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1.
Estima (Online) ; 19(1): e1021, jan.-dez. 2021.
Artigo em Português | BDENF - enfermagem (Brasil) | ID: biblio-1280950

RESUMO

Objetivo:identificar e descrever os fatores de risco para desenvolvimento de lesão por pressão em pacientes oncológicos adultos e as intervenções preventivas interdisciplinares. Método: revisão integrativa da literatura. A coleta de dados foi realizada no período de março e abril de 2019 e dezembro de 2020, utilizando as bases de dados: BDENF; PubMed/Medline; Embase; Scopus; Cinahal e Web of Science. Resultados: a amostra foi composta por 16 artigos publicados no período de 2008 a 2019. Dentre os fatores de risco identificados destacam-se: situação nutricional, idade avançada, incontinência e imobilidade; as intervenções preventivas interdisciplinares identificadas foram: mudança de decúbito, avaliação e acompanhamento nutricional, cuidados com a pele e uso de superfícies de suporte. Conclusão: há necessidade de mais estudos para um olhar cuidadoso e assertivo para os pacientes oncológicos.


Objective:identify and describe the risk factors for the development of pressure injuries in adult cancer patients and interdisciplinary preventive interventions. Method: integrative literature review. Data collection was carried out between March and April 2019 and December 2020, using the databases: BDENF; PubMed/Medline; Embase; Scopus; Cinahal and Web of Science. Results: the sample consisted of 16 articles published from 2008 to 2019. Among the risk factors identified, the following stand out: nutritional status, advanced age, incontinence and immobility; the interdisciplinary preventive interventions identified were: decubitus change, nutritional assessment and monitoring, skin care and use of support surfaces. Conclusion: further studies are needed to take a careful and assertive look at cancer patients.


Assuntos
Equipe de Assistência ao Paciente , Fatores de Risco , Lesão por Pressão , Oncologia
2.
Estima (Online) ; 19(1): e1521, jan.-dez. 2021.
Artigo em Português | LILACS, BDENF - enfermagem (Brasil) | ID: biblio-1291477

RESUMO

Objetivo:Analisar as percepções dos pacientes com câncer colorretal em uso de colostomia sobre os cuidados de enfermagem das unidades de internação em oncologia de um hospital do oeste de Santa Catarina. Métodos: Estudo descritivo-exploratório de abordagem qualitativa realizado nas unidades de internação em oncologia do Hospital Regional do Oeste, no período de janeiro a agosto de 2020, por meio de um questionário contendo dados sociodemográficos e entrevista semiestruturada, aplicado a 20 pacientes com câncer colorretal em uso de colostomia. Os dados foram analisados por meio da Análise de Conteúdo de Laurence Bardin. Resultados: Os resultados apontaram prevalência de colostomizados do sexo masculino, com idade média de 60,25 anos, casados, aposentados e com ensino fundamental incompleto. A partir da análise qualitativa das entrevistas surgiu a categoria: percepções dos pacientes sobre os cuidados de enfermagem, a qual foi subdividida em: cuidados de enfermagem com a bolsa e a estomia e cuidados de enfermagem na internação. Conclusão: Ao término da pesquisa, conclui-se que os colostomizados percebem que a equipe de enfermagem realiza os cuidados essenciais à bolsa e à estomia, incluindo sua troca e higiene durante a internação, atendendo às necessidades dos pacientes. Além disso, fornecem orientações importantes sobre o uso dos dispositivos, promovendo educação em saúde.


Assuntos
Colostomia , Neoplasias Colorretais , Pesquisa Qualitativa , Estomaterapia , Oncologia , Cuidados de Enfermagem
3.
Rev Infirm ; 70(275): 35-36, 2021 Nov.
Artigo em Francês | MEDLINE | ID: mdl-34752359

RESUMO

The return back home of certain patients treated for cancer in the palliative phase requires efficient coordination of caregivers in order to guarantee the well-being of patients and the quality and safety of the care provided. Two hospital coordination nurses have developed a quality approach that aims to reinforce the security of technical care at home in a perfect coordination of all the city-hospital contributors.


