The first results of targeted screening with a distress thermometer and initiation of psycho-oncological care of cancer patients.

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 113-113
Author(s):  
Maria Angerer-Shpilenya ◽  
Axel Heidenreich
Keyword(s):  
Cancer Patients ◽  
Stress Level ◽  
Sleep Disturbances ◽  
Psychological Impact ◽  
Distress Thermometer ◽  
University Hospital ◽  
Sense Of Security ◽  
Targeted Screening ◽  
First Results ◽  
Change Of Life

113 Background: Tumor disease has not only somatic but also psychological impact on patients with complete change of life dimension. This resonates not only to the patients, their relatives and friends, but also to the therapy. A precise screening helps to determine the stress factor, to capture the psychological comorbidity and to initiate an early psycho-social care. Methods: 420 patients with various tumors got since October 2011 in the Urological Clinic of Aachen University Hospital screening using a Distress Thermometer. 410 patients were stationary and 10 patients came to the outpatient (ambulant) chemotherapy. 23 of the 40 questions of the Distress Thermometer depend on somatic complaints of patients. The other 17 questions cover the psycho-social problems. Results: 141 of the 420 patients reported to have a low stress level by the tumor. 139 patients showed, according to the Distress Thermometer, an average and 140 patients significantly higher stress level. This means that 279 of the 420 patients need a psycho-oncological counseling and possibly even further care and treatment. The most common entered symptoms were fears, nervousness, sleep disturbances, fatigue, sadness and worry. Depending on the wishes of the patient the psycho-oncological consultation was initiated. Only completing the Distress Thermometer helps the patient to face their problems and worries and makes perhaps the first great step in the perception of the disease. Since January 2012 a new component was inserted into the discharge reports of the tumor patients. This component contains the recommendation, depending on the result of the Distress Thermometer, to start if necessary the professional psycho-oncological support. That gives the patients a sense of security and a feeling not to fight alone against the disease. Conclusions: A targeted screening and an interdisciplinary, together with psycho-oncologists, care to cancer patients support them and their families at all stages of the disease, helps to deal with the new life situation and can possibly also increase the patient's compliance and the therapeutic response.

Is it the Time to Implement the Routine Use of Distress Thermometer Among Egyptian Cancer Patients?

2020 ◽  
Vol 106 (1_suppl) ◽  
pp. 21-21
Author(s):  
N Abdel Aziz ◽  
GH Elgohary ◽  
S Khallaf ◽  
S Mohamed ◽  
W Abozeed ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Hematological Malignancies ◽  
Univariate Analysis ◽  
Distress Thermometer ◽  
University Hospital ◽  
Treatment Quality ◽  
Egyptian Patients ◽  
Different Types ◽  
The Mean

Background: Emotional distress is common among cancer patients (25-30 %), as a result of the serious diagnosis and suffering from aggressive treatment. This may negatively affect their participation in treatment, quality of life, and satisfaction with care. To best of our knowledge, it has not been studied before in Egypt, this study aims to implement the distress thermometer in Egyptian cancer patients as a screening tool for the distress and its associated factors. Methods: The Arabic version of DT that has been recently validated was used in this study to screen patients. Egyptian Patients diagnosed with different types of hematological malignancies and solid cancers who were following at three Oncology Centers (South Egypt Cancer Institute, Assiut University Hospital, and Mansura University Oncology department) were recruited. All Patients were asked to rate their distress in the past week on an 11-point visual analog scale ranging from 0 (no distress) to 10 (extreme distress), then, they were asked to fill in the Problem List (PL), to check whether or not they had any of the problems listed during the previous 7 days. Univariate and multivariate analyses were used to identify the significant problems correlated with the patient distress at a cut-off score of 4. Results: A total of 550 patients agreed to participate. The mean age was 51.3 (18–85) years. Different types of solid and hematological malignancies were included; the most common three types were breast cancer (32.7 %), gastrointestinal cancer (23%), and hematological malignancies (15.5 %). The patients’ average DT score was 3.7. The most frequent problems were fatigue (49%), worry (47%), fear (44 %), and pain (42%). The univariate analysis showed a significant correlation between the DT at Cut – off the value of 4 and transportation, dealing with children, depression, fears, sadness, sleep, loss of usual activity, and fatigue. Multivariate analysis confirmed the transportation, depression, fears, sadness, sleep and fatigue as independent factors for such distress. Conclusion: Egyptian cancer patients are suffering from significant distress at a cut value of 4. We recommend the involvement of the psycho-oncology service for all cancer patients at the time of diagnosis.

