scholarly journals 542. Use of Bamlanivimab in Cancer Patients with Mild-to-Moderate COVID-19

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S372-S373
Author(s):  
Patricia Brock ◽  
Hiba Dagher ◽  
Adriana H Wechsler ◽  
Demis N Lipe ◽  
Patrick Chaftari ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Patient Population ◽  
Care Center ◽  
Severe Disease ◽  
Hematologic Malignancies ◽  
Emergency Department Visits ◽  
Oxygen Desaturation ◽  
Control Group ◽  
Presenting Symptoms ◽  
The Difference

Abstract Background Bamlanivimab is a monoclonal antibody that was granted an emergency use authorization by the US Food and Drug Administration in November 2020 for patients with mild to moderate coronavirus disease 2019 (COVID-19). It initially showed promising results with decreasing hospitalizations and return emergency department visits in immunocompetent patients. We evaluated the role of bamlanivimab in the cancer patient population. Methods We conducted a retrospective matched study of all cancer patients diagnosed with mild to moderate COVID-19 who received bamlanivimab in our acute cancer care center (ACCC) from December 2020 to February 2021. These patients were compared to a control group of cancer patients who presented to our ACCC and were diagnosed with mild to moderate COVID-19 from March to November 2020 before the introduction of bamlanivimab. Control patients were matched by age and underlying malignancy. All patients had a baseline oxygen saturation ≥ 94% and an absolute neutrophil count > 500 mm3. Demographics, clinical characteristics, and outcome that included COVID-related admissions, oxygen desaturation, ICU admission and 30-day mortality were compared in both groups. Results A total of 108 patients were analyzed with 54 patients in each group, of which 59% consisted of hematologic malignancies, and 33% were ≥ 65 years. The presenting symptoms were similar in both groups and mainly consisted of cough, fever, and dyspnea. Patients who received bamlanivimab were less likely to be admitted to the hospital (24% vs. 91%; p< 0.0001), experience oxygen desaturation < 94% during follow-up (11% vs 44%; p=0.0001), require oxygen supplement (7% vs. 44%; p< 0.0001), or be admitted to the ICU (4% vs 15%; p=0.046). No 30-day mortality was observed in the bamlanivimab group with 2 (4%) occurring in the control group. However, the difference was not significant. Conclusion Bamlanivimab decreased hospital and ICU admissions in cancer patients. In addition, bamlanivimab reduced oxygen requirement and the risk of hypoxia and progression to severe disease in this patient population. Disclosures Samuel L. Aitken, PharmD, MPH, BCIDP, Melinta Therapeutoics (Individual(s) Involved: Self): Consultant, Grant/Research Support

Analysis of the Impact of Personalized Nursing Service and Hospice Care on the Quality of Life of Elderly Cancer Patients

2021 ◽  
Vol 7 (4) ◽  
pp. 469-473
Author(s):  
Ting Fang ◽  
Nian Wang ◽  
Meng Chen ◽  
Hongmei Ma
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Hospice Care ◽  
Pain Treatment ◽  
Control Group ◽  
Study Group ◽  
The Difference ◽  
The Impact

Objective Explore the impact of personalized nursing services and hospice care on the quality of life of elderly patients with advanced cancer. Method We selected 80 elderly cancer patients admitted to our hospital from September 2020 to May 2021, and divided these patients into a study group and a control group using a random number table method. The patients in the control group used conventional nursing methods to treat and care for the patients, and the patients in the study group used hospice care measures and combined personalized nursing measures. The quality of life and pain treatment effects of the two groups of patients before and after treatment were compared. Result Before treatment, the quality-of-life scores of the two groups of patients were low, and there was no statistical difference (P>0.05); After treatment, the quality of life of the two groups of patients improved, but compared with the control group, the improvement was more obvious in the study group, and the difference was statistically significant (P<0.05). In terms of pain treatment effect, the total effective rate of pain treatment in the study group was 87.5%, which was significantly better than the 62.5% in the control group. The difference was statistically significant (P<0.05). Conclusion Personalized nursing services and hospice care are conducive to improving the survival and treatment of elderly patients with advanced cancer, and can be used as a clinical application program for the care of advanced cancer patients.

