scholarly journals Triaging and adaptations of surveillance of cancer services in the COVID pandemic

2020 ◽  
pp. 1-3
Author(s):  
Shirley Lewis ◽  
Lavanya Gurram ◽  
Umesh Velu ◽  
Krishna Sharan
Keyword(s):  
Cancer Patients ◽  
Clinical Examination ◽  
Cancer Care ◽  
Middle Income ◽  
Face To Face ◽  
Middle Income Countries ◽  
Cancer Services ◽  
Low Middle Income Countries

Abstract Introduction: Coronavirus disease (COVID-19) has significantly challenged the access to cancer care and follow-up for a patient with cancer. Methods: Based on published literature and our experiences, it is reasonable to presume that clinical examination and follow-up visits have been significantly curtailed worldwide in order to adhere to the new norms during the pandemic. Although telephonic and telemedicine consultations may help bridge a few gaps, completely dispensing with in-person consultation has its challenges, especially in low middle-income countries. Telephonic consultations could facilitate triaging of ambulatory cancer patients and allocation of face-to-face consultations for high priority patients. Conclusions: We propose a telephonic consultation-based triaging approach for ambulatory cancer patients in order to identify those needing in-hospital consultations.

Smartphone-based DIY home microsurgical training with 3D printed microvascular clamps and Japanese noodles

2021 ◽  
Author(s):  
Zhi Yang Ng ◽  
Calum Honeyman ◽  
Alexandre G Lellouch ◽  
Ankur Pandya ◽  
Theodora Papavasiliou
Keyword(s):  
Back Wall ◽  
Internal Validation ◽  
Middle Income ◽  
Face To Face ◽  
Middle Income Countries ◽  
Video Recordings ◽  
Low Middle Income Countries ◽  
Konjac Flour ◽  
3D Printed ◽  
Set Up

We have recently incorporated simple modifications of the konjac flour noodle model to enable DIY home microsurgical training by (i) placing a smartphone on a mug to act as a microscope with at least 3.5-5x magnification, and (ii) rather than cannulating with a 22G needle as described by others, we have found that cannulation with a 23G needle followed by a second pass with an 18G needle will create a lumen (approx. 0.83 mm) without an overly thick and unrealistic “vessel” wall. The current set-up however, did not allow realistic evaluation of anastomotic patency as the noodles became macerated after application of standard microvascular clamps, which also did not facilitate practice of back-wall anastomoses. In order to simulate the actual operative environment as much as possible, we introduced the use of 3D printed microvascular clamps. These were modified from its previous iteration (suitable for use in silastic and chicken thigh vessels) and video recordings were submitted for internal validation by senior surgeons. A “wet” operative field where the knojac noodle lumen can be distended or collapsed, unlike other non-living models, was noted by senior surgeons. With the 3D clamps, the noodle could now be flipped over for back-wall anastomosis and allowed patency testing upon completion as it did not become macerated, unlike that from clinical microvascular clamps. The perceived advantages of this model are numerous. Not only does it comply with the 3Rs of simulation-based training, it can also reduce the associated costs of training by up to a hundred-fold or more when compared to a traditional rat course, and potentially, be extended to low-middle income countries (LMICs) without routine access to microsurgical training for capacity development. That it can be utilised remotely also bodes well with the current limitations on face to-face training due to COVID restrictions and lockdowns.

scholarly journals 66. CLINICAL CHARACTERISTICS AND RESULTS OF PEDIATRIC SOLID TUMORS WITH BRAIN METASTASES: EXPERIENCE FROM A SINGLE REFERRAL CANCER CENTER

2020 ◽  
Vol 2 (Supplement_2) ◽  
pp. ii14-ii14
Author(s):  
Clarissa Aguilar ◽  
Víctor Toro ◽  
Rina Medina
Keyword(s):  
Brain Metastases ◽  
Childhood Cancer ◽  
Solid Tumors ◽  
Metastatic Disease ◽  
Cancer Center ◽  
Middle Income ◽  
Middle Income Countries ◽  
Pediatric Solid Tumors ◽  
Low Middle Income Countries

