The use of a novel burn dressing out of bacterial nanocellulose compared to the French standard of care in paediatric 2nd degree burns – a retrospective analysis

Introduction: Digestive metastases (DMs) from renal cell cancer (RCC) are rare. Over the past decade, the overall survival of metastatic RCC (mRCC) has been improved by tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors. The main objective of this study was to assess the incidence of metastases of the digestive tract in this new field of treatment. The secondary objectives were to evaluate the clinical characteristics, prognosis, treatments used for DMs, and median time between the diagnosis of RCC or mRCC and DMs.Materials and Methods: A retrospective analysis of data collected from all patients with mRCC between 2007 (the time of TKI was a standard of care) and 2019 was carried out at the Paoli-Calmettes Institute (Marseille, France). Computer research software using artificial intelligence (ConSoRe®) was used to identify patients and assess their characteristics.Results: Between January 2007 and December 2019, 11 out of 660 (1.6%) mRCC patients had metastases of the gastrointestinal tract. The median age was 62 years. Of the 11 patients, 81.8% experienced digestive bleeding or anemia. Only 2 patients were asymptomatic. The metastases were mainly duodenal (50%) and gastric (41.6%). The median time from cancer diagnosis and from metastatic disease to gastrointestinal metastasis was 4.3 years (3 months−19.2 years) and 2.25 years (0 days−10.2 years), respectively. Local treatment was performed in 38.5% of cases by endoscopy (60%), surgery (20%) and radiotherapy (40%) with success rates of 33, 100, and 50%, respectively. Etiological treatment was modified following the discovery of DM in 84.6% of the cases. The median survival was 1 year from the diagnosis of DM (13 days−9.4 years). Two patients were still alive 2.9 and 9.4 years after the diagnosis of DM.Conclusion: This is the largest monocentric retrospective analysis of DM in patients with RCC. It seems to be a rare and late event in the course of the disease. Local treatment combined with systemic treatment could improve survival. In the context of prolonged survival with the new based immunotherapy treatments in mRCC, we suggest that unexplained anemia or persistent digestive symptoms could be explored by endoscopy.

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Retinoblastoma: A retrospective analysis of 141 patients from 1983 to 2013 at a tertiary care hospital in Nagpur, India

South Asian Journal of Cancer ◽

10.4103/sajc.sajc_314_18 ◽

2019 ◽

Vol 08 (03) ◽

pp. 195-197

Author(s):

Rohit S. Kabre ◽

Krishna M. Kamble

Keyword(s):

Retrospective Analysis ◽

Tertiary Care Hospital ◽

External Beam Radiotherapy ◽

Tertiary Care ◽

Standard Of Care ◽

Invasive Disease ◽

Care Hospital ◽

Medical College ◽

Unilateral Disease ◽

Clinical Records

Abstract Purpose: There is scarcity of data regarding clinical presentation and outcome of retinoblastoma patients in India. Objectives: The objective of this study was to assess the clinical profile of retinoblastoma patients in a tertiary care hospital in India from 1983 to 2013. Subjects and Methods: A retrospective analysis of clinical records of 141 patients with retinoblastoma registered from 1983 to 2013 at Government Medical College, Nagpur, India, was conducted. Demographics, clinical features, modes of treatment, and outcome of the patients were assessed. Results: Majority of patients (81 [57.45%]) presented in the age group of 1–3 years and were males. One hundred and fourteen patients (80.85%) had unilateral disease, while rare presentations of trilateral/quadrilateral retinoblastoma were also noted. Proptosis was seen in 81 (57.45%) patients as presenting symptom. Eighty-nine patients (63.12%) had locally invasive disease-involving sites. Forty-four patients (31.19%) developed distant metastasis. Surgical management and external beam radiotherapy were followed in majority of patients. Trend of increased usage of chemotherapy was seen from the mid-1990s. One hundred and twelve patients (79.43%) died with the disease. Conclusions: Data from this study show late diagnosis, leading to poor outcome for patients with advanced retinoblastoma, which is in accordance with data from other developing countries. Even though management of patients changed in accordance with changing standard of care over the decade, mortality remained high.

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Impact of High Dose Cyclophosphamide on the Outcome of Autologous Stem Cell Transplant in Patients with Newly Diagnosed Multiple Myeloma,

Blood ◽

10.1182/blood.v118.21.4127.4127 ◽

2011 ◽

Vol 118 (21) ◽

pp. 4127-4127 ◽

Cited By ~ 7

Author(s):

Wendi A. Bacon ◽

Gwynn D. Long ◽

David A. Rizzieri ◽

Mitchell E. Horwitz ◽

John P. Chute ◽

...

