An Italian Oncology Research to Evaluate Adherence to Clinical Guidelines for Cancer Treatment: The Right Program

Abstract Background Clinical guidelines do not recommend further investigation for occult malignancy in the scenario of unprovoked venous thromboembolism in the absence of additional clinical features suggestive of malignancy. We present the case of a young gentleman with pulmonary embolism who was diagnosed with testicular seminoma despite lack of symptoms or signs suggestive of malignancy. This is a unique case describing a scenario not well documented in existing literature where contravention of clinical guidelines had a potentially advantageous outcome for the patient. Case presentation A 37-year-old white male presented with seemingly unprovoked acute pulmonary embolism with right heart strain. He did not have any predisposing factors for venous thromboembolism and did not have any symptoms or signs suggestive of malignancy. Clinical guidelines do not recommend further investigation to screen for malignancy in this scenario. Despite this, our young, otherwise healthy patient proceeded to computed tomography scanning, resulting in the diagnosis of localized testicular seminoma. Testicular ultrasound described normal-sized testes (despite a discrete lesion in the right testis), suggesting this was not detectable by the patient or clinician on routine examination. The patient was anticoagulated and had an inferior vena cava filter inserted to facilitate orchidectomy followed by adjuvant radiotherapy. Conclusions This case highlights the importance of considering malignancy in seemingly unprovoked venous thromboembolism and the availability of guidelines to direct further investigation. Our patient’s treatment was not in line with clinical guidelines and was considered a “lucky find.”

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HeCaSe2

Multi-Agent Systems for Healthcare Simulation and Modeling ◽

10.4018/978-1-60566-772-0.ch007 ◽

2010 ◽

pp. 113-136 ◽

Cited By ~ 1

Author(s):

David Isern ◽

Antonio Moreno

Keyword(s):

Patient Care ◽

Clinical Guidelines ◽

Daily Practice ◽

Complex Task ◽

Basic Step ◽

Agent Based ◽

Knowledge Based ◽

Clinical Procedures ◽

General Goal ◽

The Right

Clinical guidelines (CGs) contain a set of directions or principles to assist the healthcare practitioner with patient care decisions about appropriate diagnostic, therapeutic, or other clinical procedures for specific clinical circumstances. It is widely accepted that the adoption of guideline-execution engines in daily practice would improve the patient care, by standardising the care procedures. Guideline-based systems constitute part of a knowledge-based decision support system in order to deliver the right knowledge to the right people in the right form at the right time. The automation of the guideline execution process is a basic step towards its widespread use in medical centres. To achieve this general goal, different topics should be tackled, such as the acquisition of clinical guidelines, its formal verification, and finally its execution. This chapter focuses on the execution of CGs and describes the design and implementation of an agent-based platform in which the actors involved in health care coordinate their activities to perform the complex task of guideline enactment.

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Updated clinical guidelines on the oral management of oncology patients

Faculty Dental Journal ◽

10.1308/rcsfdj.2019.62 ◽

2019 ◽

Vol 10 (2) ◽

pp. 62-65

Author(s):

Navdeep Kumar

Keyword(s):

Quality Of Life ◽

Cancer Treatment ◽

Clinical Guidelines ◽

Oral Care ◽

Oncology Patients ◽

Dental Services ◽

Before And After ◽

After Cancer

As the rate of dentists treating children and adults who present before and after cancer treatment increases, appropriate preventive regimens, timely oral care and improved dental services are crucial for improving patients’ quality of life. https://www.rcseng.ac.uk/dental-faculties/fds/publications-guidelines/clinical-guidelines/

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Quality and reporting of clinical guidelines for breast cancer treatment: A systematic review

The Breast ◽

10.1016/j.breast.2020.07.011 ◽

2020 ◽

Vol 53 ◽

pp. 201-211

Author(s):

Marta Maes-Carballo ◽

Luciano Mignini ◽

Manuel Martín-Díaz ◽

Aurora Bueno-Cavanillas ◽

Khalid Saeed Khan

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Cancer Treatment ◽

Clinical Guidelines ◽

Breast Cancer Treatment

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Cancer repercussions on play in children: implications for nursing care

