Exploring the Potential of Electronic Patient-Reported Outcome Measures to Inform and Assess Care in Sarcoma Centers: A Longitudinal Multicenter Pilot Study.

BACKGROUND: Electronic patient-reported outcome measures (ePROMs) are useful tools to assess care needs of patients diagnosed with cancer and to monitor their symptoms along the illness trajectory. Studies regarding the application of ePROMs by advanced practice nurses (APNs) specialized in sarcoma care and the use of such electronic measures for care planning and assessing quality of care are lacking. OBJECTIVE: To explore the potential of ePROMs in clinical practice for assessing the patient's quality of life, physical functionality, needs, and fear of progression, as well as distress and the quality of care in sarcoma centers. METHODS: A multicenter longitudinal pilot study design was chosen. Three sarcoma centers with and without APN service located in Switzerland were included. The instruments EQ-5D-5L, Pearman Mayo Survey of Needs, the National Comprehensive Cancer Network Distress Thermometer, PA-F12, and Toronto Extremity Salvage Score were used as ePROMs. Data were analyzed descriptively. RESULTS: Overall, 55 patients participated in the pilot study; 33 (60%) received an intervention by an APN, and 22 (40%) did not. Patients in sarcoma centers with APN service reported overall higher scores in quality of life and functional outcome. The number of needs and distress level were lower in sarcoma centers with APN service. No differences were found with respect to patients' fear of progression. CONCLUSIONS: Most of the ePROMs proved to be reasonable in clinical practice. PA-F12 has shown low clinical relevance. IMPLICATIONS FOR PRACTICE: Using ePROMs appears to be reasonable to obtain clinically relevant patient information and to evaluate the quality of care in sarcoma centers.

[Care provided by an advanced practice nurse: Experiences of patients with sarcoma and family members. A qualitative study]. / Betreuung durch eine Advanced Practice Nurse: Erfahrungen von Patient_innen mit Sarkom und Angehörigen.

Care provided by an advanced practice nurse: Experiences of patients with sarcoma and family members. A qualitative study Abstract. Background: Sarcomas are a rare, heterogeneous group of malignant tumors with different trajectories, which cause significant burden to patients and families. Due to the complex nature of treatment, an interprofessional team at the sarcoma center of a Swiss university hospital provides care to affected individuals. This interprofessional team includes an advanced practice nurse (APN) who cares for patients and family members throughout the trajectory of the disease. To date, there are limited descriptions within literature of APN care from the perspective of patients with sarcoma and their family members. Aim: To investigate how patients with sarcoma and their family members experienced APN care. Methods: The study was guided by the qualitative research methodology "Interpretive Description". Individual interviews with seven patients and five family members were conducted and analyzed in an iterative process. Results: For patients and family members, the time from diagnosis to therapy and follow-up was very stressful. They experienced the APN's care during this time as a great support and described her as a compassionate, trustworthy and continuous contact person who expertly provided information and advice while acting as a coordinator. Conclusions: Patients with sarcoma and their family members require continuous contact with a person who is compassionate, while also professional, confident and competent. Providing APN care can meet all of these essential requirements.

Etiology of viral respiratory infections in Northern Lao People's Democratic Republic.

In Lao People's Democratic Republic (PDR), acute respiratory infections overburden the health care system, but viral etiology, genetic diversity, and seasonality, especially in light of the introduction of influenza vaccination in the country, are poorly understood. From August 2010 to April 2011, 309 outpatients were recruited at the Luang Prabang Provincial Hospital covering highland Lao communities. Nasopharyngeal swabs were screened for the presence of 13 respiratory viruses. At least one virus was detected in 69.6% and dual/triple viral infections in 12.9%/1.9% of the patients. Influenza A and B viruses combined were the most frequently detected pathogens, followed by human adenovirus and respiratory syncytial virus (RSV). The other viruses were detected in less than 10% of the patients. Phylogenetic analyses on a representative set of RSV strains revealed that, while otherwise very rare, the RSV-B CB1/THB genotype cocirculated with other common genotypes. A single wave of influenza virus and RSV activity was observed during the rainy season, providing further support to influenza vaccination before the onset of the rains. This study provides recommendations for influenza vaccination that still needs optimization and highlights the need for revised guidelines for treatment and prevention of respiratory infections in Lao PDR, as well as for increased surveillance efforts.

Human endogenous retrovirus protein Rec interacts with the testicular zinc-finger protein and androgen receptor.

More than 2000 human endogenous retrovirus (HERV) sequences are present in the human genome, yet only a few are intact and able to produce proteins. The normal functions of these, if any, are unknown, but some HERV proteins have been implicated in cancers, in particular germ-cell cancers. For instance, it has been documented that (i) patients with germ-cell tumours frequently produce antibodies against HERV proteins; (ii) transgenic mice expressing HERV-K (HML-2) rec are prone to testicular carcinoma in situ; and (iii) Rec can bind and suppress a guardian of germline stem-cell pluripotency, the promyelocytic leukaemia zinc-finger protein (PLZF). This study identified the PLZF-related testicular zinc-finger protein (TZFP) as a binding partner of HERV-K (HML-2) Rec. Interactions occurred via the N- and C-terminal domains of Rec and the C-terminal DNA-binding zinc-finger domain of TZFP (aa 375-450). Not much is known about the function of TZFP. The protein is expressed predominantly in the testis, where it functions as a transcriptional repressor that is active during specific stages of spermatogenesis. The most intensely studied function of TZFP is that of a co-repressor of the activated androgen receptor (AR). Here, it was shown that Rec can form a trimeric complex with TZFP and AR, and can relieve the TZFP-mediated repression of AR-induced transactivation. In addition, Rec was able to overcome the direct transcriptional repression by TZFP of the c-myc gene promoter in reporter assays. Thus, HERV-K (HML-2) Rec may function as an oncoprotein by de-repressing oncogenic transcription factors such as AR.