QOLP-36. THE IMPORTANCE OF SLEEP DISTURBANCE IN PRIMARY BRAIN TUMOR (PBT) PATIENTS: CLINICAL CHARACTERISTICS & CO-OCCURRENCE WITH TUMOR-RELATED & PSYCHOLOGICAL SYMPTOMS

Abstract Sleep disturbance (SD) is a common symptom reported by PBT patients and research has demonstrated a link between sleep and stress circadian pathways. SD can impact perceived severity of other symptoms and development of psychopathology. This study explored the prevalence of moderate-severe SD in PBT patients, identifying associated clinical characteristics and co-occurrence with other tumor-related and psychological symptoms. Demographic, clinical characteristics, MDASI-Brain Tumor, and PROMIS Depression and Anxiety Short-Forms were collected at study entry. Descriptive statistics, Chi-square tests, and independent t-tests were used to report results. The sample included 424 patients (58% male, 81% Caucasian) with a median age of 49 years (range 18–81) and 58% with high-grade gliomas. Most had received treatment with surgery, radiation or chemotherapy prior to study entry, with 44% reporting a past recurrence. Moderate-severe SD (³ 5 on a 0–10 scale) was reported in 19% of patients and was associated with younger age (mean difference = 5 years), poor KPS (OR 2.2), current steroid use (OR 2.4), and tumor progression on MRI (OR 2). Those with moderate-severe SD had a higher overall symptom burden (mean difference = 2.3) and reported more moderate-severe symptoms (8 vs. 2). Patients reporting moderate-severe SD also reported higher severity in affective and cognitive symptom domains and mood-interference, with fatigue (72%), drowsiness (59%), and distress (56%) the most frequently co-occurring symptoms. Patients with moderate-severe SD also had increased prevalence of moderate-severe anxiety (32%) and depression (23%), compared to 10% in those without SD. PBT patients with moderate-severe SD are more symptomatic and have higher incidence of mood disturbance, suggesting a key role for sleep in the development of tumor-related and psychological symptoms. Future work delineating specific pathways involving sleep disturbance and co-occurring symptoms will be foundational for designing targeted sleep interventions to improve symptom burden and quality of life.

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HOUT-22. EVALUATING CLINICAL IMPACT UTILIZING THE RANO-PRO COLLABORATIVE’S STANDARDIZED PRIORITY CONSTRUCTS

Neuro-Oncology ◽

10.1093/neuonc/noz175.487 ◽

2019 ◽

Vol 21 (Supplement_6) ◽

pp. vi116-vi117

Author(s):

Elizabeth Vera ◽

Mark Gilbert ◽

Orwa Aboud ◽

Ramya Antony ◽

Lisa Boris ◽

...

Keyword(s):

Brain Tumor ◽

Malignant Glioma ◽

Clinical Care ◽

Symptom Burden ◽

Symptom Assessment ◽

Mean Difference ◽

Study Entry ◽

Additional Measure ◽

Core Symptom ◽

Core Symptoms

Abstract Increasing recognition of the symptom burden and functional limitations among primary brain tumor (PBT) patients has led to proposing clinical outcomes assessments as an additional measure of a treatment’s effectiveness. The RANO-PRO Collaborative recommended core symptoms for evaluation in clinical care and research for malignant glioma are weakness, walking, seizures, communication, memory, and treatment-specific symptoms. We evaluated these symptoms using the MDASI-Brain Tumor (BT) in the PBT patient sample of the NCI-NOB Natural History Study, in relation to disease progression, by descriptive statistics, and independent- and paired-samples t-tests. The sample included 434 PBT patients (59% male, median age=50 (18–83), 82% white, 43% with a prior recurrence). In the 60% with a malignant glioma, weakness, walking, seizures, difficulty remembering, and fatigue were significantly worse in the group with progression at time of imaging compared to the group with stable disease (p< 0.05). In a subset of 114 patients with progression after study entry, reported severity in all symptoms (except seizures) significantly worsened from study entry to time of progression (-1.7< mean difference< -0.1, p< 0.02, 0.3< r< 0.5). Walking, weakness, difficulty remembering, and fatigue each had a difference greater than 1-point, the minimally important difference for MDASI-BT. No one core symptom accounted for the severity change; each was reported by 17%-35% of patients as their largest change in severity. Utilizing the symptom with the largest change increased the magnitude of the worsening and its effect size (mean difference=-2.9, r=0.5). The analysis was repeated in the larger PBT sample with similar statistical findings but with smaller mean differences. RANO-PRO Collaborative core symptoms were shown to worsen at time of progression on imaging, highlighting the importance of continual symptom assessment and validating this core symptom group. Further analysis will focus on degree of change with each core symptom and validation in other datasets.

