽  
World Health ◽  
Rt Pcr ◽  
Oncology Patients ◽  
Rna Detection ◽  
Recommended Treatment ◽  
Anti Cancer ◽  
The World ◽  
Oropharyngeal Swab ◽  
Health Organization

Abstract Background/Aim: Severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) has deeply affected life all over the World. The World Health Organization named this disease as COVID-19. The most important factor in the transmission of the disease is asymptomatic carriers. We’ve tested all oncology patients, that receive anti-cancer therapy, for COVİD-19 to prevent asymptomatic oncology patients from spreading infection and to make the decision to postpone chemotherapy in infected patients. Then, we analyzed the clinical and radiological findings of infected patients.Materials and Methods: Oncology patients who have indications of receiving anti-cancer treatment in the hospital were tested for COVID-19, two day prior to their treatment even if they were asymptomatic by collecting nasopharyngeal and oropharyngeal swab specimens for RT-PCR for viral RNA detection. Positive patients, underwent inspiratory phase of chest computed tomography (CT) examination. Infected patients were given the recommended treatment for COVID-19. Anti-cancer treatment of all patients that had positive PCR results was delayed for 14 days.Results: PCR test was positive in 28 of 312 patients that we tested, and the positivity rate was 8.9%. Three patients (10.7%) had symptoms; 2 of whom had dyspnea and cough, and 1 had headache, and 25 patients (89.3%) had no symptoms.Conclusion: In oncology patients, who are receiving anti-cancer treatment, we have to recognize the asymptomatic COVID-19 infection. We recommend testing for COVID-19 in oncology patients receiving chemotherapy, periodically or before each anti-cancer treatment, in order to continue their treatment without any problems and to prevent the risk of transmission.

scholarly journals Safety of systemic anti-cancer treatment in oncology patients with non-severe COVID-19: a cohort study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
C. van Marcke ◽  
N. Honoré ◽  
A. van der Elst ◽  
S. Beyaert ◽  
F. Derouane ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Adverse Events ◽  
Cancer Treatment ◽  
Performance Status ◽  
Rt Pcr ◽  
Bleeding Events ◽  
Oncology Patients ◽  
Treatment Delays ◽  
Ambulatory Oncology ◽  
Anti Cancer

Abstract Background The viral pandemic coronavirus disease 2019 (COVID-19) has disrupted cancer patient management around the world. Most reported data relate to incidence, risk factors, and outcome of severe COVID-19. The safety of systemic anti-cancer therapy in oncology patients with non-severe COVID-19 is an important matter in daily practice. Methods ONCOSARS-1 was a single-center, academic observational study. Adult patients with solid tumors treated in the oncology day unit with systemic anti-cancer therapy during the initial phase of the COVID-19 pandemic in Belgium were prospectively included. All patients (n = 363) underwent severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) serological testing after the first peak of the pandemic in Belgium. Additionally, 141 of these patients also had a SARS-CoV-2 RT-PCR test during the pandemic. The main objective was to retrospectively determine the safety of systemic cancer treatment, measured by the rate of adverse events according to the Common Terminology Criteria for Adverse Events, in SARS-CoV-2-positive patients compared with SARS-CoV-2-negative patients. Results Twenty-two (6%) of the 363 eligible patients were positive for SARS-CoV-2 by RT-PCR and/or serology. Of these, three required transient oxygen supplementation, but none required admission to the intensive care unit. Hematotoxicity was the only adverse event more frequently observed in SARS-CoV-2 -positive patients than in SARS-CoV-2-negative patients: 73% vs 35% (P < 0.001). This association remained significant (odds ratio (OR) 4.1, P = 0.009) even after adjusting for performance status and type of systemic treatment. Hematological adverse events led to more treatment delays for the SARS-CoV-2-positive group: 55% vs 20% (P < 0.001). Median duration of treatment interruption was similar between the two groups: 14 and 11 days, respectively. Febrile neutropenia, infections unrelated to COVID-19, and bleeding events occurred at a low rate in the SARS-CoV-2-positive patients. Conclusion Systemic anti-cancer therapy appeared safe in ambulatory oncology patients treated during the COVID-19 pandemic. There were, however, more treatment delays in the SARS-CoV-2-positive population, mainly due to a higher rate of hematological adverse events.

