scholarly journals ORAL MANIFESTATIONS ARISING FROM ANTINEOPLASTIC THERAPY IN CHILD ONCOLOGICAL PATIENTS

2021 ◽  
Vol 58 ◽  
pp. eUJ3532-eUJ3532
Author(s):  
Híttalo Carlos Rodrigues Almeida ◽  
◽  
Mabel Cristina Paiva Machado Silva ◽  
Maria Carlla Aroucha Lyra ◽  
Maria Cristina Valença de Oliveira ◽  
...  
Keyword(s):  
Antineoplastic Therapy ◽  
Odds Ratio ◽  
Oral Manifestations ◽  
Oncological Patients

No Brasil, o câncer é a principal causa de morte por doença em crianças e adolescentes. O Instituto Nacional do Câncer (INCA) estima a ocorrência de 8.460 novos casos de câncer em crianças e adolescentes no ano de 2020.O objetivo desse estudo foi identificar as manifestações bucais mais frequentes nos pacientes pediátricos em tratamento antineoplásico. Essa pesquisa incluiu 137 crianças e adolescentes de 0 a 19 anos de idade. Os dados incluíram um questionário semiestruturado para verificar as manifestações bucais mais frequentes decorrentes da terapia antineoplásica. Os testes estatísticos utilizados foram o teste Qui-quadrado de Pearson e para avaliar a força da associação foi obtido o Odds Ratio (OR) ou Razão das Chances (RC) com respectivo intervalo de confiança. Os resultados encontrados demonstram que a idade média dos pacientes pesquisados foi de 6,8 anos; o sexo masculino (57,7%) foi predominante na amostra; a neoplasia maligna mais incidente foi à leucemia (67,9%); 70,1% dos pacientes apresentaram pelo menos uma manifestação oral, sendo a mucositede maior prevalência (56,2%), seguida da xerostomia (46,7%), gengivite (41,6%), disfagia (35,8%), disgeusia (35,8%), candidíase (34,3%) e herpes (21,2%). Encontraram-se 54,7% dos pacientes com saúde bucal favorável e 40,9% deles com saúde bucal desfavorável. Concluímos que o paciente infantil deve ser avaliado por um odontopediatra previamente ao início da quimioterapia para minimizar as complicações bucais durante o tratamento antineoplásico.

Chemotherapy Near the End of Life in Onco–Hematological Adult Patients

2020 ◽  
Vol 37 (8) ◽  
pp. 641-647
Author(s):  
Marina Sánchez-Cuervo ◽  
Lorena García-Basas ◽  
Esther Gómez de Salazar-López de Silanes ◽  
Cristina Pueyo-López ◽  
Teresa Bermejo-Vicedo
Keyword(s):  
Observational Study ◽  
End Of Life ◽  
End Of Life Care ◽  
Odds Ratio ◽  
Chemotherapy Regimen ◽  
Female Gender ◽  
Tertiary Hospital ◽  
Life Care ◽  
Oncological Patients ◽  
Scarce Data

Objective: The use of chemotherapy near the end of life is not advisable. There are scarce data in Europe but shows signs of aggressiveness. We designed this study to analyze the proportion of onco–hematological patients receiving chemotherapy within their last 2 weeks of life as well as starting a new chemotherapy regimen in the 30 days prior to death. Methods: A retrospective observational study was conducted in a tertiary hospital. Adults who died of an onco-hematological neoplasia while hospitalized between April 2017 and March 2018 were included. We assessed the use of chemotherapy over the course of the last 14 days of life, defined as the administration of at least one dose of chemotherapy. We also examined the proportion of patients starting a new chemotherapy regimen in the last 30 days of life. Results: A total of 298 inpatients died in the Hematology and Oncology units. During the last 14 days, 28.2% (n = 11) of hematological and 26.3% (n = 68) of oncological patients received chemotherapy; the overall rate was 26.5% (n = 79). Furthermore, the proportion of patients starting a new chemotherapy regimen in the last 30 days of life was high (20.5% and 20.8%, respectively). Female gender (odds ratio [OR] = 1.99, 95% confidence interval [CI] = 1.18-3.35) and age <45 (OR = 2.68, 95% CI = 1.05-6.88) were associated with higher rates of chemotherapy. Conclusion: The proportion of patients receiving chemotherapy in the last 14 days of life was high, as well as the proportion of patients starting a new regimen in their last 30 days. This was indicative of excessive aggressiveness at the end-of-life care.

