scholarly journals Infection prevention in patients with cancer: microbiological evaluation of portable laminar air flow isolation, topical chlorhexidine, and oral non-absorbable antibiotics

1980 ◽  
Vol 84 (3) ◽  
pp. 457-465 ◽  
Author(s):  
A. S. D. Spiers ◽  
Sylvia F. Dias ◽  
J. A. Lopez
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Drug Therapy ◽  
Acute Leukaemia ◽  
Infection Prevention ◽  
Cytotoxic Chemotherapy ◽  
Prevention Of Infection ◽  
Patients With Cancer ◽  
Flow Apparatus ◽  
Laminar Air Flow ◽  
Nose And Throat

SUMMARYThe increasing use of intensive cytotoxic chemotherapy for patients with solid tumors enhances the risk of opportunistic infection to levels formerly seen only in patients with acute leukaemia, and prevention of infection is a major concern. A relatively simple regimen of isolation, topical antisepsis, and orally administered non-absorbable antibiltics was stuidied in 18 patients. Sixteen of 21 studies were performed using portable laminar ait flow apparatus and five with isolation only. All patients became severly neutropenic but there were no major infections. Microbiological results showed effective decontamination of the skin, which was maintained without recolonization or acquisition of new organisms. The ears, nose and throat were effectively decontaminated only when the regimen was intensified. Colonization with Pseudomonas aeruginosa, a major pathogen in compromised hosts, did not occur. The propective regimen is less expensive than regimens previously desribed, is acceptable to patients, and requires no modification of existing hospital rooms. It merits further evaluation in patients with common cancers who receive intensive cytotoxic drug therapy.

IJV thrombophlebitis: be wary of the occult

2021 ◽  
Vol 14 (3) ◽  
pp. e238813
Author(s):  
Pamela Oshinyemi ◽  
Charlotte Lee ◽  
Antony Gough-Palmer ◽  
Iain McKay-Davies
Keyword(s):  
Colorectal Adenocarcinoma ◽  
Palliative Chemotherapy ◽  
Jugular Vein ◽  
Thrombus Formation ◽  
Locally Advanced ◽  
Patients With Cancer ◽  
Occult Malignancy ◽  
Night Sweats ◽  
History Of ◽  
Nose And Throat

A 43-year-old woman was referred to the Ear, Nose and Throat Department with a 3-day history of left-sided neck pain and swelling associated with fevers and night sweats. She also reported a cough, oral thrush and a dental extraction more than a month previously. A CT scan of the neck with contrast revealed left internal jugular vein (IJV) thrombophlebitis and the patient was initially managed for suspected Lemierre’s syndrome. Subsequent investigations revealed a locally advanced metastatic colorectal adenocarcinoma as the cause of her thrombosis, which was deemed inoperable. The patient was referred to oncology and commenced on palliative chemotherapy.The incidence of thrombophlebitis in patients with cancer is high. Although the IJV is a relatively uncommon site of thrombus formation, IJV thrombophlebitis is associated with significant morbidity and mortality. As it may be the first manifestation of an occult malignancy, a neoplastic cause should always be considered.

Painful gynecomastia following cytotoxic therapy for testis cancer: a potentially favorable prognostic sign?

1983 ◽  
Vol 1 (7) ◽  
pp. 416-420 ◽  
Author(s):  
D L Trump ◽  
S A Anderson
Keyword(s):  
Drug Therapy ◽  
Complete Remission ◽  
Advanced Disease ◽  
Cytotoxic Chemotherapy ◽  
Beta Subunit ◽  
Testis Cancer ◽  
Adult Males ◽  
Cytotoxic Therapy ◽  
Prognostic Sign ◽  
Recurrent Malignancy