scholarly journals Single Center Experience on Screening Oncology Patients for Covid-19 Before Anti-Cancer Treatment

2020 ◽  
Vol 30 (4) ◽  
pp. 207-212
Author(s):  
ESAT NAMAL
Keyword(s):  
Cancer Treatment ◽  
High Rate ◽  
Rt Pcr ◽  
Oncology Patients ◽  
Rna Detection ◽  
Asymptomatic Carriers ◽  
Single Center Experience ◽  
Recommended Treatment ◽  
Anti Cancer ◽  
Oropharyngeal Swab

The most important factor in the transmission of the COVID-19 is asymptomatic carriers. We’ve tested all oncology patients , that receive anti-cancer therapy, for COVID-19. We aimed to determine the rate of asymptomatic carriers, and analyze the clinical and ra- diological findings of infected patients. Oncology patients who have indications of receiving anti-cancer treatment in the hospital were tested for COVID-19, two day prior to their treatment even if they were asymptomatic by collecting nasopharyngeal and oropharyngeal swab specimens for RT-PCR for viral RNA detection. Positive patients, underwent inspiratory phase of chest computed tomography examination. Infected patients were given the recommended treatment for COVID-19. PCR test was positive in 28 of 312 patients that we tested, and the positivity rate was 8.9%. Three patients (10.7%) had symptoms, 25 patients (89.3%) had no symptoms. Covid-19 testing before anti-cancer treatment may be recommended in order to continue their treatment without any problems and to prevent the risk of transmission due to the high rate of asymptomatics in infected patients. Keywords: COVID-19, Pandemic, Chemotherapy, Oncology

P4722Using the multidimensional prognostic index (MPI) to predict outcome in patients undergoing transcatheter mitral valve repair with MitraClip: a prospective observational single centre study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M I Koerber ◽  
M Schaefer ◽  
R Vimalathasan ◽  
S Baldus ◽  
R Pfister
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Barthel Index ◽  
Prognostic Index ◽  
Risk Scores ◽  
Valve Repair ◽  
Single Centre ◽  
Centre Study ◽  
Number Of Patients ◽  
Single Centre Study

Abstract Background Selection of patients who benefit from percutaneous mitral valve repair (PMVR) is challenging. We used the multidimensional prognostic index (MPI) to evaluate patients' prognosis. Methods We conducted a prospective observational single centre study, including patients who did undergo PMVR from 11/2017 to 07/2018. MPI score was used for geriatric assessment and calculated from 63 separate items distributed in eight domains including instrumental activities of daily living, mental status, nutrition, risk of pressure ulcers, comorbidity, medication and marital/cohabitation status. Results 82 patients were included. Mean MPI-Score was 0.22±0.21. 41 patients (50%) belonged to MPI-1 group (low risk), 37 (45.1%) to MPI-2 group (medium risk) und 4 patients (4.9%) to MPI-3 group (high risk). Due to the low number of patients in MPI-3 group, MPI-2 group and MPI-3 group were combined for statistical analysis. Baseline characteristics, functional assessment and outcome of patients are shown in Table1. During follow-up 4 patients died. All of these belonged to the higher risk group MPI 2/3. Table1 MPI 1 MPI 2+3 p value Age 73.2±8.8 78.9±7.6 0.002 6 min walk 303±107 175±122 <0.001 EuroScore II (%) 6.61±7.24 7.6±5.55 0.49 EF (%) 43.7±17.2 39.4±15.6 0.36 NT-pro BNP 4611±5413 6045±12670 0.54 Diabetes 7 (17.1) 16 (39) 0.027 Coronary artery disease 25 (61) 26 (63.4) 0.82 Arterial hypertension 26 (63.4) 31 (75.6) 0.23 Barthel index baseline 98±4 80±24 <0.001 Barthel index 30 days 97±5 82±24 <0.001 MLWHFQ baseline 45.7±20.9 49.1±14.5 0.39 MLWHFQ 30 days 38.4±25 34.7±18.2 0.53 ICU stay (days) 1.7±1.2 3.9±7.4 0.069 Death at 30 days 0 4 (10.5) 0.033 Conclusion The MPI score is associated with age and impaired functional capacity at baseline but not with traditional cardiovascular prognostic markers. Thus, MPI may provide additional prognostic information on mortality and functional outcome of patients beyond established risk scores.