scholarly journals Dental Treatment in Patients with Leukemia

2015 ◽  
Vol 2015 ◽  
pp. 1-14 ◽  
Author(s):  
Caroline Zimmermann ◽  
Maria Inês Meurer ◽  
Liliane Janete Grando ◽  
Joanita Ângela Gonzaga Del Moral ◽  
Inês Beatriz da Silva Rath ◽  
...  
Keyword(s):  
Health Care ◽  
Bone Marrow ◽  
Bone Marrow Transplantation ◽  
Literature Review ◽  
Antineoplastic Therapy ◽  
Dental Treatment ◽  
Oral Manifestations ◽  
Dental Procedures ◽  
Hematological Abnormalities ◽  
Haematological Indices

Dental treatment of patients with leukemia should be planned on the basis of antineoplastic therapy which can be chemotherapy with or without radiotherapy and bone marrow transplantation. Many are the oral manifestations presented by these patients, arising from leukemia and/or treatment. In addition, performing dental procedures at different stages of treatment (before, during, or after) must follow certain protocols in relation to the haematological indices of patients, aimed at maintaining health and contributing to the effectiveness of the results of antineoplastic therapy. Through a literature review, the purpose of this study was to report the hematological abnormalities present in patients with leukemia, trying to correlate them with the feasibility of dental treatment at different stages of the disease. It is concluded in this paper that dental treatment in relation to haematological indices presented by patients with leukemia must follow certain protocols, mainly related to neutrophil and platelet counts, and the presence of the dentist in a multidisciplinary team is required for the health care of this patient.

scholarly journals Oral Manifestations and Salivary pH Changes in Children undergoing Antineoplastic Therapy

2016 ◽  
Vol 16 (1) ◽  
pp. 403-410 ◽  
Author(s):  
LMO Hanna ◽  
MTSR Botti ◽  
RJG Araújo ◽  
JM Damasceno ◽  
ASB Mayhew ◽  
...  
Keyword(s):  
Antineoplastic Therapy ◽  
Oral Manifestations ◽  
Ph Changes ◽  
Salivary Ph

Use of therapeutic outcomes monitoring method for performing of pharmaceutical care in oncology patients

2021 ◽  
pp. 107815522110050
Author(s):  
Renata RV Cataldo ◽  
Liliane AR Manaças ◽  
Priscila HM Figueira ◽  
Carla VG Ferraz ◽  
Sabrina Calil-Elias
Keyword(s):  
Pharmaceutical Care ◽  
Antineoplastic Therapy ◽  
Medication Administration ◽  
Health Problems ◽  
Oral Chemotherapy ◽  
Monitoring Method ◽  
Prospective Longitudinal Study ◽  
Oncological Patients ◽  
Outcome Monitoring ◽  
Prospective Longitudinal

This study aimed to implement pharmaceutical care using the therapeutic outcome monitoring (TOM) method for pharmacotherapeutic follow-up of oncological patients. This was a prospective longitudinal study involving patients undergoing oral chemotherapy. The study environment was an outpatient pharmacy at a tertiary-level oncology hospital. Ninety patients who received oral chemotherapy were evaluated, and 27 patients were followed up in accordance with the exclusion criteria and acceptability of participation in the study. The patients were predominantly diagnosed with gynecological tumors, with a mean age of 57.56 ± 13.06. The average consumption of drugs per patient was 4.63 ± 4.85, and more than 55% of patients had undergone oral antineoplastic therapy for more than a year. The main therapeutic groups used were drugs that acted on the gastrointestinal tract and metabolism (34%). All patients had at least one drug-related problem (DRP). In total, 133 DRP were identified. Approximately 33% of patients had DRPs related to antineoplastic therapy; non-adherence, incorrect administration, and the probability of adverse events were among the frequently reported DRPs. We identified 43 negative outcomes associated with medication (NOM), with untreated health problems (47%) and non-quantitative insecurity (30%) being the most frequently reported. 81 pharmaceutical interventions were performed, and 96% were accepted. The main errors avoided with the interventions were untreated health problems, misuse, and interruptions associated with medication administration. The TOM method effectively achieved the desired results of therapy, improving the use of medicines, and thus increasing patient safety.

