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Critical care oncology

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https://www.readbyqxmd.com/read/29145584/critical-lessons-from-high-value-oncology-practices
#1
Douglas W Blayney, Melora K Simon, Beatrice Podtschaske, Scott Ramsey, Margaret Shyu, Craig Lindquist, Arnold Milstein
Importance: Cancer care is expensive. Cancer care provided by practice organizations varies in total spending incurred by patients and payers during treatment episodes and in quality of care, and this unnecessary variation contributes to the high cost. Objective: To use the variation in total spending and quality of care to assess oncology practice attributes distinguishing "high value" that may be tested and adopted by others to produce similar results. Design, Setting, and Participants: "Positive deviance" was used in this exploratory mixed-methods (quantitative and qualitative) analysis of interview results...
November 16, 2017: JAMA Oncology
https://www.readbyqxmd.com/read/29142747/clinical-characteristics-of-critically-ill-cancer-patients-who-are-undergoing-isolated-limb-perfusion
#2
Silvio A Ñamendys-Silva, Arturo M Ruiz-Beltran, Mireya Barragán-Dessavre, Andoreni R Bautista-Ocampo, Abelardo Meneses-García, Octavio González-Chon, Angel Herrera-Gómez
The aim of the present study was to investigate the incidence of organ dysfunction, and to describe the clinical characteristics and intensive care unit (ICU) outcomes of critically ill cancer patients who were admitted to an oncological ICU during the isolated limb perfusion post-operative period. The present study was an observational investigation of 42 critically ill cancer patients who were admitted to the ICU of the Instituto Nacional de Cancerología, during the isolated limb perfusion post-operative period, between July 2010 and February 2016...
November 2017: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/29137835/venous-thromboembolism-risk-and-prophylaxis-in-the-portuguese-hospital-care-setting-the-arte-study
#3
Daniel Ferreira, Joaquim Abreu de Sousa, Paulo Felicíssimo, Ana França
INTRODUCTION: Venous thromboembolism (VTE) is a relatively common complication during hospital stay and determination of VTE risk is critical to choosing the best prophylactic strategy for each patient. OBJECTIVES: In the present study we studied the risk profile for VTE in hospitalized patients in a group of hospitals in Portugal. METHODS: Based on an open cohort of 4248 patients hospitalized in surgical, internal medicine, orthopedic or oncology departments, we determined thromboembolic risk at admission by applying a new score, modified from the Caprini and Khorana scores...
November 11, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29136212/neoadjuvant-and-adjuvant-therapy-for-stage-iii-non-small-cell-lung-cancer
#4
Shun-Ichi Watanabe, Kazuo Nakagawa, Kenji Suzuki, Kazuya Takamochi, Hiroyuki Ito, Jiro Okami, Keiju Aokage, Hisashi Saji, Hiroshige Yoshioka, Yoshitaka Zenke, Tadashi Aoki, Yasuhiro Tsutani, Morihito Okada
The treatments for advanced non-small cell lung cancer (NSCLC) should control both local and microscopic systemic disease, because the 5-year survival of patients with Stage III NSCLC who underwent surgical resection alone has been dismal. One way to improve surgical outcome is the administration of chemotherapy before or after the surgical procedure. During the last two decades, many clinical studies have focused on developing optimal adjuvant or neoadjuvant chemotherapy regimens that can be combined with surgical treatment and/or radiotherapy...
November 9, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29134826/cancer-patients-recommendations-for-nature-based-design-and-engagement-in-oncology-contexts-qualitative-research
#5
Sarah Blaschke, Clare C O'Callaghan, Penelope Schofield
OBJECTIVES: To explore cancer patients' recommendations for nature engagement based on their subjective nature experiences and observations in the cancer setting. The rationale was to gain practical insight for delineating relevant and translatable nature-based care and design opportunities in oncology contexts. BACKGROUND: Innovative cancer care services are needed to respond to growing demand and shifting healthcare needs. Engagement with nature has shown multiple health benefits and presents a promising opportunity for application in healthcare to improve outcomes...
January 1, 2017: HERD
https://www.readbyqxmd.com/read/29128883/a-systematic-review-and-meta-analysis-of-the-effect-of-low-level-laser-therapy-lllt-on-chemotherapy-induced-oral-mucositis-in-pediatric-and-young-patients
#6
REVIEW
Mengxue He, Binghua Zhang, Nanping Shen, Na Wu, Jiwen Sun
Oral mucositis is one of the most frequent complications after chemotherapy, occurring in approximately 52 to 80% of children receiving treatment for cancer. Recently, it has been suggested that the use of low-energy laser could reduce the grade of oral mucositis and alleviate the symptoms. In 2014, Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology has recommended low-level laser therapy in prevention of mucositis for hematopoietic stem cell transplantation patients because of its beneficial effects in majority of recent studies...
November 11, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29121199/the-next-19-years-of-the-american-head-and-neck-society
#7
Jeffrey N Myers
Jeffrey N. Myers, MD, PhD, president of the American Head and Neck Society (AHNS) for 2016 to 2017, offered his perspectives on the AHNS's history, present-day activities, and future plans at this year's annual meeting of the society. The society was created from the 1998 merger of 2 societies, the Society for Head and Neck Surgeons (SHNS), founded in 1954, and the American Society for Head and Neck Surgery (ASHNS), founded in 1959, to become the largest organization in North America for the advancement of research and education in head and neck oncology...
