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Oncology Unit (oncology + unit)
Selected AbstractsEfficacy and safety of linezolid in immunocompromised children with cancerPEDIATRICS INTERNATIONAL, Issue 5 2010Maria Moschovi Abstract Background:, The aim of this study was to determine the safety, tolerance and efficacy of linezolid for the treatment of infections from Gram-positive bacteria in immunocompromised children with cancer. Methods:, This was a prospective non-comparative unblinded study in the Hematology/Oncology Unit over a two-year period, administering linezolid as monotherapy in children with cancer. Results:, Seventeen children received linezolid (30 mg/kgr: 3 i.v. per day). Mean duration of linezolid administration was 12.2 days (range, 6,38 days), while the median age of the evaluable patients was 2.2 years (range, 6 months,11.2 years). Primary diagnosis was acute lymphoblastic leukemia (nine patients), brain tumor (three patients), multi-organ Langerhans cell histiocytosis (two patients), rhabdomyosarcoma, Burkitt's lymphoma and ovarian tumor (one patient each). All patients were in the midst of chemotherapy cycles. Ten out of 17 children had positive blood cultures (methicillin-resistant Staphylococcus aureus, four patients; vancomycin-resistant Enterococcus, three patients; penicillin-resistant Streptococcus pneumoniae, three patients), while seven of the 17 had fever and vancomycin-resistant Enterococcus in stool cultures. All patients were considered clinically cured after the end of the linezolid regimen (100% efficacy). The main adverse events were thrombocytopenia grade 1,3 and anemia grade 2,3 (four and two patients, respectively). Chemotherapy-induced myelotoxicity (six patients) was not worsened during linezolid therapy. No bleeding episodes were presented. Self-limited diarrhea grade 1,2 was presented in four patients (mean duration 2 days). The total adverse event rate was 23.5%; however, there was no premature cessation of linezolid in any patient. Conclusions:, Linezolid may be another effective and safe therapy to treat infections from resistant Gram-positive bacteria in immunocompromised children, even in young ages. [source] Diagnosing cancer: changing patterns of careINTERNAL MEDICINE JOURNAL, Issue 2 2007E. Lim Abstract We prospectively assessed 100 consecutive inpatient referrals made to the Medical Oncology Unit. The major end-point was the time to diagnostic biopsy. Referral trends and treatment outcomes were also recorded. Our results show that the referring units undertook the diagnostic process in the vast majority and the time to inpatient diagnostic biopsy has fallen from 10 to 4.6 days, compared with a similar study 13 years ago. This emphasizes the changing role of the oncologist in current day multidisciplinary cancer care. [source] Ocular conservation in patients with uveal melanoma by a multimodality approach to treatmentACTA OPHTHALMOLOGICA, Issue 2007C GARCIA-ALVAREZ Purpose: To analyse eye survival in patients with uveal melanoma with a multimodality approach to treatment Methods: 273 patients with uveal melanoma diagnosed at Ocular Oncology Unit of the University Hospital of Valladolid from 1997 September to 2007 April. Pearson's Chi-square test was used to identify between variables and primary enucleation. Logistic regression was used to identify independent variables predicting primary enucleation. Cox's univariate proportional hazards model was used to identify associations between variables and time to secondary enucleation.Kaplan-Meier estimates were used to draw survival curves for time to secondary enucleation Results: 273 patients were included in the study. Primary enucleation was performed in 80 patients. Secondary enucleation in 12. Gender (p=0,032), basal tumour diameter >15mm (p<0,001), tumour weight >10mm (p<0,001), anterior tumour margin (p<0,001) and extraocular spread (p<0,001) were associated with primary enucleation. Predictive factors for primary enucleation were largest basal tumor diameter (odds ratio [OR], 3,8; 95% confidence interval [IC], 1,5-9,1) and tumour weight (OR, 2,7; IC, 1-7,5). Ocular conservation probability 5 years after conservative treatment was 88%. Largest basal tumor diameter, anterior tumour margin and extraocular spread had influence in ocular survival after conservative treatment. Only largest basal tumor diameter was a predictive factor of secondary enucleation Conclusions: In the present series 69,9% of patiens had a conservative treatment and 88% of them conserved treated eye 5 years [source] Can objective parameters derived from videofluoroscopic assessment of post-laryngectomy valved speech replace current subjective measures?CLINICAL OTOLARYNGOLOGY, Issue 6 2006An e-tool-based analysis Objectives:, The primary purpose of this study was to assess the pharyngoesophageal segment in total laryngectomy patients using a videofluoroscopy e-tool. Study design:, Cross-sectional study. Setting:,, Head and Neck Oncology Unit, Tertiary Referral Centre. Patients:, Forty-two patients following total laryngectomy. Intervention:, Videofluoroscopy using an e-tool (JRuler). Main outcome measures:, Subjective