Hand-foot syndrome and nail disorders secondary to treatment with paclitaxel: Is there a relationship with the presence of fungi?

2021 ◽  
pp. 107815522110437
Author(s):  
Paulina Patente Pereira ◽  
Mário Nunes Filho ◽  
Tomaz de Aquino Moreira ◽  
Lucivânia Duarte Silva Malvino ◽  
Lúcio Borges de Araújo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Medical Records ◽  
Treatment Protocol ◽  
Safe Management ◽  
Life Impact ◽  
Hand Foot Syndrome ◽  
Nail Lesion ◽  
Hands And Feet ◽  
Management Alternatives ◽  
Structured Questionnaire

Introduction This study aimed to evaluate the frequency of nail disorders and the presence of fungi on the nails of the hands and feet of patients with hand-foot syndrome secondary to treatment with paclitaxel. Methods Prospective study, carried out from October 2018 to December 2019, which included 81 patients undergoing treatment for breast cancer using paclitaxel and had signs and or symptoms of hand-foot syndrome with or without nail disorders. The data were collected through interviews guided by a structured questionnaire, information from medical records and reports of mycological exams. Results The average age of women was 54.7 ± 7.4 years. Nail disorders occurred in 69 patients (85.2%), and of these, 43 (62.3%) were positive for fungi. The fungi were yeasts ( n = 38; 69%), dermatophytes ( n = 15; 27.2%) and non-dermatophyte filamentous fungi ( n = 8; 14.5%). Conclusions Nail disorders were the most frequent manifestations in patients with hand-foot syndrome treated with paclitaxel and occurred in 85.2% of them. It was evidenced that fungi are present on the nails of these patients and can occur in up to 65.28%. The most prevalent fungi were Candida and Trichophyton. The nail lesion was associated with the type of treatment protocol used by the patient. The results of the study point to the need to select safe management alternatives for patients, so they can prevent nail lesions and prevent the proliferation of fungi, consequently reducing negative life impact during treatment.

scholarly journals Risk factors for pegylated liposomal doxorubicin-induced moderate to severe hand-foot syndrome in breast cancer patients: assessment of baseline clinical parameters

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Guohua Liang ◽  
Wenjie Ma ◽  
Yanfang Zhao ◽  
Eryu Liu ◽  
Xiaoyu Shan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Prediction Model ◽  
Cancer Patients ◽  
Blood Circulation ◽  
Pegylated Liposomal Doxorubicin ◽  
Dose Intensity ◽  
Breast Cancer Patients ◽  
Hand Foot Syndrome ◽  
Peripheral Blood Circulation

Abstract Background Hand-foot syndrome (HFS) is a side effect of skin related to pegylated liposomal doxorubicin (PLD) application. Moderate to severe hand-foot syndrome (MSHFS) might have a serious impact on patients’ quality of life and treatment. However, information on risk factors for the development of MSHFS is still limited. To analyze the risk factors for PLD-induced MSHFS in breast cancer patients and constructed a logistic regression prediction model. Methods We conducted a retrospective analysis of breast cancer patients who were treated with a PLD regimen in the Tumor Hospital of Harbin Medical University from January 2017 to August 2019. A total of 26 factors were collected from electronic medical records. Patients were divided into MSHFS (HFS > grade 1) and NMHFS (HFS ≤ grade 1) groups according to the NCI classification. Statistical analysis of these factors and the construction of a logistic regression prediction model based on risk factors. Results A total of 44.7% (206/461) of patients developed MSHFS. The BMI, dose intensity, and baseline Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) levels in the MSHFS group, as well as good peripheral blood circulation, excessive sweat excretion, history of gallstones, and tumour- and HER2-positive percentages, were all higher than those in the NMHFS group (P < 0.05). The model for predicting the occurrence of MSHFS was P = 1/1 + exp. (11.138–0.110*BMI-0.234*dose intensity-0.018*baseline ALT+ 0.025*baseline AST-1.225*gallstone history-0.681* peripheral blood circulation-1.073*sweat excretion-0.364*with or without tumor-0.680*HER-2). The accuracy of the model was 72.5%, AUC = 0.791, and Hosmer-Lemeshow fit test P = 0.114 > 0.05. Conclusions Nearly half of the patients developed MSHFS. The constructed prediction model may be valuable for predicting the occurrence of MSHFS in patients.

