scholarly journals Cancer Treatment Helpline: a retrospective study of the NHS Tayside experience

2021 ◽  
Vol 10 (2) ◽  
pp. e001488
Author(s):  
Ilse Trip ◽  
Sherie George ◽  
Micheal Thomson ◽  
Russell D Petty ◽  
Mark A Baxter
Keyword(s):  
Retrospective Study ◽  
Early Stage ◽  
Descriptive Analysis ◽  
Anticancer Therapy ◽  
Local Health ◽  
Clinical Team ◽  
Patient Demographics ◽  
Time Period ◽  
Telephone Advice ◽  
Local Health System

BackgroundTreatment-related toxicity and delays in the management of this toxicity can impact the outcomes of patient with cancer. In Scotland, a national cancer helpline was established to provide triage assessment for patients receiving systemic anticancer therapy (SACT) in an attempt to minimise delays in toxicity management. In this article, we describe the use and impact of the helpline in our region over the last 5 years.MethodsPatients who contacted the NHS Tayside cancer helpline between 1 January 2016 and 31 December 2020 were retrospectively identified. Patient demographics as well as the reason and outcome of each call was recorded. A descriptive analysis was performed.Results6562 individual patients received SACT and 8385 calls were recorded during the time period. Median age of callers was 63 years (range 17–98) and 59.2% were women. Use of the helpline increased by 83.6% between 2016 and 2020, driven by an increase in in-hours calls. 41% of calls required review by a healthcare professional only, 24% required review and admission and the remaining 35% telephone advice only. The majority of cases (85%) were either assessed or advised solely by oncology. The proportional use of general practitioner services has decreased.ConclusionsThe helpline provides a way for patients to report symptoms directly to their clinical team and receive appropriate specialist advice at an early stage. We demonstrate that most of these calls can be managed solely by our oncology team. This system can reduce pressure on other parts of the local health system.

scholarly journals The Cancer Treatment Helpline – a retrospective study of the NHS Tayside Experience

2021 ◽  
Author(s):  
Ilse Trip ◽  
Sherie George ◽  
Michael J. Thomson ◽  
Russell Petty ◽  
Mark Baxter
Keyword(s):  
Patient Outcomes ◽  
Early Stage ◽  
Descriptive Analysis ◽  
Anticancer Therapy ◽  
Local Health ◽  
Clinical Team ◽  
Patient Demographics ◽  
Time Period ◽  
Telephone Advice ◽  
Local Health System

Abstract Background: Treatment related toxicity and delays in the management of this toxicity can impact cancer patient outcomes. In Scotland, a national cancer helpline was established to provide triage assessment for patients receiving systemic anticancer therapy (SACT) in an attempt to minimize delays in toxicity management. In this article we describe the use and impact of the helpline in our region over the last 5 years.Methods: Patients who contacted the NHS Tayside cancer helpline between the 1st January 2016 and 31st December 2020 were retrospectively identified. Patient demographics as well as the reason and outcome of each call was recorded. A descriptive analysis was performed.Results: 6,562 individual patients received SACT and 8,397 calls were recorded during the time period. Median age of callers was 63 years (range 17-98) and 59.2% were female. Use of the helpline increased by 83.6% between 2016 and 2020, driven by an increase in in-hours calls. 41% of calls required review by a healthcare professional only, 24% required review and admission and the remaining 35% telephone advice only. The majority of cases (85%) were either assessed or advised solely by oncology. The proportional use of General Practitioner services has decreased. Conclusions: The helpline provides a way for patients to report symptoms directly to their clinical team and receive appropriate specialist advice at an early stage. We demonstrate that most of these calls can be managed solely by our oncology team. This system can reduce pressure on other parts of the local health system.

Comprehensiveness of Pediatric Antiepileptic Prescribing in Clinic Letters: Are We Communicating Well?

2017 ◽  
Vol 06 (04) ◽  
pp. 169-173
Author(s):  
Mohamed Babiker ◽  
Christopher Butler
Keyword(s):  
Retrospective Study ◽  
Pediatric Epilepsy ◽  
Problem List ◽  
Medication List ◽  
Royal Hospital ◽  
Pediatric Neurology ◽  
Patient Demographics ◽  
Time Period ◽  
Trade Name ◽  
Learning Points

