Use of Tunneled-Cuffed Central Catheters in Patients with Cancer: A Single-Center Experience

2018 ◽  
Vol 23 (1) ◽  
pp. 23-29
Author(s):  
Irappa Madabhavi ◽  
Apurva Patel ◽  
Asha Anand ◽  
Pritam Kataria ◽  
Nagaveni Kadakol ◽  
...  
Keyword(s):  
Lymphoblastic Leukemia ◽  
Tertiary Care ◽  
Hematologic Malignancies ◽  
Venous Access ◽  
Cytotoxic Agents ◽  
Observational Research ◽  
Common Indication ◽  
Hickman Catheter ◽  
Patients With Cancer ◽  
Solid Malignancies

Abstract Background: Effective and reliable venous access is among the cornerstones of modern medical therapy in oncology. Materials and Methods: This was a prospective observational study of collected data of patients with a diagnosis of any cancer, at a tertiary care oncology hospital in Ahmadabad, Gujarat, India, during a 2-year period. Results: A Hickman catheter was inserted in 200 patients and most commonly used in solid malignancies (n = 103; 51.5%), followed by hematologic conditions (n = 93; 48.5%). Among solid malignancies, hepatoblastoma (n = 21; 10.5%) was the most common indication, whereas in hematologic malignancies acute lymphoblastic leukemia was the most common indication (n = 56; 28%) for Hickman catheter insertion. Hickman catheters were inserted most commonly in the right side (n = 170; 85%) of the venous system. The various complications in the Hickman study group in descending order were 28 patients (14%) developed arrhythmias, 15 patients (7.5%) developed infection, 12 patients (6%) developed bleeding, 8 patients (4%) developed pneumothorax, 7 patients (3.5%) developed catheter blockage, and 6 patients (3%) required premature catheter removal. The median time of Hickman catheter in situ was 207 days. Conclusions: The most disturbing aspect of treatment of patients with cancer is multiple painful venipunctures made for administration of cytotoxic agents, antibiotics, blood products, and nutritional supplements. The focus of this prospective observational research was to study the various indications for Hickman catheter in different solid and hematologic malignancies as well as the various complications and outcomes in pediatric and adult cancer patients.

scholarly journals A Study of Use of “PORT” Catheter in Patients with Cancer: A Single-Center Experience

2017 ◽  
Vol 11 ◽  
pp. 117955491769103 ◽  
Author(s):  
Irappa Madabhavi ◽  
Apurva Patel ◽  
Malay Sarkar ◽  
Asha Anand ◽  
Harsha Panchal ◽  
...  
Keyword(s):  
Hematologic Malignancies ◽  
Underlying Disease ◽  
Catheter Insertion ◽  
Cytotoxic Agents ◽  
Observational Research ◽  
Study Group ◽  
Port Catheter ◽  
Port Placement ◽  
Patients With Cancer ◽  
Solid Malignancies

Background: Effective and reliable venous access is one of the cornerstones of modern medical therapy in oncology. Materials and methods: This is a prospective observational study, which collected data of patients who require “PORT” catheter insertion for any cancer, at a tertiary care oncology hospital in Ahmadabad, Gujarat, India, during a 2-year period. Aims and objectives: The main objective of this study was to study the various complications and outcomes related to “PORT” catheters. Results: “PORT” catheter was inserted in 100 patients and was most commonly used in solid malignancies (n = 86, 86%), followed by hematologic malignancies (n = 14, 14%). Among the solid malignancies, breast cancer (38, 38%) was the most common underlying disease, whereas among the hematologic malignancies, acute lymphoblastic leukemia (6, 6%) was the most common underlying disease for “PORT” catheter insertion. Chemotherapy was started on the first day of “PORT” catheter in 74% of patients in the “PORT” study group. The various complications developed in the “PORT” study group in the descending order are as follows: 4 patients (4%) developed early infection (⩽30 days after “PORT” placement), 4 (4%) late infection (⩾30 days after “PORT” placement), 4 (4%) bloodstream infection, 2 (2%) local skin infection at the “PORT” insertion site, 2 (2%) dislodgment of the “PORT” catheter, 2 (2%) fracture of the “PORT” catheter, and 1 recurrent pleural effusion. One patient (1%) developed thrombosis as the complication of “PORT” catheter insertion. Conclusions: The most disturbing aspect of treatment for a patient with cancer is multiple painful venipunctures made for administration of cytotoxic agents, antibiotics, blood products, and nutritional supplements. The focus of this prospective observational research is to study the various underlying diseases for which “PORT” catheter is needed in different solid and hematologic malignancies and the various complications and outcomes in pediatric and adult patients with cancer.

