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1.
Pan Afr Med J ; 35(Suppl 2): 140, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33193955

RESUMEN

The COVID-19 pandemic and its public health control measures have led to worldwide interruptions in healthcare service delivery, and cancer services are no exception. These interruptions have exacerbated the effects of previously reported barriers to accessing cancer care which was reportedly low even before the pandemic. If these effects are not mitigated, the achievements in cancer control that had already been made could be watered down. Measuring the impact of COVID-19 pandemic control measures on delivery of and access to cancer services in Uganda as well as other countries worldwide can inform the design of current and future responses to epidemics while putting into context other diseases like cancer that have a high burden.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Accesibilidad a los Servicios de Salud , Neoplasias/terapia , Pandemias , Neumonía Viral/epidemiología , Continuidad de la Atención al Paciente , Prestación de Atención de Salud , Países en Desarrollo , Promoción de la Salud , Necesidades y Demandas de Servicios de Salud , Humanos , Tamizaje Masivo , Neoplasias/diagnóstico , Neoplasias/epidemiología , Cuarentena , Sistema de Registros , Uganda/epidemiología
2.
Rev Med Liege ; 75(S1): 38-40, 2020.
Artículo en Francés | MEDLINE | ID: mdl-33211420

RESUMEN

The COVID-19 pandemic has had a major impact in the world of Oncology. Surprised by the rapidity of the extension of the pandemic, the oncological department had to be reorganised in a very short time period in a hospital which had the primary objective to treat infected patients. The author describes how with the help of an international network and local research projects all efforts have been done to offer the best patient's care in a secure environment.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus , Neoplasias , Pandemias , Neumonía Viral , Humanos , Oncología Médica , Neoplasias/epidemiología , Neoplasias/terapia
3.
In Vivo ; 34(6): 3731-3734, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33144491

RESUMEN

BACKGROUND/AIM: In 2020, because of coronavirus pandemic, medical activities changed. The aim of this report is to compare the volumes of Pisa radiotherapy activities from March 9th to May 31st, 2020, with the same period in 2019. PATIENTS AND METHODS: We analyzed the activity of our Unit to evaluate how logistics changes, related to the COVID-19 epidemic, impacted on volumes of radiotherapy (RT) activity and on the number of cases of COVID-19 infections observed in healthcare professionals and patients. RESULTS: The total number of first-time visits between March-May 2020 was reduced by 18%, probably due to delays in diagnosis and histological tests as well as the temporary closure of the operating rooms. None of the healthcare professionals and only two patients contracted the infection. CONCLUSION: We were able to treat all patients referred to our hospital and we were able to reduce risk of infection for both our patients and healthcare staff, guaranteeing continuum of care for our oncological patients.


Asunto(s)
Infecciones por Coronavirus/radioterapia , Neoplasias/radioterapia , Pandemias , Neumonía Viral/radioterapia , Betacoronavirus/patogenicidad , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/virología , Femenino , Humanos , Masculino , Neoplasias/complicaciones , Neoplasias/epidemiología , Neoplasias/virología , Neumonía Viral/complicaciones , Neumonía Viral/epidemiología , Neumonía Viral/virología
4.
Rev Assoc Med Bras (1992) ; 66(10): 1361-1365, 2020 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-33174927

RESUMEN

OBJECTIVE: The aim of our study was to investigate whether there has been a reduction in patient admission to a high-complexity cancer care center in Brasil during the COVID-19 pandemic, similar to what was reported in Europe. METHODS: We reviewed the cancer tracking database of the largest cancer center in southern Brasil and performed statistical tests to compare first-time appointments from the onset of the outbreak until the end of June to those of the equivalent period in 2019. RESULTS: We observed a dramatic reduction (-42%) in first-time appointments during the pandemic compared to the same period in the previous year (P <0.001). This reduction was observed among all medical specialties (P <0.001). CONCLUSION: The onset of COVID-19 was correlated with a reduction in admission to a high-complexity cancer care center in Brasil. Since a delay in diagnosis and treatment may influence prognosis, it is important that cancer centers and public health strategies reinforce care for non-COVID-19 patients to prevent potentially unnecessary deaths.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Neoplasias , Admisión del Paciente/estadística & datos numéricos , Neumonía Viral/epidemiología , Betacoronavirus , Brasil/epidemiología , Humanos , Neoplasias/epidemiología , Neoplasias/terapia , Pandemias
5.
Med Oncol ; 37(11): 108, 2020 Nov 04.
Artículo en Inglés | MEDLINE | ID: mdl-33150476

