scholarly journals Continuous Intravenous Administration of Granulocyte-Colony-Stimulating Factors—A Breakthrough in the Treatment of Cancer Patients with Febrile Neutropenia

Medicina ◽  
2021 ◽  
Vol 57 (7) ◽  
pp. 675
Author(s):  
Călin Căinap ◽  
Sânziana Cetean-Gheorghe ◽  
Laura Ancuta Pop ◽  
Daniel Corneliu Leucuta ◽  
Doina Piciu ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Recovery Time ◽  
Severe Side Effect ◽  
Colony Stimulating Factors ◽  
Reactive Protein ◽  
Grade 5 ◽  
History Of ◽  
Male Patients ◽  
Number Of Cycles ◽  
A Prospective Study

(1) Background: Febrile neutropenia (FN) remains one of the most challenging problems in medical oncology and is a very severe side effect of chemotherapy. Its late consequences, when it is recurrent or of a severe grade, are dose reduction and therapy delays. Current guidelines allow the administration of granulocyte-colony-stimulating factors (G-CSF) for profound FN (except for the case when a pegylated form of G-CSF is administrated with prophylactic intention) in addition to antibiotics and supportive care. (2) Methods: This is a prospective study that included 96 patients with confirmed malignancy, treated with chemotherapy, who developed FN during their oncological therapy, and were hospitalized. They received standard treatment plus a dose of G-CSF of 16 µg/Kg/day IV continuous infusion. (3) Results: The gender distribution was almost symmetrical: Male patients made up 48.96% and 51.04% were female patients, with no significance on recovery from FN (p = 1.00). The patients who received prophylactic G-CSF made up 20.21%, but this was not a predictive or prognostic factor for the recovery time from aplasia (p = 0.34). The median chemotherapy line where patients with FN were included was two and the number of previous chemotherapy cycles before FN was three. The median serological number of neutrophils (PMN) was 450/mm3 and leucocytes (WBC) 1875/mm3 at the time of FN. Ten patients possess PMN less than 100/mm3. The median time to recovery was 25.5 h for 96 included patients, with one failure in which the patient possessed grade 5 FN. Predictive factors for shorter recovery time were lower levels of C reactive protein (p < 0.001) and procalcitonin (p = 0.002) upon hospital admission and higher WBC (p = 0.006) and PMN (p < 0.001) at the time of the provoking cycle of chemotherapy for FN. The best chance for a shorter duration of FN was a short history of chemotherapy regarding the number of cycles) (p < 0.0001). (4) Conclusions: Continuous IV administration of G-CSF could be an alternative salvage treatment for patients with profound febrile neutropenia, with a very fast recovery time for neutrophiles.

scholarly journals Clinical profile and surgical management of primary vaginal hydrocele: our experience in a rural India

2017 ◽  
Vol 4 (5) ◽  
pp. 1653
Author(s):  
Mohd Hamid Shafique Ahmed ◽  
Bankar S. S. ◽  
Gosavi V. S. ◽  
Dalavi S. B. ◽  
Gurav P. D.
Keyword(s):  
Wound Infection ◽  
Surgical Management ◽  
Surgical Procedures ◽  
Clinical Profile ◽  
Medical College ◽  
History Of ◽  
Male Patients ◽  
A Prospective Study ◽  
Age Range

Background: Hydrocele is one of the commonest diseases occurring worldwide. Since olden days surgical procedures have been described for the treatment of hydrocele. Aim of the study was to analyse the clinical profile, diagnosis and surgical management of primary vaginal hydrocele in adults (>12 years)Methods: A prospective study of 60 male patients of age range of more than 12 years with a history of scrotal swellings were studied for their clinical profiles, diagnosis and management. The study was carried out in Government Medical College, Miraj, Maharashtra, India from November 2010 to November 2012. In the present study Jaboulay's Procedure was performed on 48 patients and Lord's Procedure was performed on 12 patients.Results: The data was collected and results were analysed. Post-operatively about 1.6% of patients developed hematoma, 5% developed wound infection, 21.66% of the patients developed skin oedema and only 1 patient i.e 1.6 % had recurrence over a period of 2 years of follow up. Out of the total 60 patients,12 patients who underwent Lord's plication 8.33%,0%,0% developed skin oedema, hematoma and wound infection respectively as compared to 25%,2.08%,6.25% in the remaining 48 patients who underwent Jaboulay's procedure, respectively.Conclusions: These two surgical procedures were very safe, easy to perform and economical and associated with minimal recurrence. Lord's procedure has lesser incidence of post-operative complications as compared to Jaboulay's procedure.

