scholarly journals Hipertensi pada Pasien Kanker Kolorektal Metastatik dengan Terapi Bevacizumab di RSUP Dr. Kariadi

2020 ◽  
Vol 7 (2) ◽  
pp. 388-392
Author(s):  
Bayu Prio Septiantoro ◽  
Dyah Aryani Perwitasari ◽  
Imaniar Noor Faridah ◽  
Indra Pradipta
Keyword(s):  
Colorectal Cancer ◽  
Medical Records ◽  
Chemotherapy Regimen ◽  
Combination Regimen ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Keywords Colorectal Cancer ◽  
Colorectal Cancer Patients ◽  
Level 2 ◽  
Initial Cycle

Latar belakang: Kanker kolorektal saat ini sudah menjadi penyebab utama ketiga kematian akibat kanker di dunia, penyakit ini membutuhkan terapi yang progresif dimana salah satu terapinya adalah bevacizumab. Namun diketahui bevacizumab dapat menimbulkan hipertensi pada sebagian pasien. Penelitian ini bertujuan untuk untuk mengetahui onset terjadinya hipertensi akibat bevacizumab dengan rejimen kemoterapi apa yang digunakan. Metode: Penelitian ini merupakan sebuah tinjauan deskriptif restrospektif yang dilakukan di RSUP Dr. Kariadi, Semarang. Kriteria inklusi terdiri dari pasien kanker kolorektal metastatik yang berusia ? 18 tahun dengan hipertensi tingkat ?2 berdasarkan NCI CTCAE version 5.0 setelah diberikan terapi bevacizumab 5 mg/kg berat badan  di RSUP Dr. Kariadi. Pengambilan data dalam 1 tahun (bulan April 2018 hingga April 2019) melalui peninjauan dari rekam medis, laporan penggunaan obat bevacizumab dan laporan penggunaan obat kardiovaskuler instalasi farmasi. Kriteria ekslusi dalam penelitian ini yaitu hipertensi tingkat ?2 berdasarkan NCI CTCAE version 5.0 yang muncul setelah ?4 kali waktu paruh bevacizumab (t 1/2 = 20 hari) dari kemoterapi yang terakhir. Hasil: Total 95 pasien sesuai kriteria, sebanyak 24 pasien (25,26%) teridentifikasi mengalami hipertensi tingkat ? 2 berdasarkan NCI CTCAE version 5.0. Dengan 20 pasien (83,33%) pasien mendapatkan kemoterapi rejimen FOLFOX4, sedangkan sisanya (16,66%) dengan rejimen de Gramont. Hipertensi ini muncul sebagian besar pada siklus III, diikuti siklus ke II, ke I dan ke VI. Tidak satupun pasien dengan kombinasi FOLFIRI yang terdeteksi mengalami hipertensi ini. Kesimpulan: Penelitian ini menunjukkan onset munculnya hipertensi tingkat ?2 NCI CTCAE version 5.0 paling banyak adalah pada siklus awal terapi yaitu I-III dan dengan rejimen kombinasi FOLFOX4 + bevacizumab. Kata Kunci: Kanker kolorektal, bevacizumab, hipertensi   Background: Colorectal cancer nowadays is the third leading cause of cancer deaths in the world, this disease requires progressive therapy where one of the treatments is bevacizumab. But it is known that bevacizumab can cause hypertension in some patients. This study aims to determine the onset of the hypertension with chemotherapy regimen used. Method: This research is a retrospective descriptive review conducted at Dr. Kariadi General Hospital, Semarang. Inclusion criteria consisted of metastatic colorectal cancer patients aged ?18 years old with hypertension level ?2 based on NCI CTCAE version 5.0 after being given bevacizumab therapy dose 5 mg/kg body weight. Retrieval of data in 1 year (April 2018 to April 2019) through a review of medical records, reports on the use of bevacizumab drugs and reports on the use of cardiovascular drugs in Department of Pharmacy. The exclusion criteria in this study were hypertension level on NCI CTCAE version 5.0 which appeared after 4 times the half-life of bevacizumab (t 1/2 = 20 days) from the last chemotherapy. Result: Total 95 patients according to the criteria, 24 patients (25.26%) were identified as having hypertension level ? 2 based on NCI CTCAE version 5.0. With 20 patients (83.33%) patients received FOLFOX4 regimen, while the rest (16.66%) with de Gramont regimen. This hypertension occurs mostly in cycle III, followed by cycle II, to I and to VI. None of the patients with a combination of FOLFIRI. Conclusion: This research shows that the onset of hypertension level ?2 NCI CTCAE version 5.0 mostly in the initial cycle of therapy (I-III) with the FOLFOX4 + bevacizumab combination regimen. Keywords: Colorectal cancer, bevacizumab, hypertension  

