The impact of COVID 19 pandemic on pattern of cancer mortality in Najran, Saudi Arabia: a single-cancer center experience

Abstract Background: Trophoblast cell-surface antigen 2 (TROP2) is expressed on the surface of trophoblast cells and many malignant tumor cells. However, data on TROP2 expression in advanced lung cancer is insufficient, and its changes have not been fully evaluated. Methods: We assessed the prevalence and changes in TROP2 expression in lung cancer patients receiving anti-cancer treatments using immunohistochemical (IHC) analysis with an anti-TROP2 (clone: SP295). IHC scores were graded from 0–3; grade ≥2 was considered positive for TROP2 expression. We defined a difference in IHC score, before and after anti-cancer treatments, as the change in TROP2 expression.Results: Before anti-cancer treatment, TROP2 expression was observed in 89% (143/160) of patients and was significantly more common in adenocarcinoma and squamous cell carcinoma than in neuroendocrine carcinoma (P < 0.001). After anti-cancer treatment, TROP2 expression was observed in 87% (139/160) of patients. The distribution of TROP2 expression in post-treatment samples was analogous to that in pre-treatment samples when compared using the Wilcoxon signed-rank test (P = 0.509). However, an increase in TROP2 expression was seen in 19 (12%), and a decrease in 20 (13%) patients. Patients treated with targeted therapy showed significantly higher changes in TROP2 expression (P = 0.019) and thoracic radiotherapy was more likely to increase TROP2 expression than chemotherapy alone.Conclusion: TROP2 was expressed in most lung cancer specimens before and after anti-cancer treatments. Additionally, some anti-cancer treatments might alter the TROP2 expression. These results may provide a strong rationale for TROP2-directed therapy against advanced lung cancer.

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Maximal Strength Training for Breast Cancer Patients Undergoing Adjuvant Treatment. Doctoral Thesis

10.25143/prom-rsu_2021-07_dt ◽

2021 ◽

Author(s):

◽

Rūdolfs Cešeiko ◽

Keyword(s):

Breast Cancer ◽

Clinical Trials ◽

Muscle Strength ◽

Cancer Treatment ◽

Strength Training ◽

Cancer Patients ◽

Adjuvant Treatment ◽

Primary Therapy ◽

Anti Cancer ◽

The Impact

Objective. Breast cancer (BC) is the most frequently diagnosed type of cancer among women, with more than 2 million new cases and over 600 000 deaths annually (Bray et al., 2018), and its global incidence is steadily rising. BC patients through the cancer continuum experience complex health and psychosocial challenges. BC and anti-cancer treatment accompanied by an inactive lifestyle may further impair muscle strength and muscle force development characteristics. Historically, patients diagnosed with cancer were advises to rest and avoid vigorous activity following their diagnosis, but this dogma has changed markedly over the last 20 years as exercise oncology intervention studies have gained broad acceptance and acknowledgment. Strength training can optimally affect muscles and increased muscle strength may contribute to participation in daily activities, thus potentially improving the health-related quality of life (HRQoL). However, the optimal type, intensity and frequency of strength training, as a part of cancer care, that will most enhance muscle strength during anti-cancer treatment is yet unknown. Christensen et al. (Christensen et al., 2014) investigated newly confirmed (breast, gastric, colorectal, lung and pancreas) cancer patients and concluded that these patients had 0.9 kg lower muscle mass compared with healthy controls even before the initiation of anti-cancer treatment. Furthermore, during adjuvant chemotherapy, BC patients lost 1.3 kg lean body mass (LBM), and continued to lose LBM after therapy was completed. Ultimately, BC survivors evaluated after completion of primary therapy displayed 20–30% lower muscle strength compared with healthy counterparts. Most physical activity interventions for BC patients combine aerobic endurance training with strength training and diverse relaxation therapies, hence making it more complicated to evaluate the impact of training type. There has been a limited number of well-defined clinical trials on BC patients that include higher intensity strength training, moreover when intervention is administered during adjuvant treatment. Training intensities vary substantially across cancer studies ranging from 25–80% of one-repetition maximum (1RM), although, it has been documented that higher training intensities yield greater strength gains in young healthy individuals (Campos et al., 2002). Similarly, greater gains in muscle strength are documented with increasing intensity for cancer patients, however, these patients are likely to have some improvement even at low training intensities (Fairman et al., 2017). The common consent from clinical trials when strength training interventions were applied for cancer patients states that training programs were well tolerated, they are safe, feasible and showed strength improvements that led to improved physical functioning and improved HRQoL (Segal et al., 2003), (De Backer et al., 2007), (Battaglini et al., 2014). Recognizing that training intensity during strength training is a key factor to improve maximal muscular strength and strength related characteristics. Therefore, well-defined training methods with high intensity could also be preferable to induce greater physiological adaptations, thus contribute to faster recovery from specific cancer treatment and enhancing the completion of prescribed anti-cancer treatment.