scholarly journals Pulmonary Nodules in Patients With Nonpulmonary Cancer: Not Always Metastases

2016 ◽  
Vol 2 (3) ◽  
pp. 138-144 ◽  
Author(s):  
Rafael Caparica ◽  
Milena Perez Mak ◽  
Claudio Henrique Rocha ◽  
Pedro Henrique Isaacsson Velho ◽  
Publio Viana ◽  
...  
Keyword(s):  
Metastatic Disease ◽  
Lung Tumor ◽  
Pulmonary Nodules ◽  
Hematologic Malignancies ◽  
Scar Tissue ◽  
Second Primary ◽  
Single Institution ◽  
Lung Cancers ◽  
Patients With Cancer ◽  
Solid Malignancies

Introduction The differential diagnosis of pulmonary nodules (PNs) includes metastases, lung cancers, infectious diseases, and scar tissue, among others. Because data regarding whether and when to perform a PN biopsy in patients with cancer are scarce, clinicians tend to assume that PNs are metastatic disease based solely on imaging. The current study evaluated the findings of PN biopsies in a population of patients with cancer and sought to determine the variables that correlated with higher odds of metastatic disease. Patients and Methods We conducted a retrospective, single-institution study that included consecutive patients with nonpulmonary solid malignancies who underwent PN biopsy from January 2011 to December 2013. Imaging and clinical variables were analyzed by logistic regression to determine the correlation between such variables and the odds of metastatic disease. Patients with previously known metastatic disease or primary hematologic malignancies were excluded. Results Two hundred twenty-eight patients were included in the study. Metastatic disease was found in 146 patients (64%), 60 patients (26.3%) were diagnosed with a second primary lung tumor, and 22 patients (9.6%) had no cancer on biopsy. On multivariate analysis, the presence of multiple PNs (> 5 mm) and cavitation/necrosis were the only variables associated with higher odds (P < .05) of metastatic disease. We registered six (2.6%) procedure complications demanding active interventions, and no procedure-related death occurred. Conclusion Multiple PNs (> 5 mm) and cavitation were the two characteristics associated with the highest chances of metastatic disease. Our findings demonstrate that PNs should not be assumed to be metastases without performing a biopsy. This assumption may lead to high rates of misdiagnosis. Tissue sampling is fundamental for accurately diagnosing patients with cancer.

Immunophenotyping and cytogenetic profile of children with acute lymphoblastic leukemia: A study from a tertiary care center from Kashmir.

JMS SKIMS ◽  
2020 ◽  
Vol 23 (2) ◽  
Author(s):  
Faisal R Guru ◽  
Nisar Ahmad Syed ◽  
Shumail Bashir ◽  
Sanudev Sadanandan Vp ◽  
Hashim Kunju Ismail ◽  
...  
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Cytogenetic Study ◽  
Lymphoblastic Leukemia ◽  
Tertiary Care ◽  
Medical Science ◽  
Fish Analysis ◽  
Jammu And Kashmir ◽  
Mll Gene ◽  
Cytogenetic Profile ◽  
Study Participants

Background The complete cytogenetic and immunophenotyping data in children suffering from acute lymphoblastic leukemia (ALL) in Jammu and Kashmir is scarce. To bridge this knowledge gap the present study proposes to evaluate the immunophenotype and cytogenetic profile of pediatric ALL patients treated in our hospital. Material and methods This hospital-based observational study was conducted on 180 pediatric patients aged between 1  to 18 years who had visited the Paediatric unit of the  Department of Medical Oncology at Sher-I -Kashmir Institute of Medical Science, Srinagar ,Jammu and Kashmir between the January 2015 to December 2019. Result Among the study participants, 57.8% were male and 42.2% were female with a mean age of 9.24 years and median of 8 Years. Among the participants, 57.2% were below 10 years of age and 42.8% were above 10years of age. CNS disease was reported in 7.8%  of the study participants.  63.3% patients  had a TLC count of less than 20000. Immunophenotyping data revealed pre-B ALL in 77.8% of children. Cytogenetic study was conducted on 153 patients among them 74.4% had a normal karyotype, 7.2% s had hyperdiploidy and 3.3% had hypodiploidy. The FISH analysis showed that 23.3% of study participants were positive for the TEL-AML study, 11.1% were positive for BCR-ABL analysis and 4.4% of participants were positive for MLL gene analysis. The overall survival in the study population was 78.9% among the study participants. Only the MLL gene rearrangement analysis showed a statistically significant correlation with the survival analysis (P<0.5). Conclusion In summary, the present study reported the complete cytogenetic and immunophenotyping profile of the children suffering from acute lymphoblastic leukemia in Jammu and Kashmir.