scholarly journals The bevacizumab plus oxaliplatin-based chemotherapy regimen is more suitable for metastatic colorectal cancer patients with a history of schistosomiasis

2019 ◽  
Author(s):  
Li-Na Zhou ◽  
Li-Qiang Weng ◽  
Chun-Xia Feng ◽  
Yan Zhang ◽  
Ping Li ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Platelet Count ◽  
Liver Fibrosis ◽  
Metastatic Colorectal Cancer ◽  
Medical Records ◽  
Chemotherapy Regimen ◽  
Splenic Enlargement ◽  
History Of ◽  
Colorectal Cancer Patients ◽  
The Impact

Abstract Background: People suffer from schistosomiasis, leading to liver fibrosis, splenomegaly and thrombocytopenia. The effects of bevacizumab plus oxaliplatin or irinotecan-based chemotherapy regimens on platelets are different, but have not been determined. We conducted a retrospective analysis in metastatic colorectal cancer (mCRC) patients evaluating the impact of bevacizumab on platelet, in order to find a more suitable plan for mCRC patients with a history of schistosomiasis.Methods: The medical records of all mCRC patients with a history of schistosomiasis who received FOLFOX or FOLFIRI with or without bevacizumab from September 1, 2017 to June 30, 2019 in Kunshan Hospital were reviewed. Platelet counts and spleen sizes were compared from the first cycle until completion of chemotherapy.Results: Evaluable splenic enlargement and thrombocytopenia results were obtained from 73 Bevacizumab-treated patients and 80 non-bevacizumab treated patients. In patients treated with oxaliplatin, the rates of splenic enlargement (19.5% vs. 66.7%, P=0.01) and thrombocytopenia (31.7% vs. 77.2%, P=0.02) were lower in the bevacizumab-treated cohort than that in the nonbevacizumab cohort. When stratified for irinotecan, there were no statistical differences of frequency of splenic enlargement between the two groups, however, the rates of thrombocytopenia were higher in the bevacizumab-treated cohort than that in the nonbevacizumab cohort (59.4% vs. 8.7%, P=0.01 ).Conclusion: The bevacizumab plus oxaliplatin-based chemotherapy regimen is more suitable for mCRC patients with a history of schistosomiasis, especially for lower platelet count patients.

scholarly journals The association of triglyceride levels with the incidence of initial and recurrent acute pancreatitis

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Robert J. Sanchez ◽  
Wenzhen Ge ◽  
Wenhui Wei ◽  
Manish P. Ponda ◽  
Robert S. Rosenson
Keyword(s):  
Acute Pancreatitis ◽  
Medical Records ◽  
Adult Population ◽  
Baseline Period ◽  
Prior History ◽  
Inclusion Criteria ◽  
Exclusion Criteria ◽  
Recurrent Acute Pancreatitis ◽  
History Of ◽  
Nationally Representative