A breakthrough in treatment of cancer patients with grade 4/profound febrile neutropenia.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14513-e14513
Author(s):  
Calin Ioan Cainap ◽  
Simona Sorana Cainap ◽  
Sanziana Cetean- Gheorghe ◽  
Daniel Corneliu Leucuta ◽  
Ovidiu Vasile Bochis ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Protein C ◽  
Severe Renal Impairment ◽  
Chemotherapy Treatment ◽  
Reactive Protein ◽  
Myeloablative Chemotherapy ◽  
Hospitalised Patients ◽  
Life Threatening ◽  
History Of ◽  
Time Of Administration

e14513 Background: febrile neutropenia (FN) remains one of the most serious side effects of chemotherapy treatment, which is life-threatening. Late consequence of FN is dose reduction and delaying of therapies. Actual guidelines allows granulocyte-colony-stimulating factors (G-CSF) in management of profound FN in addition to antibiotics and supportive care Methods: it is an original prospective study, approved by local ethics comitee, which included 73 patients with confirmed malignancy, treated in our Institute with chemotherapy, who developed febrile neutropenia (FN) and were hospitalised. Patients with myeloablative chemotherapy and bone marrow transplantation support, severe renal impairment, abnormal liver function or with a history of allergic reactions to the antibiotics were excluded from the study. There were recorded 96 episodes of grade 4 FN (1-3 episodes / patients). Each of one was hospitalised according to institutional guideline but with a dose of G-CSF of 16 µg/Kg/day i.v. continous infusion Results: median age of included patients was 59 years, with approximately 48 % male and 52% female, whithout significance in terms of recovery from FN (p = 1.00). 30% of the patients had prophilactic G-CSF administrated, but not significant for recovery from aplasia for included patients (p = 0.34). Median chemotherapy line responsible for FN was 2, and median cycle which produced FN was 3. Median level of neutrophiles (PMN) 450/mm3 and leucocytes (WBC) 1875/ mm3 at time of FN, 10 patients being in profound FN (PMN < 100/mm3). Median time to recovery was 25.5 hours for 72 included patients, with 1 patient dead whithout recovery. Predictive factors for shortened recovery were lower levels of reactive protein C (p < 0.001) and procalcitonine (p = 0.002) and higher WBC (p = 0.006) and PMN (p < 0.001) at time of administration of responsible chemotherapy regimen for FN. The earlier cycle responsible, between a line of chemotherapy, for FN, the better chance for patient to have shortened duration of FN (p < 0.0001). Conclusions: continous i.v. administration of G-CSF could represents a very effective alternative for patients with profound febrile neutropenia, with the shortest ever reported interval for neutrophiles recovery

scholarly journals Procalcitonin and C-Reactive Protein As Markers of Bacteremia in Patients With Febrile Neutropenia Who Receive Chemotherapy for Acute Leukemia: A Prospective Study From Nepal

2019 ◽  
pp. 1-6 ◽  
Author(s):  
Ramila Shilpakar ◽  
Bishnu Dutta Paudel ◽  
Prakash Neupane ◽  
Aarati Shah ◽  
Bibek Acharya ◽  
...  
Keyword(s):  
Febrile Neutropenia ◽  
Acute Leukemia ◽  
Carbapenem Resistance ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Culture Sensitivity ◽  
Gram Negative Bacteremia ◽  
Study Population ◽  
A Prospective Study