Abstract BACKGROUND 80% of childhood cancer are located in low- and middle-income countries (LMIC). The most common form of presentation is disseminated or metastatic disease. The rate of survival has not been equitable across the world, since in these countries only 1 of 5 children are cured. OBJECTIVE To evaluate the clinical and histopathological features of patients with metastatic pediatric solid tumors, in a single referral cancer center in Honduras. METHODS We conducted a retrospective review of patients diagnosed with pediatric solid tumors from January 2010 to April 2020. Among the 260 patients through a collection form, we obtained: sociodemographic characteristics, clinical presentation at diagnosis, common histological subtypes, sites of metastasis, treatment and outcome at the time of follow-up. RESULTS During the last 10 years, 260 cases of childhood cancer were referred to our center for treatment. 127 patients (48.8%), have a solid tumor, patients ranged in age from 1 to 18 years and distribution for sex were 38% for males and 62% females. At the time of initial diagnosis 40/127 (31%) have advanced disease (stages III and IV). We found brain metastases in 22/40 cases (55%), the primary cancer was localized at CNS in 13/22 (59%) and the most common extracranial tumors causing brain metastases were neuroblastoma (4/22), rhabdomyosarcoma (3/22), retinoblastoma (2/22). Currently in the follow-up there were 18/22 (82%) died and 4/22 (18%) are in treatment with palliative intent. CONCLUSION There is a lack of information about the epidemiology of brain metastases among children with solid tumors in the low/middle income countries (LMIC) where the prognosis of metastatic disease is very poor, despite efforts, multimodal therapy and multidisciplinary management, in absence of other options like bone marrow transplantation, and reliable access to high-quality medicines. For our countries, timely diagnosis is still the main determining factor for cure.

Disparity of cervical cancer care delivery in low-middle income countries

2014 ◽  
Vol 133 ◽  
pp. 190
Author(s):  
L.T. Chuang ◽  
S.S. Tedjarati ◽  
F.V. Price ◽  
W.T. Creasman
Keyword(s):  
Cervical Cancer ◽  
Cancer Care ◽  
Care Delivery ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low Middle Income Countries

scholarly journals The Role of “Liquid Biopsy” Repositories in Cancer Care in Low to Middle–Income Countries

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 244s-244s
Author(s):  
M. Kohli
Keyword(s):  
Cancer Patients ◽  
Whole Blood ◽  
Cancer Care ◽  
Liquid Biopsy ◽  
Healthcare Delivery ◽  
Cancer Center ◽  
Cell Free Dna ◽  
Middle Income ◽  
Middle Income Countries ◽  
Free Dna

Background and context: Translation of underlying individual genomic heterogeneity in cancer into precision medicine practice requires annotated cancer biorepositories. The potential for practice of precise medicine is also coupled to saving vital resources in low to middle–income countries. An overview of experience and outcomes from a tertiary level cancer center in a high-income country for liquid biobank established since 2009 is presented. Aim: To understand the challenges of building economically viable biorepositories that can be used for molecular diagnostics while delivering cancer care. Strategy/Tactics: An institutional ethics–approved prospective liquid biorepository was established in September of 2009 for advanced cancer patients. Informed consent–approved collection of 29.5 mL blood/urine was performed serially on enrolled patients and clinical annotation was obtained during follow-up including previous, current and future treatments and their outcomes. All specimens were processed using a uniform protocol in which extraction of germline DNA from buffy coats; serum for proteomics; platelet-poor and platelet-rich plasma (in citrate and EDTA anticoagulants) for microRNA and cell-free DNA extractions; and extraction of PAXgene RNA/DNA from whole blood was performed. Processing was done within 45 minutes of sample acquisition and storage in −80°C freezers with no freeze–thaw cycles. Program/Policy process: Biobanking for cancer care. Outcomes: Between September of 2009 and January of 2015, 535 advanced-stage prostate cancer patients in hormone-sensitive and castrate-resistant stage; 250 advanced kidney cancer patients; 110 testicular cancer patients were enrolled and 1550 collections were performed serially. This generated >60,000 plasma/serum/DNA/RNA aliquots. Nucleic acids (DNA/RNA) from buffy coats and whole blood of 500-1000 ng volume each were also extracted. Cell-free DNA for somatic mutational and copy number analysis; single nucleotide profiling from germline DNA; RNA expression profiling from whole blood and microRNA analysis in plasma has been performed from this cohort along with proteomics using tandem mass spectrometry. By 2017, this has resulted in >35 scientific publications; 5 patents; multiple national and international grant awards and enhanced precision cancer care for patient care. The cost burden for establishing the infrastructure was highly economical. What was learned: In our experience, liquid biopsy repositories can augment clinical cancer globally, but do not find this discussed in low to middle–income nations. Advancing and applying molecular oncology and team science to prospectively collected and retrospectively annotated biobanks can be a cost-efficient resource in a global cancer healthcare delivery system and a useful tool for scientific and economic opportunities and collaborations.

