Abstract W P205: Potential Hematological Biomarkers of Stroke in Cancer Patients

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Dylan Bobrow ◽  
Kajal J Kothadia ◽  
Hooman Kamel ◽  
Costantino Iadecola ◽  
Mitchell S Elkind ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Tertiary Care ◽  
Endothelial Activation ◽  
Cross Sectional Study ◽  
Cancer Center ◽  
Solid Cancer ◽  
Cross Sectional ◽  
Stage 4 ◽  
Stroke Group ◽  
D Dimer

Introduction: Cancer patients can develop hypercoagulability, leading to stroke. The pathophysiology of cancer-mediated hypercoagulability, however, is poorly understood and biomarkers associated with stroke in cancer patients are uncertain. Methods: We performed a pilot cross-sectional study at a tertiary-care cancer center to evaluate potential hematological biomarkers of stroke in cancer patients. From October 2013 through May 2014, we prospectively identified 15 inpatients with active systemic cancer and acute ischemic stroke and 15 inpatients with active systemic cancer and no stroke. Using collected plasma, we compared six potential biomarkers of stroke, selected in advance based on expert opinion and prior data, which included markers of coagulation (thrombin-antithrombin complex and D-dimer), platelet function (P-selectin), and endothelial activation state (sICAM-1, vICAM-1, and thrombomodulin). We used the Wilcoxon rank-sum test to compare biomarker levels between groups. Results: Each group comprised 14 patients with solid cancer and one patient with hematological cancer. All patients in the cancer and stroke group had stage 4 disease, while only 60% of the cancer and no stroke group had stage 4 disease. Age and demographics were similar between groups. Median levels of thrombin-antithrombin complex, D-dimer, P-selectin, sICAM-1, and vICAM-1 were significantly increased in cancer patients with stroke, but thrombomodulin was not (Table). Our results were substantially unchanged in a sensitivity analysis limited to patients with only stage 4 cancer. Conclusion: These preliminary data suggest that thrombin-antithrombin complex, D-dimer, P-selectin, sICAM-1, and vICAM-1 could serve as the focus of future prospective studies to elucidate the potential predictive, diagnostic, or etiologic role of hematological biomarkers for stroke in the cancer population.

scholarly journals Pathways to care and diagnostic delay among cervical cancer patients attending a tertiary care hospital in Puducherry: a cross-sectional study

2020 ◽  
Vol 7 (6) ◽  
pp. 2298
Author(s):  
Roshina Sunny ◽  
Sitanshu Sekhar Kar ◽  
Dasari Papa ◽  
Sujiv Akkilagunta ◽  
Jeby Jose Olickal
Keyword(s):  
Cervical Cancer ◽  
Cancer Patients ◽  
Tertiary Care ◽  
Diagnostic Delay ◽  
Cross Sectional Study ◽  
Cancer Center ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Care Facilities

Background: The high mortality among cervical cancer patients in India can be attributed to presentation at advanced stages. The varied and lengthy pathway taken up to diagnosis could be a major reason for advanced stage at presentation. Hence, we aimed to describe the care pathways and diagnostic delay among cervical cancer patients.Methods: A hospital-based cross-sectional study was conducted among 101 cervical cancer patients attending a cancer clinic at a Regional Cancer Center. The histo-pathologically confirmed cases of cervical cancer, who registered in July to October 2018 were approached. Data were collected through personal interviews using a semi-structured questionnaire. Descriptive statistics were used to describe the number of providers visited and diagnostic delay.Results: The median (range) number of providers visited by the patients up to diagnosis was 2 (1-5). As the first point of care, 14% of participants approached sub-center or primary care facilities, 27% approached secondary care facilities, 49% participants approached tertiary care facilities and 11% came directly to a regional cancer center. Diagnosis was made only in 24% of participants at secondary and tertiary care levels. The median (IQR) number of days to get diagnosed was 66 (30-130) days and three fourth of the patients had a diagnostic delay.Conclusions: The diagnostic delay was higher among patients who consulted multiple providers. Implementing a protocol to be followed at all three levels of health care delivery system may enhance the early diagnosis. 