scholarly journals Incidence of Capillary Leak Syndrome as an Adverse Effect of Drugs in Cancer Patients: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 8 (2) ◽  
pp. 143 ◽  
Author(s):  
Gwang Jeong ◽  
Keum Lee ◽  
I Lee ◽  
Ji Oh ◽  
Dong Kim ◽  
...  
Keyword(s):  
Adverse Effect ◽  
Cancer Treatment ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Interleukin 2 ◽  
Capillary Leak Syndrome ◽  
Capillary Leak ◽  
Number Of Patients ◽  
Anti Cancer ◽  
Study Heterogeneity

Capillary leak syndrome (CLS) is a rare disease with profound vascular leakage, which can be associated with a high mortality. There have been several reports on CLS as an adverse effect of anti-cancer agents and therapy, but the incidence of CLS according to the kinds of anti-cancer drugs has not been systemically evaluated. Thus, the aim of our study was to comprehensively meta-analyze the incidence of CLS by different types of cancer treatment or after bone marrow transplantation (BMT). We searched the literatures (inception to July 2018) and among 4612 articles, 62 clinical trials (studies) were eligible. We extracted the number of patients with CLS, total cancer patients, name of therapeutic agent and dose, and type of cancer. We performed a meta-analysis to estimate the summary effects with 95% confidence interval and between-study heterogeneity. The reported incidence of CLS was categorized by causative drugs and BMT. The largest number of studies reported on CLS incidence during interleukin-2 (IL-2) treatment (n = 18), which yielded a pooled incidence of 34.7% by overall estimation and 43.9% by meta-analysis. The second largest number of studies reported on anti-cluster of differentiation (anti-CD) agents (n = 13) (incidence of 33.9% by overall estimation and 35.6% by meta-analysis) or undergoing BMT (n = 7 (21.1% by overall estimation and 21.7% by meta-analysis). Also, anti-cancer agents, including IL-2 + imatinib mesylate (three studies) and anti-CD22 monoclinal antibodies (mAb) (four studies), showed a dose-dependent increase in the incidence of CLS. Our study is the first to provide an informative overview on the incidence rate of reported CLS patients as an adverse event of anti-cancer treatment. This meta-analysis can lead to a better understanding of CLS and assist physicians in identifying the presence of CLS early in the disease course to improve the outcome and optimize management.

A Multicenter Retrospective Review of Systemic Anti-Cancer Treatment and Palliative Care Provided to Solid Tumor Oncology Patients in the 12 Weeks Preceding Death in Ireland

2021 ◽  
pp. 104990912098523 ◽  
Author(s):  
Victoria Mallett ◽  
Anna Linehan ◽  
Orla Burke ◽  
Laura Healy ◽  
Sara Picardo ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Treatment ◽  
End Of Life ◽  
Solid Tumor ◽  
Retrospective Review ◽  
Invasive Procedure ◽  
Hospital Death ◽  
Incurable Cancer ◽  
Number Of Patients ◽  
Anti Cancer

Background: Systemic anti-cancer treatment (SACT) can improve symptoms and survival in patients with incurable cancer but there may be harmful consequences. Information regarding the use of SACT at the end-of-life and its impact on patients has not been described in Ireland. Aims: The study aimed to quantify and describe the use of SACT at end-of-life. The primary outcome of interest was the number of patients who received treatment in the last 12, 4 and 2 weeks of life. Secondary outcomes included the frequency of admissions and procedures, location of death, and timing of specialist palliative care (SPC) referral. Methods: Retrospective review. Fisher exact testing was used for analyses. Patients were included if they died between January 2015 and July 2017 and received at least 1 dose of treatment for a solid tumor malignancy. Results: Five hundred and eighty two patients were included. Three hundred and thirty eight (58%), 128 (22%) and 36 (6%) received treatment in the last 12, 4 and 2 weeks of life respectively. Patients who received chemotherapy in the last 12 weeks of life were more likely to be admitted to hospital, undergo a procedure, and die in hospital than those who did not (P < 0.001 for all). Median time of SPC referral before death was shorter in those patients who received chemotherapy than those who did not (61 v129 days, p = 0.0001). Conclusion: Patients who received chemotherapy had a higher likelihood of hospital admission, invasive procedure, and in-hospital death. They were less likely to have been referred early to SPC services.