PURPOSE The purpose of this study was to evaluate the clinical significance of the biomarkers procalcitonin (PCT) and C-reactive protein (CRP) in patients with febrile neutropenia (FN) undergoing chemotherapy for acute leukemia. METHODS We conducted a prospective, observational study in patients who developed FN while undergoing chemotherapy for acute leukemia. PCT and CRP were obtained in patients who presented with FN. Blood cultures also were obtained. The primary goals were to evaluate the ability of PCT and CRP to predict bacteremia in patients with FN. The secondary goals were to assess the prognostic role of PCT and CRP and to assess the microbiologic profile and culture sensitivity patterns in the study population. RESULTS A total of 124 episodes of FN that involved 67 patients with acute leukemia occurred in the study. PCT was superior to CRP in the prediction of bacteremia. The median PCT level in the bacteremia group was 3.25 ng/mL compared with 0.51 ng/mL in the group without bacteremia ( P < .01). The median values of CRP in the bacteremia and without-bacteremia groups were 119.3 mg/L and 94.5 mg/L, respectively ( P = .07). There were no differences in median PCT and CRP in patients who died and those who improved. Of the 42 positive cultures, Gram-negative bacteremia was common (86%), and Escherichia coli was the most frequent organism isolated. Carbapenem resistance was seen in 39% of positive cultures. CONCLUSION PCT is an effective biomarker to predict bacteremia in patients with FN undergoing chemotherapy for acute leukemia.

scholarly journals A prospective study of erectile dysfunction in men after pelvic surgical procedures and its association with non - modifiable risk factors

2019 ◽  
Author(s):  
Sofia Artemi ◽  
Panteleimon Vassiliu ◽  
Nikolaos Arkadopoulos ◽  
Maria - Eleni Smyrnioti ◽  
Pavlos Sarafis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Erectile Dysfunction ◽  
Erectile Function ◽  
Pelvic Surgery ◽  
Modifiable Risk Factors ◽  
Analysis Model ◽  
History Of ◽  
Male Patients ◽  
A Prospective Study

Abstract Objective: Erectile dysfunction can be caused iatrogenically, due to pelvic surgery. The purpose of this study was to evaluate sexual function at various times after pelvic surgery in male patients and to investigate the non-modifiable risk factors associated with the presence and intensity of sexuality in these patients. Results: The mean age of the participants was 66.16 ± 13.07 years old. Regarding comorbidity, 47.2% reported various cardiovascular problems, 20.8% hypertension, 9.4% diabetes mellitus and 5.7% depression. A history of colectomy was present in 36.8%, 18.9% had undergone sigmoidectomy, and 33% inguinal hernia repair. The percentage of severe erectile function increased from 38.7% before surgery to 48.1% (25% increase) after surgery, at the end of the follow-up period (p <0.05). In the multivariate analysis model, age emerged as an independent predictor of erectile function ( p <0.001). Age was the most important determinant of the IIEF score, which was aggravated by 25% from the first to the last assessment of patients.

scholarly journals ACUTE CORONARY SYNDROME;

2017 ◽  
Vol 24 (08) ◽  
pp. 1185-1189
Author(s):  
Abubakar Maqbool ◽  
Naeem Asghar ◽  
Shakeel Ahmad
Keyword(s):  
Acute Coronary Syndrome ◽  
Unstable Angina ◽  
Clinical Presentation ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
Agglutination Method ◽  
History Of ◽  
Male Patients ◽  
The Mean

Introduction: Atherosclerosis is intrinsically an inflammatory disease. Numerousstudies has shown that elevated levels of C-reactive protein (CRP) are associated with increasedcardiovascular risk. The objectives of this study was to determine the correlation of clinicaloutcome in terms of 30 day mortality with various level of C-reactive proteins among patientspresenting with acute coronary syndrome Study Design: Descriptive. Setting: Department ofCardiology, Punjab Institute of Cardiology Lahore. Period: 06 months. Material and Methods:Total 250 patients presented in emergency department and diagnosed as cases of acutecoronary syndrome base on history of chest pain, ECG and cardiac biochemical markers wereincluded in the study. Management of ACS was continued while CRP levels of each patientwere measured by latest Agglutination method. Results: Our study included 250 patients withacute coronary syndrome with a mean age of 52.90±10.34 years. Male patients were 220(88%). Regarding the clinical presentation of patients, 20 (8%) had unstable angina, 95(38%)had NSTEMI and 135 (54%) had STEMI.CRP level were measured, 184(73.6%) patients hadCRP levels < 22mg/L with mortality of 12 (6.5%) at 30 days and 66 (26.4%) patients hadCRP levels >22mg/L with mortality of which 13(19.6%) at 30 days. The mean CRP level was17.9±12.47, 18.08±15.73 and 22.38 + 17.92 for patients with unstable angina, NSTEMI andSTEMI respectively. The stratification of data for effect modifiers showed that 60(24%) patientshad diabetes, 138 (55.2%) patients had hypertension and 65(26%) patients were smokers.Conclusion: Patients having higher CRP levels had higher risk of 30 day mortality.