scholarly journals Real-World Palbociclib Use in HR+/HER2− Advanced Breast Cancer in Canada: The IRIS Study

2021 ◽  
Vol 28 (1) ◽  
pp. 678-688
Author(s):  
Katie Mycock ◽  
Lin Zhan ◽  
Gavin Taylor-Stokes ◽  
Gary Milligan ◽  
Debanjali Mitra
Keyword(s):  
Breast Cancer ◽  
Real World ◽  
Medical Records ◽  
Survival Rates ◽  
Growth Factor Receptor ◽  
Metastatic Breast ◽  
Retrospective Chart Review ◽  
Hormone Receptor Positive ◽  
Kaplan Meier ◽  
Epidermal Growth

Background: Palbociclib is a selective cyclin-dependent kinase (CDK) 4/6 inhibitor used in combination with aromatase inhibitors or fulvestrant for patients with hormone receptor-positive (HR+) human epidermal growth factor receptor 2 (HER2)-negative advanced/metastatic breast cancer (ABC/MBC). Palbociclib was the first CDK 4/6 inhibitor approved for HR+/HER2− ABC/MBC treatment in Canada in combination with letrozole (P+L) as an initial endocrine-based therapy (approved March 2016), or with fulvestrant (P+F) following disease progression after prior endocrine therapy (approved May 2017). The Ibrance Real World Insights (IRIS) study (NCT03159195) collected real-world outcomes data for palbociclib-treated patients in several countries, including Canada. Methods: This retrospective chart review included women with HR+/HER2− ABC/MBC receiving P+L or P+F in Canada. Physicians reviewed medical records for up to 14 patients, abstracting demographic and clinical characteristics, treatment patterns, and clinical outcomes. Progression-free rates (PFRs) and survival rates (SRs) at 6, 12, 18, and 24 months were estimated via Kaplan–Meier analysis. Results: Thirty-three physicians examined medical records for 247 patients (P+L, n = 214; P+F, n = 33). Median follow-up was 8.8 months for P+L and 7.0 months for P+F. Most patients were initiated on palbociclib 125 mg/d (P+L, 90.2%; P+F, 84.8%). Doses were reduced in 16.6% of P+L and 14.3% of P+F patients initiating palbociclib at 125 mg/d. The PFR for P+L was 90.3% at 12 months and 78.2% at 18 months; corresponding SRs were 95.6% and 93.0%. For P+F, 6-month PFR was 91.0%; 12-month SR was 100.0%. Conclusions: Dose reduction rates were low and PFR and SR were high in this Canadian real-world assessment of P+L and P+F treatments, suggesting that palbociclib combinations are well tolerated and effective.

Assessment of vitamin D deficiency and COVID-19 diagnosis in patients with breast or prostate cancer using electronic medical records.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. 6589-6589
Author(s):  
Aaron Galaznik ◽  
Emelly Rusli ◽  
Vicki Wing ◽  
Rahul Jain ◽  
Sheila Diamond ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Prostate Cancer ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Cancer Patients ◽  
Electronic Medical Records ◽  
Medical Records ◽  
Research Database ◽  
Breast Cancer Cohort ◽  
Icd 10