Assuntos
Serviços de Assistência Domiciliar , Neoplasias , Hospitais , Humanos , Oncologia , Neoplasias/terapia , Cuidados Paliativos
4.
Curr Protoc ; 1(11): e284, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34762346

RESUMO

Metastases are the most common malignancy of the adult central nervous system and are becoming an increasingly troubling problem in oncology largely due to the lack of successful therapeutic options. The limited selection of treatments is a result of the currently poor understanding of the biological mechanisms of metastatic development, which in turn is difficult to achieve because of limited preclinical models that can accurately represent the clinical progression of metastasis. Described in this article are in vitro and in vivo model systems that are used to enhance the understanding of metastasis and to identify new therapies for the treatment of brain metastasis. © 2021 Wiley Periodicals LLC.


Assuntos
Neoplasias Encefálicas , Neoplasias Encefálicas/terapia , Sistema Nervoso Central , Humanos , Oncologia
5.
Anticancer Res ; 41(11): 5377-5391, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34732407

RESUMO

BACKGROUND/AIM: To assess the quantity and quality of systematic reviews of in vitro cancer studies. MATERIALS AND METHODS: PubMed, MEDLINE, Embase, Web of Knowledge and PROSPERO databases were searched. Articles described as systematic reviews of in vitro studies, focused on or relevant to cancer and published in English were selected and appraised using an adapted version of AMSTAR 2 'critical domains'. RESULTS: From 4,021 records, 41 reviews described as systematic and cancer-related were identified. Publication dates indicate increasing frequency of systematic review conduct. Mean number of databases searched was three (range=1-8). Thirty-six reviews (88%) reported search methods, 35 (85%) specified inclusion criteria, 26 (63%) reported study selection methods, and 21 (51%) used reporting guidelines. Only 13 reviews (32%) involved formal quality assessment. CONCLUSION: Detailed investigation of reviews of cancer-relevant in vitro studies indicates need for further development and use of robust search strategies, appropriate quality assessment tools, and researchers with relevant skills.


Assuntos
Pesquisa Biomédica/normas , Confiabilidade dos Dados , Oncologia/normas , Publicações Periódicas como Assunto/normas , Projetos de Pesquisa/normas , Revisões Sistemáticas como Assunto/normas , Animais , Guias como Assunto/normas , Humanos , Controle de Qualidade
6.
Lancet Oncol ; 22(11): e474-e487, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-34735817

RESUMO

The increasing burden of cancer represents a substantial problem for Latin America and the Caribbean. Two Lancet Oncology Commissions in 2013 and 2015 highlighted potential interventions that could advance cancer care in the region by overcoming existing challenges. Areas requiring improvement included insufficient investment in cancer control, non-universal health coverage, fragmented health systems, inequitable concentration of cancer services, inadequate registries, delays in diagnosis or treatment initiation, and insufficient palliative services. Progress has been made in key areas but remains uneven across the region. An unforeseen challenge, the COVID-19 pandemic, strained all resources, and its negative effect on cancer control is expected to continue for years. In this Series paper, we summarise progress in several aspects of cancer control since 2015, and identify persistent barriers requiring commitment of additional resources to reduce the cancer burden in Latin America and the Caribbean.


Assuntos
COVID-19/epidemiologia , Neoplasias/prevenção & controle , SARS-CoV-2 , Região do Caribe/epidemiologia , Efeitos Psicossociais da Doença , Atenção à Saúde/economia , Detecção Precoce de Câncer , Acesso aos Serviços de Saúde , Humanos , América Latina/epidemiologia , Oncologia/educação , Neoplasias/epidemiologia
8.
Radiographics ; 41(7): 2071-2089, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34723703

