scholarly journals Continuous Recording of Vital Signs With a Wearable Device in Pediatric Patients Undergoing Chemotherapy for Cancer – an Operational Feasibility Study

2021 ◽  
Author(s):  
Christa Koenig ◽  
Roland A Ammann ◽  
Claudia E Kuehni ◽  
Jochen Roessler ◽  
Eva Brack
Keyword(s):  
Heart Rate ◽  
Pediatric Patients ◽  
Clinical Symptoms ◽  
Vital Signs ◽  
Wearable Device ◽  
Continuous Recording ◽  
Patient Specific ◽  
Patients With Cancer ◽  
Severe Infections ◽  
Age Range

Abstract PurposePediatric patients with cancer are at high risk for severe infections. Infections can trigger changes of vital signs long before clinical symptoms arise. Continuous recording may detect such changes earlier than discrete measurements. We aimed to assess the feasibility of continuous recording of vital sings by a wearable device (WD) in pediatric patients undergoing chemotherapy for cancer.MethodsIn this prospective, observational single-center study pediatric patients undergoing chemotherapy for cancer wore the Everion® WD for 14 days.ResultsTwenty patients were included (median age, 6 years; range, 2-16). Six patients (predefined feasibility criterion, ≥15 patients) aged 3-16 years fulfilled the patient specific goal, defined as heart rate recorded with good quality during ≥18 hours/day on ≥7 consecutive days. The quality of heart rate recording was good during 3992 of 6576 (61%) hours studied, poor during 300 (5%) hours, and no data was recorded during 2284 (35%) hours. Eighteen of 20 participants indicated that this WD is acceptable to measure vital sings in children undergoing chemotherapy for cancer. ConclusionWe found that continuous recording of vital signs is feasible across a very wide age range in pediatric patients undergoing chemotherapy for cancer. In the configuration studied, however, the predefined feasibility criterion was not fulfilled. This was mainly due to important compliance problems and independent of the WD itself. These results will influence the design of future WD-studies including those aiming to identify patterns predicting fever or infection. This study was registered at ClinicalTrials.gov (NCT04134429) the 22th of October, 2019.

scholarly journals Continuous recording of vital signs with a wearable device in pediatric patients undergoing chemotherapy for cancer—an operational feasibility study

2021 ◽  
Author(s):  
Christa Koenig ◽  
Roland A. Ammann ◽  
Claudia E. Kuehni ◽  
Jochen Roessler ◽  
Eva Brack
Keyword(s):  
Heart Rate ◽  
Pediatric Patients ◽  
Clinical Symptoms ◽  
Vital Signs ◽  
Wearable Device ◽  
Continuous Recording ◽  
Patient Specific ◽  
Specific Goal ◽  
Severe Infections ◽  
Age Range

Abstract Purpose Pediatric patients with cancer are at high risk for severe infections. Infections can trigger changes of vital signs long before clinical symptoms arise. Continuous recording may detect such changes earlier than discrete measurements. We aimed to assess the feasibility of continuous recording of vital signs by a wearable device (WD) in pediatric patients undergoing chemotherapy for cancer. Methods In this prospective, observational single-center study, pediatric patients under chemotherapy wore the Everion® WD for 14 days. The predefined patient-specific goal was heart rate recorded in good quality during ≥18/24 h per day, on ≥7 consecutive days. The predefined criterion to claim feasibility was ≥15/20 patients fulfilling this patient-specific goal. Results Twenty patients were included (median age, 6 years; range, 2–16). Six patients aged 3–16 years fulfilled the patient-specific goal. Quality of heart rate recording was good during 3992 of 6576 (61%) hours studied and poor during 300 (5%) hours, and no data was recorded during 2284 (35%) hours. Eighteen of 20 participants indicated that this WD is acceptable to measure vital signs in children under chemotherapy. Conclusion The predefined feasibility criterion was not fulfilled. This was mainly due to important compliance problems and independent of the WD itself. However, continuous recording of vital signs was possible across a very wide age range in pediatric patients undergoing chemotherapy for cancer. We recommend to study feasibility in the Everion® again, plus in further WDs, applying measures to enhance compliance. Trial registration ClinicalTrials.gov (NCT04134429) on October 22, 2019.