scholarly journals Characteristics of infective endocarditis in a cancer population

Open Heart ◽  
2021 ◽  
Vol 8 (2) ◽  
pp. e001664
Author(s):  
Cullen Grable ◽  
Syed Yusuf ◽  
Juhee Song ◽  
George M Viola ◽  
Owais Ulhaq ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Mortality Data ◽  
Limited Information ◽  
Tertiary Care Centre ◽  
Indwelling Catheters ◽  
Patients With Cancer ◽  
Duke Criteria ◽  
Immunocompromised State

BackgroundInfective endocarditis (IE) is more common in patients with cancer as compared with the general population. Due to an immunocompromised state, the need for invasive procedures, hypercoagulability and the presence of indwelling catheters, patients with cancer are particularly predisposed to the development of IE.ObjectivesLimited information exists about IE in patients with cancer. We aimed to evaluate the characteristics of patients with cancer and IE at our tertiary care centre, including a comparison of the microorganisms implicated and their association with mortality.MethodsA retrospective chart review of patients with cancer who had echocardiography for suspicion of endocarditis was conducted. A total of 56 patients with a confirmed diagnosis of cancer and endocarditis, based on the modified Duke criteria, were included in the study. Baseline demographics, risk factors for developing IE, echocardiography findings, microbiology and mortality data were analysed.ResultsFollowing the findings of vegetations by echocardiography, the median survival time was 8.5 months. Staphylococcus aureus was the most common organism identified as causing endocarditis. The mitral and aortic valves were the most commonly involved sites of endocarditis. Patients with S. aureus endocarditis (SAE) had a significantly poorer survival when compared with patients without SAE (p=0.0217) over the 12-month period from diagnosis of endocarditis.ConclusionsOverall survival of patients with cancer and endocarditis is poor, with a worse outcome in patients with SAE.

Promising Anti-leukemic Effect of Zataria Multiflora Extract in Combination with Doxorubicin to Combat Acute Lymphoblastic Leukemia Cells (Nalm-6)

2021 ◽  
Author(s):  
Mahla Lashkari ◽  
Ahmad Fatemi ◽  
Hajar Mardani Valandani ◽  
Roohollah Mirzaee Khalilabadi
Keyword(s):  
Molecular Docking ◽  
Lymphoblastic Leukemia ◽  
Annexin V ◽  
Hematologic Malignancies ◽  
Chemotherapeutic Drugs ◽  
Zataria Multiflora ◽  
Old Adults ◽  
Drug Doses ◽  
Dose Dependent ◽  
Dose Dependent Effect

Abstract Purpose: One of the heterogeneous hematologic malignancies of the lymphocyte precursors or lymphoblasts is ALL. ALL has two incidence peaks that were determined in 2-5 years children and 60 years old adults. Cardiotoxicity of chemotherapeutic drugs is one of important side effect which may occur during or after chemotherapy period. Methods: The aim of this study was to evaluate the effect of Zataria Multiflora extract (ZME), DOX, and ZME/DOX combination on Nalm-6 cells. In this vein, the cell viability was assessed by Trypan blue and MTT assay. Evaluation of apoptosis was also analyzed by Annexin-V/7-PI staining. Moreover, the expression of Bax, Bcl-2, hTERT, c-Myc, P53, and P21 genes was detected by Real-Time PCR. Molecular docking as an in-silico method was performed for BCL2 and P53 as well. Result: Our achievements indicated that ZME had dose-dependent effect on Nalm-6 cells and ZME synergistically potentiated DOX effect. The expression of Bax, P53 and P21 genes increased although the expression of Bcl-2, hTERT, and c-Myc genes decreased when cells treated with ZME/DOX combination. Molecular docking showed the interactions of Carvacrol and Thymol in the active cavities of BCL2 and P53. Conclusions: Regarding to present study, ZME could be utilized as a combinatorial and potential drug for leukemic patients, which is under the treatment by DOX due to reducing the chemotherapy drug doses.

