Assessment of Peripheral Intravenous Catheter Site in Oncologic Patients Receiving Chemotherapy: Delphi Technique

2021 ◽  
Vol 104 (7) ◽  
pp. 1124-1131
Keyword(s):  
Cancer Patients ◽  
Delphi Technique ◽  
Blood Stream ◽  
Chemotherapeutic Agents ◽  
Dominant Hand ◽  
Upper Arm ◽  
Antecubital Fossa ◽  
Oncologic Patients ◽  
Peripheral Intravenous Catheter ◽  
And Control

Background: A peripheral intravenous catheterization is performed for injecting therapeutic agents into the blood stream. However, it is not easily done in most cancer patients due to the abnormalities of blood vessels because of the repetition of intravenous insertion as well as toxicity of the chemotherapeutic agents. Objective: To study the proper venipuncture sites for chemotherapy in cancer patients. Materials and Methods: Using the Delphi technique, nine of the ten experts, with more than seven years of experience, volunteered to respond to the Likert rating questionnaires. Results: All participants accomplished the study without procedure-related problems. Items concerning peripheral intravenous assessment on the dorsum of hand, forearm, antecubital fossa, and upper arm on the first, second, and third round were 58.3%, 58.3%, 58.3% and 48.3%; 71.6%, 71.6%, 73.3%, and 60.0%; 78.3%, 75.0%, 76.6%, and 65.0%, respectively. Discussion: Veins located on the dorsum of hand were preferred in the first rank due to the facility to identify as well as to care, clean and control infection. This was followed by antecubital veins for its larger size, small risks of thrombophlebitis, and less irritation during chemotherapy, and veins at the forearm for its facilitating self-care management, as well as preventing dislodgement and occlusion. Conclusion: The dorsum of hand followed by the antecubital fossa, forearm and upper arm of the non-dominant hand were the favorable sites of venipuncture for all cancer patients. Keywords: Delphi Technique; Venipuncture sites; Chemotherapy

scholarly journals Breast Radiotherapy-Related Cardiotoxicity. When, How, Why. Risk Prevention and Control Strategies

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1712
Author(s):  
Ana Aurora Díaz-Gavela ◽  
Lourdes Figueiras-Graillet ◽  
Ángel Montero Luis ◽  
Juliana Salas Segura ◽  
Raquel Ciérvide ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Prevention And Control ◽  
Cardiovascular Health ◽  
Control Strategies ◽  
Risk Prevention ◽  
Breast Cancer Patients ◽  
Cancer Management ◽  
Oncologic Patients ◽  
And Control

In recent decades, improvements in breast cancer management have increased overall patient survival; however, many cancer therapies have been linked to an important risk of cardiovascular adverse events. Cardio-oncology has been proposed as an emerging specialty to coordinate preventive strategies that improve the cardiovascular health of oncologic patients. It employs the most suitable personalized multidisciplinary management approach for each patient to optimize their cardiovascular health and improve their survival and quality of life. Radiotherapy is an essential part of the therapeutic regimen in breast cancer patients but can also increase the risk of cardiovascular disease. Therefore, minimizing the negative impact of radiation therapy is an important challenge for radiotherapy oncologists and cardiologists specializing in this field. The aim of the present review is to update our knowledge about radiation-induced cardiotoxicity in breast cancer patients by undertaking a critical review of the relevant literature to determine risk prevention and control strategies currently available.

Prevalence of Major Cardiac Events of Anthracycline-Induced Cardiotoxicity in Southwestern Iran: Different Response Patterns to Cumulative Dose

2020 ◽  
Vol 15 (1) ◽  
pp. 78-84
Author(s):  
Mahsa Behrouzian ◽  
Babak Najibi ◽  
Sabahat Haghi ◽  
Chehreh Mahdavi ◽  
Kaveh Jaseb ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Cumulative Dose ◽  
Chemotherapeutic Agents ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Significant Difference ◽  
High Cumulative Dose ◽  
And Control