Initial report on hospitalized cancer patients with COVID-19 from the National Cancer Institute (NCI) COVID-19 in Cancer Patients Study (NCCAPS).

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6566-6566
Author(s):  
Nicholas M. Mark ◽  
Ana F. Best ◽  
Alok A. Khorana ◽  
Steven Pergam ◽  
Grace E. Mishkin ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Mechanical Ventilation ◽  
Cancer Patients ◽  
Clinical Data ◽  
Invasive Mechanical Ventilation ◽  
Hematologic Malignancies ◽  
Initial Report ◽  
Discharge Data ◽  
Presenting Symptoms ◽  
High Dependency

6566 Background: Hospitalized cancer patients (pts) with COVID-19 have a severe disease course and high mortality. Pts with lung cancer, hematologic malignancies and metastatic disease may be at higher risk. Detailed prospective inpatient data may help to identify those at greatest risk for poor outcomes. Methods: NCCAPS is a longitudinal study aiming to accrue 2,000 cancer pts undergoing treatment for hematologic malignancy or solid tumor with COVID-19. For pts’ first COVID-19 hospitalization, clinical data, research blood specimens and imaging are collected, and additional clinical data are collected during subsequent hospitalizations. Results: As of Jan. 22, 2021, among 757 enrolled adult patients from 204 sites, 124 (16.3%) reported at least one hospitalization for COVID-19, and discharge data was available for 98 hospitalizations in 88 patients. The median age was 67 (range 21-93, 1Q:56, 3Q:72), 35/88 (40%) were female. The most common malignancies in hospitalized adult pts were lymphoma (18.2%), lung cancer (15.9%) and multiple myeloma (10.2%). The most common presenting symptoms were shortness of breath (65%), fatigue/malaise (64%), and fever (49%). 8/88 (9%) pts were neutropenic (ANC < 1000) at presentation; 17/88 (19%) were thrombocytopenic. Median length of stay was 6.5 days (range 1-41, 1Q:4, 3Q:12). Among those hospitalized, 20/88 (22.7%) received care in the ICU or high dependency unit, with a median ICU stay of 7 days (range 1-22, 1Q:2.5, 3Q:9.5); of those admitted to the ICU, 25% (5/20) received invasive mechanical ventilation. Of those in whom inpatient medications were recorded (n = 63), 63% received corticosteroids, 46% received remdesivir, and 14% received convalescent plasma. One pt received bamlanivimab and 2 patients received tocilizumab. Most (46/63; 73%) received anticoagulation, primarily prophylactic low molecular weight heparin; 11/63 (17%) received therapeutic dose anticoagulation. Inpatient D-dimer values were recorded in 43 inpatients, 26 of whom had multiple measurements. 16/98 hospitalizations ended with death (16%). Conclusions: Preliminary analysis of NCCAPS data reveals that inpatient hospital admission is common among oncology patients with COVID-19 and mortality rates appear high within this cohort. Hematologic malignancies and lung cancer are the most common underlying diagnoses in patients requiring hospitalization. Corticosteroids and anti-coagulation were the most commonly used therapies. Despite high rates of ICU admission, invasive mechanical ventilation may be instituted less often in an oncology cohort. These observations may inform decisions about vaccine policy and decisions to limit life sustaining treatment. Clinical trial information: NCT04387656.

Effect of Nursing Measures Based on Self-Efficacy Theory on State Self-Esteem of Breast Cancer Patients

2021 ◽  
Vol 7 (6) ◽  
pp. 6469-6476
Author(s):  
Li Qiu ◽  
Hongli Wang ◽  
Yuan Yuan ◽  
Ying Wang ◽  
Ping Yu
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Self Efficacy ◽  
Self Esteem ◽  
The Self ◽  
Control Group ◽  
Observation Group ◽  
Breast Cancer Patients ◽  
Functional Exercise ◽  
The Difference

