Sensitization to aztreonam and cross-reactivity with other beta-lactam antibiotics in high-risk patients with cystic fibrosis

Abstract Purpose The Japanese Society of Medical Oncology published a guideline (GL) on febrile neutropenia (FN) in 2017. The study’s purpose is to reveal how widely GL penetrated among physicians and surgeons providing chemotherapy. Methods A questionnaire survey was conducted with SurveyMonkey™ for members of the Japanese Association of Supportive Care in Cancer and relevant academic organizations. Each question had four options (always do, do in more than half of patients, do in less than half, do not at all) and a free description form. Responses were analyzed with statistical text-analytics. Result A total of 800 responses were retrieved. Major respondents were experts with more than 10-year experience, physicians 54%, and surgeons 46%. Eighty-seven percent of respondents knew and used GL. Forty-eight percent assessed FN with Multinational Association of Supportive Care in Cancer (MASCC) score “always” or “more than half.” Eighty-one percent chose beta-lactam monotherapy as primary treatment in high-risk patients. Seventy-seven percent did oral antibacterial therapy in low-risk patients ambulatorily. Seventy-eight percent administered primary prophylactic G-CSF (ppG-CSF) in FN frequency ≥ 20% regimen. Fifty-nine percent did ppG-CSF for high-risk patients in FN frequency 10–20% regimen. Ninety-seven percent did not use ppG-CSF in FN frequency < 10% regimen. The medians of complete and complete plus partial compliance rates were 46.4% (range 7.0–92.8) and 77.8% (range 35.4–98.7). The complete compliance rates were less than 30% in seven recommendations, including the MASCC score assessment. Conclusion GL is estimated to be widely utilized, but some recommendations were not followed, presumably due to a mismatch with actual clinical practices in Japan.

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Automated Computed Tomography Lung Densitometry in Bronchiectasis Patients

10.21203/rs.3.rs-268711/v1 ◽

2021 ◽

Author(s):

Marcio Valente Yamada Sawamura ◽

Rodrigo Abensur Athanazio ◽

Maria Cecilia Nieves Teixeira Maiorano de Nucci ◽

Samia Zahi Rached ◽

Alberto Cukier ◽

...

Keyword(s):

Computed Tomography ◽

Cystic Fibrosis ◽

High Risk ◽

Prognostic Scores ◽

Quantitative Ct ◽

Air Trapping ◽

High Risk Patients ◽

Risk Patients ◽

Lung Densitometry ◽

Better Than

Abstract Rationale: Bronchiectasis is a complex and heterogeneous disease. Visual computed tomography (CT) scoring systems are used to assess disease severity, disease progression and predict outcomes in bronchiectasis although they have some limitations such as subjectivity, requirement of previous training and are time-consuming. Objective: To correlate quantitative CT lung densitometry measurements with pulmonary function test (PFT) and multidimensional prognostic scores in patients with bronchiectasis.Materials and methods: From 2014 to 2017, 100 consecutive adult patients with non-cystic fibrosis bronchiectasis underwent inspiratory and expiratory volumetric chest CT and PFT (spirometry, plethysmograph, diffusing capacity of carbon monoxide measurement [DLCO]). Visual CT score (CF-CT score), CT lung densitometry parameters (kurtosis, skewness and expiratory/inspiratory mean lung density [E/I MLD]) and multidimensional prognostic scores (BSI and FACED) were calculated in all patients and correlated to PFT.Results: CT lung densitometry parameters (kurtosis and skewness), correlated with forced expiratory volume in 1 second (FEV1) (R=0.32; p=0.001 and R=0.34; p<0.001) and DLCO (R=0.41 and R=0.43; p<0.001). Automated CT air trapping quantification (E/I MLD) showed correlation with residual volume (RV), multidimensional score FACED (R=0.63 and R=0.53; p<0.001) and performed better than the CF-CT score in the diagnosis of high-risk patients and severe air trapping. Conclusion: CT lung densitometry parameters showed correlations with PFT in non-cystic fibrosis bronchiectasis patients. Automated CT air trapping quantification performed better than visual CT score in the identification of high-risk patients and severe air trapping, suggesting it could be a useful tool in the evaluation of these patients, although further studies are needed to confirm these findings.

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