6589 Background: While patients with cancer are known to be at increased risk of infection in part due to the immunocompromising nature of cancer treatments, recent data indicate a particularly high risk for COVID-19 infection and poor outcomes (Wang et al., 2020). A recent study (Meltzer et al., 2020) demonstrated Vitamin D deficiency may increase risk of COVID-19 infection, and a small randomized controlled trial in Spain reported significant improvement in mortality among hospitalized patients treated with calcifediol. Vitamin D deficiency has been reported in two leading causes of cancer deaths: breast and prostate. In this study, we performed a retrospective cohort analysis on nationally representative electronic medical records (EMR) to assess whether Vitamin D deficiency affects risk of COVID-19 among these patients. Methods: Patients with breast (female) or prostate (male) cancer were identified between 3/1/2018 and 3/1/2020 from EMR data provided pro-bono by the COVID-19 Research Database ( covid19researchdatabase.org ). Patients with an ICD-10 code for Vitamin D deficiency or < 20ng/mL 20(OH)D laboratory result within 12 months prior to 3/1/2020 were classified as Vitamin D deficient. COVID-19 diagnosis was defined using ICD-10 codes and laboratory results for COVID-19 at any time after 3/1/2020. Logistic regressions, adjusting for baseline demographic and clinical characteristics, were conducted to estimate the effect of Vitamin D deficiency on COVID-19 incidence in each cancer cohort. Results: A total of 16,287 breast cancer and 14,919 prostate cancer patients were included in the study. The average age was 68.9 years in the breast cancer cohort and 73.6 years in the prostate cancer cohort. The breast cancer cohort consisted of 85% Whites, 13% Black or African Americans, and less than 5% of other races. A similar race distribution was observed in the prostate cancer cohort. Unadjusted analysis showed the risk of COVID-19 was higher among Vitamin D deficient patients compared to non-deficient patients in both cohorts (breast: OR = 1.60 [95% C.I.: 1.15, 2.20]; prostate: OR = 1.59 [95% C.I.: 1.08, 2.33]). Similar findings were observed when assessed in subgroups of patients with newly diagnosed cancer in the dataset, as well as after adjusting for baseline characteristics. Conclusions: Our study suggests breast and prostate cancer patients may have an elevated risk of COVID-19 infection if Vitamin D deficient. These results support findings by Meltzer et al., 2020 demonstrating a relationship between Vitamin D deficiency and COVID-19 infection. While a randomized clinical trial is warranted to confirm the role for Vitamin D supplementation in preventing COVID-19, our study underscores the importance of monitoring Vitamin D levels across and within cancer populations, particularly in the midst of the global COVID-19 pandemic.

scholarly journals Cost analysis of breast cancer diagnostic assessment programs

2017 ◽  
Vol 24 (5) ◽  
pp. 354 ◽  
Author(s):  
G.N. Honein-AbouHaidar ◽  
J.S. Hoch ◽  
M.J. Dobrow ◽  
T. Stuart-McEwan ◽  
D.R. McCready ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cost Effectiveness ◽  
Medical Records ◽  
Diagnostic Tests ◽  
Estimation Method ◽  
Financial Data ◽  
Diagnostic Assessment ◽  
Future Cost ◽  
Total Cost ◽  
The Cost

Objectives Diagnostic assessment programs (daps) appear to improve the diagnosis of cancer, but evidence of their cost-effectiveness is lacking. Given that no earlier study used secondary financial data to estimate the cost of diagnostic tests in the province of Ontario, we explored how to use secondary financial data to retrieve the cost of key diagnostic test services in daps, and we tested the reliability of that cost-retrieving method with hospital-reported costs in preparation for future cost-effectiveness studies.Methods We powered our sample at an alpha of 0.05, a power of 80%, and a margin of error of ±5%, and randomly selected a sample of eligible patients referred to a dap for suspected breast cancer during 1 January–31 December 2012. Confirmatory diagnostic tests received by each patient were identified in medical records. Canadian Classification of Health Intervention procedure codes were used to search the secondary financial data Web portal at the Ontario Case Costing Initiative for an estimate of the direct, indirect, and total costs of each test. The hospital-reported cost of each test received was obtained from the host-hospital’s finance department. Descriptive statistics were used to calculate the cost of individual or group confirmatory diagnostic tests, and the Wilcoxon signed-rank test or the paired t-test was used to compare the Ontario Case Costing Initiative and hospital-reported costs.Results For the 191 identified patients with suspected breast cancer, the estimated total cost of $72,195.50 was not significantly different from the hospital-reported total cost of $72,035.52 (p = 0.24). Costs differed significantly when multiple tests to confirm the diagnosis were completed during one patient visit and when confirmatory tests reported in hospital data and in medical records were discrepant. The additional estimated cost for non-salaried physicians delivering diagnostic services was $28,387.50.Conclusions It was feasible to use secondary financial data to retrieve the cost of key diagnostic tests in a breast cancer dap and to compare the reliability of the costs obtained by that estimation method with hospital-reported costs. We identified the strengths and challenges of each approach. Lessons learned from this study have to be taken into consideration in future cost-effectiveness studies.