AbstractThis study aims to determine the comprehensiveness of pediatric epilepsy outpatient clinic letters in a tertiary pediatric neurology center with particular focus on the prescribing instructions. A retrospective study was conducted for all pediatric outpatient epilepsy clinic letters between August and October 2016. This study was undertaken in a tertiary pediatric neurology department at the Bristol Royal Hospital for Children, United Kingdom. A total of 160 patients were identified during the time period and included in the study. Letters were evaluated for the following information: patient demographics, inclusion of problem list, and medication details including the clarity of prescribing instructions. The comprehensiveness of letters was scored out of nine based on the nine categories; weight, diagnosis list, medication list, dose in milligrams, dose equivalence in milligrams/kilograms/day, formulation, strength or concentration of medication, if applicable is the volume of medication provided and is the trade name provided. A total of 94% of letters had a diagnosis or problem list provided which was clear. Only 68% letters had a separate medication list provided. The dose of antiepileptic drugs (AEDs) in milligrams was provided in 95% of letters. The formulation of the AED was provided in only 30% of letters. Only 24% of letters where a category 1 AED was prescribed had the trade name provided. This study has demonstrated significant omissions from outpatient pediatric epilepsy letters. The omissions presented in this study may culminate in inefficient communication and increased morbidity. We share practice improving learning points for writing comprehensive letters which we believe can be generalized to other pediatric specialties.

Integrated care: learning from East London

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697265
Author(s):  
Sonia Bussu
Keyword(s):  
Integrated Care ◽  
Evidence Base ◽  
Community Health Services ◽  
Health Economy ◽  
Local Health ◽  
Frontline Staff ◽  
Care Community ◽  
Organisation Development ◽  
Integrated Care Pathways ◽  
Local Health System

BackgroundDespite a growing body of literature on integrated, there remains a relatively small evidence base to suggest which elements of integrated care are most effective and how to implement them successfully. This might also be due to the fact that policy thinking around integrated care is struggling to translate into organisation change at the point of delivery. Better understanding of patterns of collaborations and integrated pathways is crucial to understand frontline staff’s OD needs and provide adequate support.AimThis paper focuses on the frontline level to assess progress towards integrated care in East London.MethodWe use admission avoidance (Rapid Response service) and discharge services (Discharge to Assess) as a lens to examine how frontline staff from secondary care, community health services and social service work together to deliver more integrated care. The study uses the Researcher in Residence (RiR), where the researcher is embedded in the in the organisations she is evaluating, as a key member of the delivery team.ResultsInitial findings suggest that while work on integrated care has enabled some level of collaborative working at strategic levels in partner organisations, on the frontline professionals are grappling with issues such as professional identity, professional boundaries, mutual trust and accountability, as new services and roles struggle to be fully embedded within the local health system.ConclusionThe paper sheds light on to the complexity on integrated care at the point of delivery. Better understanding of integrated care pathways is crucial to evidence patterns of collaboration across organisations; assess how these new roles and teams are embedding themselves within the local health economy; identify organisation development needs; and provide adequate support to frontline staff.

Trends in Craniofacial Injuries Associated with the Introduction of Electric Scooter Sharing Services

FACE ◽  
2021 ◽  
pp. 273250162199244
Author(s):  
Elizabeth M. Boudiab ◽  
Thomas D. Zaikos ◽  
Christopher Issa ◽  
Kongkrit Chaiyasate ◽  
Stephen M. Lu
Keyword(s):  
Maxillofacial Surgery ◽  
Age Groups ◽  
Injury Surveillance System ◽  
Patient Demographics ◽  
Time Period ◽  
Electric Scooter ◽  
Before And After ◽  
Trends Over Time ◽  
Patterns Of Injury ◽  
Craniofacial Fractures

Electric scooters are an increasingly common and convenient mode of transportation worldwide and have effectively revolutionized the shared micromobility industry. As electric scooter sharing companies have increased in popularity there has been a concomitant increase in the frequency of all electric scooter-related injuries. The purpose of this study is to describe the most up-to-date trends in craniofacial fractures and lacerations related to electric scooter use among all age groups. We queried the National Electronic Injury Surveillance System (NEISS) for craniofacial fractures and lacerations related to e-scooters between 2010 and 2019. We then compared injury trends over time and between time periods before and after 2017 when electric scooter share apps revolutionized micromobility. We compared incidence of injury overall and by day of the week, patient demographics, and case severity based on clinical disposition. We identified an increase in the frequency of craniofacial lacerations and fractures in the 3 years following the introduction of electric scooter share services in 2017 (2017 and 2019), compared to the 3 years before this time (2014-2016). Young adults (18-39 years) were the age group with the greatest interval increase in craniofacial injuries. There was also an increase in number of craniofacial injuries occurring on Mondays and a decrease number occurring on Fridays in the later time period. Finally, patients who presented with electric scooter-related craniofacial injuries in this later time period showed a higher frequency of overnight observation and hospital admission for their injuries. The number of craniofacial injuries secondary to electric scooter use has increased dramatically since the introduction of share services. Craniofacial fractures and lacerations are a common reason for craniofacial or maxillofacial surgery consultation and understanding these patterns of injury will help prepare surgeons for patient care, preventative education, and public advocacy.

