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https://www.readbyqxmd.com/read/28152838/a-schematic-case-episode-format-to-aid-in-choosing-wisely
#1
B Brooke Mann, Jad Hayes, Lalan S Wilfong, Marcus A Neubauer
: 181 Background: The recommendations of the Choosing Wisely campaign are evidence -based strategies to reduce cost without sacrificing outcomes. Yet tying the recommendations to indicators of use at the physician and case level has been challenging. As practices become responsible for total cost of care, an easy to use analytic method to determine appropriate use will be critical. We here describe a tool for rapid assessment of individual cases to achieve that objective. METHODS: The population was a payer defined cohort of lung cancer patients treated at Texas Oncology (TxO)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152738/designing-and-implementing-a-payment-system-to-support-cancer-care-coordination-a-literature-review
#2
Chloe Gerves-Pinquie, Etienne Minvielle
: 40 Background: Demands for new payment systems to better coordinate services along the care continuum are emerging in oncology. Among them, bundling payments for defined episodes of care are considered as a promising payment option. The study objective was to understand how to develop an optimal payment system in order to foster coordination between hospitals and post-acute providers, and to identify potential pitfalls associated with its implementation. METHODS: We conducted a literature review, exploring articles published between 2010 and 2015 in Medline...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152727/a-prospective-study-of-an-inpatient-febrile-neutropenia-clinical-practice-guideline-in-oncology-patients
#3
Tanya Thomas, Joshua Reuss, Gina Degennaro, Elizabeth Daniels, Jin Li, Mark Smolkin, Michael Kenneth Keng
: 114 Background: Febrile neutropenia (FN) is a common complication in oncology patients and is associated with significant morbidity and mortality if untreated. Because of this, it is regarded as a medical emergency. FN treatment guidelines universally recommend the prompt initiation ( < 60 minutes) of intravenous antibiotic therapy. We hypothesized that a quality initiative project creating a new FN clinical practice guideline (CPG) would reduce the time to antibiotic administration (TTA) for inpatient oncology patients with FN...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28095701/malignant-bowel-obstruction-in-advanced-ovarian-cancer
#4
Emma Dean, Leila Khoja, Andrew Clamp, Gordon C Jayson, Dilly Goonetilleke, Alicia M Conway, Jurjees Hasan
AIM: Malignant bowel obstruction (MBO) in ovarian cancer is poorly understood. METHODS: This retrospective cohort study analyzed 129 patients with ovarian cancer and MBO. RESULTS: At presentation, 69 (53%) had platinum-resistant, 37 (29%) platinum-sensitive and 23 (18%) chemotherapy-naive disease. In patients receiving chemotherapy following the MBO episode, median overall survival (OS) was 107 days for chemotherapy-naive patients compared with 83 and 86 for platinum-sensitive or platinum-resistant patients (p = 0...
March 2017: Future Oncology
https://www.readbyqxmd.com/read/28089143/long-term-mortality-following-pseudomonas-aeruginosa-bloodstream-infection
#5
K L McCarthy, D L Paterson
BACKGROUND: Pseudomonas aeruginosa bloodstream infections (BSI) are associated with substantial short-term mortality. There is little data on long-term mortality associated with this BSI. AIM: To describe mortality rates up to one year post infection and the significant factors associated with death. METHODS: Positive blood cultures for P. aeruginosa were identified retrospectively from January 2008 to January 2011 at seven tertiary care hospitals...
March 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/27889413/molecular-diagnosis-of-bloodstream-infections-in-onco-haematology-patients-with-pcr-esi-ms-technology
#6
Elena Jordana-Lluch, Belén Rivaya, Clara Marcó, Montserrat Giménez, Mª Dolores Quesada, Agustín Escobedo, Montserrat Batlle, Elisa Martró, Vicente Ausina
OBJECTIVES: Onco-haematological patients are prone to develop infections, and antibiotic prophylaxis may lead to negative blood cultures. Thus, the microbiological diagnosis and subsequent administration of a targeted antimicrobial therapy is often difficult. The goal of this study was to evaluate the usefulness of IRIDICA (PCR/ESI-MS technology) for the molecular diagnosis of bloodstream infections in this patient group. METHODS: A total of 463 whole blood specimens from different sepsis episodes in 429 patients were analysed using the PCR/ESI-MS platform, comparing the results with those of blood culture and other clinically relevant information...