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Maximal Strength Training for Breast Cancer Patients Undergoing Adjuvant Treatment. Summary of the Doctoral Thesis

10.25143/prom-rsu_2021-07_dts ◽

2021 ◽

Author(s):

◽

Rūdolfs Cešeiko ◽

Keyword(s):

Breast Cancer ◽

Clinical Trials ◽

Muscle Strength ◽

Cancer Treatment ◽

Strength Training ◽

Cancer Patients ◽

Adjuvant Treatment ◽

Primary Therapy ◽

Anti Cancer ◽

The Impact

Objective. Breast cancer (BC) is the most frequently diagnosed type of cancer among women, with more than 2 million new cases and over 600 000 deaths annually (Bray et al., 2018), and its global incidence is steadily rising. BC patients through the cancer continuum experience complex health and psychosocial challenges. BC and anti-cancer treatment accompanied by an inactive lifestyle may further impair muscle strength and muscle force development characteristics. Historically, patients diagnosed with cancer were advises to rest and avoid vigorous activity following their diagnosis, but this dogma has changed markedly over the last 20 years as exercise oncology intervention studies have gained broad acceptance and acknowledgment. Strength training can optimally affect muscles and increased muscle strength may contribute to participation in daily activities, thus potentially improving the health-related quality of life (HRQoL). However, the optimal type, intensity and frequency of strength training, as a part of cancer care, that will most enhance muscle strength during anti-cancer treatment is yet unknown. Christensen et al. (Christensen et al., 2014) investigated newly confirmed (breast, gastric, colorectal, lung and pancreas) cancer patients and concluded that these patients had 0.9 kg lower muscle mass compared with healthy controls even before the initiation of anti-cancer treatment. Furthermore, during adjuvant chemotherapy, BC patients lost 1.3 kg lean body mass (LBM), and continued to lose LBM after therapy was completed. Ultimately, BC survivors evaluated after completion of primary therapy displayed 20–30% lower muscle strength compared with healthy counterparts. Most physical activity interventions for BC patients combine aerobic endurance training with strength training and diverse relaxation therapies, hence making it more complicated to evaluate the impact of training type. There has been a limited number of well-defined clinical trials on BC patients that include higher intensity strength training, moreover when intervention is administered during adjuvant treatment. Training intensities vary substantially across cancer studies ranging from 25–80% of one-repetition maximum (1RM), although, it has been documented that higher training intensities yield greater strength gains in young healthy individuals (Campos et al., 2002). Similarly, greater gains in muscle strength are documented with increasing intensity for cancer patients, however, these patients are likely to have some improvement even at low training intensities (Fairman et al., 2017). The common consent from clinical trials when strength training interventions were applied for cancer patients states that training programs were well tolerated, they are safe, feasible and showed strength improvements that led to improved physical functioning and improved HRQoL (Segal et al., 2003), (De Backer et al., 2007), (Battaglini et al., 2014). Recognizing that training intensity during strength training is a key factor to improve maximal muscular strength and strength related characteristics. Therefore, well-defined training methods with high intensity could also be preferable to induce greater physiological adaptations, thus contribute to faster recovery from specific cancer treatment and enhancing the completion of prescribed anti-cancer treatment.