Ninety-six patients who received cytotoxic chemotherapy for germ cell neoplasms of the testis were studied. Painful gynecomastia developed in eight patients (8%) between 6 and 24 weeks after the initiation of cytotoxic therapy (mean 18 wk). Serum content of the beta subunit of human chorionic gonadotropin was normal in each patient when gynecomastia developed. Gynecomastia occurred following cytotoxic therapy for advanced disease in seven patients, and one patient was receiving adjunctive drug therapy for stage I disease. Six of the seven patients with advanced disease were in complete remission when gynecomastia developed; survival was superior in patients who developed treatment-related gynecomastia compared to those patients who did not (p less than 0.05). Gynecomastia may occur in adult males after cytotoxic therapy for testis cancer; such gynecomastia does not necessarily indicate recurrent malignancy and may be a favorable prognostic sign.

scholarly journals Laminar air flow reduces particle load in TKA—even outside the LAF panel: a prospective, randomized cohort study

2020 ◽  
Author(s):  
Stephanie Kirschbaum ◽  
Hagen Hommel ◽  
Peggy Strache ◽  
Roland Horn ◽  
Roman Falk ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Protective Factor ◽  
Fine Particles ◽  
Air Flow ◽  
Operating Table ◽  
Level Of Evidence ◽  
Airborne Contamination ◽  
Total Knee ◽  
Major Increase ◽  
Laminar Air Flow

Abstract Purpose Released particles are a major risk of airborne contamination during surgery. The present prospective study investigated the quantitative and qualitative particle load in the operating room (OR) depending on location, time of surgery and use of laminar air flow (LAF) system. Methods The particle load/m3 was measured during the implantation of 12 total knee arthroplasties (6 × LAF, 6 × Non-LAF) by using the Met One HHPC 6 + device (Beckmann Coulter GmbH, Germany). Measurement was based on the absorption and scattering of (laser) light by particles and was performed at three different time-points [empty OR, setting up, ongoing operation) at 3 fixed measurement points [OR table (central LAF area), anaesthesia tower (marginal LAF area), surgical image amplifier (outside LAF area)]. Results Independent of time and location, all measurements showed a significantly higher particle load in the Non-LAF group (p < 0.01). With ongoing surgical procedure both groups showed increasing particle load. While there was a major increase of fine particles (size < 1 µm) with advancing activity in the LAF group, the Non-LAF group showed higher particle gain with increasing particle size. The lowest particle load in the LAF group was measured at the operating column, increasing with greater distance from the operating table. The Non-LAF group presented a significantly higher particle load than the LAF group at all locations. Conclusion The use of a LAF system significantly reduces the particle load and therefore potential bacterial contamination regardless of the time or place of measurement and therefore seems to be a useful tool for infection prevention. As LAF leads to a significant decrease of respirable particles, it appears to be a protective factor for the health of the surgical team regardless of its use in infection prevention. Level of evidence I.

Neoplastic Meningitis

2005 ◽  
Vol 23 (15) ◽  
pp. 3605-3613 ◽  
Author(s):  
Marc C. Chamberlain
Keyword(s):  
Drug Therapy ◽  
Cranial Nerves ◽  
Clinical Manifestations ◽  
Chemotherapeutic Agents ◽  
Neoplastic Meningitis ◽  
Cns Metastases ◽  
Symptomatic Disease ◽  
Patients With Cancer ◽  
Involved Field ◽  
Involved Field Radiotherapy

Neoplastic meningitis (NM) is a common problem in neuro-oncology occurring in approximately 5% of all patients with cancer, and is the third most common site of CNS metastases. NM is a disease affecting the entire neuraxis, and therefore clinical manifestations are pleomorphic affecting the spine, cranial nerves, and cerebral hemispheres. Because of craniospinal disease involvement, staging and treatment need to encompass all CSF compartments. Treatment of NM utilizes involved-field radiotherapy of bulky or symptomatic disease sites and intra-CSF drug therapy. The inclusion of concomitant systemic therapy may benefit patients with NM and may obviate the need for intra-CSF chemotherapy. At present, intra-CSF drug therapy is confined to three chemotherapeutic agents (ie, methotrexate, cytarabine, and thiotepa) administered by a variety of schedules either by intralumbar or intraventricular drug delivery. Although treatment of NM is palliative with an expected median patient survival of 2 to 6 months, it often affords stabilization and protection from further neurologic deterioration in patients with NM.

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