scholarly journals MASCC Multidisciplinary Evidence-Based Recommendations for the Management of Malignant Bowel Obstruction in Advanced Cancer

2021 ◽  
Author(s):  
Ainhoa Madariaga ◽  
Jenny Lau ◽  
Arunangshu Ghoshal ◽  
Tomasz Dzierżanowski ◽  
Philip Larkin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Advanced Cancer ◽  
Bowel Obstruction ◽  
Psychosocial Support ◽  
Study Group ◽  
Evidence Based ◽  
Malignant Bowel Obstruction ◽  
Bowel Movements ◽  
Study Type

Abstract PurposeTo provide evidence based recommendations on the management of malignant bowel obstruction (MBO) for patients with advanced cancer.MethodsThe Multinational Association for Supportive Care in Cancer (MASCC) MBO study group conducted a systematic review of databases (inception to March 2021) to identify studies about patients with advanced cancer and MBO that reported on the following outcomes: symptom management, bowel obstruction resolution, prognosis, overall survival and quality of life. The review was restricted to studies published in English but no restrictions were placed on publication year, country and study type. As per the MASCC Guidelines Policy, the findings were synthesized to determine the levels of evidence to support each MBO intervention and, ultimately, the graded recommendations and suggestions.ResultsThe systematic review identified 17,656 published studies and 397 selected for the guidelines. The MASCC study group developed a total of 25 evidence-based suggestions and recommendations about management of MBO-related nausea and vomiting, bowel movements, pain, inflammation, bowel decompression and nutrition. Expert consensus-based guidance about advanced care planning and psychosocial support is also provided.ConclusionThis MASCC guideline provides comprehensive, evidence-based recommendations about MBO management for patients with advanced cancer.

scholarly journals Malignant Bowel Obstruction in Advanced Gynecologic Cancers: An Updated Review from a Multidisciplinary Perspective

2018 ◽  
Vol 2018 ◽  
pp. 1-10 ◽  
Author(s):  
Yeh Chen Lee ◽  
Nazlin Jivraj ◽  
Catherine O’Brien ◽  
Tanya Chawla ◽  
Eran Shlomovitz ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bowel Obstruction ◽  
Treatment Guidelines ◽  
Clinical Trial Design ◽  
Major Complication ◽  
Evidence Based ◽  
Malignant Bowel Obstruction ◽  
Gynecologic Cancers ◽  
The Impact

Malignant bowel obstruction (MBO) is a major complication in women with advanced gynecologic cancers which imposes a significant burden on patients, caregivers, and healthcare systems. Symptoms of MBO are challenging to palliate and result in progressive decompensation of already vulnerable patients with limited therapeutic options and a short prognosis. However, there is a paucity of guidelines or innovative approaches to improve the care of women who develop MBO. MBO is a complex clinical situation that requires a multidisciplinary approach to ensure the appropriate treatment modality and interprofessional care to optimally manage these patients. This review summarizes the current literature on the different approaches targeting MBO management including surgical intervention, chemotherapy, total parenteral nutrition, and pharmacological treatment. In addition, the impact of MBO management on patients’ quality of life (QOL) is examined. This article focuses on the challenges in developing evidence-based treatment guidelines for MBO and barriers in clinical trial design for MBO and proposes strategies to advance the MBO management. Collaboration is essential to design studies that may improve the overall care and quality of life for these patients. Prospective data are needed to inform clinical practice, establish a new benchmark for evidence-based MBO management, and better understand the biology of MBO.

scholarly journals Non-Surgical Management of Malignant Bowel Obstruction in Advanced Ovarian Cancer patients: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 104990912110430
Author(s):  
Praveena Idaikkadar ◽  
Athina Georgiou ◽  
Simon Skene ◽  
Agnieszka Michael
Keyword(s):  
Systematic Review ◽  
Ovarian Cancer ◽  
Cancer Patients ◽  
Surgical Management ◽  
Bowel Obstruction ◽  
Meta Analysis ◽  
Advanced Ovarian Cancer ◽  
Main Concern ◽  
Malignant Bowel Obstruction

Background: Malignant bowel obstruction is a common cause of morbidity and mortality in patients with advanced ovarian cancer. Many patients aren’t suitable for, or decline, surgical decompression. The outcomes for this frail group of patients are not well characterized. Aim: To evaluate survival outcomes of ovarian cancer patients who undergo non-surgical management of malignant bowel obstruction. Design: Systematic review and meta-analysis. Data Sources: Online literature search of Pubmed, Embase and Medline libraries up until December 2020. Searching abstracts of scientific meetings, reference lists of included studies and contacting experts in the field. Selection Criteria: Studies that investigated non-surgical management of confirmed bowel obstruction in advanced ovarian cancer patients were included. All levels of evidence including RCTs, cohort studies and case-series if they included greater than 5 patients. Data Collection and Analysis: The studies were independently chosen by two reviewers who extracted and analyzed the data separately through OpenMeta Analyst software. Study quality was assessed using the JADAD score and the Newcastle Ottawa Score. Results: 24 studies met the eligibility criteria for the systematic review and 9 for the meta-analysis. Median survival of patients managed non-surgically for bowel obstruction was 44 days (95% CI 38-49 days, I 2 = 0%, P = 0.128). Conclusion: The quality of studies was relatively low, however the evidence shows that non-surgical management of bowel obstruction results in a short life expectancy but with controlled symptoms. Where quality of life is the main concern, this may be a feasible and effective strategy.

scholarly journals A Review of Evidence-Based Recommendations for Pericoronitis Management and a Systematic Review of Antibiotic Prescribing for Pericoronitis among Dentists: Inappropriate Pericoronitis Treatment Is a Critical Factor of Antibiotic Overuse in Dentistry