Psychological Impact of Coronavirus (COVID-19) Disease on Cancer Patients

Coronaviruses ◽  
2021 ◽  
Vol 01 ◽  
Author(s):  
Gaurav Dhiman
Keyword(s):  
Cancer Patients ◽  
Related Problem ◽  
Preventive Measures ◽  
Psychological Impact ◽  
Vulnerable Group ◽  
Recommended Care ◽  
Health Related ◽  
The Face ◽  
Mental Trauma ◽  
The Cost

: In this letter, the psychological impact of COVID-19 on cancer infected patients is discussed. Cancer is a serious health-related problem in the human body nowadays. The 2019 pandemic of coronavirus disease has developed into an unheard-of pandemic. Given the havoc wreaked by this pathogen worldwide, many countries have implemented a severe, legally enforced method of social distancing, in the form of a lockdown. Unless adequate preventive measures are taken, the cost of the pandemic and subsequent lockdown can prove to be irreparable. The obvious consequences of this lockout, such as the escalating levels of unemployment, imminent economic crisis, and extreme food scarcity faced by the sudden unemployed migrant labour population, have been widely reported. Cancer patients are a highly vulnerable group even during non-pandemic periods, often presenting late in the course of their illness, without the services required to avail recommended care. The incidence of psychological complications and emotional distress is considerably higher than in the general population, and the trauma of both the pandemic and subsequent lockdown contributes significantly to their mental trauma. This analysis is geared at solving the challenges faced by cancer patients in the face of this pandemic and subsequent lockdown, with a look at potential solutions that can be enforced.

scholarly journals Circulating regulatory T cells predict efficacy and atypical responses in lung cancer patients treated with PD-1/PD-L1 inhibitors

2021 ◽  
Author(s):  
Da Hyun Kang ◽  
Chaeuk Chung ◽  
Pureum Sun ◽  
Da Hye Lee ◽  
Song-I Lee ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cancer Patients ◽  
Advanced Nsclc ◽  
Checkpoint Inhibitors ◽  
Standard Of Care ◽  
Treg Cells ◽  
University Hospital ◽  
X Rays ◽  
Lung Cancer Patients ◽  
National University

Abstract Background Immune checkpoint inhibitors (ICIs) have become the standard of care for a variety of cancers, including non-small cell lung cancer (NSCLC). In this study, we investigated the frequency of pseudoprogression and hyperprogression in lung cancer patients treated with ICIs in the real world and aimed to discover a novel candidate marker to distinguish pseudoprogression from hyperprogression soon after ICI treatment. Methods This study included 74 patients with advanced NSCLC who were treated with PD-1/PD-L1 inhibitors at Chungnam National University Hospital (CNUH) between January 2018 and August 2020. Chest X-rays were examined on day 7 after the first ICI dose to identify changes in the primary mass, and the response was assessed by computed tomography (CT). We evaluated circulating regulatory T (Treg) cells using flow cytometry and correlated the findings with clinical outcomes. Results The incidence of pseudoprogression was 13.5%, and that of hyperprogression was 8.1%. On day 7 after initiation of treatment, the frequency of CD4+CD25+CD127loFoxP3+ Treg cells was significantly decreased compared with baseline (P = 0.038) in patients who experienced pseudoprogression and significantly increased compared with baseline (P = 0.024) in patients who experienced hyperprogression. In the responder group, the frequencies of CD4+CD25+CD127loFoxP3+ Treg cells and PD-1+CD4+CD25+CD127loFoxP3+ Treg cells were significantly decreased 7 days after commencement of treatment compared with baseline (P = 0.034 and P < 0.001, respectively). Conclusion Circulating Treg cells represent a promising potential dynamic biomarker to predict efficacy and differentiate atypical responses, including pseudoprogression and hyperprogression, after immunotherapy in patients with NSCLC.

