Premedications for Cancer Therapies: A Primer for the Hematology/Oncology Provider

2021 ◽  
Vol 12 (8) ◽  
Author(s):  
Amber Clemmons, PharmD, BCOP ◽  
Arpita Gandhi, PharmD, BCOP ◽  
Andrea Clarke, PharmD ◽  
Sarah Jimenez, APN-BC, AGACNP, AOCNP ◽  
Thuy Le, MD ◽  
...  
Keyword(s):  
Best Practices ◽  
Adverse Events ◽  
Chemotherapeutic Agents ◽  
Patient Specific ◽  
Cancer Therapies ◽  
Quality Of Data ◽  
Advanced Practitioner ◽  
Patients At Risk ◽  
Radiation Induced

Chemotherapeutic agents and radiation therapy are associated with numerous potential adverse events (AEs). Many of these common AEs, namely chemotherapy- or radiation-induced nausea and vomiting, hypersensitivity reactions, and edema, can lead to deleterious outcomes (such as treatment nonadherence or cessation, or poor clinical outcomes) if not prevented appropriately. The occurrence and severity of these AEs can be prevented with the correct prescribing of prophylactic medications, often called “premedications.” The advanced practitioner in hematology/oncology should have a good understanding of which chemotherapeutic agents are known to place patients at risk for these adverse events as well as be able to determine appropriate prophylactic medications to employ in the prevention of these adverse events. While several guidelines and literature exist regarding best practices for prophylaxis strategies, differences among guidelines and quality of data should be explored in order to accurately implement patient-specific recommendations. Herein, we review the existing literature for prophylaxis and summarize best practices.

scholarly journals Bevacizumab Combined with Corticosteroids Does Not Improve the Clinical Outcome of Nasopharyngeal Carcinoma Patients With Radiation-Induced Brain Necrosis

2021 ◽  
Vol 11 ◽  
Author(s):  
Honghong Li ◽  
Xiaoming Rong ◽  
Weihan Hu ◽  
Yuhua Yang ◽  
Ming Lei ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nasopharyngeal Carcinoma ◽  
Adverse Events ◽  
Clinical Outcomes ◽  
World Health ◽  
World Health Organization Quality ◽  
Brain Necrosis ◽  
Radiation Induced

ObjectiveOur aim was to compare the clinical outcomes of patients treated with bevacizumab combined with corticosteroids and those with bevacizumab monotherapy from a radiation-induced brain necrosis (RN) registry cohort (NCT03908502).MethodsWe utilized clinical data from a prospective RN registry cohort (NCT03908502) from July 2017 to June 2020. Patients were considered eligible if they had symptomatic RN after radiotherapy for nasopharyngeal carcinoma (NPC) and received bevacizumab (5 mg/kg, two to four cycles) with a minimum follow-up time of 3 months. The primary outcome was a 2-month response rate determined by MRI and clinical symptoms. Secondary outcomes included quality of life [evaluated by the abbreviated World Health Organization Quality of Life (WHOQOL-BREF) questionnaire] and cognitive function (evaluated by the Montreal Cognitive Assessment scale) at 2 months, RN recurrence during follow-up, and adverse events.ResultsA total of 123 patients (34 in the combined therapy group and 89 in the monotherapy group) were enrolled in our study with a median follow-up time of 0.97 year [interquartile range (IQR) = 0.35–2.60 years]. The clinical efficacy of RN did not differ significantly between patients in these two groups [odds ratio (OR) = 1.642, 95%CI = 0.584–4.614, p = 0.347]. Furthermore, bevacizumab combined with corticosteroids did not reduce recurrence compared with bevacizumab monotherapy [hazard ratio (HR) = 1.329, 95%CI = 0.849–2.079, p = 0.213]. The most common adverse events of bevacizumab were hypertension (17.89%), followed by nosebleed (8.13%) and fatigue (8.13%). There was no difference in grade 2 or more severe adverse events between the two groups (p = 0.811).InterpretationOur results showed that the treatment strategy of combining bevacizumab with corticosteroids did not lead to better clinical outcomes for RN patients with a background of radiotherapy for nasopharyngeal carcinoma.

A Study on the Effect of Dietary Modifications in decreasing or delaying Radiation Induced Acute Gastrointestinal Adverse Events in patients receiving Pelvic Radiotherapy

2021 ◽  
pp. 4029-4034
Author(s):  
Devina Janeendran ◽  
Bhama Santhosh Kumar ◽  
Jiya Marium George ◽  
Ayana S. Kumar ◽  
Ram Madhavan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Radiation Therapy ◽  
Adverse Events ◽  
Treatment Modality ◽  
Dietary Intervention ◽  
Gastrointestinal Side Effects ◽  
Radiation Induced ◽  
Gastrointestinal Adverse Events ◽  
Dietary Modifications