scholarly journals Prevalence of Depression and Anxiety amongst Cancer Patients in a Hospital Setting: A Cross-Sectional Study

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Anish Khalil ◽  
Muhammad Faheem ◽  
Ammad Fahim ◽  
Haran Innocent ◽  
Zainab Mansoor ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Tertiary Care ◽  
Hospital Setting ◽  
Depression Scale ◽  
Cross Sectional Study ◽  
Mental Wellbeing ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Sectional Study ◽  
Cross Sectional

Background. The biomedical care for cancer has not been complemented by psychosocial progressions in cancer care.Objectives. To find the prevalence of anxiety and depression amongst cancer patients in a hospital setting.Design and Setting. This cross-sectional study was conducted at the tertiary care hospitals Shifa International Hospital Islamabad and Nuclear Medicine, Oncology, and Radiotherapy Institute [NORI].Patients and Methods. 300 patients were interviewed from both the outpatient and inpatient department using The Aga Khan University Anxiety and Depression Scale (AKUADS).Main Outcome Measures. Using a score of 20 and above on the AKUADS, 146 (48.7%) patients were suffering from anxiety and depression.Results. When cross tabulation was done between different factors and the cancer patients with anxiety and depression, the following factors were found out to be significant with associatedpvalue < 0.05: education of the patient, presence of cancer in the family, the severity of pain, and the patient’s awareness of his anxiety and depression. Out of 143 (47.7%) uneducated patients, 85 (59.4%) were depressed, hence making it the highest educational category suffering from depression and anxiety.Conclusion. The prevalence of anxiety and depression amongst cancer patients was high showing that importance should be given to screening and counseling cancer patients for anxiety and depression, to help them cope with cancer as a disease and its impact on their mental wellbeing.Limitations. The frequency of female patients in our research was higher than those of male patients.

scholarly journals Utility of telemedicine in COVID-19 pandemic: our experience at a tertiary cancer center in North East India

2020 ◽  
Vol 8 (11) ◽  
pp. 4027
Author(s):  
Ashok Kumar Das ◽  
Sumanjit S. Boro ◽  
Anupam Das ◽  
Partha Pratim Medhi ◽  
Kaberi Kakati ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Task Force ◽  
Demographic Data ◽  
Cross Sectional Study ◽  
Cancer Center ◽  
Cross Sectional ◽  
Ongoing Treatment ◽  
North East ◽  
Phone Calls

Background: Telemedicine is a very useful tool of communication between the doctor and the patient. The aim of this study was to find out the utility of telemedicine during the lockdown period of COVID-19 pandemic in North East India.Methods: It is a cross sectional study among the cancer patients at our center on follow up or ongoing treatment and analysis of all the data acquired from telephonic conversation with our patients from 30th March, 2020 to 3rd May, 2020. Have contacted 4181 patients during this period over phone. All phone calls were done by respective department doctors.Results: From the demographic data, we get that 35.4% of patients were at good physical condition, 3.5% with poor general condition, 11.6% patients having ongoing treatment in our institute, 21.1% patients expired, 0.9% patients have nonmalignant diagnosis, 1.4% patients left the institute due to various reasons. Analyzed this data with brain storming sessions amongst the COVID-19 task force doctors and tried to find out solutions of each problem.Conclusions: Telemedicine cannot replace conventional method of in person treatment, but it proved to be a useful tool during the COVID-19 pandemic for patient follow up and treatment of cancer patients.