scholarly journals THE SIZE PROFILE OF EXTERNAL URETHRAL ORIFICIUM IN MALE ADULT

2019 ◽  
Vol 26 (1) ◽  
Author(s):  
Gaeta Nurprimavera Susanto ◽  
Raden Danarto ◽  
Zulfikar Ali
Keyword(s):  
General Hospital ◽  
Adult Male ◽  
Primary Data ◽  
Male Adult ◽  
Size Profile ◽  
History Of ◽  
Kolmogorov Smirnov ◽  
Male Patients ◽  
Average Size ◽  
A Prospective Study

Objective: External urethral orificium (EUO) is the outermost part of the urethra. It lies on the outside, then the operation tool for endourology transurethra must pass urethra meatus externus first before they can go deeper. Unfortunately there is no study addresses the size of EUO of male adults in Indonesia. This study was aimed to know the size of the EUO in males adult. Material & Methods: This study was a prospective study by taking the primary data in the Sardjito General Hospital and Kardinah General Hospital, Tegal and implemented during the period from October to December 2016. There were 50 samples of males adult. The exclusion criteria in this study were male patients with meatal stenosis or patients with a history of surgery on the penis or instrumentation of the urethra. External urethra orifice size measurements performed with a digital caliper, and then converted to scale the size of Fr. The data were then analyzed by Npar test with the Kolmogorov-Smirnov test, and then T-test with linear regression. Results: There were 50 adult male patients with a mean age of 52.54 ± 10.34 years. For sizes vary with the size of 16.5-26.4 Fr. From the analysis of the size of the EUO obtained a mean size of 22.72 ± 2.62 for Indonesian adult male. Conclusion: The average size of the adult male EUO was 22.72 ± 2.62 Fr. 

Renal Impairment in Young Patients with Unilateral Ureteral Lithiasis Obstruction: What Factors can be Responsible?

2018 ◽  
Vol 69 (2) ◽  
pp. 375-378
Author(s):  
Catalin Pricop ◽  
Ileana Adela Vacaroiu ◽  
Daniela Radulescu ◽  
Daniel Andone ◽  
Dragos Puia
Keyword(s):  
Renal Impairment ◽  
Serum Creatinine ◽  
Young Patients ◽  
Kidney Injury ◽  
Contralateral Kidney ◽  
Reactive Protein ◽  
Ureteral Lithiasis ◽  
Unilateral Hydronephrosis ◽  
Duration Of Hospitalization ◽  
History Of

In the literature, occurrence of acute kidney injury (AKI) in young patients with unilateral ureteral lithiasic obstruction and without previous renal impairment is not very often reported, and the underlined pathophysiological mechanisms are poorly known; according to some studies, it is a false kidney failure, the increase in serum creatinine being due to absorbtion of obstructed urine in the affected kidney. We have conducted a retro and prospective study in order to identify the possible risk factors that can cause renal function impairment in young patients (18-40 years) with unilateral ureteral lithiasis obstruction and a normal contralateral kidney. Results. From 402 patients included in the study, 20.64% (83 cases) presented with serum creatinine ] 1.3 mg/dL. In patients with renal impairment, prevalence of male gender and history of NSAIDS use before admission were significantly higher than in non-AKI group. Serum urea/creatinine ratio, and estimated glomerular filtration rate (MDRD formula) were significantly higher, and respectively lower in AKI group. We found no significant differences between the two groups regarding age, prevalence of urinary tract infection after relief of obstruction, C-reactive protein value, and the duration of hospitalization. Conclusions. AKI in young patients with unilateral ureteral lithiasis obstruction and normal contralateral kidney is not quite a rare finding in our region. NSAIDs use can influence development of AKI, and should be used cautiously even in young patients with renal colic. In our opinion, the presence of AKI in patients with unilateral hydronephrosis demands urgent endourological intervention. Choosing conservative therapy in these patients, especially treatment with NSAIDS may aggravate the renal dysfunction.