Ionizing radiotherapy is a very common treatment modality for various types of cancer. However, its uses are expected to increase drastically with several advances in screening as well as early detection of cancer. Radiation injury due to radiation to the gastrointestinal tract is an imperative factor that works against better utility of this critical treatment modality. Moreover, following radiotherapy there are a higher chances of acute as well as chronic symptoms that would significantly reduce the quality of life of patients and furthermore adding an extra burden to the patients in terms of cost of healthcare. Thus interventions to reduce these adverse events can have long term benefits. Acute radiation induced gastrointestinal adverse events can be managed by modification of diet. Dietary modification of fat, lactose or non-starch polysaccharides (fibre) or combination of these dietary modifications reduces acute gastrointestinal adverse events during radiotherapy. In our study, we observed patients diagnosed with prostate and rectal cancer and those patients receiving neo adjuvant chemo-radiotherapy of rectum. The patients were advised to follow certain dietary modifications which aid in controlling the acute gastrointestinal side effects that developed after exposing to radiation therapy. The patients were followed up on a weekly basis and recorded the severity of the gastro intestinal symptoms after each cycle of radiation therapy and the quality of life was also calculated. Our study demonstrates that the dietary intervention appears to be a promising treatment option to control these adverse events. The dietary restriction of fat, fibre and lactose also helped in reducing the grades of adverse events during the radiotherapy. The Quality of Life of patients, however, after radiotherapy was found to be decreased when compared to the baseline.

An Overview of Chemotherapy-Induced Peripheral Neuropathy

2008 ◽  
Vol 21 (2) ◽  
pp. 138-145 ◽  
Author(s):  
Jose R. Murillo ◽  
James E. Cox ◽  
Michael S. Oholendt
Keyword(s):  
Adverse Event ◽  
Peripheral Neuropathy ◽  
Positive Impact ◽  
Chemotherapeutic Agents ◽  
Patient Specific ◽  
Drug Discontinuation ◽  
Neurologic Complication ◽  
Patients With Cancer ◽  
Neurological Adverse Event

Peripheral neuropathy remains a major limitation of chemotherapeutic agents used in cancer treatment. This neurologic complication from chemotherapy occurs frequently and can be debilitating. Although difficult to predict, both chemotherapeutic and patient-specific risk factors may contribute to this adverse event. Symptoms of peripheral neuropathy may appear acutely after treatment or persist chronically upon drug discontinuation. The taxanes, vinca alkaloids, and immunomodulatory drugs commonly cause peripheral nervous system toxicity. Prompt recognition and evaluation of this neurological adverse event by those who provide care to patients with cancer can prove to have a positive impact on the quality of life of those patients.

Antiphospholipid Antibody Syndromes and the Internet

Lupus ◽  
1996 ◽  
Vol 5 (5) ◽  
pp. 418-424
Author(s):  
GA McCarty
Keyword(s):  
Patient Specific ◽  
The Internet ◽  
Antiphospholipid Antibody ◽  
Antiphospholipid Antibody Syndrome ◽  
Quality Of Data

Information regarding the antiphospholipid antibody syndrome is accessible on the Internet, and encompasses both physician specific and patient specific files. The quantity and quality of data available at these sites, however, varies greatly and both search-refining and data manipulating protocols and software need improvement.

A Proof of Concept Study Regarding the Utilization of Different Patient-related Outcome Measurements in a Certified Centre of Excellence for Joint Replacement (EndoProthetikZentrum)

2019 ◽  
Vol 157 (05) ◽  
pp. 501-509
Author(s):  
Katrin Osmanski-Zenk ◽  
Anastasia Oskina ◽  
Rainer Bader ◽  
Wolfram Mittelmeier
Keyword(s):  
Risk Score ◽  
Joint Replacement ◽  
Patient Specific ◽  
Quality Of Data ◽  
Quality Of Life Scale ◽  
Centre Of Excellence ◽  
Oxford Hip Score ◽  
Patient Related Outcome

Abstract Background The aim of the study is to identify those patients without improved pain sensation and functionality of the joint, thus with a potential necessity of re-intervention by using the evaluation of the PROMs (Oxford Hip Score, European Quality of Life Scale, EndoCert-Risk-Score). The task was to determine the value of the scores which represents the limit above/below, which a re-examination of the patient is necessary. Additionally, further secondary objectives such as influence of complications on scores, the percentage of questionnaire return and the quality of the provided data in the questionnaires were recorded to define minimal requirements on patientʼs response. Material and Methods Members of the EndoCert certification committee developed a questionnaire for pre- (decision on treatment) and post-operative (discharge and 3-months follow-up) use. A total of 112 primary hip replacements and 25 hip revision arthroplasties, which were recruited from a centre of excellence for joint replacement (EndoProthetikZentrum der Maximalversorgung), were included in the study. Results The return of questionnaires amounted to 80%. Quality of data in the questionnaires declined with BMI (≥ 25), ASA classification (≥ 3), age (≥ 65) and depended on the time point questioning. Based on the EndoCert risk score there was a significant improvement in the experience of pain postoperatively compared to pre-operation (p < 0.05). However, the functionality of the joint, as measured as the use of walking frames or crutches as well as the need for help from others, did not improve. The results revealed that there was no correlation between the incidence of complications and a detrimental score. It was furthermore shown that patient specific attributes, e.g. age or BMI, or perioperative performance (duration of operation) did not influence the likelihood of a complication. Conclusion It was shown that Oxford Hip Score and EQ-5D were not negatively influenced by complication during hospital stay. The evaluation of the EndoCert risk score showed not improvement between pre- and post-operative values regarding function but revealed a significant pain relief. A further study is intended to evaluate the intensity of pain after three months as part of an extended systemic follow-up. This could provide further insights whether the EndoCert risk score is a suitable tool to identify unsuccessfully treated patients.