scholarly journals Short-Course Versus Long-Course Colistin for Treatment of Carbapenem-Resistant A.baumannii in Cancer Patient

Antibiotics ◽  
2021 ◽  
Vol 10 (5) ◽  
pp. 484
Author(s):  
Wasan Katip ◽  
Suriyon Uitrakul ◽  
Peninnah Oberdorfer
Keyword(s):  
Clinical Response ◽  
Cancer Patients ◽  
Therapy Group ◽  
University Hospital ◽  
P Value ◽  
Chiang Mai ◽  
Carbapenem Resistant ◽  
Short Course ◽  
Significant Difference ◽  
Long Course

Carbapenem-resistant Acinetobacter baumannii (CRAB) is one of the most commonly reported nosocomial infections in cancer patients and could be fatal because of suboptimal immune defenses in these patients. We aimed to compare clinical response, microbiological response, nephrotoxicity, and 30-day mortality between cancer patients who received short (<14 days) and long (≥14 days) courses of colistin for treatment of CRAB infection. A retrospective cohort study was conducted in cancer patients with CRAB infection who received short or long courses of colistin between 2015 to 2017 at Chiang Mai University Hospital (CMUH). A total of 128 patients met the inclusion criteria. The results of this study show that patients who received long course of colistin therapy had a higher rate of clinical response; adjusted odds ratio (OR) was 3.16 times in patients receiving long-course colistin therapy (95%CI, 1.37–7.28; p value = 0.007). Microbiological response in patients with long course was 4.65 times (adjusted OR) higher than short course therapy (95%CI, 1.72–12.54; p value = 0.002). Moreover, there was no significant difference in nephrotoxicity (adjusted OR, 0.91, 95%CI, 0.39–2.11; p value = 0.826) between the two durations of therapy. Thirty-day mortality in the long-course therapy group was 0.11 times (adjusted OR) compared to the short-course therapy group (95%CI, 0.03–0.38; p value = 0.001). Propensity score analyses also demonstrated similar results. In conclusion, cancer patients who received a long course of colistin therapy presented greater clinical and microbiological responses and lower 30-day mortality but similar nephrotoxicity as compared with those who a received short course. Therefore, a long course of colistin therapy should be considered for management of CRAB infection in cancer patients.

scholarly journals PO-0740: MR-guided single dose pre-operative radiotherapy in low-risk breast cancer patients: first results

2018 ◽  
Vol 127 ◽  
pp. S379-S380
Author(s):  
J. Vasmel ◽  
R. Charaghvandi ◽  
A. Houw eling ◽  
M. Philippens ◽  
W. Veldhuis ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Single Dose ◽  
Cancer Patients ◽  
Low Risk ◽  
Breast Cancer Patients ◽  
First Results ◽  
Risk Breast Cancer

scholarly journals POS0998 SPONDYLOARTHRITIS AND SLEEP DISORDERS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 767.2-768
Author(s):  
S. Lahrichi ◽  
K. Nassar ◽  
S. Janani
Keyword(s):  
Functional Impairment ◽  
Sleep Disturbances ◽  
Negative Impact ◽  
University Hospital ◽  
Quality Of Sleep ◽  
The Mean ◽  
Sleep Deficit ◽  
Impaired Sleep ◽  
The Impact

