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https://www.readbyqxmd.com/read/28317631/lactic-acidosis-a-rare-oncological-emergency-in-solid-tumors-at-presentation
#1
Ranjit Nair, Usman Shah
Lactic acidosis is a potentially life-threatening complication characterized by accumulation of blood lactate resulting in low arterial pH. The majority of lactic acidosis in malignancies are reported in association with hematologic malignancies. It may result from an imbalance between lactate production and hepatic lactate utilization, but the exact pathophysiology is far more complex than what we can fathom from current micromolecular studies. We report a case of a 71-year-old male with metastatic lung cancer presenting with fatal lactic acidosis in the absence of liver involvement...
April 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28315558/toxicity-management-development-of-a-novel-and-immune-mediated-adverse-events-algorithm%C3%A2
#2
Haleigh Mistry, Sheryl G Forbes, Nathan Fowler
BACKGROUND: Novel immunotherapy and biologic agents are being developed with the potential to improve outcomes and reduce long-term toxicities among individuals with hematologic malignancies. These emerging drugs affect neoplastic cells and the surrounding microenvironment, causing unique immune-mediated toxicities.
. OBJECTIVES: The aim was to develop an algorithm for clinical staff to manage unique toxicities associated with next-generation immunotherapies indicated in the hematologic population, using a system-focused approach...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28282274/improving-the-management-of-patients-with-low-risk-neutropenic-fever-at-the-cleveland-clinic-taussig-cancer-institute
#3
Lindsey Martin Goodman, Bassam Estfan, Alberto Montero, Girish Kunapareddy, Jessica Lau, Erika Gallagher, Carolyn Best, Barb Tripp, Machelle Moeller, Brian Bolwell, James Stevenson
PURPOSE: Neutropenic fever (NF) is an oncologic emergency and has resulted historically in inpatient management. The Multinational Association for Supportive Care in Cancer (MASCC) score can be used to identify patients with NF at a low risk of complications who can be managed safely as outpatients. Despite established guidelines supporting outpatient management of low-risk neutropenic fever (LRNF), provider awareness is low, and inpatient admission for intravenous antibiotics continues to be standard of care...
March 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28152918/using-information-technology-it-to-improve-communication-between-the-emergency-room-and-cancer-clinic
#4
Conrad B Falkson, Tara D Baetz
158 Background: A communication gap was identified at the Cancer Centre of Southeastern Ontario which resulted in oncologists at the cancer centre (CC) not consistently being informed when oncology patients (pt) were seen in the emergency room (ER). An automated IT notification system was developed to inform oncologists when their pt were seen in the ER. METHODS: Pt who had been seen within 60 days in the CC were considered active. An IT notification system linked active CC visits and ER visits...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152896/current-landscape-of-acute-myeloid-leukemia-quality-measures-in-the-united-states
#5
Cat N Bui, Kyung Min Song, Eleanor Fitall, Kristi Mitchell, Stephanie Greenstein Braun, Erkut Bahceci, Bhavik Pandya, Dayo Jagun
261 Background: Acute myeloid leukemia (AML) is a rare, but deadly hematological, disease with 20,830 new cases estimated in 2015 in the United States (US). As new treatments emerge, quality measures (QMs) will become important to assess the value of care. Our aim was to evaluate the current US AML QM landscape. METHODS: We reviewed literature and online resources (eg, National Quality Measures Clearinghouse, Centers for Medicare & Medicaid Services, etc.) published within the last 5 years to identify AML-specific and AML-related QMs...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152756/making-steps-to-decrease-emergency-room-visits-in-patients-with-cancer-our-experience-after-participating-in-the-asco-quality-training-program
#6
Alvaro Jose Alencar, Aurelio Bartolome Castrellon, Luis E Raez, Vedner Guerrier
51 Background: Overutilization of emergency room services by oncology patients is a known problem associated with increased admission rates and health care expenditure. A review of our oncology patients' emergency room (ER) visits from January to May 2015 demonstrated that 48% of ER visits happened during office hours. Consequently a rapid cycle quality improvement project was developed with an aim to decrease ER visits by 30% by September 2015. METHODS: A multidisciplinary team completed an action plan, starting with a project charter and definition of aim statement...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152750/impact-of-a-best-practice-alert-on-transfusion-practices-for-solid-tumor-oncology-patients