RESUMEN

BACKGROUND: Italy experienced one of the world's severest COVID-19 outbreak, with Lombardy being the most afflicted region. However, the imposed safety measures allowed to flatten the epidemic curve and hence to ease the restrictions and inaugurate, on the 4th of May 2020, the Italian phase (P) 2 of the pandemic. The present survey study, endorsed by CODRAL and AIRO-L, aimed to assess how radiotherapy (RT) departments in Lombardy have dealt with the recovery. MATERIALS AND METHODS: A questionnaire dealing with the management of pandemic was developed online and sent to all CODRAL Directors on the 10th of June 2020. Answers were collected in full anonymity one week after. RESULTS: All the 33 contacted RT facilities (100%) responded to the survey. Despite the scale of the pandemic, during P1 14 (42.4%) centres managed to safely continue the activity (≤ 10% reduction). During P2, 10 (30.3%) centres fully recovered and 14 (42.4%) reported an increase. Nonetheless, 6 (18.2%) declared no changes and, interestingly, 3 (9.1%) reduced activities. Overall, 21 centres (63.6%) reported suspected or positive cases within healthcare workforce since the beginning of the pandemic. Staff units were quarantined in 19 (57.6%) and 6 (18.2%) centres throughout P1 and P2, respectively. In the two phases, about two thirds centres registered positive or suspected cases amongst patients. CONCLUSION: The study revealed a particular attention to anti-contagion measures and a return to normal or even higher clinical workload in most RT centres in Lombardy, necessary to carry out current and previously deferred treatments.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neoplasias/epidemiología , Neoplasias/radioterapia , Servicio de Oncología en Hospital/tendencias , Neumonía Viral/epidemiología , Encuestas y Cuestionarios , Infecciones por Coronavirus/terapia , Personal de Salud/tendencias , Humanos , Italia/epidemiología , Pandemias , Equipo de Protección Personal/tendencias , Neumonía Viral/terapia
6.
ESMO Open ; 5(Suppl 3)2020 11.
Artículo en Inglés | MEDLINE | ID: mdl-33158968

RESUMEN

BACKGROUND: In the midst of the COVID-19 pandemic, patients with cancer are regarded as a highly vulnerable population. Overall, those requiring hospital admission for treatment administration are potentially exposed to a higher risk of infection and worse outcome given the multiple in-hospital exposures and the treatment immunosuppressive effects. METHODS: COVINT is an observational study assessing COVID-19 incidence among patients receiving anticancer treatment in the outpatient clinic of the Istituto Nazionale dei Tumori di Milano. All consecutive patients with non-haematological malignancies treated with intravenous or subcutaneous/intramuscular anticancer therapy in the outpatient clinic were enrolled. The primary endpoint is the rate of occurrence of COVID-19. Secondary endpoints included the rate of COVID-19-related deaths and treatment interruptions. The association between clinical and biological characteristics and COVID-19 occurrence is also evaluated. COVID-19 diagnosis is defined as (1) certain if confirmed by reverse transcriptase PCR assay of nasopharyngeal swabs (NPS); (2) suspected in case of new symptoms or CT scan evidence of interstitial pneumonia with negative/not performed NPS; (3) negative in case of neither symptoms nor radiological evidence. RESULTS: In the first 2 months (16 February-10 April 2020) of observation, 1081 patients were included. Of these, 11 (1%) were confirmed and 73 (6.7%) suspected for COVID-19. No significant differences in terms of cancer and treatment type emerged between the three subgroups. Prophylactic use of myeloid growth factors was adopted in 5.3%, 2.7% and 0% of COVID-19-free, COVID-19-suspected and COVID-19-confirmed patients (p=0.003). Overall, 96 (8.9%) patients delayed treatment as a precaution for the pandemic. Among the 11 confirmed cases, 6 (55%) died of COVID-19 complications, and anticancer treatment was restarted in only one. CONCLUSIONS: During the pandemic peak, accurate protective measures successfully resulted in low rates of COVID-19 diagnosis, although with high lethality. Prospective patients' surveillance will continue with NPS and serology testing to provide a more comprehensive epidemiological picture, a biological insight on the impact of cytotoxic treatments on the immune response, and to protect patients and healthcare workers.