RESUMO

Fluorodeoxyglucose (FDG) PET/CT is a vital imaging technique used for staging, assessing treatment response, and restaging following completion of therapy in patients who are undergoing or have completed oncologic treatment. A variety of adverse effects from chemotherapy, targeted therapy, immunotherapy, and radiation therapy are commonly encountered in oncologic patients. It is important to be aware of the manifestations of these adverse effects seen on FDG PET/CT images to avoid misinterpreting these findings as disease progression. Furthermore, early identification of these complications is important, as it may significantly affect patient management and even lead to a change in treatment strategy. The authors focus on the FDG PET/CT manifestations of a broad spectrum of oncologic therapy-related adverse effects in the thorax, as well as some treatment-related changes that may potentially mimic malignancy. Online supplemental material is available for this article. ©RSNA, 2021.


Assuntos
Fluordesoxiglucose F18 , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada , Humanos , Oncologia , Tomografia por Emissão de Pósitrons , Tórax
9.
J Altern Complement Med ; 27(11): 1002-1010, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34668735

RESUMO

Introduction: This article examines the feedback of health care providers within the implementation of an integrative care project in a clinic for pediatric oncology in São Paulo, Brazil. Since 2017, the project has implemented external anthroposophic therapies in the activities of daily nursing. The objective is to evaluate how the project evolved and what impact it had on the daily operation of the hospital. A special focus emphasizes the perspective of study nurses. Materials and Methods: Twelve qualitative semistructured interviews were conducted. Audio files were transcribed, translated to German, and underwent a MAXQDA software-assisted analysis. Using a thematic approach, coherent cross-case topics were defined. Results: Three main topics emerged from analysis of the data. (1) The implementation and its effects on daily patient care demonstrated positive outcomes in patients and were well accepted with minimal changes in daily activities. (2) The perspective of study nurses showed a large motivation due to beneficial and stress-relieving effects of the application and a growing patient-health care provider relationship. (3) Problems and aspirations for improvement were the lack of time and the urge to make the project grow in the future. Conclusion: Not only patients but also health care providers seem to benefit from integrative methods. They have the potential to improve the working atmosphere and to strengthen relations between patients, caregivers, and family members. General feedback was positive and acceptance in the team arose over time when beneficial effects became visible.


Assuntos
Oncologia Integrativa , Neoplasias , Brasil , Criança , Humanos , Oncologia , Neoplasias/terapia , Pesquisa Qualitativa , Padrão de Cuidado
10.
Radiographics ; 41(6): 1717-1732, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34597235

RESUMO

Radiomics refers to the extraction of mineable data from medical imaging and has been applied within oncology to improve diagnosis, prognostication, and clinical decision support, with the goal of delivering precision medicine. The authors provide a practical approach for successfully implementing a radiomic workflow from planning and conceptualization through manuscript writing. Applications in oncology typically are either classification tasks that involve computing the probability of a sample belonging to a category, such as benign versus malignant, or prediction of clinical events with a time-to-event analysis, such as overall survival. The radiomic workflow is multidisciplinary, involving radiologists and data and imaging scientists, and follows a stepwise process involving tumor segmentation, image preprocessing, feature extraction, model development, and validation. Images are curated and processed before segmentation, which can be performed on tumors, tumor subregions, or peritumoral zones. Extracted features typically describe the distribution of signal intensities and spatial relationship of pixels within a region of interest. To improve model performance and reduce overfitting, redundant and nonreproducible features are removed. Validation is essential to estimate model performance in new data and can be performed iteratively on samples of the dataset (cross-validation) or on a separate hold-out dataset by using internal or external data. A variety of noncommercial and commercial radiomic software applications can be used. Guidelines and artificial intelligence checklists are useful when planning and writing up radiomic studies. Although interest in the field continues to grow, radiologists should be familiar with potential pitfalls to ensure that meaningful conclusions can be drawn. Online supplemental material is available for this article. Published under a CC BY 4.0 license.