scholarly journals Subtle cardiac dysfunction in lymphoma patients receiving low to moderate dose chemotherapy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hsien-Yuan Chang ◽  
Chun-Hui Lee ◽  
Po-Lan Su ◽  
Sin-Syue Li ◽  
Ming-Yueh Chen ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Exercise Capacity ◽  
Cardiac Dysfunction ◽  
Primary Outcome ◽  
Early Stage ◽  
Systolic Dysfunction ◽  
Anticancer Therapy ◽  
Cardiopulmonary Exercise Test ◽  
Left Ventricular ◽  
Relative Reduction

AbstractLeft ventricular (LV) global peak systolic longitudinal strain (GLS) is a sensitive measurement for detecting subtle LV systolic dysfunction and a powerful prognostic predictor. However, the clinical implication of LV GLS in lymphoma patients receiving cancer therapy remains unknown. We prospectively enrolled 74 lymphoma patients (57.9 ± 17.0 years old, 57% male). We performed echocardiographic studies after the 3rd and 6th cycles and 1 year after chemotherapy and a cardiopulmonary exercise test upon completion of 3 cycles of anticancer therapy. Cancer therapy-related cardiac dysfunction (CTRCD) was defined as a ≥ 15% relative reduction in GLS value from baseline. The primary outcome was a composite of all-cause mortality and heart failure events. Thirty-six patients (49%) had CTRCD (LV GLS: baseline vs. after 3rd cycle of therapy: 20.1 ± 2.6 vs. 17.5 ± 2.3%, p < 0.001). CTRCD was detected after the 3rd cycle of anticancer therapy. CTRCD patients had impaired exercise capacity (minute oxygen consumption/kg, CTRCD vs. CTRCD (-): 13.9 ± 3.1 vs. 17.0 ± 3.9 ml/kg/min, p = 0.02). More primary outcome events occurred in the CTRCD group (hazard ratio 3.21; 95% confidence interval 1.04–9.97; p = 0.03). LV GLS could detect subtle but clinically significant cardiac dysfunction in lymphoma patients in the early stage of anticancer therapy. CTRCD may be associated with not only a reduced exercise capacity but also a worse prognosis.

scholarly journals EPID-26. CLINICAL AND HISTOLOGICAL CHARACTERIZATION OF PRIMARY CENTRAL NERVOUS SYSTEM SARCOMA IN PEDIATRICS. A SINGLE INSTITUTION EXPERIENCE IN A MIDDLE-INCOME COUNTRY

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii84-ii84
Author(s):  
Edgar Cabrera ◽  
Nelson Aponte ◽  
Johnny Garcia ◽  
Fredy Salazar ◽  
Eric Bouffet ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Pediatric Population ◽  
Progression Free Survival ◽  
Molecular Data ◽  
Middle Income ◽  
Patient Demographics ◽  
Time Period ◽  
Cell Architecture ◽  
Intracranial Lesions

Abstract INTRODUCTION Primary central nervous system (CNS) sarcomas are rare mesenchymal non-meningothelial tumors accounting for less than 0.2% of intracranial lesions. Diagnosis and management are challenging due to the current lack of substantive clinical, histological and molecular data. METHODS We retrospectively identified all patients with diagnosis of primary CNS sarcoma at the Hospital Fundación Pediatrico la Misericordia (HOMI) in Bogota, Colombia. We collected patient demographics, disease characteristics, and outcomes for analysis. RESULTS Between 2008 and 2020, twenty-four consecutive patients were diagnosed at the HOMI representing 6% of all CNS tumors diagnosed over the same time period. The median age at presentation was 9.48 years (range:1.6–13.4). The median time of symptoms prior to diagnosis was 2 weeks (0.1–24). The most common presentation was headache (21/24- 89%) and vomiting (19/24- 79%). The frontal lobe was involved in 63% of patients (15/24) and only one patient presented with a cerebellar lesion. Histologically, these tumors were characterized by a pleomorphic spindle cell architecture and high mitotic activity. All samples lacked immunoreactivity to GFAP, CD34, EMA, and S100 and all samples had strong nuclear immunopositivity for TLE-1; BCL-2 was reactive in eighteen cases. Gross total resection was attained in fifteen patients, most patients received focal radiation therapy and ICE chemotherapy. Progression-free survival at 12 and 24 months was 57% and 31% respectively. Overall survival was 77% at 12 months and 39% at 24 months. Thirteen patients relapsed, 11 presented with local failures, and 2 with intracranial recurrences outside of the radiation field. CONCLUSION Our study identifies TLE-1 as a diagnostic marker of primary CNS sarcoma, a highly malignant supratentorial tumor of childhood. Further molecular studies are urgently needed to elucidate the biology of this disease and the unusually high incidence observed in the Colombian pediatric population.