Asunto(s)
Antineoplásicos/uso terapéutico , Infecciones por Coronavirus/epidemiología , Neoplasias/tratamiento farmacológico , Neumonía Viral/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Atención Ambulatoria , Betacoronavirus , Instituciones Oncológicas , Infecciones por Coronavirus/mortalidad , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Mortalidad , Estadificación de Neoplasias , Neoplasias/epidemiología , Neoplasias/patología , Pandemias , Neumonía Viral/mortalidad , Tiempo de Tratamiento , Adulto Joven
7.
BMJ Open ; 10(11): e041790, 2020 11 10.
Artículo en Inglés | MEDLINE | ID: mdl-33172947

RESUMEN

INTRODUCTION: Scholars believe that COVID-19 can be particularly lethal for patients with cancer. Some studies found that COVID-19 appears to be more lethal in patients with lung cancer than in other cancer patients. In order to take appropriate measures to balance a delay in lung cancer treatment against the risk for a potential COVID-19 exposure, we first need to know whether patients with lung cancer have special risks. We aim to conduct a systematic review and meta-analysis to examine differences in terms of presentation and outcomes between patients with lung cancer as opposed to other solid organ cancer after infection with SARS-CoV-2. METHODS AND ANALYSIS: A comprehensive search of published original research studies will be performed in Embase, MEDLINE, Web of Science, WangFangData, CQVIP, COMPENDEX and CNKI. The medRxiv preprint server will also be searched for applicable studies (grey literature). Original research studies will be included if they include patients with: (A) laboratory-confirmed SARS-CoV-2 infection and (B) confirmed solid cancer, and (C) measurable clinical presentation or outcome, such as mortality rate, intensive care unit admission rate, incidence of pneumonia. One author will conduct the electronic database searches, two authors will independently screen studies, two will extract data and two will assess study quality. If I² exceeds 60% for the pooled analysis, we will explore sources of heterogeneity in subgroups of studies. We will use fixed-effect, random-effects or mixed-effects models to estimate the relative risk or OR. If the data reporting allows, a subgroup analysis between non-small cell lung cancer and small cell lung cancer patients will be performed. ETHICS AND DISSEMINATION: The proposed study will not collect individual-level data and, therefore, does not require ethical approval. We will submit our findings to a peer-reviewed scientific journal and will disseminate results through presentations at international scientific conferences. PROSPERO REGISTRATION NUMBER: CRD42020190118.


Asunto(s)
Infecciones por Coronavirus/fisiopatología , Neoplasias Pulmonares/epidemiología , Neoplasias/epidemiología , Neumonía Viral/fisiopatología , Betacoronavirus , Estudios de Casos y Controles , Comorbilidad , Infecciones por Coronavirus/mortalidad , Humanos , Unidades de Cuidados Intensivos/estadística & datos numéricos , Metaanálisis como Asunto , Pandemias , Neumonía Viral/mortalidad , Revisiones Sistemáticas como Asunto
8.
Rev Med Suisse ; 16(713): 2099-2103, 2020 Nov 04.
Artículo en Francés | MEDLINE | ID: mdl-33146958

RESUMEN

The new federal Act on registration of oncological diseases requires since January 1st 2020 institutions and treating physicians to transmit regulated data on all Swiss cancer cases and some precancerous pathologies to the competent tumour registry, and to inform their patients about it. This legal basis is intended to enlarge cancer data collection and registration in a traceable, better standardized, more complete and rapid manner. These legal provisions are expected to improve the reliability and efficiency of the analysis of the data, which is crucial for the epidemiological surveillance of cancer in Switzerland, for the benefit of public health policy, clinical management and for the population.


Asunto(s)
Legislación como Asunto , Neoplasias/epidemiología , Sistema de Registros , Humanos , Suiza/epidemiología
9.
Wiad Lek ; 73(9 cz. 2): 2068-2072, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33148861

RESUMEN

Cancer in dialysis patients is a common problem and is one of the most common reasons of mordibity and mortality in developed countries. An impaired renal function leads to the accumulation in the blood products of nitrogen transformation, which negatively affect organ function, especially the immune system. The Standardized Cancer Incidence is higher in patients with end-stage kidney failure than in the general population and reaches 1,18-1,42. The cancer risk is three times higher in dialysis patients over age 65 years and is more common among hemodialysis than peritoneal dialysis patients. The most common type of cancer occurring in this group of patients is urinary tract cancer which often develops on the basis of acquired cysts and in patients previously treated with cyclophosphamide. Nonetheless, patients with kidney problems are not regularly tested for these diseases and the only group that is screened for cancer are patients tested for kidney transplantation. Some problems in this topic are briefly presented in this article.