Abstract Background This retrospective cohort study assessed the annualized incidence rate (IR) of acute pancreatitis (AP) in a nationally representative US adult population, as well as the variation in the risk of AP events across strata of triglyceride (TG) levels. Methods Data were obtained from IQVIA’s US Ambulatory Electronic Medical Records (EMR) database linked with its LRxDx Open Claims database. Inclusion criteria included ≥1 serum TG value during the overlapping study period of the EMR and claims databases, ≥1 claim in the 12-month baseline period, and ≥ 1 claim in the 12 months post index. All TG measurements were assigned to the highest category reached: < 2.26, ≥2.26 to ≤5.65, > 5.65 to ≤9.94, > 9.94, and > 11.29 mmol/L (< 200, ≥200 to ≤500, > 500 to ≤880, > 880, and > 1000 mg/dL, respectively). The outcome of interest was AP, defined as a hospitalization event with AP as the principal diagnosis. Results In total, 7,119,195 patients met the inclusion/exclusion criteria, of whom 4158 (0.058%) had ≥1 AP events in the prior 12 months. Most patients (83%) had TGs < 2.26 mmol/L (< 200 mg/dL), while < 1% had TGs > 9.94 mmol/L (> 880 mg/dL). Overall, the IR of AP was low (0.08%; 95% confidence internal [CI], 0.08–0.08%), but increased with increasing TGs (0.08% in TGs < 2.26 mmol/L [< 200 mg/dL] to 1.21% in TGs > 11.29 mmol/L [> 1000 mg/dL]). In patients with a prior history of AP, the IR of AP increased dramatically; patients with ≥2 AP events at baseline had an IR of 29.98% (95% CI, 25.1–34.9%). Conclusion The risk of AP increases with increasing TG strata; however, the risk increases dramatically among patients with a recent history of AP.

Risk Factors for Febrile Neutropenia among Breast, Lung, and Colorectal Cancer Patients: A Retrospective Analysis of Health Plan Databases

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 4696-4696
Author(s):  
Scott Davi d Ramsey ◽  
Jeannine S McCune ◽  
David K Blough ◽  
Lauren C Clarke ◽  
Cara L McDermott ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Lung Cancer ◽  
Cancer Patients ◽  
Chemotherapy Regimen ◽  
Patient Factors ◽  
Myelosuppressive Chemotherapy ◽  
Chemotherapy Administration ◽  
Factors Influencing ◽  
Colorectal Cancer Patients

Abstract Chemotherapy regimens, patient factors, and the use of colony stimulating factor (CSF) influence cancer patients’ risk for febrile neutropenia (FN) when they receive myelosuppressive chemotherapy. The incidence of FN and patient factors influencing that risk are relatively unknown in community settings. Using claims from Medicare, Medicaid and two private health insurance plan enrollees linked to the Puget Sound SEER registry, we examined the incidence of FN among breast, lung and colorectal cancer patients diagnosed 2002–05 who received adjuvant chemotherapy. We used logistic regression models to determine factors influencing the risk for FN within the first chemotherapy cycle, controlling for cancer stage, age, sex, race, comorbidities, chemotherapy-regimen related FN risk (as designated by the National Comprehensive Cancer Network), CSF use, health insurance type, and surgery or radiation ≤30 days from administration of first chemotherapy. Over the time horizon, 1096 breast, 1142 lung, and 755 colorectal cancer patients received chemotherapy. The incidence of any FN in the first chemotherapy cycle was (counts per 100 recipients by high, intermediate, and low-risk myelosuppressive chemotherapy according to NCCN categories respectively) 7.36, 10.0, 4.70 for breast cancer, 17.12, 14.15, 12.22 for lung cancer, and 25.0, 8.96, 6.37 for colorectal cancer. Significant predictors (p&lt;0.05) of any FN were: breast cancer—radiation ≤ 30 days from first chemotherapy administration (OR 2.90, 95% CI 1.21–6.94), other non-black race vs. white race (OR 2.82, 95% CI 1.29–6.17), or Medicaid insurance (OR 2.31, 95% CI 1.10–4.89); lung cancer—radiation ≤ 30 days from first chemotherapy administration (OR 1.63, 95% CI 1.01–2.61), surgery ≤ 30 days from first chemotherapy administration (OR 2.08, 95% CI 1.02–4.25), Medicaid insurance (OR 2.29, 95% CI 1.08–4.84), or a Charlson comorbidity score ≥ 2 (OR 2.56, 95% CI 1.11–5.91); colorectal cancer—female gender (OR 1.86, 95% CI 1.02–3.41) or high myelosuppressive risk chemotherapy regimen (OR 7.66, 95% CI 2.95–19.89). In this analysis, predictors of FN varied between cancers. Limitations of this analysis include lack of information about chemotherapy and CSF doses, as this is not captured in the SEER registry or claims data. These results indicate that several factors may interact to influence a patient’s likelihood of developing FN in the first cycle of adjuvant chemotherapy.