Background: Anthracyclines are widely used chemotherapeutic agents in several cancers. Since its use, survival improved significantly among cancer patients and has been reported to be up to 80%. However, anthracyclines possess several cardiac, renal and hematological toxicities which limit their use in practice. Cardiotoxicity is still the most important and dose-limiting side effect of anthracycline treatment. Here we aimed to investigate the frequency of anthracyclineinduced cardiomyopathy in pediatric malignancies in Khuzestan Province, Iran. Methods: A total of 112 patients were enrolled in the present study. Patients were allocated to the case or control group based on receiving anthracycline. Echocardiographic examinations were performed by a cardiologist. Electrocardiograms were also recorded. Results: We showed that cancer patients who underwent anthracycline treatment showed cardiomyopathy as defined by lower LVEF (Left Ventricular Ejection Fraction) among patients (p = 0.041). Abnormal LVEF was reported with a frequency of about 9.5% in patients (p = 0.026). However, LVFS (Left Ventricular Fraction Shortening), QRS voltage and QT interval did not differ significantly between treatment and control groups. Our data analysis revealed that this difference is mainly related to high cumulative dose since high cumulative dose of anthracycline (>300 mg/m2) leads to lower LVEF and LVFS and higher QRS voltage in comparison with lower cumulative dose (<300 mg/m2) and control group; but there was no significant difference between low dose and control group. Different age groups and type of malignancy including hematological and solid tumors did not show any significant differences for echocardiographic and electrocardiograms parameters. Conclusion: In our study, lower LVEF among patients who received anthracyclines were mainly related to a high cumulative dose of anthracyclines, which emphasizes the effect of cumulative dose for cardiotoxic effects. Larger studies are needed to investigate possible other risk factors for cardiotoxicity.

KIDNEY INJURY IN CANCER THERAPY

2018 ◽  
Vol 22 (5) ◽  
pp. 17-24 ◽  
Author(s):  
E. V. Burnasheva ◽  
Y. V. Shatokhin ◽  
I. V. Snezhko ◽  
A. A. Matsuga
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Cancer Therapy ◽  
Cancer Patients ◽  
Cytotoxic Effect ◽  
Tumor Lysis Syndrome ◽  
Kidney Injury ◽  
Chemotherapeutic Agents ◽  
Oxygen Intermediates ◽  
Circulating Blood Volume

Кidney injury is a frequent and significant complication of cancer and cancer therapy. The kidneys are susceptible to injury from malignant infiltration, damage by metabolites of malignant cells, glomerular  injury, nephrotoxic drugs including chemotherapeutic agents. Also  bone marrow transplantation complications, infections with immune  suppression (including septicemia), tumor lysis syndrome should be  taken into account. Chemotherapeutic agents are a common cause  of acute kidney injury but can potentially lead to chronic kidney  disease development in cancer patients. This article summarizes risk  factors of acute kidney injury in cancer patients. Risk factors are  divided into two groups. The systemic are decrease of total  circulating blood volume, infiltration of kidney tissue by tumor cells,  dysproteinemia, electrolyte disturbances. The local (renal) risk  factors are microcirculation disturbances, drugs biotransformation  with formation of reactive oxygen intermediates, high concentration of nephrotoxic agents in proximal tubules and its  sensitivity to ischemia. Drug-related risk factors include: drugs  combination with cytotoxic effect high doses long term use necessity, direct cytotoxic effect of not only chemotherapeutic agents but also its metabolites, mean solubility forming intratubular  precipitates. Early diagnosis, timely prevention and treatment of  these complications provide significantly improve nononcologic results of treatment.

scholarly journals Clinical impact of PTEN methylation status as a prognostic marker for breast cancer

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Amal Ramadan ◽  
Maha Hashim ◽  
Amr Abouzid ◽  
Menha Swellam
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Tumor Markers ◽  
Prognostic Marker ◽  
Methylation Status ◽  
Clinical Impact ◽  
Breast Cancer Patients ◽  
Duct Carcinoma ◽  
Cancer Group ◽  
And Control