Asunto(s)
Enfermedades Renales , Fallo Renal Crónico , Trasplante de Riñón , Neoplasias , Diálisis Peritoneal , Humanos , Fallo Renal Crónico/epidemiología , Fallo Renal Crónico/terapia , Neoplasias/complicaciones , Neoplasias/epidemiología , Diálisis Renal/efectos adversos
11.
JAMA Netw Open ; 3(10): e2025197, 2020 10 01.
Artículo en Inglés | MEDLINE | ID: mdl-33084902

RESUMEN

Importance: Black patients are overrepresented in the number of COVID-19 infections, hospitalizations, and deaths in the US. Reasons for this disparity may be due to underlying comorbidities or sociodemographic factors that require further exploration. Objective: To systematically determine patient characteristics associated with racial/ethnic disparities in COVID-19 outcomes. Design, Setting, and Participants: This retrospective cohort study used comparative groups of patients tested or treated for COVID-19 at the University of Michigan from March 10, 2020, to April 22, 2020, with an outcome update through July 28, 2020. A group of randomly selected untested individuals were included for comparison. Examined factors included race/ethnicity, age, smoking, alcohol consumption, comorbidities, body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), and residential-level socioeconomic characteristics. Exposure: In-house polymerase chain reaction (PCR) tests, commercial antibody tests, nasopharynx or oropharynx PCR deployed by the Michigan Department of Health and Human Services and reverse transcription-PCR tests performed in external labs. Main Outcomes and Measures: The main outcomes were being tested for COVID-19, having test results positive for COVID-19 or being diagnosed with COVID-19, being hospitalized for COVID-19, requiring intensive care unit (ICU) admission for COVID-19, and COVID-19-related mortality (including inpatient and outpatient). Medical comorbidities were defined from the International Classification of Diseases, Ninth Revision, and International Classification of Diseases, Tenth Revision, codes and were aggregated into a comorbidity score. Associations with COVID-19 outcomes were examined using odds ratios (ORs). Results: Of 5698 patients tested for COVID-19 (mean [SD] age, 47.4 [20.9] years; 2167 [38.0%] men; mean [SD] BMI, 30.0 [8.0]), most were non-Hispanic White (3740 patients [65.6%]) or non-Hispanic Black (1058 patients [18.6%]). The comparison group included 7168 individuals who were not tested (mean [SD] age, 43.1 [24.1] years; 3257 [45.4%] men; mean [SD] BMI, 28.5 [7.1]). Among 1139 patients diagnosed with COVID-19, 492 (43.2%) were White and 442 (38.8%) were Black; 523 (45.9%) were hospitalized, 283 (24.7%) were admitted to the ICU, and 88 (7.7%) died. Adjusting for age, sex, socioeconomic status, and comorbidity score, Black patients were more likely to be hospitalized compared with White patients (OR, 1.72 [95% CI, 1.15-2.58]; P = .009). In addition to older age, male sex, and obesity, living in densely populated areas was associated with increased risk of hospitalization (OR, 1.10 [95% CI, 1.01-1.19]; P = .02). In the overall population, higher risk of hospitalization was also observed in patients with preexisting type 2 diabetes (OR, 1.82 [95% CI, 1.25-2.64]; P = .02) and kidney disease (OR, 2.87 [95% CI, 1.87-4.42]; P < .001). Compared with White patients, obesity was associated with higher risk of having test results positive for COVID-19 among Black patients (White: OR, 1.37 [95% CI, 1.01-1.84]; P = .04. Black: OR, 3.11 [95% CI, 1.64-5.90]; P < .001; P for interaction = .02). Having any cancer was associated with higher risk of positive COVID-19 test results for Black patients (OR, 1.82 [95% CI, 1.19-2.78]; P = .005) but not White patients (OR, 1.08 [95% CI, 0.84-1.40]; P = .53; P for interaction = .04). Overall comorbidity burden was associated with higher risk of hospitalization in White patients (OR, 1.30 [95% CI, 1.11-1.53]; P = .001) but not in Black patients (OR, 0.99 [95% CI, 0.83-1.17]; P = .88; P for interaction = .02), as was type 2 diabetes (White: OR, 2.59 [95% CI, 1.49-4.48]; P < .001; Black: OR, 1.17 [95% CI, 0.66-2.06]; P = .59; P for interaction = .046). No statistically significant racial differences were found in ICU admission and mortality based on adjusted analysis. Conclusions and Relevance: These findings suggest that preexisting type 2 diabetes or kidney diseases and living in high-population density areas were associated with higher risk for COVID-19 hospitalization. Associations of risk factors with COVID-19 outcomes differed by race.