Assuntos
Inteligência Artificial , Processamento de Imagem Assistida por Computador , Diagnóstico por Imagem , Humanos , Oncologia , Radiografia
11.
Biochim Biophys Acta Rev Cancer ; 1876(2): 188635, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34656686

RESUMO

The involvement of the Gasdermin (GSDM) protein family in cancer and other pathologies is one of the hottest topics in biomedical research. There are six GSDMs in humans (GSDMA, B, C, D, GSDME/DFNA5 and PJVK/DFNB59) and, except PJVK, they can trigger cell death mostly by pyroptosis (a form of lytic and pro-inflammatory cell death) but also other mechanisms. The exact role of GSDMs in cancer is intricate, since depending on the biological context, these proteins have diverse cell-death dependent and independent functions, exhibit either pro-tumor or anti-tumor functions, and promote either sensitization or resistance to oncologic treatments. In this review we provide a comprehensive overview on the multifaceted roles of the GSDMs in cancer, and we critically discuss the possibilities of exploiting GSDM functions as determinants of anti-cancer treatment and as novel therapeutic targets, with special emphasis on innovative GSDM-directed nano-therapies. Finally, we discuss the issues to be resolved before GSDM-mediated oncologic therapies became a reality at the clinical level.


Assuntos
Biologia , Oncologia/métodos , Proteínas de Neoplasias/uso terapêutico , Neoplasias/terapia , Humanos , Proteínas de Neoplasias/farmacologia
12.
Nutrients ; 13(10)2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34684523

RESUMO

Pancreatic cancer represents a very challenging disease, with an increasing incidence and an extremely poor prognosis. Peculiar features of this tumor entity are represented by pancreatic exocrine insufficiency and an early and intense nutritional imbalance, leading to the highly prevalent and multifactorial syndrome known as cancer cachexia. Recently, also the concept of sarcopenic obesity has emerged, making the concept of pancreatic cancer malnutrition even more multifaceted and complex. Overall, these nutritional derangements play a pivotal role in contributing to the dismal course of this malignancy. However, their relevance is often underrated and their assessment is rarely applied in clinical daily practice with relevant negative impact for patients' outcome in neoadjuvant, surgical, and metastatic settings. The proper detection and management of pancreatic cancer-related malnutrition syndromes are of primary importance and deserve a specific and multidisciplinary (clinical nutrition, oncology, etc.) approach to improve survival, but also the quality of life. In this context, the introduction of a "Nutritional Oncology Board" in routine daily practice, aimed at assessing an early systematic screening of patients and at implementing nutritional support from the time of disease diagnosis onward seems to be the right path to take.


Assuntos
Dietética/métodos , Desnutrição/terapia , Oncologia/métodos , Neoplasias Pancreáticas/complicações , Conselhos de Especialidade Profissional , Caquexia/etiologia , Caquexia/terapia , Insuficiência Pancreática Exócrina/etiologia , Insuficiência Pancreática Exócrina/terapia , Humanos , Desnutrição/etiologia , Apoio Nutricional , Sarcopenia/etiologia , Sarcopenia/terapia
13.
Oncol Nurs Forum ; 48(6): 589-600, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34673760

RESUMO

PURPOSE: The Oncology Nursing Society (ONS) formed a team to develop a necessary expansion of the 2019-2022 ONS Research Agenda, with a focus on racism and cancer care disparities. METHODS: A multimethod consensus-building approach was used to develop and refine the research priorities. A panel of oncology nurse scientists and equity scholars with expertise in health disparities conducted a rapid review of the literature, consulted with experts and oncology nurses, and reviewed priorities from funding agencies. RESULTS: Critical gaps in the literature were identified and used to develop priority areas for oncology nursing research, practice, and workforce development. SYNTHESIS: This is the first article in a two-part series that discusses structural racism and health inequities within oncology nursing. In this article, three priority areas for oncology nursing research are presented; in the second article, strategies to improve cancer disparities and equity and diversity in the oncology workforce are described. IMPLICATIONS FOR RESEARCH: Research priorities are presented to inform future research that will provide methods and tools to increase health equity and reduce structural racism in oncology nursing practice, research, education, policy, and advocacy.