scholarly journals Optic Nerve Drusen Is Highly Prevalent Among Children With Pseudotumor Cerebri Syndrome

2021 ◽  
Vol 12 ◽  
Author(s):  
Jacob Genizi ◽  
Doron Meiselles ◽  
Elisheva Arnowitz ◽  
Idan Segal ◽  
Rony Cohen ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Medical Records ◽  
Medical Center ◽  
Pseudotumor Cerebri ◽  
Inclusion Criteria ◽  
Increased Intracranial Pressure ◽  
Exclusion Criteria ◽  
Pseudotumor Cerebri Syndrome ◽  
Optic Nerve Drusen ◽  
Rule Out

Introduction: The clinical presentation of pseudotumor cerebri syndrome (PTCS) usually includes headache, nausea, and vomiting with normal physical examination apart from papilledema and diplopia. However, pseudopapilledema, which can be caused by optic nerve drusen, may lead to misdiagnosis. The prevalence of optic nerve drusen in the general population is 0.5–2%. The purpose of our study was to evaluate the prevalence and risk factors of optic nerve drusen among patients with PTCS.Materials and Methods: Medical records of children evaluated in the pediatric department at Bnai Zion Medical Center due to PTCS between 2008 and 2020 were assessed. Inclusion criteria were children age under 18 years with a PTCS diagnosis and ophthalmic B-mode ultrasonography (US). Exclusion criteria were secondary intracranial hypertension.Results: Thirty-four children were included with a mean age 10.1 years which included 50% boys. A majority of the patients, 24 (72.4%), complained of headaches, while 15 (45.5%) complained of transient visual obscuration, and 9 (26.5%) of vomiting. Visual acuity on presentation was normal (20/20–20/30) in 23 of the children (67%), moderately diminished (20/40–20/80) in 9 (26%), and showing profound loss (20/200) in 2 (7%). Five patients (14.7%) were diagnosed with optic nerve drusen via B-mode ophthalmic ultrasonography (US). However, they still fulfilled the diagnostic criteria for PTCS, and disc swelling improved after treatment. There were no statistically significant differences between the group with optic nerve drusen and the rest of the patients.Conclusions: Optic nerve drusen are common among pediatric patients with PTCS. Diagnosis of optic nerve drusen should not rule out the presence of increased intracranial pressure.

scholarly journals Prevalence of orofacial trauma in soccer players of a Brazilian club

2019 ◽  
Author(s):  
Barbara Capitanio de Souza ◽  
Larissa Leci Fernandes ◽  
Debora Magalhaes Barreto ◽  
Cornelis Robert Springer
Keyword(s):  
Soft Tissue ◽  
Medical Records ◽  
Soccer Player ◽  
Soccer Players ◽  
Inclusion Criteria ◽  
Anatomic Site ◽  
Exclusion Criteria ◽  
Male And Female ◽  
The Face ◽  
Record Type

Introduction: The objectives of the study were to evaluate the prevalence of orofacial injuries in soccer players of a Brazilian club, considering the category, the position in the field, and the most affected anatomic site, through medical records. Methods: A total of 126 charts of players from the base categories (sub-15, sub-17, and sub-20) and male and female professional categories from 2016 to 2018 were evaluated. It was considered inclusion criteria to be a soccer player hired by a club in the indicated period. The exclusion criteria of the study correspond to the medical records registered after the chronological date stipulated or that did not have the correct registry of the occurred trauma. Results: The data analyzed presented a moderate value in relation to the orofacial traumas prevalence, and 64.3% of the athletes of the club have some record type of trauma in the face. We observed that soft-tissue lacerations of the lips and dental fractures present the highest frequencies (73% and 27%, respectively). The positions of defender, striker, and midfield are the most susceptible to injuries (31%, 24%, and 23%, respectively). Conclusion: Dental and orofacial trauma are a problem commonly encountered in sports, being present also in collective sports, such as football. It was observed a moderate prevalence of injuries on the face, especially among the athletes who are ahead of the attack line, with lip lacerations and dental fractures being the most common events.