Bone Marrow Culture Yield for the Diagnosis of Opportunistic Diseases in Patients with AIDS and Disseminated Kaposi Sarcoma

2020 ◽  
Vol 18 (4) ◽  
pp. 277-282
Author(s):  
P. Cornejo-Juárez ◽  
B. Islas-Muñoz ◽  
A.F. Ramírez-Ibargüen ◽  
G. Rosales-Pedraza ◽  
B. Chávez-Mazari ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Complete Blood Count ◽  
Kaposi Sarcoma ◽  
Opportunistic Pathogens ◽  
Reactive Protein ◽  
Negative Results ◽  
Recent Diagnosis ◽  
Male Patients ◽  
Liver Tests ◽  
Rule Out

Background: Disseminated Kaposi sarcoma (DKS) is present in patients with advanced HIV infection in whom co-infection with other opportunistic pathogens can occur. Bone marrow (BM) aspirate and biopsy comprises a robust diagnostic tool in patients with fever, cytopenias, and abnormal liver tests. However, the yield in patients with DKS has not been determined. Objective: The aim of this study was to evaluate the utility of BM aspirate and biopsy in patients with DKS. Methods: We included 40 male patients with recent diagnosis of DKS. BM aspirate and biopsy was performed as part of the workup to rule out co-infections. Results: In four patients, Mycobacterium avium complex (MAC) was recovered from culture. In another four patients, intracellular yeasts were observed in the Grocott stain, diagnosed as Histoplasma. The yield of BM was calculated in 20%. Only 12 patients (30%) had fever and 11 (27.5%) had pancytopenia. Alkaline phosphatase (ALP) above normal values and C-reactive protein (CRP) were higher in patients with positive results for BM than in those with negative results (63% vs. 21.9%, and 3.0 vs. 1.2 mg/L; p = 0.03 in both comparisons). No differences were found on comparing complete blood-count abnormalities. Conclusion: We recommend performing a BM aspirate for stains, culture, and biopsy in all HIV patients with DKS, as this will permit the early diagnosis of co-infections and prevent further complications in those who receive chemotherapy.

scholarly journals Ectopic pregnancy in a tertiary care centre of Jharkhand, India

2019 ◽  
Vol 8 (8) ◽  
pp. 2969
Author(s):  
Meetali Parashar ◽  
Meena Mehta
Keyword(s):  
Ectopic Pregnancy ◽  
Clinical Presentation ◽  
Previous History ◽  
First Trimester ◽  
Near Miss ◽  
Obstetrics And Gynaecology ◽  
Maternal Morbidity And Mortality ◽  
History Of ◽  
Β Hcg ◽  
A Prospective Study

Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions:Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.Background: Ectopic pregnancy is one in which the fertilized ovum is implanted and develops outside the endometrial cavity. It is an important cause of maternal morbidity and mortality in first trimester. The present study was conducted to study the risk factors, clinical presentation and management of ectopic pregnancy in RIMS, Ranchi, Jharkhand, India.Methods: This was a prospective study conducted in the department of obstetrics and gynaecology, RIMS, Ranchi, Jharkhand during May 2017 to September 2018. A total of 90 cases were included in the study.Results: 80% of the patients presented with amenorrhoea, 98% had abdominal pain and 69% had vaginal bleeding. Ultrasonography revealed hemoperitoneum in about 93% patients. 16 (18%) patients had history of infertility whereas 10 patients (11%) had taken treatment of infertility.6 (7%) patients had history of STD or PID.14 (16%) had undergone bilateral tubectomy.2 (2%) had history of IUCD insertion and 12 (13%) patients had undergone previously lscs. 54 patients (60%) had undergone D and C and 6 patients (7%) had a previous history of ectopic pregnancy. 68 (76%) underwent only salpingectomy.12 (13%) had salpingo-oophorectomy and 10 (11%) had salpingectomy with contralateral tubectomy.Conclusions: Diagnosis of ectopic pregnancy requires clinical suspicion and supportive investigations like UPT, ultrasonography, β HCG and laparoscopy. It is an important cause of admission to RIMS as maternal near miss cases.

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