To analyze the effect of nursing measures based on self-efficacy theory on the state self-esteem of breast cancer patients. 110 breast cancer patients who were treated in our hospital from October 2018 to October 2019 were randomly divided into control group and observation group. The control group was given routine nursing measures, and the observation group was given nursing measures under the guidance of self-efficacy theory. Before operation, 1 week after operation and 3 months after operation, the general data of the two groups before and after treatment were recorded. The self-efficacy level and self-esteem level of the patients before and after treatment were assessed by the self-efficacy scale (GSEs) and state self-esteem scale (SSEs). The compliance of functional exercise and shoulder joint activity (ROM) of the two groups were compared, and the physical status of the two groups were analyzed. To analyze the effect of nursing measures based on self-efficacy theory on the state self-esteem of breast cancer patients. The GSEs score of the two groups increased with the time, and there was no significant difference between the two groups before operation (P > 0.05). After 1 week and 3 months, the GSEs score of the observation group was significantly higher than that of the control group (P < 0.05). The compliance evaluation table of functional exercise in the two groups increased with the time, and the compliance evaluation table of functional exercise in the observation group was significantly higher than that in the control group, the difference was statistically significant (P < 0.05). ROM of the two groups increased with time, and ROM of the observation group was significantly better than that of the control group, the difference was statistically significant (P < 0.05). The self-esteem level of the two groups increased with time, and the self-esteem level of the observation group was significantly higherthan that of the control group, the difference was statistically significant (P <0.05). The nursing measures under tne guidance of self-efficacy theory can help patients to complete functionalexercise, improve theirquality of life, improve their self-esteem level, a nd can be widely used in clinical practice.

scholarly journals Immature Platelet Fraction: A Useful Marker for Identifying the Cause of Thrombocytopenia and Predicting Platelet Recovery

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 128-128
Author(s):  
Young Kyung Lee ◽  
Kibum Jeon ◽  
Miyoung Kim ◽  
Eunyup Lee ◽  
Jiwon Lee ◽  
...  
Keyword(s):  
Platelet Count ◽  
Cancer Patients ◽  
The Other ◽  
Discriminatory Power ◽  
Control Group ◽  
Platelet Recovery ◽  
P Values ◽  
Platelet Counts ◽  
Immature Platelet Fraction ◽  
The Difference