November 9, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29120700/basket-studies-redefining-clinical-trials-in-the-era-of-genome-driven-oncology
#8
Jessica J Tao, Alison M Schram, David M Hyman
Understanding a tumor's detailed molecular profile has become increasingly necessary to deliver the standard of care for patients with advanced cancer. Innovations in both tumor genomic sequencing technology and the development of drugs that target molecular alterations have fueled recent gains in genome-driven oncology care. "Basket studies," or histology-agnostic clinical trials in genomically selected patients, represent one important research tool to continue making progress in this field. We review key aspects of genome-driven oncology care, including the purpose and utility of basket studies, biostatistical considerations in trial design, genomic knowledge-base development, and patient matching and enrollment models, which are critical for translating our genomic knowledge into clinically meaningful outcomes...
November 8, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/29114990/contextualisation-of-patient-centred-care-a-comparative-qualitative-study-of-healthcare-professionals-approaches-to-communicating-with-seriously-ill-patients-about-their-dependent-children
#9
A Dencker, M Kristiansen, B A Rix, P Bøge, T Tjørnhøj-Thomsen
Patients' family relations play an important part in the provision of patient-centred cancer care, not least when healthcare professionals encounter seriously ill patients with dependent children. Little is known about how children are perceived and dealt with in clinical encounters. In this qualitative comparative study, we explore the influence of medical contexts in three Danish hospital wards, haematology, oncological gynaecology and neuro-intensive care, on communication with patients about their children...
November 7, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/29107532/palliative-care-communication-in-the-icu-implications-for-an-oncology-critical-care-nursing-partnership
#10
REVIEW
Deborah A Boyle, Susan Barbour, Wendy Anderson, Janice Noort, Michelle Grywalski, Jeannette Myer, Heather Hermann
OBJECTIVES: To describe the development, launch, implementation, and outcomes of a unique multisite collaborative (ie, IMPACT-ICU [Integrating Multidisciplinary Palliative Care into the ICU]) to teach ICU nurses communication skills specific to palliative care. To identify options for collaboration between oncology and critical care nurses when integrating palliation into nursing care planning. DATA SOURCES: Published literature and collective experiences of the authors in the provision of onco-critical-palliative care...
October 26, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/29107529/learning-the-patient-s-story
#11
REVIEW
Sandra L Ragan, Elisa Kanter
OBJECTIVES: To provide a brief history on narrative medicine and highlight its importance in providing quality patient care. DATA SOURCES: Explains narrative medicine using published, peer-reviewed literature and highlights some of the literary, medical, sociological, and communication perspectives that contributed to the narrative medicine movement. CONCLUSION: A commitment to the patient-provider relationship and knowing the patient's story is a critical aspect in providing quality cancer care...
October 26, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/29098756/reducing-the-risk-of-healthcare-associated-infections-through-lean-six-sigma-the-case-of-the-medicine-areas-at-the-federico-ii-university-hospital-in-naples-italy
#12
Giovanni Improta, Mario Cesarelli, Paolo Montuori, Liberatina Carmela Santillo, Maria Triassi
RATIONALE, AIMS, AND OBJECTIVES: Lean Six Sigma (LSS) has been recognized as an effective management tool for improving healthcare performance. Here, LSS was adopted to reduce the risk of healthcare-associated infections (HAIs), a critical quality parameter in the healthcare sector. METHODS: Lean Six Sigma was applied to the areas of clinical medicine (including general medicine, pulmonology, oncology, nephrology, cardiology, neurology, gastroenterology, rheumatology, and diabetology), and data regarding HAIs were collected for 28,000 patients hospitalized between January 2011 and December 2016...
November 3, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29096987/end-of-life-reflecting-on-things-that-matter
#13
REVIEW
Constance Dahlin, Patrick Coyne
OBJECTIVES: To promote oncology nurse communication that is grounded on principles of ethics, individual care, and shared decision-making. DATA SOURCES: Articles and references in the communication, nursing and oncology nursing literature CONCLUSION: Communication is essential to effectively advocate to meet the needs of cancer patients and their families, and other health care providers, particularly in the quality-of life domains. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses are in a prime position to facilitate quality communication...
October 30, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/29095016/hospital-malnutrition-screening-at-admission-malnutrition-increases-mortality-and-length-of-stay
#14
Elisabet Leiva Badosa, Maria Badia Tahull, Núria Virgili Casas, Gema Elguezabal Sangrador, Concepción Faz Méndez, Ignacio Herrero Meseguer, Àngels Izquierdo González, Rafael López Urdiales, Francisco Javier Oca Burguete, María Tubau Molas, Concepció Vilarasau Farré, Josep Manel Llop Talaveron
INTRODUCTION: Malnutrition is common in patients admitted to hospital and is associated with morbidity and mortality. We conducted a study to assess the prevalence of nutritional risk, risk factors associated and its consequences in a third-level hospital. METHODS: This is a prospective nutritional screening study of hospitalized patients evaluated within the first 72 hours of admission, by Malnutrition Universal Screening Tool (MUST) and Short Nutritional Assessment Questionnaire (SNAQ) screening tests...