scholarly journals Influence of the COVID-19 Pandemic on Dental Emergency Admissions in an Urgent Dental Care Service in North Italy

2021 ◽  
Vol 18 (4) ◽  
pp. 1812 ◽  
Author(s):  
Maria Grazia Cagetti ◽  
Araxi Balian ◽  
Nicole Camoni ◽  
Guglielmo Campus
Keyword(s):  
Retrospective Study ◽  
Dental Care ◽  
Tooth Extraction ◽  
Care Service ◽  
Emergency Admissions ◽  
Exact Test ◽  
Remarkable Increase ◽  
Time Period ◽  
Dental Emergency ◽  
Second Wave

A retrospective study was performed to verify if the number of admissions for urgent dental care in the Urgent Dental Care Service of San Paolo Hospital in Milan (Italy) was directly related to the different phases of the COVID-19 pandemic. Different periods were analyzed: 25 March–5 April 2019 (pre-COVID); 23 March–3 April 2020 (lockdown); 8 June–19 June 2020 (reopening); and November 9–November 20 (second wave). Raw data regarding admissions, diagnoses, and treatments were extracted. Descriptive and bivariate analyses were performed. The survey included 901 admissions, 285 in pre-COVID, 93 during lockdown, 353 in reopening, and 170 in the second wave. In each time period, statistically significant differences were found in the prevalence of each kind of diagnoses (χ2(3) = 20.33 p = 0.01 for endodontic emergencies, χ2(3) = 29.05 p < 0.01 for cellulitis/phlegmon, χ2(3) = 28.55 p < 0.01 for periodontal emergencies, Fisher’s Exact Test p < 0.01 for trauma, and χ2(3) = 59.94 p < 0.01 for all other kinds of diagnosis). A remarkable increase in consultations (+186.36%) and other treatments (+90.63%) occurred during reopening. Tooth extraction was the most frequently delivered treatment, but suffered the largest reduction during lockdown (−79.82%). The COVID-19 pandemic has highly affected dental activity in north Italy, underling the weaknesses of a private dental system in a pandemic scenario.

scholarly journals Retrospective study of myiasis in ruminants at Babuganj Upazilla Veterinary Hospital of Barisal district

2018 ◽  
Vol 5 (1) ◽  
pp. 57-64
Author(s):  
Most Tahmina Khan ◽  
Md Tahmid Rahman Pavel ◽  
Imam Hasan ◽  
Md Monowarul Islam ◽  
Md Muket Mahmud ◽  
...  
Keyword(s):  
Retrospective Study ◽  
High Risk ◽  
Descriptive Analysis ◽  
Wound Management ◽  
Occurrence Rate ◽  
Treatment Protocols ◽  
Local Breed ◽  
Duration Of Illness ◽  
Veterinary Hospital ◽  
Structured Questionnaire

The study was conducted to know the occurrence of myiasis in cattle and goats at Babuganj Upazilla Veterinary Hospital, Barisal, Bangladesh. A total of 160 animals were examined. Among them 46 animals were found to be myiasis infested. A structured questionnaire was used to collect data on species, breed, age, sex, body condition of the animal, onset and duration of illness, affected sites of myiasis. The study was conducted during March 2014 to May 2015. All the data that were collected were entered into MS excel. Descriptive analysis was done by column and pie charts. It was possible to follow the response of treatment using two treatment protocols. The overall occurrence of myiasis was 28.75% where 39.13% in cattle and 60.87% in goat. The occurrence was higher in cross breed cattle (55.56%) than the local (44.44%). Similarly the occurrence rate was higher in cross breed goat (42.86%) than local breed (28.57%). Less than 6 months aged animals (71.73%) and females (cattle-61.11% and goat-64.29%) were more prone to myiasis. The frequency of maggot infestation was higher in navel region (54.35%) followed by vaginal (28.26%) and rectal (10.87%) regions respectively. The percentage of recovery to Inj. SP vet, Inj. Asta vet and Inj. Vermic were 67.86%. Myiasis is the major problem in livestock production in our country. Animals at high risk should be managed properly to avoid wound and special attention on wound management should be given after castration and parturition to prevent myiasis.Res. Agric., Livest. Fish.5(1): 57-64, April 2018

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