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Does a treatment delay affect the survival of octogenarian patient population?

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.8_suppl.149 ◽

2017 ◽

Vol 35 (8_suppl) ◽

pp. 149-149

Author(s):

Ali Mehmood Raufi ◽

Hassaan Jafri ◽

Todd W. Gress

Keyword(s):

Cancer Treatment ◽

Cancer Patients ◽

Patient Population ◽

Gynecological Cancer ◽

Eastern Cooperative Oncology Group ◽

Treatment Delay ◽

Comprehensive Cancer Center ◽

Cancer Center ◽

Cancer Management ◽

The Impact

149 Background: The cancer management of the elderly patient is an increasingly important and challenging issue. The aim of this retrospective analysis is to evaluate the impact of treatment delay on survival outcome of cancer in octogenarian patients. Methods: From 2006 to 2015, established cancer patients age 80 and above who received treatment at our comprehensive cancer center were retrospectively reviewed. We evaluated the relationship between a delay in cancer treatment of more than 30 days in the octogenarian patient and survival using Kaplan-Meier survival and Cox proportional hazards models. Results: There were 235 octogenarian cancer patients available for evaluation and 115 of these had a delay in initiation of cancer treatment ( > 30 days). Mean age was 83.7 years the treatment delay (TD) group and 83.9 in the no treatment delay (NTD) group (p = 0.70) Eastern Cooperative Oncology Group (ECOG) score of 2 or more was present in 22.6% of the TD group and 18.3% of the NTD group (p = 0.42). Metastatic disease was higher in the NTD group (22.5% vs. 11.3% TD group; p = 0.051). There were more breast (36.5% TD vs. 12.5% NTD group) and lung cancer (26.9% TD vs. 18.3% NTD group) in the TD group, and more genitourinary (20.8% NTD vs. 9.6% TD group) and gynecological cancer (20.8% NTD vs. 15.6% TD group) in the NTD group (p < 0.001 for overall comparison). Median overall survival was higher in the TD group (50 vs. 24 months NTD group; p = 0.001). Treatment delay was still associated with improved survival even after adjusting for age, gender, ECOG, stage of disease, and type of tumor (HR 0.64, CI 0.44-0.92). Conclusions: We found that a delay in cancer treatment in the octogenarian patient was associated with better overall survivial. Bias in regards to the reasons for the treatment delay may exist and could have affected our results. We attempted to minimize this bias by adjusting for characteristics that influence treatment between our two study groups. Nevertheless, our findings suggest that a delay in cancer treatment at minimum did not adversely affect mortality in this older patient population.

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216. Are Automatic Antimicrobial Stop Orders an Effective Stewardship Tool for Urinary Tract and Intra-Abdominal Infections?

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.260 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S110-S110

Author(s):

Christina Maguire ◽

Dusten T Rose ◽

Theresa Jaso

Keyword(s):