The experience of pain among cancer patients at the University of the Philippines: Philippine General Hospital Cancer Institute—A cross-sectional study.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e24078-e24078
Author(s):  
Harold Nathan C. Tan ◽  
Rogelio Nona Velasco ◽  
Lance Isidore Garcenila Catedral ◽  
Michael Ducusin San Juan ◽  
Corazon Ngelangel ◽  
...  
Keyword(s):  
Pain Management ◽  
Cancer Patients ◽  
Pain Control ◽  
Severe Pain ◽  
Cross Sectional Study ◽  
The Philippines ◽  
Pain Interference ◽  
Cancer Center ◽  
Cross Sectional ◽  
Adequate Pain Management

e24078 Background: Pain is one of the most common and dreaded sequelae of cancer, occurring in approximately 55% of patients. The experience of pain takes a toll on the patients’ quality of life. However, many patients do not receive adequate pain management. This study aimed to determine the prevalence of pain, its severity, and the adequacy of pain management among cancer patients in the Philippines. Methods: A cross-sectional study was conducted at a representative cancer center in the Philippines, enrolling 351 cancer patients. Pain severity was assessed using the Brief Pain Inventory-Short Form (BPI-SF) Filipino. The BPI evaluates pain severity and its impact on daily functioning (pain interference). To ascertain the adequacy of pain control, the pain management index (PMI) was calculated by subtracting the subtracting the severity of pain reported by the patient from the type of analgesic treatment received. Logistic regression analysis was conducted to evaluate the factors associated with worst pain and adequacy of pain management. Data were analyzed using Stata version 16.0, with statistical significance set at p < 0.05. Results: Three hundred three cancer patients (86.3%) experienced pain. Approximately 3 out of 5 patients (n = 208) did not receive adequate pain control, and one-third of patients experienced severe pain (n = 121). Patients who reported severe pain interference (n = 110) had three times greater odds to experience severe pain (OR 3.2, 95% CI 1.82-5.61, p < 0.001). Those patients who had regular follow up were 65% less likely to experience severe pain (OR 0.35, 95% CI 0.16 – 0.78, p = 0.01). Patients who used pain medications (n = 196) were 14 times more likely to experience adequate pain management (OR 14.19, 95% CI 6.53 – 30.83, p < 0.001). Patients who were referred to pain service (n = 25) were seven times more likely to report adequate pain control (OR 6.62, 95% CI 2.50 – 17.56, p < 0.001). Conversely, those patients who reported a severe rating on total pain interference were 75% less likely to experience adequate pain management (OR 0.25, 95% CI 0.17 – 0.35, p < 0.001). Conclusions: Unexpectedly, there was a high prevalence of pain among cancer patients at a representative cancer center in the Philippines. Pain exerts a heavy toll on patients, affecting daily functioning. The undertreatment of pain discovered in this study (59% of cancer patients) is alarming. Timely pain evaluation can help identify the presence of pain and the need for appropriate use of analgesics. The assessment and management of pain is a critical component of cancer care that should not be neglected.

scholarly journals Self-reported awareness and attitude of cancer patients towards clinical nurse coordinators

2017 ◽  
Vol 7 (7) ◽  
pp. 95 ◽  
Author(s):  
Ahmad Deeb ◽  
Mohammad O. AlKaiyat ◽  
Emad Abu Hlal ◽  
Areej Attari ◽  
Rania Mahaireh ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Positive Attitude ◽  
Clinical Care ◽  
Negative Attitude ◽  
Patient Characteristics ◽  
Cross Sectional Study ◽  
Cancer Center ◽  
Cross Sectional ◽  
Clinical Nurse ◽  
Roles And Responsibilities