November 23, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27862499/pain-assessment-and-management-in-paediatric-oncology-a-cross-sectional-audit
#7
Karin Plummer, Maria McCarthy, Ian McKenzie, Fiona Newall, Elizabeth Manias
AIMS AND OBJECTIVES: To describe the pain assessment and management practices documented by health professionals within a tertiary-level Children's Cancer Centre and to evaluate how these practices were compared with international recommendations. BACKGROUND: Children with cancer are vulnerable to pain due to the intensity of antineoplastic therapy. Therefore, it is imperative to ensure that current pain management practices provided to paediatric oncology inpatients are of a high quality...
November 10, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27854183/prognostic-factors-in-the-survival-of-patients-with-blood-disorders-recovering-from-septic-shock
#8
Anna Waszczuk-Gajda, Wieslaw Wiktor Jedrzejczak
BACKGROUND: Septic shock is one of the major direct causes of death in patients in hematology departments. OBJECTIVES: The knowledge about clinical outcomes and factors associated with negative outcome in these patients can be important and useful for physicians to identify the patients who are most likely to benefit from ICU therapy. METHODS: We retrospectively analyzed records of 214 episodes of septic shock in patients with different blood diseases hospitalized between 1998 and 2011 in the Department of Hematology, Oncology and Internal Medicine, the Medical University of Warsaw, Poland...
November 17, 2016: Hematology (Amsterdam, Netherlands)
https://www.readbyqxmd.com/read/27814324/outcome-of-pediatric-gastroenterology-outpatients-with-fever-and-central-line
#9
Thomas Alexander, Julie Blatt, Asheley Cockrell Skinner, Ravi Jhaveri, Meghan Jobson, Katherine Freeman
OBJECTIVE: Although management algorithms for fever and central venous catheters (CVCs) have been implemented for pediatric oncology (PO) patients, management of pediatric outpatients with noncancer diagnoses and CVCs lacks clear protocols. The aim of the study was to assess outcomes for pediatric outpatients with gastrointestinal disorders presenting with fever and CVC. METHODS: Using a microbiology database and emergency department records, we created a database of pediatric gastroenterology (PGI) and PO outpatients with fever and a CVC who presented to our emergency department or clinics from January 2010 through December 2012...
November 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27804875/clostridium-difficile-infection-associations-with-chemotherapy-radiation-therapy-and-targeting-therapy-treatments
#10
REVIEW
Avi Peretz, Izhar Ben Shlomo, Orna Nitzan, Luigi Bonavina, Pmela M Schaffer, Moshe Schaffer
BACKGROUND: Although mucositis, diarrhea, and constipation as well as immunosuppression are well recognized side-effects of cancer treatment, the underlying mechanisms including changes in the composition of gut microbiota and Clostridium difficile infection have not yet been thoroughly reviewed. OBJECTIVE: We herein set out to review the literature regarding the relations between cancer chemotherapy, radiation treatment, and Clostridium difficile-associated colitis...
2016: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/27698881/impact-of-intense-systemic-therapy-and-improved-survival-on-the-use-of-palliative-radiotherapy-in-patients-with-bone-metastases-from-prostate-cancer
#11
Carsten Nieder, Ellinor Haukland, Bård Mannsåker, Jan Norum
More effective drugs may reduce the requirement for palliative external beam radiotherapy for bony target volumes; however, living with metastases for prolonged periods of time may result in more frequent episodes of bone pain or serious skeletal-related events. The purpose of the present study was to evaluate how recent advances in systemic therapy impact radiotherapy utilization. A retrospective analysis of a comprehensive regional database was performed. All oncology care in this region was provided by only one center, assuring complete data...