Teleoncology

2019 ◽  
pp. 259-266
Author(s):  
Groesbeck Parham ◽  
Hans Junkermann ◽  
Gert Van den Eynden ◽  
Paul van Diest
Keyword(s):  
Clinical Oncology ◽  
Cancer Care ◽  
Middle Income ◽  
Remote Areas ◽  
Middle Income Countries ◽  
Quality Cancer Care ◽  
Local Setting ◽  
Information And Communication ◽  
Radiology And Pathology

Abstract: Teleoncology is defined as delivery of clinical oncology services from a distance for diagnosis, treatment, and patient follow-up using information and communication technology. Quality cancer care is often unavailable in low- and middle-income countries but also in remote areas of high-income countries. To reach its full transformational potential, it is in these areas where this technology is most needed. Areas where teleoncology has been most successfully applied are surgery, radiology, and pathology. Best practices must be identified for each local setting.

scholarly journals Hierarchy of Loss in Functional Capability: Findings From a 15-Year Follow-Up in a Brazilian Aging Cohort

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 664-664
Author(s):  
Cesar de Oliveira ◽  
Dorina Cadar ◽  
Jane Biddulph ◽  
Juliana Vaz de Melo Mambrini ◽  
Fabiola Bof de Andrad ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Middle Income ◽  
Functional Loss ◽  
Middle Income Countries ◽  
Risk Of Death ◽  
Disability Rate ◽  
Low Middle Income Countries ◽  
Hierarchical Pattern

Abstract Functional loss among older adults is known to follow a hierarchical sequence, but little is known about this in low-middle income countries. We examined longitudinally the hierarchy of loss in physical functioning in 1,602 older Brazilian adults (aged 60+) from the Bambui Cohort Study of Aging. Functional loss was ascertained using self-reported difficulties in six basic activities of daily living (BADL). The incidence for each BADL limitation was assessed using survival analysis while controlling for the competing risk of death. Over the 15-year follow-up, the incidence in BADL disability rate was highest for dressing, followed by getting out of bed, bathing/showering, walking across a room, using the toilet or eating. The findings from this 15-year follow-up Brazilian aging cohort support a hierarchical pattern of disability in activities of daily living based on both prevalence and incidence of disabilities over time, and they suggest gender differences in the incidence of disability.

The Impact of Covid 19 on Pregnant Women and Child Health

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1367-1373
Author(s):  
Nikhil Sanjay Mujbaile ◽  
Smita Damke
Keyword(s):  
Social Issues ◽  
Middle Income ◽  
Web Based ◽  
Middle Income Countries ◽  
Low Middle Income Countries ◽  
The Social ◽  
Social Separation ◽  
The Impact ◽  
And Child Health ◽  
General Wellbeing

The Covid illness (COVID-19) pandemic has spread rapidly all through the world and has had a drawn-out impact. The Pandemic has done incredible damage to society and made genuine mental injury to numerous individuals. Mental emergencies frequently cause youngsters to deliver sentiments of relinquishment, despondency, insufficiency, and fatigue and even raise the danger of self-destruction. Youngsters with psychological instabilities are particularly powerless during the isolate and colonial removing period. Convenient and proper assurances are expected to forestall the event of mental and social issues. The rising advanced applications and wellbeing administrations, for example, telehealth, web-based media, versatile wellbeing, and far off intuitive online instruction can connect the social separation and backing mental and conduct wellbeing for youngsters. Because of the mental advancement qualities of youngsters, this investigation additionally outlines intercessions on the mental effect of the COVID-19 Pandemic. Further difficulties in Low Middle-Income Countries incorporate the failure to actualize successful general wellbeing estimates, for example, social separating, hand cleanliness, definitive distinguishing proof of contaminated individuals with self-disconnection and widespread utilization of covers The aberrant impacts of the Pandemic on youngster wellbeing are of extensive concern, including expanding neediness levels, upset tutoring, absence of admittance to the class taking care of plans, decreased admittance to wellbeing offices and breaks in inoculation and other kid wellbeing programs. Kept tutoring is critical for kids in Low Middle-Income Countries. Arrangement of safe situations is mainly testing in packed asset obliged schools. 

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