#7
Kelley Wachsberg, Charlotta Weaver, Lyndsey Dombrowski, Madeleine Ma, Jungwha Lee, Kevin O'Leary
57 Background: Recent evidence supports a restrictive transfusion strategy in the majority of hospitalized patients, though transfusion practices for oncology patients remain highly variable. We evaluated whether use of a best practice alert for solid tumor oncology inpatients would result in more restrictive transfusion practices and impact patient outcomes. METHODS: We conducted a retrospective, historical control analysis at a large academic hospital in Chicago, IL. We compared transfusion utilization among solid tumor oncology patients before and after implementation of a transfusion alert...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152702/improving-the-treatment-of-patients-with-low-risk-neutropenic-fever-a-quality-improvement-project-at-the-cleveland-clinic-taussig-cancer-institute-tci
#8
Jessica Lau, Erika M Gallagher, Machelle Moeller, Carolyn Best, James Stevenson
101 Background: NF is an oncologic emergency and has historically resulted in inpatient (inpt) management. The Multinational Association for Supportive Care in Cancer (MASCC) score can be used to identify NF pts at LR for complications who can be safely managed in the outpatient (outpt) setting. Despite established guidelines supporting outpt management of LRNF, provider awareness is low and inpt admission for intravenous antibiotics (abx) continues to be standard of care. METHODS: A multidisciplinary team performed a QI project to improve management of LRNF (baseline cohort of LRNF pts treated from Jan - Mar 2014, N = 13)...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28125373/health-care-resource-utilization-and-costs-in-patients-with-chronic-myeloid-leukemia-with-better-adherence-to-tyrosine-kinase-inhibitors-and-increased-molecular-monitoring-frequency
#9
Dominick Latremouille-Viau, Annie Guerin, Patrick Gagnon-Sanschagrin, Katherine Dea, Benjamin G Cohen, George J Joseph
BACKGROUND: Frequent molecular monitoring (qPCR tests), as recommended by evidence-based monitoring guidelines, is associated with higher adherence to tyrosine kinase inhibitors (TKIs) in the management of chronic myeloid leukemia (CML); both factors have been associated with better clinical and economic outcomes. OBJECTIVES: To (a) estimate the effect of more frequent qPCR tests on health care resource utilization (HRU) and associated costs, including direct (effect of qPCR test frequency on HRU) and indirect (through TKI adherence) effects, and (b) develop an economic model applicable to multiple clinical practice scenarios...
February 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27915303/candida-species-isolated-from-different-body-sites-and-their-antifungal-susceptibility-pattern-cross-analysis-of-candida-albicans-and-candida-glabrata-biofilms
#10
Valentina Cataldi, Emanuela Di Campli, Paolo Fazii, Tonino Traini, Luigina Cellini, Mara Di Giulio
Candida species are regular commensal in humans, but-especially in immunocompromised patients-they represent opportunistic pathogens giving rise to systemic infection. The aim of the present work was to isolate and characterize for their antifungal profile Candida species from different body sites and to analyze the biofilms produced by C. albicans and C. glabrata isolates. Eighty-one strains of Candida species from 77 patients were identified. Epidemiological study showed that the most isolated species were C...
December 2, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/27903214/chemotherapy-and-cardiotoxicity-in-hematologic-malignancies-a-review
#11
Antonio Stellitano, Roberta Fedele, Santina Barillà, Antonino Iaria, Carmelo Massimiliano Rao, Massimo Martino
Antineoplastic agents affect the cardiovascular system, and the incidence of cardiotoxicity is continuously growing in patients with hematologic malignancies and treated with antineoplastic therapy. Cardio-oncology is a quite young discipline, designed for diagnosis, prevention and treatment of cardiovascular complications of anticancer agents. Nowadays, with the current treatments and an accurate pharmacological control of comorbidities present at the time of the oncological diagnosis, early clinical events are infrequent, and it seems indeed that cardiotoxicity could emerge as time and years go by, after therapies completion...