Keyword(s):

Multiple Myeloma ◽

Stem Cell ◽

Retrospective Analysis ◽

Stem Cell Transplant ◽

Standard Of Care ◽

Autologous Stem Cell Transplant ◽

High Dose ◽

Cell Transplant ◽

Newly Diagnosed ◽

Cell Mobilization

Abstract Abstract 4127 In the age of novel targeted agents, autologous stem cell transplant (ASCT) remains the standard of care for younger patients with newly diagnosed multiple myeloma (MM), offering similar treatment responses and overall survivals as standard chemotherapeutic agents but with the added benefit of a prolonged treatment-free period. Nevertheless, a standard of care for stem cell mobilization for ASCT has yet to be determined. Even in the era of new mobilization agents such as Plerixafor, Cyclophosphamide (Cy) and G-CSF combination remains the preferred mobilizing approach for patients with MM. Several studies have shown that Cy improves the stem cell yield at the expense of increased toxicity, but whether the administration of this chemotherapeutic agent pre-transplant has any impact on the long-term event-free and/or overall survival of myeloma patients remains controversial. In this study, we present a retrospective analysis of 186 patients with newly diagnosed MM who underwent ASCT with high-dose melphalan 200 mg/m2 (HDM) between December of 2000 and 2008 at our Institution. Eighty-three patients were mobilized with single agent G-CSF and 103 patients received high dose Cy (4 gm/m2) and G-CSF combination. Patient characteristics were similar between the treatment groups, including: age, gender, disease stage, and disease status prior to transplant. However, toxicity post-mobilization with Cy/G-CSF was significantly higher compared with G-SCF alone, including: febrile neutropenia (23%), hemorrhagic cystitis (8%), GI toxicity (57%), re-hospitalization due to complications and transplant delay (14%). The overall post-transplant toxicity was similar in the 2 groups, though the treatment related mortality was slightly higher in the Cy/G-CSF arm (4% versus 2%). Post transplant responses were not significantly different in the 2 groups, with 60% of patients achieving a VGPR or better after ASCT in the G-CSF group and 49% in the Cy/G-CSF group (p = 0.33). The median event-free survivals (EFS) for the Cy/G-CSF and G-CSF cohorts were 21.6 and 22.6 months, respectively, (p = 0.62) yielding no significant difference (Figure 1). Similarly, with a median follow up for surviving patients of 34.3 and 32.7 months, the median overall survivals were 68.2 and 62.3 months (p = 0.23) for the Cy/G-CSF and G-CSF cohorts, respectively (Figure 2). This retrospective analysis confirms that the addition of high dose Cy as part of the mobilizing regimen offers no improvement on the transplant outcome for patients with newly diagnosed myeloma and should therefore only be used in cases of difficult stem cell mobilization. Disclosures: No relevant conflicts of interest to declare.

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Are symptoms of ovarian cancer evident: A retrospective analysis of claims data to determine prior symptoms to diagnosis.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.5565 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. 5565-5565

Author(s):

Denise Manon Langabeer ◽

Cecilia Ganduglia Cazaban ◽

Michael D Swartz ◽

Trudy Krause

Keyword(s):