October 2016: Oncology Letters
https://www.readbyqxmd.com/read/27688611/bloodstream-infections-in-febrile-neutropenic-patients-at-a-tertiary-cancer-institute-in-south-india-a-timeline-of-clinical-and-microbial-trends-through-the-years
#12
K Govind Babu, D Lokanatha, K C Lakshmaiah, M C Suresh Babu, Linu A Jacob, Gita R Bhat, Harsha Vardhana, Mahua Sinha, B R Vijaykumar, B G Sumati, R S Jayshree
INTRODUCTION: Febrile neutropenia (FN) is an oncological emergency. The choice of empiric therapy depends on the locally prevalent pathogens and their sensitivities, the sites of infection, and cost. The Infectious Diseases Society of America guidelines are being followed for the management of FN in India. METHODS: This is a prospective observational study conducted at a tertiary care cancer centre from September 2012 to September 2014. OBJECTIVES: The objectives of this study were as follows: (1) To review the pattern of microbial flora, susceptibility pattern, and important clinical variables among bloodstream infections in febrile neutropenic patients with solid tumors and hematological malignancies...
July 2016: Indian Journal of Medical and Paediatric Oncology
https://www.readbyqxmd.com/read/27637823/value-based-care-and-bundled-payments-anesthesia-care-costs-for-outpatient-oncology-surgery-using-time-driven-activity-based-costing
#13
Katy E French, Alexis B Guzman, Augustin C Rubio, John C Frenzel, Thomas W Feeley
BACKGROUND: With the movement towards bundled payments, stakeholders should know the true cost of the care they deliver. Time-driven activity-based costing (TDABC) can be used to estimate costs for each episode of care. In this analysis, TDABC is used to both estimate the costs of anesthesia care and identify the primary drivers of those costs of 11 common oncologic outpatient surgical procedures. METHODS: Personnel cost were calculated by determining the hourly cost of each provider and the associated process time of the 11 surgical procedures...
September 2016: Healthcare
https://www.readbyqxmd.com/read/27602414/use-of-procalcitonin-in-clinical-oncology-a-literature-review
#14
Andrea Sbrana, Martina Torchio, Giuditta Comolli, Andrea Antonuzzo, Marco Danova
The use of procalcitonin (PCT) as an early marker of infectious episodes in cancer patients is still controversial. We performed a MEDLINE search of peer-reviewed articles published between January 1990 and December 2015, and finally we analysed 15 articles. PCT seems to have a good diagnostic value of infectious episodes in cancer patients and its accuracy seems greater if we consider major events, such as bloodstream infections and sepsis. Serial evaluations of this protein seem to be more accurate in the diagnostic phase and useful to predict outcome and response to antibacterial treatment...
September 2016: New Microbiologica
https://www.readbyqxmd.com/read/27578209/epidemiology-of-diarrheal-illness-in-pediatric-oncology-patients
#15
Mohammad N Mhaissen, Alicia Rodriguez, Zhengming Gu, Haiqing Zhu, Li Tang, Yilun Sun, Stacey T Schultz-Cherry, Randall T Hayden, Elisabeth E Adderson
BACKGROUND: Diarrhea is common in children with cancer, but this has not been systematically studied to date. METHODS: Remnant stool samples collected between January 2010 and June 2011 from pediatric oncology patients with diarrhea were tested for bacterial, viral, and parasitic enteropathogens using a combination of standard-of-care (SOC) diagnostic tests, including broad-range, real-time polymerase chain reaction (PCR) assays for adenoviruses, astroviruses, and sapoviruses and 2 commercially available multiplexed PCR assays...
August 30, 2016: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/27570854/prevalence-and-risk-factors-of-gram-negative-bacilli-causing-blood-stream-infection-in-patients-with-malignancy
#16
Fawzia E Al-Otaibi, Elham E Bukhari, Mona Badr, Abdulkarim A Alrabiaa
OBJECTIVES: To evaluate the epidemiology, risk factors, and antibiotic resistance of Gram negative bacteria (GNB) in patients with hematologic or solid organ malignancies.   METHODS: This is a retrospective study of 61 episodes of GNB bacteremia occurring in 56 patients with malignancy admitted to the Oncology Units in King Khalid University Hospital, Riyadh. Kingdom of Saudi Arabia during the period from January 2013 to October 2015. Data were retrieved from the computerized database of the microbiology laboratory and the patient's medical records...