scholarly journals Profil dan Kesintasan Penderita Kanker Kolorektal di RSUP Dr. M. Djamil Padang

2019 ◽  
Vol 1 (1) ◽  
pp. 45-49
Author(s):  
Nurul Septi Arbi Astuti ◽  
Rhandyka Rafli ◽  
Laura Zeffira
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Survival Data ◽  
Sampling Method ◽  
Data Retrieval ◽  
Simple Random Sampling ◽  
Age Group ◽  
Inclusion Criteria ◽  
Cross Sectional ◽  
Colorectal Cancer Patients

Colorectal cancer is ranked fourth with 694.000 death. As many as 5.7% of patients with colorectal cancer from all types of cancer in Indonesia. The incidence of colorectal cancer patients is still quite high, and there is still minimal profile and survival data in Sumatera Barat. This study aims to determine the profile and survival of colorectal cancer patients in Dr. RSUP M. Djamil Padang uses descriptive category design through a cross-sectional approach. Samples from this study were taken from medical records of all colorectal cancer patients who met the inclusion criteria. Data retrieval was done by the "Simple Random Sampling" method. The results showed that the highest age group was the age group 46-55 years (38.1%), the highest sex male (81%), chief complaint with constipation (33.3%), stage B with (47.6%), most management operations with (61.9%), and survival for 2 years as much as (54.5%)

Clinical outcome in patients with metastatic colorectal cancer harboring KRAS p.G13D mutation treated with cetuximab.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 448-448 ◽  
Author(s):  
H. Bando ◽  
T. Yoshino ◽  
E. Shinozaki ◽  
S. Yuki ◽  
T. Nishina ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Metastatic Colorectal Cancer ◽  
Statistical Significance ◽  
Progression Free Survival ◽  
Therapeutic Benefit ◽  
Combination Regimen ◽  
Wild Type ◽  
Kras Status ◽  
Clinical Benefits ◽  
Colorectal Cancer Patients

448 Background: Metastatic colorectal cancer patients with KRAS codon 12 or 13 mutated tumors are presently excluded from treatment with cetuximab (Cmab). On the other hand, a few patients who have mutated KRAS status occasionally respond to Cmab. The tumors of those patients predominantly had codon 13 mutation, and all codon 13 responder have mutation of p.G13D. We now compared the efficacy of Cmab among patients with p.G13D- mutant, other KRAS mutant and KRAS wild-type colorectal cancer. Methods: The patients from 9 Japanese institutions were retrospectively collected and analyzed. All patients were refractory to fluoropyrimidine, oxaliplatin and irinotecan, and were treated with Cmab and irinotecan combination regimen. Response rate (RR), progression-free survival (PFS) and overall survival (OS) were calculated respectively according to KRAS status. Results: Ninety four patients were treated with combination therapy. Among 94 cases, 7 cases were p.G13D-mutant KRAS, 23 cases were other mutant KRAS and 63 cases were wild-type KRAS. Baseline characteristics by each subset were well-balanced. While one partial response (PR) and 4 stable diseases (SD) cases were found in 7 p.G13D-mutated cases, no PR was found in other KRAS mutated cases. Median PFS of the patients with p.G13D-mutant, other KRAS mutant and KRAS wild-type were 4.5 months (95%CI 1.7-), 2.3 months (95%CI 1.9-4.3), 4.6 months (95%CI 3.5-6.5) respectively. And median OS of the patients with p.G13D- mutant, other KRAS mutant and KRAS wild-type were 9.3months (95%CI 8.5- 11.8), 7.4 months (95%CI 4.5-9.4), 12.2 months (95%CI 8.7-19.8) respectively. Although statistical significance was not found between the two mutated groups, there are trends that the patients with p.G13D-mutant may have received better clinical benefits from Cmab than the patients with other KRAS mutant. Conclusions: Cmab may have therapeutic benefit in the patients with KRAS p.G13D-mutant colorectal cancer although further evaluation is warranted. No significant financial relationships to disclose.