Abstract Introduction: The assessment of thrombopoietic activity in bone marrow is necessary for patients with thrombocytopenia to achieve correct diagnoses and effective treatments. We evaluated the discriminatory power of the immature platelet fraction (IPF%) in differentiating hyperdestructive/consumptive thrombocytopenia from hypoproductive thrombocytopenia, and its potential use as a predictive marker for platelet recovery. Methods: Platelet indices including IPF% were measured in 105 healthy individuals (the control group), 31 patients with hyperdestructive/consumptive thrombocytopenia (14 with immune thrombocytopenic purpura [ITP] and 17 with liver cirrhosis), and 34 patients with hypoproductive thrombocytopenia (4 with aplastic anemia and 30 with cancer who were undergoing chemotherapy) by using a Sysmex XN-3000 hematology analyzer. Results: The platelet number in the hyperdestructive/consumptive thrombocytopenia group was significantly lower than that in the hypoproductive thrombocytopenia group (P <0.001). The difference of plateletcrit (PCT) between the 2 thrombocytopenia groups was not statistically significant (P= 0.363). The IPF% was significantly higher in the hyperdestructive/consumptive thrombocytopenia group (median: 6.2% [IQR 4.3-10.3%]) than in both the control group (1.8% [1.3-2.4%]) and the hypoproductive thrombocytopenia group (1.8% [0.9-2.3%]) (all P-values < 0.001). However, the difference between the hypoproductive thrombocytopenia and control groups was not statistically significant (P= 0.331). Compared to the control group, the hyperdestructive/consumptive thrombocytopenia group showed a 190.5% increase in the median IPF% value, while the hypoproductive thrombocytopenia group showed a 9.5% decrease. The IPF# was significantly different between the 3groups; it was highest in the control group (median: 4.3 ×109/L [IQR 3.5-5.8×109/L]), followed by the hyperdestructive/consumptive thrombocytopenia group (3.2×109/L [1.7-4.5×109/L]), and lowest in the hypoproductive thrombocytopenia group (1.3 ×109/L [0.7-2.0×109/L]) (all P-values <0.001). Compared to the control group, the hyperdestructive/consumptive thrombocytopenia group showed a 25.6% decrease and the hypoproductive thrombocytopenia group a 69.8% decrease. PDW, MPV, and P-LCR were higher in the hyperdestructive/consumptive thrombocytopenia group (14.5 ± 3.0 fL, 12.0 fL [IQR: 11.0-12.0 fL], and 38.9 ± 6.8%, respectively) than in the other 2 groups, but there was no statistical difference between the other 2 groups. The IPF% in the hyperdestructive/consumptive group increased significantly as the number of platelets decreased, especially in patients with severe thrombocytopenia with platelet counts under 40.0 ×109/L. The IPF% was 4.7% (3.1-4.7%), 6.2% (3.2-7.6%), and 11.4% (7.1-16.6%) in patients with platelet counts>90.0 ×109/L, 40.0-90.0 ×109/L and<40.0 ×109/L, respectively (P = 0.010). However, this phenomenon was not observed in the hypoproductive thrombocytopenia group. The area under the curve (AUC) was highest for IPF% (0.938), indicating that this parameter showed the best discriminatory ability between the 2 groups, followed by PDW (0.885), P-LCR (0.859), IPF# (0.827), and MPV (0.824) (all P-values <0.001). The best IPF% cut-off value indicative of the highest sensitivity and specificity was 2.3%. The AUC of PCT was under 0.5 (0.445, P = 0.477), showing no discriminatory power. The IPF% decreased 3-4 days in advance of platelet count elevation in patients with ITP, while the IPF# ratio (compared to baseline) increased 3 days in advance of the same. Furthermore, the IPF% and IPF# ratio increased 5.5 days and 8.5 days, respectively, before platelet counts increased up to 130.0 × 109/L in cancer patients receiving chemotherapy. Conclusion: IPF% showed the most % value difference between the 3 groups and the largest AUC, showing it has the best discriminatory power in distinguishing the cause of thrombocytopenia. Also, IPF% showed an inverse correlation with platelet count in the hyperdestructive/consumptive thrombocytopenia group, but not in the hypoproductive thrombocytopenia group. The IPF% and IPF# were useful markers to predict the elevation of platelet count in advance in ITP and in cancer patients receiving chemotherapy. Disclosures No relevant conflicts of interest to declare.

Using a chatbot to reduce emergency department visits and unscheduled hospitalizations among patients with gynecologic malignancies during chemotherapy: a pilot study (Preprint)

2021 ◽  
Author(s):  
Ming-Yuan Huang ◽  
Chia-Sui Weng ◽  
Hsiao-Li Kuo ◽  
Yung-Cheng Su
Keyword(s):  
Emergency Department ◽  
Pilot Study ◽  
Usual Care ◽  
Cancer Patients ◽  
Text Messaging ◽  
Emergency Department Visits ◽  
Control Group ◽  
Gynecologic Malignancies ◽  
Patient Reported ◽  
Ed Visits