and objective videofluoroscopy parameters correlated with the GRBAS scale and treatment variables. Results:, Of 32 men and 10 women, mean age 63.5 years (10.8) the majority (64.3%) had a reasonable voice (good = 11 and poor = 4 patients). Comparing subjective and objective parameters, significant correlations were only seen with a smaller minimal neoglottic distance at phonation with no regurgitation of barium at phonation (P = 0.05) and a type 1 shape of neoglottis at phonation (P = 0.02). There were also significant correlations between smaller maximum sub-neoglottic distance at phonation and type 1 shape of neoglottis (P = 0.02), smaller maximum sub-neoglottic distance at rest and absence of stasis of barium at phonation (P = 0.05) and the length of neoglottis at phonation and type 1 shape of neoglottis (P = 0.01). For perceptual evaluation, significant correlation was seen only between G1 voice and a smaller minimal neoglottic distance at phonation (P = 0.03) amongst the subjective and objective parameters. There were no correlations between visual parameters and the clinical parameters. Conclusions:, Our observations suggest that this interesting concept has limitations. While objective and quantifiable data can be obtained using videofluoroscopy in laryngectomees, only a few correlate with each other and with voice quality. [source] Concept development of family resilience: a study of Korean families with a chronically ill childJOURNAL OF CLINICAL NURSING, Issue 5 2004Insook Lee RN Aims., To clarify and delineate the concept of family resilience in the context of the chronic illness of a child. This study also investigated the concept of family resilience in relation to family functioning in order to compare and contrast family resilience and family functioning. Design and method., Three phases of the hybrid model of concept development were applied: theoretical, fieldwork and final analytical. In the theoretical phase, a working definition of family resilience was developed by a literature review. The fieldwork phase comprised in-depth interviews with 11 parents with a chronically ill child, in the paediatric oncology unit of a university hospital in South Korea. The qualitative data obtained from the interviews were analysed to find attributes of family resilience. The final analytical phase compared and interpreted the findings from the theoretical and fieldwork phases in order to clarify and refine the concept of resilience. Results., The definition of family resilience was of an enduring force that leads a family to change its functioning dynamics in order to solve problems encountered. Twenty-one conceptual attributes of family resilience emerging from this study were differentiated into four dimensions: (i) intrinsic family characteristics, (ii) family member orientation related to family characteristics, (iii) responsiveness to stress and (iv) external orientation. Conclusions., Family resilience is an enduring force that leads a family to change its dynamics of functioning in order to solve problems associated with stresses encountered. This conceptualization led to the development of a model of family coping that incorporates both family resilience and family functioning, as the property and as the process of change, respectively. Relevance to clinical practice., In order to build a family that functions better under stress, it is necessary for nurses to focus more attention on family resilience, especially in terms of the development of intervention strategies to strengthen family resilience. [source] Comparison of radiologically inserted arm ports versus surgically placed chest ports for chemotherapyASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, Issue 3 2009Andrew WEICKHARDT Abstract Aim: Central venous access ports (CVAP) are often required to deliver chemotherapy to cancer patients. Arm-sited CVAP are an alternative to traditional chest-sited CVAP, but their durability and complication rates have not been thoroughly compared. Methods: A retrospective analysis at a single institution was conducted of all patients who had a chest port inserted for chemotherapy over a 30-month period and compared to patients who had an arm port inserted over a subsequent 30-month period. The minimum follow-up period in patients who did not die from cancer was 6 months. The primary endpoint was successful use of the port, defined as a patient completing chemotherapy without a complication prompting removal of the port. Results: The success rate was not significantly different between arm port (92 patients) or chest port (49 patients) groups (88 vs 92%). There were no significant differences between infective or thrombotic complications in the two groups. Conclusion: Arm CVAP were found to be equivalent in durability and complications compared to chest CVAP for chemotherapy administration at a regional oncology unit. [source] Glove perforations during open surgery for gynaecological malignanciesBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 8 2008AP Manjunath Objective, To audit glove perforations at laparotomies for gynaecological cancers. Setting, Gynaecological oncology unit, cancer