scholarly journals Continuous monitoring of health data with a wearable device in pediatric patients undergoing chemotherapy for cancer – a feasibility pilot study

2021 ◽  
Author(s):  
Brack Eva ◽  
Koenig Christa ◽  
Roessler Jochen ◽  
Ammann Roland A.
Keyword(s):  
Pilot Study ◽  
Continuous Monitoring ◽  
Pediatric Patients ◽  
Clinical Symptoms ◽  
Vital Signs ◽  
Ethics Committees ◽  
Health Data ◽  
Wearable Device ◽  
Delayed Treatment ◽  
Patient Will

Abstract Pediatric patients with cancer are at high risk for severe infections and delayed treatment increases mortality. Infections can trigger changes of vital signs long before clinical symptoms arise. Continuous recording may detect such changes earlier than discrete measurements. This is the protocol for an investigator-initiated, single-center observational pilot study on the feasibility of continuous monitoring of health data with a wearable device (WD) in pediatric patients undergoing chemotherapy of cancer. A total of 20 patients will be included, including at least 4 patients <6 years. Each patient will wear the WD for 14 days and we expect study duration of three to four months. The protocol had been registered at www.clinicaltrials.com (NCT04134429) and was approved by the local Ethics Committees (Ethikkommission der Universitätskinderkliniken Bern, “Gesuch 1912”, Kantonale Ethikkommission Bern, BASEC-No.: 2019-01919).

Dificuldades do Profissional Enfermeiro ao Cuidar de Pacientes Pediátricos Portadores de Câncer/ Difficulties of the Professional Nurse when Taking Care of Pediatric Patients with Cancer

1970 ◽  
Vol 4 (3) ◽  
pp. 41-47
Author(s):  
Renata Pinto Ribeiro ◽  
Teresa Francisca Moraes Pinto ◽  
Clarissa Santos Carvalho Ribeiro ◽  
Valdinéa Luiz Hertel
Keyword(s):  
Qualitative Study ◽  
Pediatric Patients ◽  
Structured Interview ◽  
Coping Mechanisms ◽  
Emotional Involvement ◽  
Children With Cancer ◽  
Professional Nurse ◽  
Patients With Cancer ◽  
Oncological Diseases ◽  
Taking Care

Objetivo: O objetivo desse estudo foi de identificar as dificuldades do profissional enfermeiro frente à criança com câncer, verificar se há preparo adequado para atender às necessidades de uma criança com doenças oncológicas; e qual a forma de enfrentamento utilizada pelo profissional diante das dificuldades encontradas, no atendimento a essa criança. Metodologia: Trata-se de uma pesquisa qualitativa, objetivando identificar quais dificuldades o profissional de enfermagem enfrenta no cuidado de criança com câncer e de seus familiares, os mecanismos de enfrentamento dessas dificuldades no atendimento dos mesmos e se há preparo adequado dos mesmos para atender as necessidades dessas crianças. Os sujeitos foram quatro enfermeiras que cuidam ou já cuidaram de crianças com câncer no Hospital Bom Pastor – Varginha/MG. A coleta de dados foi desenvolvida por uma entrevista semiestruturada. Resultados: Constatou-se que as dificuldades são: cuidar de criança em estado grave, seus pais e o envolvimento emocional. Aos meios de enfrentamento referem à oração e a distração. Quanto ao preparo do profissional referem despreparo para atuar nesta área. Conclusão: Conclui-se que há falta de preparo aos profissionais, embora os mesmos cuidem com humanização dessas crianças.  Palavras-chave: Enfermeiro; Crianças; Câncer.   ABSTRACT: Objective: The aim of this study was to identify the difficulties of the professional nurse when taking care of a child with cancer, check the adequate preparation to meet the needs of children with oncological diseases; and what form of coping with the situation the professionals used when taking care of this child. Methodology: This was a qualitative study , aiming to identify the difficulties the professional faces in the care of children with cancer and their families , the coping mechanisms of these difficulties in the care  and if there is adequate preparation thereof to meet the needs of these children. The subjects were four nurses who care or have cared for children with cancer at Good Shepherd Hospital – Varginha/MG. Data collection was carried out by a semi - structured interview. Results: It was found that the difficulties are care of a child in serious condition, his parents and the emotional involvement. Means of coping relate to prayer and distraction. As to their preparation, professionals refer as being unprepared to act in this area. Conclusion: We concluded that there is lack of preparation of professionals, although they take care of these children in a humanistic way  Keywords: Nurse; children; Cancer.