Background and objective: Lack of knowledge or poor perception towards the roles and responsibilities of clinical nurse coordinators among cancer patients might lead to a decrease in seeking their services. The objective of the study was to assess the knowledge, perception and attitude towards clinical nurse coordinators among cancer patients at a specialized cancer center in Jordan.Methods: This is a cross sectional study that was conducted by distributing a self-reported and anonymous survey to 240 cancer patients visiting the center. The survey questioned some patient characteristics such as sex, age, educational level, marital status, disease type and duration, type of therapy. The patients’ knowledge (12-statement), the perception (9-statement) regarding the actual roles/responsibilities of coordinators and the attitude (5-statement) towards seeking their services were measured. Responses on Likert scales were converted to percentage mean scores.Results: The overall percentage mean scores ± standard deviation of knowledge was 59 ± 17, perception towards clinical nurse coordinators (79 ± 14) and attitude towards seeking their services (69 ± 16). Linear regression showed that participants on chemotherapy had significantly better perception (higher scores) compared to participants on concurrent therapies (β = -3.91, p = .049). Participants with higher knowledge scores had better perception indicating a better comprehension about the clinical nurse coordinators’ roles, compared to those with lower knowledge percentage mean scores (β = 0.13, p = .019). Female patients had higher percentage mean score of attitude compared to male particpants (β = -3.77, p = .034). Better perception of Clinical nurse coordinators (CNCs) among cancer patients was significantly more associated with  a more positive attitude towards seeking CNC services (β = 0.72, p < .001).Conclusions: Patients’ knowledge about the roles and responsibilities of nurse coordinators is associated with a better patients’ perception towards coordinators, which in return is associated with a more positive attitude towards seeking their services. Special consideration should be paid for patients on concurrent therapies who were more likely to have poorer perception towards clinical care coordinators compared to patients on chemotherapy. In addition, coordinators are expected to observe a more negative attitude towards seeking their services among male cancer patients.

Association of Inflammatory Markers with the Severity of COVID-19 in a Tertiary Care Hospital in Bagalkot, India - A Cross-Sectional Study

2021 ◽  
Vol 8 (28) ◽  
pp. 2520-2525
Author(s):  
Sunil Baragi ◽  
Pavani Mallikarjun Dyavannavar
Keyword(s):  
Serum Ferritin ◽  
Inflammatory Markers ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Care Hospital ◽  
Sectional Study ◽  
Cross Sectional ◽  
Prediction Of Mortality ◽  
Severe Group ◽  
D Dimer

BACKGROUND A novel coronavirus was identified as being responsible for a cluster of pneumonia cases worldwide. With an upward trajectory of (corona virus disease-19) COVID-19 cases and its numerous presentations, there is an urgent requirement of identifying initial signs of decline of quality and an adequate response in order to shift a patient to specialized intensive care units (ICU) for those who progress morbidly to severe or critical categories. It has been reported that various acute phase reactants like erythrocyte sedimentation rate (ESR), ferritin, C-reactive protein (CRP), lactate dehydrogenase (LDH) and D-dimer are raised much more in severe and critical patients than in the mild cases. These markers might have a role to predict mortality. The present study was done to assess the relationship of serum ferritin, and CRP levels at admission with in-hospital mortality among patients with COVID-19 infection and to determine cut-off values of the best prediction of mortality. METHODS A cross-sectional study of 109 reverse transcription polymerase chain reaction (RTPCR) confirmed COVID-19 patients admitted in our hospital was done. The outcome of cases was categorized into mild, moderate and severe grades. RESULTS Out of 109, 80(73.4 %) were males and 29 (26.6 %) were females. Majority patients of both genders were having severe disease with 30 males and females 10 (P - value = 0.066). Among 109 patients, mild cases (33), moderate case (36), severe case (40). Serum ferritin value severe group (n = 49) 422.45 ng/mL, moderate group (n = 33) 563.64 ng/mL, mild group (n = 27) 529.63 ng/mL. Mean ESR value in severe group 98.37, moderate group 100, mild group 100. Mean CRP in severe group 242.86 mg/L, moderate group 248.48 mg/L, mild group 307.41 mg/L. Mean d-dimer in severe group 971.43 ng/mL, moderate group 803.03 ng/mL, mild group 811.11 ng/mL. CONCLUSIONS Our study showed higher levels of markers like ferritin, D-dimer, CRP and ESR in severe patients as compared to mild and helped in forecasting the advancement of mild cases to severe. Also, the blood levels of CRP and ferritin and the duration to complete symptomatic relief all demonstrated a substantial statistical link thus aiding for monitoring of patients at home and in hospitals. KEYWORDS Covid-19, Inflammatory Markers

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