July 28, 2017: Nutrición Hospitalaria: Organo Oficial de la Sociedad Española de Nutrición Parenteral y Enteral
https://www.readbyqxmd.com/read/29068312/the-role-of-proteomic-testing-in-improving-prognosis-and-care-planning-quality-measures-for-lung-cancer
#15
Ray D Page, A Christine Argento, David B Nash, Alexandria Skoufalos, Eric S Schaefer
PURPOSE: The Oncology Care Model (OCM) is a payment model from the Centers for Medicare and Medicaid Services designed to reduce costs and improve quality in cancer care. Key components of quality for the OCM originate from the 13-component cancer care plan. We surveyed the literature to understand the value of prognosis in OCM-directed planning for non-small-cell lung cancer (NSCLC) care and to investigate how the results of a prognostic, proteomic biomarker test, the VeriStrat test, can help OCM-participating providers meet the specific quality measures...
September 2017: Managed Care
https://www.readbyqxmd.com/read/29067584/impact-of-surgical-approach-on-perioperative-and-long-term-outcomes-following-esophagectomy-for-esophageal-cancer
#16
Negar Ahmadi, Agnes Crnic, Andrew J Seely, Sudhir R Sundaresan, P James Villeneuve, Donna E Maziak, Farid M Shamji, Sebastien Gilbert
BACKGROUND: Surgical resection remains a critical component of esophageal cancer treatment with curative-intent. The aim of this study was to compare open (OE) to minimally invasive Ivor Lewis esophagectomy (MIE) with respect to perioperative and oncologic outcomes. METHODS: Retrospective single-institution review of MIE and OE patients operated between 2001 and 2015 was conducted. Univariable and multivariable models were created using Cox regression. The Kaplan-Meier method was used to compare oncologic outcomes...
October 24, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/29066928/assessment-and-treatment-of-breakthrough-cancer-pain-from-theory-to-clinical-practice
#17
REVIEW
Renato Vellucci, Rocco Domenico Mediati, Silvia Gasperoni, Massimo Mammucari, Franco Marinangeli, Patrizia Romualdi
Breakthrough cancer pain (BTcP) is a common condition in oncological patients. However, its management is still suboptimal. Improved knowledge of BTcP and its management in clinical practice may have immediate importance for all physicians involved in the supportive care of cancer patients. This review critically discusses the most important concepts for the correct diagnosis of BTcP and presents some intriguing cases of the management of this condition in clinical practice. Overall, the most appropriate therapeutic choice appears to be a rapid-onset opioid (ROO), and in particular, the nasal route of administration is the quickest and most convenient mode of administration for the management of BTcP, especially when the patient needs rapid resolution of pain...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/29056275/current-and-future-applications-of-novel-immunotherapies-in-urological-oncology-a-critical-review-of-the-literature
#18
REVIEW
Berna C Özdemir, Arlene O Siefker-Radtke, Matthew T Campbell, Sumit K Subudhi
CONTEXT: Immunotherapies promote anticancer responses with varying levels of success based on the tumor type. OBJECTIVE: In this narrative review article, we searched the literature regarding immunotherapies in genitourinary malignancies to define the state of the field, explore future applications of immune checkpoint inhibitors, cytokines, vaccines, and cellular therapies in urological oncology and evaluate possible strategies to improve the selection of patients who might benefit from such approaches...
October 19, 2017: European Urology Focus
https://www.readbyqxmd.com/read/29056247/haemato-oncology-patients-perceptions-of-health-related-quality-of-life-after-critical-illness-a-qualitative-phenomenological-study
#19
Geraldine O'Gara, Simon Tuddenham, Natalie Pattison
INTRODUCTION: Haemato-oncology patients often require critical care support due to side-effects of treatment. Discharge can mark the start of an uncertain journey due to the impact of critical illness on health-related quality of life. Qualitatively establishing needs is a priority as current evidence is limited. AIMS: To qualitatively explore perceptions of haemato-oncology patients' health-related quality of life after critical illness and explore how healthcare professionals can provide long-term support...
October 19, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29047353/precision-medicine-for-all-challenges-and-opportunities-for-a-precision-medicine-approach-to-critical-illness
#20
REVIEW
Christopher W Seymour, Hernando Gomez, Chung-Chou H Chang, Gilles Clermont, John A Kellum, Jason Kennedy, Sachin Yende, Derek C Angus
All of medicine aspires to be precise, where a greater understanding of individual data will lead to personalized treatment and improved outcomes. Prompted by specific examples in oncology, the field of critical care may be tempted to envision that complex, acute syndromes could bend to a similar reductionist philosophy-where single mutations could identify and target our critically ill patients for treatment. However, precision medicine faces many challenges in critical care. These include confusion about terminology, uncertainty about how to divide patients into discrete groups, the challenges of multi-morbidity, scale, and the need for timely interventions...
October 18, 2017: Critical Care: the Official Journal of the Critical Care Forum
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