Asunto(s)
Afroamericanos , Infecciones por Coronavirus/etnología , Grupo de Ascendencia Continental Europea , Disparidades en el Estado de Salud , Hospitalización , Neumonía Viral/etnología , Adulto , Anciano , Betacoronavirus , Comorbilidad , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/virología , Diabetes Mellitus Tipo 2/epidemiología , Femenino , Humanos , Unidades de Cuidados Intensivos , Enfermedades Renales/epidemiología , Masculino , Michigan/epidemiología , Persona de Mediana Edad , Neoplasias/epidemiología , Obesidad/epidemiología , Oportunidad Relativa , Pandemias , Neumonía Viral/epidemiología , Neumonía Viral/terapia , Neumonía Viral/virología , Densidad de Población , Estudios Retrospectivos , Factores de Riesgo
12.
BMJ ; 371: m3464, 2020 09 30.
Artículo en Inglés | MEDLINE | ID: mdl-32998909

RESUMEN

OBJECTIVE: To evaluate whether irregular or long menstrual cycles throughout the life course are associated with all cause and cause specific premature mortality (age <70 years). DESIGN: Prospective cohort study. SETTING: Nurses' Health Study II (1993-2017). PARTICIPANTS: 79 505 premenopausal women without a history of cardiovascular disease, cancer, or diabetes and who reported the usual length and regularity of their menstrual cycles at ages 14-17 years, 18-22 years, and 29-46 years. MAIN OUTCOME MEASURES: Hazard ratios and 95% confidence intervals for all cause and cause specific premature mortality (death before age 70 years) were estimated from multivariable Cox proportional hazards models. RESULTS: During 24 years of follow-up, 1975 premature deaths were documented, including 894 from cancer and 172 from cardiovascular disease. Women who reported always having irregular menstrual cycles experienced higher mortality rates during follow-up than women who reported very regular cycles in the same age ranges. The crude mortality rate per 1000 person years of follow-up for women reporting very regular cycles and women reporting always irregular cycles were 1.05 and 1.23 for cycle characteristics at ages 14-17 years, 1.00 and 1.37 for cycle characteristics at ages 18-22 years, and 1.00 and 1.68 for cycle characteristics at ages 29-46 years. The corresponding multivariable adjusted hazard ratios for premature death during follow-up were 1.18 (95% confidence interval 1.02 to 1.37), 1.37 (1.09 to 1.73), and 1.39 (1.14 to 1.70), respectively. Similarly, women who reported that their usual cycle length was 40 days or more at ages 18-22 years and 29-46 years were more likely to die prematurely than women who reported a usual cycle length of 26-31 days in the same age ranges (1.34, 1.06 to 1.69; and 1.40, 1.17 to 1.68, respectively). These relations were strongest for deaths related to cardiovascular disease. The higher mortality associated with long and irregular menstrual cycles was slightly stronger among current smokers. CONCLUSIONS: Irregular and long menstrual cycles in adolescence and adulthood are associated with a greater risk of premature mortality (age <70 years). This relation is slightly stronger among women who smoke.


Asunto(s)
Ciclo Menstrual , Trastornos de la Menstruación/epidemiología , Mortalidad Prematura , Salud Reproductiva/estadística & datos numéricos , Adolescente , Adulto , Enfermedades Cardiovasculares/epidemiología , Causas de Muerte , Estudios de Cohortes , Femenino , Humanos , Persona de Mediana Edad , Neoplasias/epidemiología , Medición de Riesgo , Factores de Riesgo , Autoinforme , Fumar/epidemiología , Estados Unidos/epidemiología
13.
Epidemiol Infect ; 148: e263, 2020 10 29.
Artículo en Inglés | MEDLINE | ID: mdl-33115547