scholarly journals Aprepitant, a novel neurokinin-1 receptor antagonist in management of chemotherapy induces nausea vomiting (CINV) in cancer patients

2019 ◽  
Vol 2 (1) ◽  
pp. 1-4
Author(s):  
Robin George ◽  
E. Sunil Kumar ◽  
Kondi Charitha Reddy ◽  
Shaik Habeebjan
Keyword(s):  
Quality Of Life ◽  
Adverse Event ◽  
Adverse Events ◽  
Treatment Options ◽  
Chemotherapeutic Agents ◽  
Major Adverse Event ◽  
New Class ◽  
Nausea And Emesis ◽  
Neurokinin 1

Nausea and emesis are two major concerns for patients undergoing chemotherapy for cancer. The 5HT3 receptors antagonist ondansetron is the major factor for preventing and treatment for CINV either alone or often is combination with dexamethasone. Even these treatment options exist, CINV remind as major adverse event for all chemotherapeutic agents. The adverse events have major impact on patients quality of life and compliance with treatment. Aprepitant, a novel neurokinin-1 (NK-1) antagonist has been introduced as a new class of drug to prevent CINV. Many trials and studies reveals that comparison of aprepitant to the standard ondansetron and dexamethasone is superior in protecting against CINV. Here this study evaluate and reveals the use and benefits of aprepitant in the management of CINV.

Methods to Monitor and Improve the Performance of Specimen Holders for Transmission Electron Cryomicroscopy

1996 ◽  
Vol 54 ◽  
pp. 454-455
Author(s):  
B. L. Armbruster ◽  
B. Kraus ◽  
M. Pan
Keyword(s):  
Electron Microscopy ◽  
Electron Beam ◽  
Electron Beam Irradiation ◽  
Beam Irradiation ◽  
Quality Of Data ◽  
Electron Cryomicroscopy ◽  
Thermal Equilibration ◽  
Transmission Electron ◽  
Electron Microscopes

One goal in electron microscopy of biological specimens is to improve the quality of data to equal the resolution capabilities of modem transmission electron microscopes. Radiation damage and beam- induced movement caused by charging of the sample, low image contrast at high resolution, and sensitivity to external vibration and drift in side entry specimen holders limit the effective resolution one can achieve. Several methods have been developed to address these limitations: cryomethods are widely employed to preserve and stabilize specimens against some of the adverse effects of the vacuum and electron beam irradiation, spot-scan imaging reduces charging and associated beam-induced movement, and energy-filtered imaging removes the “fog” caused by inelastic scattering of electrons which is particularly pronounced in thick specimens.Although most cryoholders can easily achieve a 3.4Å resolution specification, information perpendicular to the goniometer axis may be degraded due to vibration. Absolute drift after mechanical and thermal equilibration as well as drift after movement of a holder may cause loss of resolution in any direction.

PROFESSIONAL TRAINING OF ELECTRONICS ENGINEERS: APPLYING US EXPERICENCE TO UKRAINAN HIGHER EDUCATION INSTITUTIONS

2020 ◽  
pp. 80-85
Author(s):  
Olha Pavlenko
Keyword(s):  
Higher Education ◽  
Education Research ◽  
Best Practices ◽  
Cost Reduction ◽  
Professional Training ◽  
Higher Education Institutions ◽  
Academic Staff ◽  
Research And Innovation ◽  
Current State

The article discusses the current state of professional training of engineers, in particular, electronics engineers in Ukrainian higher education institutions (HEIs) and explores best practices from US HEIs. The research outlines the features of professional training of electronics engineers and recent changes in Ukrainian HEIs. Such challenges for Ukrainian HEIs as lack of collaboration between higher education and science with industry, R&D cost reduction for HEIs, and downsizing the research and academic staff, the disparity between the available quality of human capital training and the demanded are addressed. The study attempts to identify successful practices of US HEIs professional training of engineers in order to suggest potential improvements in education, research, and innovation for training electronics engineers in Ukraine.

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