Assuntos
Pesquisa em Enfermagem , Racismo , Humanos , Oncologia , Enfermagem Oncológica , Sociedades de Enfermagem
15.
BMC Health Serv Res ; 21(1): 1159, 2021 Oct 26.
Artigo em Inglês | MEDLINE | ID: mdl-34702268

RESUMO

BACKGROUND: Pediatric Early Warning Scores (PEWS) are nurse-administered clinical assessment tools utilizing vital signs and patient signs and symptoms to screen for patients at risk for clinical deterioration.1-3 When utilizing a PEWS system, which consists of an escalation algorithm to alert physicians of high risk patients requiring a bedside evaluation and assessment, studies have demonstrated that PEWS systems can decrease pediatric intensive care (PICU) utilization, in-hospital cardiac arrests, and overall decreased mortality in high income settings. Yet, many hospital based settings in low and lower middle income countries (LMIC) lack systems in place for early identification of patients at risk for clinical deterioration. METHODS: A contextually adapted 16-h pediatric resuscitation program included training of a PEWS tool followed by implementation and integration of a PEWS system in a pediatric hematology/oncology ward in Beit Jala, Palestine. Four PDSA cycles were implemented post-implementation to improve uptake and scoring of PEWS which included PEWS tool integration into an existing electronic medical record (EMR), escalation algorithm and job aid implementation, data audits and ward feedback. RESULTS: Frequency of complete PEWS vital sign documentation reached a mean of 89.9%. The frequency and accuracy of PEWS scores steadily increased during the post-implementation period, consistently above 89% in both categories starting from data audit four and continuing thereafter. Accuracy of PEWS scoring was unable to be assessed during week 1 and 2 of data audits due to challenges with PEWS integration into the existing EMR (PDSA cycle 1) which were resolved by the 3rd week of data auditing (PDSA cycle 2). CONCLUSIONS: Implementation of a PEWS scoring tool in an LMIC pediatric oncology inpatient unit is feasible and can improve frequency of vital sign collection and generate accurate PEWS scores. CONTRIBUTION TO THE LITERATURE: This study demonstrates how to effectively implement a PEWS scoring tool into an LMIC clinical setting. This study demonstrates how to utilize a robust feedback mechanism to ensure a quality program uptake. This study demonstrates an effective international partnership model that other institutions may utilize for implementation science.


Assuntos
Deterioração Clínica , Escore de Alerta Precoce , Neoplasias , Criança , Hospitais , Humanos , Unidades de Terapia Intensiva Pediátrica , Oncologia
16.
BMJ Open ; 11(10): e047813, 2021 10 05.
Artigo em Inglês | MEDLINE | ID: mdl-34610932

RESUMO

OBJECTIVES: The study aimed to explore patients' experiences of experimental cancer medicine (ECM) clinical trials. DESIGN: The study's design was qualitative. Two focus groups with patients were undertaken followed by semistructured interviews, to explore patients' experiences of ECM clinical trials. Interviews and focus groups were audiorecorded and transcribed verbatim. Data were analysed using thematic analysis. SETTING: A regional cancer centre (tertiary care) in North-West England. PARTICIPANTS: Twelve patients (aged 52-79) participated in one of the two focus groups and 22 patients (aged 42-83) participated in interviews. PRIMARY OUTCOME MEASURE: Patients' experiences of an ECM trial. RESULTS: Four main themes were identified from the analysis: decision making, information needs, the experience of trial participation and impact of trial participation. Subthemes are presented in the manuscript. CONCLUSION: To make fully informed decisions about trial participation, patients required the simplification of trial information and wanted more information about side effects, their response to trial treatment and the overall trial progress throughout the trial. Patients highlighted the need for improvement for the support provided to their family and friends.