RESUMEN

Diverse risk factors intercede the outcomes of coronavirus disease 2019 (COVID-19). We conducted this retrospective cohort study with a cohort of 1016 COVID-19 patients diagnosed in May 2020 to identify the risk factors associated with morbidity and mortality outcomes. Data were collected by telephone-interview and reviewing records using a questionnaire and checklist. The study identified morbidity and mortality risk factors on the 28th day of the disease course. The majority of the patients were male (64.1%) and belonged to the age group 25-39 years (39.4%). Urban patients were higher in proportion than rural (69.3% vs. 30.7%). Major comorbidities included 35.0% diabetes mellitus (DM), 28.4% hypertension (HTN), 16.6% chronic obstructive pulmonary disease (COPD), and 7.8% coronary heart disease (CHD). The morbidity rate (not-cured) was 6.0%, and the mortality rate (non-survivor) was 2.5%. Morbidity risk factors included elderly (AOR = 2.56, 95% CI = 1.31-4.99), having comorbidity (AOR = 1.43, 95% CI = 0.83-2.47), and smokeless tobacco use (AOR = 2.17, 95% CI = 0.84-5.61). The morbidity risk was higher with COPD (RR = 2.68), chronic kidney disease (CKD) (RR = 3.33) and chronic liver disease (CLD) (RR = 3.99). Mortality risk factors included elderly (AOR = 7.56, 95% CI = 3.19-17.92), having comorbidity (AOR = 5.27, 95% CI = 1.88-14.79) and SLT use (AOR = 1.93, 95% CI = 0.50-7.46). The mortality risk was higher with COPD (RR = 7.30), DM (RR = 2.63), CHD (RR = 4.65), HTN (RR = 3.38), CKD (RR = 9.03), CLD (RR = 10.52) and malignant diseases (RR = 9.73). We must espouse programme interventions considering the morbidity and mortality risk factors to condense the aggressive outcomes of COVID-19.


Asunto(s)
Infecciones por Coronavirus/mortalidad , Neumonía Viral/mortalidad , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Bangladesh/epidemiología , Betacoronavirus , Niño , Preescolar , Comorbilidad , Enfermedad Hepática en Estado Terminal/epidemiología , Femenino , Humanos , Lactante , Masculino , Persona de Mediana Edad , Morbilidad , Neoplasias/epidemiología , Pandemias , Enfermedad Pulmonar Obstructiva Crónica/epidemiología , Insuficiencia Renal Crónica/epidemiología , Estudios Retrospectivos , Factores de Riesgo , Adulto Joven
14.
Cancer Control ; 27(1): 1073274820960457, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33043705

RESUMEN

In this retrospective study we analyze and compare clinical characteristics and outcomes of patients with and without cancer history who were infected with novel coronavirus disease 19 (COVID-19). Medical records were reviewed and a comparative analysis of 53 cancer and 135 non-cancer patients with COVID-19 were summarized. Results: The median age for COVID-19 patients with and without cancer was 71.5 and 61.6 years, respectively. Patients aged 60 years and above were 86.8% and 60.7% in cancer and non-cancer groups, respectively. A high proportion of cases were seen in African Americans 73.6% (with cancer) and 75.6% (without cancer) followed by Hispanic patients. Male and female patients had a high percentage of prostate (39.3%) and breast (32%) cancer respectively. Prostate cancer (18.9%) and myeloma (11.3%) were common among solid and hematological cancers respectively. Hypertension and smoking were prevalent among cancer (83% and 41.5%) compared to non-cancer (67.4% and 9.6%) patients. The common symptoms in cancer patients were dyspnea (64.2%) followed by fever and cough (50.9%) compared to fever (68.1%) and cough (66.7%) in non-cancer patients. Cancer patients had higher levels of lactic acidosis, C-reactive protein, lactate dehydrogenase, and alkaline phosphatase than non-cancer patients (p < 0.05). Conclusions: Rapid clinical deterioration was seen in cancer patients who were aged 60 years and above. Higher mortality was seen in this subgroup, especially when they had associated hypertension and elevated levels of CRP and LDH.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Neoplasias/epidemiología , Pandemias , Neumonía Viral/epidemiología , Anciano , Comorbilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Distribución por Sexo , Factores Sexuales , Tasa de Supervivencia/tendencias
16.
Cent Eur J Public Health ; 28 Suppl: S65-S68, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-33069184

