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1.
Support Care Cancer ; 29(12): 7715-7724, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34159428

RESUMO

Patient-reported outcome measures obtained via E-Health tools ease the assessment burden and encourage patient participation in cancer care (PaCC Study) BACKGROUND: E-health based patient-reported outcome measures (PROMs) have the potential to automate early identification of both nutrition status and distress status in cancer patients while facilitating treatment and encouraging patient participation. This cross-sectional study assessed the acceptability, accuracy, and clinical utility of PROMs collected via E-Health tools among patients undergoing treatment for stomach, colorectal, and pancreatic tumors. RESULTS: Eight-nine percent mostly, or completely, agreed that PROMs via tablets should be integrated in routine clinical care. Men were significantly more likely to require help completing the questionnaires than women (inv.OR= 0.51, 95% CI=(0.27, 0.95), p = 0.035). The level of help needed increased by 3% with each 1-year increase in age (inv. OR=1.03, 95% CI=(1.01, 1.06), p = 0.013). On average, a patient tended to declare weight which was 0.84 kg inferior to their true weight (Bland and Altman 95 % CI=(-3.9, 5.6); SD: 2.41) and a height which was 0.95 cm superior to their true height (Bland and Altman 95 % CI=(-5, 3.1); SD 2.08). Patient-reported nutrition status was significantly associated with the professionally generated assessment (95% CI=(2.27, 4.15), p < 0.001). As nutrition status declined, the distress score increased (95%CI=(0.88, 1.68), p < 0.001). Of the patients, 48.8% who were both distressed and malnourished requested supportive care to address their problems. CONCLUSION: Patient-reported assessments utilizing E-health tools are an accurate and efficient method to encourage patient participation in cancer care while simultaneously ensuring that regular assessment of psycho-social and nutritional aspects of care are efficiently integrated in the daily clinical routine.


Assuntos
Desnutrição , Neoplasias , Telemedicina , Estudos Transversais , Feminino , Humanos , Masculino , Neoplasias/terapia , Avaliação Nutricional , Estado Nutricional , Participação do Paciente , Medidas de Resultados Relatados pelo Paciente
2.
Bone Marrow Transplant ; 50(5): 679-84, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25642765

RESUMO

Prognosis is poor for patients with biologically aggressive Non-Hodgkin lymphoma (NHL), refractory to chemotherapy or relapsed after autologous transplantation, especially when no disease control before allogeneic transplantation is achieved. In 16 patients (median age 53, median prior regimes 5) with relapsed or refractory non-remission NHL, we analysed retrospectively the efficacy of a sequential therapy comprising clofarabine re-induction followed by a reduced-intensity conditioning with fludarabine, CY and melphalan, and T-cell-replete HLA-haploidentical transplantation. High-dose CY was utilized post-transplantation. All patients engrafted. Early response (day +30) was achieved in 94%. Treatment-related grade III-IV toxicity occurred in 56%, most commonly transient elevation of transaminases (36%), while there was a low incidence of infections (19% CMV reactivation, 19% invasive fungal infection) and GVHD (GVHD: acute III-IV: 6%; mild chronic: 25%). One-year non-relapse mortality was 19%. After a median follow-up of 21 months, estimated 1- and 2-year PFS was 56 and 50%, respectively, with 11 patients (69%) still alive after 2 years. In summary, sequential therapy is feasible and effective and provides an acceptable toxicity profile in high-risk non-remission NHL. Presumably, cytotoxic reinduction with clofarabine provides enough remission time for the graft-versus lymphoma effect of HLA-haploidentical transplantation to kick in, even in lymphomas that are otherwise chemo-refractory.


Assuntos
Nucleotídeos de Adenina/administração & dosagem , Antimetabólitos Antineoplásicos/administração & dosagem , Arabinonucleosídeos/administração & dosagem , Antígenos HLA , Transplante de Células-Tronco Hematopoéticas , Linfoma não Hodgkin , Adulto , Idoso , Aloenxertos , Clofarabina , Intervalo Livre de Doença , Feminino , Humanos , Linfoma não Hodgkin/mortalidade , Linfoma não Hodgkin/terapia , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Taxa de Sobrevida
4.
Bone Marrow Transplant ; 48(1): 129-34, 2013 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-22609882