A Prospective Observational Study on Prevalence and Prognostic Indicators among Tuberculosis and Multidrug Resistance Tuberculosis Patients in Tertiary Care Teaching Hospital

2021 ◽  
pp. 43-48
Author(s):  
A. Noorjahan ◽  
B. Bhargavi ◽  
K. Mallikarjuna ◽  
B. Mohammad Ishaq ◽  
L. Siva Sankar Reddy ◽  
...  
Keyword(s):  
Teaching Hospital ◽  
Tertiary Care ◽  
Observational Research ◽  
Prognostic Indicators ◽  
Treatment Result ◽  
High Morbidity ◽  
Tertiary Care Teaching Hospital ◽  
Care Teaching ◽  
Number Of Patients ◽  
Mdr Tb

Tuberculosis (TB) is a communicable systemic infectious disease with high morbidity and mortality associated with it. Resistance to medications used to treat tuberculosis has been on the rise in recent years. (multidrug-resistant tuberculosis)  (MDR-TB)  is a significant challenge to (TB) control around the world. An observational research was conducted in a tertiary care teaching hospital to determine the interim pharmacological and microbial results of Rifampicin resistance TB patients. Data from Santhiram Medical College and General Hospital, Nandyal, Kurnool Dist. Andhra Pradesh were obtained from Aug 2020 to Feb 2021, after receiving ethical approval from the Institutional Ethics Committee. The effects of the regimen are determined in terms of cure, finished treatment, treatment failure, number of patients moved to MDR-TB, number of patients who died in long-term MDR-TB regimen patients. Microsoft Excel 2007 was used to analyse the data. There were 82 male and 23 female out of 105 patients included in the study. Of these 75 patients were from rural areas and 40 from urban areas Using the Chi-square test and X2=12.1026, p=0.0005, which was important, the correlation between geographical spread and treatment result was determined. Out of 115 patients, 99 (86.09 percent) were cured of their disease, 06 (5.22 percent) died, 10 (8.69 percent) developed MDR-TB, and 2 (1.74 percent) were deemed medication errors. Males between the ages of 51 and 70 are more vulnerable to TB than females, according to our results. Compared to females of the same age, male patients over 40 years of age are more vulnerable to MDRTB. this was not part of the research objectives, emphasis should not be placed on this as either conclusion or recommendation.

Fetomaternal Outcome of Pregnancy with COVID-19: An Observational Study in Tertiary Care Hospitals of Pakistan

2021 ◽  
Vol 15 (6) ◽  
pp. 1903-1906
Author(s):  
Nabila Khan ◽  
Zahra Wasim ◽  
Aesha Sadaf Rizwan ◽  
Afshan Ahmad ◽  
Muhammad Tahir ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Negative Impact ◽  
Heart Defects ◽  
Tertiary Care ◽  
World Health ◽  
Observational Research ◽  
Military Hospital ◽  
Corona Virus ◽  
Study Results ◽  
The World

Background: The new corona virus first appeared in Wuhan, China in December 2019 and has since spread around the world to other countries. The World Health Organization believes that this new CoV-19 epidemic is a public health emergency of international concern (PHEIC) on January 30, 2020Worldwide.The mortality rate of this viral infection ranges from 2% in Pakistan to 14.4% in Italy. Lympopenia, elevated transminase, proteinuria, increased LDH, and C-reactive protein levels are all common laboratory findings in the early stages of the disease. Covid patients have experienced a variety of complications, including extreme pneumonia, ARDS, heart defects, sepsis and septic shock, and respiratory tract super infection. Methodology: This retrospective observational research study was carried out at the Gynecology Unit of MardanMedical Complex, Mardan and Combined Military Hospital, Risalpur for 06 months duration from April 2020 to September 2020. In a pre-constructed data collection form, biochemical and radiological parameters of medical history, test results, symptoms, pregnancy, and neonatal outcomes were noted. Patients treated in an outpatient setting were not included in the study. Results: There were 121 patients in total, with mean age of 27 having standard deviation ± 5, having range 19-40 years. 48.3% pregnant women reported their first pregnancy(primigravida). 51.3% of SARS-Cov-2 were in their 3rd trimester while 34.7% were in their 35-40 weeks of gestational age. Common complications are gestational hypertension (PIH) (16 cases), hypothyroidism (14 cases) and gestational diabetes (GDM) 9 cases. More than half (53%) of patients are asymptomatic. Common symptoms are cough (22%) and fever (11%). The incidence of multiple organ failure was 2% as shown in table 01. Lymphopenia was common (84%). A CT scan of 24 patients showed bilateral invasion. Conclusion: COVID-19 has a negative impact on the foetus, according to our results. Although pregnant women do not seem to be more vulnerable to COVID-19 complications than non-pregnant adults, previous research has suggested that pregnant women could be at higher risk for negative pregnancy outcomes such as preterm birth, foetal pain and respiration, symptoms, and LBW in a newborn baby. Keywords: Corona virus, COVID-19, Pregnancy, Outcome.

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