Assuntos
Pesquisa Biomédica , Neoplasias , Grupos Focais , Humanos , Oncologia , Neoplasias/terapia , Pesquisa Qualitativa
17.
Br J Nurs ; 30(17): S32-S34, 2021 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-34605268
18.
JCO Clin Cancer Inform ; 5: 1034-1043, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34662145

RESUMO

The international pediatric oncology community has a long history of research collaboration. In the United States, the 2019 launch of the Children's Cancer Data Initiative puts the focus on developing a rich and robust data ecosystem for pediatric oncology. In this spirit, we present here our experience in constructing the Pediatric Cancer Data Commons (PCDC) to highlight the significance of this effort in fighting pediatric cancer and improving outcomes and to provide essential information to those creating resources in other disease areas. The University of Chicago's PCDC team has worked with the international research community since 2015 to build data commons for children's cancers. We identified six critical features of successful data commons design and implementation: (1) establish the need for a data commons, (2) develop and deploy the technical infrastructure, (3) establish and implement governance, (4) make the data commons platform easy and intuitive for researchers, (5) socialize the data commons and create working knowledge and expertise in the research community, and (6) plan for longevity and sustainability. Data commons are critical to conducting research on large patient cohorts that will ultimately lead to improved outcomes for children with cancer. There is value in connecting high-quality clinical and phenotype data to external sources of data such as genomic, proteomics, and imaging data. Next steps for the PCDC include creating an informed and invested data-sharing culture, developing sustainable methods of data collection and sharing, standardizing genetic biomarker reporting, incorporating radiologic and molecular analysis data, and building models for electronic patient consent. The methods and processes described here can be extended to any clinical area and provide a blueprint for others wishing to develop similar resources.


Assuntos
Pesquisa Biomédica , Neoplasias , Criança , Ecossistema , Genômica , Humanos , Oncologia , Neoplasias/epidemiologia , Neoplasias/terapia , Estados Unidos
19.
Arq Bras Cardiol ; 117(4): 845-909, 2021 10.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34709307
20.
BMJ Open ; 11(10): e047294, 2021 10 25.
Artigo em Inglês | MEDLINE | ID: mdl-34697110

RESUMO

The role and use of independent data monitoring committees (IDMCs) has evolved over the past decades. The Food and Drug Administration and European Medicines Agency have issued guidelines on the role and functioning of such committees. In general, data monitoring committees are recommended for large, often randomised clinical trials involving life-threatening diseases, studies performed in vulnerable populations or where the experimental intervention can potentially harm the trial participant. Such committees play an important role in trials evaluating treatments with the potential to prolong life or reduce the risk of major adverse health outcomes.Typically, oncology clinical trials fall within these recommendations, as they are often large, randomised, multicentric protocols aiming at improving survival outcomes by exploring the use of study treatments that may be associated with a significant risk of serious, even life-threatening adverse events. IDMCs are required for National Cancer Institute phase III randomised trials, European Organisation for Research and Treatment of Cancer phase II/III trials with formal interim analyses, early-stopping rules or adaptive studies. The primary role of an IDMC of ensuring the safety of study participants and maintaining clinical trial integrity is particularly important in oncology trials, due to the nature of the disease, the potential for treatment toxicity and for instilling confidence that the clinical trial data are reliable. A clear understanding by IDMC members of the natural course of the disease, treatment landscape, importance and relevance of certain adverse events in trial participants, clinical trial methodology in general and stopping rules for oncology trials in particular, is crucial for the functioning of an IDMC.It is recommended that IDMC members should be experienced trialists, have a track record of strong clinical, statistical and/or methodological expertise and the required level of independence, as they play a highly important role in the protection of study participants, and in commercially and strategically important go/no decisions. Ideally, IDMC members should have relevant experience or have some training, mentorship or guidelines.


Assuntos
Comitês de Monitoramento de Dados de Ensaios Clínicos , Neoplasias , Humanos , Oncologia , Neoplasias/tratamento farmacológico , Ensaios Clínicos Controlados Aleatórios como Assunto , Estados Unidos , United States Food and Drug Administration
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