Background:Spondyloarthropathies (SpA) are a group of chronic and progressive diseases, characterized in particular by a progressive stiffening of the spine, spreading to neighboring joints or to certain tissues, which could lead in the long term to progressive stiffening and functional impairment. This conditioncancauseinsomnia problems and impaired sleep quality.Objectives:To assess the impact of SpA on the quality of sleep.Methods:This is a retrospective study over a period of 4 years from January 2015 to December 2019, including all the medical records of patients with SpA followed in the Department of Rheumatology of the University Hospital of Ibn Rochd, Casablanca. We evaluated for each patient two validated scores: the Epworth somnolence scale rated from 0 to 24, and the Pittsburgh sleep score rated from 0 to 21 with 7 components. Patients with a psychiatric history or who were followed up for neurological pathologies were excluded.Results:178 patients were included. 60.67% were men with an average age of 36.32 years (14-68 years). 45.01% had axial SpA, 29.77% had psoriatic arthritis, and 25.22% were followed for SpA associated with inflammatory bowel disease. 45% had associated comorbidities: there were 18 diabetics and 34 hypertensive, 16.58% were smokers. Clinically, 85.42% presented a back pain initially on examination, 55% presented a polyarthralgia, and 39.88% an oligoarthritis. 63% had radiological sacroiliitis, and 35.14% had bilateral coxitis. 13.48% had a positive HLA B27 and 58.89% had a positive inflammatory assessment with very high activity indices,with a mean of 4.6. 64.66% of the patients received NSAIDs,of which 11% responded well. 57% were treated with csDMARDs, and 17.86% were treated with biologics. At the time of our study, the mean visual analog scale was 5.84 ± 1.7 out of 10 (2-9). The mean Epworth score was 8.38 ± 5.2 (0-21). 56.1% of patients had no sleep debt, 33.3% had a sleep deficit, and only 10.6% had signs of drowsiness. For the overall Pittsburgh score, the mean was 7.02 ± 3.6 (1-18). The mean of “subjective quality of sleep” was 1.12, “sleep latency” was 1.22, “duration of sleep” was 1.06, “usual sleep efficiency” was 0.74, “Sleep disturbance” of 1.28, “use of a sleep medication” of 0.54, and the average of the component concerning “poor shape during the day” was 1.03 out of 3. The LEQUESNE index went from an average of 6 to 8, which corresponds to an average handicap (P = 0.2) over a period of 3 years. 68% of the patients had an alteration in the quality of sleep, starting on average three years after the onset of symptoms. 11% reported having experiencedanxiety and depressive symptoms, and reported having used antidepressants or anxiolytics in the past 5 years.Conclusion:Our study showed the negative impact of SpA on the duration and overall quality of sleep. The degree of pain as well as functional impairment can cause and worsen sleep disturbances in SpA. We have shown that the Pittsburg score increases significantly with the increase of pain.The Lequesne score and that the Epworth score increase with disease activity[1].References:[1]StolwijkC,vanTubergenA,Castillo-OrtizJD,BoonenA.Prevalenceofextra-articularmanifestationsinpatientswithankylosingspondylitis:asystematicreviewandmeta-analysis.AnnRheumDis2015;74:65—73.Disclosure of Interests:None declared.

scholarly journals Implementation of a Targeted Screening Program to Detect Airflow Obstruction Suggestive of Chronic Obstructive Pulmonary Disease within a Presurgical Screening Clinic

2015 ◽  
Vol 22 (4) ◽  
pp. 209-214 ◽  
Author(s):  
Chantal Robitaille ◽  
Esther Dajczman ◽  
Andrew M Hirsch ◽  
David Small ◽  
Pierre Ernst ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Screening Program ◽  
Tertiary Care ◽  
Airflow Obstruction ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Targeted Screening ◽  
History Of

BACKGROUND: Targeted spirometry screening for chronic obstructive pulmonary disease (COPD) has been studied in primary care and community settings. Limitations regarding availability and quality of testing remain. A targeted spirometry screening program was implemented within a presurgical screening (PSS) clinic to detect undiagnosed airways disease and identify patients with COPD/asthma in need of treatment optimization.OBJECTIVE: The present quality assurance study evaluated airflow obstruction detection rates and examined characteristics of patients identified through the targeted screening program.METHODS: The targeted spirometry screening program was implemented within the PSS clinic of a tertiary care university hospital. Current or ex-smokers with respiratory symptoms and patients with a history of COPD or asthma underwent prebronchodilator spirometry. History of airways disease and smoking status were obtained during the PSS assessment and confirmed through chart reviews.RESULTS: After exclusions, the study sample included 449 current or ex-smokers. Abnormal spirometry results were found in 184 (41%) patients: 73 (16%) had mild, 93 (21%) had moderate and 18 (4%) had severe or very severe airflow obstruction. One hundred eighteen (26%) new cases of airflow obstruction suggestive of COPD were detected. One-half of these new cases had moderate or severe airflow obstruction. Only 34% of patients with abnormal spirometry results had reported a previous diagnosis of COPD. More than one-half of patients with abnormal spirometry results were current smokers.CONCLUSIONS: Undiagnosed airflow obstruction was detected in a significant number of smokers and ex-smokers through a targeted screening program within a PSS clinic. These patients can be referred for early intervention and secondary preventive strategies.

