Early initiation of appropriate treatment is associated with increased survival in cancer patients with Candida glabrata fungaemia: a potential benefit from infectious disease consultation

BackgroundA significant proportion of cancer patients experience psychiatric morbidity in association with diagnosis and treatment. If this morbidity is to be reduced, a better understanding is needed of the factors which influence adjustment to cancer.MethodA review of the literature was carried out to explore those factors associated with poor psychological adjustment to cancer. These are described under four headings: characteristics of the patient; disease and treatment variables; the interaction between patient and illness; and environmental factors.ResultsA number of risk factors for psychiatric morbidity can be identified from each of the four areas. Methodological limitations are highlighted, in particular the preponderance of cross-sectional study designs.ConclusionsIncreased awareness of the risk factors for psychiatric morbidity should lead to earlier detection and more appropriate treatment. Future research should focus on those risk factors which are potentially modifiable.

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The Impact of Infectious Disease Consultation on Clinical Management and Outcome of Patients With Bacteremia in China: A Retrospective Cohort Study

Open Forum Infectious Diseases ◽

10.1093/ofid/ofw194.110 ◽

2016 ◽

Vol 3 (suppl_1) ◽

Author(s):

Guangmin Tang ◽

Zhiyong Zong

Keyword(s):

Infectious Disease ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Clinical Management ◽

Retrospective Cohort ◽

Infectious Disease Consultation ◽

The Impact

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3425 Cardiac Replacement Fibrosis in Cancer Treatment Related Cardiotoxicity

Journal of Clinical and Translational Science ◽

10.1017/cts.2019.90 ◽

2019 ◽

Vol 3 (s1) ◽

pp. 37-37

Author(s):

Chetan Shenoy ◽

Kalpit Modi

Keyword(s):

Cancer Treatment ◽

Cancer Patients ◽

Patient Outcomes ◽

Myocardial Infarctions ◽

Myocardial Calcification ◽

Appropriate Treatment ◽

Replacement Fibrosis ◽

Study Population ◽

Eosinophilic Myocarditis ◽

Artery Disease

OBJECTIVES/SPECIFIC AIMS: Our goals were to understand the pattern, location, and extent of cardiac replacement fibrosis seen as late gadolinium enhancement on cardiovascular magnetic resonance imaging in a large cohort of cancer patients treated with anthracyclines and/or trastuzumab. METHODS/STUDY POPULATION: We performed a retrospective cohort study of consecutive adult cancer patients treated with anthracyclines and/or trastuzumab from 2004 through 2017. CMRs were analyzed for the presence, location, and pattern of LGE. RESULTS/ANTICIPATED RESULTS: Of 238 patients, 220/(92.4%) had no LGE. Among the 18/(7.6%) patients with LGE, 13/(72.2%) were ischemic in pattern (myocardial infarctions); 10 of these had known coronary artery disease (CAD). Of 5/(27.8%) patients with non-ischemic LGE, the etiologies were known for 4 – myocarditis, cardiac sarcoidosis, eosinophilic myocarditis, and acute myocardial calcification. Only 4/(1.7%) patients had unexpected LGE, of which 3 were unrecognized myocardial infarctions. DISCUSSION/SIGNIFICANCE OF IMPACT: The assessment of fibrosis helps to diagnose the cause of LVSD in cancer patients treated with potentially cardiotoxic medications. This is necessary because currently, the cause of LVSD in cancer patients cannot be established conclusively even though the cause is closely linked to patient outcomes. Our results demonstrate that cancer treatment-related LVSD is not associated with fibrosis. A minority of cancer patients with LVSD have fibrosis related to other reasons, most commonly CAD. Identification of the correct cause of LVSD in cancer patients treated with cardiotoxic medications allows for appropriate treatment. This, in turn, could improve patient outcomes.

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Infectious disease consultations and newly diagnosed cancer patients

Medicine ◽

10.1097/md.0000000000020876 ◽

2020 ◽

Vol 99 (25) ◽

pp. e20876

Author(s):

Yoshiro Hadano ◽

Takashi Watari ◽

Hiroshi Yasunaga

Keyword(s):

Infectious Disease ◽

Cancer Patients ◽

Newly Diagnosed

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Impact of Infectious Disease Consultation in Patients With Candidemia: A Retrospective Study, Systematic Literature Review, and Meta-analysis

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa270 ◽

2020 ◽

Vol 7 (9) ◽

Author(s):

Takaaki Kobayashi ◽

Alexandre R Marra ◽

Marin L Schweizer ◽

Patrick Ten Eyck ◽

Chaorong Wu ◽

...

Keyword(s):

Infectious Disease ◽

Literature Review ◽

Systematic Literature Review ◽

Meta Analysis ◽

Tertiary Care ◽

Care Hospital ◽

Inclusion Criteria ◽

Infectious Disease Consultation ◽

Significant Difference ◽

The Impact

Abstract Background Morbidity and mortality from candidemia remain unacceptably high. While infectious disease consultation (IDC) is known to lower the mortality from Staphylococcus aureus bacteremia, little is known about the impact of IDC in candidemia. Methods We conducted a retrospective observational cohort study of candidemia patients at a large tertiary care hospital between 2015 and 2019. The crude mortality rate was compared between those with IDC and without IDC. Then, we systematically searched 5 databases through February 2020 and performed a meta-analysis of the impact of IDC on the mortality of patients with candidemia. Results A total of 151 patients met the inclusion criteria, 129 (85%) of whom received IDC. Thirty-day and 90-day mortality rates were significantly lower in the IDC group (18% vs 50%; P = .002; 23% vs 50%; P = .0022, respectively). A systematic literature review returned 216 reports, of which 13 studies including the present report fulfilled the inclusion criteria. Among the 13 studies with a total of 3582 patients, IDC was performed in 50% of patients. Overall mortality was 38.2% with a significant difference in favor of the IDC group (28.4% vs 47.6%), with a pooled relative risk of 0.41 (95% CI, 0.35–0.49). Ophthalmology referral, echocardiogram, and central line removal were performed more frequently among patients receiving IDC. Conclusions This study is the first systematic literature review and meta-analysis to evaluate the association between IDC and candidemia mortality. IDC was associated with significantly lower mortality and should be considered in all patients with candidemia.

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