RESUMO

The influence of personality on health related quality of life (QoL) and physical functioning in the setting of allogeneic hematopoietic SCT (alloHSCT) is unknown. We conducted a joint evaluation within two independent cohorts of alloHSCT recipients to investigate the impact of personality on reported QoL and physical functioning. Two-hundred-eight patients (median age 44 years, range 18-72) of cohort 1 and 93 patients (median age 55 years, range 19-79) of cohort 2 after alloHSCT were evaluated. Personality was assessed using the 24-adjective measure (AM), which measures the Big-Five personality domains and the Life Orientation Test-Revised (LOT-R), measuring optimism and pessimism. QoL was measured using the Functional Assessment of Cancer Therapy with bone marrow transplantation subscale (FACT-BMT), Short Form 36 (SF-36), the human activity profile (HAP), as well as the NIH criteria-based cGVHD activity assessment form and the Lee cGVHD symptom scale. Neuroticism was significantly associated with worse function measured by the HAP and FACT-BMT. Optimism significantly improved QoL captured by the FACT-BMT. Pessimism significantly impaired physical function captured by the HAP and SF-36. Extraversion was significantly associated with reduced depression and lower severity of cGVHD symptoms reported by the patient and the physician. The results suggest that personality traits and pre-treatment QoL assessments should be measured in clinical trials to facilitate the interpretation of QoL data.


Assuntos
Doença Enxerto-Hospedeiro/psicologia , Neoplasias Hematológicas/terapia , Transplante de Células-Tronco Hematopoéticas/psicologia , Transtornos da Personalidade/psicologia , Personalidade , Qualidade de Vida , Atividades Cotidianas , Adolescente , Adulto , Idoso , Transtornos de Ansiedade/complicações , Transtornos de Ansiedade/psicologia , Áustria , Estudos de Coortes , Seguimentos , Alemanha , Doença Enxerto-Hospedeiro/complicações , Doença Enxerto-Hospedeiro/fisiopatologia , Neoplasias Hematológicas/complicações , Neoplasias Hematológicas/psicologia , Humanos , Estudos Longitudinais , Pessoa de Meia-Idade , Neuroticismo , Transtornos da Personalidade/complicações , Estudos Prospectivos , Índice de Gravidade de Doença , Transplante Homólogo , Washington , Adulto Jovem
5.
Nanotechnology ; 22(10): 105605, 2011 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-21289394

RESUMO

We report a simple and fast approach to fabricate large, non-flaking arrays of CuO nanowires by oxidizing thin copper substrates in air. Oxidative CuO nanowire growth is commonly accompanied by oxide layer flaking due to stress at the copper-copper oxide interface. Using thin substrates is shown to prevent this flaking by introducing favourable material thickness ratios in the samples after oxidation. Additionally, thin foils allow larger scale topographic patterns to be transferred from an underlying mould to realize non-flat, nanowire-decorated surfaces. Further patterning is possible by electrodeposition of a nickel layer, which restricts nanowire growth to specific areas of the sample.

6.
Bioinspir Biomim ; 5(2): 026005, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20498518

RESUMO

A biopolymer-based template assembly constructed around the spines of the bristle worm Aphrodita aculeata (sea mouse) was used to fabricate very high aspect ratio nanowires and nanotubes using established methods adopted from nanofabrication in porous membranes. The easily available bio-originated template contains more than 100 000 highly ordered, very high aspect ratio nanochannels, each about 150 to 200 nm in diameter but up to a centimetre in length. Their parallel, hexagonal arrangement in the spine constitutes a photonic crystal, which gives the animal its colourful, iridescent appearance. Around the nanochannels, the spines consist of a chitin/protein composite material, which has been shown to withstand the chemical and thermal conditions needed for established template-assisted nanofabrication strategies. A template preparation procedure was developed and the template was used to fabricate copper and nickel nanowires by electrodeposition and aluminium oxide nanotubes by atomic layer deposition. Due to their high thermal and chemical stability, decomposition of the filled templates proved to be difficult, and different approaches to obtain separated nanostructures are described and discussed. Alongside this, the presented system of parallel nanowires or nanotubes in a biopolymer matrix might be utilized in applications, where such separated structures are not needed. Comparing to porous membranes, the presented template allows us to increase the maximum length of nanotubes and nanowires produced using nanochannel-based templates by at least one order of magnitude.


Assuntos
Materiais Biomiméticos/química , Cristalização/métodos , Compostos Inorgânicos/química , Nanoestruturas/química , Nanoestruturas/ultraestrutura , Nanotecnologia/métodos , Sesbania/química , Animais , Substâncias Macromoleculares/química , Teste de Materiais , Conformação Molecular , Tamanho da Partícula , Propriedades de Superfície
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