Intranasal dexmedetomidine: the ideal drug for sedation in the pediatric echo lab?

2021 ◽  
pp. 1-5
Author(s):  
David E Saudek ◽  
Deborah Walbergh ◽  
Peter Bartz ◽  
Sara Shreve ◽  
Amy Schaal ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Disease ◽  
Chart Review ◽  
Chloral Hydrate ◽  
Vital Signs ◽  
Cyanotic Heart Disease ◽  
Historical Cohort ◽  
Safety And Efficacy ◽  
Attractive Option ◽  
The Ideal

Abstract Background: Intranasal dexmedetomidine is an attractive option for procedural sedation in pediatrics due to ease of administration and its relatively short half-life. This study sought to compare the safety and efficacy of intranasal dexmedetomidine to a historical cohort of pediatric patients sedated using chloral hydrate in a pediatric echo lab. Methods: Chart review was performed to compare patients sedated between September, 2017 and October, 2019 using chloral hydrate and intranasal dexmedetomidine. Vital signs, time to sedation, duration of sedation, need for second dose of medication, rate of failed sedation, and impact on vital signs were compared between groups. Subgroup analysis was performed for those with complex and cyanotic heart disease. Results: Chloral hydrate was used in 356 patients and intranasal dexmedetomidine in 376. Patient age, complexity of heart disease, and duration of sedation were similar. Rates of failed sedation were very low and similar. Average heart rate and minimum heart rate were lower for those receiving intranasal dexmedetomidine than chloral hydrate. Impact on vital signs was similar for those with complex and cyanotic heart disease. No adverse events occurred in either group. Conclusions: Sedation with intranasal dexmedetomidine is comparable to chloral hydrate in regards to safety and efficacy for children requiring echocardiography. Consistent with the mechanism of action, patients receiving intranasal dexmedetomidine have a lower heart rate without morbidity.

Have Duchenne Muscular Dystrophy Patients an Increased Cancer Risk?

2021 ◽  
pp. 1-5
Author(s):  
Gian Luca Vita ◽  
Luisa Politano ◽  
Angela Berardinelli ◽  
Giuseppe Vita
Keyword(s):  
Duchenne Muscular Dystrophy ◽  
Muscular Dystrophy ◽  
Systematic Investigation ◽  
Mdx Mice ◽  
True Incidence ◽  
Patients With Cancer ◽  
Dmd Gene ◽  
Age Range ◽  
Prevalence Of Cancer

Background: Increasing evidence suggests that Duchenne muscular dystrophy (DMD) gene is involved in the occurrence of different types of cancer. Moreover, development of sarcomas was reported in mdx mice, the murine model of DMD, in older age. So far, nine isolated DMD patients were reported with concomitant cancer, four of whom with rhabdomyosarcoma (RMS), but no systematic investigation was performed about the true incidence of cancer in DMD. Methods: All members of the Italian Association of Myology were asked about the occurrence of cancer in their DMD patients in the last 30 years. Results: Four DMD patients with cancer were reported after checking 2455 medical records. One developed brain tumour at the age of 35 years. Two patients had alveolar RMS at 14 and 17 years of age. The fourth patient had a benign enchondroma when 11-year-old. Conclusion: Prevalence of cancer in general in the Italian DMD patients does not seem to be different from that in the general population with the same age range. Although the small numbers herein presented do not allow definitive conclusion, the frequent occurrence of RMS in DMD patients raises an alert for basic researchers and clinicians. The role of DMD gene in cancer merits further investigations.