Use of breast-conserving surgery for treatment of stage I and stage II breast cancer.

1998 ◽  
Vol 16 (1) ◽  
pp. 101-106 ◽  
Author(s):  
E Guadagnoli ◽  
J C Weeks ◽  
C L Shapiro ◽  
J H Gurwitz ◽  
C Borbas ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cohort Study ◽  
Surgical Treatment ◽  
Rural Areas ◽  
Medical Records ◽  
Retrospective Cohort ◽  
Early Stage ◽  
Breast Conserving Surgery ◽  
Teaching Hospitals ◽  
Type Of Surgery

PURPOSE To assess the use of breast-conserving surgery in two states reported to differ with respect to surgical treatment of breast cancer. METHODS A retrospective cohort study based on data collected from medical records and patients was performed among 1,514 patients diagnosed with early-stage breast cancer in Massachusetts and 1,061 patients in Minnesota. Patients were identified at 18 randomly selected hospitals in Massachusetts and at 30 hospitals in Minnesota. The rate of breast-conserving surgery in both states and the correlates of breast-conserving surgery among women eligible for the procedure were determined. RESULTS The rate of breast-conserving surgery in both states was much higher than previously reported. Among those eligible for the procedure, nearly 75% underwent breast-conserving surgery in Massachusetts and nearly half did so in Minnesota. Significantly (P < .003) more women who underwent mastectomy in Minnesota (27%) than in Massachusetts (15%) reported that their surgeon did not discuss breast-conserving surgery with them. Among women who underwent mastectomy and who reported being informed of both surgical alternatives, more women (P < .001) in Minnesota (74%) than in Massachusetts (62%) said they ultimately chose mastectomy because their surgeon recommended it. In Massachusetts, women treated at teaching hospitals were twice as likely as other women to undergo breast-conserving surgery. In Minnesota, women over age 70 and those who lived in rural areas were less likely than other women to undergo breast-conserving surgery. CONCLUSION Although the rate of breast-conserving surgery in each state was higher than expected based on earlier reports, the rates differed considerably between states. Additional studies are needed to determine whether variation in practice between geographic areas is due to differences in patients' preferences and values or to surgeons' propensity for one type of surgery based on where they practice.

scholarly journals Relationship between Ribosomal Protein S6-pS240 Expression and other Prognostic Factors in Non-Special Type Invasive Breast Cancer

Breast Care ◽  
2018 ◽  
Vol 14 (3) ◽  
pp. 171-175
Author(s):  
Frederik Cuperjani ◽  
Lumturije Gashi ◽  
Fisnik Kurshumliu ◽  
Shemsedin Dreshaj ◽  
Fitim Selimi
Keyword(s):  
Breast Cancer ◽  
Ribosomal Protein ◽  
Invasive Breast Cancer ◽  
Menopausal Status ◽  
Treatment Protocol ◽  
Prognostic Index ◽  
Disease Free Survival ◽  
Ki 67 ◽  
Free Survival ◽  
Disease Free

Background: The aim of this study was to investigate the immunohistochemical expression of ribosomal protein (RP) S6-pS240 in non-special type invasive breast cancer in relation to other prognostic markers and gain new insights to facilitate more individualized treatment. Methods: The following clinical and histopathological parameters of 120 patients were determined: S6-pS240 expression, age, menopausal status, tumor size and grade, TNM stage, Nottingham Prognostic Index (NPI), lymph node stage, estrogen and progesterone receptor (ER/PR) expression, HER2/neu amplification, lymphovascular invasion, and proliferative index as measured by Ki-67. Treatment protocol and disease-free survival were evaluated accordingly. Results: Significant positive correlations were seen between S6-pS240 expression and Ki-67 values (rho = 0.530, p < 0.001), and NPI (rho = 0.370, p < 0.001) and HER2/neu amplification (rho = 0.368, p < 0.001). A negative correlation was found between S6-pS240 and ER/PR expression (rho = 0.362, p < 0.001). Patients with negative RP S6-pS240 expression had significantly longer disease-free survival (log-rank test, p = 0.005). Conclusion: Immunohistochemical analysis of RP S6-pS240 is a valuable additional prognostic marker in patients with invasive breast cancer. Routine use of S6-pS240 immunohistochemistry is recommended.