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Sleep disturbance in primary brain tumor: prevalence, risk factors, and patient preferences

Supportive Care in Cancer ◽

10.1007/s00520-021-06476-3 ◽

2021 ◽

Author(s):

Kelcie D. Willis ◽

Scott G. Ravyts ◽

Autumn Lanoye ◽

Ashlee R. Loughan

Keyword(s):

Risk Factors ◽

Brain Tumor ◽

Sleep Disturbance ◽

Patient Preferences ◽

Primary Brain Tumor

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Symptoms Burden among Women with Gynecological Cancer in Indonesia: A Descriptive Study

KnE Life Sciences ◽

10.18502/kls.v4i13.5314 ◽

2019 ◽

Author(s):

Nunung Nurhayati ◽

Astri Mutiar ◽

Fitriani Miraz ◽

Linlin Lindayani ◽

Dewi Marfuah

Keyword(s):

Psychological Symptoms ◽

Gynecological Cancer ◽

Symptom Burden ◽

Symptom Assessment ◽

Common Symptom ◽

Cross Sectional ◽

Descriptive Research ◽

Cancer Nursing ◽

Symptom Assessment Scale ◽

Serious Disease

Background: Gynecological cancer is one of the most common reproductive health problems of cancer. Factors that cause high rates of the incidence of gynecological cancer, because many symptoms are ignored so that symptoms that can actually be treated early become a very serious disease. Women with gynecological cancer have a burden of symptoms over time which can cause a negative response to the patient’s physical, psychological and emotional. Objectives: This study aimed to describe the symptom burden in women with gynecological cancer. Methods: This study used quantitative and descriptive research using cross sectional approach. Conducted in May2019,with95subjectsresearchatRumahSinggahinBandungusingconvenience sampling. Symptom Burden was assessed using Memorial Symptom Assessment Scale (MSAS). Resuts: Ten common symptoms experienced by respondents with gynecological cancer were worrying 96.8% (92), feeling sad 95.8% (91), insomnia 93.7% (89), problems with activity or sexual arousal 89, 5% (85), feeling tired 86.3% (82), lack of appetite 81.1% (77), dizziness 80% (76), irritability 80% (76), pain 78.9% (75), less energy 78.9 (75), with a symptom mean of 1.08 (± 0.386). Conclusion: Indicated that psychological symptoms is the common symptom that experienced by women with gynecological cancer. Nursing and other healthcare professional is expected to pay more attention to psychological symptoms to meets the need of patient.

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QOLP-19. FINANCIAL TOXICITY AND DISTRESS DURING THE COVID-19 PANDEMIC IN PEOPLE LIVING WITH PRIMARY BRAIN TUMORS

Neuro-Oncology ◽

10.1093/neuonc/noab196.740 ◽

2021 ◽

Vol 23 (Supplement_6) ◽

pp. vi187-vi187

Author(s):

Heather Leeper ◽

Elizabeth Vera ◽

Alvina Acquaye ◽

Nicole Briceno ◽

Anna Choi ◽

...

Keyword(s):