Prädiktoren der Stabilität des Elternberichts über die ADHS-Lebenszeitprävalenz und Inzidenz der elternberichteten ADHS-Diagnose im Entwicklungsverlauf über sechs Jahre – Ergebnisse aus der KiGGS-Studie

2018 ◽  
Vol 66 (4) ◽  
pp. 233-247 ◽  
Author(s):  
Robert Schlack ◽  
Kristin Göbel ◽  
Heike Hölling ◽  
Franz Petermann ◽  
Marcel Romanos
Keyword(s):  
Odds Ratio ◽  
Strengths And Difficulties Questionnaire ◽  
Strengths And Difficulties

Zusammenfassung. ADHS ist durch die Kernsymptome Unaufmerksamkeit, motorische Unruhe und Impulsivität gekennzeichnet. Die Diagnostik der ADHS ist aufwändig und kann nur klinisch erfolgen. Anhand der Verlaufsdaten aus zwei Erhebungszeitpunkten der KiGGS-Studie wird hier untersucht, (a) wie häufig Eltern eine für ihre zum Ersterhebungszeitpunkt (t0, 2003–2006) drei bis 11 Jahre alten Kinder berichtete ADHS-Lebenszeitprävalenz zum zweiten Erhebungszeitpunkt (t1, 2009–2012) erneut berichten und (b) wie häufig eine jemals durch einen Arzt oder Psychologen gestellte ADHS-Diagnose in einem Zeitraum von sechs Jahren erstmalig berichtet wird (Diagnose-Inzidenz). Dazu wurden ausgewählte kind- und umfeldbezogene Einflussfaktoren wie Geschlecht, Transition in eine andere Lebensphase, Rauchen und Alkoholkonsum der Mutter während der Schwangerschaft und Stillzeit, Familienstruktur und Sozialstatus sowie die psychopathologische Symptombelastung gemäß Strengths and Difficulties Questionnaire (SDQ) zu beiden Messzeitpunkten longitudinal untersucht. Im Ergebnis berichteten 57.4% der Eltern, die zum Ersterhebungszeitpunkt eine jemals gestellte ADHS-Diagnose berichtet hatten, diese nach sechs Jahren erneut. Multivariat betrug das Odds Ratio für einen stabilen Elternbericht der ADHS-Lebenszeitprävalenz für Jungen OR = 5.04, für Rauchen der Mutter in der Schwangerschaft OR = 2.84 für Peerprobleme OR = 1.30 und für Hyperaktivitätsprobleme OR = 1.21 zu t0. Die Diagnose-Inzidenz lag insgesamt bei 3.6%. Die Inzidenz war für Jungen dreimal so hoch wie für Mädchen und nahm mit steigendem Alter ab. Alle Prädiktoren mit Ausnahme des Alkoholkonsums der Mutter in der Schwangerschaft waren bivariat mit der Diagnose-Inzidenz signifikant assoziiert. Multivariat erwiesen sich jedoch nur männliches Geschlecht (OR = 2.89), die Transition in die Adoleszenz (OR = 0.38) sowie Verhaltens- (OR = 1.15) und Peerprobleme (OR = 1.46) zu t0 als signifikante Prädiktoren.

Update DVO-Osteoporoseregister

2016 ◽  
Vol 25 (01) ◽  
pp. 27-30
Author(s):  
R. Pfaff ◽  
M. Warda ◽  
A. Defèr
Keyword(s):  
Odds Ratio ◽  
Statistische Auswertung