Urinary Tract ◽

Antimicrobial Therapy ◽

Source Control ◽

Clostridioides Difficile ◽

Days Of Therapy ◽

Before And After ◽

The Difference ◽

Tract Infections ◽

Length Of Therapy ◽

The Impact

Abstract Background Automatic antimicrobial stop orders (ASOs) are a stewardship initiative used to decrease days of therapy, prevent resistance, and reduce drug costs. Limited evidence outside of the perioperative setting exists on the effects of ASOs on broad spectrum antimicrobial use, discharge prescription duration, and effects of missed doses. This study aims to evaluate the impact of an ASO policy across a health system of adult academic and community hospitals for treatment of intra-abdominal (IAI) and urinary tract infections (UTI). ASO Outcome Definitions ASO Outcomes Methods This multicenter retrospective cohort study compared patients with IAI and UTI treated before and after implementation of an ASO. Patients over the age of 18 with a diagnosis of UTI or IAI and 48 hours of intravenous (IV) antimicrobial administration were included. Patients unable to achieve IAI source control within 48 hours or those with a concomitant infection were excluded. The primary outcome was the difference in sum length of antimicrobial therapy (LOT). Secondary endpoints include length and days of antimicrobial therapy (DOT) at multiple timepoints, all cause in hospital mortality and readmission, and adverse events such as rates of Clostridioides difficile infection. Outcomes were also evaluated by type of infection, hospital site, and presence of infectious diseases (ID) pharmacist on site. Results This study included 119 patients in the pre-ASO group and 121 patients in the post-ASO group. ASO shortened sum length of therapy (LOT) (12 days vs 11 days respectively; p=0.0364) and sum DOT (15 days vs 12 days respectively; p=0.022). This finding appears to be driven by a decrease in outpatient LOT (p=0.0017) and outpatient DOT (p=0.0034). Conversely, ASO extended empiric IV LOT (p=0.005). All other secondary outcomes were not significant. Ten patients missed doses of antimicrobials due to ASO. Subgroup analyses suggested that one hospital may have influenced outcomes and reduction in LOT was observed primarily in sites without an ID pharmacist on site (p=0.018). Conclusion While implementation of ASO decreases sum length of inpatient and outpatient therapy, it may not influence inpatient length of therapy alone. Moreover, ASOs prolong use of empiric intravenous therapy. Hospitals without an ID pharmacist may benefit most from ASO protocols. Disclosures All Authors: No reported disclosures

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Assessing the impact of chemotherapy-induced nausea and vomiting on patients’ quality of life: An Arabic version of the Functional Living Index-Emesis

Journal of Oncology Pharmacy Practice ◽

10.1177/1078155221998447 ◽

2021 ◽

pp. 107815522199844

Author(s):

Abdullah M Alhammad ◽

Nora Alkhudair ◽

Rawan Alzaidi ◽

Latifa S Almosabhi ◽

Mohammad H Aljawadi

Keyword(s):

Quality Of Life ◽

Cancer Patients ◽

Arabic Language ◽

Nausea And Vomiting ◽

Cancer Center ◽

Arabic Version ◽

Patient Reported ◽

Arabic Speaking ◽

The Impact

Introduction Chemotherapy-induced nausea and vomiting is a serious complication of cancer treatment that compromises patients’ quality of life and treatment adherence, which necessitates regular assessment. Therefore, there is a need to assess patient-reported nausea and vomiting using a validated scale among Arabic speaking cancer patient population. The objective of this study was to translate and validate the Functional Living Index-Emesis (FLIE) instrument in Arabic, a patient-reported outcome measure designed to assess the influence of chemotherapy-induced nausea and vomiting on patients’ quality of life. Methods Linguistic validation of an Arabic-language version was performed. The instrument was administered to cancer patients undergoing chemotherapy in a tertiary hospital's cancer center in Saudi Arabia. Results One-hundred cancer patients who received chemotherapy were enrolled. The participants’ mean age was 53.3 ± 14.9 years, and 50% were female. Half of the participants had a history of nausea and vomiting with previous chemotherapy. The Cronbach coefficient alpha for the FLIE was 0.9606 and 0.9736 for nausea and vomiting domains, respectively, which indicated an excellent reliability for the Arabic FLIE. The mean FLIE score was 110.9 ± 23.5, indicating no or minimal impact on daily life (NIDL). Conclusions The Arabic FLIE is a valid and reliable tool among the Arabic-speaking cancer population. Thus, the Arabic version of the FLIE will be a useful tool to assess the quality of life among Arabic speaking patients receiving chemotherapy. Additionally, the translated instrument will be a useful tool for future research studies to explore new antiemetic treatments among cancer patients.