BACKGROUND A chatbot is an automatic text-messaging tool that creates a dynamic interaction and simulates a human conversation through text or voice via smartphones or computers. A chatbot could be an effective solution for cancer patients’ follow-up during treatment, and could save time for healthcare providers. OBJECTIVE We conducted a retrospective cohort pilot study to evaluate whether a chatbot-based collection of patient-reported symptoms during chemotherapy, with automated alerts to clinicians, could decrease emergency department (ED) visits and hospitalizations. A control group received usual care. METHODS Self-reporting symptoms were communicated via the chatbot, a Facebook Messenger-based interface for patients with gynecologic malignancies. The chatbot included questions about common symptoms experienced during chemotherapy. Patients could also use the text-messaging feature to speak directly to the chatbot, and all reported outcomes were monitored by a cancer manager. The primary and secondary outcomes of the study were emergency department visits and unscheduled hospitalizations after initiation of chemotherapy after diagnosis of gynecologic malignancies. Multivariate Poisson regression models were applied to assess the adjusted incidence rate ratios (aIRRs) for chatbot use for ED visits and unscheduled hospitalizations after controlling for age, cancer stage, type of malignancy, diabetes, hypertension, chronic renal insufficiency, and coronary heart disease. RESULTS Twenty patients were included in the chatbot group, and 43 in the usual-care group. Significantly lower aIRRs for chatbot use for ED visits (0.27; 95% CI 0.11–0.65; p=0.003) and unscheduled hospitalizations (0.31; 95% CI 0.11–0.88; p=0.028) were noted. Patients using the chatbot approach had lower aIRRs of ED visits and unscheduled hospitalizations compared to usual-care patients. CONCLUSIONS The chatbot was helpful for reducing ED visits and unscheduled hospitalizations in patients with gynecologic malignancies who were receiving chemotherapy. These findings are valuable for inspiring the future design of digital health interventions for cancer patients.

Analysis of the Impact of Personalized Nursing Service and Hospice Care on the Quality of Life of Elderly Cancer Patients

2021 ◽  
Vol 7 (5) ◽  
pp. 3320-3324
Author(s):  
Ting Fang ◽  
Nian Wang ◽  
Meng Chen ◽  
Hongmei Ma
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Hospice Care ◽  
Pain Treatment ◽  
Control Group ◽  
Study Group ◽  
The Difference ◽  
The Impact

Objective Explore the impact of personalized nursing services and hospice care on the quality of life of elderly patients with advanced cancer. Method We selected 80 elderly cancer patients admitted to our hospital from September 2020 to May 2021, and divided these patients into a study group and a control group using a random number table method. The patients in the control group used conventional nursing methods to treat and care for the patients, and the patients in the study group used hospice care measures and combined personalized nursing measures. The quality of life and pain treatment effects of the two groups of patients before and after treatment were compared. Result Before treatment, the quality-of-life scores of the two groups of patients were low, and there was no statistical difference (P>0.05); After treatment, the quality of life of the two groups of patients improved, but compared with the control group, the improvement was more obvious in the study group, and the difference was statistically significant (P<0.05). In terms of pain treatment effect, the total effective rate of pain treatment in the study group was 87.5%, which was significantly better than the 62.5% in the control group. The difference was statistically significant (P<0.05). Conclusion Personalized nursing services and hospice care are conducive to improving the survival and treatment of elderly patients with advanced cancer, and can be used as a clinical application program for the care of advanced cancer patients.

Effect of Chemotherapy Treatment on Fetal-Maternal Microchimerism in Parous Cancer Patients.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5134-5134
Author(s):  
Gary L. Gilmore ◽  
Melissa M. Holm ◽  
Yuliya Anikanova ◽  
Bushra Haq ◽  
Sri Lakshmi Jasthy ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Solid Tumor ◽  
Hematologic Malignancy ◽  
Post Partum ◽  
Hematologic Malignancies ◽  
Tumor Patients ◽  
Specific Sequence ◽  
Benign Condition ◽  
The Difference ◽  
Primer Sets