Brain Tumor ◽

Family Income ◽

Functional Limitations ◽

Symptom Burden ◽

High Grade Glioma ◽

Primary Brain Tumor ◽

High Grade ◽

Strongly Correlated ◽

Financial Toxicity ◽

Patient Reported

Abstract Primary brain tumor (PBT) patients experience high symptom burden and functional limitations, which may be impacted by the economic strain and mood disturbance during the COVID-19 pandemic. We assessed financial toxicity and associated patient reported outcomes (PROs) after one year of lockdown in a cohort of PBT patients. Patient and disease characteristics and PROs including FACIT-COST, MDASI-Brain Tumor, PROMIS-Anxiety/Depression short forms, and EQ-5D-3L were collected from 7/2020 to 5/2021 from participants in our Natural History Study. Descriptive statistics, Pearson correlations, and independent samples t-tests evaluated PRO relationships. The cohort included 112 PBT patients: 57% male, 87% white, mean age = 47 (range 25 – 80). Majority were married (65%), completed ≥ 4-year college degree (73%), earned annual family income ≥ $50,000 (68%) and living with a high-grade glioma (72%) complicated by recurrence (51%). Using FACIT-COST, 56% reported some financial hardship due to illness with a mean FACIT-COST of 28.3 (SD = 11.3, range: 0 - 44). Half of patients reported feeling moderately to extremely anxious or depressed. Non-Whites and Hispanics as well as those not currently working reported worse financial toxicity compared to White non-Hispanics and individuals currently working (21.4 vs 29.8 and 25.7 vs 30.4, respectively). Worse financial toxicity scores strongly correlated with worse overall symptom burden (r = -0.55) and interference (r = -0.42), worse anxiety (r = -0.39) and depression scores (r = -0.44), and worse overall HRQOL scores (r = –0.33)[all p< .01]. This is the first report of FACIT-COST in PBT patients to our knowledge and demonstrates that non-White individuals living with high grade glioma who are not currently working due to their tumor reported worse financial toxicity which was strongly correlated with higher symptom burden and interference with lower HRQOL. Future studies to assess financial toxicity longitudinally and post-pandemic using the FACIT-COST are needed.

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Clinical Characteristics of COVID-19-Infected Cancer Patients in Pakistan: Differences Between Survivors and Non-Survivors

Frontiers in Oncology ◽

10.3389/fonc.2021.655634 ◽

2021 ◽

Vol 11 ◽

Author(s):

Kashif Asghar ◽

Muhammad Abu Bakar ◽

Muhammad Junaid Akram ◽

Asim Farooq ◽

Kashif Siddique ◽

...

Keyword(s):

Risk Factors ◽

Cancer Patients ◽

Clinical Characteristics ◽

Clinicopathological Characteristics ◽

Research Centre ◽

Common Symptom ◽

Chi Square ◽

Exact Test ◽

Logistic Regression Models ◽

D Dimer

BackgroundCancer patients are considered as highly vulnerable individuals in the current COVID-19 pandemic. We studied the clinical characteristics of survivor and non-survivor COVID-19-infected cancer patients in Pakistan.Patients and MethodsWe did a retrospective study of 70 cancer patients with PCR-confirmed COVID-19 infection from Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore and Peshawar, Pakistan between April 13 and July 09, 2020. These patients were discharged from the hospital or had died by July 09, 2020. Clinical, pathological and radiological characteristics were compared between survivors and non-survivors by fisher’s exact test and chi-square test. Univariable and multivariable logistic regression models were performed to explore the risk factors of mortality.ResultsSeventy cancer patients with SARS-CoV-2 infection were enrolled and the majority were males 38 (54.3%). 57 (81.4%) had solid tumors and 13 (18.6%) had hematological malignancies. Dyspnea (44 cases) was the most common symptom (62.9%). Complications were reported in 51 (72.9%) patients during the course of disease. 19 (27.1%) patients were admitted to an intensive care unit (ICU). A significant increase in the C-reactive protein level and neutrophil count was observed in the deceased patients as compared to the surviving patients. D-dimer values of ≥0.2 mg/L were significantly associated with mortality (P=0.01). We identified two independent risk factors associated with death, ICU admission (P=0.007) and D-dimer (P=0.003).ConclusionPakistani cancer patients with COVID-19 infection reported poor prognosis. Intensive surveillance of clinicopathological characteristics of cancer patients infected with COVID-19 especially D-dimer values may play a pivotal role in the outcome of the disease.

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QOLP-19. INSOMNIA IN BRAIN TUMOR PATIENTS: ASSESSING NEEDS IN NEURO-ONCOLOGY

Neuro-Oncology ◽

10.1093/neuonc/noaa215.744 ◽

2020 ◽

Vol 22 (Supplement_2) ◽

pp. ii178-ii179

Author(s):

Kelcie Willis ◽

Scott Ravyts ◽

Autumn Lanoye ◽

Ashlee Loughan

Keyword(s):