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P9 A study to investigate the impact of the COVID-19 pandemic on paediatric cancer patients: an international, multicentre, observational cohort study (COVIDPaedsCancer)

BJS Open ◽

10.1093/bjsopen/zrab032.008 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

Author(s):

◽

Soham Bandyopadhyay

Keyword(s):

Cohort Study ◽

Cancer Treatment ◽

Childhood Cancer ◽

Multivariate Logistic Regression Analysis ◽

Global Health Research ◽

Cancer Outcomes ◽

Paediatric Cancer ◽

Cancer Management ◽

Anti Cancer ◽

The Impact

Abstract Introduction Childhood cancers are a leading cause of non-communicable disease deaths for paediatric patients around the world. The COVID-19 pandemic may have impacted on global children’s cancer services, which can have consequences for childhood cancer outcomes. The Global Health Research Group on Children’s Non-Communicable Diseases (Global Children’s NCDs) is currently undertaking the first international study to determine the variation in paediatric cancer management during the COVID-19 pandemic, and the short to medium term impacts on childhood cancer outcomes. Methods and analysis This is a multicentre, international, cohort study that will use routinely collected hospital data in a de-identified and anonymised form. Patients will be recruited consecutively into the study, with a 12 -month follow-up period. Patients will be included if they are below the age of 18 years and undergoing anti-cancer treatment for the following cancers: Acute lymphoblastic leukaemia, Burkitt’s Lymphoma, Hodgkin's lymphoma, Wilms Tumour, Sarcoma, Retinoblastoma, Gliomas, Medulloblastomas and Neuroblastomas. Patients must be newly presented or be undergoing active anti-cancer treatment from the 12th March 2020 to the 12th December 2020. The primary objective of the study is to determine 30- and 90-day all-cause mortality rates. This study will examine the factors that influenced these outcomes. Chi-squared analysis will be used to compare mortality between low and middle-income countries and high-income countries. Multilevel, multivariate logistic regression analysis will be undertaken to identify patient-level and hospital-level factors affecting outcomes with adjustment for confounding factors. Ethics and dissemination At the host centre, this study was deemed to be exempt from ethical committee approval due to the use of anonymised registry data. At other centres, participating collaborators have gained local approvals in accordance with their institutional ethical regulations. Collaborators will be encouraged to present the results locally, nationally, and internationally. The results will be submitted for publication in a peer reviewed journal.

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Celecoxib Analogues for Cancer Treatment: An Update on OSU-03012 and 2,5-Dimethyl-Celecoxib

Biomolecules ◽

10.3390/biom11071049 ◽

2021 ◽

Vol 11 (7) ◽

pp. 1049

Author(s):

Cyril Sobolewski ◽

Noémie Legrand

Keyword(s):

Cancer Treatment ◽

Metabolic Diseases ◽

Catalytic Site ◽

Antitumor Effects ◽

Anti Cancer ◽

Cox 2 ◽

Cox 2 Inhibitors ◽

The Impact ◽

Important Enzyme ◽

Specific Inhibitors

Cyclooxygenase-2 (COX-2) is an important enzyme involved in prostaglandins biosynthesis from arachidonic acid. COX-2 is frequently overexpressed in human cancers and plays a major tumor promoting function. Accordingly, many efforts have been devoted to efficiently target the catalytic site of this enzyme in cancer cells, by using COX-2 specific inhibitors such as celecoxib. However, despite their potent anti-tumor properties, the myriad of detrimental effects associated to the chronic inhibition of COX-2 in healthy tissues, has considerably limited their use in clinic. In addition, increasing evidence indicate that these anti-cancerous properties are not strictly dependent on the inhibition of the catalytic site. These findings have led to the development of non-active COX-2 inhibitors analogues aiming at preserving the antitumor effects of COX-2 inhibitors without their side effects. Among them, two celecoxib derivatives, 2,5-Dimethyl-Celecoxib and OSU-03012, have been developed and suggested for the treatment of viral (e.g., recently SARS-CoV-2), inflammatory, metabolic diseases and cancers. These molecules display stronger anti-tumor properties than celecoxib and thus may represent promising anti-cancer molecules. In this review, we discuss the impact of these two analogues on cancerous processes but also their potential for cancer treatment alone or in combination with existing approaches.

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The impact of a ‘milking the COW’ campaign in a regional hospital in Singapore

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-021-00948-1 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Surinder Kaur M. S. Pada ◽

Poh Lishi ◽

Kim Sim Ng ◽

Sarathamani Rethenam ◽

Lilibeth Silagan Alenton ◽

...