scholarly journals The intersection of COVID-19 and cancer: signaling pathways and treatment implications

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Zhi Zong ◽  
Yujun Wei ◽  
Jiang Ren ◽  
Long Zhang ◽  
Fangfang Zhou
Keyword(s):  
Signaling Pathways ◽  
Health Concern ◽  
Type I ◽  
The Novel ◽  
Checkpoint Signaling ◽  
Patients With Cancer ◽  
Advantages And Disadvantages ◽  
Anticancer Treatment ◽  
Severe Infections ◽  
Novel Coronavirus

AbstractThe outbreak of the novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has emerged as a serious public health concern. Patients with cancer have been disproportionately affected by this pandemic. Increasing evidence has documented that patients with malignancies are highly susceptible to severe infections and mortality from COVID-19. Recent studies have also elucidated the molecular relationship between the two diseases, which may not only help optimize cancer care during the pandemic but also expand the treatment for COVID-19. In this review, we highlight the clinical and molecular similarities between cancer and COVID-19 and summarize the four major signaling pathways at the intersection of COVID-19 and cancer, namely, cytokine, type I interferon (IFN-I), androgen receptor (AR), and immune checkpoint signaling. In addition, we discuss the advantages and disadvantages of repurposing anticancer treatment for the treatment of COVID-19.

scholarly journals FRI0618-HPR EFFECTS OF MUSIC THERAPY ON PAIN, ANXIETY, AND VITAL SIGNS IN CHRONIC INFLAMMATORY RHEUMATIC DISEASES PATIENTS DURING BIOLOGICAL DRUGS INFUSION

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 914.2-914
Author(s):  
S. Boussaid ◽  
M. Ben Majdouba ◽  
S. Jriri ◽  
M. Abbes ◽  
S. Jammali ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Music Therapy ◽  
Systolic Blood Pressure ◽  
Respiratory Rate ◽  
Vital Signs ◽  
Biological Therapies ◽  
Biological Drugs ◽  
Pain Anxiety ◽  
The Mean

Background:Music therapy is based on ancient cross-cultural beliefs that music can have a “healing” effect on mind and body. Research determined that listening to music can increase comfort and relaxation, relieve pain, lower distress, reduce anxiety, improve positive emotions and mood, and decrease psychological symptoms. Music therapy has been used greatly in various medical procedures to reduce associated anxiety and pain. Patients have a high level of anxiety when they are in the hospital, this is the case of patients with rheumatic diseases who consult regularly to have intravenous infusion of biological therapies.Objectives:The purpose of this study was to examine the effectiveness of music therapy on pain, anxiety, and vital signs among patients with chronic inflammatory rheumatic diseases during intravenous infusion of biological drugs.Methods:Fifty patients were divided into two groups: The experimental group G1 (n=25) received drug infusion while lestening to soft music (30 minutes); and the control group G2 (n=25) received only drug infusion. Measures include pain, anxiety, vital signs (blood pressure, heart rate and respiratory rate). The pain was measured using visual analogic scale (VAS). The state-trait anxiety inventory (STAI) was used for measuring anxiety, low anxiety ranges from 20 to 39, the moderate anxiety ranges from 40 to 59, and high anxiety ranges from 60 to 80. Vital signs (systolic blood pressure [SBP], diastolic blood pressure [DBP], heart rate [HR], and respiratory rate [RR]) were measured before, during and immediately after the infusion.Statistical package for social sciences (SPSS) was used for analysis.Results:The mean age in G1 was 44.45 years (26-72) with a sex ratio (M/F) of 0.8. Including the 25 patients, 12 had rheumatoid arthritis, 10 had ankylosing spondylitis and 3 had psoriatic arthritis. The mean disease duration was 8 years. In G2, the mean age was 46 years (25-70) with a sex ratio (M/F) of 0.75, 12 had rheumatoid arthritis, 11 had ankylosing spondylitis and 2 had psoriatic arthritis. The mean disease duration was 7.5 years. The biological drugs used were: Infliximab in 30 cases, Tocilizumab in 12 cases and Rituximab in 8 cases.Before the infusion, the patients of experimental group had a mean VAS of 5/10±3, a mean STAI of 50.62±6.01, a mean SBP of 13.6 cmHg±1.4, a mean DBP of 8.6 cmHg±1, a mean HR of 85±10 and a mean RR of 18±3. While in control group the mean VAS was 5.5±2, the mean STAI was 50.89±5.5, the mean SBP was 13.4±1.2, the mean DBP was 8.8±1.1, the mean HR was 82±8 and the mean RR was 19±2.During the infusion and after music intervention in G1, the mean STAI became 38.35±5 in G1 versus 46.7±5.2 in G2 (p value=0.022), the mean SBP became 12.1±0.5 in G1 versus 13±1 in G2 (p=0.035), the mean DBP became 8.1±0.8 in G1 versus 8.4±0.9 in G2 (p=0.4), the mean HR became 76±9 in G1 versus 78±7 in G2 (p=0.04) and the mean RR became 17.3±2.1 in G1 versus 18.2±1.7 in G2 (p=0.39).This study found a statistically significant decrease in anxiety, systolic blood pressure and heart rate in patients receiving music interventions during biological therapies infusion, but no significant difference were identified in diastolic blood pressure and respiratory rate.Conclusion:The findings provide further evidence to support the use of music therapy to reduce anxiety, and lower systolic blood pressure and heart rate in patients with rheumatic disease during biological therapies infusion.References:[1] Lin, C., Hwang, S., Jiang, P., & Hsiung, N. (2019).Effect of Music Therapy on Pain After Orthopedic Surgery -A Systematic review and Meta-Analysis. Pain Practice.Disclosure of Interests:None declared