Abstract Fetal-maternal microchimerism [MC] is a benign condition arising from cross-trafficking of circulating cells between the fetus and the mother during gestation. It is known that MC persists for decades post-partum. The reported incidence of MC is 33% in normal parous women, but the MC status of cancer patients has not been examined. We have completed our study of 200 parous cancer patients, using a sensitive two-round PCR technique with nested primer sets specific for the Y-chromosome specific sequence, DSY14, to detect male DNA in blood samples from female patients. Exhaustive analysis of samples from parous cancer patients gave a frequency of 34% MC+ [68 of 200], which is significantly lower than the 57% MC+ [114 of 200] we found in normal parous women [p&lt;.0001]. We reported an apparent dichotomy based on diagnosis, in that patients with hematologic malignancies had a greater frequency of MC than solid tumor patients [46% vs 29%; p&lt;.0001]. Both groups received similar numbers of chemotherapy cycles [3.4 cycles for solid tumor patients; 3.2 for hem/onc patients], suggesting this difference was not due to less intensive treatment. When we separated the untreated patients from each population, we found that only 25% [3 of 12] untreated patients with hematologic malignancies were MC, whereas 32% of untreated solid tumor patients were MC+ [12 of 38; p=.66, ns]. Therapy appeared to increase the frequency of MC in hematologic patients to 52% [25 of 48; p=.09, ns], but MC was essentially unaffected in solid tumor patients [27%, 28 of 104; p = .18, ns]. The difference between treated solid tumor patients and those with hematologic malignancies was significant [p=.0001]. Thus, one side effect of chemotherapy may be to increase MC in hematologic malignancy, but in solid tumor patients, MC is not affected. The reason for the increased MC in treated hematologic patients in unclear, but we speculate the reduced frequency in untreated patients is due to dilution by the malignant clone, and that chemotherapy restores the normal balance of blood cells in these patients. The reason for reduced MC in solid tumor patients is also not obvious, as DNA yields are roughly equivalent between the two groups of cancer patients. Further analysis of the data is underway to see if an underlying cause can be determined.

The Relationship Between the Imaging Characteristics of Tumor Angiogenesis and the Expression of Serum Cytokines in Lung Cancer

2020 ◽  
Vol 10 (9) ◽  
pp. 2228-2235
Author(s):  
Xihu Yao ◽  
Jianying Zhou ◽  
Zhicheng Zhang ◽  
Qingyun Zhou ◽  
Bernice Brown
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Blood Supply ◽  
Matrix Metalloproteinase 2 ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Lung Cancer Patients ◽  
Imaging Characteristics ◽  
The Difference ◽  
The Relationship

Objective: As for the lung cancer patients, their imaging characteristics of CT and DSA are evaluated, so as to analyze the relationship between the degree of angiogenesis and the expression of cytokines. Method: Firstly, the CT and DSA data of 40 lung cancer patients who are confirmed by pathology and received intravascular interventional therapy are collected. 5 mL venous blood of patients is extracted and serum samples are extracted. The levels of matrix metalloproteinase-2 (MMP-2) as well as basic fibroblast growth factor (bFGF) in 40 patients with lung cancer are detected by enzyme-linked immunosorbent assay (ELISA). Meanwhile, the contents of MMP-2 and bFGF in serum of 40 healthy people are collected as normal control group. Normal distribution, t-test and F-test are used to verify the correlation between the image features of lung cancer and the expression levels of MMP-2 and bFGF in serum. Results: Firstly, the levels of MMP-2 and bFGF in lung cancer group are obviously higher than those in the control group, and the difference was statistically significant. P values were 0.002 and 0, respectively (P < 0.01). In addition, a positive correlation exists between MMP-2 and bFGF in the group of lung cancer as well as control, and the correlation coefficients are 0.602 as well as 0.712, respectively. Secondly, DSA of lung cancer shows that MMP-2 and bFGF of different types of blood supply lung cancer are different. The P value of intra group and inter group comparison was 0, and the difference is statistically significant. Thirdly, on the image, the lung cancer has necrotic cavity. The P value of MMP-2 and bFGF are 0.046 and 0.005 respectively. The P value of MMP-2 and bFGF are 0.001 and 0.001 respectively with the burr sign on the image. The P value of serum MMP-2 and bFGF are 0 and 0.001 with the deep lobulated sign on the image, both of which are statistically significant. There is no correlation between the size and location of lung cancer focus, whether there is peripheral obstructive pneumonia and the level of MMP-2 and bFGF. Conclusion: The DSA blood supply of lung cancer is related to the expression of MMP-2 as well as bFGF in serum, which can reflect the angiogenic state of tumor and be used as the basis of anti-angiogenic therapy. Whether the CT image of lung cancer shows necrotic cavity, burr sign and deep lobulated sign has a correlation with the expression of MMP-2 as well as bFGF in the serum. The combination of the two is helpful for the accurate assessment of the disease.