RESUMEN

Traditional approaches and study design in cancer epidemiology have not been very successful in identifying and evaluating adequately the potential risk and/or protective factors associated with the disease. The main reasons for the failure are often due the small study sample size, and inadequate exposure information. In this paper, issues and approaches relevant to these two challenges are discussed. Multicentre study is proposed as a way to increase study size and to mitigate criticism about meta-analysis of independent studies. A multicentre study of large cohort or case-control studies also offer an exciting opportunity to study the contribution of epigenetic events that may be associated with lifestyle and environmental risk factors for human health. Optimizing methods for exposure assessment and how to reduce exposure to misclassification represent a difficult component in epidemiological studies. A potentially useful approach for improving exposure estimation is to rely on biomarkers of exposures. An example is provided to demonstrate how biomarkers of exposures could provide valuable information in addition to exposure measurements in traditional epidemiological studies. Finally, it is argued that risk assessment and the precautionary principle should not be viewed as conflicting paradigms but, rather, as a complementary approach for developing appropriate policies to address risks posed by exposure to carcinogens and a wide spectrum of other health hazards.


Asunto(s)
Neoplasias , Proyectos de Investigación , Estudios de Casos y Controles , Estudios de Cohortes , Humanos , Neoplasias/inducido químicamente , Neoplasias/epidemiología , Medición de Riesgo
17.
Environ Sci Process Impacts ; 22(11): 2276-2290, 2020 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-33103680

RESUMEN

This study aims (1) to determine the seasonal and spatial distribution of THMs formed in chlorinated groundwater containing low levels of organic matter (0.4-0.8 mg L-1) and low to high levels of bromine (40-380 µg L-1), and (2) to evaluate the multi-route cancer risks associated with them. The study was conducted in Kayseri (Turkey), where drinking water is supplied from groundwater after chlorination only. THM formation in 50 water samples from 18 storage tanks and 32 distribution points was investigated to evaluate the spatial and temporal changes in THM concentrations for 12 months. The lifetime cancer risk associated with exposure to THMs through multiple pathways (i.e., oral ingestion, dermal absorption, and inhalation) was estimated for males and females. For a 12 month sampling period, the minimum and maximum THM concentrations varied from 2 µg L-1 to 17 µg L-1 and from 2 µg L-1 to 29 µg L-1 in storage tanks and distribution points, respectively. The ranges of median concentrations of THM were 5 µg L-1 to 9 µg L-1 in storage tanks and 5 µg L-1 to 12 µg L-1 in distribution points. In all samples dibromochloromethane was the dominant species, followed by bromoform, chloroform, and bromodichloromethane. The average values of total cancer risk associated with exposure to THMs via oral ingestion, dermal absorption, and inhalation for females and males were 1.31 × 10-5 and 1.25 × 10-5 in storage tanks, and 1.46 × 10-5 and 1.39 × 10-5 in distribution points, respectively. Although THM concentrations were very low, cancer risk values are 1.0 × 10-6 < CR < 1.0 × 10-4, which are higher than the negligible risk level (1.0 × 10-6).


Asunto(s)
Agua Subterránea , Neoplasias , Contaminantes Químicos del Agua , Bromuros , Femenino , Humanos , Masculino , Neoplasias/inducido químicamente , Neoplasias/epidemiología , Medición de Riesgo , Trihalometanos/análisis , Trihalometanos/toxicidad , Turquia , Contaminantes Químicos del Agua/análisis , Contaminantes Químicos del Agua/toxicidad
18.
PLoS One ; 15(10): e0241261, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33104715

RESUMEN

OBJECTIVE: This study aimed to describe the demographic and clinical characteristics of cancer inpatients with COVID-19 exploring clinical outcomes. METHODS: A retrospective search in the electronic medical records of cancer inpatients admitted to the Brazilian National Cancer Institute from April 30, 2020 to May 26, 2020 granted identification of 181 patients with COVID-19 confirmed by RT-PCR. RESULTS: The mean age was 55.3 years (SD ± 21.1). Comorbidities were present in 110 (60.8%) cases. The most prevalent solid tumors were breast (40 [22.1%]), gastrointestinal (24 [13.3%]), and gynecological (22 [12.2%]). Among hematological malignancies, lymphoma (20 [11%]) and leukemia (10 [5.5%]) predominated. Metastatic disease accounted for 90 (49.7%) cases. In total, 63 (34.8%) had recently received cytotoxic chemotherapy. The most common complications were respiratory failure (70 [38.7%]), septic shock (40 [22.1%]) and acute kidney injury (33 [18.2%]). A total of 60 (33.1%) patients died due to COVID-19 complications. For solid tumors, the COVID-19-specific mortality rate was 37.7% (52 out of 138 patients) and for hematological malignancies, 23.5% (8 out of 34). According to the univariate analysis COVID-19-specific mortality was significantly associated with age over 75 years (P = .002), metastatic cancer (p <0.001), two or more sites of metastases (P < .001), the presence of lung (P < .001) or bone metastases (P = .001), non-curative treatment or best supportive care intent (P < .001), higher C-reactive protein levels (P = .002), admission due to COVID-19 (P = .009), and antibiotics use (P = .02). After multivariate analysis, cases with admission due to symptoms of COVID-19 (P = .027) and with two or more metastatic sites (P < .001) showed a higher risk of COVID-19-specific death. CONCLUSION: This is the first Brazilian cohort of cancer patients with COVID-19. The rates of complications and COVID-19-specific death were significantly high.


Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Pacientes Internos/estadística & datos numéricos , Neoplasias/epidemiología , Pandemias , Neumonía Viral/epidemiología , Academias e Institutos/estadística & datos numéricos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antineoplásicos/efectos adversos , Antineoplásicos/uso terapéutico , Brasil/epidemiología , Instituciones Oncológicas/estadística & datos numéricos , Causas de Muerte , Niño , Preescolar , Comorbilidad , Diabetes Mellitus/epidemiología , Susceptibilidad a Enfermedades , Femenino , Mortalidad Hospitalaria , Humanos , Hipertensión/epidemiología , Huésped Inmunocomprometido , Lactante , Masculino , Persona de Mediana Edad , Neoplasias/tratamiento farmacológico , Estudios Retrospectivos , Adulto Joven
20.
Oncology (Williston Park) ; 34(10): 432-441, 2020 10 09.
Artículo en Inglés | MEDLINE | ID: mdl-33058111

RESUMEN

Worldwide incidence and mortality due to the coronavirus disease 2019 (COVID-19) pandemic is greatest in the United States, with the initial epicenter in New York. In Nassau County, New York, where we practice, our institution has had more than 2500 cases and has discharged from the hospital more than 1000 patients. As many academic and private institutions have swiftly shifted their clinical and research priorities to address the pandemic, data are emerging regarding both the impact of malignancy on COVID-19 outcomes as well as the challenges faced in assuring that cancer care remains unimpeded. Of concern, recent studies of cancer patients primarily in China and Italy have suggested that advanced malignancy is associated with increased susceptibility to severe COVID-19 infection. At present, more than 500 clinical trials are underway investigating the pathogenesis and treatment of COVID-19, including expanded use of oncology drugs, such as small molecular inhibitors of cytokine pathways. Here, we begin by reviewing the latest understanding of COVID-19 pathophysiology and then focus our attention on the impact of this virus on hematologic and oncologic practice. Finally, we highlight ongoing investigational treatment approaches that are so relevant to the care of oncology patients during this extraordinary pandemic.


Asunto(s)
Antineoplásicos , Betacoronavirus , Infecciones por Coronavirus , Prestación de Atención de Salud , Control de Infecciones , Oncología Médica , Neoplasias , Pandemias , Neumonía Viral , Antineoplásicos/clasificación , Antineoplásicos/farmacología , Betacoronavirus/efectos de los fármacos , Betacoronavirus/patogenicidad , Betacoronavirus/fisiología , Ensayos Clínicos como Asunto/métodos , Ensayos Clínicos como Asunto/normas , Infecciones por Coronavirus/epidemiología , Infecciones por Coronavirus/prevención & control , Infecciones por Coronavirus/terapia , Infecciones por Coronavirus/virología , Prestación de Atención de Salud/organización & administración , Prestación de Atención de Salud/normas , Prestación de Atención de Salud/tendencias , Drogas en Investigación/farmacología , Humanos , Control de Infecciones/métodos , Control de Infecciones/organización & administración , Oncología Médica/métodos , Oncología Médica/normas , Neoplasias/epidemiología , Neoplasias/terapia , New York/epidemiología , Pandemias/prevención & control , Atención al Paciente/métodos , Atención al Paciente/normas , Neumonía Viral/epidemiología , Neumonía Viral/prevención & control , Neumonía Viral/terapia , Neumonía Viral/virología , Ajuste de Riesgo/métodos , Medición de Riesgo
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