November 21, 2016: Current Cancer Drug Targets
https://www.readbyqxmd.com/read/27856600/tti-621-sirp%C3%AE-fc-a-cd47-blocking-innate-immune-checkpoint-inhibitor-with-broad-antitumor-activity-and-minimal-erythrocyte-binding
#12
Penka S Petrova, Natasja Nielsen Viller, Mark Wong, Xinli Pang, Gloria H Y Lin, Karen Dodge, Vien Chai, Hui Chen, Vivian Lee, Violetta House, Noel T Vigo, Debbie Jin, Tapfuma Mutukura, Marilyse Charbonneau, Tran Truong, Stephane Viau, Lisa D Johnson, Emma Linderoth, Eric L Sievers, Saman Maleki Vareki, Rene Figueredo, Macarena Pampillo, James Koropatnick, Suzanne Trudel, Nathan Mbong, Liqing Jin, Jean C Y Wang, Robert A Uger
PURPOSE: The ubiquitously expressed transmembrane glycoprotein CD47 delivers an anti-phagocytic (do not eat) signal by binding signal-regulatory protein α (SIRPα) on macrophages. CD47 is overexpressed in cancer cells and its expression is associated with poor clinical outcomes. TTI-621 (SIRPαFc) is a fully human recombinant fusion protein that blocks the CD47-SIRPα axis by binding to human CD47 and enhancing phagocytosis of malignant cells. Blockade of this inhibitory axis using TTI-621 has emerged as a promising therapeutic strategy to promote tumor cell eradication...
November 17, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/27855948/-data-regarding-the-roles-and-impact-of-pharmaceutical-activities-quantitative-and-qualitative-study-with-four-groups-of-experts
#13
M Breton, E Ferreira, N Letarte, J-F Bussières
OBJECTIVES: The use of scientific data about the roles and the impact of pharmacists is suboptimal. The objective is to evaluate the opinion and attitude of expert pharmacists on the measurement of indicators for the pharmaceuticals activities, sharing and appropriation of scientific knowledge and the place of the website "Impact Pharmacie". METHODS: This is a descriptive cross-sectional study. Four expert groups were interviewed (hematology-oncology, intensive care, emergency and infectious diseases)...
March 2017: Annales Pharmaceutiques Françaises
https://www.readbyqxmd.com/read/27749799/making-improvements-in-the-ed-does-ed-busyness-affect-time-to-antibiotics-in-febrile-pediatric-oncology-patients-presenting-to-the-emergency-department
#14
Christopher A Benner, Erika Mora, Emily Mueller, F Jacob Seagull, Kelly Walkovich, Kaleena Johnson, Schuyler Halverson, Ed Rothman, George Hucks, John G Younger, Michele M Nypaver
OBJECTIVES: Febrile neutropenic pediatric patients are at heightened risk for serious bacterial infections, and rapid antibiotic administration (in <60 minutes) improves survival. Our objectives were to reduce the time-to-antibiotic (TTA) administration and to evaluate the effect of overall emergency department (ED) busyness on TTA. METHODS: This study was a quality improvement initiative with retrospective chart review to reduce TTA in febrile children with underlying diagnosis of cancer or hematologic immunodeficiency who visited the pediatric ED...