An association between lung cancer and gastroesophageal reflux

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 18195-18195
Author(s):  
Z. Ghanem ◽  
A. Sedfawy ◽  
V. Debari ◽  
M. Maroules
Keyword(s):  
Lung Cancer ◽  
Gastroesophageal Reflux ◽  
Cell Carcinoma ◽  
Cancer Patients ◽  
Wide Spectrum ◽  
Care Center ◽  
Tertiary Care ◽  
Control Group ◽  
Upper Aerodigestive Tract ◽  
Lung Cancer Patients

18195 Background: Many studies have demonstrated the association between gastroesophageal reflux and a wide spectrum of extra-esophageal complications of the upper aerodigestive tract. A major risk factor for adenocarcinoma of the esophagus is intestinal metaplasia, which occurs as a consequence of GERD. In addition to that, laryngoscopy and bronchoscopy can reveal findings with a high positive predictive value for the presence of GERD. The probable role of this chronic irritative disorder as a causative agent in carcinoma of the lung has not been studied. The aim of our study is to determine the correlation between GERD and lung cancer. Methods: A hospital based retrospective age, sex, ethnicity and smoking matched case control study was performed in a tertiary care center. The medical records of 325 patients diagnosed with lung cancer and 325 matched control cases were reviewed between January 2003 and December 2005. We looked at many aspects at the presentation of the disease including right or left sided lung cancer, pathology of the tumor and the presence of other co-morbid conditions. GERD diagnosis was determined either by endoscopy, manometry or clinical diagnosis retrospectively. Results: Among the 325 lung cancer patients 75 (23%) were found to have GERD at the time of diagnosis. On the other hand, only 46 (15%) patients were found in the control group. By using the Fisher Exact Probability Test there was a statistically significant increase in the incidence of GERD among lung cancer patients compared to the control group at the time of diagnosis (p=0.0046, 95% CI = 1.21- 2.73 and Odds Ratio =1.82). Patients with lung cancer were also divided into 5 major categories: Adenocarcinoma (n=110, 34%), Squamous cell carcinoma (n=70, 22%), Small cell carcinoma (n=40, 12%), NSCLCA (n=52, 16%) and Others (e.g. large cell, neuroendocrine...etc) (n=53, 16%). Conclusion: Our analyses suggest an association between GERD and lung cancer. For this reason we may consider GERD as a possible co-promoting factor of lung cancer in some patients. No significant financial relationships to disclose.

scholarly journals Reasons for emergency department visits among advanced cancer patients in their last week of life

2017 ◽  
Vol 27 (1) ◽  
pp. 59-62
Author(s):  
Grace Meijuan Yang ◽  
Eeyang Ng ◽  
Sherman Lian ◽  
Marcus Eng Hock Ong
Keyword(s):  
Emergency Department ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Demographic Data ◽  
Emergency Department Visits ◽  
Advanced Cancer Patients ◽  
Record System ◽  
Cross Sectional ◽  
Presenting Symptoms ◽  
Singapore General Hospital

For advanced cancer patients, an emergency department (ED) visit in the last week of life may result in aggressive care that is inappropriate and futile. The objective of this study is to explore the characteristics of advanced cancer patients who present to ED in the last week of life. Specifically, we describe the spectrum of presenting symptoms. This was a retrospective cross-sectional study of ED attendances in the Singapore General Hospital during a one-year period. The electronic medical record system was used to retrieve demographic data, characteristics of the ED visits and presenting complaints. A total of 145 patients with advanced cancer dying in hospital within seven days of an ED visit were included. Breathlessness was the most common reason for presenting to ED (85 patients, 58.62%), followed by pain (50 patients, 34.48%), generalised weakness or lethargy (39 patients, 26.90%) and decreased appetite or anorexia (35 patients, 24.14%). Strategies to improve end-of-life care can focus on pre-emptive management of breathlessness and pain. Community programmes can also help prepare families for symptoms like generalised weakness and appetite loss which may signal a progression of the disease. Supportive and palliative care interventions will need to be implemented in the ED setting to better manage the symptoms suffered by these advanced cancer patients.

Sign in / Sign up

Export Citation Format

Share Document