scholarly journals Impacted Upper Central Incisors – Frequency and Factors Complicating the Treatment Protocol

Folia Medica ◽  
2021 ◽  
Vol 63 (3) ◽  
pp. 405-412
Author(s):  
Greta Yordanova ◽  
Gergana Gurgurova
Keyword(s):  
Medical Records ◽  
Treatment Protocol ◽  
Mixed Dentition ◽  
Successful Outcome ◽  
Central Incisor ◽  
Supernumerary Teeth ◽  
Impacted Tooth ◽  
Female Patients ◽  
Male Patients ◽  
Bone Coverage

Introduction: Eruption of central incisors occurs at a time when the mixed dentition starts to develop and their impaction is mostly a severe esthetic problem.Aim: Our aim was to assess the frequency of impaction of an upper central incisor and to analyse the factors which affect the successful outcome and the protocols for orthodontic treatment in cases of impacted upper central incisors.Materials and methods: In the present study, we used all medical records of 651 patients treated in our private practice over the last 3 years and also the medical records of 18 patients we diagnosed and treated for this problem over the last 8 years.Results: We found the ratio of impacted upper central incisors to be 1.4% as there were more male than female patients affected. There were 2.8% male patients and 0.7% female patients. The most frequent cause of impaction of the upper central incisor was the presence of mesiodentes and supernumerary teeth (55.5%), followed by presence of follicular cysts (44.4%) and odontoma collections (22.2%) or a combination of these.Several approaches have been used in treating the different positions of impacted incisors. It is necessary first to rotate the axle of the incisor and assure its root full bone coverage. We used directly TPA for support. In other patients, we waited for the spontaneous eruption after removal of the etiological factor and in another patient, we used conventional fixed techniques.Conclusions: It is important that dental doctors should monitor the formation of the dentition so that they detect the impacted tooth early in its development.

scholarly journals S-1-associated hand-foot syndrome as a prognostic factor in patients with metastatic breast cancer

2015 ◽  
Vol 23 (1) ◽  
pp. 9-13
Author(s):  
Akira Hirano ◽  
Akinori Hattori ◽  
Hiroaki Inoue ◽  
Kaoru Ogura ◽  
Fumie Okubo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metastatic Breast Cancer ◽  
Prognostic Factor ◽  
Metastatic Breast ◽  
Hand Foot Syndrome

A Robust Deep Neural Network Based Breast Cancer Detection and Classification

2020 ◽  
Vol 19 (01) ◽  
pp. 2050007
Author(s):  
Romany F. Mansour
Keyword(s):  
Breast Cancer ◽  
Cancer Detection ◽  
Adaptive Learning ◽  
Medical Records ◽  
Breast Cancer Detection ◽  
Aggregate Model ◽  
Element Analysis ◽  
Linear Discriminant ◽  
Characteristic Extraction ◽  
Assessment Measures

The exponential upward push in breast cancer cases across the globe has alarmed academia-industries to obtain certain more effect and strong Breast cancer laptop Aided prognosis (BC-CAD) device for breast most cancers detection. Some of techniques have been evolved with focus on case centric segmentation, feature extraction and class of breast cancer Histopathological photos. However, rising complexity and accuracy regularly demands more sturdy answer. Recently, Convolutional Neural community (CNN) has emerged as one of the maximum efferent techniques for medical records evaluation and diverse picture classification issues. On this paper, a notably strong and green BC-CAD solution has been proposed. Our proposed gadget consists of pre-processing, more suitable adaptive learning based totally Gaussian aggregate model (GMM), connected element analysis based vicinity of interest localization, and AlexNet-DNN primarily based characteristic extraction. The precept factor analysis (PCA) and Linear Discriminant analysis (LDA) primarily based on characteristic selection that's used as dimensional discount. One of the blessings of the proposed method is that not one of the current dimensional reduction algorithms hired with SVM to perform breast most cancers detection and class. The overall results acquired signify that the AlexNet-DNN based capabilities at completely connected layer; FC6 together with LDA dimensional discount and SVM-based totally classification outperforms other country-of-artwork techniques for breast cancer detection. The proposed method completed 96.20 for AlexNet-FC6 and 96.70 for AlexNet-FC7 in term of assessment measures.

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