Abstract Background Aberrant DNA methylation of phosphatase and tensin homolog (PTEN) gene has been found in many cancers. The object of this study was to evaluate the clinical impact of PTEN methylation as a prognostic marker in breast cancer. The study includes 153 newly diagnosed females, and they were divided according to their clinical diagnosis into breast cancer patients (n = 112) and females with benign breast lesion (n = 41). A group of healthy individuals (n = 25) were recruited as control individuals. Breast cancer patients were categorized into early stage (0–I, n = 48) and late stage (II–III, n = 64), and graded into low grade (I–II, n = 42) and high grade (III, n = 70). Their pathological types were invasive duct carcinoma (IDC) (n = 66) and duct carcinoma in situ (DCI) (n = 46). Tumor markers (CEA and CA15.3) were detected using ELISA. DNA was taken away from the blood, and the PTEN promoter methylation level was evaluated using the EpiTect Methyl II PCR method. Results The findings revealed the superiority of PTEN methylation status as a good discriminator of the cancer group from the other two groups (benign and control) with its highest AUC and increased sensitivity (96.4%) and specificity (100%) over tumor markers (50% and 84% for CEA and 49.1% and 86.4% for CA15.3), respectively. The frequency of PTEN methylation was 96.4% of breast cancer patients and none of the benign and controls showed PTEN methylation and the means of PTEN methylation (87 ± 0.6) were significantly increased in blood samples of breast cancer group as compared to both benign and control groups (25 ± 0.7 and 12.6 ± 0.3), respectively. Methylation levels of PTEN were higher in the blood of patients with ER-positive than in patients with ER-negative cancers (P = 0.007) and in HER2 positive vs. HER2 negative tumors (P = 0.001). The Kaplan-Meier analysis recognizes PTEN methylation status as a significant forecaster of bad progression-free survival (PFS) and overall survival (OS), after 40 months follow-up. Conclusions PETN methylation could be supposed as one of the epigenetic aspects influencing the breast cancer prognosis that might foretell more aggressive actions and worse results in breast cancer patients.

scholarly journals IL15RA and SMAD3 Genetic Variants Predict Overall Survival in Metastatic Colorectal Cancer Patients Treated with FOLFIRI Therapy: A New Paradigm

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1705
Author(s):  
Elena De Mattia ◽  
Jerry Polesel ◽  
Rossana Roncato ◽  
Adrien Labriet ◽  
Alessia Bignucolo ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Overall Survival ◽  
Metastatic Colorectal Cancer ◽  
Cancer Patients ◽  
Prognostic Score ◽  
Chemotherapeutic Agents ◽  
Rank Test ◽  
P Value ◽  
Genetic Determinants ◽  
New Paradigm

A new paradigm in cancer chemotherapy derives from the interaction between chemotherapeutics, including irinotecan and 5-fluorouracil (5-FU), and the immune system. The patient’s immune response can modulate chemotherapy effectiveness, and, on the other hand, chemotherapeutic agents can foster tumor cell immunogenicity. On these grounds, the analysis of the cancer patients’ immunogenetic characteristics and their effect on survival after chemotherapy represent a new frontier. This study aims to identify genetic determinants in the immuno-related pathways predictive of overall survival (OS) after FOLFIRI (irinotecan, 5-FU, leucovorin) therapy. Two independent cohorts comprising a total of 335 patients with metastatic colorectal cancer (mCRC) homogeneously treated with first-line FOLFIRI were included in the study. The prognostic effect of 192 tagging genetic polymorphisms in 34 immune-related genes was evaluated using the bead array technology. The IL15RA rs7910212-C allele was associated with worse OS in both discovery (HR: 1.57, p = 0.0327, Bootstrap p-value = 0.0280) and replication (HR:1.71, p = 0.0411) cohorts. Conversely, SMAD3 rs7179840-C allele was associated with better OS in both discovery (HR:0.65, p = 0.0202, Bootstrap p-value = 0.0203) and replication (HR:0.61, p = 0.0216) cohorts. A genetic prognostic score was generated integrating IL15RA-rs7910212 and SMAD3-rs7179840 markers with inflammation-related prognostic polymorphisms we previously identified in the same study population (i.e., PXR [NR1I2]-rs1054190, VDR-rs7299460). The calculated genetic score successfully discriminated patients with different survival probabilities (p < 0.0001 log-rank test). These findings provide new insight on the prognostic value of genetic determinants, such as IL15RA and SMAD3 markers, and could offer a new decision tool to improve the clinical management of patients with mCRC receiving FOLFIRI.