October 4, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27741957/where-teachers-are-few-documenting-available-faculty-in-five-tanzanian-medical-schools
#15
Charles A Mkony, Ephata E Kaaya, Alex J Goodell, Sarah B Macfarlane
BACKGROUND: Faced with one of the lowest physician-to-population ratios in the world, the Government of Tanzania is urging its medical schools to train more physicians. The annual number of medical students admitted across the country rose from 55 in the 1990s to 1,680 approved places for the 2015/16 academic year. These escalating numbers strain existing faculty. OBJECTIVE: To describe the availability of faculty in medical schools in Tanzania. DESIGN: We identified faculty lists published on the Internet by five Tanzanian medical schools for the 2011/12 academic year and analyzed the appointment status, rank, discipline, and qualifications of faculty members...
2016: Global Health Action
https://www.readbyqxmd.com/read/27736871/determinants-of-treatment-abandonment-in-childhood-cancer-results-from-a-global-survey
#16
Paola Friedrich, Catherine G Lam, Geetinder Kaur, Elena Itriago, Raul C Ribeiro, Ramandeep S Arora
BACKGROUND: Understanding and addressing treatment abandonment (TxA) is crucial for bridging the pediatric cancer survival gap between high-income (HIC) and low-and middle-income countries (LMC). In childhood cancer, TxA is defined as failure to start or complete curative cancer therapy and known to be a complex phenomenon. With rising interest on causes and consequences of TxA in LMC, this study aimed to establish the lay-of-the-land regarding determinants of TxA globally, perform and promote comparative research, and raise awareness on this subject...
2016: PloS One
https://www.readbyqxmd.com/read/27724969/survival-outcomes-in-patients-with-oropharyngeal-cancer-treated-with-carboplatin-paclitaxel-and-concurrent-radiotherapy
#17
M Roskies, E Kay-Rivest, M A Mascarella, K Sultanem, A Mlynarek, M Hier
BACKGROUND: A commonly employed treatment for advanced staged oropharyngeal squamous cell carcinoma (OPSCC) is concurrent radiation and chemotherapy with cisplatin as the gold standard. Carboplatin is reported to have the same radiopotentiation properties and a superior side effect profile; however, its use in head and neck cancer has been limited due to the paucity of data and reported hematologic side effects. In this study, we describe our institution's experience with carboplatin, paclitaxel and radiation in the treatment of oropharyngeal squamous cell carcinoma over a 10 year period...
October 10, 2016: Journal of Otolaryngology—Head & Neck Surgery
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
#18
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/27581596/risk-management-of-onco-hematological-drugs-how-and-how-fast-can-we-improve
#19
Mattia Altini, Marna Bernabini, Paolo Marchetti, Laura Orlando, Barbara Rebesco, Valeria Sirna
PURPOSE: Medication errors in oncology may cause severe damage to patients, professionals, and the environment. The Italian Ministry of Health issued Raccomandazione 14 to provide guidelines for prevention of errors while using antineoplastic drugs. This work aimed at analyzing Raccomandazione 14 through the different viewpoints of the hospital pharmacist, the nurse, the oncologist, and the hospital director. METHODS: Twenty-seven Italian healthcare organizations participated in a self-assessment survey evaluating compliance with Raccomandazione 14 within the oncology, hematology, and pharmacy departments...
August 29, 2016: Tumori
https://www.readbyqxmd.com/read/27404978/bacteremia-due-to-carbapenem-resistant-enterobacteriaceae-in-neutropenic-patients-with-hematologic-malignancies
#20
Michael J Satlin, Nina Cohen, Kevin C Ma, Zivile Gedrimaite, Rosemary Soave, Gülce Askin, Liang Chen, Barry N Kreiswirth, Thomas J Walsh, Susan K Seo
OBJECTIVES: To determine the prevalence, risk factors, treatments, and outcomes of bloodstream infections (BSIs) due to carbapenem-resistant Enterobacteriaceae (CRE) in adult neutropenic patients with hematologic malignancies. METHODS: We reviewed all BSIs between 2008 and 2012 in this population at two New York City oncology centers. A case-control study was conducted to identify CRE BSI risk factors, using three controls of non-CRE BSIs per case. RESULTS: CRE caused 43 (2...
October 2016: Journal of Infection
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