scholarly journals DISTRIBUSI POLA DIET PASIEN KANKER KOLOREKTAL DI RSUD ULIN BANJARMASIN PERIODE AGUSTUS OKTOBER 2015

2016 ◽  
Vol 12 (2) ◽  
pp. 215
Author(s):  
Emma Rahmadania ◽  
Agung Ary Wibowo ◽  
Lena Rosida
Keyword(s):  
Colorectal Cancer ◽  
Cancer Patients ◽  
Age Group ◽  
Cross Sectional ◽  
Food Frequency ◽  
Consecutive Sampling ◽  
Keywords Colorectal Cancer ◽  
Increased Risk ◽  
Protein Fiber ◽  
Colorectal Cancer Patients

Abstract: Colorectal cancer is a malignancy of epithelial cells of the colon or rectum. Factors associated with an increased risk of this type of cancer include eating habits. The purpose of this study was to determine distribution the dietary patterns in colorectal cancer patients at hospitals Ulin Banjarmasin period from August to October 2015 by a review of fat dietary, protein dietary, fiber dietary  by age and gender. This research is a descriptive observasional with  cross sectional approach. Data was collected using a food frequency questionnaire and interviews. Sampling was conducted with consecutive sampling technique to obtain the sample amounted to 30 patients in accordance with the inclusion criteria. Obtained the age group of patients when first diagnosed with colorectal cancer is highest in the age group 41-60 years (50%) as many as 15 people. Sex ratio of colorectal cancer patients in hospitals Ulin Banjarmasin the period August-October 2015 that men of 15 people (50%) and women of 15 people (50%). Of the 30 respondents, there are 28 (93.4%) patients with colorectal cancer who rarely consume fat, there are 25 (83.4%) patients with colorectal cancer who rarely consume protein, and there were 25 (88.7%) patients with colorectal cancer are rare consuming fiber. Distribution of pattern dietary (fat, protein, fiber)by age and sex obtained the same result that most are in the rare category. Keywords: colorectal cancer, fat, protein, fiber. Abstrak: Kanker kolorektal adalah suatu keganasan dari sel epitel kolon atau rektum. Faktor yang berkaitan dengan peningkatan risiko kanker jenis ini antara lain kebiasaan makan. Tujuan penelitian ini adalah untuk mengetahui distribusi pola diet pasien kanker kolorektal  di RSUD Ulin Banjarmasin periode Agustus-Oktober  2015 dengan tinjauan terhadap diet lemak, diet protein, diet serat berdasarkan usia dan jenis kelamin. Penelitian ini merupakan penelitian yang bersifat deskriptif observasioal dengan pendekatan cross sectional. Data dikumpulkan dengan menggunakan lembar kuesioner food frequency dan wawancara. Pengambilan sampel  dilakukan dengan teknik consecutive sampling sehingga didapatkan sampel berjumlah 30 pasien yang sesuai dengan kriteria inklusi. Didapatkan kelompok usia pasien saat pertama kali terdiagnosis kanker kolorektal terbanyak adalah pada kelompok usia 41-60 tahun (50%) yaitu sebanyak 15 orang. Rasio perbandingan jenis kelamin pasien kanker kolorektal di RSUD Ulin Banjarmasin periode Agustus-Oktober 2015 yaitu laki-laki sebanyak  15 orang (50%)  dan perempuan sebanyak 15 orang (50%). Dari 30 responden, terdapat 28 (93,4%) pasien kanker kolorektal yang jarang mengkonsumsi lemak, terdapat 25 (83,4%) pasien kanker kolorektal yang jarang mengkonsumsi protein, dan terdapat 25 (88,7%) pasien kanker kolorektal yang jarang mengkonsumsi serat. Distribusi pola diet (lemak, protein, serat) berdasarkan usia dan jenis kelamin didapatkan hasil yang sama yaitu paling banyak berada pada kategori jarang. Kata-kata kunci: kanker kolorektal, lemak, protein, serat

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