Brain Tumor ◽

Sleep Disturbance ◽

Pharmacological Treatment ◽

Medical Center ◽

Academic Medical Center ◽

Primary Brain Tumor ◽

Academic Medical ◽

Fatigue Severity ◽

Negative Side Effects ◽

The Relationship

Abstract BACKGROUND Insomnia is a prevalent consequence of cancer diagnosis and treatment. In primary brain tumor (PBT) patients specifically, insomnia has been rated as one of the most severe symptoms and linked with other negative side effects, such as increased fatigue and emotional distress. Despite these findings, research has consistently omitted PBT patients in understanding the detailed effects and treatment for insomnia. METHODS Adult PBT patients (N=74) completed anonymous surveys at routine neuro-oncology appointments at an NCI-designated academic medical center. The surveys included validated measures of insomnia (ISI & PSQI), fatigue (BFI), and other original items (e.g., How would you describe your feelings towards medication treatment for insomnia?). The current investigation aimed to assess: 1) the prevalence of clinically elevated symptoms of insomnia, 2) the relationship between sleep disturbance and daytime fatigue and distress, and 3) patients’ preferences for pharmacological and non-pharmacological treatment for insomnia in PBT patients. RESULTS Of the sampled PBT patients, 38% reported significant sleep disturbance as measured by the PSQI. Moreover, 23% endorsed clinically elevated, moderate-severe symptoms of insomnia as measured by the ISI. Excessive worrying (r =.31) and bad dreams (r =.29, p< .05) were both associated, though not predictive of insomnia severity (p >.05). Insomnia symptoms predicted increased fatigue severity, F(1,72) =52.60, β=.65, p< .001, R2 =.42. Of the patients with clinical insomnia, 59% felt that their symptoms were not well-managed by their medical team; 53% expressed interest in pharmacological treatment and 47% in non-pharmacological treatment. CONCLUSIONS The prevalence and consequences of insomnia identified in PBT patients are similar to that of other cancers, yet the majority of PBT patients with insomnia reported their symptoms were poorly managed. Though there was slight preference for pharmacological treatment, the sizeable proportion of those interested in non-pharmacological treatments warrants investigations into such therapies (e.g., CBT-I) in medical settings

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PCSM-06COMPARISON OF THE SYMPTOM BURDEN IN ACTIVE TREATMENT VERSUS FOLLOW-UP FOR PRIMARY BRAIN TUMOR PATIENTS

Neuro-Oncology ◽

10.1093/neuonc/nov227.06 ◽

2015 ◽

Vol 17 (suppl 5) ◽

pp. v177.1-v177

Author(s):

Anna Leisy ◽

Terri Armstrong ◽

Avlina Acquaye ◽

Elizabeth Vera-Bolanos ◽

Mark Gilbert ◽

...

Keyword(s):

Brain Tumor ◽

Active Treatment ◽

Symptom Burden ◽

Primary Brain Tumor ◽

Tumor Patients

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What are the Most Widely Used and Effective Attack Coverage Systems in Men’s Volleyball?

Journal of Human Kinetics ◽

10.1515/hukin-2017-0163 ◽

2018 ◽

Vol 62 (1) ◽

pp. 111-121

Author(s):

Raúl Hileno ◽

Antonio García-de-Alcaraz ◽

Bernat Buscà ◽

Cristòfol Salas ◽

Oleguer Camerino

Keyword(s):

Mean Difference ◽

First Line ◽

Chi Square ◽

Residuals Analysis ◽

Specific Position ◽

Pan American ◽

Guiding Principles ◽

High Level ◽

Tests For Independence ◽

Chi Square Tests

Abstract In volleyball, attack coverage is one of the play actions most neglected in coaching and research. The purpose of this study was to find out which attack coverage systems are used by high-level men’s teams in different game situations and the characteristics of the most effective systems. We analysed 15 matches from the 2010 Men’s Pan-American Volleyball Cup, with a total of 1,415 coverage actions. Chi-square tests for independence, adjusted residuals analysis and calculations of standardised mean difference were performed. The results show that high-level men’s volleyball uses many coverage systems other than the traditional 3-2-0 and 2-3-0. At this level of play, the most frequent systems were 1-3-1 and 1-2-2, which occurred significantly often at the culmination of a third-tempo attack at the wing. The most effective systems consisted of three coverage lines, with fewer than five players covering the spiker and at least one player in the first coverage line, in both the attack and counterattack phases. Given the large number of coverage systems identified in different game situations, we recommend flexible, loosely structured training in these systems, based on a set of guiding principles that all players on a team must internalise for the specific position they are playing. Regarding the systems’ efficacy, the main watchword is that on each coverage line there should always be at least one player, but the first line should not be exposed.