Toxicity Profile of Chemotherapeutic Agents among Cancer Patients Receiving Care in a Nigerian Tertiary Health Care Facility.

2020 ◽  
Vol 1 (5) ◽  
pp. 53-64
Author(s):  
A.A. Biambo ◽  
◽  
U.M. Aliyu ◽  
M.O. Adibe ◽  
A. Samaila ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Liver Enzymes ◽  
Care Facility ◽  
Chemotherapeutic Agents ◽  
T Test ◽  
University Teaching ◽  
Full Blood Count ◽  
Percentage Increase ◽  
Toxicity Profile ◽  
Essentially Normal

Background: Chemotherapeutic agents are among the mainstay of managing cancer patients. However, they are associated with various degrees of toxicity. Objectives: To evaluate the toxicity profile of chemotherapeutic agents among cancer patients receiving care in Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria. Method: Retrospective cross-sectional design and systematic random sampling were used in selecting the records of patients that met the eligibility criteria for the study. Five-year records (2014–2018) of Full Blood Count (FBC), Serum Electrolyte Urea and Creatinine (SrEUCr) and Liver Function Test (LFT) were evaluated for changes from baseline to the end of chemotherapy. The data were compared with standards and analysed using descriptive, t-test and correlation analyses at p<0.05. Results: The mean age of the 260 patients evaluated was 47.1±16.3 years. T-test analysis showed that the percentage changes in the patients’ parameters under FBC and SrEUCr tests were normal while the ones under LFT were abnormal. Patients on platinum-based combinations especially Cisplatin+Fluorouracil+Paclitaxel (87.5±87.4%) and Carboplatin+Paclitaxel (68.4±114.5%) had the highest percentage increase in their overall LFT results while those on Doxorubicin+Cyclophosphamide+Vincristine (4.8±18.7%) and Doxorubicin+ Cyclophosphamide+ Paclitaxel (12.3±27.9%) had the least. The number of chemotherapy cycles was weakly correlated with Hepatotoxicity (r=0.165, p=0.046). Conclusion: The patients had essentially normal FBC and SrEUCr results, however, LFT was abnormal due to the elevation of liver enzymes. Platinum-based combinations especially Cisplatin + Fluorouracil + Paclitaxel and Carboplatin + Paclitaxel had the highest elevation in liver enzymes while Doxorubicin+Cyclophosphamide+Vincristine and Doxorubicin+Cyclophosphamide+Paclitaxel had the least. These findings should be considered by clinicians in managing cancer patients to minimise their medication-related toxicities.

scholarly journals A Case Series of Nontuberculous Mycobacterial Blood Stream Infections Among Non-cancer Patients

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Masako Mizusawa ◽  
Tine Vindenes ◽  
Catharina Armstrong ◽  
Sarah Buckley
Keyword(s):  
Cancer Patients ◽  
Case Series ◽  
Blood Stream ◽  
Blood Stream Infections

What Cancer Patients Want to Know? Questions from Oncologic Patients in a Brazilian Private Cancer Center

2019 ◽  
Author(s):  
João Marcos Cansian ◽  
Tyana Mara Ribas D’Ávila Raymundo de Oliveira ◽  
Augusto Marques Moreira ◽  
Mariana Oliveira Tripoli de Mattos ◽  
Carla Isabel Borré ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Cancer Center ◽  
Oncologic Patients

Outcomes for and Risk Factors Associated With Vancomycin-ResistantEnterococcus faecalisand Vancomycin-ResistantEnterococcus faeciumBacteremia in Cancer Patients