centre, London. Design, Prospective audit. Sample, Twenty-nine laparotomies for gynaecological cancers over 3 months. Methods, Gloves used during laparotomies for gynaecological cancer were tested for perforations by the air inflation and water immersion technique. Parameters recorded were: type of procedure, localisation of perforation, type of gloves, seniority of surgeon, operation time and awareness of perforations. Main outcome measure, Glove perforation rate. Results, Perforations were found in gloves from 27/29 (93%) laparotomies. The perforation rate was 61/462 (13%) per glove. The perforation rate was three times higher when the duration of surgery was more than 5 hours. The perforation rate was 63% for primary surgeons, 54.5% for first assistant, 4.7% for second assistant and 40.5% for scrub nurses. Clinical fellows were at highest risk of injury (94%). Two-thirds of perforations were on the index finger or thumb. The glove on the nondominant hand had perforations in 54% of cases. In 50% of cases, the participants were not aware of the perforations. There were less inner glove perforations in double gloves compared with single gloves (5/139 versus 26/154; P = 0.0004, OR = 5.4, 95% CI 1.9,16.7). The indicator glove system failed to identify holes in 44% of cases. Conclusions, Glove perforations were found in most (93%) laparotomies for gynaecological malignancies. They are most common among clinical fellows, are often unnoticed and often not detected by the indicator glove system. [source] Posttraumatic growth in cancer patients and partners,effects of role, gender and the dyad on couples' posttraumatic growth experiencePSYCHO-ONCOLOGY, Issue 1 2010Diana Zwahlen Abstract Background/Aim: Little is known about factors influencing positive effects in couples facing a cancer diagnosis. Methods: A heterogeneous sample of 224 couples from a multi-site study (four oncology units) completed questionnaire surveys including the Posttraumatic Growth Inventory (PTGI) as a measure of positive psychological effects. Results: The data demonstrated that all three investigated factors,gender, role (patient vs partner) and the dyad (belonging to any of the 224 couples),significantly contributed to variation in PTGI total scores and subscales. Variability between couples (factor dyad) appeared stronger than variability between patient and partner participants (factor role) and between male and female participants (factor gender). Role and gender analysis showed that patients demonstrated higher levels of posttraumatic growth than partners; and female participants scored higher on PTGI than males. Male patient,female partner pairs show greater association in their experience of posttraumatic growth than female patient,male partner pairs. Correlations also suggested that, regardless of the gender and role composition, patients and partners may experience parallel growth. Conclusions: Our findings indicate that positive psychological experiences may be shared by partners affected by cancer in similar ways as have been shown for negative psychological effects. Intra-couple similarities or processes may have a more important function in experiencing benefits than factors like gender or being the patient or the partner. These results underline the importance of a family approach to understanding negative and positive psychological effects of cancer. Copyright © 2009 John Wiley & Sons, Ltd. [source] Intraperitoneal chemotherapy for advanced epithelial ovarian malignancy: Lessons learnedAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 6 2009Michael BUNTING Background:, The administration of intraperitoneal (IP) chemotherapy as first-line adjuvant treatment for women with optimally debulked advanced ovarian malignancy results in improved median and overall survival when compared with intravenous (IV) chemotherapy. However, the number of adverse events and toxicities are increased in patients treated with IP chemotherapy. In addition, the administration of IP chemotherapy is technically more challenging and the schedule is more demanding in terms of time and resources. Aims:, We report on our initial experience with the administration of IP chemotherapy at two gynaecological oncology units in Australia. Methods:, We collected retrospective data from a series of 23 women undergoing IP chemotherapy as adjuvant treatment for advanced ovarian cancer. In addition to standard (Common Terminology Criteria for Adverse Events v3.0, CTCAE) toxicity data, we collected technical data specific to the administration of IP chemotherapy. Results:, The average number of IP chemotherapy cycles received was 4.3. Forty-three per cent of patients received all six planned IP chemotherapy cycles. Thirty-nine per cent of patients discontinued their IP treatment. Of those, 22% were discontinued because of drug-related toxicities and the remaining 17% experienced a port complication or toxicity directly related to the route of administration. Conclusions:, This study demonstrates the feasibility and practicality of and lessons learned from initial experiences with IP chemotherapy for ovarian cancer in Australia. [source] | ||||||||||