Effect of Education on Symptom Management and Control in Cancer Patients Receiving Palliative Care.

OBJECTIVE: This study aims to investigate the effect of an educational intervention on cancer patients receiving palliative care and their caregivers concerning symptom management and family needs. METHODS: This study involved 120 participants-60 cancer patients and their respective caregivers-divided into intervention and control groups. Over a 2-week period, the intervention group received a comprehensive educational program focusing on symptom management, while the control group did not receive any educational intervention. The Edmonton Symptom Assessment System (ESAS) and Palliative Performance Scale (PPS) were used to assess patients' symptoms, their intensity, and performance, while the Family Need Scale (FNS) was utilized to evaluate caregivers' needs. These assessments were conducted at the beginning and end of the study. Primary outcomes focused on symptom assessment using ESAS and PPS, along with evaluating caregivers' needs through FNS. Secondary outcomes involved assessing participant satisfaction with the intervention. RESULTS: At the end of the study, comparing initial and second evaluations, both ESAS and PPS scores significantly increased in the intervention and control groups (p = .003, p = .002, respectively). Additionally, a statistically significant decrease in the severity of symptoms, except for lethargy/hypokinesis, was observed in the intervention group compared to the control group. The FNS scale indicated that family needs satisfaction was higher in the intervention group compared to the control group. The data obtained demonstrated that there was a reduction the pain, fatigue, depression, anxiety, drowsiness, and shortness of breath levels in the intervention group compared to the control group, but there was no significant difference other than these symptoms. CONCLUSIONS: The educational intervention positively impacted symptom management and family needs. Optimizing symptom control would greatly benefit palliative care patients and their caregivers.

Ferritin/lymphocyte percentage ratio to predict the severity and mortality of COVID-19.

Objective: In this study, we aimed to investigate the relationship between ferritin/lymphocyte percentage ratio (FLPR) with clinical and radiological disease severity and mortality in COVID-19 patients. Methods: This retrospective study was conducted with patients who had polymerase chain reaction positive results for COVID-19. We calculated FLPRs from laboratory tests taken during emergency clinic admission. The relationship between chest computed tomography (CT) scores, disease severity, and 30-day mortality with FLPR was evaluated. Results: Our study included 309 patients. 30-day mortality occurred in 12.3% (n=38) of the patients. A statistically significant association was found between FLPR and clinical disease severity (p <0.001). In the post hoc analysis, the difference was caused by the critical and severe groups and FLPR was significantly higher in these groups. A significant correlation was found between CT scores and FLPR (r=0.496, p<0.001). Logistic regression analysis revealed that hypertension, smoking, C-reactive protein (CRP), and FLPR levels were independent risk factors for mortality in COVID-19 patients. In the receiver operating characteristics curve analysis, determined the predictive value and the optimal cut-off value of FLPR. The areas under the curve of WBC, lymphocyte, neutrophil, ferritin, CRP, FLPR were found 0.707, 0.233, 0.735, 0.878, 0.831, 0.924 (p<0.001), respectively. This analysis showed that the FLPR can predict 30-day mortality better than the other biomarkers in the comparison. When the optimal cut-off value of FLPR is 42.4, the sensitivity is 84.2% and specificity is 86.7%. Conclusion: FLPR can be used as an independent biomarker of disease severity and mortality in COVID-19.

Epidemiological and clinical characteristics of 3334 cases with prediagnosis coronavirus disease - 2019 (COVID-19) in Turkey.

AIM: This study aims to analyse the epidemiological and clinical features of the patients admitted to the hospital with the prediagnosis of coronavirus disease 19 (COVID-19) in Turkey. MATERIALS AND METHODS: In this retrospective study, epidemiological and clinical features, laboratory markers, radiological features, therapeutic approaches, and survival conditions of the patients with the prediagnosis of COVID-19 from March 11th to June 30th, 2020 have been analysed and reported. The data of the cases were divided into four groups and then compared with each other: first group includes confirmed cases with positive reverse transcriptase polymerase chain reaction (RT-PCR) and chest computed tomography (CT) imaging results considered as COVID-19 lung involvement, second group includes the clinically diagnosed cases with negative RT-PCR and positive CT imaging abnormalities, third group includes mild and asymptomatic cases with positive RT-PCR and negative CT findings, fourth group includes suspected cases with negative RT-PCR and negative CT findings. Post-hoc analysis was performed to evaluate the differences among the groups. RESULTS: In total, 3334 patients with the prediagnosis of COVID-19 admitted to the emergency department. Based on the post hoc analyses, significant differences were found among the four groups in terms of their test results of leukocytes, haemoglobin, platelet, neutrophils, urea and C-reactive protein (CRP) (P < .001). Furthermore, the factors of age groups, hospitalisation, intensive care unit follow-up and mortality rate of the four groups showed a significant difference among the groups (P = .001). CONCLUSION: The mean leukocytes, neutrophils and platelet counts of patients with positive RT-PCR were found to be lower than the ones with negative RT-PCR. The mean serum levels of CRP were found to be higher in patients with lung involvement compared with other patient groups.