2007 ◽  
Vol 28 (9) ◽  
pp. 1054-1059 ◽  
Author(s):  
G. Ghanem ◽  
R. Hachem ◽  
Y. Jiang ◽  
R. F. Chemaly ◽  
I. Raad
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Mortality Rate ◽  
Cancer Patients ◽  
Independent Risk Factor ◽  
Response To Therapy ◽  
Aminoglycoside Therapy ◽  
Significant Difference ◽  
Vancomycin Resistant ◽  
And Control

Objective.Vancomycin-resistant enterococci (VRE) are a major cause of nosocomial infection. We sought to compare vancomycin-resistant (VR)Enterococcus faecalisbacteremia and VREnterococcus faeciumbacteremia in cancer patients with respect to risk factors, clinical presentation, microbiological characteristics, antimicrobial therapy, and outcomes.Methods.We identified 210 cancer patients with VRE bacteremia who had been treated between January 1996 and December 2004; 16 of these 210 had VRE. faecalisbacteremia and were matched with 32 patients with VRE. faeciumbacteremia and 32 control patients. A retrospective review of medical records was conducted.Results.Logistic regression analysis showed that, compared with VRE. faecalisbacteremia, VRE. faeciumbacteremia was associated with a worse clinical response to therapy (odds ratio [OR], 0.3 [95% confidence interval (CI), 0.07-0.98];P= .046) and a higher overall mortality rate (OR, 8.3 [95% CI, 1.9-35.3];P= .004), but the VRE-related mortality rate did not show a statistically significant difference (OR, 6.8 [95% CI, 0.7-61.8];P= .09). Compared with control patients, patients with VRE. faecalisbacteremia were more likely to have received an aminoglycoside in the 30 days before the onset of bacteremia (OR, 5.8 [95% CI, 1.2-27.6];P= .03), whereas patients with VRE. faeciumbacteremia were more likely to have received a carbapenem in the 30 days before the onset of bacteremia (OR, 11.7 [95% CI, 3.6-38.6];P<.001). In a multivariate model that compared patients with VRE. faeciumbacteremia and control patients, predictors of mortality included acute renal failure on presentation (OR, 15.1 [95% CI, 2.3-99.2];P= .004) and VRE. faeciumbacteremia (OR, 11 [95% CI, 2.7-45.1];P<.001). No difference in outcomes was found between patients with VRE. faecalisbacteremia and control patients.Conclusions.VRE. faeciumbacteremia in cancer patients was associated with a poorer outcome than was VRE. faecalisbacteremia. Recent receipt of carbapenem therapy was an independent risk factor for VRE. faeciumbacteremia, and recent receipt of aminoglycoside therapy was independent risk factor forE. faecalisbacteremia.

scholarly journals Differential Expression of Serum Exosomal miRNAs in Breast Cancer Patients and Healthy Controls

2021 ◽  
Author(s):  
Rahim Asgari ◽  
Jafar Rezaie
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Circulatory System ◽  
Health Concern ◽  
Healthy Controls ◽  
Flow Cytometry Analysis ◽  
Breast Cancer Patients ◽  
Serum Samples ◽  
Exosomal Mirnas ◽  
And Control

Purpose: Breast cancer has become as a serious public health concern worldwide. Breast cancer cells release exosomes into the circulatory system, which are easily accessible for further analysis like cancer diagnosis. In this study, we aimed to investigate expression of circulating exosomal miRNAs (miRs) in the serum of individuals with breast cancer and healthy controls. Methods: Exosomes were collected from serum samples using a commercial kit and characterized by scanning electron microscopy (SEM) and flow cytometry analysis. Expression of miRs such as miR-21, miR-155, miR-182, miR-373, and miR-126 were evaluated by real-time PCR. Results: The result showed that the expression level of exosomal miR-21, miR-155, miR-182, and miR-373 in the serum of breast cancer patients was higher than of those controls (P<0.05). However, expression of miR-126 did not change between breast cancer and control individuals (P>0.05). Conclusion: Our results showed a different miRs expression pattern between breast cancer and healthy samples, supposing potential biomarkers for breast cancer. Further studies focusing on these miRs are required to confirm our findings.

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