Measuring distress in cancer patients: the Distress Thermometer in an Australian sample

2009 ◽  
Vol 17 (2) ◽  
pp. 61-68 ◽  
Author(s):  
Alistair Campbell ◽  
Suzanne K. Steginga ◽  
Megan Ferguson ◽  
Alison Beeden ◽  
Melissa Walls ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Distress Thermometer ◽  
Australian Sample

scholarly journals Non-pharmacological sleep interventions for pediatric cancer patients and survivors: a systematic review protocol

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Peter L. Stavinoha ◽  
Ineke M. Olsthoorn ◽  
Maria C. Swartz ◽  
Sara Nowakowski ◽  
Stephanie J. Wells ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sleep Quality ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
Sleep Disturbances ◽  
Sleep Onset ◽  
Standard Of Care ◽  
Sleep Diary ◽  
Pharmacological Interventions ◽  
Pediatric Cancer Patients

Abstract Background Sleep disturbances constitute a common complication in pediatric cancer patients and survivors and are frequently severe enough to warrant treatment. Suboptimal sleep has been associated with decreased emotional well-being and cognitive functioning and increased behavioral problems. Standardized guidelines for non-pharmacological sleep interventions for adults with cancer exist, but no standard of care intervention or standard guidelines are available to guide such intervention in pediatric cancer patients and survivors. Therefore, effective behavioral interventions for improving sleep quality need to be identified. The objective of the review is to evaluate the effect of non-pharmacological sleep interventions on sleep quality in pediatric cancer patients and survivors. Methods The review will consider studies that include children and adolescents between 0 and 18 years diagnosed with cancer or who have a history of cancer who have non-respiratory sleep disturbance. We will include experimental and quasi-experimental studies evaluating non-pharmacological interventions such as psychological interventions, technical/device interventions, interventions targeting physical activity, and complementary and alternative medicine interventions (e.g., yoga, massage, music). Interventions involving medications, ingestible supplements, products purported to work through absorption, and medical devices will be excluded. Primary outcome will be sleep quality as measured by methods including retrospective ratings, daily sleep diary, and validated questionnaires. Secondary outcomes will include total sleep time, sleep onset latency, wake after sleep onset, daytime sleepiness, and daytime sleep duration (naps) as measured by retrospective ratings, daily sleep diary, validated questionnaires, and/or actigraphy. Databases will include MEDLINE (Ovid), EMBASE (Ovid), Cochrane Library, CINAHL (Ebsco), and PsycINFO (Ovid) and will be queried from database inception to present. Two reviewers will independently screen all citations, full-text articles, and extract data. The study methodological quality will be assessed using Joanna Briggs Institute (JBI) critical appraisal tools. Data will be extracted and findings pooled and synthesized using a meta-aggregation approach via the JBI System for the Unified Management, Assessment, and Review of Information (SUMARI). If feasible, we will conduct random effects meta-analysis. Additional analyses will be conducted to explore the potential sources of heterogeneity (e.g., methodological quality, study design, outcome measures). Discussion This systematic review will synthesize and consolidate evidence on existing non-pharmacological interventions to improve sleep in pediatric cancer patients and survivors. Findings may help inform practitioners working with pediatric cancer patients and survivors experiencing sleep disturbances and is intended to identify gaps and opportunities to improve methodical quality of further non-pharmacological sleep intervention research in this population toward developing an eventual standard of care. Systematic review registration PROSPERO CRD42020200397.

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