Ovarian Cancer ◽

Retrospective Analysis ◽

Claims Data ◽

Standard Of Care ◽

Screening Methods ◽

Eligibility Criteria ◽

Diagnosis Codes ◽

Health Insurance Claims ◽

Analysis Of Claims Data ◽

Specific Symptoms

5565 Background: There are no standard of care screening methods for ovarian cancer. Over sixty percent (60%) of ovarian cancer cases are found at Stage III and IV, which ultimately impacts a woman’s survival rate. The purpose of this study is to determine if specific symptoms are evident prior to diagnosis of ovarian cancer. Methods: A retrospective analysis of health insurance claims between 2008 through 2013 from a commercial payer was performed based on the following eligibility criteria: 1) women diagnosed with ovarian cancer, 2) at the time of diagnosis, 24 years of age or older, 3) enrolled in healthcare plan for a period of 24 months or more prior to diagnosis, and 4) resident in the state of Texas. Symptoms were identified based on ICD-9 diagnosis codes and categorized specific to pain, abdominal and pelvis, digestive, and bladder and were evaluated at minimum of six months prior to diagnosis. ICD9 codes are used for this analysis as the data is limited to years before the change to ICD10. Results: Baseline data of 3,641 women diagnosed with ovarian cancer were identified and were associated with 927,528 claims specific to the symptoms. The age of women diagnosed with cancer ranged between 24 and 88 (mean=52; SD: 0.1833). Nearly 70% of women were treated for one or more symptoms prior to diagnosis. The symptoms women experienced the most were associated with abdomen and pelvis at 60%. Pain, digestive, and bladder ranged between 20% and 30%. Conclusions: This research is intended to further explore whether symptoms are evident in women diagnosed with this disease, and if so, how long and how frequent did the symptoms occur prior to diagnosis. Additionally, a review of combination of symptoms is explored. This research is intended to provide a better understanding of the disease as well as support that women may need to be referred to an oncologist earlier for further evaluation should reoccurring symptoms present.

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Effectiveness of a sepsis programme in a resource-limited setting: a retrospective analysis of data of a prospective observational study (Ubon-sepsis)

BMJ Open ◽

10.1136/bmjopen-2020-041022 ◽

2021 ◽

Vol 11 (2) ◽

pp. e041022

Author(s):

Suchart Booraphun ◽

Viriya Hantrakun ◽

Suwatthiya Siriboon ◽

Chaiyaporn Boonsri ◽

Pulyamon Poomthong ◽

...

Keyword(s):

Observational Study ◽

Retrospective Analysis ◽

Sofa Score ◽

Prospective Observational Study ◽

Standard Of Care ◽

Exposed Group ◽

Sepsis Management ◽

Risk Of Death ◽

Study Hospital ◽

Sepsis Care

ObjectiveTo evaluate the effectiveness of a Sepsis Fast Track (SFT) programme initiated at a regional referral hospital in Thailand in January 2015.DesignA retrospective analysis using the data of a prospective observational study (Ubon-sepsis) from March 2013 to January 2017.SettingGeneral medical wards and medical intensive care units (ICUs) of a study hospital.ParticipantsPatients with community-acquired sepsis observed under the Ubon-sepsis cohort. Sepsis was defined as modified Sequential Organ Failure Assessment (SOFA) Score ≥2.Main exposureThe SFT programme was a protocol to identify and initiate sepsis care on hospital admission, implemented at the study hospital in 2015. Patients in the SFT programme were admitted directly to the ICUs when available. The non-exposed group comprised of patients who received standard of care.Main outcomeThe primary outcome was 28-day mortality. The secondary outcomes were measured sepsis management interventions.ResultsOf 3806 sepsis patients, 903 (24%) were detected and enrolled in the SFT programme of the study hospital (SFT group) and 2903 received standard of care (non-exposed group). Patients in the SFT group had more organ dysfunction, were more likely to receive measured sepsis management and to be admitted directly to the ICU (19% vs 4%). Patients in the SFT group were more likely to survive (adjusted HR 0.72, 95% CI 0.58 to 0.88, p=0.001) adjusted for admission year, gender, age, comorbidities, modified SOFA Score and direct admission to the ICUs.ConclusionsThe SFT programme is associated with improved sepsis care and lower risk of death in sepsis patients in rural Thailand, where some critical care resources are limited. The survival benefit is observed even when all patients enrolled in the programme could not be admitted directly into the ICUs.Trial registration numberNCT02217592.

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Choosing wisely and the use of antibiotics in ophthalmic surgery: There is more than meets the eye

European Journal of Ophthalmology ◽

10.1177/1120672117747043 ◽

2018 ◽

Vol 28 (6) ◽

pp. 625-632

Author(s):

Andrea Grosso ◽

Piero Ceruti ◽

Giuseppe Scarpa ◽

Franco Giardini ◽

Giorgio Marchini ◽

...

Keyword(s):

Retrospective Analysis ◽

State Of The Art ◽

Tertiary Care ◽

Standard Of Care ◽

Day Surgery ◽

Choosing Wisely ◽

Eye Care ◽

Ophthalmic Surgery ◽

Tertiary Care Centers

Background: One of the directions of modern ophthalmology is toward an odontoiatric model, and new settings of eye care are becoming the standard of care: one day surgery and also office-based therapies. Methods: Retrospective analysis of three tertiary-care centers in Italy and analysis of the literature. Results: We provide readers with state-of-the-art measures of prophylaxis in ophthalmic surgery. Discussion and conclusion: Role of antibiotics is criticized in the light of stewardship antimicrobial paradigm.

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