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Clinical Characteristics and Prognostic Factors of Early-Onset Pancreatic Neuroendocrine Tumors

Cancer Control ◽

10.1177/1073274820986827 ◽

2021 ◽

Vol 28 ◽

pp. 107327482098682

Author(s):

Min Shi ◽

Biao Zhou

Keyword(s):

Prognostic Factors ◽

Neuroendocrine Tumors ◽

Early Onset ◽

Older Patients ◽

Clinical Characteristics ◽

Clinicopathological Characteristics ◽

Pancreatic Neuroendocrine Tumors ◽

Chi Square ◽

Younger Patients ◽

Significant Difference

Background: The incidence of pancreatic neuroendocrine tumors (PNETs) has increased significantly. The purpose of this study was to analyze the clinical characteristics and prognosis of patients under 50 years old. Methods: Patients with PNETs recorded in the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015 were analyzed. The clinical characteristics were analyzed by Chi-square test. The Kaplan-Meier method was used to estimate overall survival (OS). Multivariate Cox proportional risk regression analysis was used to determine independent prognostic factors. Results: 2,303 patients included, of which 547 (23.8%) patients were younger than 50 years old. The number of younger patients has increased steadily, while the proportion in total PNETs decreased recently. Compared with older group, the proportion of the Black, grade I/II, and surgery were higher in early-onset PNETs. Liver was the most frequent metastatic site. There was no significant difference in the incidence of different metastatic sites between younger and older PNETs patients, while younger patients had better OS (P < 0.05). Grade, N stage, M stage, and surgery were independent prognostic factors for OS in early-onset PNETs. Conclusions: Younger patients have unique clinicopathological characteristics compared with older patients in PNETs. Better OS was observed in younger patients which might due to the higher proportion of well-differentiated tumor and surgery than older patients.

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Antimicrobial Efficacy of Propolis in Comparison to Chlorhexidine against Enterococcus faecalis: A Systematic Review and Meta-Analysis

Applied Sciences ◽

10.3390/app11083469 ◽

2021 ◽

Vol 11 (8) ◽

pp. 3469

Author(s):

Khalid H. Almadi ◽

Muhammad Adeel Ahmed ◽

Tuba Ghazal ◽

Rizwan Jouhar ◽

Mazen F. Alkahtany ◽

...

Keyword(s):

Enterococcus Faecalis ◽

Meta Analysis ◽

Mean Difference ◽

Permanent Teeth ◽

Antibacterial Efficacy ◽

Chi Square ◽

Reporting Standard ◽

Standard Mean Difference ◽

Significant Difference ◽

Chi Square Test

Propolis is proposed to possess antibacterial and anti-inflammatory properties, which can be used in endodontic applications. However, evidence on its efficacy in comparison to chlorhexidine against Enterococcus faecalis (E. faecalis) is controversial. The aim of the current study was to compare the antibacterial efficacy of Propolis and chlorhexidine as an intracanal medicament against E. faecalis in extracted human permanent teeth. The focused question was, “Does Propolis show better antibacterial efficacy than Chlorhexidine (CHX) as an intracanal medicament against E. faecalis in extracted human permanent teeth?”. Databases including PubMed/Medline, Scopus, EMBASE, ISI-Web of Science were searched from 1990 to August 2020 using different combinations of the following keywords: “Propolis”, “Intracanal medicament”, “E. faecalis”, “Antibacterial activity” and “Chlorhexidine”. Ten studies fulfilling inclusion criteria were considered for qualitative analysis, followed by quantitative analysis of eight studies. Heterogeneity was calculated for colony forming units (CFU) of E. Faecalis using the Chi-square test and I2 statistics. Forest plots were computed reporting standard mean difference (SMD) of outcomes and 95% confidence intervals. The overall mean difference for CFU of E. faecalis showed a statistically significant difference between the antibacterial efficacy of Propolis and CHX (SMD = 3.20 [1.70, 4.69] Z = 4.20; p < 0.001). CHX showed superior antibacterial efficacy against E. faecalis compared to Propolis.

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