Patient expectations of palliative cancer treatment for noncurable malignancies: A pilot study.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 194-194
Author(s):  
Katherine E. Faricy-Anderson ◽  
Susan M. Allen ◽  
Nancy J. Freeman ◽  
Vincent Mor
Keyword(s):  
Pilot Study ◽  
Cancer Treatment ◽  
Structured Interview ◽  
Treatment Goals ◽  
Department Of Veterans Affairs ◽  
Number Of Patients ◽  
Patient Reported ◽  
Anti Cancer ◽  
Clinical Interactions ◽  
Unrealistic Expectations

194 Background: Many people with advanced non-curable malignancies have unrealistic expectations of palliative cancer treatment including a belief that treatment may cure their cancer. However, qualitative data describing how patients define “cure” or other treatment goals are lacking. We initiated a pilot study to assess patient understanding of the goals of palliative anti-cancer treatment. Methods: Patients with advanced non-curable malignancy were eligible. Enrolled patients completed a structured interview with both quantitative and qualitative components to assess their understanding of treatment goals and their perceptions of clinical interactions. Additional data included age, race/ethnicity, education, type of malignancy, co-morbidities, and palliative care involvement. Results: We enrolled 30 patients initiating non-curative anti-cancer treatment. Ages ranged from 58 to 92 years. The most common malignancies were lung (33%) and prostate (17%) cancer. Ninety-three percent reported that their doctors explained things in “a way you can understand” and provided “as much information as you want” about treatment. However, only 53% accurately reported that treatment was “not at all likely” to cure their cancer; 40% reported some chance of cure; and 7% weren’t sure. Patient-reported definitions of “cure” ranged from “make it go away” to “no further symptoms” to “less pain.” Of those who reported some chance of cure, about half defined cure as eradication but half used more traditionally palliative language. Overall, 80% reported that treatment was “very” or “somewhat” likely to help them live longer and their definitions of “live longer” ranged from “wake up the next morning” to “20 more years” to “live to 105.” Conclusions: Patient-reported definitions of “cure” and other treatment goals vary widely and a substantial number of patients report unrealistic expectations. These results suggest the need for an intervention to improve patient-physician communication to ensure that patients fully understand the goals of their palliative treatments. “The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.”

Short- and mid-term results of xenograft–bovine pericardial patch in the repair of intracardiac defects: final results of a single-centre study

2013 ◽  
Vol 24 (3) ◽  
pp. 510-514 ◽  
Author(s):  
Hafize Yaliniz ◽  
Orhan K. Salih ◽  
Atakan Atalay ◽  
Vecih Keklik ◽  
Ugur Gocen ◽  
...  
Keyword(s):  
Bovine Pericardium ◽  
Ease Of Use ◽  
Complication Rates ◽  
Pericardial Patch ◽  
Single Centre ◽  
Aneurysmal Dilatation ◽  
Bovine Pericardial Patch ◽  
Number Of Patients ◽  
Single Centre Study ◽  
Mid Term Results

AbstractIntroduction: A variety of patch materials have been used in the repair of intracardiac defects. We evaluated the short- and mid-term clinical and echocardiography results of glutaraldehyde-preserved bovine pericardium patches used to repair intracardiac defects in our clinic.Methods and results: This study examines the short- (up to 30 days post-operatively) and mid-term (up to 24 months post-operatively) results of 533 patients with intracardiac defects who underwent surgical correction with glutaraldehyde-preserved bovine pericardium patches between 2004 and 2010 at a university clinic. Short- and mid-term post-operative echocardiographic studies showed no evidence of calcification, thrombus, or aneurysmal dilatation on the patch. Vegetation developed in two (0.37%) of the 533 patients.Conclusion: These results that have been obtained from a group of large number of patients imply that the glutaraldehyde-preserved bovine pericardium patches may be preferable in the closure of cardiac defects because of their low complication rates and ease of use.

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