2021 ◽  
Vol 18 (13) ◽  
pp. 6796
Author(s):  
Jan Schmidt ◽  
Martina Kunderova ◽  
Nela Pilbauerova ◽  
Martin Kapitan
Keyword(s):  
Systematic Review ◽  
Local Therapy ◽  
Critical Factor ◽  
Antibiotic Use ◽  
Narrative Review ◽  
Antibiotic Prescribing ◽  
Evidence Based ◽  
Antibiotic Overuse ◽  
Clinically Significant

This work provides a narrative review covering evidence-based recommendations for pericoronitis management (Part A) and a systematic review of antibiotic prescribing for pericoronitis from January 2000 to May 2021 (Part B). Part A presents the most recent, clinically significant, and evidence-based guidance for pericoronitis diagnosis and proper treatment recommending the local therapy over antibiotic prescribing, which should be reserved for severe conditions. The systematic review includes publications analyzing sets of patients treated for pericoronitis and questionnaires that identified dentists' therapeutic approaches to pericoronitis. Questionnaires among dentists revealed that almost 75% of them prescribed antibiotics for pericoronitis, and pericoronitis was among the top 4 in the frequency of antibiotic use within the surveyed diagnoses and situations. Studies involving patients showed that antibiotics were prescribed to more than half of the patients with pericoronitis, and pericoronitis was among the top 2 in the frequency of antibiotic use within the monitored diagnoses and situations. The most prescribed antibiotics for pericoronitis were amoxicillin and metronidazole. The systematic review results show abundant and unnecessary use of antibiotics for pericoronitis and are in strong contrast to evidence-based recommendations summarized in the narrative review. Adherence of dental professionals to the recommendations presented in this work can help rapidly reduce the duration of pericoronitis, prevent its complications, and reduce the use of antibiotics and thus reduce its impact on patients' quality of life, healthcare costs, and antimicrobial resistance development.

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.

scholarly journals Chronic pancreatitis.Evidence based management guidelines of the Hungarian Pancreatic Study Group

2015 ◽  
Vol 156 (7) ◽  
pp. 262-288 ◽  
Author(s):  
Tamás Takács ◽  
László Czakó ◽  
Zsolt Dubravcsik ◽  
Gyula Farkas ◽  
Péter Hegyi ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Treatment Guidelines ◽  
Task Force ◽  
Correct Diagnosis ◽  
Study Group ◽  
Evidence Based ◽  
International Guidelines ◽  
Basic Reference ◽  
Evidence Based Guideline

Chronic pancreatitis is an inflammatory disease associated with structural and functional damage of the pancreas. In most cases pain, maldigestion and weight loss are the leading sympthoms, which significantly worsen the quality of life. Correct diagnosis and differential diagnosis of chronic pancreatitis and treatment of these patients requires up-to-date and evidence based treatment guidelines. The Hungarian Pancreatic Study Group proposed to prepare an evidence based guideline based on the available international guidelines and evidence. The preparatory and consultation task force appointed by the Hungarian Pancreatic Study Group translated and complemented and/or modified the international guidelines if it was necessary. 123 relevant clinical questions in 11 topics were defined. Evidence was classified according to the UpToDate®grading system. The draft of the guidelines were presented and discussed at the consensus meeting in September 12, 2014. All clinial questions were accepted with total or strong agreement. The present guideline is the first evidence based chronic pancreatitis guideline in Hungary. This guideline provides very important and helpful data for tuition, everyday practice and proper financing of chronic pancreatitis. Therefore, the authors believe that these guidelines will widely become a basic reference in Hungary. Orv. Hetil., 2015, 156(7), 262–288.

scholarly journals Prognostic Factors for Development of Subsequent Metastases in Localized Osteosarcoma: A Systematic Review and Identification of Literature Gaps

Sarcoma ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Patrick Basile ◽  
Emily Greengard ◽  
Brenda Weigel ◽  
Logan Spector
Keyword(s):  
Systematic Review ◽  
Prognostic Factors ◽  
Predictive Models ◽  
Pulmonary Metastases ◽  
Tumor Location ◽  
Evidence Based ◽  
Review Of The Literature ◽  
Histologic Response ◽  
Exclusion Criteria

Aim. To investigate prognostic factors in pediatric and young adult patients with localized osteosarcoma that could predict the development of subsequent pulmonary metastases and lead to an ability to risk-stratify therapy. We performed a systematic review of the literature published since January 1990 to establish common evidence-based prognostic factors. Methods. PubMed and Embase searches (Jan 1990–Aug 2018) were performed. Two reviewers independently selected papers for patients with localized osteosarcoma with subsequent metastatic development and then reviewed for quality of methods and prognostic factors. Results. Database searches yielded 216 unique results. After screening, 27 full-text articles were studied in depth, with 9 items fulfilling predetermined inclusion and exclusion criteria. Age, tumor location, tumor size/volume, and histologic response carried independent prognostic value in the majority of the studies. Conclusions. Several prognostic factors seemed to be consistent amongst the studies, but the heterogeneity and smaller sizes of the study populations made pooling of results difficult. Standardization of larger patient populations and consistent definitions/cutoffs for prognostic factors are needed to further assess for consistent prognostic factors and potential predictive models to be developed.

Medical management of malignant bowel obstruction in patients with advanced cancer: 2021 MASCC guideline update

2021 ◽  
Author(s):  
Mellar Davis ◽  
David Hui ◽  
Andrew Davies ◽  
Carla Ripamonti ◽  
Andreia Capela ◽  
...  
Keyword(s):  
Advanced Cancer ◽  
Bowel Obstruction ◽  
Medical Management ◽  
Malignant Bowel Obstruction
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