Texto & Contexto - Enfermagem ◽

10.1590/0104-07072014002380013 ◽

2014 ◽

Vol 23 (4) ◽

pp. 935-943 ◽

Cited By ~ 7

Author(s):

Liliane Faria da Silva ◽

Ivone Evangelista Cabral

Keyword(s):

Qualitative Research ◽

Discourse Analysis ◽

Cancer Treatment ◽

Childhood Cancer ◽

Nursing Care ◽

Family Members ◽

Oncological Treatment ◽

Data Production ◽

Thematic Units ◽

The Right

The study aimed to identify cancer repercussions on play among children in oncological treatment. This was qualitative research implemented according to a creative and sensible method. Twenty-two family members of seven children in ambulatory cancer treatment in a hospital from Rio de Janeiro participated. Data production occurred in family members' houses, from September 2011 to May 2012. The data were analyzed according to discourse analysis. Two thematic units emerged: childhood cancer - a happening about play; and playing in the course of the child's illness and treatment: a possibility to rescue care of maintaining life. Maintaining play is a child's need that demands nursing care of a different nature, to assure the right to play during treatment, in order to reduce traumas and damage to their development.

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Current Landscape of Nutrition Within Prehabilitation Oncology Research: A Scoping Review

Frontiers in Nutrition ◽

10.3389/fnut.2021.644723 ◽

2021 ◽

Vol 8 ◽

Author(s):

Chelsia Gillis ◽

Sarah J. Davies ◽

Francesco Carli ◽

Paul E. Wischmeyer ◽

Stephen A. Wootton ◽

...

Keyword(s):

Cancer Treatment ◽

Scoping Review ◽

Process Model ◽

Nutritional Assessment ◽

Nutrition Intervention ◽

Care Process ◽

Cancer Type ◽

Model Assessment ◽

Nutrition Interventions ◽

Oncology Research

Background: Prehabilitation aims to improve functional capacity prior to cancer treatment to achieve better psychosocial and clinical outcomes. Prehabilitation interventions vary considerably in design and delivery. In order to identify gaps in knowledge and facilitate the design of future studies, we undertook a scoping review of prehabilitation studies to map the range of work on prehabilitation being carried out in any cancer type and with a particular focus on diet or nutrition interventions.Objectives: Firstly, to describe the type of prehabilitation programs currently being conducted. Secondly, to describe the extent to which prehabilitation studies involved aspects of nutrition, including assessment, interventions, implementation, and outcomes.Eligibility Criteria: Any study of quantitative or qualitative design that employed a formal prehabilitation program before cancer treatment (“prehabilitation” listed in keywords, title, or abstract).Sources of Evidence: Search was conducted in July 2020 using MEDLINE, PubMed, EMBASE, EMCARE, CINAHL, and AMED.Charting Methods: Quantitative data were reported as frequencies. Qualitative nutrition data were charted using a framework analysis that reflects the Nutrition Care Process Model: assessment, intervention, and monitoring/evaluation of the nutrition intervention.Results: Five hundred fifty unique articles were identified: 110 studies met inclusion criteria of a formal prehabilitation study in oncology. prehabilitation studies were mostly cohort studies (41%) or randomized-controlled trials (38%) of multimodal (49%), or exercise-only (44%) interventions that were applied before surgery (94%). Nutrition assessment was inconsistently applied across these studies, and often conducted without validated tools (46%). Of the 110 studies, 37 (34%) included a nutrition treatment component. Half of these studies provided the goal for the nutrition component of their prehabilitation program; of these goals, less than half referenced accepted nutrition guidelines in surgery or oncology. Nutrition interventions largely consisted of counseling with dietary supplementation. The nutrition intervention was indiscernible in 24% of studies. Two-thirds of studies did not monitor the nutrition intervention nor evaluate nutrition outcomes.Conclusion: Prehabilitation literature lacks standardized and validated nutritional assessment, is frequently conducted without evidence-based nutrition interventions, and is typically implemented without monitoring the nutrition intervention or evaluating the intervention's contribution to outcomes. We suggest that the development of a core outcome set could improve the quality of the studies, enable pooling of evidence, and address some of the research gaps identified.

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