ZusammenfassungStürze sind die häufigste Frakturursache. Eine effiziente Diagnostik von sturzund frakturgefährdeten Patienten unter Praxisbedingungen ist von hoher Bedeutung.Es wurden die im DVO-Osteoporoseregister dokumentierten Daten von 10 804 Frauen bezüglich der Ergebnisse von Chair-Rising-Test, “Up and go”-Test und Tandemstand ausgewertet. Für 633 Frauen lag auch das Ergebnis einer Handkraftmessung vor. Die statistische Auswertung erfolgte zum einen über die Anwendung des Chi-Quadrat- Tests mit Hilfe von Kreuztabellen, zum anderen durch die Bestimmung der Odds Ratio.Bei einem auffälligen Testergebnis ist die Wahrscheinlichkeit, dass prävalente und/oder inzidente Frakturen vorhanden sind, bei Frauen signifikant erhöht. So beträgt die Odds Ratio beim Chair-Rising- Test 1,975, beim Tandemstand 2,3938 und beim “Up an go”-Test 2,0382. Bei Frauen, bei denen eine auffällige Handkraftmessung beobachtet wurde, zeigt sich, dass weder beim Chair- Rising-Test (p = 0,8706) noch beim „Up and go”-Test (p = 0,0526) eine Abhängigkeit zwischen einem auffälligen Test - ergebnis und vorhandenen Frakturen besteht. Der Tandemstand jedoch signalisiert bezüglich eines Zusammenhangs zwischen einem auffälligen Testergebnis und vorhandenen Frakturen eine hochsignifikante Abhängigkeit (p < 0,001). Die Wahrscheinlichkeit, dass eine Fraktur bei einem auffälligen Testergebnis des Tandemstands vorhanden ist, ist um den Faktor 6,2585 erhöht.Die Testung des Tandemstands in Verbindung mit einer Handkraftmessung hat einen hohen Aussagewert für die Ermittlung des Sturz- und Frakturrisikos bei älteren Frauen. Frauen mit einem negativen Ergebnis bei der Testung des Chair-Rising- oder des „Up and go”-Manövers hatten ebenfalls signifikant mehr Frakturen als Frauen mit normalem Testergebnis.

Orolinguales Angioödem nach Schlaganfall-Thrombolyse

2010 ◽  
Vol 29 (03) ◽  
pp. 147-149
Author(s):  
A. Stoll ◽  
F. Fluri ◽  
P. Lyrer ◽  
S. Engelter ◽  
J. Berrouschot
Keyword(s):  
Odds Ratio ◽  
Intravenöse Thrombolyse

ZusammenfassungFragestellung: Wir untersuchten orolinguale Angioödeme bei Schlaganfall-Patienten, die eine intravenöse Thrombolyse erhielten. Material und Methoden: In zwei Zentren wurden von Januar 2004 bis Dezember 2008 Häufigkeit, Ausprägung und Folgen eines orolingualen Angioödems während Thrombolyse mitrt- PA erfasst. In einer Metaanalyse wurde das Risiko für Angioödeme unter ACE-Hemmern berechnet. Ergebnisse: Bei 548 thombolysierten Patienten traten sechs orolinguale Angioödeme auf. Vier dieser Patienten mussten intubiert und beatmet werden. Fünf Patienten nahmen vor Thrombolyse ACE-Hemmer ein. In einer Metaanalyse betrug die Odds ratio 24, das heißt, das Risiko unter ACE-Hemmern während der Thrombolyse mit rt-PA ein orolinguales Angioödem zu bekommen, ist stark erhöht. Schlussfolgerung: Ärzte und Pflegekräfte müssen Patienten während der Thrombolyse engmaschig klinisch überwachen und über die Möglichkeit des zwar seltenen, aber potenziell lebensbedrohlichen orolingualen Angioödems informiert sein.

F-18-FDG Positron Imaging in Oncological Patients: Gamma Camera Coincidence Detection versus Dedicated PET

1999 ◽  
Vol 38 (04) ◽  
pp. 108-114 ◽  
Author(s):  
H.-J. Kaiser ◽  
U. Cremerius ◽  
O. Sabri ◽  
M. Schreckenberger ◽  
P. Reinartz ◽  
...  
Keyword(s):  
Attenuation Correction ◽  
Spatial Resolution ◽  
Gamma Camera ◽  
Lesion Detection ◽  
Coincidence Detection ◽  
System Sensitivity ◽  
Oncological Patients ◽  
Phantom Studies ◽  
Pet System ◽  
Dedicated Pet