scholarly journals Predictive Value of Subacute Heart Rate Variability for Determining Outcome Following Adolescent Concussion

2021 ◽  
Vol 10 (1) ◽  
pp. 161
Author(s):  
Colt A. Coffman ◽  
Jacob J. M. Kay ◽  
Kat M. Saba ◽  
Adam T. Harrison ◽  
Jeffrey P. Holloway ◽  
...  
Keyword(s):  
Heart Rate ◽  
Heart Rate Variability ◽  
Cognitive Performance ◽  
Predictive Value ◽  
System Integration ◽  
Sports Medicine ◽  
Clinical Symptoms ◽  
Physiological Stress ◽  
Neurological Dysfunction ◽  
Neurobehavioral Function

Objective assessments of concussion recovery are crucial for facilitating effective clinical management. However, predictive tools for determining adolescent concussion outcomes are currently limited. Research suggests that heart rate variability (HRV) represents an indirect and objective marker of central and peripheral nervous system integration. Therefore, it may effectively identify underlying deficits and reliably predict the symptomology following concussion. Thus, the present study sought to evaluate the relationship between HRV and adolescent concussion outcomes. Furthermore, we sought to examine its predictive value for assessing outcomes. Fifty-five concussed adolescents (12–17 years old) recruited from a local sports medicine clinic were assessed during the initial subacute evaluation (within 15 days postinjury) and instructed to follow up for a post-acute evaluation. Self-reported clinical and depressive symptoms, neurobehavioral function, and cognitive performance were collected at each timepoint. Short-term HRV metrics via photoplethysmography were obtained under resting conditions and physiological stress. Regression analyses demonstrated significant associations between HRV metrics, clinical symptoms, neurobehavioral function, and cognitive performance at the subacute evaluation. Importantly, the analyses illustrated that subacute HRV metrics significantly predicted diminished post-acute neurobehavioral function and cognitive performance. These findings indicate that subacute HRV metrics may serve as a viable predictive biomarker for identifying underlying neurological dysfunction following concussion and predict late cognitive outcomes.

Catheter-related infections in pediatric patients with cancer

2012 ◽  
Vol 31 (11) ◽  
pp. 2869-2877 ◽  
Author(s):  
V. Cecinati ◽  
L. Brescia ◽  
L. Tagliaferri ◽  
P. Giordano ◽  
S. Esposito
Keyword(s):  
Pediatric Patients ◽  
Patients With Cancer
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