Keyword(s):

Hand Hygiene ◽

Pathogenic Bacteria ◽

Mixed Model ◽

Mixed Model Analysis ◽

Colony Forming Units ◽

Skin Flora ◽

Before And After ◽

The Difference ◽

And Control ◽

The Impact

Abstract Background Computerisation of various processes in hospitals and reliance on electronic devices raises the concern of contamination of these devices from the patient environment. We undertook this study to determine if an attached hand hygiene device that unlocks the screen of a computer on wheels (COW) on usage can be effective in decreasing the microbiological burden on computer keyboards. Methods An electronic hand sanitizer was integrated onto the COW. A prospective cohort study with a crossover design involving 2 control and 2 intervention wards was used. The study end point was the number of colony forming units found on the keyboards. Bacteria were classified into 4 main groups; pathogenic, skin flora, from the environment or those thought to be commensals in healthy individuals. We then used a mixed effects model for the statistical analysis to determine if there were any differences before and after the intervention. Results Thirty-nine keyboards were swabbed at baseline, day 7 and 14, with 234 keyboards cultured, colony forming units (CFUs) counted and organisms isolated. By mixed model analysis, the difference of mean bacteria count between intervention and control for week 1 was 32.74 (− 32.74, CI − 94.29 to 28.75, p = 0.29), for week 2 by 155.86 (− 155.86, CI − 227.45 to − 83.53, p < 0.0001), and after the 2-week period by 157.04 (− 157.04, CI − 231.53 to − 82.67, p < 0.0001). In the sub-analysis, there were significant differences of pathogenic bacteria counts for the Intervention as compared to the Control in contrast with commensal counts. Conclusion A hand hygiene device attached to a COW may be effective in decreasing the microbiological burden on computer keyboards.

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Impact of Louisiana’s HPV Vaccine Awareness Policy on HPV Vaccination Among 13- to 17-Year-Old Females

Health Education & Behavior ◽

10.1177/1090198116684766 ◽

2017 ◽

Vol 44 (4) ◽

pp. 548-558 ◽

Cited By ~ 3

Author(s):

Dudith Pierre-Victor ◽

Mary Jo Trepka ◽

Timothy F. Page ◽

Tan Li ◽

Dionne P. Stephens ◽

...

Keyword(s):

Hpv Vaccine ◽

Hpv Vaccination ◽

Female Adolescents ◽

Physician Recommendation ◽

Vaccination Rates ◽

National Immunization ◽

Before And After ◽

The Difference ◽

Vaccine Information ◽

The Impact

The Advisory Committee on Immunization Practices recommends routine human papillomavirus (HPV) immunization for 11- to 12-year-old adolescents. In 2008, Louisiana required the school boards to distribute HPV vaccine information to parents or guardian of students in Grades 6 to 12. This article investigates the impact of this policy on HPV vaccination among 13- to 17-year-old female adolescents using National Immunization Survey-Teen (NIS-Teen) data. Drawing on the data from the 2008 to 2012 NIS-Teen, we compared the difference in proportions of females who have been vaccinated before and after the policy. Using difference-indifference estimation, we explored the change in vaccination rates before and after the policy implementation in Louisiana compared with Alabama and Mississippi, two states that did not have such a policy in place. The difference-in-differences estimates for HPV vaccination were not significant. Physician recommendation for HPV vaccination was significantly associated with vaccination among females in Louisiana and Alabama (adjusted odds ratio [aOR] = 7.74; 95% confidence interval [CI; 5.22, 11.5]), and for those in Louisiana and Mississippi (aOR = 7.05; 95% CI [4.6, 10.5]). Compared to the proportion of female adolescents who had received physician recommendation in Alabama or Mississippi, the proportion in Louisiana did not increase significantly in the postpolicy period. HPV vaccination rates did not increase significantly in Louisiana compared to Alabama or Mississippi following the implementation of the policy. Despite Louisiana’s policy, physician recommendation remains the key determinant of HPV vaccination. HPV vaccine awareness does not necessarily result in HPV vaccination.

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