Summary Aim of the present study was to investigate the feasibility of 2-[fluorine-18]-fluoro-2-deoxy-D-glucose (FDG) imaging in oncological patients with a dual head gamma camera modified for coincidence detection (MCD). Methods: Phantom studies were done to determine lesion detection at various lesion-to-background ratios, system sensitivity and spatial resolution. Thirty-two patients with suspected or known malignant disease were first studied with a dedicated full-ring PET system (DPET) applying measured attenuation correction and subsequently with an MCD system without attenuation correction. MCD images were first interpreted without knowledge of the DPET findings. In a second reading, MCD and DPET were evaluated simultaneously. Results: The phantom studies revealed a comparable spatial resolution for DPET and MCD (5.9 × 6.3 × 4.2 mm vs. 5.9 × 6.5 × 6.0 mm). System sensitivity of MCD was less compared to DPET (91 cps/Bq/ml/cmF0V vs. 231 cps/ Bq/ml/cmFOv). At a lesion-to-background ratio of 4:1, DPET depicted a minimal phantom lesion of 1.0 cm in diameter, MCD a minimal lesion of 1.6 cm. With DPET, a total of 91 lesions in 27 patients were classified as malignant. MCD without knowledge of DPET results revealed increased FDG uptake in all patients with positive DPET findings. MCD detected 72 out of 91 DPET lesions (79.1 %). With knowledge of the DPET findings, 11 additional lesions were detected (+12%). MCD missed lesions in six patients with relevance for staging in two patients. All lesions with a diameter above 18 mm were detected. Conclusion: MCD FDG imaging yielded results comparable to dedicated PET in most patients. However, a considerable number of small lesions clearly detectable with DPET were not detected by MCD alone. Therefore, MCD cannot yet replace dedicated PET in all oncological FDG studies. Further technical refinement of this new method is needed to improve image quality (e.g. attenuation correction).

Laboratory Evaluation and Clinical Characteristics of 2,132 Consecutive Unselected Patients with Venous Thromboembolism – Results of the Spanish Multicentric Study on Thrombophilia (EMET*-Study)

1997 ◽  
Vol 77 (03) ◽  
pp. 444-451 ◽  
Author(s):  
José Mateo ◽  
Artur Oliver ◽  
Montserrat Borrell ◽  
Núria Sala ◽  
Jordi Fontcuberta ◽  
...  
Keyword(s):  
Venous Thrombosis ◽  
Odds Ratio ◽  
Protein C ◽  
Protein S ◽  
Laboratory Evaluation ◽  
Clinical Factors ◽  
Recurrent Thrombosis ◽  
Heparin Cofactor Ii ◽  
Crude Odds Ratio ◽  
History Of

SummaryPrevious studies on the prevalence of biological abnormalities causing venous thrombosis and the clinical characteristics of thrombotic patients are conflicting. We conducted a prospective study on 2,132 consecutive evaluable patients with venous thromboembolism to determine the prevalence of biological causes. Antithrombin, protein C, protein S, plasminogen and heparin cofactor-II deficiencies, dysfibrinoge-nemia, lupus anticoagulant and antiphospholipid antibodies were investigated. The risk of any of these alterations in patients with familial, recurrent, spontaneous or juvenile venous thrombosis was assessed. The overall prevalence of protein deficiencies was 12.85% (274/2,132) and antiphospholipid antibodies were found in 4.08% (87/2,132). Ten patients (0.47%) had antithrombin deficiency, 68 (3.19%) protein C deficiency, 155 (7.27%) protein S deficiency, 16 (0.75%) plasminogen deficiency, 8 (0.38%) heparin cofactor-II deficiency and 1 had dysfib-rinogenemia. Combined deficiencies were found in 16 cases (0.75%). A protein deficiency was found in 69 of 303 (22.8%) patients with a family history of thrombosis and in 205/1,829 (11.2%) without a history (crude odds ratio 2.34, 95% Cl 1.72-3.17); in 119/665 (17.9%) patients with thrombosis before the age of 45 and in 153/1,425 (10.7%) after the age of 45 (crude odds ratio 1.81, 95% Cl 1.40-2.35); in 103/616 (16.7%) with spontaneous thrombosis and in 171/1,516 (11.3%) with secondary thrombosis (crude odds ratio 1.58, 95% Cl 1.21-2.06); in 68/358 (19.0%) with recurrent thrombosis and in 206/1,774 (11.6%) with a single episode (crude odds ratio 1.78,95% Cl 1.32-2.41). Patients with combined clinical factors had a higher risk of carrying some deficiency. Biological causes of venous thrombosis can be identified in 16.93% of unselected patients. Family history of thrombosis, juvenile, spontaneous and recurrent thrombosis are the main clinical factors which enhance the risk of a deficiency. Laboratory evaluation of thrombotic patients is advisable, especially if some of these clinical factors are present.

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