September 2016: Saudi Medical Journal
https://www.readbyqxmd.com/read/27566265/-when-silence-is-dangerous-speaking-up-about-safety-concerns
#17
David L B Schwappach
BACKGROUND: Open and direct communication ("speaking-up") about errors, bypassed safety rules and risky behaviours among hospital staff is required to avoid patient harm, and it is an essential characteristic of an established safety culture. In German-speaking countries, little is known about speaking-up behaviour among health care professionals (HCPs) in hospitals. METHOD: Safety concerns and speaking-up behaviours among HCPs of nine oncological units of eight hospitals were assessed using a self-administered survey...
2016: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/27525978/performance-of-the-clinical-index-of-stable-febrile-neutropenia-cisne-in-different-types-of-infections-and-tumors
#18
A Carmona-Bayonas, P Jiménez-Fonseca, J Virizuela, M Antonio, C Font, M Biosca, A Ramchandani, J Martinez-Garcia, J Hernando, J Espinosa, E M de Castro, I Ghanem, C Beato, A Blasco, M Garrido, R Mondéjar, M Á Arcusa, I Aragón, A Manzano, E Sevillano, E Castañón, F Ayala
PURPOSE: The clinical index of stable febrile neutropenia (CISNE) can contribute to patient safety without increasing the complexity of decision-making. However, febrile neutropenia (FN) is a diverse syndrome. The aim of this analysis is to assess the performance of CISNE according to the type of tumor and infection and to characterize these patients. METHODS: We prospectively recruited 1383 FN episodes in situations of apparent clinical stability. Bonferroni-adjusted z tests of proportions were used to assess the association between the infections suspected at the time of onset and the type of tumor with the risk of serious complications and mortality...
August 15, 2016: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/27447001/langerhans-cell-histiocytosis-mimicking-aggressive-periodontitis-challenges-in-diagnosis-and-management
#19
Vasileios Panis, Nikolaos Nikitakis, Argyrios Daskalopoulos, Theodora Maragkou, Konstantinos Tsiklakis, Alexandra Sklavounou
OBJECTIVE: Langerhans cell histiocytosis (LCH) is a rare disorder characterized by clonal proliferation of Langerhans cells that affects various organs. Oral involvement may simulate periodontal disease and cause significant diagnostic and management difficulties. Here, we present an interesting LCH case with severe periodontal destruction in a young woman in order to facilitate early recognition of this aggressive disease and successful participation of the general practitioner in the management of such patients...
2016: Quintessence International
https://www.readbyqxmd.com/read/27434595/trapeze-a-randomised-controlled-trial-of-the-clinical-effectiveness-and-cost-effectiveness-of-chemotherapy-with-zoledronic-acid-strontium-89-or-both-in-men-with-bony-metastatic-castration-refractory-prostate-cancer
#20
Nicholas James, Sarah Pirrie, Ann Pope, Darren Barton, Lazaros Andronis, Ilias Goranitis, Stuart Collins, Duncan McLaren, Joe O'Sullivan, Chris Parker, Emilio Porfiri, John Staffurth, Andrew Stanley, James Wylie, Sharon Beesley, Alison Birtle, Janet Brown, Prabir Chakraborti, Martin Russell, Lucinda Billingham
BACKGROUND: Bony metastatic castration-refractory prostate cancer is associated with a poor prognosis and high morbidity. TRAPEZE was a two-by-two factorial randomised controlled trial of zoledronic acid (ZA) and strontium-89 (Sr-89), each combined with docetaxel. All have palliative benefits, are used to control bone symptoms and are used with docetaxel to prolong survival. ZA, approved on the basis of reducing skeletal-related events (SREs), is commonly combined with docetaxel in practice, although evidence of efficacy and cost-effectiveness is lacking...
July 2016: Health Technology Assessment: HTA
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